Un nombre croissant de preuves suggèrent le rôle bénéfique des anthocyanes alimentaires, composés phyto-chimiques principalement présents dans les baies et les produits dérivés, sur la santé cardiovasculaire. Ces bénéfices peuvent être attribués à leur effet sur les cellules endothéliales ou les plaquettes qui sont les acteurs clés dans le développement des maladies cardiovasculaires (MCV). Cependant, les mécanismes moléculaires sous-jacents aux effets cardio-protecteurs de l'anthocyanine ne sont pas entièrement compris. L'objectif de cette thèse était d'évaluer l'effet in vitro des anthocyanines et de leurs métabolites, dans des conditions physiologiques, sur la fonction endothéliale et plaquettaire et d'identifier les mécanismes sous-jacents à leur action. Les résultats de ma thèse ont montré que le prétraitement des cellules endothéliales avec des concentrations physiologiques d'anthocyanes et de leurs métabolites circulants diminue l'adhésion des monocytes aux cellules endothéliales activées ainsi que leur migration transendothéliale qui sont les étapes initiales du développement de l'athérosclérose précédant le MCV. En accord avec ces résultats, l'analyse de l'expression génique a révélé que le traitement des cellules endothéliales avec ces molécules modulait l'expression des gènes impliqués dans la régulation de l'adhésion cellulaire, le réarrangement du cytosquelette d'actine, l'adhésion focale et la transmigration leucocytaire. Les analyses bioinformatiques de ces données ont permis d'identifier les facteurs de transcription potentiellement impliqués dans les effets nutrigénomiques observés ainsi que les protéines de signalisation cellulaire régulant leur activité. Les analyses bioinformatiques ont permit d’identifier des protéines de signalisation cellulaire auxquelles ces bioactifs peuvent se lier et potentiellement affecter leur activité entraînant modification d’activité des protéines de signalisation en aval. L’impact sur des facteurs de transcription a également été cherché et ces effets ont été confirmés par les résultats obtenus des analyses par Western blot. Les anthocyanines et leurs métabolites ont également modulé l'expression de microARN, en particulier ceux impliqués dans la régulation de la perméabilité des cellules endothéliales, contribuant ainsi aux changements observés dans la fonction endothéliale. En plus de leurs effets sur les cellules endothéliales, les résultats de mes travaux ont également montré la capacité des anthocyanes et de leurs métabolites à moduler la fonction plaquettaire en diminuant l'activation plaquettaire et leur agrégation avec les leucocytes, qui contribuent fortement au développement des MCV.En conclusion, les résultats de ma thèse ont révélé les effets positifs des anthocyanes et de leurs métabolites, aux concentrations physiologiques, sur la fonction endothéliale et plaquettaire et ont fourni de nouvelles informations sur les mécanismes sous-jacents de leurs effets cardio-protecteurs. / Increasing number of scientific evidence suggests the beneficial role of dietary anthocyanins, phytochemicals mainly present in berries and derived products, in cardiovascular health. These anthocyanin health benefits may be attributed to their effect on endothelial cells or platelets that represent the key players in the development of cardiovascular diseases (CVD). However, the exact molecular mechanisms underlying anthocyanin cardioprotective effects are not fully understood. The aim of this thesis was to investigate the effect of anthocyanins and their metabolites in vitro on endothelial and platelet function and identify the underlying mechanisms of their action using physiologically relevant conditions.Results from this thesis showed that the pretreatment of endothelial cells with physiologically relevant concentrations of circulating anthocyanins and their metabolites attenuated monocyte adhesion to activated endothelial cells as well as their transendothelial migration, which are the initial steps in the development of atherosclerosis that precede CVD. In agreement with these results, gene expression analysis revealed that the treatment of endothelial cells with these compounds modulated the expression of genes involved in regulation of cell-cell adhesion, actin cytoskeleton reorganisation, focal adhesion and leukocyte transmigration. Bioinformatics analyses of gene expression data allowed the identification of potential transcription factors involved in the observed nutrigenomic effects and cell signalling proteins regulating their activity.Molecular docking analyses further revealed cell signalling proteins to which these bioactives may bind to and potentially affect their activity and the activation of downstream signalling proteins and transcription factors, effects that were in agreement with the results of Western blot analyses. Anthocyanins and their metabolites also modulated the expression of microRNAs, especially those involved in regulation of endothelial cell permeability, contributing to the observed changes in endothelial cell function.In addition to their effects on endothelial cells, anthocyanins and their metabolites displayed the capacity to modulate platelet function by decreasing platelet activation and their aggregation with leukocytes, the processes that are important contributors to CVD development.In conclusion, results from this thesis revealed the positive effects of anthocyanins and their metabolites, at physiologically relevant concentrations, on endothelial and platelet function and provided new insights into the mechanisms underlying their cardioprotective effects.

