This document explores the performance of taboo on the stage. The exploration is focused around the establishment of my personal aesthetic, which was developed through my studies at Virginia Commonwealth University. Starting with my first trip to Broadway, my journey goes through the class work that I did at VCU and the two plays that I did on the Shafer Street Alliance Laboratory Theatre stage: my performance and use of latex costumes in Funnyhouse of a Negro, and my direction and the troubles with producing Killer Joe. The exploration concludes with a look at the theatre in parts of Virginia and the ability to pursue an acting career with an aesthetic that pushes boundaries.

Increasingly the role of epigenetic machinery as a bridge between underlying DNA sequence and cellular phenotype is being discovered. The establishment of a myriad of unique cellular types sharing identical gene sequences in a multicellular organism gives a broad sense for the inherent role of epigenetic influence on cell differentiation. Importantly, the epigenetic mechanisms involved in establishing cell identity unsurprisingly contribute to diseased states, including cancer. Recent research continues to elucidate contributory roles of epigenetic mechanisms, such as DNA methylation, histone modification, and microRNA regulation, in human cancers. Additionally, chromatin remodelers, such as the Nucleosome Remodeling Factor (NURF), have been identified as important regulators for normal cell biology. While much has been done to identify and characterize the role of NURF chromatin remodeling complex as a key regulator of development in a number of model organisms, little has been published on the implications of NURF in diseases such as cancer. Our preliminary data shows dysregulation of E-cadherins, N-cadherins, and MHC-I genes in Bptf (an essential subunit of NURF) knocked down murine breast cancer cell lines. These proteins have well documented roles in the development and metastatic progression of cancers. To study the effect of Bptf knockdown on the development and progression of cancer we injected Bptf knocked down mouse breast cancer cell lines, 4T1, 66cl4, and 67NR, into syngenic BALB/c mice. Our findings reveal decreased tumor growth in 66cl4 and 67NR as measured by tumor weight at 3-4 weeks post injection. Tumor growth did not appear to be significantly affected in 4T1 challenged mice. However, mice inoculated with Bptf knockdown 4T1 cell lines have decreased metastasis to lungs as compared to control while metastasis of 66cl4 tumors to the lungs appear unaffected. To assess the role of the immune system in decreasing tumor growth in BALB/c mice, we injected 66cl4 tumors into NOD-SCID-Gamma (NSG) immune deficient mice. The tumors from these mice show no difference in tumor growth between Bptf knockdown and control tumors, implicating a role for the immune system regulating the decreased tumor weight in BALB/c mice. To delineate which immune cell effector may impede breast cancer carcinogenesis, we performed an in vitro natural killer (NK) cell cytotoxicity assay against 66cl4 tumors and found greater susceptibility to NK killing in Bptf knockdown tumors.

La criminalité sexuelle constitue aujourd’hui l’un des enjeux politiques et sociaux de nos sociétés contemporaines. Les débats auxquels elle donne lieu sont généralement l’occasion de souligner le rôle central des criminels sexuels récidivistes et de certains types de personnalités particulièrement dangereuses, parfois désignés sous le terme de « prédateurs sexuels », les plus dangereux étant les tueurs en série en raison de leur violence sexuelle meurtrière et les pédophiles en raison d’une inclination qui non seulement repousserait les limites de la morale en les amenant à s’en prendre à des enfants mais qui, de plus, pourrait participer, selon les théoriciens de l’abuseur-abusé, à reproduire un contingent d’agresseurs sexuels toujours plus important. Dans un tel contexte cette recherche doctorale a tout d’abord eu pour objectifs de contribuer à une meilleure connaissance des catégories de tueur en série et de pédophile ; d’analyser ensuite comment un ensemble de pratiques et d'idées à-travers un processus de catégorisation sont amenées à être pensées comme relevant d'un problème plus large, en l’occurrence la criminalité sexuelle ; et, enfin, inspiré par l’approche de Ian Hacking des maladies mentales transitoires de mettre en évidence les effets de la catégorisation sur les individus ainsi catégorisés et l’action en retour de ces derniers sur les catégories. / Sex-related crime is currently one of the most concerning political and social issues of our day. The resulting debates usually highlight the central role of repeat sex offenders and a number of particularly dangerous types of personality, often referred to as “sexual predators”, the most dangerous of which are serial killers, who are responsible for sexual violence and death, and paedophiles. The latter display an inclination that far exceeds moral boundaries by targeting children as victims, and could also, according to the theorists of the abuser-abused relationship, reproduce a more significant contingent of sexual aggressors. Within this context, this doctoral research aims first to contribute towards a better understanding of serial killer and paedophile categories and, subsequently analyse how, through a long categorisation process, specific practices and ideas are considered relevant to the broader issues regarding sexual criminality. Finally, this research, inspired by Ian Hacking’s approach to transitory mental illness, seeks to underline the effects that categorisation has on the persons concerned, including the latter’s influence on the former.

