L’infection du système nerveux central (SNC) par le virus herpès simplex 1 (VHS-1) peut mener au développement d’une encéphalite herpétique qui représente l’infection cérébrale sporadique la plus répandue dans les pays développés. Cette infection dévastatrice a une prévalence de 1/250 000 individus, et atteint un taux de mortalité de 30% malgré l’administration d’un traitement antiviral à base d’acyclovir. De plus, la majorité des patients qui survivent à l’infection conservent des séquelles neurologiques graves et permanentes. Il est suggéré, qu’en plus des dommages causés par la réplication virale, la réponse immunitaire inflammatoire induite par l’infection serait responsable de l’exacerbation de l’encéphalite herpétique. Cette réponse inflammatoire est initiée par les macrophages résidents du SNC, nommés microglies. Dans certains désordres neurologiques, Il est proposé qu’en plus des microglies, les monocytes sanguins pourraient infiltrer le SNC et participer à la réponse immunitaire. Les connaissances concernant le recrutement des monocytes périphériques au SNC et leur rôle dans l’élaboration de la réponse immunitaire durant l’encéphalite herpétique sont très limitées. Une meilleure compréhension des mécanismes impliqués dans cette réponse dirigée contre l’infection du cerveau par le VHS-1 pourrait permettre d’identifier de nouvelles cibles thérapeutiques et mener au développement de nouvelles stratégies combinant des antiviraux et des agents immunomodulateurs pour contrôler à la fois la propagation du virus et l'état inflammatoire dans le SNC. Les travaux présentés dans le cadre de cette thèse s’intéressent à l’implication des monocytes périphériques recrutés au niveau du cerveau dans la réponse immunitaire innée développée dans un modèle murin d’encéphalite herpétique. Pour atteindre nos objectifs, nous avons d’abord utilisé des souris chimériques dont les précurseurs myéloïdes dérivés de la moelle osseuse et les leucocytes sanguins expriment la protéine fluorescente verte (GFP pour «green fluorescent protein»). Ce modèle nous a principalement permis de distinguer les macrophages d’origine hématopoïétique des microglies résidentes du SNC car il n’existe aucun marqueur naturel permettant de différencier ces deux populations cellulaires. Cette stratégie nous a aidé à mieux caractériser la cinétique d’infiltration des monocytes, leur localisation dans le cerveau, et leur participation à la réponse immunitaire suite à l’infection du SNC par le VHS-1. La deuxième partie des travaux porte sur les mécanismes impliqués dans le recrutement de ces monocytes et dans le contrôle de l’état inflammatoire au niveau du SNC durant l’encéphalite herpétique. Plus précisément, les expériences réalisées s’intéressent aux rôles de la signalisation via les récepteurs de chimiokines CCR2 et CX3CR1, exprimés à la surface des monocytes sanguins et des microglies, dans la protection ainsi que dans le recrutement des deux sous-types de monocytes sanguins, soient les monocytes «inflammatoires» et «patrouilleurs», au cours de l’encéphalite herpétique. Nos résultats ont montré pour la première fois que les monocytes sanguins infiltraient le SNC pour donner naissance à des macrophages ayant le même profil que les microglies résidentes et que ces cellules participaient à la réponse immunitaire suite à l’infection par le VHS-1. Nous avons également démontré, en utilisant des souris chimériques ayant des déficiences compartimentées en récepteurs CX3CR1 et CCR2 au niveau du SNC au niveau du système hématopoïétique, que les voies de signalisation via CX3CR1 au niveau des cellules résidentes du cerveau et de CCR2 au niveau des cellules hématopoïétiques étaient importantes pour la survie des souris, pour le contrôle de la réplication virale ainsi que pour contenir la réponse inflammatoire cérébrale durant l’encéphalite herpétique expérimentale. / Herpes simplex virus 1 (HSV-1) is the main cause of sporadic viral encephalitis in developed countries with an annual incidence of 1/250 000 individuals per year. Despite the use of acyclovir that aimed at blocking virus replication, the mortality rate associated with HSV encephalitis (HSE) is still high (i.e., 30%), with the majority of surviving patients developing severe neurological sequelae. It is believed that the high mortality rate and neurological disorders attributable to HSE could involve both virally- and immune-induced damages of the central nervous system (CNS). The inflammatory response is initiated by the resident macrophages of the brain, namely microglia. In addition, blood leukocytes, particularly monocytes, are thought to infiltrate the CNS and contribute to the control of viral infection together with microglia. However, it is also argued that these cells may also amplify the inflammatory response, thereby contributing to brain damages. Knowledge concerning the recruitment of peripheral monocytes to the CNS and their role in the immune response