The successful regeneration of muscle tissue is dependent upon the infiltration of phagocytic CD14++CD16- monocytes that support the proliferation and differentiation of myogenic precursor cells. Physiologically, the magnitude of the cellular response following resistance exercise is dictated by the level of receptor expression on the plasma membrane of the monocyte, as well as the secretion of their cognate ligands from tissue resident cells. However, it remains unclear whether the innate pro-inflammatory immune response varies with different resistance training protocols, and how it may impact recovery and the muscle remodeling process. Therefore, the purpose of this investigation was to examine temporal changes in the expression of chemotactic and adhesion receptors following an acute bout of high-volume, moderate-intensity (VOL) versus high-intensity, low-volume (HVY) lower-body resistance exercise in experienced, resistance trained men. Changes in receptor expression were assessed in conjunction with plasma concentrations of MCP-1, TNF?, and cortisol. Ten resistance-trained men (90.1 ± 11.3 kg; 176.0 ± 4.9 cm; 24.7 ± 3.4 yrs; 14.1 ± 6.1% body fat) performed each resistance exercise protocol in a random, counterbalanced order. Blood samples were obtained at baseline (BL), immediately (IP), 30 minutes (30P), 1 hour (1H), 2 hours (2H), and 5 hours (5H) post-exercise. Analysis of target receptor expression on CD14++CD16- monocytes was completed at BL, IP, 1H, 2H and 5H time points via flow cytometric analysis. Plasma concentrations of myoglobin, and LDH AUC were significantly greater following HVY compared to VOL (p = 0.003 and p = 0.010 respectively). Changes in plasma TNF?, MCP-1, and expression of CCR2, CD11b, and GCR on CD14++CD16- monocytes were similar following HVY and VOL. When collapsed across groups, TNF? was significantly increased at IP, 30P, 1H and 2H post-exercise (p = 0.001 – 0.004), while MCP-1 was significantly elevated at all post-exercise time points (p = 0.002 – 0.033). CCR2 expression was significantly lower at IP, 1H, 2H and 5H post-exercise (p = 0.020 – 0.040). In contrast, CD11b receptor expression was significantly greater at 1H relative to BL (p = 0.001), while GCR expression was not significantly different from baseline at any time point. As expected, plasma cortisol concentrations were significantly higher following VOL compared to HVY (p = 0.001), although this did not appear to be related to changes in receptor expression. Plasma testosterone concentrations and TNFr1 receptor expression did not appear to be affected by resistance exercise. Our results do not support a role for cortisol in the modulation of CCR2 receptors in vivo, while the degree of muscle damage does not appear to influence plasma concentrations of TNF?, or MCP-1. It is therefore likely that both HVY and VOL protocols constitute an exercise stimulus that is sufficient enough to promote a robust pro-inflammatory response, which is similar in timing and magnitude.