O setor agropecuário responde atualmente por cerca de 9,2% do Produto interno bruto (PIB) brasileiro, sendo que a cana-de-açúcar ocupa cerca de 9% da área cultivada, fato que lhe confere especial relevância com relação ao desenvolvimento nacional. Os dois produtos mais importantes desta cultura são o açúcar e o álcool etílico produzido por fermentação com leveduras. Durante o processo de fermentação alcoólica, o fermento sofre inúmeras reciclagens e interferências externas advindas do caldo, do ambiente e de outras fontes, tornando-se vulnerável à contaminação por outros microrganismos e mesmo leveduras indesejáveis. Métodos de monitoramento microbiológico que possibilitem a discriminação das linhagens de forma rápida e inequívoca, além de baratos, são altamente desejáveis. A utilização de meios diferenciais e seletivos, métodos bioquímicos e análise molecular tem se mostrado eficientes, porém são demorados e dispendiosos. A reação ‘killer’ é um fenômeno descoberto há 40 anos em S. cerevisiae, e resultados satisfatórios já foram obtidos na caracterização de leveduras, considerando-se o perfil de sensibilidade ‘killer’. O padrão de sensibilidade às toxinas killer foi utilizado nesse projeto em leveduras industriais (isoladas de processo fermentativo para produção de etanol). Os dados gerados com os testes de sensibilidade às toxinas Killer geraram polimorfismos entre as linhagens, mesmo em nível intra-específico, validando a metodologia na biotipagem das leveduras. As informações obtidas subsidiam o desenvolvimento de uma metodologia de biotipagem aplicável para o monitoramento microbiológico na indústria sucro-alcooleira, com a seleção de nove leveduras killer contra as quais as leveduras industriais apresentaram um perfil característico de sensibilidade, dependendo do grupo ao qual pertencem (S. cerevisiae ou não Saccharomyces). Finalmente, vale citar que os testes foram corroborados pelos resultados obtidos com a taxonomia clássica e pelos métodos de biologia molecular com reações de PCR (Polymerase Chain Reaction) e RAPD (Random Amplified Polimorphism DNA). / Agriculture is an important sector in the economy of Brazil. The sugar cane occupies 9% of the cultivated area in this country. The most important products from the sugar cane industry are sugar and alcohol, the latest produced by fermentative process by yeasts. During the fermentation the yeast population changes due to the interferences coming from the sugar cane juice or other sources, turning the process susceptible to undesirable contaminations. In this way, fast, reliable and cheap methods for microbiological monitoring can be helpful. Selective culture media, biochemical tests and molecular analyses have been used but they are time-consuming or expensive. The killer phenomenon discovered initially in Saccharomyces cerevisiae have shown interesting results to yeast biotyping. The sensibility pattern to different killer toxins was used to make a "fingerprinting" and successfully separate different strains of yeasts. This method was corroborated by classical taxonomy and molecular biology results (PCR and RAPD-PCR). The results obtained gives support to development of a methodology useful on fermenting microbiologic monitoring with the selection of nine strains of killers yeasts with highly discrimination between industrial bakker yeasts and contaminants of the fermentation process.

