A dermatite de contato alérgica decorre de uma reação imunológica, mediada por células T, contra um contactante em pessoas previamente sensibilizadas. O exame padrão ouro para o diagnóstico da DCA é o teste de contato (TC). Infelizmente, o TC demanda tempo, não é inócuo e tem algumas limitações. O teste de proliferação linfocitária (TPL) convencional, uma alternativa ao TC, apresenta baixa sensibilidade no diagnóstico de alergia ao cromo. A fim de aprimorar a sensibilidade o resultado do teste foi obtido pela detecção de citocinas no sobrenadante das culturas e não por timidina radiomarcada. Dezoito pacientes alérgicos ao cromo e 19 controles foram testados com o teste convencional e com as citocinas IFN-?, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 e rantes. Houve correlação entre alergia ao cromo e detecção das citocinas IFN-gama, IL-2, IL-5, IL-12 e IL-13. Dessas, os melhores resultados foram encontrados com a IL-13. O TPL pode ser utilizado como exame adicional ou alternativo no diagnóstico da DCA pelo cromo / Allergic contact dermatitis (ACD) elapses from an specific T cell immunologic reaction against an allergen in a sensitized individual. The gold standard exam to confirm ACD is the patch test (PT). However, PT demands time, has potential side efects and some limitations. The standard lymphocyte proliferation assay (LPA) has sensitivity in the diagnosis of chromium allergy. To optimize this test the results were obtained by detection of cytokines instead radiolabeled thymidine. Eighteen patients allergic to chromium and 19 controls were tested with the conventional LPA and for the following cytokines: IFN-?, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 and rantes. Correlation between allergy to chromium and detection of IFN-gama, IL-2, IL-5, IL-12 e IL-13 was found. The best results were found with IL-13. LPA can be used as an alternative or additional test in the diagnosis of ACD by chromium.

Introdução. Apesar das evidências dos efeitos imunomodulatórios da morfina, não há na literatura estudos que tenham comparado a interação entre citocinas, imunidade celular (linfócitos T, B e NK) e a administração prolongada de morfina administrada pelas vias oral ou intratecal em doentes com dor crônica neuropática não relacionada ao câncer. Foram avaliados de forma transversal e comparativa 50 doentes com diagnóstico de dor lombar crônica e com presença de radiculopatia (dor neuropática) previamente operados para tratar hérnia discal lombar (Síndrome Dolorosa Pós- Laminectomia), sendo 18 doentes tratados prolongadamente com infusão de morfina pela via intratecal com uso de sistema implantável no compartimento subaracnóideo (grupo intratecal); 17 doentes tratados prolongadamente com morfina pela via oral (n=17) e 15 doentes tratados com fármacos mas sem opióides (grupo sem opioide). Foram analisadas as concentração das citocinas IL-2, IL-4, IL-8, TNFalfa, IFNy, IL-5, GM-CSF, IL-6, IL-10 e IL-1beta no plasma e no líquido cefalorraquidiano; imunofenotipagem de linfócitos T, B e células NK e avaliados os Índice de Escalonamento de Opióide (em percentagem de opióide utilizada e em mg), dose cumulativa de morfina (mg), duração do tratamento em meses, dose final de morfina utilizada (em mg), e equivalente de morfina por via oral (em mg). Resultados. Não houve diferença estatisticamente significativa entre o número de linfócitos T, B e NK nos doentes com morfina administrada pelas vias IT, VO e os não usuários de morfina. Houve correlação positiva entre as concentrações de linfócitos T CD4 e o Índice de Escalonamento de Opióide (em % e mg) nos doentes tratados com morfina por via intratecal. Houve correlação negativa entre as concentrações de células NK (CD56+) e o Índice de Escalonamento de Opióide (em % e mg) nos doentes tratados com morfina por via intratecal. Houve correlação positiva entre o número de células NK (CD56+) e a dose cumulativa de morfina (em mg) administrada pelas vias intratecal e oral. Houve correlação positiva entre as concentrações de linfócitos T CD8 e a duração do tratamento em meses nos doentes tratados com morfina pela via oral. As concentrações de IL-8 e IL-1beta foram maiores no LCR do que no plasma em todos os doentes da amostra analisada. As concentrações de IFNy no LCR foram maiores nos doentes que utilizavam morfina pela via oral e nos não usuários de morfina do que nos que a utilizavam pela via intratecal. As concentrações de plasmáticas de IL-5 foram maiores nos doentes utilizavam morfina pela via oral ou intratecal do que nos que não a utilizavam. A concentração de IL-5 no LCR correlacionou-se negativamente com a magnitude da dor de acordo com a EVA nos doentes tratados com morfina pelas via oral ou intratecal. Nos doentes tratados com morfina pelas via oral ou intratecal, a concentração de IL-2 no LCR correlacionou-se positivamente com a magnitude da dor de acordo com a EVA e negativamente com o Índice de Escalonamento de Opióide (em % e mg) e a dose cumulativa de morfina (em mg). As concentrações plasmáticas de GMCSF foram maiores nos doentes utilizavam morfina pela via oral ou intratecal do que nos não a utilizavam. A concentração de TNFalfa no LCR nos doentes tratados com morfina pela via intratecal correlacionou-se negativamente com o Índice de Escalonamento de Opióide (em % e mg), a dose cumulativa de morfina (em mg) e dose equivalente por via oral (em mg) de morfina. A concentração plasmática das citocinas IL-6 e IL-10 correlacionou-se negativamente com a duração do tratamento (em meses) nos doentes tratados com morfina administrada pela via oral. O Índice