IL-12 family cytokines IL-23 and IL-27 play an important role linking innate and adaptive immunity, and regulating T-cell responses. The production of IL-12, a structurally similar cytokine, is decreased in chronic HIV infection; therefore IL-23 and IL-27 may also be influenced by HIV infection. I hypothesized that HIV inhibits LPS-induced IL-23 and IL-27 production in human MDMs by suppressing the activation of signalling pathways regulating their expression. In vitro HIV-infection of MDMs did not have any effect on basal secretion of IL-23 or IL-27; however, HIV inhibited LPS-induced production of IL-12/23 p40 and IL-23 p19, and IL-27 EBI3 and IL-27 p28 mRNA expression, and IL-23, IL-12/23 p40 and IL-27 secretion. In order to evaluate the molecular mechanisms by which HIV inhibits IL-23 and IL-27 in LPS-stimulated MDMs, the signalling pathways regulating their expression were evaluated. The PI3K, p38 MAPK, and JNK MAPK pathways were found to positively regulate LPS-induced IL-27 secretion. Interestingly, in vitro HIV infection inhibited LPS-induced p38 and JNK MAPK activation in MDMs. In summary, I have shown that HIV inhibits IL-23 and IL-27 production in LPS-stimulated MDMs and that HIV may inhibit LPS-induced IL-27 production through the inhibition of p38 and JNK MAPK activation. It is currently unknown whether PKCs regulate LPS-induced IL-23 or IL-27 in human monocytes/macrophages. I demonstrated that classical PKCs differentially regulate LPS-induced IL-23 and IL-27 secretion within THP-1 cells, primary monocytes, and MDMs. Classical PKCs were found to positively regulate LPS-induced IL-12/23 p40 and IL-27 p28 mRNA expression and IL-12/23 p40, IL-23, and IL-27 secretion in primary human monocytes. Similarly, the classical PKCs were found to positively regulate IL-27 p28 mRNA expression and IL-27 secretion in THP-1 cells. However, classical PKCs did not regulate LPS-induced IL-27 production in MDMs, or LPS-induced IL-23 production in THP-1 cells. Overall, this demonstrates that classical PKCs differentially regulate LPS-induced IL-23 and IL-27 production in different myeloid cells.

Introdução: A nefrite lúpica (NL) é o maior preditor de morbidade e mortalidade em pacientes portadores de lupus eritematoso sistêmico. Recentes estudos mostram que a proteína quimiotática de monócitos (MCP-1) está implicada na ativação de células inflamatórias, afetando a progressão e a severidade da NL, e que a excreção urinária do MCP-1 (uMCP-1) está aumentada em pacientes com NL em atividade. Na literatura os dados sobre o polimorfismo do gene MCP-1 A(-2518)G e do seu receptor CCR2 V(-64)I sobre a susceptibilidade para nefrite lúpica ainda estão em discussão. Objetivos: Avaliar a associação entre o polimorfismo do gene MCP-1 e do seu receptor CCR2 em pacientes com NL e indivíduos saudáveis, além da associação de ambos os polimorfismos com parâmetros clínicos e histológicos nos pacientes portadores de NL. Além disso, avaliar a associação entre a excreção urinária do MCP-1 em pacientes portadores de nefrite lúpica em atividade com parâmetros clínicos e histológicos. Pacientes e Métodos: As genotipagens do MCP-1 e do CCR2 foram realizadas em 197 pacientes com nefrite lúpica através da extração do DNA genômico, seguido da técnica de reação em cadeia da polimerase, utilizando-se primers específicos. A dosagem urinária do MCP-1 foi realizada em 34 pacientes com nefrite lúpica em atividade através da técnica de ELISA. Resultados: Foram estudados 197 pacientes portadores de nefrite lúpica, do sexo feminino, com idade média de 28±9,8 anos, sendo 65,5% de etnia branca e 34,5% não-branca, acompanhados em nosso ambulatório durante o período de 69±37,1 meses. Como grupo controle, utilizou-se um grupo de 220 indivíduos saudáveis do sexo feminino, pareados de acordo com idade e etnia. Quanto à distribuição do genótipo do MCP-1, evidenciou-se que a freqüência do genótipo GG foi significativamente maior nos pacientes portadores de nefrite lúpica quando comparado ao grupo controle (12,7%x5,0%) (p=0,019), enquanto que o genótipo AA apresentou maior freqüência no grupo controle, porém sem significância estatística (48,7%x56,8%). Com relação aos alelos, a