Introdução: A endometriose é uma doença com características inflamatórias que atinge as mulheres em idade reprodutiva. A patogênese da endometriose não está esclarecida. Tem sido demonstrada associação entre distúrbios imunológicos e endometriose, como alterações nos macrófagos, células NK, citocinas e nas repostas Th1, Th2 e Th17. As células iNKT, um tipo especial de linfócitos T, tem importante papel na resposta inflamatória como mediadores das repostas Th1, Th2 e Th17. Objetivos: o objetivo principal deste estudo foi comparar as frequências das células iNKT e seus subtipos entre pacientes com endometriose e pacientes sem endometriose. Procuramos também comparar as frequências destas células em ambos os grupos relacionando com alguns os aspectos clínicos e cirúrgicos da doença. Métodos: Realizamos estudo transversal, prospectivo entre fevereiro de 2013 a fevereiro de 2015 que avaliou a porcentagem de células iNKT e os subtipos iNKT CD4+, iNKT CD4+ CCR7+, iNKT CD4+ CD25+, iNKT DN, iNKT DN CCR7+, iNKT DN CD25+, iNKT CD4+ IL6+, iNKT CD4+ IL10+, iNKT CD4+ IL17+, iNKT CD8+ IL6+, iNKT CD8+ IL10+, iNKT CD8+ IL17+, iNKT DN IL6+, iNKT DN IL10+, iNKT DN IL17+ no sangue periférico, por citometria de fluxo, em pacientes com endometriose profunda (n = 47) e sem endometriose (n = 26). As frequências de células iNKT e seus subtipos foram comparadas entre os grupos de acordo com os sintomas, fase do ciclo, estádio da doença e classificação histológica. Resultados: Na avaliação da frequência das células iNKT, iNKT DN e iNKT DN IL17+ foi evidenciada diminuição significativa nas pacientes com endometriose (p=0,010, p=0,020, p=0,050; respectivamente). Além disso, foi observada diminuição significativa nas frequências das células iNKT CD4+ CCR7+ e aumento significativo das células iNKT CD4+ IL-17+ em pacientes com endometriose e dismenorréia severa em comparação a dismenorréia ausente/leve. Nas pacientes com endometriose e dor acíclica severa observou-se diminuição significativa da frequência das células iNKT CD4+ IL17+ em comparação a dor acíclica ausente/leve (p=0,048). Houve diminuição das células iNKT nas pacientes com endometriose em relação ao grupo controle na fase secretora do ciclo menstrual (p=0,030). Na avaliação da fase do ciclo menstrual foi observado na fase proliferativa aumento significativo na frequência das células iNKT CD4+ CD25+ (p=0,022) e diminuição significativa das células iNKT DN (p=0,011) nas pacientes com endometriose. Na fase secretora foi evidenciado diminuição significativa na frequência das células iNKT DN IL17+ (p=0,049) nas pacientes com endometriose. Foi identificado também nas pacientes com endometriose uma diminuição na frequência das células iNKT DN CD25+ na fase secretora em relação a fase proliferativa do ciclo menstrual. Conclusões: As células iNKT e os subtipos iNKT DN e iNKT DN IL17+ se mostraram alteradas nas pacientes com endometriose profunda. Subtipos específicos de células iNKT estão alteradas nas pacientes com endometriose profunda em pacientes com dismenorréia e dor acíclica severas. As fases do ciclo menstrual estão relacionadas a alteração nas frequências das células iNKT e dos subtipos iNKT CD4+ CD25+, iNKT DN, iNKT DN IL17+ e iNKT DN CD25+ nas pacientes com endometriose profunda. Estes resultados sugerem participação das células iNKT no desenvolvimento da endometriose / Introduction: Endometriosis is a disease with inflammatory characteristics that affects women of reproductive age. The pathogenesis of endometriosis is unclear. There has been an association between immune disorders and endometriosis, such as changes in macrophages, NK cells, cytokines, and Th1, Th2 and Th17 responses. iNKT cells, a special type of T lymphocytes, play an important role in the inflammatory response as mediators of the Th1, Th2 and Th17 responses. Objectives: The main objective of this study was to compare the frequencies of iNKT cells and their subtypes between patients with endometriosis and patients without endometriosis. We also compare the frequencies of these cells in both groups relating to some clinical and surgical aspects of the disease. Methods: We performed a prospective cross-sectional study between February 2013 and February 2015, which evaluated the percentage of iNKT cells and iNKT CD4+, iNKT CD4+ CCR7+, iNKT CD4+ CD25+, iNKT DN, iNKT DN CCR7+, iNKT DN CD25+, iNKT CD4+ IL6+ , iNKT CD8+ IL17+, iNKT DN IL6+, iNKT DN IL10+, iNKT DN IL17+ in the peripheral blood, by flow cytometry, in patients with deep endometriosis (n = 47), iNKT CD4+ IL10+, iNKT CD4+ IL17+, iNKT CD8+ ) and without endometriosis (n = 26). The frequencies of iNKT cells and their subtypes were compared between groups according to symptoms, stage of the cycle, stage of the disease and