Surgery precipitates a hypercoagulable state and has been shown to increase the development of cancer metastases in animal models, however mechanism(s) responsible for this are largely unknown. We hypothesize that the prometastatic effect of surgery may be secondary to postoperative hypercoagulable state. Surgical stress was induced in mice by partial hepatectomy or nephrectomy, preceded by intravenous injection of CT26-LacZ or B16F10-LacZ cells to establish pulmonary metastases with or without perioperative anticoagulation and their lung tumor cell emboli (TCE) were quantified. Fibrinogen and platelets were fluorescently labeled prior to surgical stress to evaluate TCE-associated fibrin and platelet clots. Surgery significantly increased metastases while anticoagulation with five different agents attenuated this effect. Fibrin and platelet clots were associated with TCE significantly more frequently in surgically stressed mice. Surgery promotes the formation of fibrin and platelet clots around TCE and this appears to be the mechanism for the increase in metastases seen following surgery.

Title page, table of contents and summary only. The complete thesis in print form is available from the University of Adelaide Library. / Herpes simplex virus type I (HSV-I) produces acute muco-cutaneous infections, followed by spread to sensory nerve ganglia, and establishment of latency. In the peripheral nervous system, primary sensory neurons, which are found in dorsal root ganglia of the of the spinal nerves, are the target for HSV and they may undergo either productive or latent intection. Productive infection of sensory neurons generates the potential for lethal spread of virus through the nervous system but in immunocom petent hosts, viral replication is terminated by limely development of an adaptive immune response. The infection of dorsal root ganglia that follows cutaneous inoculation of the flanks of mice with HSV provides a well-characterized model of peripheral nervous system infection. The mechanisms responsible for clearance of HSV are complex. At mucosal and cutaneous sites, local innate immune mechanisms act to interrupt the initial spread of virus to the nervous system, while adaptive immunity is important in limiting replication in the ganglia and extension of the virus to adjacent dennatomes. Thus actions of both the innate and the adaptive immune systems are vital in defence against replicating HSV-1, while it is thought that latent infection in the ganglia is contained by the surveillance of the adaptive immune system. Natural killer T (NKT) cells are a conserved subpopulation of lymphocytes that recognize glycolipid antigens presented by the invariant MHC class I-like molecule CD1d. Upon activation through their semi-invariant T cell receptor, these cells rapidly release large amounts of immuno-modulating Th1 and Th2 cytokines. NKT cells have, therefore, been implicated in immune responses controlling various diseases, including infection, cancer, and autoimmunity, as well as having an involvement in allo-graft survival. Consideration of the important contributions of innate and adaptive immunity to clearance of HSV prompted this investigation of the role of CD1d and of CD1d-restricted NKT cells in the pathogenesis of HSV infection. The first part of this thesis (Chapter 3 and 4) describes investigations into the role of NKT cells in immunity to HSV-1, using a zosteriform model of infection and two gene knockout strains of C57BL/6 mice. CD1d GKO and Ja18 GKO mice, which are deficient in NKT cells, are compromised in controlling HSV-1 as evidenced by mortality, virus loads in skin and dorsal root ganglia, presence and size of skin lesions, persistence of HSV antigen, neuronal damage and extent of latency. Comparisons between wild type (NKT cell replete), Ja18 GKO (deficient in invariant Va14⁺ NKT cells) and CD1d GKO (deficient in all CD1d-dependant NKT cells) mice allowed assessment of CD1d-dependant NKT cell subsets in defence against the virus at various stages of infection. It was concluded that both subsets play important roles in controlling the virus and in preventing lethal neuro-invasive disease, that both are vital adjuncts to the adaptive immune response and that without them, low doses of neuropathogenic HSV-1 can establish quickly and cause fatal infections. The NKT-cell population appears to be quite dynamic in its response to a range of pathogens and other disease processes. The study described in Chapter 5 presents evidence suggesting that the response of NKT cells during HSV infection is no less dynamic. In the axillary lymph nodes, observations on numbers of cells expressing NK1.1 antigen and the invariant TCR suggest that NKT cells are activated in the regional lymph nodes draining the infection site. Observations on lymphocytes prepared from liver and spleen also suggested activation of NKT cells, indicating that NKT cells at these sites are also activated during the course of acute HSV infection. The role of NKT cells in the control of HSV infection was further examined by adoptive transfer studies, to investigate whether the defect in handling of HSV-1 by Ja18 GKO mice could be complemented by the adoptive transfer of lymphocytes from wt mice (Chapter 6). Finally, the relevance of activated NKT cells in the anti-HSV response was examined by observing the effects of a-GalactosylCeramide therapy on the severity of HSV-1 infection (Chapter 6). Activation of NKT cells by this compound delayed the onset of HSV disease, decreased prevalence and severity of zosteriform lesions and reduced viral titres in skin and ganglia. The beneficial effects of a-GalactosylCeramide on the outcome and severity of HSV infection in the skin were dose-dependent. Collectively, the studies described in this thesis provide insights into how NKT cells, normally a rare population of cells, has the ability to regulate the protective immune response to HSV-1. As more understanding is gained about how NKT cells become activated during HSV-1 infection, and how they mediate their antiviral effects, other ways may be developed to modulate and activate this interesting subset to the benefit of infected individuals. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1277283 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2007