freqüência do alelo A foi significativamente maior no grupo controle (75,9%x68%) (p=0,007) quando comparada aos pacientes com NL. Já em relação ao polimorfismo do CCR2, não foi observada nenhuma diferença na freqüência do genótipo entre os dois grupos, porém foi observada maior freqüência do alelo V no grupo controle (89,8%x86,3%) (p=0,046). Não houve associação entre o genótipo e alelos do MCP-1 e do CCR2 com a função renal no início e no final do estudo, marcadores imunológicos, manifestações clínicas (SLEDAI) e a classe histológica. Porém, observou-se um predomínio significante dos flares moderado e grave nos pacientes portadores dos genótipos AA e AG (p< 0,05) em relação ao genótipo GG, enquanto que, em relação à distribuição alélica do MCP-1 e ao CCR2, não se notou diferença estatística. Não se evidenciou diferença estatística entre as curvas de sobrevida renal funcional dos pacientes portadores de nefrite lúpica e os genótipos do MCP-1 e CCR2 e seus respectivos alelos. Notou-se diferença estatística na variação da creatinina sérica ao longo do seguimento (p<0,001). Foram também estudados 34 pacientes portadores de nefrite lúpica em atividade, do sexo feminino, com idade média de 28,4 ± 9,9 anos, sendo 26,5% pacientes de etnia branca e 73,5% de etnia não-branca. A dosagem do MCP-1 urinário foi realizada no início do quadro e após 3 e 6 meses de seguimento. Em relação ao uMCP-1, houve um aumento significante do mesmo no início do quadro renal quando comparado com 3 e 6 meses de tratamento (p<0,05). Evidenciou-se um aumento do uMCP-1 nos pacientes que apresentavam creatinina plasmática inicial > 1,2mg/dl (p<0,05), porém não houve associação entre uMCP-1 e a creatinina após 6 meses de tratamento. Não se observou associação entre os níveis de uMCP-1 com as manifestações clínicas (SLEDAI), classe histológica e marcadores imunológicos, exceto quanto ao anticorpo antifosfolípide, pois houve excreção aumentada do uMCP-1 em pacientes com anticorpo antifosfolípide positivo no início do quadro (p<0,05). Notou-se valores elevados do uMCP-1 nos pacientes que apresentaram flares grave e moderado em relação ao flare leve (p<0,05). Quanto à distribuição genotípica do MCP-1 em relação ao uMCP-1, foi observado uma associação do uMCP-1 em pacientes portadores dos genótipos AG e AA quando comparados ao genótipo GG (p<0,05). Já em relação à distribuição genotípica e alélica do CCR2, não se notou nenhuma diferença na freqüência dos mesmos e a dosagem de uMCP-1. Conclusões: Houve uma significante associação do genótipo GG do polimorfismo do MCP-1 em pacientes portadoras de NL na população estudada, além de uma associação entre os níveis do uMCP-1 com a severidade do flare renal e a função renal nas pacientes portadoras de NL. / Introduction: Lupus Nephritis (LN) contributes substantially to morbidity and mortality in patients with systemic lupus erythematosus. Literature data show monocyte chemoattractant protein (MCP-1) is implicated in the activation of inflamatory cells and has been suggested to affect the progression and severity of lupus nephritis and urinary MCP-1 levels (uMCP-1) are increased in LN patients during active renal disease. Literature data about genotype polymorphism of MCP-1 A(-2518)G and of its receptor CCR2 V(-64)I and susceptibility to LN is still open to discussion. Objectives: The aim of our protocol was to study association of the genotype polymorphism of MCP-1 and CCR2 with LN compared to a healthy matched population and study association these polymorphisms with clinical and histological parameters in LN patients. Moreover, investigate the relationship of uMCP-1 on the onset, severity and resolution of LN flare. Patients and Methods: Genomic DNA was extracted from peripheral leukocytes from 197 LN patients and MCP-1 and CCR2 genomic variants were detected by polymerase chain reaction followed by restriction enzyme-fragment analysis. uMCP-1 levels were mesured by enzyme-linked immunosorbent assay from 34 LN flare patients. Results: One hundred and ninety seven (197) female patients with histological diagnosis de LN undergoing follow up in our institution and 220 ethnically matched healthy controls were enrolled in this