Malgré plusieurs chimiothérapies suivies d’une transplantation et d’une immunothérapie, 40% des patients avec un neuroblastome (NB) à haut risque subissent une progression de la maladie ou une rechute. L’échec de ces traitements est attribué à la présence de cellules initiatrices de tumeur (TIC) qui expriment le marqueur CD133 et qui sont souvent résistantes aux agents chimiothérapeutiques. Les cellules Natural Killer (NK), qui possèdent un effet anti-tumoral, peuvent être utilisées dans le cadre du développement de nouvelles approches immuno-thérapeutiques. Nous posons l’hypothèse que les cellules NK activées éliminent efficacement les TIC et contribuent à la réduction des risques de rechute. De plus, il est possible d’augmenter l’effet anti-tumoral des cellules NK contre le NB. L’activité cytotoxique des cellules NK est augmentée par des cellules dendritiques plasmacytoïdes (pDC) activées. A la suite de la stimulation de leurs récepteurs Toll-like les pDC produisent de grandes quantités d'interféron-alpha (IFN-α). Nous avons étudié les propriétés lytiques des cellules NK contre des lignées cellulaires de NB à la suite de leur activation par l’IFN-α ou des pDC activées. Nos résultats révèlent une augmentation de l’activité cytolytique des cellules NK contre ces lignées en réponse à une stimulation par les pDC activées. De plus, les cellules de NB CD133+ ou celles résistantes à l’immunothérapie dirigée contre le GD2 sont sensibles à la lyse médiée par les cellules NK stimulées par les pDC. Nous avons examiné les mécanismes cellulaires impliqués dans la lyse des cellules de NB. Nous montrons que cette cytotoxicité est médiée en partie par TRAIL induisant l'apoptose et en partie par la libération des granules cytotoxiques. Ainsi, ces résultats permettent de proposer une nouvelle approche immuno-thérapeutique complémentaire au traitement par l’anticorps anti-GD2 pour les patients atteints de NB à haut risque. / Despite aggressive treatment by chemotherapy followed by transplantation and treatment with anti-tumor cell disialoganglioside (GD2) monoclonal antibody, IL-2, GM-CSF and retinoic acid, 40% of patients with high-risk neuroblastoma (NB) still undergo disease progression or relapse. Furthermore, tumor-initiating cells (TIC) expressing the CD133 marker are present in NB tumors and are more resistant to chemotherapy. To evaluate a new immunotherapeutic approach, we took advantage of the anti-tumor effect of Natural Killer (NK) cells. We hypothesized that activated NK cells would be a potent therapeutic strategy to eliminate TIC and reduce relapse of NB. We aimed to establish the best strategy to increase the NK cell mediated cytotoxicity against NB. NK cell cytotoxic activity is increased by cytokines, chemokines and activated plasmacytoid dendritic cells (pDC) which produce high amounts of interferon-alpha (IFN-α) upon Toll-like receptor stimulation. We investigated NK-cell lytic properties against NB cell lines following activation by IFN-α or activated pDC. Our results reveal an increased cytolytic activity of NK cells against NB cell lines after stimulation by activated pDC, CD133+ (TIC) as well as anti-GD2 resistant NB cells are sensitive to NK cell mediated cytotoxicity following stimulation by activated pDC. We also examined the cellular mechanisms involved in NK cell-mediated lysis of NB cell lines. The increased cytotoxicity is partially mediated by TRAIL induced apoptosis and as well as by the release of cytolytic granules. In conclusion, we propose a new immunotherapeutic approach that can be used in combination with the anti-GD2 therapy for the treatment of high-risk NB patients.

