Localized Aggressive Periodontitis (LAgP) is an aggressive, early onset form of periodontitis characterized by a unique myeloid cell phenotype. In addition to its bacterial origin, the unique phenotype of the myeloid cell contributes to disease pathogenesis and progression through mechanisms mediating host inflammatory and immune responses. LAgP monocytes synthesize increased levels of the potent proinflammatory lipid mediator, Prostaglandin E2 (PGE2), preferentially differentiate into dendritic cells, and lead to increased IgG2 production. In addition, levels of Platelet Activating Factor (PAF) have shown to be elevated in the gingival tissue and gingival crevicular fluid of subjects with periodontitis. The aim of this study was to further characterize the unique phenotype of the myeloid cell by investigating its role in the increased levels of PAF in periodontitis subjects, examining differences in gene expression of the immune response gene, STATl which is involved in IFN-γ signaling, and by examining the differential expression and function of the scavenger receptor CD36. LAgP monocytes have exhibited decreased activity of the PAF-acetylhydrolase (PAFAH), the catalytic enzyme that breaks down PAF. Since PAF levels are regulated by synthesis and degradation, we hypothesized that synthesis by myeloid cells, monocytes or PMN, also contribute to the increased PAF levels in LAgP. We also hypothesized, based on initial microarray data that myeloid cells have decreased gene expression of STATl and downstream IFNy related genes in LAgP. In addition, based on the initial microarray results, we hypothesized that LAgP monocytes have increased CD36 expression with increased capacity for the binding and uptake of chemically modified versions of LDL. Monocytes were isolated from the peripheral blood of LAgP and NP control subjects over a Ficoll gradient. A radiolabeled PAF assay was used to quantify total PAF synthesis in both resting monocytes and PMN, and in monocytes and PMN stimulated with calcium ionophore A23 187. Quantitative RT-PCR was used to quantify STATl and CD36 gene expression from RNA isolated from adherent monocytes, and CD36 expression and AcLDL (acetylated LDL) uptake was quantified using flow cytometry. Our results indicate that PAF synthesis is increased in LAgP PMN but not in monocytes. LAgP monocytes synthesize less PAF compared to NP control, and their response to calcium ionophore A23 187 (IoA), expressed as fold increase, was blunted. LAgP and NP monocytes did not differ in STATl gene expression as determined by quantitative RT-PCR, and CD36 experiments suggest the possibility that dendritic cells express increased scavenger receptor CD36 than macrophage cells. In conclusion, LAgP myeloid cells are unique in their response to A23 187, and LAgP PMN contribute to increased PAF primarily through synthesis, whereas the LAgP monocytes contributes to elevated PAF through decreased catabolism. STAT1 gene expression did not differ between LAgP and NP monocytes, however this does not rule out the possibility of differential STATl signaling in LAgP monocytes though inhibitory proteins or differential phosphorylation of STATl. Finally, CD36 expression appears from preliminary data to be increased in dendritic cells. These findings add to the current understanding of the unique phenotype of the LAgP monoctye and further experiments will continue to expand our understanding of how unique biology of myeloid cells and their ability to facilitate crosstalk between the innate and adaptive immune system, and the host inflammatory system.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22740号 / 医博第4658号 / 新制||医||1046(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 羽賀 博典, 教授 髙折 晃史, 教授 伊藤 貴浩 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18127号 / 医博第3847号 / 新制||医||1001(附属図書館) / 30985 / 京都大学大学院医学研究科医学専攻 / (主査)教授 千葉 勉, 教授 松田 道行, 教授 野田 亮 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

Myeloid precursor cell reprogramming into a myeloid-derived suppressor cell (MDSC) contributes to high mortality rates in mouse and human sepsis. S100A9 mRNA and intracellular protein levels increase during early sepsis and remain elevated in Gr1+CD11b+ MDSCs after pro-inflammatory sepsis transitions to the later chronic anti-inflammatory and immunosuppressive phenotype. The purpose of this study was to determine whether intracellular S100A9 protein might sustain Gr1+CD11b+ MDSC repressor cell reprogramming during sepsis. We used a chronic model of sepsis in mice to show that S100A9 release from MDSCs and circulating phagocytes decreases after early sepsis and that targeting the S100a9 gene improves survival. Surprisingly, we find that intracellular S100A9 protein translocates from the cytosol to nucleus in Gr1+CD11b+ MDSCs during late sepsis and promotes expression of miR-21 and miR-181b immune repressor mediators. We further provide support of this immunosuppression pathway in human sepsis. This study may inform a new therapeutic target for improving sepsis outcome.