during HSE is limited. A better understanding of the mechanisms involved in their dynamic of recruitment might lead to the identification of new therapeutic targets and the development of new strategies combining antiviral agents and immunomodulatory molecules to better control both HSV replication as well as the inflammatory environment in the CNS. The studies presented in this thesis are intended to better evaluate the involvement of monocytes-derived macrophages, together with microglia, in the cerebral innate immune response during experimental HSE. To achieve our goals, we first used chimeric mice in which bone marrow progenitor cells and blood leukocytes express the green fluorescent protein (GFP). This model allowed us to better characterize the kinetics of infiltration of blood monocytes into the CNS, their distribution in different anatomical areas of the brain and their involvement in the immune response during experimental HSE. The second part of the work focuses on the mechanisms involved in the recruitment of monocytes into the CNS and in the control of the inflammatory state in mouse brain following HSV-1 infection. More precisely, experiments aimed at characterizing the role of signaling pathways through chemokine receptors CCR2 and CX3CR1, expressed on the surface of blood monocytes and microglia, in protecting and modulating the recruitment of the two blood monocytes subtypes, namely the "inflammatory" and "patrolling" monocytes, during HSE. To achieve this aim, we used chimeric mouse models of CCR2- and CX3CR1-deficient animals, in which the lack of either receptor was restricted to the hematopoietic system (blood monocytes) or the CNS (microglia). Our results showed that blood monocytes are recruited to the CNS following HSV-1 infection and give rise to microglia-like macrophages. These cells are involved in the immune response together with microglia by performing immunological functions including phagocytosis and antigen presentation. Furthermore, we showed that CX3CR1 and CCR2 expressed on cells of the CNS and in the hematopoietic system, respectively, are important for mouse survival, viral replication control and in maintaining an appropriate inflammatory response during experimental HSE.

La réaction inflammatoire est un processus complexe et essentiel à la défense de l'hôte contre l'infection et le dommage tissulaire. Le déclenchement de cette réponse s'effectue suite à l'activation des récepteurs «Toll-like» (TLRs) par des motifs moléculaires associés aux pathogènes (PAMPs). Cette activation entraine la sécrétion de médiateurs inflammatoires solubles qui servent à recruter les cellules immunes au site de l'infection. Les neutrophiles sont les leucocytes circulants les plus abondants et sont les premiers arrivés au site inflammatoire/infectieux afin d'éliminer les micro-organismes. Le recrutement du neutrophile est un processus finement régulé qui nécessite d'abord son interaction avec l'endothélium vasculaire pour le franchir et ensuite se rendre au site inflammatoire via un processus appelé chimiotaxie. Au cours de cette dernière décennie, des études ont montré que les nucleotides tels que l'ATP sont relâchés par les cellules activées, lésées et/ou stressées, et tout particulièrement au site inflammatoire où ils agissent comme des signaux de danger ou des motifs moléculaires associés aux dommages (DAMPs). Une fois à la surface des cellules, ils entraînent des réponses immunes via l'activation des récepteurs P2. Durant mes études doctorales, nous avons montré que la relâche et l'action des nucleotides étaient impliquées dans les réponses suscitées par l'activation des TLRs. Plus particulièrement, nous avons mis en évidence un rôle central des nucleotides extracellulaires et de l'activation des récepteurs P2 dans différents mécanismes de contrôle de la migration des neutrophiles en réponse à des PAMPs. Nous avons montré que les nucleotides extracellulaires en activant les récepteurs P2 contrôlent la migration des neutrophiles via la sécrétion de l'interleukine-8 (IL-8) produite par les monocytes humains. Nous avons aussi démontré que la production de l'IL-8 par les monocytes activés par les ligands de TLR2 et TLR4 requiert l'activation concomitante des récepteurs P2 par les nucleotides extracellulaires. De plus, nous avons montré que les nucleotides ne sont pas uniquement impliqués dans la production d'IL-8 mais sont également nécessaires dans la chimiotaxie des neutrophiles induite par l'IL-8. Les études in vitro et in vivo présentées dans ma thèse montrent que les nucleotides extracellulaires contrôlent également la migration transendothéliale des neutrophiles induite par le ligand de TLR4 en agissant sur les cellules endothéliales. Les travaux présentés dans cette thèse contribuent à définir de nouveaux mécanismes utilisés par les nucleotides extracellulaires pour réguler le recrutement des neutrophiles lors de la réponse infectieuse et/ou inflammatoire.