study. Epidemiological characteristics of the LN group were: age 28±9.8 years, race 65.5% of caucasians and 34.5% of Brazilian afro-south-latins. Baseline values were collected at the onset of LN and final values in their last follow up (69±37.1 months). There was a significant association of the GG genotype polymorphism of MCP-1 with LN patients compared to controls (12.7%x5.0%) (p=0.019), while the allele A distribuition was associated with healthy controls (75.9%x68%) (p=0.007). Considering CCR2 -64 V/I polymorphism genotype there was a association of the allele V with the control group compared to LN (89.8%x86.3%) (p=0.046). Analyzing genotype polymorphism of MCP-1 and CCR2 there werent correlation with renal function, immunological markers, clinical manifestations (SLEDAI) or histological classes of LN. There was a significant association of the AA and AG genotypes polymorphism of MCP-1 with moderate and severe renal flares compared to GG genotype polymorphism of MCP-1 (p< 0.05). Kaplan-Meier analysis of the renal survival curves with respect to the studied genotypes did not show any influence in the progression of renal disease. There was a significant association of the creatinine onset and on follow up (p<0.001). Thrity four (34) female patients with criteria for active LN and histological diagnosis were enrolled and treated for six months. Each patient was evaluated once a month and uMCP-1 bimonthly. Epidemiological characteristics of the group showed: age 28.4±9.9 years and race 26.5% caucasians and 73.5% Brazilian afro-south-latins. uMCP-1 excretion at onset (T0) of LN was significantly increased when compared to uMCP-1 measured on the third (T3) and sixth months (T6) (p<0.05). Analyzing uMCP-1 values on T0 there was a correlation with creatinine (p<0,05), but not with, clinical manifestations histological classes of LN or immunological markers, except in patients with positive antiphospholipid autoantibodies demonstrated increased of uMCP-1 (p<0.05). Otherwise, uMCP-1 levels were associated with seriousness of nephritis flares, severe and moderate over mild (p<0.05). Considering MCP-1 polymorphism genotype there was association of the AA and AG genotypes with increased uMCP-1 in patients with active renal disease (p<0.05). Conclusions: There is a significant association of the GG genotype of MCP-1 -2518 A/G polymorphism with LN in our population. uMCP-1 levels in LN is associated with flare seriousness and renal function.

Seit vielen Jahren werden Glukokortikoide routinemäßig eingesetzt, um Zeichen der inflammatorischen Reaktion nach kardiochirurgischen Eingriffen unter extrakorporaler Zirkulation (EKZ) zu mildern. Glukokortikoide sind jedoch für ihre immunsuppressiven Wirkungen bekannt, und bisher blieben die möglichen Auswirkungen auf immunologische Funktionen weitgehend hypothetisch. Ziel der vorliegenden Studie war es daher, den Einfluss von Methylprednisolon (MP) und Tirilazad Mesylat (TM), einer antiinflammatorischen Substanz aus der Klasse der Aminosteroide auf immunologische Funktionen nach koronarchirurgischen Eingriffen mit EKZ zu untersuchen. 38 Patienten wurden randomisiert den Behandlungsgruppen Placebo (NaCl 0,9 %, n=13), MP (15 mg/ kg KG, n=12) und TM (10 mg/kg KG, n=13) zugeteilt. Die Verläufe der Plasmakonzentrationen von IL-6 und IL-10, der monozytären HLA-DR Expression und der ex vivo LPS-stimulierten TNF-alpha, IL-1RA, IFN-gamma und IL-12 Sekretion wurden bestimmt. Im Vergleich zu Placebo resultierte die Gabe von MP in geringeren postoperativen Plasmakonzentrationen von IL-6, aber einer deutlichen Erhöhung von IL-10. Die monozytäre HLA-DR Expression nahm postoperativ in allen Gruppen ab mit einer deutlichen Verstärkung durch MP. Die ex vivo stimulierte TNF-alpha Sekretion nahm postoperativ in allen Gruppen deutlich ab, ebenfalls mit einer deutlichen Verstärkung durch MP. Die IL-1RA Sekretion hingegen war zu keinem Zeitpunkt eingeschränkt. Die ex vivo stimulierte IFN-gamma und IL-12 war postoperativ in allen Gruppen stark vermindert ohne Einfluss einer medikamentösen Behandlung. Die Gabe von TM zeigte keinerlei Beeinflussung aller gemessenen Parameter im Vergleich zu Placebo. Nach koronarchirurgischen