de Escalonamento de Opióide (em mg e %) correlacionou-se negativamente com as concentrações no LCR de IL-2 e TNFalfa nos doentes tratados com morfina administrada pela via intratecal. O Índice de Escalonamento de Opióide (em mg e %) correlacionou-se negativamente com as concentrações no LCR de IL-2 e IL-5 nos doentes tratados com morfina administrada pela via oral. Houve correlação negativa entre a intensidade da dor de acordo com a EVA e as concentrações de IL-5 e IL-2 no LCR nos doentes tratados com morfina administrada pelas vias oral e intratecal. Houve correlação negativa entre a intensidade da dor de acordo com a EVA e as concentrações plasmáticas de IL-4 nos doentes tratados com morfina administrada pela via intratecal. Houve correlação negativa entre a intensidade da dor de acordo com a EVA e as concentrações plasmáticas de IL-1beta nos doentes tratados com morfina administrada pela via intratecal. Conclusões: Os resultados sugerem associações entre citocinas e imunidade celular (células T , B e NK) e o tratamento prolongado com morfina administrada pela via oral ou intratecal. Estes resultados podem contribuir para a compreensão da imunomodulação da morfina administrada por diferentes vias em doentes com dor neuropática crônica não oncológica . São necessários mais estudos sobre os efeitos da morfina sobre o sistema imunológico / Objective: To analyze plasma and cerebrospinal fluid (CSF) cytokine levels and cell-mediated immunity (T, B and NK cells) of chronic neuropathic pain patients under long-term morphine treatment administered through the oral or spinal routes. Design: Cross- sectional clinical and laboratory analysis. Subjects:Fifty ambulatory patients with diagnosis of chronic low back pain and presence of radiculopathy (neuropathic pain) previously operated to treat lumbar disc hernia (failed back surgery syndrome) receiving long term morphine treatment (minimum 180 days); 18 patients receiving long term morphine into the intrathecal space through a implanted pump (\"spinal group\"); 17 patients treated with long-term oral morphine (\"oral group\") and 15 patients treated with non-opioid analgesics (\"without opioid group\"). Methods: Were analyzed plasma and cerebrospinal fluid concentrations of 10 cytokines using a multiplex system (Luminex®) for the following cytokines: IL- 2, IL-4, IL-8, TNFalfa, IFNy, IL-5, GM-CSF, IL-6, IL-10 and IL-1beta; immunophenotyping of lymphocytes T, B and NK cells. Results: There were no significant group demographic differences. No significant T, B and NK cells differences were observed between the 3 groups. CD4 levels and Opioid Escalation Index (OEI) were positively correlated in spninal group. NK cells levels and OEI were negatively correlated in spinal group. NK cells levels and cumulative morphine dose were positively correlated in spninal and oral groups. CSF concentrations of IL-8 and IL-1beta were higher than plasma concentrations in all groups. CSF concentration of FNg were higher in oral and without opioid group. Plasma IL-5 concentrations were higher in the oral and spinal groups compared to without opioid group. CSF concentration of IL-5 was negatively correlated with pain intensity in the oral and spinal groups. CSF concentrations of IL-2 was positively correlated with pain intensity and negatively correlated with OEI and cumulative morphine dose in the oral and spinal groups. GM-CSF plasma concentrations were higher in oral and spinal group compared to without opioid group. TNFa CSF concentrations was negatively correlated with OEI, cumulative morphine dose and equivalent oral morphine dose in the spinal group. IL-6 and IL-10 plasma concentrations were negatively correlated with treatment duration in the oral group. OEI The significant inverse correlations observed between pain intensity and the plasma IL-6 and IL-10 concentrations in patients receiving longterm i.t. opioids for chronic pain management, suggests that these cytokines are worthy of further investigation as possible biomarkers of persistent pain. CSF concentrations of IL-2 and TNFa were negatively correlated with OEI in spinal group. CSF concentrations of IL-2 and IL-5 were negatively correlated with OEI in oral group and with pain intensity in the oral and spinal group. Plasma concentrations of IL-4 was negatively correlated with pain intensity in spinal group. Plasma concentrations of IL-1beta were negatively correlated with pain intensity in spinal group. Conclusions: The results suggest associations between long term morphine treatment administered by oral or spinal routes and cytokines concentrations and cellmediated immunity (T, B and NK cells). These results can contribute to the understanding of immunomodulation by morphine administered through diferent routes in patients with chronic neuropathic non-cancer pain. Further studies on the effects of morphine on the immune system are needed