La leishmaniose viscérale est une maladie systémique mortelle en l’absence de traitement. Elle est due aux protozoaires Leishmania donovani et L. infantum, parasites des phagocytes mononucléés, capables d’envahir les organes lymphoïdes et le foie. Le contrôle de l’infection hépatique repose sur la mise en place d’une réponse granulomateuse efficace, promue par une réponse immunitaire Th1, dans un environnement tissulaire Th2. L’objectif de ce travail était l'étude du rôle d’une cytokine Th2 récemment décrite, l’IL-33, dans cette réponse hépatique complexe encore partiellement incomprise. Des dosages d’IL-33 sur des sérums de patients et la détection de cellules IL-33+ dans le foie d’un patient rennais ont placé l’IL-33 comme un biomarqueur possible de la maladie active. L’IL-33 étant exprimée dans les cellules étoilées du foie au cours d’hépatites chroniques, ces cellules ont été exposées à L. donovani. Leur permissivité aux leishmanies sans toxicité apparente ni perturbation de leurs propriétés fonctionnelles, ainsi que la persistance des leishmanies sur une culture de plusieurs semaines, nous ont conduit à proposer les cellules étoilées comme cellules sanctuaires possibles pour les leishmanies viscérotropes, contribuant donc potentiellement au portage asymptomatique. En revanche, elles ne sont pas apparues comme une source majeure d'IL-33 au cours de la leishmaniose viscérale. Chez des souris C57BL/6 et BALB/c infectées par L. donovani, l'IL-33 a été observée dans des cellules ne s'apparentant pas à des cellules étoilées, et principalement localisées dans les granulomes. Des cellules exprimant son récepteur ST2 ayant été également observées dans le foie, un rôle de l’axe IL-33/ST2 a été recherché. Les résultats obtenus chez des souris BALB/c déficientes en ST2 ou traitées par de l'IL-33 recombinante suggèrent que l'IL-33 régule négativement l'expression de cytokines Th1 (IL-12, IFN-γ) et l'infiltrat de neutrophiles et monocytes dans le foie, limitant ainsi le contrôle de la charge parasitaire. Ainsi, l'IL-33 semble être un facteur de susceptibilité pour la leishmaniose viscérale. En parallèle, des travaux entrepris sur des souris C57BL/6 infectées par L. donovani suggèrent de possibles rôles différentiels de l'IL-33 en fonction de l'environnement immunitaire inhérent au fond génétique de l'hôte. / Visceral leishmaniasis is a life-threatening systemic disease caused by Leishmania protozoans, L. donovani and L. infantum, which invade mononuclear phagocytes in the lymphoid organs and the liver. The control of the hepatic parasite burden depends on the granuloma formation, which is favored by a Th1 immune response in a Th2 tissue microenvironment. The aim of this work was to study the role of the recently described Th2 cytokine IL-33 in this complex immune response, which remains partially misunderstood. IL-33 dosages in different patient sera and IL-33+ cells detected in the liver of a patient from Rennes suggested that IL-33 could be a biomarker for active visceral leishmaniasis. As IL-33 was described in hepatic stellate cells during chronic hepatitis, these cells were exposed to L. donovani in primary culture. The cell permissivity to L. donovani and the parasite persistence during a long term culture led us to propose hepatic stellate cells as a new type of sanctuary cells, which could partially explain asymptomatic carriage. However, these cells were apparently not the main source of IL-33 during visceral leishmaniasis. In infected BALB/c and C57BL/6 mice, IL-33 was detected in the liver in non stellate cells preferentially localized in granulomas. The presence of cells expressing its specific receptor ST2 in the liver led us to explore the role of the IL-33/ST2 axis. BALB/c mice deficient in ST2 or treated with recombinant IL-33 and infected with L. donovani revealed that IL-33 downregulates the expression of Th1 key cytokines (IL-12, IFN-γ) and the recruitment of neutrophils and monocytes. Finally, IL-33 acts as a susceptibility factor during visceral leishmaniasis. Besides, the model of L. donovani infected C57BL/6 mice deficient in IL-33 or treated with recombinant IL-33 suggests possible differential roles of IL-33 depending on the immune environment related to the host genetic background.

