Orientadores: Carlos Alberto Petta, Fernando Guimarães / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T13:56:32Z (GMT). No. of bitstreams: 1 Silva_RodrigoFernandesda_M.pdf: 2312952 bytes, checksum: 26e5506763c6314d5615c77880da2e51 (MD5) Previous issue date: 2013 / Resumo: As células NK são linfócitos conhecidos pela capacidade de eliminar uma variedade de células malignas, sem a necessidade de estímulo prévio e por meio de um processo de reconhecimento inato, o qual envolve receptores ativadores e inibidores. Esta capacidade também foi observada nos linfócitos NK-like T, porém a via de reconhecimento imunológico envolvida pode ser tanto a inata quanto a adaptativa. Neste estudo, avaliou-se a atividade funcional e a expressão de receptores ativadores DNAM-1, NKp30 e NKp44 das células NK e NK-like T, do sangue e ascite de pacientes com neoplasia de ovário. Foi colhido sangue de 24 pacientes com neoplasia de ovário (11 benignas, Bng; 6 malignas sem metástases, Mlg e 7 malignas com metástases, MlgMt) e ascite (Asc) de 6 pacientes, mediante consentimento assinado. Células mononucleares foram separadas por gradiente de centrifugação. A ativação das células NK e NK-like T foi determinada pela expressão da molécula CD107a por meio da citometria de fluxo, quando coincubadas com as células K562 (proporção 1:1). Foram comparados os efeitos de dois procedimentos de cultivo celular, um de curta duração (18h) empregando meio RPMI-1640 suplementado com SFB (10%), L-glutamina (2mM) e IL-2 (1000UI/ml) e outro de longa duração (21 dias) empregando meio SCGM CellGro suplementado com anti-CD3 (10ng/ml, nos primeiros 5 dias), IL-2 (1000UI/ml) e SFB (10%) em relação à atividade funcional e a expressão dos receptores ativadores. A atividade funcional das células NK pareceu ser afetada em decorrência da evolução da doença. A estimulação com IL-2 de curta duração aumentou a atividade funcional das células NK, mas não significantemente. A estimulação com IL-2 de longa duração aumentou a atividade funcional das células NK significantemente (p<0.001). A porcentagem de células NK expressando os receptores ativadores DNAM-1, NKp30 e NKp44 aumentou significantemente (p<0.05) depois da estimulação com IL-2 de longa duração. As células NK-like T apresentaram baixa atividade funcional nos períodos de estimulação de pré e curta duração e nenhuma atividade na estimulação de longa duração. Foi observado que a integridade funcional das células NK foi comprometida com o desenvolvimento do câncer de ovário. A estimulação de longa duração resultou em um maior número de células NK funcionais quando comparado à de curta duração, conferindo este método para uso imunoterápico. A estimulação de longa duração também foi eficiente no aumento da expressão do receptor ativador DNAM-1 nas células NK, sugerindo este método para reverter à supressão deste receptor, que frequentemente é observada em pacientes com carcinoma de ovário. A falta de ativação das células NK-like T (pré, curta e longa duração) sugere que, no sistema experimental aplicado, estas células não são ativadas pela via imune inata / Abstract: NK cells are lymphocytes known by their ability to eliminate a variety of malignant cells without previous stimulation, in a process involving innate recognition by an array of stimulatory and inhibitory receptors. Similarly, the variant subset of NK-like T lymphocytes has been reported to eliminate tumor cells, but the targeting process might involve either innate or adaptive immune recognition. This study evaluated the functional activation of NK and NK-like T cells, the expression of activating receptors DNAM-1, NKp30 and NKp44 (pre, short- and long-term IL-2 stimulated), from blood and ascites of ovarian neoplasia patients. Blood was collected from 24 patients with ovarian neoplasias after signed consent: 11 benign (Bng), 6 malignant without metastasis (Mlg) and 7 malignant with metastasis (MlgMt). Ascites (Asc) was collected from 6 patients with ovarian neoplasia. Mononuclear cells were separated by gradient centrifugation. NK and NK-like T cells activation (pre, short- and long-term stimulated) was evaluated against K562 (1:1 ratio) by the expression of CD107a, analyzed by flow cytometry. Short-term stimulation with IL-2 (1000UI/ml) was conducted overnight in RPMI-1640 medium supplemented with FBS (10%) and L-glutamine (2mM). Long-term stimulation was conducted by a 21 day