Agamaglobulinemia ligada ao X (XLA) é uma imunodeficiência primária caracterizada por ausência ou número reduzido de células B maduras em sangue periférico, de todos os isotipos de imunoglobulina e um aumento da susceptibilidade a infecções bacterianas e enterovirais graves. XLA é causada por mutações no gene Bruton\'s tirosino quinase, que codifica um membro da proteína da família das tirosino quinases citoplasmáticas que tem papel vital na modulação de muitos processos celulares. Neste estudo foram analisados trinta e três pacientes quanto à presença de mutações de BTK, por SSCP/HA e seqüenciamento. A análise da expressão foi realizada pela técnica por PCR em tempo real. Foram encontradas mutações do tipo stop codons, substituições de aminoácido, defeitos de splicing, pequenas deleções/inserções e frameshift nestes pacientes afetando os domínios PH, SH3, SH2 e o domínio da quinase da proteína. A análise da expressão mostrou níveis baixos nos pacientes com mutação do tipo stop codon, e nas outras mutações, os níveis de expressão foram de aproximadamente 15% e se correlacionaram com os tipos de mutação. / X-linked Agammaglobulinemia (XLA) is a primary immunodeficiency characterized by the absence or decreased numbers of mature B cells in peripheral blood, and by a lack of all immunoglobulin isotypes, leading to an increased susceptibility to severe bacterial and enteroviral infections. XLA is caused by mutations in the gene encoding for Bruton\'s tyrosine kinase (BTK), a protein member of the Tec family of cytoplasmic tyrosine kinases and plays a vital modulation role in many cellular processes. In this study thirty-three patients were analyzed for the presence of BTK mutations by SSCP/HA and sequencing. The expression analysis was carried out by the technique of Real-Time PCR. It was found mutations of the stop codons type, amino acid substitutions, splice defects, small deletions/insertions and frameshift in these patients affecting the PH, SH3, SH2 and tyrosine kinase domains of protein. The expression levels were very low in the patients with stop codon mutations, and in the other mutations, the expression levels were about 15% and were correlated with the mutation types.

Lors de l’infection par le VIH, les réponses T CD8+ présentent de nombreux défauts fonctionnels d’ordre qualitatif et quantitatif. Les « HIV controllers » (HIC) constituent un rare groupe de patients (0,5%) qui contrôle spontanément in vivo la réplication virale. Des études ont montré que les fortes réponses T CD8+ observées chez les HIC jouent probablement un rôle majeur dans ce contrôle. Par ailleurs, l’activation immunitaire joue un rôle clé dans la déplétion T CD4+ et la progression. En effet, les patients virémiques présentent une forte activation mesurée par la fréquence de lymphocytes T CD8+ CD38+/HLA-DR+ alors que l’activation observée chez les HIC est faible, similaire à celle des patients sous traitements anti-rétroviraux ce qui pourrait expliquer l’absence fréquente de progression chez ces patients. De plus, les HIC sont caractérisés par une activation paradoxale avec une forte proportion de lymphocytes T CD8+ présentant une forte expression de HLA-DR contrastant avec une faible expression de CD38 et donc une fréquence plus importante de lymphocytes T CD8+ exprimant le phénotype particulier CD38-/HLA-DR+ que les lymphocytes T CD8+ des patients ne contrôlant pas le VIH.L’objectif de mon projet de thèse a été de caractériser les réponses T optimales pour le contrôle de la réplication virale chez les patients HIC. En étudiant la sous population CD38-/HLA-DR+, nous avons démontré que cette sous population exprime un phénotype particulier avec l’expression seule de HLA-DR comme marqueur d’activation mais aussi qu’elle possède de très bonnes fonctions effectrices (cytotoxicité) et mémoires (survie, polyfonctionnalité et prolifération). Nous avons par la suite étudié le mécanisme responsable de l’induction de ce phénotype particulier et démontré qu’une activation par de faibles doses d’antigènes induit préférentiellement le phénotype d’intérêt CD38-/HLA-DR+ alors qu’une activation par de fortes doses d’antigènes induit préférentiellement le phénotype CD38+/HLA-DR+.Nous avons par la suite caractérisé les lymphocytes T CD8+ des HIC à l’aide de marqueurs associés à une activité cytotoxique : les facteurs de transcription de la « boîte T », T-bet et Eomes et le marqueur CD57. Nous avons ainsi montré qu’il existe une hétérogénéité de l’expression d’Eomes et que seules les sous populations CD57+/Eomeshi et CD57+/Eomesint présentent ex vivo des capacités cytotoxiques. Il s’avère que les lymphocytes T CD8+ spécifiques du VIH des HIC expriment préférentiellement le phénotype CD57+/Eomeshi qui démontre de bonnes fonctionnalités (prolifération, survie). De plus la fréquence de cette sous population corrèle avec une faible charge virale suggérant que ces cellules CD57+/Eomeshi participent au contrôle de la réplication virale. Cependant, les fortes réponses T CD8+ ne sont pas retrouvées chez tous les patients HIC et il existe un certain nombre de patients, authentiquement contrôleurs in vivo mais dont les lymphocytes T CD8+ ne possèdent pas une activité inhibitrice ex vivo et que l’on a appelé « Weak Responders » par opposition aux « Strong Responders » qui présentent une forte capacité antivirale. Notre étude a permis de montrer que les réponses T CD8+ sont corrélés aux réponses T CD4+ : les « Weak Responders » présentent de faibles réponses T CD4+ et T CD8+ et les « Strong Responders » présentent de fortes réponses T CD4+ et T CD8+. Ces résultats ont permis de définir deux sous populations T CD8+ probablement impliquées dans le contrôle de la réplication virale in vivo. La faible dose d’antigène et la faible activation des lymphocytes pourraient être impliquées dans l’induction et la persistance de fortes réponses T CD8+ anti-VIH. L’utilisation de faibles doses d’antigènes permettant d’induire des lymphocytes T CD8+ avec une forte capacité d’inhibition de la réplication virale pourrait être envisagée dans de futurs essais cliniques vaccinaux. / Several defects of the immune response have been evidenced during HIV infection, especially CD8+ T cell response. A rare group of patients (0.5%) called HIV controllers (HIC) can