La majorité des infections par le VIH sont acquises hétérosexuellement surtout chez les femmes en Afrique subsaharienne. Le tractus génital féminin (TGF) est la principale porte d’entrée pour le VIH et joue un rôle important dans la défense de l’organisme. De concert avec les cellules épithéliales, les cellules dendritiques (DC) aident à maintenir une balance immunitaire entre tolérance et inflammation. Dans un groupe de travailleuses du sexe (CSW) à Cotonou, au Bénin, des femmes (CSW ≥ 8 ans) ont été identifiées comme hautement exposées séronégatives (HESN). La fréquence de populations cellulaires myéloïdes de type Monocytes-Derived Dendritic Cells (MoDC) présentant un potentiel antiviral et « tolérogénique/régulateur » est augmentée au niveau du TGF des HESNs et les monocytes pourraient être impliqués dans leur génération. Les résultats de RNA-seq sur les monocytes totaux permettent de constater une augmentation de gènes associés à des fonctions effectrices, de protection/contrôle de l’infection et de régulation chez les HESNs comparé aux contrôles (2,5-5 années CSWs HIV- « early HESN », CSWs HIV+ et des femmes de la population générale Non CSWs HIV-). Les résultats de cytométrie en flux (FACS) démontrent une proportion élevée de non-classiques comparé aux autres sous-populations de monocytes sanguins, exprimant davantage de molécules effectrices et régulatrices, suggérant un lien avec les MoDCs tolérogéniques observées. Cinq individus ont séroconverti et ont présenté des modifications bien avant la séroconversion, soit une diminution de β-chimiokines et des IgG anti-gp41 dans le compartiment sanguin et mucosal du TGF. Un bris du profil « tolérogénique/régulateur » pourrait donc favoriser la séroconversion. / Most HIV infection are acquired through heterosexual intercourse, mostly in women in subsaharian Africa. The female genital tract (FGT) is the principal portal of entry for HIV and plays a critical role in host defense. Together, epithelial cells and dendritic cells (DC) help maintain immunological balance between inflammation and tolerance. In a group of commercial sex worker (CSW) from Cotonou, in Benin, women (CSW 8 ≥ years) have been identified as HIV-1 highly exposed seronegative (HESN). The frequency of myeloid cell populations alike to Monocytes-Derived Dendritic Cells (MoDC) presenting an antiviral potential and a tolerogenic/regulating profile were increased in FGT of HESNs and their monocytes could be implied in their generation. The RNA-seq results on total blood monocytes show an increase expression of genes associated with effector, protection/control of HIV infection and regulation functions in HESNs compared with control groups (2,5-5 years CSWs HIV- « early HESN », CSWs HIV+ and women from general population Non CSWs HIV-). Our flow cytometry (FACS) results show an elevated frequency of non-classical compared with other sub-populations in blood monocytes, expressing more effector and regulator molecules, suggesting a link with observed tolerogenic MoDCs. Moreover, five individuals have seroconverted and presented modifications before seroconversion such as lower levels of β-chemokines and anti-gp41 IgG in blood and mucosal compartments in the FGT. A break of this “tolerogenic/regulating” profile could favor seroconversion.

Since being identified as the cause of AIDS in 1983, HIV-1 infection has reached pandemic proportions. Despite public awareness about prevention, the growing incidence of HIV-1 infection and the limitations of current antiretroviral therapy underscore the imperative need for a vaccine. Understanding the basis of an immune response that controls infection or provides sterilizing immunity remains a major goal in the search for effective vaccines or immunotherapies. Research into correlates of immunity to HIV-1 have largely focused on CD8⁺ T cells or neutralising antibodies (NAbs) but to date these responses have not proved effective in containing viral replication in vaccinees who become infected. Natural killer cells (NKs), monocytes (MCs), and neutrophils (PMNs) are cells of the innate immune system with intrinsic cytotoxic function that can be enhanced by antibodies (Abs) in what is termed antibody-dependent cellular cytotoxicity (ADCC). In my studies I investigated the production of PMNs from human stem cells, the elimination of HIV-1 infected cells by these effector cells, the modulation of cellular cytotoxicity by Ab, and characterized how Abs facilitate a potent ADCC response. I developed a novel flow cytometry assay to measure cytotoxic activity against HIV-1 infected CD4⁺ T cells. Using this, effector cells were shown to have different cytotoxic capacities which were enhanced by Ab. Comparing ADCC mediated by patient serum revealed that higher levels correlated with IgG binding to infected cells. I observed no correlation between serum-mediated ADCC and markers of disease progression including patient status, viral RNA load, CD4⁺ T cell count, or NAb titers. The data presented here have implications for acquisition and control of early HIV-1 infection by NKs, MCs, and PMNs prior to activation of an adaptive immune response, at later stages in the presence of HIV-1-specific Abs, and are relevant to vaccine-induced anti- HIV-1 Ab-based effector mechanisms.

