Orientador: Pedro Paulo Chaves de Souza / Resumo: A periodontite é resultado do desequilíbrio entre o biofilme bacteriano e a resposta imune do hospedeiro. Componentes bacterianos, como o lipopolissacarídeo (LPS) e as lipoproteínas, são reconhecidos pelo sistema imune e desencadeiam a produção de citocinas que auxiliam no combate à infecção, mas também induzem a destruição tecidual. A participação do LPS na destruição óssea já é bem estabelecida, porém o papel das lipoproteínas na periodontite permanece carente de investigação. Na periodontite, citocinas pró-inflamatórias participam do processo de destruição do tecido ósseo. Neste processo, são secretadas também citocinas osteoprotetoras. Dentre elas, a interleucina 4 (IL-4) é reconhecida pela propriedade de inibir a produção citocinas pró inflamatórias como IL-1, IL-6 e TNF-α. O papel protetor de IL-4 na osteoclastogênese e na doença periodontal induzida por lipoproteína ainda não foi investigado. Nosso estudo foi divido em dois capítulos. No capítulo 1, hipotetizamos que a lipoproteína sintética Pam2CSK4 (PAM2) poderia induzir a reabsorção óssea periodontal. Para isso, foram utilizados camundongos C57bl/6, que receberam injeções a cada 2 dias, por 24 dias, do veículo, LPS de Escherichia. coli ou PAM2, entre o primeiro e segundo molar superior. Após o período experimental, os animais foram eutanasiados e destinados à análise por microCT, análise histológica e imunohistoquímica para marcação dos osteoclastos. A PAM2 apresentou a capacidade de induzir a perda óssea alveolar, ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The pathogenesis of periodontitis is a result of imbalance between the bacterial biofilm and the host immune response. Bacterial components such as lipopolysaccharide (LPS) and lipoproteins, activate the immune system leading to periodontal distruction. The participation of LPS in periodontal bone destruction is well established, but there is a lack of information about the role of lipoproteins in periodontitis. In the pathogenesis of periodontitis, these molecular patterns are recognized by host immune system and trigger the production of cytokines that participate of antimicrobial response, but also induce tissue destruction. On the other hand, antinflamatory cytokines produced by Th2 cells, such as IL-4, have an osteoprotective phenotype. The role of IL-4 in lipoprotein-induced periodontitis was not yet investigated. Thus, this thesis was divided in two chapters. In chapter 1, we investigated the role of lipoproteins in the pathogenesis of periodontitis in mice. In this study, we hypothesized that the synthetic lipoprotein Pam2CSK4 (PAM2) can induce periodontal bone resorption. C57bl / 6 mice received bilateral injections every other day for 24 days of: vehicle, Escherichia coli LPS or PAM2, between the first and second upper molars. Twenty-four hours after the last injection, the mice were euthanized and the jaw bones were scanned for micro computed tomography, decalcified and processed for histological analysis and stained for tartrate-resistant acid phosphatase, phenoty... (Complete abstract click electronic access below) / Doutor

Vitamin A and the T helper 2 cytokines IL-4 and IL-13 play important roles in the induction of mucin gene expression and mucus hypersecretion. However, the effects of these agents on enzymes responsible for mucin glycosylation have received little attention. Here, we report the upregulation of core 2 β1,6 N-acetylglucosaminyltransferase (C2GnT) activity both by all-trans retinoic acid (RA) and by IL-4 and IL-13 in the H292 airway epithelial cell line. Northern blotting analysis showed that the M isoform of C2GnT, which is expressed in mucus-secreting tissues and can form all mucin glycan β1,6-branched structures, including core 2, core 4, and blood group I antigen, was upregulated by both RA and IL-4/13. The L isoform, which forms only the core 2 structure, was moderately upregulated by IL-4/13 but not by RA. Enhancement of the M isoform of C2GnT by RA was abolished by an inhibitor, of RA receptor α, implicating RA receptor α in the effect of RA. Likewise, an inhibitor of the Janus kinase 3 pathway blocked the enhancing effects of IL-4/13 on the L and M isoforms of C2GnT, suggesting a role of this pathway in the upregulation of these two C2GnTs by these cytokines. Taken together, the results suggest that IL-4/13 T helper 2 cytokines and RA can alter the activity of enzymes that synthesize branching mucin carbohydrate structure in airway epithelial cells, potentially leading to altered mucin carbohydrate structure and properties.

Selective molecular recognition between proteins is a fundamental event in biological processes that governs cellular growth, function, survival, and differentiation. The immune system, for example, is a complex network of cellular processes regulated by protein-protein interactions (PPIs) between cells, receptors, and secreted molecules. Generating and maintaining an appropriate immune response and regulation requires coordination across many cell types and components, while dysregulation of these interactions can lead to disease. A major obstacle in small molecule therapy development towards these PPIs is their restriction to small protein-protein interfaces and a well-defined hydrophobic pocket. Most PPIs have large contact surface areas and lack traditional binding pockets making them historically challenging for the development of potent small-molecule modulators. To address this limitation, we utilized two binding-based approaches, a unique peptidomimetic fragment library and high-throughput small-molecule microarrays to design and discover molecules that target three important immunoregulatory PPIs: the DQ8-insulin complex, the KEAP1-Nrf2 complex, and the IL-4/IL-4R receptor complex. Many autoimmune diseases involve the ternary PPI complex between immunogenic peptides presented to T cell receptors through the major histocompatibility complex (MHC). Inhibiting this interaction may provide a therapeutic approach for delaying or preventing disease. To target type 1 diabetes, we developed a unique library consisting of 125 fragment-sized molecules that mimic glutamic acid and tyrosine residues from the immunogenic insulin B:9-23 peptide responsible for CD4+ T cell activation. Screening of our library after generation of the MHC class II protein responsible for insulin B:9-23 presentation, DQ8, has resulted in identification of 15 lead fragment compounds to date. Application of our fragment library towards pharmaceutically validated target for inflammation and neurogenerative diseases, the Kelch like ECH-associated protein 1 (KEAP1) and nuclear factor erythroid 2 like 2 (Nrf2), resulted in a 30% hit rate. These are promising results for the further development of selective compounds to inhibit these interactions. For treating inflammatory diseases, such as asthma or cancer, we report the identification of a first-in-class small molecule inhibitor to the cytokine Interleukin-4 (IL-4). The PPI between IL-4 and its receptor complex (IL-4Rα) contains no conventional binding pockets and binding is driven through clusters of complementary residues. Through the combination of small-molecule microarrays and cell-based assays we identified the lead compound, Nico-52, with micromolar inhibitory potency and micromolar affinity. A library of 60 analogs of Nico-52 was synthesized and preliminary structure activity relationships suggest amenability of the p-fluorophenyl substituent and importance of the diol substituent to retain binding potency. These studies resulted in development of a more potent inhibitor to IL-4 with a p-aniline substituent, which could be developed into a targeting ligand to deliver additional therapeutic payloads to an IL-4 enriched microenvironment. In summary, we have developed a peptidomimetic small molecule fragment library as a toolkit for screening against challenging PPI targets with applications towards type 1 diabetes and developed a first-in-class small molecule inhibitor towards IL-4 with applications towards inflammatory diseases. / 2025-09-21T00:00:00Z