spontaneously control HIV infection and studies showed that these patients present high HIV-specific CD8+ T cell responses. Moreover excessive activation of CD8+ T cells seems to play a major role since this parameter correlates strongly with disease progression. Indeed, immune activation observed in HIC is lower than in viremic patients and similar as in HAART-treated patients. Furthermore HIC exhibit a peculiar activation phenotype with low CD38 expression and high HLA-DR expression and characterized by a higher frequency of CD38-/HLA-DR+ expressing cells. The aim of these works was to characterize optimal HIV-specific T cells which are implicated in the control of viral replication in HIC. We first studied this subpopulation CD38-/HLA-DR+ and showed that it is characterized by an absence of activation marker expression except for HLA-DR and by efficient effector functions (high cytotoxicity) and good memory functions (better survival, proliferation and higher frequency of polyfunctional cells). We then deciphered the mechanism responsible for the induction of this phenotype and demonstrated that low dose of antigen induce preferentially CD38-/HLA-DR+ phenotype while high dose of antigen induce preferentially CD38+/HLA-DR+. We next characterized HIV-specific CD8+ T cells from HIC by markers associated with cytotoxicity: T-box transcription factor T-bet and Eomes and CD57. We demonstrated heterogeneity of Eomes expression and only CD57+/Eomeshi and CD57+/Eomesint subpopulation exhibit cytotoxic capacity ex vivo. We then showed that HIC exhibited higher frequency of CD57+/Eomeshi expressing HIV specific CD8+ T cells with high functionalities (proliferation, survival). Furthermore frequency of this subpopulation correlated with low viral load suggesting a role of CD57+/Eomeshi in the control of viral replication. Nevertheless, the high CD8+ T cell responses are not found in all HIC and some patients who control viral replication in vivo exhibit low inhibition by CD8+ T cells ex vivo and are called Weak Responders by opposition to Strong Responders who exhibit high inhibition by CD8+ T cells. Our study demonstrated that the CD8+ T cell response is associated with the CD4+ T cells: Weak Responders showed low CD4+ and CD8+ T cell responses especially low CD38-/HLA-DR+ frequency and Strong Responders showed high CD4+ and CD8+ T cell response especially high CD38-/HLA-DR+ frequency. We therefore defined two subpopulations which are overrepresented in HIC and which are probably implicated in control of HIV. The low dose and low immune activation could be involved in the induction and persistence of high anti-HIV CD8+ T cell response and might have implications for HIV vaccine strategies.

Le rejet d’allogreffe représente un obstacle majeur en transplantation rénale humaine. Le lymphocyte B (LB) joue un rôle lors de cette réaction contre le greffon, mal défini à ce jour. Notre objectif a été de caractériser et identifier son implication dans le rejet humoral chronique (cABMR) et le rejet cellulaire aigu (ACR). Dans une première partie, la caractérisation phénotypique des LB par cytométrie en flux chez ces patients a mis en évidence d’importantes différences dans la distribution des sous-populations de LB uniquement chez les patients cABMR. Chez les patients ACR, dont la distribution des LB n’est pas altérée, l’analyse de coupes de biopsies rénales a permis de mettre en évidence un infiltrat cellulaire constitué de lymphocytes B et T. Dans une seconde partie, l’activité fonctionnelle et régulatrice des LB issus de patients cABMR et ACR a été évaluée à l’aide d’un modèle in vitro de coculture entre des LB et des LT. Cette étude a révélé que les LB, issus des patients cABMR uniquement, sont dépourvus d’activités régulatrices sur la fonction des LT autologues. Cette étude a aussi mis en exergue que les LB des patients cABMR présentaient une déficience dans la sécrétion de molécules immunosuppressives telles que le TGFβ et l’indoleamine 2,3-dioxygénase (IDO). Ce défaut conduit à une incapacité à générer des lymphocytes T régulateurs. Finalement, notre étude a clairement démontré le rôle du LB dans les mécanismes physiopathologiques conduisant au rejet. Ces travaux ont donc permis de générer d’éventuelles perspectives pour définir de nouvelles stratégies thérapeutiques dans la lutte contre le rejet d’allogreffe. / Allograft rejection is one of the main obstacles in human kidney transplantation. The role of B lymphocytes in the response against the allograft is poorly understood. Our aim is to identify and clarify its involvement in chronical humoral and cellular rejection. First of all, we identify profound changes in the distribution of B lymphocytes in cABMR patients which was not the case for ACR patients. In those last ones, we were able to detect on kidney biopsies an important cellular infiltrate composed with B and T cells. In the second part of this work, the functional and regulatory functions of B cells from both groups of patients were analyzed by using an in vitro coculture model between B and T cells. It appeared that B lymphocytes isolated from cABMR patients were unable to inhibit autologous T cell activity. This study showed those cells failed to produce immunosuppressive molecules as TGFβ and indoleamine 2,3-dioxygenase (IDO) leading to a default in the generation of regulatory T cells. To conclude, this study clearly showed the roles of B cells in physiopathological mechanisms of allograft rejection and helped to define new therapeutical strategies to prevent or reduce its consequences for the patients.