culturing process with SCGM CellGro medium supplemented with anti-CD3 (10ng/ml, first 5 days), IL-2 (1000UI/ml) and FBS (10%). The functional activation of NK cells pre stimulated seemed to be impaired with the progression of the disease. Short-term stimulation increased NK cells activation, but not significantly. Long-term stimulation increased NK cells activation significantly (p<0.001). The percentage of NK cells expressing the activating receptors DNAM-1, NKp30 and NKp44 increased significantly (p<0.05) after long-term stimulation. NK-like T cells showed low activation on pre and short-term and none activation on long-term IL-2 stimulation. Long-term stimulation resulted in a much higher number of functional NK cells compared to short-term, entitling this method for adoptive therapy. Long-term stimulation was particularly efficient to up-regulate DNAM-1 activating receptor on NK cells, representing a way to overcome down-regulation demonstrated on patients with ovarian carcinoma. The lack of activation of NK-like T cells (pre, short- and long-term IL-2 stimulated) suggests that, in the method applied; these cells are not activated through innate pathway / Mestrado / Fisiopatologia Ginecológica / Mestre em Ciências da Saúde

Durant l’infection par le virus Influenza A (IAV), les changements physiques et immunologiques du poumon prédisposent l’hôte aux surinfections bactériennes. Les cellules T Natural Killer invariantes (iNKT) sont des lymphocytes T innés pouvant avoir des rôles bénéfiques ou délétères durant l’infection. Nos objectifs ont visé à (i) étudier le rôle naturel des cellules iNKT et (ii) à rechercher l’effet d’une activation exogène des cellules iNKT dans la surinfection bactérienne post-influenza.Lors de mon arrivée, le laboratoire venait de décrire, pour la première fois en contexte infectieux, que les cellules iNKT étaient capables de produire de l’IL-22 au cours de l’infection grippale. Cette cytokine joue un rôle majeur dans les processus de maintien et de réparation des épithéliums. L’une des causes des surinfections bactériennes post-grippales étant l’altération et/ou la perte de l’intégrité de l’épithélium pulmonaire, nous nous sommes proposés d’étudier le rôle potentiel de cette cytokine dans un modèle expérimental de surinfection bactérienne à S. pneumoniae. Nous avons ainsi pu montrer que si cette cytokine ne joue pas un rôle majeur dans la réponse anti-virale de l’hôte, l’IL-22 participe au contrôle de l’inflammation au cours de l’infection grippale et joue un rôle protecteur dans la surinfection bactérienne.Par ailleurs, l’utilisation de souris dépourvues en cellules iNKT (Jα18-/-) a permis de montrer que les cellules iNKT limitent la susceptibilité aux surinfections et réduisent le synergisme létal de la coinfection virus/bactérie. Au moment de l’infection bactérienne, les cellules iNKT des souris grippées sont incapables de produire de l’IFN-γ, cytokine dont nous avons montré le rôle essentiel dans les mécanismes de défense antibactérienne. Le défaut d’activation des cellules iNKT chez les souris surinfectées est lié à l’interleukine-10 (IL-10), cytokine immunosuppressive induite par l’infection virale, plutôt qu’à un défaut intrinsèque des cellules iNKT. L’IL-10 inhibe l’activation des cellules iNKT en réponse au pneumocoque en inhibant la production d’IL-12 par les cellules dendritiques dérivées de monocytes (MoDCs). La neutralisation de l’IL-10 restaure l’activation des cellules iNKT et augmente la résistance à la surinfection. Ainsi, les cellules iNKT ont un rôle bénéfique (en amont de la colonisation bactérienne) dans le contrôle de la surinfection bactérienne de la grippe et représentent une cible de l’immunosuppression.Nous avons par la suite étudié la possibilité que le superagoniste des cellules iNKT, l’ α-galactosylceramide (α-GalCer) puisse limiter la surinfection bactérienne. Pour cela, les souris ont été traitées par voie intranasale avec de l’α-GalCer à différents temps post-influenza, juste avant l’infection par le pneumocoque. Le traitement à jour 3, au pic de la réplication virale, limite fortement la surinfection. Cependant, l’inoculation d’α-GalCer pendant la phase aiguë du virus (jour 7) ne permet pas d’activer les cellules iNKT pulmonaires et n’a pas d’effet sur la surinfection. L’absence d’activation des cellules iNKT n’est pas intrinsèque et est associée à une disparition complète des cellules