Ein wesentliches Merkmal der Immundepression ist eine Monozytendeaktivierung mit verminderter Antigenpräsentation und Sekretion proinflammatorischer Zytokine. Infolge dessen sind Patienten mit Immundepression besonders anfällig gegenüber Infektionen. Als mögliche Mediatoren werden antiinflammatorische Zytokin wie IL10 und TGF-beta diskutiert, deren immunhemmende Wirkung allerdings nach Ihrem Entfernen schnell reversibel ist. An der Entwicklung einer langanhaltenden Immundepression müssen demnach weitere Mediatoren beteiligt sein. Eine Studie mit Patienten nach Herz-Operationen zeigte eine Korrelation zwischen einer erhöhten Anfälligkeit gegenüber Infektionen und einer Überexpression des Hitzeschockproteins Hämoxygenase-1 (HO-1) in peripheren Blutleukozyten, dem in vielen Studien eine antiinflammatorische und cytoprotektive Wirkung zugeschrieben wird. Eine Porphyrin-induzierte HO-1 Überexpression in humanen Monozyten korreliert mit einer verminderten MHC-II Expression. Allerdings kann eine Hemmung der HO-1-Expression diesen Effekt nicht aufheben, so dass die verwendeten Porphyrine die Antigenpräsentation durch HO-1-unabhängige Mechanismen beeinflussen müssen. Während sich die Hemmung der IFN-Gamma-induzierten MHC-II Expression durch eine gleichzeitig verminderte STAT-1-Phosphorylierung erklären lässt, ist die Porphyrin-induzierte Hemmung der konstitutiven MHC-II-Expression unabhängig von STAT-1. Zudem konnte weder eine Abhängigkeit von STAT-3, noch von einer verstärkten Histonacetylierung oder PKA-Aktivierung gezeigt werden. Die Ergebnisse deuten zudem darauf hin, dass die Porphyrin-Effekte nicht über eine Interaktion mit dem Hämoglobin-Scavenger Rezeptor CD163 induziert werden. Eine Porphyrin-Behandlung von Monozyten in vitro resultiert in einem ähnlichen Phänotyp, wie er in Monozyten von immundepressiven Patienten beobachtet wird, so dass ein verbessertes Wissen über die beeinflussten Signalwege neue Ansätze zur frühzeitigen Behandlung einer Immundepression liefern kann. / A long lasting immunodepression is characterised by a deactivation of the function of monocytes with decreased antigen presentation and decreased secretion of pro-inflammatory cytokines. This may predispose patients with immunodepression to infectious complications. Although anti-inflammatory cytokines as IL-10 and TGF-beta are discussed, the mechanism that induces and sustains this long lasting immunodepression is still incompletely understood. A previous study with patients after cardiac surgery could show a correlation between over expression of heme oxygenase-1 (HO-1) in peripheral blood leukocytes and an increased susceptibility to infection related complications. HO-1 is a stress-inducible heat shock protein with potent anti-inflammatory and cytoprotective properties. A porphyrin-induced HO-1 overexpression in human monocytes correlates with decreased MHC-II expression. However, inhibition of HO-1 expression does not abrogate this effect. According to this, porphyrins must affect the antigen presentation by HO-1-independent mechanisms. While the inhibition of IFN-Gamma-induced MHC-II expression could be explained by a simultaneously decreased STAT-1 phosphorylation, the porphyrin-induced inhibition of the constitutive MHC-II expression is independent of STAT-1. Moreover, neither STAT-3 activity, nor an increased histone acetylation or PKA activation is clearly involved in porphyrin mediated inhibition of MHC-II. The results further suggest that the porphyrin-effects are not induced by an interaction with the hemoglobin scavenger receptor CD163. Nevertheless a porphyrin-treatment of monocytes in vitro results in a similar phenotype, as observed in monocytes from patients with immunodepression. Therefore, better understanding of the involved pathways could reveal new approaches for the early treatment of patients with immunodepression.