Kung, Wing Yee. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 92-115). / Abstracts in English and Chinese. / Abstract --- p.ii / Acknowledgements --- p.vii / Table of contents --- p.ix / List of Tables --- p.xii / List of Figures --- p.xiii / List of Abbreviations --- p.xv / Chapter Chapter 1. --- General introduction --- p.1 / Chapter Chapter 2. --- Literature review --- p.4 / Chapter 2.1 --- Food allergy and its prevalence --- p.4 / Chapter 2.2 --- Mechanism and clinical symptoms of food allergy --- p.6 / Chapter 2.3 --- Tropomyosin as the major allergen in shellfish --- p.15 / Chapter 2.4 --- Cross reactivity and epitope mapping of tropomyosin --- p.21 / Chapter 2.5 --- Novel approaches for the treatment of food allergy --- p.29 / Chapter Chapter 3. --- Expression of shrimp recombinant tropomyosin and sensitization of mice --- p.36 / Chapter 3.1 --- Introduction --- p.36 / Chapter 3.2 --- Materials and Methods --- p.40 / Chapter 3.2.1 --- "Recovery of E, coli with tropomyosin-carrying plasmid" --- p.40 / Chapter 3.2.2 --- Preparation of tropomyosin-carrying plasmid --- p.41 / Chapter 3.2.3 --- Confirmation of DNA sequence of the tropomyosin --- p.41 / Chapter 3.2.4 --- Identification of the recombinant protein --- p.43 / Chapter 3.2.5 --- Purification of the recombinant protein --- p.43 / Chapter 3.2.6 --- Sodium dedecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) --- p.44 / Chapter 3.2.7 --- Concentration measurement of the recombinant tropomyosin --- p.45 / Chapter 3.2.8 --- Mice --- p.46 / Chapter 3.2.9 --- Mice sensitization and challenging --- p.46 / Chapter 3.2.10 --- Tropomyosin-specific IgE level in blood --- p.47 / Chapter 3.2.11 --- Statistical analysis --- p.49 / Chapter 3.3 --- Results --- p.52 / Chapter 3.3.1 --- DNA sequence of the cloned tropomyosin --- p.52 / Chapter 3.3.2 --- Expression and purification of tropomyosin --- p.52 / Chapter 3.3.3 --- Hypersensitivity symptoms after challenge --- p.53 / Chapter 3.3.4 --- Blood tropomyosin-specific IgE level --- p.53 / Chapter 3.4 --- Discussion --- p.62 / Chapter Chapter 4. --- Identification of T cell epitopes --- p.67 / Chapter 4.1 --- Introduction --- p.67 / Chapter 4.2 --- Materials and methods --- p.67 / Chapter 4.2.1 --- Soluble epitope peptide synthesis --- p.68 / Chapter 4.2.2 --- Isolation of spleen cells from mice --- p.69 / Chapter 4.2.3 --- T cell proliferation assay --- p.70 / Chapter 4.3 --- Results --- p.71 / Chapter 4.3.1 --- Splenocyte proliferation to synthetic peptide --- p.72 / Chapter 4.3.2 --- Splenocyte proliferation to synthetic peptides pool --- p.72 / Chapter 4.4 --- Discussion --- p.77 / Chapter Chapter5 --- General conclusion --- p.89 / References --- p.92

Human γδ T cells expressing the Vγ2Vδ2 T cell antigen receptor play important roles in immune responses to microbial pathogens by monitoring prenyl pyrophosphate isoprenoid metabolites. Most adult Vγ2Vδ2 cells are memory cytotoxic cells that produce interferon-γ (IFN-γ). Recently, murine γδ T cells were found to be major sources of interleukin (IL)-17A in anti-microbial and autoimmune responses. To determine if primate γδ T cells play similar roles, we characterized IL-17A and IL-22 production by Vγ2Vδ2 T cells. IL-17A-producing memory Vγ2Vδ2 T cells exist at low but significant frequencies in adult humans (1:2,762 T cells) and at even higher frequencies in adult rhesus macaques. Higher levels of Vγ2Vδ2 T cells produce IL-22 (1:1,864 T cells) although few produce both IL-17A and IL-22. Unlike adult humans where many IL-17A+ V#947;2Vδ2 T cells also produce IFN-#947; (T#947;δ1/17), the majority of adult macaques IL-17A+ Vδ2 T cells (T#947;δ17) do not produce IFN-#947;. To define the cytokine requirements for T#947;δ17 cells, we stimulated human neonatal V#947;2Vδ2 T cells with the bacterial antigen, (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate, and various cytokines and mAbs in vitro. We find that IL-6, IL-1β, and transforming growth factor-β (TGF-β) are required to generate T#947;δ17 cells in neonates whereas T#947;δ1/17 cells additionally required IL-23. In adults, memory T#947;δ1/17 and T#947;δ17 cells required IL-23, IL-1β, and TGF-β but not IL-6. IL-22-producing cells showed similar requirements. Both neonatal and adult IL-17A+ V#947;2Vδ2 T cells expressed elevated levels of retinoid-related orphan receptor-#947;t. Our data suggest that, like Th17 αβ T cells, V#947;2Vδ2 T cells can be polarized into T#947;δ17 and T#947;δ1/17 populations with distinct cytokine requirements for their initial polarization and later maintenance.