histological classification. Results: iNKT, iNKT DN and iNKT DN IL17+ cells showed significant decrease in patients with endometriosis (p = 0.010, p = 0.020, p = 0.050, respectively). In addition, a significant decrease in iNKT CD4+ CCR7+ cell numbers and a significant increase of iNKT CD4+ IL17+ cells were observed in patients with endometriosis and severe dysmenorrhea compared to absent / mild dysmenorrhea. In patients with endometriosis and severe acyclic pain, there was a significant decrease in the frequency of iNKT CD4+ IL17+ cells compared to absent / mild acyclic pain (p = 0.048). There was a decrease in iNKT cells in patients with endometriosis compared to the control group in the secretory phase of the menstrual cycle (p = 0.030). In the menstrual cycle, a significant increase in iNKT CD4+ CD25+ cells (p = 0.022) and a significant decrease in iNKT DN cells (p = 0.011) was observed in the proliferative phase in patients with endometriosis. In the secretory phase there was a significant decrease in the frequency of iNKT DN IL17 + cells (p = 0.049) in patients with endometriosis. It was also identified in patients with endometriosis a decrease in the frequency of iNKT DN CD25+ cells in the secretory phase in relation to the proliferative phase of the menstrual cycle. Conclusions: iNKT cells and subtypes iNKT DN e iNKT DN IL17+ have been altered in patients with deep endometriosis. Specific subtypes of iNKT cells are altered in patients with deep endometriosis in patients with severe dysmenorrhea and acyclic pain. The phases of the menstrual cycle are related to changes in the frequencies of iNKT cells and subtypes iNKT CD4+ CD25+, iNKT DN, iNKT DN IL17+ and iNKT DN CD25+ in patients with deep endometriosis. These results suggest the participation of iNKT cells in the development of endometriosis

Les cellules Natural Killer (NK) sont capables de lyser les cellules tumorales sans la nécessité de reconnaitre un antigène tumoral spécifique. Cette propriété leur confère un avantage par rapport aux lymphocytes T et les rend intéressantes à utiliser en tant que cellules effectrices pour l’immunothérapie adoptive. A ce jour, le potentiel thérapeutique des cellules NK n’a pas été complétement exploré notamment dans le contexte du traitement de la rechute post-allogreffe de cellules souches hématopoïétiques. Actuellement, les patients en rechute post-greffe sont traités avec des injections de lymphocytes du donneur (DLI) parfois issues de petites fractions du greffon de cellules souches hématopoïétiques congelées. Les cellules souches périphériques étant fréquemment utilisées comme source de cellules souches et parfois utilisées comme DLI, nous avons souhaité évaluer l’impact du G-CSF sur le phénotype et les fonctions des cellules NK présentes dans ces fractions. Dans cet objectif, nous avons comparé différentes sources de cellules NK isolées à partir de sang de donneurs sains, de sang mobilisé de donneurs sains ou de patients et observé l’évolution des différentes sous-populations de cellules NK issues de ces prélèvements au décours d’une expansion en présence d’IL-15. Nos résultats ont montré que l’administration de G-CSF diminuait la proportion de cellules NK CD56brightCD16+ au profit d’une population CD16-, diminuait la prolifération des cellules NK lors de l’expansion en culture, et modifiait les propriétés fonctionnelles des cellules NK. / The ability of natural killer (NK) cells to kill tumor cells without the need to recognize a tumor-specific antigen provides advantages over T cells and makes them appealing for a use as effectors for adoptive immunotherapy. However, the full therapeutic potential of NK cell-based immunotherapy has not been fully investigated in the context of leukemic relapse after hematopoietic stem cell transplantation. Today, patients relapsing after hematopoietic stem cell transplantation are often treated with donor lymphocyte infusion (DLI) based on small cell fractions frozen at the time of the stem cell transplantation. Since peripheral blood stem cells are increasingly used as stem cell source and as source of cells for DLI, we aimed to evaluate the impact of G-SCF mobilization on NK cell phenotype and functions. Therefore, we compared the expansion capacity, the phenotype and the function of NK cells from blood for healthy donors, from allogeneic HSCT healthy donors or from autologous HSCT from patients. We also determine the impact of G-CSF on NK cell subset repartition before and after expansion in presence of IL-15. Our results showed that G-CSF administration to patients decreases CD56brightCD16+ NK cell population, proliferation and function. Overcoming this impairment in lymphoid capacity may be important to facilitate post-transplant immunotherapy.