As células dendríticas (DCs) são fundamentais no desencadeamento da resposta imune antitumoral. Mas, no microambiente tumoral há condições que impedem esta função imunoestimuladora das DCs. Este comprometimento funcional parece ser fruto da hiperativação de STAT-3. O presente estudo visou avaliar a capacidade de Ta1 de interferir na ativação de STAT-3. Então, monócitos e mo-DCs foram tratados ou não com Ta1 e comparados com o controle, o inibidor de STAT-3, JSI-124. Avaliou-se a expressão de moléculas de superfície e a capacidade de mo-DCs de estimular linfócitos T alogeneicos. Ta1 não interferiu na ativação de STAT-3. Além disso, Ta1 não reproduziu os efeitos encontrados em mo-DCs de pacientes com câncer. Já, o tratamento com JSI-124 levou a alterações nas mo-DCs fazendo com que exibissem perfil infamatório, com aumento de HLA-DR, CD86 e concomitante queda de PD-L1. Além disso, mostramos que STAT-3 está envolvido na expressão de leucointergrinas, uma vez que sua inibição proporcionou queda da expressão em nível proteico e gênico destas moléculas. / Dendritic cells ( DCs ) are critical in triggering antitumor immune response . But there are conditions in the tumor microenvironment that prevent this immunostimulatory function of DCs. This functional impairment appears to be the result of hyperactivation of STAT-3. The present study aimed to evaluate the ability of Ta1 to interfere in the activation of STAT-3. Then, monocytes and mo-DCs were treated or not with Ta1 and compared with the control, the STAT-3 inhibitor, JSI -124. We assessed the expression of surface molecules and the mo-DCs ability in stimulating allogeneic T lymphocytes. Ta1 did not affect the activation of STAT-3. In addition, Ta1 did not reproduce the effects found in mo-DCs from cancer patients. However, JSI -124 treatment led to changes in mo-DCs, that exhibited an inflammatory profile, with an increase of HLA-DR , CD86 and concomitant drop in PD- L1. Furthermore, we have shown that STAT-3 is involved in the expression of leukointergrins, since its inhibition resulted in down-regulation of expression level of this gene and protein molecules.

The system of mononuclear phagocytes includes macrophages that modulate their phenotype based on microenvironmental signals. Their properties vary considerably in a differentiated stage. M1 macrophages, which are classically activated (typically by IFN-γ), are involved in phagocytosis and produce some pro-inflammatory cytokines, that can stimulate other immune cells. A phenotypically different cell population are M2 macrophages, which are alternatively activated by exposure by Th2 cytokines. M2 macrophages produce preferentially anti-inflammatory cytokines IL-10, TGF-β and participate in repair and tissue healing. The main aim of this study was to standardize a model of differentiation of THP-1 cells and human monocytes towards the M2 phenotyp using an in vitro model. This is represented in particular by increased expression of CD163 and CD206 molecules. The second aim was to assess the dynamics of expression (and co-expression) of CD163 and CD206 molecules in monocytes of patients after kidney transplantation. Expression of surface markers was determined by flow cytometry. Both THP-1 cells and human monocytes, isolated from buffy coat fraction, were stimulated by IL-4, TNF-α, TGF-β and IL-10. Changes in CD163 and CD206 expression were measured after day 1, day 3 and day 6 of stimulation. The most...

INTRODUÇÃO: Os receptores Toll-like 2 e 4 (TLR-2 e TLR-4) são capazes de ativar células imunes inatas em resposta a bactérias Gram-positivas e Gram-negativas, respectivamente. Na artrite psoriásica (APs), doença articular inflamatória crônica, fatores genéticos, ambientais e infecciosos parecem estar envolvidos. OBJETIVO: Avaliar as expressões dos receptores: TLR-2; TLR-4; CD114 e do CD116 em monócitos e neutrófilos do sangue periférico de pacientes com APs e adicionalmente a prevalência do HLA-B27. MÉTODOS: Quarenta e cinco pacientes com diagnóstico de APs conforme os critérios CASPAR e 32 indivíduos saudáveis foram estudados. Dentre os 45 pacientes, 27 apresentavam APs ativa (DAS28 > 2,6) e 18 APs inativa (DAS28 < 2,5). A leitura das expressões do TLR-2, TLR-4, CD14, CD66, CD114, CD116 e do HLA-B27 foi realizada por citometria de fluxo no FACSCalibur da marca Becton-Dickson, utilizando anticorpos monoclonais da BD Biosciences, anti-humanos produzidos em murino. Os anticorpos monoclonais (AcMo) para marcar receptores de membrana empregados foram: CD14 conjugado com PerCP-Cy5.5 para marcar população de monócitos; CD66 conjugado com PE e FITC para população de neutrófilos; CD114 para marcar receptor de fator estimulatório de