B7-H6, un membre de la famille B7, est exprimé sur diverses cellules tumorales humaines et active les cellules NK via NKp30. En revanche, B7-H6 n'est pas détecté à la surface d'aucunes cellules saines testées. Mon projet de thèse était d'identifier les mécanismes impliqués dans l'induction du gène B7-H6 et savoir si d'autres conditions que la transformation tumorale peuvent induire l'expression de B7-H6.Nous avons montré que B7-H6 est induit de façon sélective à la surface de neutrophiles et de monocytes CD14+CD16+, suite à des stimulations de type inflammatoire in vitro et in vivo. De plus, cette expression est de mauvais pronostic pour la survie de patients atteints de sepsis sévère. Nous avons également mis en évidence une forme soluble de B7-H6 produite, in vitro par des monocytes et des neutrophiles activés, et in vivo chez certains patients atteints de sepsis sévère à Gram négatif. Fait intéressant, cette forme soluble semble bloquer l'activité des cellules NK et avoir une tendance à être de mauvais pronostic pour la survie de ces patients.Par conséquent, mes travaux renforcent le concept immunologique selon lequel les ligands des récepteurs NK activateurs sont sous-exprimés dans les cellules saines et subissent une dérégulation qui les surexprime dans les cellules qui subissent. De plus, B7-H6 apparait comme un acteur potentiel dans l'immunité innée antibactérienne. La description systématique du profile de B7-H6 chez les patients atteins de sepsis pourrait permettre d'envisager de nouvelles prises en charge thérapeutiques basé sur les cellules NK et B7-H6 et aider à classer les patients en fonction de leur risque de développer une forme sévère de la maladie. / B7-H6, a new member of the B7 family, is expressed on several human tumor cells and triggers NKp30-mediated activation of human NK cells. However, B7-H6 is not detected in any normal cells tested. My thesis project was to identify the mechanisms causing the induction of B7-H6 gene and whether conditions other than tumor transformation could lead to B7-H6 expression. During my thesis, we showed that B7-H6 is selectively induced at the surface of neutrophils and CD14+CD16+ monocytes upon inflammatory stimulation in vitro and in vivo, these cells could also triggers NKp30-mediated activation of human NK cells in a context of inflammation. Moreover, this expression is a poor prognosis for survival of patients with severe sepsis. We also detected a soluble form of B7-H6 produced in vitro by activated neutrophils and monocytes, and in vivo in some patients with severe Gram-negative sepsis. Interestingly, this soluble form appears to block the activity of NK cells and have a tendency to be a poor prognosis for survival of these patients.Therefore, my work supports the immune concept that ligands of NK activating receptors are downregulated in normal cells and undergo deregulation that overexpressed in cells upon stress such as tumors, infection and inflammation. In addition, B7-H6 appears as a potential player in the antibacterial innate immunity. The systematic description of B7-H6 in patients with sepsis could allow to envisage new therapeutic treatment based on NK cells and B7-H6 and help classify patients according to their risk of developing a severe form of disease.