dendritiques CD103+ respiratoires (cDCs), lesquelles sont cruciales dans l’activation des cellules iNKTs. À des temps plus tardifs (jour 14), les cDCs repeuplent le poumon et l’α-GalCer promeut l’activité antibactérienne des cellules iNKT.Pris dans son ensemble, cette étude souligne le rôle des cellules iNKT dans la surinfection bactérienne de la grippe et ouvre de nouvelles voies thérapeutiques afin de limiter les surinfections bactériennes post-influenza. / XDurant l’infection par le virus Influenza A (IAV), les changements physiques et immunologiques du poumon prédisposent l’hôte aux surinfections bactériennes. Les cellules T Natural Killer invariantes (iNKT) sont des lymphocytes T innés pouvant avoir des rôles bénéfiques ou délétères durant l’infection. Nos objectifs ont visé à (i) étudier le rôle naturel des cellules iNKT et (ii) à rechercher l’effet d’une activation exogène des cellules iNKT dans la surinfection bactérienne post-influenza.Lors de mon arrivée, le laboratoire venait de décrire, pour la première fois en contexte infectieux, que les cellules iNKT étaient capables de produire de l’IL-22 au cours de l’infection grippale. Cette cytokine joue un rôle majeur dans les processus de maintien et de réparation des épithéliums. L’une desDuring the infection by the virus Influenza A ( IAV), the physical and immunological changes of the lung predispose the host to the bacterial secondary infections. The invariant cells(units) T Natural Killer iNKT ) are lymphocytes T innate being able to have beneficial or noxious roles during the infection. Our objectives aimed at i) to study the natural role of cells(units) iNKT and ii) to look for the effect of an exogenous activation of cells(units) iNKT in the bacterial secondary infection post-influenza. During my arrival, the laboratory had just described, for the first time in infectious context, that cells(units) iNKT were capable of producing of IL-22 during the flu-like infection. This cytokine plays a major role in the processes of preservation and repair of epitheliums [...]

OBJETIVOS: Avaliar o perfil e o número absoluto e percentual de células NK verdadeiras (CD56+CD16+CD3-) e de células NK e NKT (CD56+) no sangue periférico de uma coorte de pacientes com artrite reumatóide (AR) antes e durante o tratamento com rituximabe (RTX). MÉTODOS: Foram analisados dez pacientes do grupo controle (doadores de sangue) e dez pacientes com AR que receberam duas infusões de RTX 1g separadas por intervalo de 14 dias. As análises imunofenotípicas para avaliação do perfil e quantificação de células NK foram realizadas pré e após a infusão ou até a recaída clínica. Pacientes respondedores e não respondedores foram classificados de acordo com os critérios do Colégio Americano de Reumatologia (ACR) em 6 meses. RESULTADOS: A quantidade de células NK verdadeiras não demonstrou variação significativa pré e após o tratamento com RTX. Contudo, houve aumento percentual de células CD56+ entre o primeiro e o segundo mês após a infusão com RTX. Além disso, os pacientes respondedores apresentaram uma tendência de aumento do número absoluto de células NK verdadeiras após dois meses de tratamento. Já em relação ao grupo controle, observou-se um aumento significativo do número de células NK basais nos pacientes com AR (p<0,05). CONCLUSÕES: Foi identificada uma tendência de aumento nos valores absolutos de células NK verdadeiras entre os pacientes respondedores no segundo mês após a infusão com RTX. Não foi identificada uma variação significativa no perfil e quantidade de células NK nos pacientes com AR pré e após o tratamento com RTX. Contudo, foi observado que os pacientes com AR possuem uma quantidade maior de células NK do que os controles, sugerindo um possível envolvimento destas células na AR. / OBJECTIVES: To assess the profile as well as the absolute number and percentage of true NK cells (CD56+CD16+CD3-), and NK and NKT cells (CD56+) in the peripheral blood of a cohort of patients with rheumatoid arthritis (RA) before and during rituximab (RTX) therapy. METHODS: Ten control patients (blood donors) and ten patients with RA were assessed. The latter group received two intravenous infusions of 1g RTX, separated by a 14 day interval. Immunophenotypic analyses of NK cells were conducted before and after infusion, or until clinical relapse. After six months, respondents and nonrespondents were reassessed according to