colônias de granulócitos e CD116 para marcar receptor de fator estimulatório de colônia de granulócitos-macrófagos. A análise estatística utilizou o teste U de Mann-Whitney e o teste exato de Fisher. Os valores obtidos em porcentagem foram expressos como média ± intervalo interquartil, de acordo com uma distribuição não-paramétrica, avaliados pelo teste de Shapiro-Wilk. RESULTADOS: Demonstramos aumento de expressão do TLR-2 em monócitos periféricos de pacientes com APs, APs ativa e APs inativa comparados aos controles (p < 0,002; p < 0,001 e p < 0,04, respectivamente). A expressão do TLR-4 foi similar nos pacientes com APs, APs ativa e APs inativa e controles (p < 0,23; p < 0,33 e p < 0,29, respectivamente). A expressão do receptor GCSF (CD114) e do receptor GM-CSF (CD116) foi similar nos pacientes e controles nas populações de monócitos e neutrófilos (p > 0,05). O HLA-B27 foi positivo em 1/3 dos pacientes com APs e 6% dos controles. Nos pacientes HLA-B27+ comparados aos controles HLA-B27+, a porcentagem de expressão do TLR-2 nos monócitos foi significantemente maior (p < 0,004). CONCLUSÃO: O aumento da expressão do TLR-2 em monócitos de pacientes com APs reforça o papel da imunidade inata e sugere que a exposição a bactérias Gram-positivas possa ter um papel na indução da resposta inflamatória nesta doença / INTRODUCTION: Toll-Like receptors 2 and 4 (TLR-2 and TLR-4) are able of activating innate immune cells in response to Gram-positive and Gram-negative bacteria, respectively. In Psoriatic Arthritis (APs), chronic inflammatory joint disease and genetic, environmental and infectious factors seems to be involved. OBJECTIVES: Evaluate expressions of TLR-2; TLR-4; CD114 and CD116 receptors in monocytes and neutrophils from peripheral blood patients with APs and additionally the prevalence of HLA-B27. METHODS: Forty five patients diagnosed with APs according with CASPAR criteria and 32 health individuals were studied. Among the 45 patients, 27 presented active APs (DAS28 > 2,6) and 18 inactive APs (DAS28 < 2,5). The evaluation of the TRL-2, TLR-4, CD14, CD66, CD114, CD116 and HLA-B27 expressions was held by flow cytometry in FACSCalibur from Becton-Dickson, utilizing BD Biosciences\' monoclonal antibodies, anti-human produced in mice. The monoclonal antibodies (AcMo) used to mark membrane receptors were: CD14 in conjunction with PerCP-Cy 5.5 to mark population of monocytes; CD66 in conjunction with PE and FITC for population of neutrophils; CD114 to mark stimulatory factor receptor for granulocyte colonies and CD116 to mark stimulatory factor receptor for granulocyte-macrophage colony. The statistical analysis utilized Mann-Whitney\'s U test and Fisher\'s exact test. The values obtained as percentages were expressed as median ± interquartile range, consistent with a non-parametrical distribution, assessed by Shapiro-Wilk\'s test. RESULTS: Increased expression of TLR-2 in peripheral monocytes of patients with APs, active APs and inactive APs compared to controls (p < 0.002; p < 0.001 and p < 0.04, respectively). TLR-4 expression was similar in patients with APs, active APs and inactive APs and controls (p < 0.23; p < 0.33 and p < 0.29 respectively). The expression of the G-CSF (CCD114) receptor and GM-CSF (CD116) receptor were similar in patients and controls in populations of monocytes and neutrophils (p > 0.05). HLA-B27 was positive in 1/3 of the patients with APs and 6% of the controls. The percentage of expression of TLR-2 in HLA-B27 + patients compared to HLA-B27 + controls was significantly higher (p < 0.004). CONCLUSION: Increased of TLR-2 receptors expression in patients with APs monocytes reinforces the role of innate immunity and suggests that the exposure to Gram-positive bacteria may have a role in the induction of the inflammatory response in this diseases

Resultados anteriores do nosso grupo mostraram que a melatonina (MLT) age em monócitos aumentando sua sensibilidade à IL-4 e, consequentemente, levando estas células a se diferenciarem em células dendríticas - quando in vitro e estimulados com IL-4 e GM-CSF (mo-DCs) com um perfil fenotípico e funcional mais ativado. Outros estudos do nosso grupo mostraram que mo-DCs de pacientes portadoras de câncer apresentam desvios funcionais capazes de comprometer a ativação de linfócitos por este tipo celular. Um outro apontamento de nosso grupo foi para o fato de que, muito provavelmente relacionado a estes desvios, está um comprometimento da via IL-4/STAT-6/SOCS-5, que se mostrou alterada em pacientes com leucemia linfóide crônica. Baseado nestes resultados, o presente trabalho objetivou investigar os efeitos da MLT na diferenciação in vitro de mo-DCs de doadoras saudáveis e