Les cellules Natural Killer (NK), un sous-type de lymphocytes, sont cruciales dans l’immunité innée de par leur cytotoxicité directe envers les tumeurs, les cellules infectées et les cellules stressées. Elles contribuent également à l’orchestration de la réponse immunitaire adaptative de par leur capacité à produire des cytokines immunorégulatrices. Pour développer ces fonctions effectrices, les cellules NK requièrent l’intégration d’une multitude de signaux. De là, les cellules NK matures (mNK) sont considérées comme appartenant à quatre sous-types conséquents et concordants avec la polarisation vers la prolifération, la production de cytokines ou les propriétés cytotoxiques. Dans certaines maladies auto-immunes, tel le diabète de type 1 (T1D), un bloc dans leur maturation, et conséquemment des défauts en nombre et en fonctions, peut être observé. Ainsi, afin de découvrir la régulation génétique derrière la proportion et la maturation des cellules NK, des études de liaison génétique ont été produites sur des souris F2 (B10.BR x NOD.H2k) et F2.Rag (B6.Rag1-/- x NOD.Rag1-/-), où le fond génétique NOD est un modèle de T1D. Ces analyses ont révélé des locus potentiellement impliqués dans la régulation de la proportion, des nombres absolus ainsi que dans la maturation fonctionnelle des cellules mNK. Les chromosomes 8, 9 et 17 ont été liés à la proportion des cellules mNK tandis que les chromosomes 2, 4, 7, 10, 11 et 18 ont été liés aux sous-types fonctionnels de ces mêmes cellules. De là, nous avons validé l’influence du locus du chromosome 9 sur la proportion des cellules mNK en générant des souris sous-congéniques avec des insertions de segment génétique B10.BR dans des souris de fond génétique NOD. La proportion et le nombre absolu de cellules mNK ont ensuite été analysés par cytométrie en flux et comparés à ceux de souris contrôles. Pour la maturation fonctionnelle, nous avons retenus certains gènes candidats, et régulateurs associés, liés à un ou plusieurs sous-types de mNK, dont Tbx21, Zeb2, c-Myb, Trp53 et Pmaip1. Par association de voies de signalisation, nous sommes également allés vérifier certaines protéines associées, dont Bim et Eomesodermin. Nous avons alors validé leur implication par l’utilisation de modèles murins knock-out, qPCR, essais de prolifération et d’apoptose. Enfin, nos résultats supportent un rôle pour le locus du chromosome 9 dans la régulation de la proportion de cellules mNK ainsi qu’un rôle pour Trp53, Bim et Pmaip1 dans la maturation fonctionnelle de celles-ci. Nos études révèlent donc de nouveaux gènes candidats potentiels dans la régulation des cellules NK, dont les mécanismes pourront être approfondis dans la perspective de développement de thérapies cellulaires et génétiques dans le combat contre les cancers et les infections chroniques. / Natural Killer (NK) cells, a subset of lymphocytes, are crucial in innate immunity due to their direct cytotoxicity towards tumors, viral infected cells and stressed cells. NK cells also contribute to the orchestration of the adaptive response by their ability to produce immunoregulatory cytokines. To develop those effector functions, NK cells require the integration of multiple signals. As of now, mature NK cells (mNK) can be separated into a four-stage model of functional maturation that concords with a polarization either toward proliferation and cytokine production or cytotoxic functional properties. In autoimmune diseases, like type 1 diabetes (T1D), a block in their maturation, and consequently an impaired functionality and diminished numbers, can be observed. Thus, in order to uncover the genetic regulation behind the proportion and functional maturation of NK cells, a linkage analysis was performed by our lab on F2 (B10.BR x NOD.H2k) and F2.Rag (B6.Rag1-/- x NOD.Rag1-/- intercross) mice, where the NOD genetic background is a model of T1D. This analysis revealed loci that were potentially involved in the regulation of mNK cells proportion, absolute numbers or functional maturation. Loci on chromosomes 8, 9 and 17 were linked to the proportion of mNK cells while loci on chromosomes 2, 4, 7, 10, 11 and 18 were linked to different subsets of functional mNK cells. Hence, we validated the influence of the chromosome 9 locus on the proportion of mNK cells by generating congenic sub-strains of mice with insertion of B10.BR genetic segments and NOD genetic background. The proportion and absolute numbers of mNK cells were assessed by flow cytometry and compared to those of wild-type mice. Regarding the functional maturation of mNK cells, we considered potential candidate genes, and their upstream regulators, that were linked to one or more mNK subsets, namely Tbx21, Zeb2, Myb, Trp53 and Pmaip1. From those, we also looked further their associated pathway with proteins such as Bim and Eomesodermin. We proceeded to the in vivo validation of their implication by qPCR, proliferation and apoptosis assays and the use of knock-out mice. Indeed, our results support a role for a locus on chromosome 9 in the regulation of mNK cells proportion and for Trp53, Bim and Pmaip1 in NK cell functional maturation. As such, our study has revealed new candidate genes in NK cell regulation. Further explorations of the mechanisms by which those genes act could lead to the development of cellular and genetic therapies for cancers and chronic infections.