American Rheumatology Criteria (ARC). RESULTS: The number of true NK cells did not significantly change after treatment with RTX. However, an increase in the percentage of CD56+ cells was observed between the first and second month after RTX infusion. Respondents also displayed a tendency toward an increased number of true NK cells after two months of treatment. At baseline, the number of NK cells was also found to be significantly higher in patients with RA than in control individuals (p<0.05). CONCLUSIONS: Respondents displayed a tendency toward an increase in the absolute number of true NK cells in the second month after RTX infusion. No significant changes in the profile and frequency of NK cells were found between preand post-RTX treatment assessments of patients with RA. However, it was found that patients with RA have a higher number of NK cells than control partcipants, suggesting a possible role of these cells in RA.

京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第22648号 / 医科博第111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 生田 宏一, 教授 竹内 理, 教授 髙折 晃史 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Les cellules Natural Killer (NK) sont des effecteurs de l’immunité innée qui jouent un rôle important dans la surveillance immunitaire anti-tumorale. Le concept d’immunothérapie basée sur l’activation des cellules NK a ainsi émergé comme une approche thérapeutique convaincante. Malgré les avancées spectaculaires réalisées ces dernières décennies, les connaissances concernant la biologie des cellules NK restent largement fragmentées. La mise en place de stratégies thérapeutiques anti-tumorales utilisant les cellules NK nécessite donc une compréhension approfondie des mécanismes de résistance développés au sein du microenvironnement tumoral. Les travaux menés au laboratoire ont révélé que certains mécanismes de résistance intrinsèque développés par les cellules tumorales dépendent de l’activation de l’autophagie en réponse à un stress hypoxique. Ces travaux ont démontré que l’activation de l’autophagie en condition de stress hypoxique, diminue la susceptibilité des cellules tumorales à la lyse par les cellules NK, qui peut être restaurée par l’inhibition de Beclin1. Ces mêmes travaux ont également démontré in vivo que l’inhibition de Beclin1 diminue la progression tumorale dans des modèles syngéniques murins de cancer de sein et de mélanome.Dans cette étude, nous avons montré dans un modèle murin de mélanome, que la régression des tumeurs déficientes en Beclin1 était corrélée à une augmentation significative d'infiltration des cellules NK. Nous avons établi que cette infiltration accrue est due à une augmentation d'expression et de sécrétion de la chémokine CCL5. De plus, dans les tumeurs déficientes en Beclin1, ayant une forte expression de CCL5, l’inhibition de CCL5 était suffisante pour diminuer l'infiltration des cellules NK et bloquer la régression tumorale.Ayant établi le rôle majeur de CCL5 dans l'infiltration des cellules NK dans les tumeurs de mélanome déficientes en Beclin1, nous avons étudié, dans la deuxième partie, le(s) mécanisme(s) moléculaire(s) impliqué(s) dans la régulation de CCL5. Nous avons démontré que l’inhibition génétique ou pharmacologique de l’autophagie induit la voie SAPK/JNK dans les cellules tumorales et active par conséquence le cofacteur de transcription c-Jun impliqué dans l'expression de CCL5. Plus précisément, nous avons établi que l'induction de SAPK/JNK est due à un défaut de l'activité phosphatase de la protéine phosphatase 2A (PP2A).Dans la dernière partie, nous avons étudié l'impact clinique de l’expression de CCL5 dans le cas du mélanome. L’analyse de différentes biopsies de mélanomes a montré une corrélation positive et significative de CCL5 avec l’expression du marqueur des cellules NK NKp46. Ce résultat a été validé sur une large collection de mélanomes, disponible dans la base de données TCGA (The Cancer Genome Atlas). La survie à long terme de patients atteints de mélanome ayant une expression élevée de CCL5 est significativement améliorée par rapport à ceux ayant une faible expression de cette chémokine.L'ensemble de nos résultats démontre pour la première fois que la diminution de la croissance tumorale suite l’inhibition de l'autophagie est étroitement liée à une amélioration de l'infiltration des cellules NK dans les tumeurs. Cette infiltration résulte d'une augmentation de