© 2014, American Society for Microbiology. / 京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第19630号 / 医科博第68号 / 新制||医科||5(附属図書館) / 32666 / 京都大学大学院医学研究科医科学専攻 / (主査)教授 松田 道行, 教授 竹内 理, 教授 杉田 昌彦 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The successful resolution of inflammation requires removal of neutrophils from the inflammatory site to prevent release of histotoxic contents that may potentiate inflammatory processes and promote progression to a chronic state associated with impaired repair mechanisms and/or autoimmune responses. Macrophages are “professional” phagocytes required for rapid and efficient clearance of apoptotic neutrophils. Macrophage phagocytic capacity can be critically regulated by a number of environmental factors, including cytokines, bacterial products, and glucocorticoids. We have hypothesised that modulation of macrophage phagocytic capacity may represent an effective strategy for promoting resolution of inflammation in diseases where clearance of neutrophils may be impaired or inefficient. The aim of this thesis was to investigate the molecular mechanisms underlying glucocorticoid-augmentation of macrophage phagocytosis. We have demonstrated that long-term exposure of human peripheral blood monocytes to the synthetic glucocorticoid dexamethasone dramatically increases phagocytic capacity for “early” membrane-intact apoptotic neutrophils. Increased phagocytic potential was associated with a “switch” from a serum-independent to a serum-dependent apoptotic cell recognition mechanism. We initially employed an “add back” approach to rule out several well-defined opsonins in apoptotic neutrophil clearance, including immune complexes, IgG, complement proteins, pentraxin-3, fibronectin, annexin I, and platelet-derived factors. Using a multi-step purification scheme involving anion exchange and gel filtration chromatography, we purified a high molecular weight fraction that contained the prophagocytic activity of serum and analysis by mass spectrometry identified C4-binding protein as a candidate protein. C4-binding protein circulates in human plasma bound predominately in a >570kDa complex with protein S and the presence of protein S in high molecular weight fractions was confirmed by immunoblotting. We found that protein S was equivalent to unfractionated serum in its ability to enhance phagocytosis of apoptotic neutrophils by dexamethasone-treated monocyte-derived macrophages (Dex-MDMo) and that immunodepletion of protein S resulted in loss of prophagocytic activity. Protein S was found to opsonise apoptotic neutrophils in a calcium-dependent manner and enhanced phagocytic potential by Dex-MDMo through stimulation of Mer tyrosine kinase (Mertk), a receptor that is upregulated on the surface of Dex-MDMo compared to untreated MDMo. The studies presented in this thesis have provided novel insight into the underlying molecular mechanisms required for high capacity clearance of apoptotic neutrophils by macrophages following treatment with glucocorticoids and may form the foundations for further studies investigating glucocorticoid action for development of safer and more selective therapies.

Le récepteur MerTK est impliqué dans la phagocytose des segments externes des photorécepteurs (SEP) par l'épithélium pigmentaire rétinien (EPR), fonction cruciale pour la survie des photorécepteurs et la vision. Dans la rétine, ces deux tissus sont en contact permanent et la phagocytose ne survient qu'une fois par jour, cette fonction nécessite donc d'être contrôlée précisément. Le pic de phagocytose est lié à l'activation intracellulaire de MerTK via l'intégrine αvβ5. Ce projet a eu pour but d'étudier les mécanismes extracellulaires régulant la fonction de MerTK au cours de cette phagocytose.Nous avons montré que MerTK est clivé à la surface des cellules d'EPR in vivo avant et après le pic de phagocytose. Ceci permettrait d'éviter une phagocytose trop prononcée des SEP.Nous avons démontré le rôle opposé des ligands de MerTK, spécifique à l'EPR. Gas6 semble inhibiteur, il stimule le clivage de MerTK et inhibe la phagocytose in vitro, et son expression in vivo est faible au moment du pic de phagocytose. Au contraire, Protéine S, dont l'expression augmente in vivo au moment du pic, inhibe le clivage de MerTK et stimule la phagocytose in vitro, et pourrait ainsi potentialiser cette fonction.Parmi les protéases étudiées, l'inhibition d'ADAM17 in vitro engendre une diminution du clivage de MerTK corrélée à une augmentation de sa biodisponibilité à la surface cellulaire et de son activité. Cependant, cet effet n'étant pas total, l'implication d'une autre protéase n'est pas exclue.Ainsi, mes travaux de Doctorat permettent de mieux comprendre la régulation complexe de l'activité de MerTK dans la phagocytose rétinienne, essentielle pour le rythme circadien de cette fonction. / The MerTK receptor is involved in the daily phagocytosis of photoreceptor outer segments (POS) by the retinal pigment epithelium (RPE), an indispensable process for photoreceptors survival and vision. In the retina, the contact between POS and RPE is permanent, and POS phagocytosis occurs once a day, requiring a precise control of this function. The phagocytic peak is initiated by activation of MerTK via the αvβ5 integrin receptor. This project aimed at studying extracellular mechanisms that control MerTK function during POS phagocytosis. We have shown that MerTK can be cleaved from the RPE cell surface in vivo before and just after the phagocytic peak. This process might avoid an excess of POS phagocytosis. We have also shown the opposite role of MerTK ligands, specific to RPE cells. Gas6 appears to act as an inhibitor as it stimulates MerTK cleavage and inhibits POS phagocytosis in vitro. Moreover, in vivo, Gas6 expression is weak at peak phagocytosis time. In contrast, Protein S, which in vivo expression increases at the time of the phagocytic peak, inhibits MerTK cleavage and stimulates POS phagocytosis in vitro, and thus might potentiate phagocytosis. Among the protease candidates we studied, in vitro inhibition of ADAM17 results in decreased MerTK cleavage associated with the increase of full-length receptors available at cell surface and of MerTK activation. However, as cleavage still occurs in these conditions, we cannot exclude the implication of another protease. Taken together, my PhD data allows us to better understand the complex regulation of MerTK activity during retinal phagocytosis, which is essential for the circadian rhythm of this function.

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