Les fièvres hémorragiques à virus Lassa (LASV) et Ebola (EBOV) représentent un important problème de santé publique en Afrique. Les réponses immunes et la pathogenèse associées à ces maladies sont peu connues. Les cellules NK ont un rôle important dans la réponse immune innée par leurs propriétés cytotoxiques, mais également dans l’induction des réponses adaptatives par leur production de cytokines et leurs interactions avec les cellules dendritiques (DC) et les macrophages. Ce projet s’attache à comprendre le rôle des cellules NK dans le contrôle de la réplication virale et dans l’induction des réponses immunitaires au cours de ces infections. Un modèle in vitro de coculture de cellules NK humaines avec des DC et macrophages autologues a été développé. L’activation des cellules NK et leurs fonctions ont été analysées après l’infection par LASV et EBOV. Par ailleurs, les réponses des cellules NK en réponse à LASV ont été comparées avec celles induites lors de l’infection par le virus Mopeia (MOPV), très proche de LASV mais non pathogène pour l’homme. Les macrophages, mais pas les DC, infectés par LASV ou MOPV induisent l’activation et l’augmentation des capacités cytotoxiques des cellules NK. Toutefois, les cellules NK ne sont pas capables de lyser les cellules infectées et ne produisent pas d’IFN-γ. Les cellules NK s’activent et sont capables de lyser les cellules infectées en présence de macrophages mais également de DC infectés par des LASV mutants. Cependant, les IFN de type I sécrétés en grande quantité en réponse à ces virus ne sont pas impliqués dans l’activation des cellules NK. L’infection par EBOV n’induit qu’une très faible activation des cellules NK en présence de DC ou macrophages et ne conduit pas à la sécrétion de cytokines, ni à la modification du potentiel cytotoxique.Ces résultats permettent d’améliorer la compréhension des réponses immunes et des mécanismes de pathogenèse mis en place lors des fièvres hémorragiques Lassa et Ebola. / The hemorrhagic fevers caused by Lassa (LASV) and Ebola (EBOV) viruses are important problems of public health in Africa. The immune responses and the pathogenesis associated with these diseases are unknown. NK cells are at the crossroads between the innate and adaptive immune responses through their abilities to secrete cytokines and kill the infected cells. The interactions between NK cells and dendritic cells (DC) or macrophages potentiate the immune responses. This project aims to understand the role of NK cells in the control of viral replication and in the induction of immune responses during LASV and EBOV infection.An in vitro model of coculture of human NK cells with autologous DC or macrophages has been set up. Cell activation, cytokine production, proliferation and NK cell-mediated killing were analyzed after the infection with LASV or EBOV. In addition, NK cell functions in response to LASV were compared with those induced during Mopeia virus (MOPV) infection, closely related to LASV but not pathogenic for humans.Here, we show that LASV- or MOPV-infected macrophages, but not DC, induce the activation of NK cells and the increase of their cytotoxic capacity. This process involves cell contact and type I IFN. However, these cells are neither able to kill the infected cells nor produce IFN-γ. NK cells are activated and are able to kill the infected cells when stimulated by mutated LASV-infected macrophages and DC. Surprisingly, the type I IFN which are secreted in high amounts in response to these viruses are not involved in NK cell activation. EBOV infection does not lead to NK cell activation in the presence of DC. EBOV-infected macrophages induce low NK cell activation without cytokine production or cytotoxicity.These results allow to better understand the immune responses and the mechanisms of pathogenesis associated with Lassa and Ebola hemorrhagic fevers.