Serum half-life elongation as well as the immobilization of small proteins like cytokines is still one of the key challenges for biologics. This accounts also for cytokines, which often have a molecular weight between 5 and 40 kDa and are therefore prone to elimination by renal filtration and sinusoidal lining cells. To solve this problem biologics are often conjugated to poly(ethylene glycol) (PEG), which is the gold standard for the so called PEGylation. PEG is a synthetic, non-biodegradable polymer for increasing the hydrodynamic radius of the conjugated protein to modulate their pharmacokinetic performance and prolong their therapeutic outcome. Though the benefits of PEGylation are significant, they also come with a prize, which is a loss in bioactivity due to steric hindrance and most often the usage of heterogeneous bioconjugation chemistries. While PEG is a safe excipient in most cases, an increasing number of PEG related side-effects, such as immunological responses like hypersensitivity and accelerated blood clearance upon repetitive exposure occur, which highlights the need for PEG alternative polymers, that can replace PEG in such cases. Another promising method to significantly prolong the residence time of biologics is to immobilize them at a desired location. To achieve this, the transglutaminase (TG) Factor XIIIa (FXIIIa), which is an important human enzyme during blood coagulation can be used. FXIIIa can recognize specific peptide sequences that contain a lysine as substrates and link them covalently to another peptide sequence, that contains a glutamine, forming an isopeptide bond. This mechanism can be used to link modified proteins, which have a N- or C-terminal incorporated signal peptide by mutation, to the extracellular matrix (ECM) of tissues. Additionally, both above-described methods can be combined. By artificially introducing a TG recognition sequence, it is possible to attach an azide group containing peptide site-specifically to the TG, recognition sequence. This allows the creation of a site-selective reactive site at the proteins N- or C-terminus, which can then be targeted by cyclooctyne functionalized polymers, just like amber codon functionalized proteins. This thesis has focused on the two cytokines human Interferon-α2a (IFN-α2a) and human, as well as murine Interleukin-4 (IL-4) as model proteins to investigate the above-described challenges. IFN-α2a has been chosen as a model protein because it is an approved drug since 1986 in systemic applications against some viral infections, as well as several types of cancer. Furthermore, IFN-α2 is also approved in three PEGylated forms, which have different molecular weights and use different conjugation techniques for polymer attachment. This turns it into an ideal candidate to compare new polymers against the gold standard PEG. Interleukin-4 (IL-4) has been chosen as the second model protein due to its similar size and biopotency. This allows to compare found trends from IFN-α2a with another bioconjugate platform and distinguish between IFN-α2a specific, or general trends. Furthermore, IL-4 is a promising candidate for clinical applications as it is a potent anti-inflammatory protein, which polarizes macrophages from the pro-inflammatory M1 state into the anti-inflammatory M2 state. / Die Verlängerung der Serum-Halbwertszeit sowie die Immobilisierung kleiner Proteine wie Zytokine ist nach wie vor eine der größten Herausforderungen für Biologika. Dies gilt auch für Zytokine, die häufig ein Molekulargewicht zwischen 5 und 40 kDa haben und daher leicht durch die Nierenfiltration und sinusoidale Endothelzellen eliminiert werden können. Um dieses Problem zu lösen, werden Biologika häufig an Poly(ethylenglykol) (PEG) konjugiert, das den Goldstandard für die so genannte PEGylierung darstellt. PEG ist ein synthetisches, biologisch nicht abbaubares Polymer, das den hydrodynamischen Radius des konjugierten Proteins vergrößert, um die pharmakokinetische Leistung zu modulieren und die therapeutische Wirkung zu verlängern. Obwohl die Vorteile der PEGylierung beträchtlich sind, haben sie auch ihren Preis, nämlich einen Verlust an Bioaktivität aufgrund sterischer Hindernisse und meist die Verwendung heterogener Biokonjugationstechniken. Obwohl PEG in den meisten Fällen ein sicherer Hilfsstoff ist, treten immer mehr PEG-bedingte Nebenwirkungen auf, wie z. B. immunologische Reaktionen wie Überempfindlichkeit und beschleunigter Abbau bei wiederholter Exposition, was den Bedarf an alternativen PEG-Polymeren unterstreicht, die PEG in solchen Fällen ersetzen können. Eine weitere vielversprechende Methode, um die Verweildauer von Biologika deutlich zu verlängern, besteht darin, sie an einem gewünschten Ort zu immobilisieren. Dazu kann die Transglutaminase (TG) Faktor XIIIa (FXIIIa) verwendet werden, die ein wichtiges menschliches Enzym bei der Blutgerinnung ist. FXIIIa kann bestimmte Peptidsequenzen, die ein Lysin enthalten, als Substrate erkennen und sie kovalent an eine andere Peptidsequenz, die ein Glutamin enthält, binden, wobei eine Isopeptidbindung entsteht. Dieser Mechanismus kann benutzt werden um modifizierte Proteine, welche durch Mutation ein N- oder C-terminal eingebautes Signalpeptid besitzen, mit der extrazellularen Gewebematrix (ECM) zu verknüpfen. Diese Arbeit konzentriert sich auf die beiden Zytokine humanes Interferon-α2a (IFN-α2a) und humanes sowie murines Interleukin-4 (IL-4) als Modellproteine, um die oben beschriebenen Herausforderungen zu untersuchen. IFN-α2a wurde als Modellprotein ausgewählt, weil es seit 1986 ein zugelassenes Medikament für die systemische Anwendung gegen einige Virusinfektionen und verschiedene Krebsarten ist. Darüber hinaus ist IFN-α2 auch in drei PEGylierten Formen zugelassen, die unterschiedliche Molekulargewichte haben und verschiedene Konjugationstechniken für die Polymeranbindung verwenden. Dies macht es zu einem idealen Kandidaten für den Vergleich neuer Polymere mit dem Goldstandard PEG. Interleukin-4 (IL-4) wurde als zweites Modellprotein gewählt, da es eine ähnliche Größe und Biopotenz aufweist. Dies ermöglicht es, die von IFN-α2a gefundenen Trends mit einer anderen Biokonjugat-Plattform zu vergleichen und zwischen IFN-α2a-spezifischen und allgemeinen Trends zu unterscheiden. Darüber hinaus ist IL-4 ein vielversprechender Kandidat für klinische Anwendungen, da es ein starkes entzündungshemmendes Protein ist, das Makrophagen vom entzündungsfördernden M1-Zustand in den entzündungshemmenden M2-Zustand polarisiert.