Title page, table of contents and summary only. The complete thesis in print form is available from the University of Adelaide Library. / Herpes simplex virus type I (HSV-I) produces acute muco-cutaneous infections, followed by spread to sensory nerve ganglia, and establishment of latency. In the peripheral nervous system, primary sensory neurons, which are found in dorsal root ganglia of the of the spinal nerves, are the target for HSV and they may undergo either productive or latent intection. Productive infection of sensory neurons generates the potential for lethal spread of virus through the nervous system but in immunocom petent hosts, viral replication is terminated by limely development of an adaptive immune response. The infection of dorsal root ganglia that follows cutaneous inoculation of the flanks of mice with HSV provides a well-characterized model of peripheral nervous system infection. The mechanisms responsible for clearance of HSV are complex. At mucosal and cutaneous sites, local innate immune mechanisms act to interrupt the initial spread of virus to the nervous system, while adaptive immunity is important in limiting replication in the ganglia and extension of the virus to adjacent dennatomes. Thus actions of both the innate and the adaptive immune systems are vital in defence against replicating HSV-1, while it is thought that latent infection in the ganglia is contained by the surveillance of the adaptive immune system. Natural killer T (NKT) cells are a conserved subpopulation of lymphocytes that recognize glycolipid antigens presented by the invariant MHC class I-like molecule CD1d. Upon activation through their semi-invariant T cell receptor, these cells rapidly release large amounts of immuno-modulating Th1 and Th2 cytokines. NKT cells have, therefore, been implicated in immune responses controlling various diseases, including infection, cancer, and autoimmunity, as well as having an involvement in allo-graft survival. Consideration of the important contributions of innate and adaptive immunity to clearance of HSV prompted this investigation of the role of CD1d and of CD1d-restricted NKT cells in the pathogenesis of HSV infection. The first part of this thesis (Chapter 3 and 4) describes investigations into the role of NKT cells in immunity to HSV-1, using a zosteriform model of infection and two gene knockout strains of C57BL/6 mice. CD1d GKO and Ja18 GKO mice, which are deficient in NKT cells, are compromised in controlling HSV-1 as evidenced by mortality, virus loads in skin and dorsal root ganglia, presence and size of skin lesions, persistence of HSV antigen, neuronal damage and extent of latency. Comparisons between wild type (NKT cell replete), Ja18 GKO (deficient in invariant Va14⁺ NKT cells) and CD1d GKO (deficient in all CD1d-dependant NKT cells) mice allowed assessment of CD1d-dependant NKT cell subsets in defence against the virus at various stages of infection. It was concluded that both subsets play important roles in controlling the virus and in preventing lethal neuro-invasive disease, that both are vital adjuncts to the adaptive immune response and that without them, low doses of neuropathogenic HSV-1 can establish quickly and cause fatal infections. The NKT-cell population appears to be quite dynamic in its response to a range of pathogens and other disease processes. The study described in Chapter 5 presents evidence suggesting that the response of NKT cells during HSV infection is no less dynamic. In the axillary lymph nodes, observations on numbers of cells expressing NK1.1 antigen and the invariant TCR suggest that NKT cells are activated in the regional lymph nodes draining the infection site. Observations on lymphocytes prepared from liver and spleen also suggested activation of NKT cells, indicating that NKT cells at these sites are also activated during the course of acute HSV infection. The role of NKT cells in the control of HSV infection was further examined by adoptive transfer studies, to investigate whether the defect in handling of HSV-1 by Ja18 GKO mice could be complemented by the adoptive transfer of lymphocytes from wt mice (Chapter 6). Finally, the relevance of activated NKT cells in the anti-HSV response was examined by observing the effects of a-GalactosylCeramide therapy on the severity of HSV-1 infection (Chapter 6). Activation of NKT cells by this compound delayed the onset of HSV disease, decreased prevalence and severity of zosteriform lesions and reduced viral titres in skin and ganglia. The beneficial effects of a-GalactosylCeramide on the outcome and severity of HSV infection in the skin were dose-dependent. Collectively, the studies described in this thesis provide insights into how NKT cells, normally a rare population of cells, has the ability to regulate the protective immune response to HSV-1. As more understanding is gained about how NKT cells become activated during HSV-1 infection, and how they mediate their antiviral effects, other ways may be developed to modulate and activate this interesting subset to the benefit of infected individuals. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1277283 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2007