Le système immunitaire est un ensemble de mécanismes impliquant différents types de cellules qui produisent des facteurs solubles (cytokines, chimiokines ou molécules cytotoxiques) qui contribuent à la régulation et aux réponses immunitaires. La caractérisation à l'échelle cellulaire de la production de ces facteurs solubles présente un grand intérêt d'une part sur le plan fondamental pour comprendre les cascades d'événements des régulations cellulaires, et d'autre part dans le suivi de la réponse immunitaire (infections, cancers, auto-immunités, greffes, vaccins, etc.). Cependant, la plupart des techniques actuellement disponibles (ELISpot, cytométrie en flux, microarrays, etc.) ne permettent pas d'étudier plusieurs cytokines en rapport avec le phénotype des cellules sécrétrices et/ou sans marquage et d'analyser les secrétions de cytokines en temps réel par des cellules individuelles. Dans cette étude, une « biopuce à cellules » a été développée pour analyser les secrétions de cytokines par les cellules individuelles (lymphocytes T) in vitro. La biopuce est fonctionnalisée par greffage électrochimique des motifs d'anticorps spécifiques aux protéines membranaires de cellules et/ou d'anticorps spécifiques aux cytokines, tous couplés au pyrrole. Ensuite, un traitement de surface est effectué avec du poly (éthylène glycol) thiol (Thiol-PEG) pour empêcher la fixation non spécifique de cellules sur la surface de la biopuce. Un dispositif microfluidique en polydimethyllsiloxane (PDMS) et maintenu à 37°C a aussi été développé afin d'intégrer toutes les opérations d'analyse et de détection dans un seul système. La biopuce développée dans cette étude permet la capture spécifique et stable de lymphocytes T individuels viables et la détection ultérieure de cytokines sécrétées par chaque cellule individuelle. Dans ce travail, la détection des cytokines sécrétées (IL-2 et IFN-γ) a été effectuée par fluorescence dans un format en sandwich. Cette «biopuce à cellules» est également compatible avec l'imagerie par résonance plasmonique de surface (SPRi), ce qui pourrait permettre de réaliser des analyses en temps réel et la détection sans marquage de plusieurs cytokines sécrétées par des cellules individuelles. Cette technique fournit un outil très prometteur pour l'analyse de marqueurs biologiques et de l'activité de cellules et l'étude des réponses immunitaires. / The immune system is a set of mechanisms involving many different cell types which communicate through downstream signals mediated principally by soluble factors (i.e. cytokines) to protect the host against invading organisms and to control adequate immune responses. The identification and characterization at the cellular level of cytokine production has a huge interest for both fundamental research and clinical studies. However, the majority of techniques currently available (ELISpot, flow cytometry, microarrays, etc.) have several shortcomings including notably the assessment of multiple cytokines in relation to secreting cell phenotypic classification and/or label-free and real-time analysis of cytokine secretions at individual cell level. Hence, in this study, we developed a « cell biochip » to analyze the secretion of cytokines by individual cells (T lymphocytes) activated and cultured in vitro. The biochip is functionalized by electrochemically grafting patterns of pyrrole-conjugated cell membrane-specific and cytokine-specific antibodies and treated with Poly(ethylene glycol)thiol (Thiol-PEG) self-assembled monolayers (SAMs) to stably avoid non-specific binding of cells on the surface. A polydimethyllsiloxane (PDMS)-based microfluidic device maintained at 37°C was also developed in order to integrate all the detection assay operations in a single system. The biochip developed here allows specific and stable capture of viable and bioactive individual T cells and subsequent detection of secreted cytokines in the close vicinity of each individual cell. In this work, the detection of secreted cytokines (IL-2 and IFN-γ) was performed by fluorescence in an immunosandwich assay format. This « cell biochip » is also compatible with surface plasmon resonance imaging (SPRi), which could therefore allow expanding its functionality to enable real-time and label-free detection of multiple cytokines from individual cells. Such technique provides a very promising tool for the analysis of biomarkers and cell activity and the monitoring of immune responses.