INTRODUÇÃO: O fato do vírus da Hepatite C (HCV) estabelecer uma infecção crônica persistente, na maioria dos casos, mesmo sendo reconhecido e alvejado pelos sistemas imune inato e adaptativo sugere que o mesmo tenha desenvolvido estratégias eficazes para driblar a ação desses sistemas. O HCV interfere na fase inicial de ativação da resposta imune adaptativa alterando a função das células dendríticas (DCs), o que provavelmente leva a uma ativação deficiente das células natural killer (NKs) e de linfócitos T. Portanto, a realização de estudos sobre DCs e NKs na infecção pelo HCV se torna de fundamental importância para a compreensão da patogênese e persistência desta infecção. MÉTODOS: Foram selecionados indivíduos com resolução espontânea da infecção pelo HCV, indivíduos com infecção crônica e indivíduos saudáveis. A técnica de citometria de fluxo foi utilizada para a determinação da frequência e do fenótipo de células dendríticas e NKs nesses indivíduos. Além disso, foi avaliada a atividade citotóxica das células NKs sob estímulo de IL-12 e IL-18, e também da linhagem K-562. RESULTADOS: A frequência de DC mielóides (mDC) expressando CD86, nos indivíduos crônicos, foi elevada e uma correlação positiva com a carga viral foi observada. Na análise do ensaio funcional foi observado que as populações de células NKs CD7+ CD57+ apresentaram maior expressão da molécula CD107a e baixa produção de IFNy nos indivíduos com infecção crônica. A constante exposição das células imunes ao IFN-alfa, induzido durante a infecção pelo HCV, resulta na polarização do fenótipo citotóxico, caracterizado por células NK ativadas com elevado poder de degranulação, mas com deficiente produção de IFN-y. CONCLUSÕES: As frequências das células DCs e NKs eram semelhantes em todos os indivíduos. A expressão da molécula CD86 na superfície das mDCs pode ter sido induzida pela presença do HCV, uma vez que foi observada correlação positiva com a carga viral. Células NK citotóxicas, altamente diferenciadas e incapazes de produzir IFN-y foram as mais frequentes na infecção crônica pelo HCV. A baixa produção de IFN-y por parte dessas células é um dos fatores envolvidos na deficiente ativação de uma resposta imune adaptativa capaz de controlar a infecção pelo HCV / INTRODUCTION: Hepatitis C virus (HCV) develops a chronic persistent infection in most of the cases, even being recognized and targeted by the innate and adaptive immune systems, suggests that the virus have developed effective strategies to circumvent the action of these systems. HCV interferes in the initial activation of the adaptive immune response by altering the function of dendritic cells (DCs), which probably leads to a deficient activation of natural killer cells (NK) and T lymphocytes. Therefore, studies of DCs and NK in HCV infection are very important for understanding the pathogenesis and the persistence of this infection. METHODS: We selected subjects with spontaneous resolution of HCV infection, with chronic infection and healthy subjects. Flow Cytometry was used to determine the frequency and phenotype of dendritic cells and NK cells of these individuals. In addition, we evaluated the NK cell cytotoxic activity in response to stimulation of IL-12 and IL-18 and in co-cultivation with the cell line K-562. RESULTS: In individuals with chronic infection, the frequency of myeloid (m) DC cells expressing CD86 was elevated and a positive correlation between these cells and viral load was observed. It was observed in chronic infected individuals that NK cells co-expressing CD7 and CD57 showed higher expression of CD107a and low production of IFN gamma. The constant exposure of immune cells to IFN-alfa induced during HCV infection results in the polarization of cytotoxic phenotype characterized by activated NK cells with high power degranulation, but with impaired production of IFN-y. CONCLUSIONS: The frequency of DCs and NK cells were similar in all individuals. The expression of CD86 molecule on the surface of mDCs may have been induced by the presence of HCV, since a positive correlation was observed with viral load. Cytotoxic NK cells, highly differentiated and unable to produce IFN-y, were the most frequent in chronic HCV infection. The low production of IFN-y by these cells is one of the factors involved in the poor activation of an adaptive immune response able to control HCV infection

A endometriose (EDT) é caracterizada pela presença de tecido endometrial fora da cavidade uterina, e afeta mulheres em idade reprodutiva. Postulamos que alterações na frequência de células T reguladoras (Treg), natural killer (NK), supressoras mielóides (MDSC) e dendríticas (DC) no peritônio justificariam a redução da capacidade do sistema imune de reagir contra as células endometriais, permitindo sua implantação em locais ectópicos. Aqui, células Treg, NK, MDSC e DC foram quantificadas no fluido peritoneal (FP) e sangue de mulheres com EDT, a fim de associa-las ao desenvolvimento da doença; níveis de citocinas também foram avaliados. Na EDT, observou-se aumento na frequência de Treg, MDSC e DC no sangue e aparente redução destas no FP; ainda, a concentração de IL-12 foi menor no sangue comparadas ao grupo controle. Não foram observadas diferenças quanto às células NK e as outras citocinas analisadas. Os resultados indicam aumento da frequência de populações reguladoras em amostras de sangue de pacientes EDT, entretanto esses resultados não são refletidos no FP. / Endometriosis (EDT) is a gynecological disease characterized by the presence of endometrial cells out of the uterine cavity, which affects women in reproductive age. We postulated that alterations in the frequencies of regulatory T cells (Treg), natural killer cells (NK), myeloid-derived suppressor cells (MDSC) and dendritic cells (DC) in the peritoneum could justify the reduced capacity of the immune system to react to these ectopic endometrial cells, allowing them to invade distant tissues. Here, Treg, NK, MDSC and DC were quantified in the peritoneal fluid (PF) and peripheral blood (PB) of women with EDT, in order to associate them with the development of EDT; cytokine levels were also assessed. In EDT, higher frequencies of Treg, MDSC and DC in the PB and apparent lower frequencies of these cells in the PF were observed; IL-12 concentration was smaller in PB of EDT compared to control. No differences between groups were observed for NK cells and the other cytokines evaluated. The results indicate higher frequencies of regulatory cells in PB samples of EDT patients, although these findings were not reflected in PF samples.