Eingriffen sind insbesondere monozytäre Funktionen stark eingeschränkt. Diese Suppression wird durch die Gabe von MP verstärkt, während die Gabe von TM nicht in einer zusätzlichen Immunsuppression resultiert. IL-10 scheint eine Schlüsselrolle bei der beobachteten monozytären Funktionseinschränkung einzunehmen. / Glucocorticoids have been routinely applied in cardiac surgery involving cardiopulmonary bypass (CPB) for many years in order to diminish inflammatory stress reactions. On the other hand glucocorticoids are well known for their immunosuppressive effects, and data on the consequences on immune function are scarce. Thus it was the aim of this trial to determine the influence of methylprednisolone (MP) and tirilazad mesylate (TM), an antiinflammatory drug of the class of aminosteroids, on immunological parameters after coronary surgery involving CPB. 38 patients were randomised to receive either placebo (NaCl 0.9 %, n=13), MP (15 mg/kg, n=12) or TM (10 mg/kg, n=13) treatment. Plasma concentrations of IL-6 and IL-10, monocyte surface expression of HLA-DR and the ex vivo endotoxin-stimulated secretion of TNF-alpha, IL-1RA, IFN-gamma und IL-12 were measured. Compared to placebo IL-6 concentrations were lower after MP treatment, whereas IL-10 levels were much higher. The rate of HLA-DR+-monocytes decreased in all groups with a significant aggravation by MP treatment. The ex vivo stimulated TNF-alpha secretion was postoperatively diminished in all groups, with again significantly lower values after MP treatment. IL-1RA secretion was not suppressed at any point. The ex vivo stimulated IFN-gamma and IL-12 secretion was strongly suppressed postoperatively regardless of the treatment. TM treatment resulted in no alterations of any parameter measured. It was demonstrated that especially monocyte functions are depressed after coronary surgery, and that MP treatment results in marked aggravation of this immunosuppression, whereas TM treatment shows no additional immunosuppressive effect. IL-10 seems to play a key role in the observed monocyte functional depression.

Os venenos de serpentes contêm concentrações elevadas de fosfolipases A2 secretadas (sFLA2), que apresentam homologia com as FLA2s de mamíferos, cujos níveis estão aumentados em doenças inflamatórias. Neste estudo, investigou-se a ativação e a expressão de fatores envolvidos na formação de corpúsculos lipídicos (CLs) em células fagociticas e o papel desses fatores na resposta imune inata, induzida pela MT-III, uma sFLA2s de veneno. A MT-III induziu aumento dos níveis de triacilglicerol, colesterol e lisofosfolipideos e a ativação e expressão dos fatores PPAR-g, PPAR-d/b, SREBP2 e do CD36. Sob estimulo da MT-III, o receptor PPAR-b/d, as enzimas DGAT, ACAT e FAS foram relevantes para a formação de CLs e para a expressão da PLIN2. O CD36 participa da expressão da COX-2, sem modificar a liberação de PGE2. O TLR2 e a MyD88 foram essenciais para a formação de CLs e síntese da IL-1b e IL-10. Ainda, o TLR2 foi relevante para a liberação de PGE2, PGD2 e LTB4, enquanto MyD88 foi fundamental somente para a liberação de PGE2 e expressão da PLIN2, induzidas pela MT-III. / Snake venoms contain high concentrations of secreted phospholipase A2 (sPLA2) with homology to mammalian PLA2s, whose levels are elevated in inflammatory diseases. In this study, we investigated activation and expression of factors involved in lipid droplets formation (LDs) and participation that factors in the innate immune response induced by MT-III, sPLA2s from snake venom, in phagocytic cells. MT-III induced increase of triacylglycerol, cholesterol and lysophospholipids levels and activation and expression of factors PPAR-g, PPAR-d/b, SREBP2 and CD36. PPAR-b/d receptor, DGAT, ACAT and FAS enzymes were relevant to LDs formation and critical to PLIN2 expression induced by MT-III. CD36 participates in COX-2 expression without modifying PGE2 release stimulated by MT-III. TLR2 and MyD88 were essential to LDs formation and IL-1b and IL-10 synthesis stimulated by MT-III. Moreover, TLR2 was relevant to PGE2, PGD2 and LTB4 biosynthesis, while MyD88 is essential only for PGE2 release and PLIN2 expression induced by MT-III.