Macrophages can be activated by a variety of extracellular signals to polarize to either the M1 (inflammatory and antimicrobial) or to the M2 (wound repair and inflammation resolution) phenotype. Expression of arginase 1 in macrophages is a key marker of the M2 phenotype. Arginase 1 expression is induced by interleukin 4 (IL-4), a cytokine secreted by Th2 helper cells. All-trans retinoic acid (ATRA) is a product of metabolism of dietary retinol (vitamin A). In a manner analogous to hormones, ATRA binds to nuclear receptors in cells and influences gene expression and cell physiology. ATRA is important in the resolution of inflammation systemically and on the cellular level, however it has not been linked to M2 activation or arginase 1 expression. Testing the hypothesis that ATRA can induce arginase 1 in macrophages either directly or indirectly, it was found that ATRA alone cannot cause murine bone marrow-derived macrophages (BMDM) to activate in the M2 phenotype (as indicated by arginase 1 expression), however it can dramatically potentiate induction of arginase 1 expression and activity by IL-4. This is the first observation positively linking ATRA to arginase 1. Lipopolysaccharide (LPS), is a conserved structural component of the outer membrane of Gram negative bacteria, and a potent pyrogen. In metabolic endotoxemia, LPS concentration in the blood is slightly elevated, and over the long term this contributes to diverse inflammatory diseases such as atherosclerosis, obesity, and diabetes. LPS promotes the M1 phenotype and suppresses the M2 phenotype, but its contribution at low doses such as those found in metabolic endotoxemia are not well studied. In order to investigate mechanisms of LPS suppression at low doses, mice deficient in IRAK1 and tollip, key mediators or proinflammatory LPS signaling, were used to study IL-4, ATRA, and LPS crosstalk. LPS suppression of arginase 1 was found to be dependent on IRAK1 and tollip, but only at low doses of LPS. / Ph. D.

Die 12/15-Lipoxygenasen (12/15-LOXs) gehören zu einer heterogenen Klasse Lipid-peroxidierender Enzyme, deren biologische Rolle noch nicht vollständig geklärt ist. Eine Reihe experimenteller Daten deuten darauf hin, dass diese Enzym an Reifungs- und Differenzierungsprozessen beteiligt sind und auch für die Pathogenese verschiedener Erkrankungen (Asthma bronchiale, Entzündung, Atherosklerose) bedeutsam zu sein scheinen. Die Expression von 12/15-LOXs wird in vielen Säugetierzellen durch TH2-Zytokine reguliert und die Zytokin-induzierte Signaltransduktionskaskade verläuft über die Aktivierung van JAK-Kinasen und STAT6. Nach einer Stimulation von A549 Lungenkarzinomzellen mit Interleukin-4 (IL-4) kommt es erst nach 12 Stunden zu einer Hochregulation der 12/15-LOX mRNA Expression. Untersuchungen zum Induktionsmechanismus haben gezeigt, dass Genistein, ein Hemmstoff von Tyrosinkinasen, die Phosphorylierung von STAT6 und dessen Bindung an den Promoter des 12/15-LOX Gens verhinderte. Damit konnte die Induktion der katalytisch aktiven LOX geblockt werden. In Gegensatz dazu verhinderte Zykloheximid, ein spezifischer Hemmstoff der Proteinbiosynthese, die Expression der 12/15-LOX mRNA nicht, Dieses Ergebnis deutet darauf hin, dass die Neusynthese eines Transkriptionsfaktors im Rahmen der IL-4 induzierten Transduktionskaskade unwahrscheinlich ist. Weiterhin wurde beobachtet, dass IL-4 die zelluläre Histonacetyltransferase-Aktivität stark erhöhte und dass dieser Effekt überwiegend auf die enzymatische Aktivität des (CREB-bindenden Protein)-bindenden Proteins (CBP) zurückzuführen ist. Transfektion der Zellen mit E1A, einem viralen Protein, welches als Hemmstoff der Histonacetyltransferase-Aktivität von CBP/p300 bekannt ist, führte zu einer Unterdrückung der 12/15-LOX Expression. Andererseits stimuliert Natriumbutyrat, ein Hemmstoff der Histondeacetylase, die 12/15-LOX Synthese. Damit konnte gezeigt werden, dass die Acetylierung von Histonproteinen und von STAT6 ein essentieller Prozesse bei der IL-4 induzierten 12/15-LOX Expression in A549 Zellen ist. Weiterhin belegen diese Daten, dass sowohl die Phosphorylierung als auch die Acetylierung von STAT6 an der transkriptionellen Aktivierung des 12/15-LOX Gens beteiligt sind, obwohl beide Prozesse eine unterschiedliche Kinetik aufweisen. STAT6 Phosphorylierung erfolgt innerhalb der ersten Stunde nach IL-4 Stimulation, während die Acetylierungsreaktion zeitlich verzögert abläuft. Zusammenfassend kann die Signaltransduktionskaskade, die in A549 Zellen zur Expression der 12/15-LOX führt, wie folgt beschrieben werden: IL-4 induziert über die Aktivierung von JAK-Kinasen eine Phosphorylierung von STAT6, dessen Bindung an den 12/15-LOX Promotor jedoch zunächst durch nicht-acetylierte Histonproteine verhindert wird. Nach 9-11 Stunden werden Histone und der phosphorylierte STAT6 durch die Acetyltransferase-Aktivität von CBP/p300 acetyliert. Diese Reaktion führt zu einer Veränderung der Histonstruktur, wodurch die Bindung von modifizierten STAT6 und damit die Expression des 12/15-LOX Gens ermöglicht wird. Als wesentliche zellphysiologische Konsequenz der IL-4 induzierten 12/15-LOX Expression in A549 Zellen, wurde eine Apoptoseinduktion beobachtet. Das endogene 12/15-LOX Produkt 15-HETE bindet an den Kernrezeptor PPARg und induziert damit den programmierten Zelltod. Vorinkubation von A549 Zellen mit dem LOX-Hemmstoff NDGA oder der Einsatz von PPARg Dominant Negativ Vektor verhinderten die Apoptose. Mechanistische Untersuchungen zum Ablauf des durch IL-4 induzierten Zelltodes zeigten, dass der Prozess überwiegend dem extrinsischen Mechanismus folgt, bei dem Kaspasen-8 direkt zu einer Aktivierung der Effektorkaspase-3 führt. Der mitochondriale Mechanismus (Spaltung von Bid bzw. initiale Cytochrom C Freisetzung) scheint dabei nicht involviert zu sein. Die IL-4 induzierte Apoptose könnte von patho-physiologischer Bedeutung für den Verlauf von Lungenerkrankungen sein, bei denen Zellen mit hoher konstitutiver 12/15-LOX Expression, z.B. eosinophile Granulozyten, beteiligt sind. Hepoxiline sind bioaktive Mediatoren des 12/15-LOX Weges der Arachidonsäurekaskade, die durch Isomerisierung des primären Oxygenierungsproduktes 12S-HpETE gebildet werden. Zu Beginn unserer Untersuchungen war überwiegend unklar, welche Enzyme an der Isomerisierungsreaktion beteiligt sind. Bei der Suche nach geeigneten zellulären Modellen für die Untersuchung dieser Fragestellung fanden wir heraus, dass in den Ratteninsulinom-Zellen Rinm5F, die wegen ihres Mangels an Glutathionperoxidasen eine geringe Kapazität zur Reduktion von 12S-HpETE aufweisen, die Synthese von Hepoxilin A3 (HXA3) besonders hoch ist. Da wir vermuteten, dass 12/15-LOXs für die Isomerisierung von 12S-HpETE zu HXA3 verantwortlich sein könnten, verfolgten wir eine duale Forschungsstrategie um experimentelle Hinweise für unsere Arbeitshypothese zu finden. In den 12/15-LOX exprimierenden Rinm5F Zellen führte eine Immunopräzipitation mit 12/15-LOX spezifischen Antikörper zu einen vollständigen Verlust der 12/15-LOX- und der Hepoxilinsynthase-Aktivität eines Zelllysates. Beide Aktivitäten wurden fast vollständig im Immunopräzipitat wiedergefunden. 