INTRODUÇÃO: O objetivo do estudo foi avaliar o perfil de marcadores imuno-histoquímicos relacionados às células NK em biópsias de aloenxertos renais com diagnóstico anatomopatológico de rejeição aguda (mediadas por células T ou anticorpos) e estabelecer relações desses marcadores com parâmetros morfológicos de lesão à microcirculação e sobrevida do enxerto. MÉTODOS: Estudo retrospectivo histórico que revisou 74 biópsias realizadas entre janeiro de 2009 e dezembro de 2012, de pacientes com rejeição aguda mediada por células T (n=36), rejeição aguda mediada por anticorpos com expressão positiva (n=19) ou negativa (n=19) para o marcador C4d, juntamente com levantamento de dados clínicos e laboratoriais pertinentes ao estudo. Foram realizadas reações imuno-histoquímicas, para os marcadores CD56, CD57, CD16, CD68, CD3, CD8 e CD4 com ênfase para os marcadores CD56 e CD16. Foi feita análise das células positivas em toda a cortical da biópsia nos compartimento intersticial, glomerular e vascular. Testes estatísticos foram aplicados conforme os pressupostos definidos no objetivo da pesquisa. RESULTADOS: No compartimento intersticial, células CD56+ (P = 0,004) e CD57+ (P < 0,001) foram expressas em maior quantidade em biópsias negativas para dosagem sérica de anticorpos específicos anti-doador (DSA) com diagnóstico de rejeição aguda mediada por células T. CD56 intersticial foi associado estatisticamente com presença de glomerulite (g >= 1) (P = 0,02) e ausência / leve capilarite peritubular (ptc <= 1) (P = 0,003). Células intersticiais positivas para o marcador CD56 com média superior a 0,56 céls/mm2 tiveram uma pior sobrevida do enxerto renal (P = 0,028). Biópsias com contagem inferior ou igual a 0,56 cél/mm2 tiveram associação estatisticamente significante para ausência ou leve capilarite peritubular (P = 0,012) e com contagem superior a 0,56 céls/mm2, foram associadas à presença de glomerulite (P = 0,002). Foi observado maior número de células positivas para o marcador CD16 no compartimento glomerular em biópsias positivas para dosagem sérica de DSA com diagnóstico de rejeição aguda mediada por anticorpos (P = 0,03) e em biópsias com presença de glomerulite (P = 0,009). Presença de maior número de células CD16+ no compartimento intersticial associou-se com capilarite peritubular (P = 0,0001). CONCLUSÕES: Maior expressão de células CD56 positivas no compartimento intersticial das biópsias foi significantemente associada com escores relacionados à lesão na microcirculação, especialmente glomerulite, com rejeição aguda mediada por células T e pior sobrevida do enxerto renal. Células CD16 positivas, no compartimento glomerular foram associadas com rejeição aguda mediada por anticorpos e glomerulite. As variações na expressão dos marcadores de células NK nos diferentes compartimentos da biópsia renal podem sugerir presença de envolvimento das células NK em diferentes vias do sistema imune nas rejeições agudas de aloenxertos renais / INTRODUCTION: The aim of this study was to investigate the immunohistochemical profile of markers related to NK cells from renal allograft biopsies with morphological diagnosis of acute rejection (T-cells or antibodies mediated rejection) and to study associations of those markers with types of rejection, microcirculation injury morphological parameters and graft survival. METHODOLOGY: Historical retrospective study that reviewed 74 biopsies performed between January 2009 and December 2012 in patients with acute T-cell-mediated rejection (n=36) and acute antibody-mediated rejection with (n=19) or without evident C4d deposition (n=19). The study was performed with relevant clinical and laboratory data. Immunohistochemical reactions were performed for CD56, CD57, CD16, CD68, CD3, CD8 and CD4 markers with highlights for CD56 and CD16. Counting of positive cells throughout cortical biopsy was performed in glomerular, interstitial and vascular compartments. Statistical tests were applied according to assumptions set out the goal of the study.RESULTS: DSA-negative biopsies-from patients with acute T-cell mediated rejection (aTCMR) had an increased expression of CD56+ and CD57+ cells (P = 0.004 and P < 0.001) in the interstitial compartment in comparison with donor-specific antibodies ( DSA)-positive biopsies from patients acute antibody-mediated rejection with and without C4d deposition. Interstitial CD56+ cells had an increased expression for presence of glomerulitis (g >= 1) (P = 0.02) and peritubular capillaritis (ptc >= 2) (P = 0.003). Interstitial CD56 + cells with mean superior to 0.56cells/mm2 had worse allograft survival (P = 0.028). CD56+ cells in the interstitial compartment with mean inferior or equal to 0.56cells/mm2 associated with absence or mild peritubular capillaritis (P = 0.012) and mean superior to 0.56cells/mm2 was associated with presence of glomerulitis (P = 0.002). CD16+ cells was increased in the glomerular compartment in DSA-positive biopsies (P = 0.03) and in the presence of glomerulitis (P = 0.009). Interstitial CD16+ cells associated with peritubular capillaritis (P = 0.0001).CONCLUSION: CD56+ cell infiltrates in the interstitial compartment were significantly associated with microcirculation injury scores, especially glomerulitis, acute T-cell mediated rejection and clinical outcomes. CD16+ cell infiltrates in glomerular compartment was associated with acute antibody-mediated rejection and glomerulitis. Our findings showed variations in expression of NK cells markers in renal biopsy different compartments which might suggest the involvement of NK cells in different immune system pathways in acute renal allograft rejection