This dissertation represents efforts to determine the functional consequences acquired by vascular smooth muscle cells (SMC) in response to CD40 ligation by activated CD154+ T cells, and to elucidate components of the signaling pathway(s) activated in response to CD40 signaling in both monocytes and SMC. To study the consequences of CD40 stimulation, primary human monocytes and aortic SMC were treated with plasma membranes purified from CD154 + , CD4+ T cells. The results presented in this dissertation demonstrate that SMC, like monocytes/macrophages, are capable of interacting with T cells in a manner that results in reciprocal activation events. SMC were shown to present antigen to, and activate T cells. In turn T cell stimulus resulted in the activation of proinflammatory function in SMC initiated through the CD154:CD40 interaction. CD40 stimulation of SMC resulted in the production of the chemokines interleukin 8 (IL-8) and macrophage chemotactic protein-1 (MCP-1), and the upregulation of intercellular adhesion molecule (ICAM). Examination of the intracellular signaling pathways activated through CD40 signaling revealed the involvement of MAPKs in the pathway leading to induction of proinflammatory activity. Evaluation of CD40 signaling in monocytes demonstrated the activation of the MAPK family members ERK1/2, but not the MAPK family members p38 or c-jun-N-terminal kinase (JNK). In contrast, CD40 signaling in SMC was shown to result in ERK1/2 and p38 activation, and both of these kinases were shown to play a critical role in the induction of chemokine synthesis. An examination of the ability of anti-inflammatory cytokines to modulate CD40 signaling in monocytes and SMC demonstrated that the anti-inflammatory cytokines IL-4 and IL-10 abrogate CD40-mediated induction of inflammatory cytokine production by monocytes. This inhibition was shown to be a result of a negative influence of IL-4 and IL-10 on CD40 mediated ERK1/2, activation in monocytes. However, IL-4 and IL-10 did not inhibit SMC proinflammatory responses indicating a difference in the intracellular responses to these cytokines by the two cell types. (Abstract shortened by UMI.)

<p>In the present studies, aspects of some disease activity measures in rheumatoid arthritis (RA) have been investigated, including the effect of glucocorticoids on this activity. In RA, serum interleukin(IL)-6 levels were elevated and were shown to have a circadian rhythm, with peak levels in the morning, declining towards low or normal levels in the afternoon and evening. In contrast, serum levels of tumour necrosis factor(TNF) alpha were low and stable. In other connective tissue diseases, serum TNF alpha levels were elevated but without circadian variation, while IL-6 levels were low and stable. Nocturnal administration (at 2:00 a.m.) of low-dose prednisolone a few hours before the early morning peak of IL-6 was shown to be significantly more effective in reducing clinical symptoms of disease activity and serum IL-6 levels than the traditional morning administration (at 7:30 a.m.) of the same dose of prednisolone. Circulating monocytes are activated in RA, expressing receptors related to adhesion and phagocytosis. Treatment with glucocorticoids suppressed the expression of these receptors on monocytes, and this may be one mechanism of the beneficial effect of glucocorticoids in RA. Endogenous levels of cortisol seem to play a minor role in expression of monocyte receptors. The different acute phase markers used to assess disease activity in RA showed good corrrelations with each other and with serum IL-6 levels. There were especially strong corrrelations between C-reactive protein (CRP) and Serum amyloid protein A (SAA), and between fibrinogen and erythrocyte sedimentation rate (ESR). Fibrinogen and CRP showed stronger correlation than ESR with the Modified Health Assessment Questionnaire (MHAQ) score and with the neutrophil count. Four simple objective function tests were each compared with the HAQ score a with a radiological joint damage score (Larsen score). The objective function tests correlated with the MHAQ score, and each of these two methods of assessing physical disability correlated with pain, CRP and ESR. In addition, most of the objective function tests correlated significantly with radiological joint damage, while the MHAQ score did not.</p>