l'expression la chémokine CCL5 par les cellules tumorales déficientes en Beclin1. Cette étude souligne l’intérêt de cibler l'autophagie afin d’établir un microenvironnement tumorale favorable à l'infiltration des cellules NK. Ainsi, l'inhibition sélective de l'autophagie dans les cellules tumorales pourrait améliorer les stratégies thérapeutiques anti-tumorales basées sur les cellules NK. / One of the major obstacles to define an efficient cancer immunotherapy protocol is the capacity of hypoxic tumor microenvironment to inhibit the host immune response. In line with this concept, we have shown that hypoxia impairs natural killer (NK) cell-mediated killing of cancer cells. This impairment was not related to a defect in NK cell function, but was strikingly dependent on the induction of the autophagic degradation process in hypoxic tumor cells. Genetic or pharmacological inhibition of autophagy restored NK-mediated killing of hypoxic tumor cells. . We have validated this concept in vivo by showing that targeting autophagy enhanced the NK-mediated regression of breast and melanoma tumors in mice. This regression was related to an increase in NK cells infiltrating autophagy defective tumor as demonstrated by immunohistochemistry staining of NK cells. The present project aims to investigate how autophagy inhibition increases tumor infiltration by NK cells leading to an improvement of NK-mediated anti-tumor immune response et to identify fectors which may be implicated in the infiltration of NK cells into the tumors.

BACKGROUND: Natural killer (NK) cells are traditionally considered part of the innate immune system but have recently been shown to possess adaptive qualities similar to T cells in response to an infection with a pathogen. In addition to possessing adaptive features, NK cells have also been found to reside in different organs such as the liver, spleen, and lymph nodes and differ based on phenotypic markers and their responses to different cytokines. Utilizing these findings, several groups have isolated and identified CD49a as a marker for tissue-resident NK cells. In the liver, CD49a has also been shown to be a positive indicator for NK cell memory-like responses in murine models. Building off work that demonstrated antigen-specific responses in rhesus macaques, this project focuses on characterizing the phenotypic markers and functional profile of CD49a+ NK cells in non-human primates. To better understand the role of CD49a in memory-like NK cells outside of the liver, this project utilized spleen samples from rhesus macaques infected with SIV/SHIV. This work aims to help us better understand the dysfunction NK cells experience as a result of HIV-1 infection in humans and also to demonstrate the changes NK cells experience as the disease progresses. A thorough understanding of the adaptive capabilities of NK cells can pave the way for targeted therapies to increase NK cell antiviral activity in HIV and other infections. METHODS: To characterize the functional and phenotypic profiles of CD49a+ NK cells by multiparameter flow cytometry, thirteen samples of spleen from rhesus macaques were thawed and then stained with two different protocols. A phenotyping protocol involved staining with antibodies against surface markers as well as intracellular markers T-Bet and Eomes. For the functional characterization protocol, the same thirteen samples were stained intracellularly after being stimulated with a cocktail of PMA and ionomyocin. The antibodies used in this were for functional markers. Of the thirteen samples used, six were infected with SHIVSF162P3, two were infected with SIVmac239X, and the remaining five were uninfected. After staining, these samples were analyzed on an BD LSRII from BD Biosciences. The data obtained were then analyzed using FlowJo software to study NK cells, which were characterized as CD45+CD14-CD20-CD3-CD159+. RESULTS: The analysis compared NK cells with T cells, B cells, and NKB cells. Some increases were seen among CD49a+ NK cells in the frequency of CD336+ (NCR2/NKp44), CD337+ (NKp30), and CD366+ (Tim-3) after infection. Although there were some mild increases in CD107a and TNF- in infected samples compared to uninfected, a significant increase was observed in the frequency of IFN-ɣ among infected CD49a+ NK cells compared to uninfected. CONCLUSION: When comparing samples that were infected vs uninfected, it