2. Transfektion von HeLa Zellen, die selbst keine 12/15-LOX exprimieren, mit 12/15-LOX und gleichzeitige Hemmung der zellulären Glutathionperoxidasen (Depletion von GSH mit Diethlmaleat) führte zu einer deutlichen zellulären Hepoxilinsynthese. Bei entsprechenden Kontrolltransfektanten wurde diese Aktivität nicht beobachtet. Weiterhin konnte festgestellt werden, dass rekombinante 12/15-LOXs (Expression in E. coli) in vitro eine intrinsische Hepoxinsynthase-Aktivität aufweisen, wenn 12S-HpETE als Substrat angeboten wird. Diese Daten belegen, dass 12/15-LOXs neben den bisher beschriebenen katalytischen Aktivitäten (Oxygenase, Hydroperoxidase, Leukotrienesynthase) auch Hepoxilinsynthase-Aktivität aufweisen. / 12/15-Lipoxygenases (human 15-LOX-1, rat 12/15-lipoxygenase) belong to family of lipid peroxidising enzymes. The enzyme has been implicated with roles in a variety of pathological conditions such as asthma, atherosclerosis, inflammation and in cellular differentiation. The enzyme expression in most human cell types is tightly regulated by Th2 cytokines, interleukin-4 (IL-4) and interleukin-13 (IL-13). Interleukin-4 (IL-4) induces expression of reticulocyte-type 15-lipoxygenase-1 (15-LOX-1) in various mammalian cells via the Janus kinase/signal transducer and activator of transcription 6 (STAT6) signaling system. 15-LOX-1 mRNA expression was first observed only 12h post IL-4 stimuation and required a minimum of 11h exposure to the cytokine. The mechanism of 15-LOX-1 induction in A549 lung epithelial cells and the observed delay was studied and it was found that genistein, a potent tyrosine kinase inhibitor, prevented phopsphorylation of STAT6, its binding to the 15-LOX-1 promoter, and the expression of catalytically active enzyme. In contrast, cycloheximide did not prevent 15-LOX-1 induction. Surprisingly, it was observed that IL-4 up-regulated the histone acetyltransferase activity of CREB-binding protein (CBP)/p300, which is responsible for acetylation of nuclear histones and STAT6. The acetylation of both proteins appears to be essential for the IL-4-induced signal transduction cascade, because inhibition of CBP/p300 by the viral wild-type E1A oncoprotein abrogated acetylation of both histones and STAT6 and strongly suppressed transcriptional activation of the 15-LOX-1 gene. Moreover, the inhibition by sodium butyrate of histone deacetylases, which apparently suppress 15-LOX-1 gene transcription, synergistically enhanced the IL-4-stimulated 15-LOX-1 expression. These data suggest that both phosphorylation and acetylation of STAT6 as well as acetylation of nuclear histones are involved in transcriptional activation of the 15-LOX-1 gene, although these reactions follow differential kinetics. STAT6 phosphorylation proceeds within the first hour of IL-4 stimulation. In contrast, CBP/p300-mediated acetylation requires 9-11 h, and similar kinetics were observed for the expression of the active enzyme. Thus, the results suggest that in the absence of IL-4, nuclear histones may be bound to regulatory elements of the 15-LOX-1 gene, preventing its transcription. IL-4 stimulation causes rapid phosphorylation of STAT6, but its binding to the promoter appears to be prevented by nonacetylated histones. After 9-11 h, when histones become acetylated, STAT6 binding sites may be demasked so that the phosphorylated and acetylated transcription factor can bind to activate gene transcription. The proinflammatory cytokine IL-4 is secreted in large amounts during allergic inflammatory response in asthma and plays a pivotal role in the airway inflammation. IL-4 has been shown to up-regulate 15-lipoxygenase and produce 15(S)-hydroxyeicosatetraenoic acid (15(S)-HETE) in A549 cells via the Janus kinase/STAT6 pathway under coactivation of CREB binding protein/p300. IL-4 has also been shown to up-regulate peroxisome proliferator-activated receptor (PPARg ) nuclear receptors in macrophages and A549 cells. In this study it is observed that 15(S)-HETE binds to PPARg nuclear receptors and induces apoptosis in A549 cells. Moreover, pre-treatment of cells with nordihydroguaiaretic acid, a 15-lipoxygenase inhibitor, prevented PPARg activation and apoptosis. The latter was accomplished by the interaction of the 15(S)-HETE/PPARg complex with the adapter protein Fas-associating protein with death domain and caspase-8, as shown by transfection of Fas-associating protein with death domain dominant negative vector and cleavage of caspase 8 to active subunits p41/42 and p18. Whereas IL-4 and PPARg ligands failed to induce cleavage of Bid and release of cytochrome c from mitochondria, they caused translocation of the proapoptotic protein Bax from cytoplasm to mitochondria with a concomitant decrease in the Bcl-XL level. The cells were, thereofre, observed to follow the extrinsic pathway of apoptosis where caspase-8 directly activates the effector caspase-3, bypassing the mitochondria. The data also suggests that in IL-4-stimulated cells the 15(S)-HETE/PPARg complex down-regulates Bcl-XL, and the translocation of Bax to the mitochondria commits the cell to apoptosis. The IL-4-induced apoptosis may contribute to severe loss of alveolar structures and infiltration of eosinophils, mononuclear phagocytes, etc., into the lung tissue as observed in chronic asthma patients. The 12(S)-lipoxygenase (12-LOX) pathway of arachidonic acid (AA) metabolism after dioxygenation to 12(S)-hydroperoxy-eicosatetraenoic acid is bifurcated in a reduction route to formation of 12(S)-hydroxy-eicosatetraenoic acid (12-HpETE) and an isomerization route to formation of hepoxilins. Interestingly, rat insulinoma RINm5F cells, which are devoid of cytoplasmic glutathione peroxidase (cGPx)/phospholipid hydroperoxide glutathione peroxidase (PHGPx), were observed to produce solely hepoxilin A3 (HXA3). Since HXA3 synthesis was abolished in heat-denatured or cGPx- or PHGPx-transfected cells, suggesting that a HXA3 synthase activity regulated by cGPx/PHGPx is present. To confirm this assumption AA was incubated with HeLa cells overexpressing the rat 12/15-LOX. Neither HXA3 nor 12(S)-HETE were detected due to abundance of cGPx/PHGPx. But, pretreatment of transfected cells with diethyl maleate, an inhibitor of glutathione and PHGPx, restored HXA3 synthase and 12-LOX activities. Moreover, recombinant rat 12/15-LOX produced HXA3 when incubated with 12-HpETE. Further confirmation was obtained by immunoprecipitation with 12/15-LOX specific antibodies. Immunoprecipitation of Rinm5F lysates results in the depletion of hepoxilin synthase activity. The hepoxilin synthase activity was localised in the immunoprecipitated protein. Thus, cells containing rat 12/15-LOX also possess an intrinsic HXA3 synthase activity, which is activated by inhibition of cGPx/PHGPx. In normal cells HXA3 is down-regulated by cGPx/PHGPx, but, it is persistently activated in oxidatively stressed cells deficient in cGPx/PHGPx, such as Rinm5F. Furthermore, formation of corresponding epoxyhydroxy products was observed when 15-HpETE was used as substrate, indicating a broad range of specificity for the enzyme.