Les cellules tueuses naturelles (NK) sont régulées par des récepteurs activateurs et inhibiteurs. La plupart des récepteurs inhibiteurs reconnaisse des molécules du complexe majeur d'histocompatibilité (CMH) de classe I, et protège les cellules saines des phénomènes d'auto-immunité médiés par les cellules NK. Cependant, certains récepteurs activateurs, incluant le récepteur killer cell Ig-like receptor (KIR) 2DS1, reconnaissent aussi des ligands CMH de classe I. Cela pose la question de savoir comment les cellules NK qui expriment des récepteurs activateurs deviennent tolérantes au soi. Nous avons cherché à déterminer si la présence de HLA-C2, le ligand du récepteurs 2DS1, peut induire les cellules NK qui expriment le 2DS1 à développer un état de tolérance au soi. Indépendamment de la présence ou de l'absence du ligand HLA-C2 dans le donneur, une activité anti-HLA-C2 a été identifiée in vitro dans certains clones NK 2DS1-positifs. La fréquence des clones NK avec réactivité anti-HLA-C2 était élevée parmi les donneurs homozygotes pour HLA-C1. De façon étonnante, nous n'avons pas constaté de différence statistiquement significative dans la fréquence de cytotoxicité anti-HLA-C2 entre les donneurs HLA-C2 hétérozygotes et les donneurs sans ligand HLA-C2. Par contre, les donneurs HLA-C2 homozygotes montrent une fréquence réduite de clones NK avec réactivité anti-HLA-C2 par rapport aux autres donneurs. Clones 2DS1-positifs qui co-expriment des KIR inhibiteurs spécifiques des molécules HLA de classe I du soi n’étaient pas communément cytotoxiques, et la cytotoxicité anti-HLA-C2 était limité presque exclusivement à des clones positifs seulement pour 2DS1 (« single positive » 2DS1 clones). Nous avons aussi identifié des clones 2DS1 « single positive » avec réactivité anti-HLA-C2 dans des patients recevant une greffe de cellules souches hématopoïétiques à partir de donneurs 2DS1. Ces résultats montrent que plusieurs cellules NK avec réactivité anti-HLA-C2 sont présentes dans des donneurs 2DS1 soit hétérozygotes soit homozygotes pour HLA-C1. En revanche, les clones 2DS1-positifs obtenus par des donneurs homozygotes pour HLA-C2 sont fréquemment tolérants aux antigènes HLA-C2. / NK cells are regulated by inhibiting and activating cell surface receptors. Most inhibitory receptors recognize MHC-class I antigens, and protect healthy cells from NK cell-mediated auto-aggression. However, certain activating receptors, including the human killer cell Ig-like receptor (KIR) 2DS1, also recognize MHC-class I. This raises the question of how NK cells expressing such activating receptors are tolerized to host tissues. We investigated whether the presence of HLA-C2, the cognate ligand for 2DS1, induces tolerance in 2DS1-expressing NK cells. Anti-HLA-C2 activity could be detected in vitro in some 2DS1 positive NK clones irrespective of presence or absence of HLA-C2 ligand in the donor. The frequency of anti-HLA-C2 reactivity was high in donors homozygous for HLA-C1. Surprisingly, there was no significant difference in frequency of anti-HLA-C2 cytotoxicity in donors heterozygous for HLA-C2 and donors without HLA-C2 ligand. However, donors homozygous for HLA-C2 had significantly reduced frequency of anti-HLA-C2 reactive clones as compared to all other donors. 2DS1 positive clones that express inhibitory KIR for self-HLA class I were commonly non-cytotoxic, and anti-HLA-C2 cytotoxicity was nearly exclusively restricted to 2DS1 single positive clones lacking inhibitory KIR. 2DS1 single positive NK clones with anti-HLA-C2 reactivity were also present post-transplantation in HLA-C2 positive recipients of hematopoietic stem cell transplants from 2DS1 positive donors. These results demonstrate that many NK cells with anti-HLA-C2 reactivity are present in HLA-C1 homozygous and heterozygous donors with 2DS1. In contrast, 2DS1 positive clones from HLA-C2 homozygous donors are frequently tolerant to HLA-C2.