Neuroblastoma is an aggressive solid tumor that develops from immature cells of the nervous system and is almost exclusively diagnosed in infants and young children. Over the past decade a multitude of immune based therapies have been explored as therapeutic candidates for patients with neuroblastoma. The anti-GD2 monoclonal antibody, 3F8, and more recently, natural kill (NK) cell based therapies have been accepted as hopeful therapeutic options for patients with Neuroblastoma. These options however have many drawbacks including dose limiting pain, the development of tolerance, reliance on MHC mismatch and possible reliance on the invariant NK (iNK) cells population. Gamma Delta T cells, a subpopulation of T cells composed of a T cell receptor (TCR) with a gamma and a delta chain instead of an alpha and a beta; chain, have been shown to recruit a more robust immune response then both 3F8 and NK cells through their activation of antigen presenting cells (APCs) and non-reliance on MHC mismatch. Gamma Delta T cells are also able to recruit NK cells as well as other cytotoxic lymphocytes. For these reasons, it is believed that Gamma Delta T cell based treatment alone or in combination with an anti-GD2 monoclonal antibody may have a greater efficacy than either NK cells or an anti-GD2 monoclonal antibody alone. The intent of this thesis is to explore and evaluate the current state of Gamma Delta T cell based immunotherapy against the backdrop of NK cell based immunotherapy for neuroblastoma.

Surgery precipitates a hypercoagulable state and has been shown to increase the development of cancer metastases in animal models, however mechanism(s) responsible for this are largely unknown. We hypothesize that the prometastatic effect of surgery may be secondary to postoperative hypercoagulable state. Surgical stress was induced in mice by partial hepatectomy or nephrectomy, preceded by intravenous injection of CT26-LacZ or B16F10-LacZ cells to establish pulmonary metastases with or without perioperative anticoagulation and their lung tumor cell emboli (TCE) were quantified. Fibrinogen and platelets were fluorescently labeled prior to surgical stress to evaluate TCE-associated fibrin and platelet clots. Surgery significantly increased metastases while anticoagulation with five different agents attenuated this effect. Fibrin and platelet clots were associated with TCE significantly more frequently in surgically stressed mice. Surgery promotes the formation of fibrin and platelet clots around TCE and this appears to be the mechanism for the increase in metastases seen following surgery.