Interleukin-4 (IL-4) und Interleukin-13 (IL-13) sind bedeutende Regulatorproteine des Immunsystems. Sie spielen eine entscheidende Rolle bei der Entstehung und dem Verlauf von allergischen Erkrankungen, wie z.B. Asthma. Um ihre Signale in die Zielzelle zu transduzieren, kann von beiden Zytokinen der gleiche Zelloberflächenrezeptor verwendet werden, wodurch sich die überlappenden, biologischen Funktionen erklären lassen. Dieser gemeinsam genutzte Rezeptor ist aus den beiden Untereinheiten IL-4Ralpha; und IL-13Ralpha1 aufgebaut. Da IL-4 und IL-13 auf Aminosäureebene nur etwa 25% Sequenzidentität besitzen und stark unterschiedliche Affinitäten zu den beiden Rezeptorketten besitzen, stellt sich die Frage, durch welchen molekularen Erkennungsmechanismus, die Affinität und die Spezifität der Ligand-Rezeptor-Interaktion unabhängig voneinander reguliert werden kann. In dieser Arbeit gelang es, rekombinante Expressions- und Aufreinigungsstrategien für IL-13 und die extrazellulären Domänen der Rezeptorketten IL-13Ralpha1 und IL-13Ralpha2 zu entwickeln. Dadurch war es mögliche, eine breite Mutations-/Interaktionsanalyse der IL-13Ralpha1-Kette durchzuführen.Es konnte gezeigt werden, dass die N-terminale FnIII-ähnliche Domäne von IL-13Ralpha1 sowohl an der Bindung von IL-13 als auch an der Interaktion mit IL-4 beteiligt ist. Im funktionellen Bindeepitop der IL-13Ralpha1-Kette wurden die Aminosäurereste Arg84, Phe253 und Tyr321 als Hauptbindungsdeterminanten für die Interaktion mit IL-13 identifiziert. Durch die Interaktionsstudien der IL-13Ralpha1-Varianten mit IL-4 wurde gezeigt, dass diese Hauptbindungsdeterminanten auch für die niederaffine Bindung von IL-4 von größter Bedeutung sind. Die funktionellen Bindeepitope für IL-4 und IL-13 auf der IL-13Ralpha1-Kette sind nahezu identisch und überlappen in einem großen Bereich. Aufgrund der Ergebnisse aus der Mutagenesestudie war es möglich, ein Strukturmodell der extrazellulären Domäne der IL-13Ralpha1-Kette zu erstellen. Darin wird eine neuartige Orientierung der N-terminalen FnIII-Domäne und deren Beteiligung an der Ligandeninteraktion dargestellt. Mit Hilfe des Strukturmodells gelang es, neue Aminosäurerest auf der Oberfläche von IL-13 zu identifizieren, die an der Bindung zu IL-13Ralpha1 beteiligt sind, was die Relevanz des Strukturmodells weiter unterstreicht. In einem weiteren Teil dieser Arbeit wurde versucht, den molekularen Mechanismus aufzuklären, durch den es den superagonistischen IL-4-Varianten T13D und F82D gelingt, mit dreifach höherer Affinität an die IL-4Ralpha-Kette zu binden, als wildtypischer Ligand. Durch strukturelle und funktionelle Untersuchungen wurde gezeigt, dass der Affinitätssteigerung ein indirekter Mechanismus zugrunde liegt, bei dem eine Konformationsänderung und die Fixierung der Arg85-Seitenkette von IL-4 zur Ausbildung von zusätzlichen Ligand-Rezeptor-Interaktionen führt. Das Bindeepitop zwischen IL-4 und der IL-4Ralpha-Kette besitzt eine modulare Architektur aus drei unabhängig voneinander agierenden Interaktionsclustern. Bei der Interaktion von wildtypischem IL-4 mit IL-4Ralpha tragen nur zwei dieser Cluster in signifikanter Weise zur freien Bindeenergie bei. Im Falle der superagonistischen IL-4-Varianten ist jedoch auch das dritte Cluster an der Generierung von zusätzlicher, freier Bindeenergie beteiligt, wodurch die Affinität zwischen Ligand und Rezeptor erhöht wird. Damit stellt der modulare Aufbau der Interaktionsfläche zwischen IL-4 und der IL-4Ralpha-Kette möglicherweise einen Mechanismus dar, über den Proteine die Affinität von Wechselwirkungen über einen großen Bereicht variieren können, ohne dabei Spezifität einzubüssen. Da IL-4 und IL-13 als interessante Zielmoleküle für die Therapie von allergischen und asthmatischen Erkrankungen erkannt worden sind, können die in der vorliegenden Arbeit gewonnenen Informationen über den Bindemechanismus und die Einblicke in den molekularen Charakter der Interaktion zwischen den beiden Zytokinen und ihren spezifischen Rezeptorketten dabei helfen, neuartige und hoch spezifische, inhibitorische Moleküle zu entwickeln. / Interleukin-4 (IL-4) and Interleukin-13 (IL-13) are important regulatory proteins of the immune system. They play a key role in the development and the progression of allergic diseases like asthma. For signal transduction into the target cell, both cytokines can use an identical cell surface receptor, which is an explanation for many overlapping biological functions of IL-4 and IL-13. This common receptor consists of the two subunits IL-4Ralpha and IL-13Ralpha1. Because IL-4 and IL-13 share only 25% sequence identity on the amino acid sequence level and because they show very different affinities to the two receptor chains, the question has to be raised, by which molecular recognition mechanism it is possible to regulate affinity and specificity of the ligand-receptor-interaction independently. In the course of this work recombinant expression and purification strategies for IL-13 and the extracellular domains of IL-13Ralpha1 and IL-13Ralpha2 were established. Therefore it was possible to perform a broad mutagenesis and interaction analysis of the IL-13Ralpha1 chain. It was shown, that the N-terminal FnIII-like domain of IL-13Ralpha1 participates in the binding of IL-13 as well as in the interaction with IL-4. As part of the functional epitope the amino acid residues Arg84, Phe253 and Tyr321 were identified to be main binding determinants for the interaction with IL-13. By carrying out interaction studies with IL-4 it could be demonstrated, that the same residues are also from great importance for the low affinity binding of IL-4. The functional epitopes for the binding of IL-4 and IL-13 are almost identical and are overlapping in a large area. Due to the results of the mutagenesis study it was possible to generate a structural model of the extracellular domain of the IL-13Ralpha1 chain. A key feature of this model is the novel orientation of the N-terminal FnIII-like domain and its involvement in ligand binding. According to the modelled structure new residues in IL-13 could be identified, that participate in the interaction with the IL-13Ralpha1. This further underlines the relevance of the shown structural model of the extracellulardomain of the IL-13Ralpha1 chain. In a different part of this work it was tried to elucidate the molecular mechanism, which enables the super-agonistic IL-4 variants T13D and F82D bind IL-4Ralpha with three times higher affinity than wildtype IL-4. With the help of structural und functional analysis it could be shown, that an indirect mechanism leads to the gain of affinity. A conformational change in and the fixation of the Arg85 side chain in IL-4 result in the formation of additional interactions between ligand and receptor. The binding interface between IL-4 and IL-4Ralpha exhibits a modular architecture consisting of three independently acting interaction clusters. For the binding of wild-type IL-4 to the IL-4Ralpha chain only two of the three clusters contribute a significant amount to the overall free binding energy. In the case of the super-agonistic IL-4 variants all three interaction clusters are used to generate additional free binding energy and to increase the affinity between ligand and receptor. Therefore the modular design of the IL-4/IL-4Ralpha interaction interface probably represents a mechanism, which enables proteins to alter the affinity of interactions over a broad range without loosing specificity. Because IL-4 and IL-13 were discovered as promising targets for the therapy of allergic and asthmatic diseases, the acquired information about the binding mechanism and the molecular characteristics of the interaction between the cytokines IL-4 and IL-13 and their specific receptor chains may help to design novel and highly specific inhibitory molecules.