In the present studies, aspects of some disease activity measures in rheumatoid arthritis (RA) have been investigated, including the effect of glucocorticoids on this activity. In RA, serum interleukin(IL)-6 levels were elevated and were shown to have a circadian rhythm, with peak levels in the morning, declining towards low or normal levels in the afternoon and evening. In contrast, serum levels of tumour necrosis factor(TNF) alpha were low and stable. In other connective tissue diseases, serum TNF alpha levels were elevated but without circadian variation, while IL-6 levels were low and stable. Nocturnal administration (at 2:00 a.m.) of low-dose prednisolone a few hours before the early morning peak of IL-6 was shown to be significantly more effective in reducing clinical symptoms of disease activity and serum IL-6 levels than the traditional morning administration (at 7:30 a.m.) of the same dose of prednisolone. Circulating monocytes are activated in RA, expressing receptors related to adhesion and phagocytosis. Treatment with glucocorticoids suppressed the expression of these receptors on monocytes, and this may be one mechanism of the beneficial effect of glucocorticoids in RA. Endogenous levels of cortisol seem to play a minor role in expression of monocyte receptors. The different acute phase markers used to assess disease activity in RA showed good corrrelations with each other and with serum IL-6 levels. There were especially strong corrrelations between C-reactive protein (CRP) and Serum amyloid protein A (SAA), and between fibrinogen and erythrocyte sedimentation rate (ESR). Fibrinogen and CRP showed stronger correlation than ESR with the Modified Health Assessment Questionnaire (MHAQ) score and with the neutrophil count. Four simple objective function tests were each compared with the HAQ score a with a radiological joint damage score (Larsen score). The objective function tests correlated with the MHAQ score, and each of these two methods of assessing physical disability correlated with pain, CRP and ESR. In addition, most of the objective function tests correlated significantly with radiological joint damage, while the MHAQ score did not.

IL-12 family cytokines IL-23 and IL-27 play an important role linking innate and adaptive immunity, and regulating T-cell responses. The production of IL-12, a structurally similar cytokine, is decreased in chronic HIV infection; therefore IL-23 and IL-27 may also be influenced by HIV infection. I hypothesized that HIV inhibits LPS-induced IL-23 and IL-27 production in human MDMs by suppressing the activation of signalling pathways regulating their expression. In vitro HIV-infection of MDMs did not have any effect on basal secretion of IL-23 or IL-27; however, HIV inhibited LPS-induced production of IL-12/23 p40 and IL-23 p19, and IL-27 EBI3 and IL-27 p28 mRNA expression, and IL-23, IL-12/23 p40 and IL-27 secretion. In order to evaluate the molecular mechanisms by which HIV inhibits IL-23 and IL-27 in LPS-stimulated MDMs, the signalling pathways regulating their expression were evaluated. The PI3K, p38 MAPK, and JNK MAPK pathways were found to positively regulate LPS-induced IL-27 secretion. Interestingly, in vitro HIV infection inhibited LPS-induced p38 and JNK MAPK activation in MDMs. In summary, I have shown that HIV inhibits IL-23 and IL-27 production in LPS-stimulated MDMs and that HIV may inhibit LPS-induced IL-27 production through the inhibition of p38 and JNK MAPK activation. It is currently unknown whether PKCs regulate LPS-induced IL-23 or IL-27 in human monocytes/macrophages. I demonstrated that classical PKCs differentially regulate LPS-induced IL-23 and IL-27 secretion within THP-1 cells, primary monocytes, and MDMs. Classical PKCs were found to positively regulate LPS-induced IL-12/23 p40 and IL-27 p28 mRNA expression and IL-12/23 p40, IL-23, and IL-27 secretion in primary human monocytes. Similarly, the classical PKCs were found to positively regulate IL-27 p28 mRNA expression and IL-27 secretion in THP-1 cells. However, classical PKCs did not regulate LPS-induced IL-27 production in MDMs, or LPS-induced IL-23 production in THP-1 cells. Overall, this demonstrates that classical PKCs differentially regulate LPS-induced IL-23 and IL-27 production in different myeloid cells.