appears there were some mild decreases after infection in the ratio of NK cells to other lymphocytes. In addition, there did not appear to be a significant increase in the frequency of CD49a+ among these NK cells as a result of the infection. However, among the CD49a+ subpopulation, there were some observed non-significant decreases in CD56-CD16+ cells. Furthermore, there was found to be an almost significant increase in TNF- (p = 0.06) among CD49a+ cells after infection. These findings demonstrate an increase in cytotoxic activity in splenic NK cells associated with an adaptation to the virus. Although there does not appear to be significant changes in the ratio of NK cell populations in the spleen, the changes observed in phenotypic and functional markers associated with CD49a+ demonstrate an increase in the cytotoxic activity of NK cells as a result of infection with SIV/SHIV. However, it remains to be seen if CD49a is a direct indicator of this type of infection. Future work geared toward memory-like NK cells in non-human primate splenic tissue could look at the contrast in CD49a+ NK cells from different states of infection with HIV-1 and/or SIV (acute vs chronic) to better understand the integrin’s role in adaptation.

Since their discovery, natural killer cells (NK) cells have been implicated as important players in cancer immunosurveillance. In recent years, researchers have taken advantage of this role by developing NK cell-based immunotherapies in the fight against cancer. While these treatments have been moderately successful against hematological malignancy, they are less effective against solid cancers. This lack of success partially results from the immunosuppressive effects of the tumor microenvironment (TME). While tumors use myriad processes to evade the immune system, the avid consumption of nutrients common to NK and cancer cell metabolism and the production of toxic waste products can have significant deleterious effects on NK cell anti-tumor function. However, it may be possible to avoid some of this tumor-induced inhibition of NK cell anti-tumor function by manipulating NK cell metabolism and/or environmental conditions. Recent studies have revealed that different activation regimens can affect the metabolic dependencies of different NK cell subsets. Furthermore, studies have identified potential targets in the TME that can make the environment less hostile for infiltrating NK cells. By considering the interrelationship of NK cell metabolism and function—especially in the TME—this thesis illuminates potential strategies to modulate immunometabolic suppression. Despite the promising work already done, many gaps in the knowledge of NK cell metabolism remain. Future work will need to investigate the specific molecular mechanisms linking metabolism and function, the role of tissue-resident NK cells in cancer immunosurveillance, and the influences of chronic disease and altered systemic metabolism on NK cell anti-tumor activity.

Invasive aspergillosis (IA) is a major opportunistic fungal infection in patients with haematological malignancies. Morbidity and mortality rates are high despite anti-fungal treatment, as the compromised status of immune system prevents the host from responding optimally to conventional therapy. This raises the consideration for immunotherapy as an adjunctive treatment. In this study, we evaluated the utility of expanded human NK cells as treatment against Aspergillus fumigatus infection in vitro and in vivo. The NK cells were expanded and activated by K562 cells genetically modified to express 4-1BB ligand and membrane-bound interleukin-15 (K562-41BBL-mbIL-15) as feeders. The efficacy of these cells was investigated in A. fumigatus killing assays in vitro and as adoptive cellular therapy in vivo. The expanded NK cells possessed potent killing activity at low effector-to-target ratio of 2:1. Fungicidal activity was morphotypal-dependent and most efficacious against A. fumigatus conidia. Fungicidal activity was mediated by dectin-1 receptors on the expanded NK cells leading to augmented release of perforin, resulting in enhanced direct cytolysis. In an immunocompromised mice pulmonary aspergillosis model, we showed that NK cell treatment significantly reduced fungal burden, hence demonstrating the translational potential of expanded NK cells as adjunctive therapy against IA in immunocompromised patients.