de pacientes portadoras de câncer de mama, sob a hipótese de que este hormônio poderia agir na via IL-4/STAT-6/SOCS-5 de modo a gerar mo-DCs com fenótipo e função relacionados à maior ativação. Para tanto, monócitos provenientes do sangue periférico de indivíduos saudáveis e de pacientes foram tratados com MLT (2,5 nM 2 horas) e induzidos à diferenciação em mo-DCs; no quinto dia as células foram ativadas com LPS (100 ng/ml 24 horas). As análises, por citometria de fluxo, do fenótipo e das citocinas ao longo da diferenciação de mo-DCs não apontou efeitos consistentes acerca do tratamento com MLT, mas indicou maior expressão de CD83+ nos monócitos das pacientes (p=0,014) e maior concentração da citocina IL-12p70 no sobrenadante das culturas de mo-DCs destes indivíduos, ao final da diferenciação (p=0,02). Para a análise da capacidade linfoestimuladora das mo-DCs foi realizada co-cultura destas células com linfócitos T (LT) alogeneicos (1 DC: 30 LT) por 5 dias. Não houve diferença na indução de proliferação de LT estimulados por mo-DCs de saudáveis nem de pacientes. A MLT mostrou efeito apenas nas co-culturas com células saudáveis aumentando as concentrações de TNF, IFN-&#947; e IL-2 nos sobrenadantes. Nas co-culturas com células de pacientes sem tratamento, houve maior nível de IL-2 e IL-10, se comparadas com saudáveis. Os monócitos foram também tratados com MLT (2.5 nM) ou IL-4 (50 ng/mL) por 15 minutos, para avaliação da expressão de STAT-6, pSTAT-6 e SOCS-5. Não foi constatado efeito da MLT nesse caso, mas os monócitos de pacientes apresentaram maior expressão de STAT-6, porém menor de pSTAT-6, comparados com saudáveis. Tomados em conjunto, os resultados globais indicam algumas diferenças fenotípicas e funcionais entre monócitos de pacientes e controles, mas não entre suas mo-DCs. Quanto à MLT, os resultados apontam para o fato de que o hormônio gera alterações apenas em células provenientes de indivíduos saudáveis e somente com relação às citocinas encontradas nos sobrenadantes das co-culturas. / Previous studies at our lab have shown that melatonin (MLT) acts on monocytes increasing their sensitivity to Interleukin-4 (IL-4) and, consequently, generating dendritic cells (DCs) when in vitro and treated with IL-4 and GM-CSF (mo-DCs) phenotically and functionally more activated. Other studies from our group have shown that mo-DCs obtained from cancer patients have functional biases capable of compromising the activation of T lymphocytes. Another result from our group pointed to the fact that part of the mo-DCs\' functional bias in cancer patients could be attributed to the decrease in STAT-6 signaling, a pathway that is activated by IL-4 and down regulated by SOCS-5, whose levels, in turn, were found elevated in cancer patients\' monocytes. Based on these results, the present work aimed to investigate the effects of MLT on the in vitro differentiation of healthy donors and breast cancer patients mo-DCs, under the hypothesis that this hormone could act on the IL-4/STAT-6/SOCS-5 axis generating better activated mo-DCs. Peripheral blood monocytes from healthy donors and breast cancer patients were treated with MLT (2,5 nM 2 hours) and induced to differentiate into mo-DCs; on the fifth day cells were activated with LPS (100 ng/ml 24 hours). Flow cytometry analysis of phenotype and cytokines in supernatants during mo-DCs differentiation didnt show MLT effects, but indicated higher frequency of CD83+ (p=0,014) monocytes among mononuclear cells of the patients, when compared with healthy donors. In addition, higher concentration of IL-12p70 was found in mo-DCs cultures (sixth day - p=0,02). The capacity to stimulate allogeneic T lymphocytes was assessed by co-cultures (1DC : 30LT), maintained for 5 days. Results indicate an effect of MLT only in order to increase the TNF, IFN-&#947; and IL-2 concentrations in supernatants of co-cultures with healthy donors mo-DCs. Patients cells showed differences only when there was no hormone treatment, showing higher levels of IL-10 in the co-culture supernatants, when compared to healthy controls. Monocytes were also treated with MLT (2,5 nM) or IL-4 (50 ng/mL) for 15 minutes to evaluate STAT-6, pSTAT-6 and SOCS-5 expression. Results showed an increase of STAT-6 in patients monocytes and a lower capacity of these cells to phosphorylate this molecule, even when in presence of IL-4. Together, the results point to some phenotypic and functional differences between patients and healthy donors monocytes, but it was not shown in their mo-DCs. Results also point to the fact that MLT generates changes only in healthy donors cells and those effects were only seen with cytokines found in cultures supernatants.