OBJETIVOS: Comparar a expressão placentária de células natural killer deciduais (dNK), e a expressão sérica e placentária de suas citocinas reguladoras em gestações gemelares com pré-eclâmpsia (grupo pré-eclâmpsia, GPE) e sem comorbidades (grupo-controle, GC). MÉTODOS: Estudo transversal do tipo caso-controle, desenvolvido na Clínica Obstétrica do HC-FMUSP no período de julho de 2015 a junho de 2017. Foram obtidas amostras das regiões deciduais placentárias, para avaliação, por meio de técnica de imuno-histoquímica, da expressão de células dNK e suas interleucinas (IL) 10, 12 e 15, em pacientes que contemplaram os critérios de inclusão e concordaram em participar do estudo. Além disso, estas pacientes tiveram amostra sérica colhida no terceiro trimestre para dosagem de IL-10, IL-12 e IL-15 - por meio de kit comercial Milliplex®, que utiliza a tecnologia Luminex® xMAP®, da EMDMillipore (Merck Millipore Co., Alemanha) - e de fatores relacionados à angiogênese, como soluble fms-like tyrosine kinase-1 (sFlt-1) e placental growth factor (PlGF) - por meio de ensaio com imunoanalisador COBAS e411 (Roche Diagnostics, Alemanha). Os valores obtidos para as análises placentárias e séricas foram comparados entre o GPE e o GC, e a significância estatística estabelecida foi p < 0,05. RESULTADOS: Foram selecionadas 30 pacientes, sendo 20 no GC e 10 no GPE. Não se observaram diferenças significativas com relação às características maternas, gestacionais e de desfechos perinatais entre os dois grupos, exceto pela idade gestacional de início do pré-natal, menor no GPE (12,5 vs. 20,0 semanas, p = 0,015). Quanto à avaliação placentária, houve maior expressão de IL-15 no GPE (p = 0,001), e não houve diferença entre os grupos quanto à expressão placentária local de células dNK (p = 0,999), IL-10 (p = 0,063) e IL-12 (p = 0,135). Com relação às interleucinas séricas maternas, demonstrou-se aumento significativo nos níveis de IL-10 (22,7 vs. 11,9 pg/mL, p = 0,024) e IL-15 (15,9 vs. 7,4 pg/mL, p = 0,024) no GPE com relação ao GC, sem diferença entre os grupos para IL-12 (102,5 vs. 61,5 pg/mL, p = 0,373). A dosagem dos fatores relacionados à angiogênese demonstrou maiores níveis séricos maternos de sFlt-1 (15920 vs. 7978 pg/mL, p = 0,009) e da razão sFlt-1/PlGF (88,71 vs. 24,63, p = 0,002), e menores valores de PlGF (193,0 vs. 340,6 pg/mL, p = 0,036) no GPE. CONCLUSÃO: Observou-se maior concentração sérica materna tanto de fatores pró quanto anti-inflamatórios no GPE, quando comparado ao GC. Entretanto, não foram observadas diferenças entre os grupos quanto à expressão placentária de IL-10, importante fator anti-inflamatório. Estes achados podem sugerir que a tentativa sérica materna de equilibrar estas interleucinas não alcançou resposta localmente na placenta, contribuindo para o desenvolvimento da doença no GPE / OBJECTIVES: To compare the placental expression of decidual natural killer cells (dNK) and serum and placental expression of their regulatory cytokines in twin pregnancies with preeclampsia (preeclampsia group, PEG) and uncomplicated twin pregnancies (control group, CG). METHODS: This was a case-control study, developed in a tertiary referral center, from July 2015 to June 2017. Samples of the placental decidual region were obtained and analyzed by immunohistochemistry technique for the expression of dNK cells and interleukins (IL) 10, 12 and 15, in patients who met the inclusion criteria. In addition, maternal serum sample was collected in the third trimester for the dosage of IL-10, IL-12 and IL-15 - by means of a commercial Milliplex® kit using Luminex® xMAP® technology from EMDMillipore (Merck Millipore Co., Germany) - and angiogenesis factors, such as soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) - by COBAS e411 immunoassay (Roche Diagnostics, Germany). The values obtained for the placental analyzes and maternal circulating factors were compared between PEG and CG and the statistical significance was set at p < 0.05. RESULTS: Thirty patients were selected, 20 in CG and 10 in PEG. There were no significant differences in maternal, gestational and perinatal outcomes between the two groups, except for the gestational age at the onset of