A hepatite C é uma doença que leva à inflamação do fígado, sendo causada pelo vírus da hepatite C (VHC). Estima-se que existam 130 a 170 milhões de casos de infecção crônica pelo VHC por todo o mundo. Apesar do VHC ser principalmente hepatotrópico, foi evidenciada a detecção de RNA viral em células mononucleares do sangue periférico (PBMC). Evidências clínicas e experimentais têm demonstrado um importante tropismo do VHC por células do sistema imune, em especial por PBMCs. Apesar deste interessante achado, a importância da infecção do sistema imune na história natural da doença não é totalmente conhecida. É possível observar em alguns estudos que, em pacientes que desenvolvem infecção aguda, observa-se uma vigorosa resposta mediada por células T, específica ao VHC, mediada, por células T CD4+ e T CD8. Esta resposta é detectada na fase inicial da doença, e prolonga-se durante vários anos após a resolução do vírus. Pelo contrário, os pacientes que desenvolvem infecção crônica, apresentam, normalmente, respostas T fracas e / ou de curta duração, bem como defeitos nas funções efetoras de células T específicas. As respostas mediadas por células T com este perfil resultam, normalmente, em um baixo controlo da viremia e na sua persistência. Outra importante questão que permanece incerta até o presente momento é como a infecção das células imunes pelo VHC altera a sua função, principalmente no que concerne às PBMCs. Informações referentes às PBMCs e o VHC são pouco estudadas e referidas na literatura internacional, embora sejam de fundamental importância para a compreensão do seu peso na história natural da infecção. OBJETIVO: Baseado nessas incertezas o presente estudo tentará contribuir para a elucidação da influência do parasitismo por VHC na função de células TCD4+ e TCD8+ em pacientes naïve com indicação de tratamento com IFNpeg+RBV e comparar os dados obtidos antes, durante e pós-tratamento com os valores encontrados dos controles negativos, avaliando a influência do tratamento sobre a função dessas células. Verificar a presença do RNA-VHC nas PBMCs por RT-PCR em Tempo Real. Verificar a influência de fatores do vírus e do hospedeiro, tais como genótipo, carga viral, idade, gênero, raça, polimorfismo IL28B e biópsia hepática sobre as células parasitadas pelo VHC e sua produção de citocinas; Determinar a contagem e a função de linfócitos T CD4+ e CD8+ no sangue periférico desses pacientes; Determinar a influência do parasitismo de linfócitos pelo VHC sobre a função dos linfócitos TCD4+ e TCD8+. METODOLOGIA: Foram estudados 52 pacientes com hepatite C crônica; destes, 17 pacientes foram tratados com IFNalfa+RBV; 10 controles sadios, atendidos no Ambulatório de Hepatites da Divisão de Clínica de Doenças Infecciosas e Parasitárias do HC FMUSP. A contagem de células da subpopulação de linfócitos T CD4+ e CD8+ periféricas foram realizadas por citometria de fluxo FACSCanto II (BD) por meio do software MultiSet(BD). Foi analisada a presença/ausência do RNA-VHC em PBMC por PCR em tempo real no sistema TaqMan, no termociclador Applied Biosystems StepOne(TM). A função dos linfócitos TCD4+ e TCD8+ foram avaliadas através da técnica ELISPOT utilizanso o Kit Human IFN-gamma/IL-4 Dual-Color FluoroSpot. A contagem dos spots foi realizada em um leitor automatizado CTL-ImmunoSpot® S6 FluoroSpot Line. As PBMCs foram fracionadas e depletadas, utilizando-se o Kit Dynabeads FlowComp Human CD4 (Invitrogen Life Technologies) segundo as instruções do fabricante. RESULTADOS: Foram estudados 52 pacientes com hepatite C crônica; destes, 17 pacientes foram tratados com IFNalfa+RBV; 10 controles sadios. O genótipo 1 foi o mais prevalente 61,5%. O RNA do VHC foi detectado nas PBMCS em 88,4% dos pacientes. XVII Nossos resultados mostraram um aumento de células CD4 e CD8 parasitadas pelo VHC antes do tratamento, com valores estatisticamente significantes quando comparadas aos controles normais apenas no caso das CD4. Ocorreu, porém, um nítido prejuízo na produção de interleucinas por estas células parasitadas, particularmente a produção de IFN- y, com valores altamente significantes (0,009). Na semana 12, podemos ver o aumento de células CD4 no pré-tratamento, porém com diminuição na semana 12 e no follow up; entretanto a produção de IL-4 pelas células CD4 aumenta na semana 12 e cai novamente no seguimento; com as células CD8 ocorre leve queda na semana 12 porém uma tentativa de recuperação no follow up; sua produção de IFN-y cai na semana 12 e no follow up para números estatisticamente significantes. É a chamada \"exaustão\" de função destas células já descrita in vitro por alguns autores. Estes dados poderão ser muito úteis nas futuras observações desses pacientes que serão tratados com esquemas de DAAs sem interferon alfa. CONCLUSÃO: Em conclusão, os resultados desta pesquisa confirmam a importante influência do parasitismo das células CD4 e CD8 em suas funções / Hepatitis C is a disease that causes inflammation of the liver, caused by hepatitis C virus (HCV). It is estimated that there are 130 million to 170 million cases of chronic HCV infection worldwide. Although HCV is primarily hepatotropic was evidenced by detection of viral RNA in peripheral blood mononuclear cells (PBMC). Clinical and experimental evidence have demonstrated an important tropism of HCV by immune system cells, in particular by PBMC. Despite this interesting finding, the importance of infection of the immune system in the natural history of the disease is not fully known. It can be observed in some studies in patients who develop acute infection a vigorous response is observed mediated by T cells specific to HCV mediated by CD4 + and CD8. This response is detected at the initial stage of the disease, and extends for years after the resolution of the virus. Conversely, patients who develop chronic infection, are typically in the low T responses and / or short-term as well as defects in the effector functions of specific T cells. The responses mediated by T cells with the profile usually result in a low control of viremia and its persistence. Another important issue that remains unclear to date is how the infection of immune cells by HCV alters its function, especially with regard to the PBMCs. Information relating to the PBMCs and HCV are little studied and reported in the international literature, although they are of fundamental importance for the understanding of its weight in the natural history of infection. OBJECTIVE: Based on these uncertainties the present study attempts to contribute to the elucidation of the influence of parasitism by HCV on CD4 T cell function + and CD8 + in naïve patients with treatment indication with IFNpeg + RBV and compare the data obtained before, during and after treatment with the values found negative controls, assessing the influence of treatment on the function of these cells. Verify the presence of HCV-RNA in PBMC by RT-PCR in real time. Check the influence of virus and host factors such as genotype, viral load, age, gender, race, IL28B polymorphism and liver biopsy on the parasitized cells with HCV and their cytokine production; Determine count and function of lymphocytes T CD4 + and CD8 + peripheral blood of patients; To determine the influence of parasitism lymphocytes HCV on the function of CD4 + and CD8 + T lymphocytes. METHODS: We studied 