The eosinophil is a leukocyte whose intracellular mediators are considered to play a central role in the pathogenesis of allergic diseases, including allergic asthma, allergic rhinitis and atopic dermatitis, and which is also involved in immunological responses to parasites. Eosinophil differentiation and maturation from bone marrow progenitors is regulated by interleukin-5 (IL-5), which may be secreted by T helper 2 (Th2) T lymphocytes, and is consistently upregulated in allergic conditions. Eotaxin is a potent chemoattractant for circulating and tissue eosinophils, and the production of this chemokine promotes eosinophil infiltration and accumulation within sites of allergic inflammation.¶ Eosinophils obtained from inflammatory tissues and secretions display an altered phenotype in comparison to peripheral blood eosinophils, with increased surface expression of major histocompatibility complex (MHC) proteins and adhesion molecules (Hansel et al., 1991), and migration across the microvascular endothelium may also increase their capacity to generate an oxidative burst (Walker et al., 1993; Yamamoto et al., 2000). Eosinophils are phagocytic cells, and have been shown to present simple (no requirement for intracellular processing) and complex antigens to MHC-restricted, antigen-specific T lymphocytes (Del Pozo et al., 1992; Weller et al., 1993). Furthermore, eosinophils express the costimulatory molecules required for effective antigen presentation (Tamura et al., 1996), and ligation of costimulatory molecules on the eosinophil cell surface can induce the release of eosinophil derived cytokines (Woerly et al., 1999; Woerly et al., 2002). Therefore the eosinophil may also regulate immune responses.¶ To date, no studies have demonstrated the ability of eosinophils to modulate activated T lymphocyte function via presentation of relevant antigen in the context of MHC class II (MHC-II), concomitant with Th2 cytokine release. In the experiments described in this thesis, murine eosinophils have been observed to rapidly migrate to sites of antigen deposition within the airways mucosa of naïve mice, suggesting a potential role for this granulocyte in the primary response to inhaled antigen. However, human allergic diseases are often diagnosed after the establishment of allergic responses, and symptom development. Therefore, a murine model of allergic airways disease (AAD) was used to investigate the ability for eosinophils to participate as antigen presenting cells (APCs), and thereby modulate activated T lymphocyte function both in vitro and in vivo. Detailed histological analysis of the pulmonary draining lymph nodes following antigen challenge in sensitised mice revealed a rapid infiltration of eosinophils into this tissue, which preceded the accumulation of eosinophils in bronchoalveolar lavage fluid (BALF). This suggested that eosinophils were preferentially translocating to the draining lymph nodes following antigen challenge, and that the subsequent accumulation of these cells in the BALF was a consequence of continued antigen delivery to the lower airways.¶ Eosinophil trafficking to lymphoid tissue via the afferent lymphatics was substantiated using electron microscopy of lymph node sections and the intravenous (i.v.) transfer of fluorescently labeled eosinophils, which did not traffic to lymph nodes via the blood. During the resolution of AAD, eosinophils were noted for their persistence in the pulmonary draining lymph nodes. These observations suggested a continued modulation of T cell function by lymph node dwelling eosinophils during AAD resolution, particularly in light of recent observations for draining lymph node T cell proliferation following instillation of antigen-pulsed eosinophils into the allergic mouse lung (Shi et al., 2000).¶ To further investigate the antigen presenting capacity, eosinophils were obtained from the BALF of mice with AAD, and their surface expression of MHC class II (MHC-II) proteins and costimulatory molecules confirmed using flow cytometric analysis. The ability to acquire and process complex antigen both in vitro and in vivo was also confirmed using naturally quenching fluorescenated ovalbumin (OVA), which is degraded into fluorescent peptides by the action of intracellular proteases. Thus, eosinophil expression of the surface molecules necessary for effective antigen presentation was confirmed, as was their ability to process complex antigen. Further investigations revealed that eosinophils can present complex OVA antigen to CD4+ T lymphocytes obtained from the allergic mouse, and to in vitro derived OVA-specific Th2 cells. In the presence of exogenous antigen, eosinophils co-cultured with T lymphocytes were able to induce Th2 cytokine production, and demonstrated an ability for eosinophils to modulate T lymphocyte function in vitro.¶ The ability for eosinophils to act as antigen presenting cells in vivo was also investigated. Eosinophils obtained from the antigen-saturated lungs of OVA sensitised and challenged mice were transferred to the peritoneal cavities of naïve host mice. When subsequently challenged with aerosolised OVA, eosinophil recipients developed a pulmonary eosinophilia similar to that of OVA sensitised and challenged mice. To validate this finding, the experimental procedure was altered to accommodate the use of non-allergy derived eosinophils, which were pulsed with OVA in vitro, prior to transfer into naïve recipients. When subsequently challenged with aerosolised OVA, eosinophil recipients developed a peripheral blood and pulmonary eosinophilia, and stimulation with OVA induced IL-5 and IL-13 cytokine production from pulmonary draining lymph node cells. Notably, the AAD induced by transfer of antigen pulsed eosinophils did not induce detectable OVA-specific IgG1, which may be attributed to the lack of soluble antigen required for B cell antibody production.