prenatal care, which was lower in PEG (12.5 vs. 20.0 weeks, p = 0.015). PEG showed strong immunostaining for IL-15 (p = 0.001) when compared to CG, with no difference between the groups concerning the placental expression of dNK (p = 0.999), IL-10 (p = 0.063), and IL -12 (p = 0.135). Relating to maternal circulating interleukins, a significant increase in IL-10 (22.7 vs. 11.9 pg/mL, p = 0.024) and IL-15 (15.9 vs. 7.4 pg/mL, p = 0.024) was observed in PEG, with no difference between the groups for IL-12 (102.5 vs 61.5 pg/mL, p = 0.373). We also demonstrated higher maternal levels of sFlt-1 (15920 vs. 7978 pg/mL, p = 0.009) and sFlt-1/PlGF ratio (88.71 vs. 24.63, p = 0.002) and lower levels of PlGF (193 vs. 340.6 pg/mL, p = 0.036) in PEG. CONCLUSION: A higher maternal serum concentration of both pro- and anti-inflammatory factors was observed in the PEG. However, no difference was found between the groups regarding the placental expression of IL-10, an important anti-inflammatory factor. These findings may suggest that the maternal serum attempt to balance these interleukins did not reach local placental response, which contribute to the development of the disease in the PEG

Introdução: A endometriose é uma doença com características inflamatórias que atinge as mulheres em idade reprodutiva. A patogênese da endometriose não está esclarecida. Tem sido demonstrada associação entre distúrbios imunológicos e endometriose, como alterações nos macrófagos, células NK, citocinas e nas repostas Th1, Th2 e Th17. As células iNKT, um tipo especial de linfócitos T, tem importante papel na resposta inflamatória como mediadores das repostas Th1, Th2 e Th17. Objetivos: o objetivo principal deste estudo foi comparar as frequências das células iNKT e seus subtipos entre pacientes com endometriose e pacientes sem endometriose. Procuramos também comparar as frequências destas células em ambos os grupos relacionando com alguns os aspectos clínicos e cirúrgicos da doença. Métodos: Realizamos estudo transversal, prospectivo entre fevereiro de 2013 a fevereiro de 2015 que avaliou a porcentagem de células iNKT e os subtipos iNKT CD4+, iNKT CD4+ CCR7+, iNKT CD4+ CD25+, iNKT DN, iNKT DN CCR7+, iNKT DN CD25+, iNKT CD4+ IL6+, iNKT CD4+ IL10+, iNKT CD4+ IL17+, iNKT CD8+ IL6+, iNKT CD8+ IL10+, iNKT CD8+ IL17+, iNKT DN IL6+, iNKT DN IL10+, iNKT DN IL17+ no sangue periférico, por citometria de fluxo, em pacientes com endometriose profunda (n = 47) e sem endometriose (n = 26). As frequências de células iNKT e seus subtipos foram comparadas entre os grupos de acordo com os sintomas, fase do ciclo, estádio da doença e classificação histológica. Resultados: Na avaliação da frequência das células iNKT, iNKT DN e iNKT DN IL17+ foi evidenciada diminuição significativa nas pacientes com endometriose (p=0,010, p=0,020, p=0,050; respectivamente). Além disso, foi observada diminuição significativa nas frequências das células iNKT CD4+ CCR7+ e aumento significativo das células iNKT CD4+ IL-17+ em pacientes com endometriose e dismenorréia severa em comparação a dismenorréia ausente/leve. Nas pacientes com endometriose e dor acíclica severa observou-se diminuição significativa da frequência das células iNKT CD4+ IL17+ em comparação a dor acíclica ausente/leve (p=0,048). Houve diminuição das células iNKT nas pacientes com endometriose em relação ao grupo controle na fase secretora do ciclo menstrual (p=0,030). Na avaliação da fase do ciclo menstrual foi observado na fase proliferativa aumento significativo na frequência das células iNKT CD4+ CD25+ (p=0,022) e diminuição significativa das células iNKT DN (p=0,011) nas pacientes com endometriose. Na fase secretora foi evidenciado diminuição significativa na frequência das células iNKT DN IL17+ (p=0,049) nas pacientes com endometriose. Foi identificado também nas pacientes com endometriose uma diminuição na frequência das células iNKT DN CD25+ na fase secretora em relação a fase proliferativa do ciclo menstrual. Conclusões: As células iNKT e os subtipos iNKT DN e iNKT DN IL17+ se mostraram alteradas nas pacientes com endometriose profunda. Subtipos específicos de células iNKT estão alteradas nas pacientes com endometriose profunda em pacientes com dismenorréia e dor acíclica severas. As fases do ciclo menstrual estão relacionadas a alteração nas frequências das células iNKT e dos subtipos iNKT CD4+ CD25+, iNKT DN, iNKT DN IL17+ e iNKT DN CD25+ nas pacientes com endometriose profunda. Estes resultados sugerem participação das células iNKT no desenvolvimento da endometriose / Introduction: Endometriosis is a disease with inflammatory characteristics that affects women of reproductive age. The pathogenesis of endometriosis is unclear. There has been an association between immune disorders and endometriosis, such as changes in macrophages, NK cells, cytokines, and Th1, Th2 and Th17 responses. iNKT cells, a special type of T lymphocytes, play an important role