52 patients with chronic hepatitis C; of these, 17 patients were treated with IFNalpha + RBV; 10 healthy controls, treated at the Hepatitis Clinic of the Division of Clinical Infectious and Parasitic Diseases of the FMUSP. The lymphocyte subpopulation of T-cell count CD4 + and CD8 + peripheral been made by FACSCanto II flow cytometer (BD) through the multiset software (BD). the presence / absence of HCV-RNA in PBMC by real-time PCR was analyzed in the TaqMan system, Applied Biosystems thermal cycler StepOne (TM). The role of CD4 + T lymphocytes and CD8 + were assessed by ELISPOT technique utilizanso the Human Kit IFN-gamma / IL-4 Dual-Color FluoroSpot. The counting of the spots was carried out in an automated reader CTL-ImmunoSpot® S6 FluoroSpot Line. And fractionated PBMCs were depleted using Dynabeads kit is the Human CD4 FlowComp (Invitrogen Life Technologies) according to manufacturer\'s instructions. RESULTS: We studied 52 patients with chronic hepatitis C; of these, 17 patients were treated with IFNalpha + RBV; 10 healthy controls. Genotype 1 was the most prevalent 61.5%. The HCV RNA was detected in PBMC in 88.4% of patients. Our results showed an increase of CD4 and CD8 cells parasitized with HCV prior to treatment, with statistically significant amounts compared to controls only if CD4. There was however, a marked impairment in production of interleukins for these parasitized cells, particularly the production of IFN- y, with highly significant values (0.009). At week 12, we can see the increase in CD4 cells before treatment, but with decreased at week 12 and at follow up; However IL-4 production by CD4 cells increased at week 12 and again falls in the following; with the CD8 cells is slightly lower at week 12 but a recovery attempt at follow up; their IFN-y production drops at week 12 and follow up to statistically significant numbers. It is called \"exhaust\" function of these cells in vitro been described by some authors. This data is very useful in future observations of these patients are treated with AADs regimens without interferon alfa. CONCLUSION: In conclusion, the results confirm the important influence of the parasitism of CD4 and CD8 cells in their functions

A hepatite C é uma doença que leva à inflamação do fígado, sendo causada pelo vírus da hepatite C (VHC). Estima-se que existam 130 a 170 milhões de casos de infecção crônica pelo VHC por todo o mundo. Apesar do VHC ser principalmente hepatotrópico, foi evidenciada a detecção de RNA viral em células mononucleares do sangue periférico (PBMC). Evidências clínicas e experimentais têm demonstrado um importante tropismo do VHC por células do sistema imune, em especial por PBMCs. Apesar deste interessante achado, a importância da infecção do sistema imune na história natural da doença não é totalmente conhecida. É possível observar em alguns estudos que, em pacientes que desenvolvem infecção aguda, observa-se uma vigorosa resposta mediada por células T, específica ao VHC, mediada, por células T CD4+ e T CD8. Esta resposta é detectada na fase inicial da doença, e prolonga-se durante vários anos após a resolução do vírus. Pelo contrário, os pacientes que desenvolvem infecção crônica, apresentam, normalmente, respostas T fracas e / ou de curta duração, bem como defeitos nas funções efetoras de células T específicas. As respostas mediadas por células T com este perfil resultam, normalmente, em um baixo controlo da viremia e na sua persistência. Outra importante questão que permanece incerta até o presente momento é como a infecção das células imunes pelo VHC altera a sua função, principalmente no que concerne às PBMCs. Informações referentes às PBMCs e o VHC são pouco estudadas e referidas na literatura internacional, embora sejam de fundamental importância para a compreensão do seu peso na história natural da infecção. OBJETIVO: Baseado nessas incertezas o presente estudo tentará contribuir para a elucidação da influência do parasitismo por VHC na função de células TCD4+ e TCD8+ em pacientes naïve com indicação de tratamento com IFNpeg+RBV e comparar os dados obtidos antes, durante e pós-tratamento com os valores encontrados dos controles negativos, avaliando a influência do tratamento sobre a função dessas células. Verificar a presença do RNA-VHC nas PBMCs por RT-PCR em Tempo Real. Verificar a influência de fatores do vírus e do hospedeiro, tais como genótipo, carga viral, idade, gênero, raça, polimorfismo IL28B e biópsia hepática sobre as células parasitadas pelo VHC e sua produção de citocinas; Determinar a contagem e a função de linfócitos T CD4+ e CD8+ no sangue periférico desses pacientes; Determinar a influência do parasitismo de linfócitos pelo VHC sobre a função dos linfócitos TCD4+ e TCD8+. METODOLOGIA: Foram estudados 52 pacientes com hepatite C crônica; destes, 17 pacientes foram tratados com IFNalfa+RBV; 10 controles sadios, atendidos no Ambulatório de Hepatites da Divisão de Clínica de Doenças Infecciosas e Parasitárias do HC FMUSP. A contagem de células da subpopulação de linfócitos T CD4+ e CD8+ periféricas foram realizadas por citometria de fluxo FACSCanto II (BD) por meio do software MultiSet(BD). Foi analisada a presença/ausência do RNA-VHC em PBMC por PCR em tempo real no sistema TaqMan, no termociclador Applied Biosystems StepOne(TM). A função dos linfócitos TCD4+ e TCD8+ foram avaliadas através da técnica ELISPOT utilizanso o Kit Human IFN-gamma/IL-4 Dual-Color FluoroSpot. A contagem dos spots foi realizada em um leitor automatizado CTL-ImmunoSpot® S6 FluoroSpot Line. As PBMCs foram fracionadas e depletadas, utilizando-se o Kit Dynabeads FlowComp Human CD4 (Invitrogen Life Technologies) segundo as instruções do fabricante. RESULTADOS: Foram estudados 52 pacientes com hepatite C crônica; destes, 17 pacientes foram tratados com IFNalfa+RBV; 10 controles sadios. O genótipo 1 foi o mais prevalente 61,5%. O RNA do VHC foi detectado nas PBMCS em 88,4% dos pacientes. XVII Nossos resultados mostraram um aumento de células CD4 e CD8 parasitadas pelo VHC antes do tratamento, com valores estatisticamente significantes quando comparadas aos controles normais apenas no caso das CD4. Ocorreu, porém, um nítido prejuízo na produção de interleucinas por estas células parasitadas, particularmente a produção de IFN- y, com valores altamente significantes (0,009). Na semana 12, podemos ver o aumento de células CD4 no pré-tratamento, porém com diminuição na semana 12 e no follow up; entretanto a produção de IL-4 pelas células CD4 aumenta na semana 12 e cai novamente no seguimento; com as células CD8 ocorre leve queda na semana 12 porém uma tentativa de recuperação no follow up; sua produção de IFN-y cai na semana 12 e no follow up para números estatisticamente significantes. É a chamada \"exaustão\" de função destas células já descrita in vitro por alguns autores. Estes dados poderão ser muito úteis nas futuras observações desses pacientes que serão tratados com esquemas de DAAs sem interferon alfa. CONCLUSÃO: Em conclusão, os resultados desta pesquisa confirmam a importante influência do parasitismo das células CD4 e CD8 em suas funções / Hepatitis C is a disease that causes inflammation of the liver, caused by hepatitis C virus (HCV). It is estimated that there are 130 million to 170 million cases of chronic HCV infection worldwide. Although HCV is