L'obésité est un facteur de risque majeur de cancer. Il est connu qu’une adiposité élevée prédispose à un stress inflammatoire accru et potentialise la croissance tumorale. Néanmoins, les mécanismes restent mal définis. De façon intéressante, la sénescence cellulaire, ou le programme moléculaire causant l’arrêt du cycle cellulaire suite à un stress insurmontable, favorise l'inflammation chronique et délétère pendant l'obésité. Nous avons donc émis l’hypothèse que l'obésité puisse être un inducteur de sénescence protumoral qu’il est possible d’exploiter, via une stratégie sénolytique, pour ralentir ou même bloquer le développement de tumeurs. Grâce à des marquages de coupes histologiques de tumeurs métastatiques, nous avons montré que les masses malignes de patients ayant un indice de masse corporelle (IMC)>35 sont associées à des marqueurs de sénescence. Cette découverte suggère une charge élevée de cellules sénescentes chez ses patients. Alors que la sénolyse, ou l’élimination thérapeutique des cellules sénescentes, s'est révélée très prometteuse dans le traitement de plusieurs maladies liées à l'âge, son efficacité en tant que traitement du cancer est souvent mitigé et dépend des antécédents du patient. Dans notre étude, nous avons utilisé un modèle murin d'obésité induit par la diète combinée avec un modèle d’injections syngéniques de différentes lignées cancéreuses occasionnant des réponses immunogéniques faibles, légères ou hautes. Chez les souris sur une diète riche en gras, nous avons identifié des cellules cancéreuses sénescentes spécifiquement dans les tumeurs faiblement immunogènes, soit faiblement reconnue par le système immunitaire et donc difficile à traiter. Un traitement sénolytique avec l'inhibiteur de la famille BCL-2 ABT-263 abolit la réponse protumorale observée via l'ablation des cellules cancéreuses sénescentes. Ainsi, nous proposons que les thérapies combinatoires avec des agents sénolytiques devraient être envisagées pour traiter les patients cancéreux présentant une adiposité accrue. De plus, dans la même cohorte de patients où nous avons rapporté des marqueurs de sénescence dans les tissus malins, les patients obèses ont aussi montré une expression importante de Toll-like receptor 4 (TLR4). Nous avons donc émis l’hypothèse que le récepteur TLR4 joue un rôle important dans l’établissement d’un microenvironnement tumoral qui favorise la sénescence cellulaire et la croissance tumorale de souris en surplus de poids. Dans notre étude, nous rapportons que l'expression systémique de TLR4 est importante pour la croissance tumorale induite par l'obésité. Nous montrons également que l’induction d’un stress du réticulum endoplasmique médié par Inositol requiring enzyme 1a (IRE1ɑ) dans les cellules myéloïdes associées à une tumeur, favorise la sénescence des cellules cancéreuses, dans un contexte de faible immunogénicité, via TLR4. Ce travail établit les fondements d’une compréhension moléculaire du lien entre les régimes à forte teneur calorique et l'immunité protumorale. / Obesity is a major risk factor for cancer. High adiposity predisposes to increased inflammatory stress, which potentiates tumor growth. However, the mechanisms remain poorly defined. Interestingly, cellular senescence, or the molecular program causing cell cycle arrest following insurmountable stress, is known to promote chronic and deleterious inflammation during obesity. We therefore hypothesized that obesity could be an inducer of a protumoral senescence that can be exploited, via a senolytic strategy, to slow down or even block tumor development. Through histological sections of metastatic tumor, we show that malignant masses from patients with a body mass index (BMI)>35 are associated with markers of senescence, suggesting a high burden of senescent cells in these patients. While senolysis, or the therapeutic elimination of senescent cells, has shown great promises in the treatment of several age-related diseases, its efficacy as a treatment for cancer is often elusive and depends on patients’ history. In our study, we used a mouse model of diet-induced obesity (DIO) combined with a model of syngeneic injections of different cancer cell lines causing low, mild, or high immunogenic responses. In mice under a DIO, we have identified senescent cancer cells specifically in weakly immunogenic tumors, or tumors poorly recognized by the immune system, and therefore difficult to treat. Moreover, a senolytic treatment with the BCL-2 family inhibitor ABT-263 abolishes the protumor response seen in these mice via the ablation of senescent cancer cells. Thus, combination therapies using senolytic agents should fall into consideration to treat cancer patients with increased adiposity. In addition, in the same cohort of patients where we reported markers of senescence in malignant tissues, obese patients also showed significant expression of TLR4. We therefore hypothesized that the TLR4 receptor plays an important role in establishing a tumor microenvironment that promotes cellular senescence and tumor growth in mice subjected to experimental obesity. In our second study, we report that systemic expression of TLR4 is important for obesity-induced tumor growth. Moreover, we show that the induction of an IRE1ɑ-mediated endoplasmic reticulum stress, in tumor-associated myeloid cells, promotes the senescence of cancer cells, in a context of low immunogenicity, via TLR4. This work lays the foundation for a molecular understanding of the link between high-calorie diets and protumoral immunity.