in the inflammatory response as mediators of the Th1, Th2 and Th17 responses. Objectives: The main objective of this study was to compare the frequencies of iNKT cells and their subtypes between patients with endometriosis and patients without endometriosis. We also compare the frequencies of these cells in both groups relating to some clinical and surgical aspects of the disease. Methods: We performed a prospective cross-sectional study between February 2013 and February 2015, which evaluated the percentage of iNKT cells and iNKT CD4+, iNKT CD4+ CCR7+, iNKT CD4+ CD25+, iNKT DN, iNKT DN CCR7+, iNKT DN CD25+, iNKT CD4+ IL6+ , iNKT CD8+ IL17+, iNKT DN IL6+, iNKT DN IL10+, iNKT DN IL17+ in the peripheral blood, by flow cytometry, in patients with deep endometriosis (n = 47), iNKT CD4+ IL10+, iNKT CD4+ IL17+, iNKT CD8+ ) and without endometriosis (n = 26). The frequencies of iNKT cells and their subtypes were compared between groups according to symptoms, stage of the cycle, stage of the disease and histological classification. Results: iNKT, iNKT DN and iNKT DN IL17+ cells showed significant decrease in patients with endometriosis (p = 0.010, p = 0.020, p = 0.050, respectively). In addition, a significant decrease in iNKT CD4+ CCR7+ cell numbers and a significant increase of iNKT CD4+ IL17+ cells were observed in patients with endometriosis and severe dysmenorrhea compared to absent / mild dysmenorrhea. In patients with endometriosis and severe acyclic pain, there was a significant decrease in the frequency of iNKT CD4+ IL17+ cells compared to absent / mild acyclic pain (p = 0.048). There was a decrease in iNKT cells in patients with endometriosis compared to the control group in the secretory phase of the menstrual cycle (p = 0.030). In the menstrual cycle, a significant increase in iNKT CD4+ CD25+ cells (p = 0.022) and a significant decrease in iNKT DN cells (p = 0.011) was observed in the proliferative phase in patients with endometriosis. In the secretory phase there was a significant decrease in the frequency of iNKT DN IL17 + cells (p = 0.049) in patients with endometriosis. It was also identified in patients with endometriosis a decrease in the frequency of iNKT DN CD25+ cells in the secretory phase in relation to the proliferative phase of the menstrual cycle. Conclusions: iNKT cells and subtypes iNKT DN e iNKT DN IL17+ have been altered in patients with deep endometriosis. Specific subtypes of iNKT cells are altered in patients with deep endometriosis in patients with severe dysmenorrhea and acyclic pain. The phases of the menstrual cycle are related to changes in the frequencies of iNKT cells and subtypes iNKT CD4+ CD25+, iNKT DN, iNKT DN IL17+ and iNKT DN CD25+ in patients with deep endometriosis. These results suggest the participation of iNKT cells in the development of endometriosis

Cette thèse s’inscrit dans les champs du management public et du contrôle de gestion. Elle a pour objectif d’apporter un éclairage sur la fonction contrôle de gestion dans les collectivités territoriales en construisant, d’une part, une typologie des contrôleurs de gestion, et en identifiant, d’autre part, certains facteurs organisationnels expliquant les différents types de contrôleurs de gestion territoriaux mis en exergue. Dans cette perspective, une analyse du rôle du contrôleur de gestion territorial s’appuyant sur la littérature académique et sur des recherches antérieures est présentée. Puis, une étude empirique combinant méthodologie qualitative et quantitative, et portant sur le contrôle de gestion dans les grandes intercommunalités, identifie quatre types de contrôleurs de gestion territoriaux : à savoir le contrôleur de gestion respectivement stratège, conseiller, partenaire et analyste. Le rôle de chaque type de contrôleur de gestion territorial est ensuite précisé, ce rôle apparaissant lié notamment à l’étendue des compétences et aux nombres de partenaires de l’intercommunalité considérée. / This thesis is in the fields of public management and management control. It aims to shed light on the management control function in local authorities by building, a typology of management controllers on one hand, and on other hand identifying certain organizational factors explaining the different types territorial management controllers highlighted. With this in mind, an analysis of the role of territorial management controller based on academic literature and previous research is presented. Then an empirical study combining qualitative and quantitative methodology, and about the management control in local council communities, identifies four types of territorial management controllers: namely respectively strategist, councillor, partner and analyst. The role of each type of territorial management controller is then qualified, that role seems to be particularly linked to the extent of powers and the numbers of partners in the latter local council community.