primarily hepatotropic was evidenced by detection of viral RNA in peripheral blood mononuclear cells (PBMC). Clinical and experimental evidence have demonstrated an important tropism of HCV by immune system cells, in particular by PBMC. Despite this interesting finding, the importance of infection of the immune system in the natural history of the disease is not fully known. It can be observed in some studies in patients who develop acute infection a vigorous response is observed mediated by T cells specific to HCV mediated by CD4 + and CD8. This response is detected at the initial stage of the disease, and extends for years after the resolution of the virus. Conversely, patients who develop chronic infection, are typically in the low T responses and / or short-term as well as defects in the effector functions of specific T cells. The responses mediated by T cells with the profile usually result in a low control of viremia and its persistence. Another important issue that remains unclear to date is how the infection of immune cells by HCV alters its function, especially with regard to the PBMCs. Information relating to the PBMCs and HCV are little studied and reported in the international literature, although they are of fundamental importance for the understanding of its weight in the natural history of infection. OBJECTIVE: Based on these uncertainties the present study attempts to contribute to the elucidation of the influence of parasitism by HCV on CD4 T cell function + and CD8 + in naïve patients with treatment indication with IFNpeg + RBV and compare the data obtained before, during and after treatment with the values found negative controls, assessing the influence of treatment on the function of these cells. Verify the presence of HCV-RNA in PBMC by RT-PCR in real time. Check the influence of virus and host factors such as genotype, viral load, age, gender, race, IL28B polymorphism and liver biopsy on the parasitized cells with HCV and their cytokine production; Determine count and function of lymphocytes T CD4 + and CD8 + peripheral blood of patients; To determine the influence of parasitism lymphocytes HCV on the function of CD4 + and CD8 + T lymphocytes. METHODS: We studied 52 patients with chronic hepatitis C; of these, 17 patients were treated with IFNalpha + RBV; 10 healthy controls, treated at the Hepatitis Clinic of the Division of Clinical Infectious and Parasitic Diseases of the FMUSP. The lymphocyte subpopulation of T-cell count CD4 + and CD8 + peripheral been made by FACSCanto II flow cytometer (BD) through the multiset software (BD). the presence / absence of HCV-RNA in PBMC by real-time PCR was analyzed in the TaqMan system, Applied Biosystems thermal cycler StepOne (TM). The role of CD4 + T lymphocytes and CD8 + were assessed by ELISPOT technique utilizanso the Human Kit IFN-gamma / IL-4 Dual-Color FluoroSpot. The counting of the spots was carried out in an automated reader CTL-ImmunoSpot® S6 FluoroSpot Line. And fractionated PBMCs were depleted using Dynabeads kit is the Human CD4 FlowComp (Invitrogen Life Technologies) according to manufacturer\'s instructions. RESULTS: We studied 52 patients with chronic hepatitis C; of these, 17 patients were treated with IFNalpha + RBV; 10 healthy controls. Genotype 1 was the most prevalent 61.5%. The HCV RNA was detected in PBMC in 88.4% of patients. Our results showed an increase of CD4 and CD8 cells parasitized with HCV prior to treatment, with statistically significant amounts compared to controls only if CD4. There was however, a marked impairment in production of interleukins for these parasitized cells, particularly the production of IFN- y, with highly significant values (0.009). At week 12, we can see the increase in CD4 cells before treatment, but with decreased at week 12 and at follow up; However IL-4 production by CD4 cells increased at week 12 and again falls in the following; with the CD8 cells is slightly lower at week 12 but a recovery attempt at follow up; their IFN-y production drops at week 12 and follow up to statistically significant numbers. It is called \"exhaust\" function of these cells in vitro been described by some authors. This data is very useful in future observations of these patients are treated with AADs regimens without interferon alfa. CONCLUSION: In conclusion, the results confirm the important influence of the parasitism of CD4 and CD8 cells in their functions

To date, the cellular mechanisms involved in the progression of diseases characterized by chronic inflammation, such as rheumatoid arthritis (RA), remain largely unknown. However, cell-to-cell contact interactions between CD4+ helper T (Th) cells and monocytes have been implicated in the induction and maintenance of pro-inflammatory cytokine synthesis that is characteristic to the pathogenesis of RA. One such cytokine produced during monocyte-Th cell contact is interleukin (IL)-1 β, a mediator directly involved in the characteristic tissue destruction that occurs in the synovia of individuals with RA. Previous studies in our laboratories have shown that ligation of CD40 on monocytes with CD40 ligand (CD40L) present on activated Th cells induces monocyte IL-1β synthesis and rescues monocytes from apoptosis. These findings suggest a role for CD40 signaling of monocyte activation in the exacerbation and maintenance of chronic inflammatory responses. This dissertation represents efforts to elucidate components of the CD40 signaling pathway critical to monocyte activation and how CD40-mediated signaling events are modulated by the anti-inflammatory cytokines IL-4 and IL-10. Using either monocytes isolated from human peripheral blood or a monocytic cell line (THP-1), cellular kinases and transcription factors activated upon CD40 ligation were examined by western blot analyses and electrophoretic mobility shift assays (EMSA), respectively. CD40-dependent interleukin-1β synthesis in monocytes was abrogated by inhibitors of protein tyrosine kinase (PTK) activity but not by inhibitors of protein kinase C (PKC). The extracellular signal-regulated kinases 1 and 2 (Erk1/Erk2) mitogen-activated protein kinases (MAPK's) were specifically activated upon CD40 ligation, and specific inhibition of Erk1/Erk2 activation diminished IL-10 production in a dose-dependent manner. Both IL-4 and IL-10 reduced Erk1/Erk2 activation and synergized in this effect. Finally, STAT3, a member of the family of transcription factors involved in cytokine signaling, was highly phosphorylated in monocytes treated with IL-10 or with IL-10 and IL-4 in combination but not with IL-4 alone. Together these results suggest that in monocytes (1) CD40-mediated IL-1β synthesis and NF-κB activation require PTK activity, (2) CD40-mediated IL-1β production is critically dependent upon Erk1/Erk2 activity, (3) both IL-4 and IL-10 target the Erk1/Erk2 signaling cascade in the downregulation of IL-1β synthesis, (4) IL-4 and IL-10 have divergent effects on the CD40 signaling pathway in that these cytokines are synergistic with respect to their ability to inhibit CD40-mediated Erk1/Erk2 activation and IL-1β synthesis, and differ in their ability to block CD40-mediated rescue from apoptosis, and (5) STAT3 activation may be directly involved in the downregulatory effects of IL-10 on CD40 signaling. (Abstract shortened by UMI.)