¶ During the course of these investigations, an OVA T cell receptor (TCR) transgenic mouse (OT-II) was procured with a view to defining the interaction between eosinophils and activated T lymphocytes (Barnden et al., 1998). Despite having specificity for the OVA323-339 peptide, an immunodominant epitope that skews naïve T cell responses towards Th2 cytokine release (Janssen et al., 2000), T lymphocytes from the OT-II mouse preferentially secreted IFN-γ in response to stimulation with either OVA peptide or OVA. These mice were further characterised in a mouse model of AAD, and found to be refractory to disease induction and progression, which may be attributed to significant IFN-γ secretion by transgenic CD4+ T lymphocytes during antigen sensitisation. Indeed, these cells were noted for their ability to attenuate pulmonary eosinophilia when transferred to OVA sensitised and challenged wild type mice, although serum OVA-specific IgG1, peripheral blood eosinophilia levels and airways response to methacholine challenge remained intact.¶ Knowledge of the biased Th1 phenotype in naïve OT-II provided a unique opportunity to investigate the fate of T lymphocytes bearing high affinity OVA-specific TCRs following neonatal antigen exposure to soluble OVA. In a previous study, subcutaneous (s.c.) administration of soluble OVA to wild type neonatal mice was suspected to have deleted OVA-specific T cells from the T cell repertoire (Hogan et al., 1998a). Using flow cytometry and TCR specific antibody, the delivery of s.c. OVA to OT-II neonates did not alter transgenic T cell populations in adult mice. Instead, it was surprising to find a skewing towards the Th2 phenotype and loss of IFN-γ secretion following OVA sensitisation and challenge in adult mice. A mechanism for this reprogramming of the transgenic T cell from the Th1 to a Th2 phenotype following OT-II neonatal exposure to soluble OVA is proposed, and further experimentation may validate this hypothesis.¶ In conclusion, eosinophils residing in the allergic lung have the capacity to interact with activated T cells, both within this tissue and the draining lymph nodes. Despite their relative inefficiency as antigen presenting cells (Mawhorter et al., 1994), eosinophils may participate en masse in the serial triggering of activated TCRs, and provide appropriate costimulatory signals that modulate T lymphocyte function. Through the elaboration of Th2 cytokines and stimulation of T cell proliferation, antigen presenting eosinophils may transiently prolong or exacerbate the symptoms of allergic diseases. Alternatively, eosinophils presenting relevant antigens may inhibit T cell activity via degranulation, and such activity has recently been observed in a parasite model (Shinkai et al., 2002). Finally, experiments in the OT-II mouse have provided valuable information to suggest that therapies designed to modulate eosinophil numbers in allergic tissues through the secretion of opposing cytokines such as IFN-γ, may be of limited benefit. The results shown here suggest that airways dysfunction remains intact despite significantly reduced pulmonary eosinophilia

Le système immunitaire est un réseau d'organes, de cellules et de molécules reliés dynamiquement chargé de surveiller l'intégrité de l'organisme. La meilleure connaissance de son fonctionnement est de nature à amener de nouvelles pistes thérapeutiques pour traiter nombre de maladies telles que le cancer, les maladies auto immunes ou les maladies infectieuses. Nos travaux sur la tolérance immunitaire ont montré sans équivoque dans deux modèles différents qu'une population spécialisée de lymphocytes T exprimant le facteur de transcription foxp3 était sélectionnée par l'expression de l'antigène cognitif dans le thymus. La redécouverte de cette population de lymphocytes a rejoint les avancées majeures de l'immunologie moderne. Nous avons montré chez la souris que l'expression de foxp3, tenu pour responsable de la fonction suppressive dans le système immunitaire, était instable et très sensible à l'action d'inhibiteurs " coupant " la voie de signalisation initié par l'IL-2. Nous rechercherons d'autres voies de signalisation spécifique aux lymphocytes T régulateurs chez la souris dans un modèle "naturel " de sélection thymique. Cette étude systémique permettra de définir de nouvelles cibles pour une inhibition pharmacologique ou génétique de foxp3. L'utilisation d'inhibiteur de foxp3 présente un intérêt évident pour l'immunothérapie anti-tumorale où la fonction régulatrice joue contre l'élimination de la tumeur. Nous avons pour projet de transposer nos résultats obtenus chez la souris à l'homme afin de développer une stratégie d'immunothérapie anti-tumorale. Nous prévoyons de développer un modèle du cancer colo-rectal humain chez la souris NOD.SCID.gc-/- afin de pouvoir valider l'idée que la déplétion pharmacologique de lymphocytes T régulateurs avant transfert de lymphocytes T a un vrai impact sur la réponse contre la tumeur autologue. Nous avons par ailleurs montré que dans ce modèle de souris, le transfert de cellules souches hématopoietiques humaines conduisait à la génération de lymphocytes T CD4+ susceptibles à l'infection par le VIH. Nous prévoyons dans un second projet d'utiliser ce nouveau modèle animal de l'infection pour tout d'abord questionner la vision actuelle de l'immunopathologie de l'infection en déterminant (i) si la réponse des lymphocytes T CD8+ est bien responsable de la résolution du pic de virémie durant la phase primaire de l'infection par le VIH et (ii) si la population de lymphocytes T double négatifs est bien la population responsable de la production de la majorité des virions infectieux. Dans un second temps, nous prévoyons d'utiliser les souris humanisées pour valider une stratégie de thérapie génique de l'infection par le VIH. La spécificité des vecteurs lentiviraux envers les lymphocytes T CD4, gage de sécurité et d'efficacité maximum, a été validé chez la souris et chez l'homme. Aussi, nous avons construit des vecteurs exprimant une combinaison de gènes thérapeutiques inhibant la fusion du virion avec la membrane de la cellule, soit en entrant en compétition avec la gp41 virale, soit en modulant l'expression de CCR5 à la surface. Le suivi des souris traitées puis infectées sera réalisée en mesurant la charge virale et la fréquence des lymphocytes T CD4+ afin de juger de la qualité de la reconstitution immunitaire après thérapie génique. L'ensemble de ces travaux et projets vise à transposer les résultats de nos travaux de recherche les plus fondamentaux au service du patient.