Natural killer (NK) cells are lymphocytes of the innate immune system that play a major role in the destruction of both tumours and virally-infected cells. The cytotoxicity of NK cells is tightly controlled by signals received through activating and inhibitory receptors. NK cells express a variety of inhibitory receptors such as Ly49 receptors. Ly49 receptors bind to class I MHC molecules that expressed on normal cells. Using Ly49-deficient (NKCKD) mice we show that Ly49-KD NK cells successfully recognize and kill influenza virus-infected cells and that NKCKD mice exhibit better survival than wild-type mice. Moreover, influenza virus infection has a propensity to upregulate cell surface expression of MHC-I on murine lung epithelial cells in vivo. Significantly, we demonstrate increased lung damage of WT-mice versus NKCKD mice after influenza virus infection as determined by histological analyses. This data indicated that absence of Ly49 inhibitory NK receptors greatly enhances survival of infected mice.

La maladie d’Alzheimer (MA) est un désordre neurologique progressif et irréversible caractérisé par l’accumulation de peptides β-amyloïdes, de plaques amyloïdes et de dégénérescence neurofibrillaires. L’inflammation et des altérations du système immunitaire ont été reliées à la MA, suggérant que le système immunitaire périphérique pourrait jouer un rôle pendant la phase asymptomatique de la maladie. Les lymphocytes natural killer et les neutrophiles (PMN) participent à la surveillance immune innée et leurs rôles demeurent controversés dans la MA. Nous avons étudié les changements phénotypiques et fonctionnels des cellules NK et des PMN du sang périphérique dans une cohorte de patients composée de personnes âgées en bonne santé, de patients amnestic mild cognitive impairment (aMCI) et de personnes atteintes de la MA à un stade léger (mMA). L’analyse phénotypique des lymphocytes NK a révélé des différences d’expression de CD16 (augmenté chez les patients mMA), de NKG2A (diminué chez les patients aMCI), et des TLR2 et TLR9 (tous deux diminués chez les patients mMA). Les tests fonctionnels ont révélé que l’activité cytotoxique des lymphocytes NK ainsi que leur capacité de dégranulation étaient inchangés dans les 3 groupes de patients. Au contraire, l’expression du récepteur CD95 était augmentée chez les aMCI et mMA et l’expression de granzyme B et la production de cytokines telles que TNFα et IFNγ étaient augmentées chez les aMCI mais pas chez les patients mMA. Le chimiotactisme induit par la chimiokine CCL19 et non par CC21 était diminué chez les aMCI et mMA, malgré l’augmentation de l’expression du CCR7 chez les patients aMCI. L’analyse des PMN révèle une augmentation spécifique de l’expression de CD177 chez les patients mMA. La stimulation à l’IL-8 entraine l’augmentation attendue de l’intégrine CD11b à la surface des PMN des patients âgés contrôles, mais les patients aMCI et mMA ne répondent pas. La baisse de l’expression des récepteurs CD14 et CD16 a été observée sur les PMN des patients mMA uniquement. Au contraire, seul les PMN des patients aMCI présentent une baisse de l’expression du marqueur CD88 et du TLR2. La phagocytose est différentiellement diminuée dans les PMN des patients aMCI et mMA tandis que l’ingestion de particules de Dextran est absente uniquement chez les patients mMA. Le killing contre Candida albicans est sévèrement diminué dans les groupes aMCI et mMA, alors que la production de radicaux libres est seulement diminuée au stade mMA. La production de cytokines inflammatoires (TNFα, IL-6, IL-1β, IL-12p70) et de chimiokines (MIP-1α, MIP-1β, IL-8) en réponse à une stimulation au LPS est très basse chez les patients aMCI et absente chez les mMA. Ces résultats suggèrent un état d’activation des cellules NK chez les patients aMCI qui pourrait refléter une réponse immunitaire active dirigée contre une agression encore non identifiée. L’altération différentielle des capacités de réponse à des agressions pathologiques des PMN des patients aMCI et mMA pourrait se traduire par une baisse progressive de la réponse immune associée au développement de la MA.

付記する学位プログラム名: 充実した健康長寿社会を築く総合医療開発リーダー育成プログラム / 京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第22121号 / 医科博第106号 / 新制||医科||7(附属図書館) / 京都大学大学院医学研究科医科学専攻 / (主査)教授 濵﨑 洋子, 教授 河本 宏, 教授 生田 宏一 / 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22371号 / 医博第4612号 / 新制||医||1043(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 河本 宏, 教授 松田 文彦, 教授 濵﨑 洋子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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