Chez la souris, les cellules dendritiques plasmacytoïdes (pDC) et natural killer (NK) contribuent à la résistance contre les infections systémiques par les virus herpétiques tels que le cytomégalovirus murin (MCMV). Les pDC représentent la source majeure d’interférons de type I (IFN-I) lors d’une infection par le MCMV. Cette réponse est dépendante de MyD88 et des récepteurs de type Toll 7 et 9. D’autre part, les cellules NK, qui expriment le récepteur d’activation Ly49H, peuvent détecter et lyser les cellules infectées par le MCMV. La perte de l’une de ces réponses augmente la sensibilité à l’infection. Cependant, la façon dont ces réponses antivirales interagissent est mal connue. Chez l’homme, bien que les réponses dépendantes des IFN-I soient essentielles, MyD88 semble superflu pour l’immunité antivirale. Cependant, les mécanismes susceptibles de compenser l’absence de MyD88 chez l’homme sont inconnus. Il a été supposé que les souris déficientes pour MyD88 ne parvenaient pas à monter de réponse protectrice dépendante des IFN-I lors d’infections par le MCMV. Afin d’évaluer cela, nous avons comparé la résistance de souris déficientes pour MyD88, les récepteurs aux IFN-I (IFNAR) et/ou Ly49H lors de cette infection. La déplétion sélective des pDC ou l’absence de MyD88 diminue drastiquement la production d’IFN-I, mais n’empêche pas l’établissement d’une forte réponse aux IFN-I dans la rate. De plus, l’absence de MyD88, mais pas celle d’IFNAR, peut être compensée par l’activité antivirale des cellules NK dépendant de Ly49H. Par conséquent, chez la souris, MyD88 est redondant pour l’établissement d’une réponse splénique aux IFN-I lors d’une infection systémique par le MCMV. / In mice, plasmacytoid dendritic cells (pDC) and natural killer (NK) cells both contribute to resistance to systemic infections with herpes viruses including mouse Cytomegalovirus (MCMV). pDCs are the major source of type I IFN (IFN-I) during MCMV infection. This response requires pDC-intrinsic MyD88-dependent signaling by Toll-Like Receptors 7 and 9. Provided that they express appropriate recognition receptors such as Ly49H, NK cells can directly sense and kill MCMV-infected cells. The loss of any one of these responses has been reported to increase susceptibility to infection. However, the relative importance of these antiviral immune responses and how they are related remain unclear. In humans, while IFN-I responses are essential, MyD88 appears to be dispensable for antiviral immunity. However, the mechanisms that could compensate MyD88 deficiency in humans have not been elucidated. Moreover, it has been assumed, but not proven, that MyD88-deficient mice fail to mount protective IFN-I responses to systemic herpes virus infections. To address these issues, we compared resistance to MCMV infection between mouse strains deficient for MyD88, the IFN-I receptor (IFNAR) and/or Ly49H. We show that selective depletion of pDC or genetic deficiencies for MyD88 drastically decreased production of IFN-I, but not the protective antiviral responses mediated by these cytokines. Moreover, MyD88, but not IFNAR, deficiency could be compensated by Ly49H mediated antiviral NK cell responses. Thus, contrary to the current dogma, but consistent with the situation in humans, we conclude that, in mice, MyD88 is redundant for splenic IFN-I responses against a systemic herpes virus infection.

Durant la grossesse, le fœtus est séparé de la mère par le placenta qui constitue une barrière protectrice efficace. Cependant, cette barrière n’est pas totalement imperméable et permet de nombreux échanges (nutriments, hormones, déchets, ...) dans des zones bien spécifiques nommées interfaces materno-fœtales. Au niveau de ces zones, les cellules fœtales entrent en contact direct avec le sang et les tissus maternels. Parmi ces interfaces, on trouve notamment la decidua basalis (paroi de l’endomètre gestant) où les villosités choriales du placenta s’ancrent profondément et l’espace intervilleux où les villosités flottantes sont baignées par le sang maternel. L’accès au placenta au niveau de ces interfaces est un processus finement régulé par de nombreux mécanismes. Cependant, certains pathogènes qui infectent la mère peuvent détourner ces mécanismes, franchir la barrière placentaire et se disséminer au fœtus. La famille des pathogènes TORCH (Toxoplasmosis, Others, Rubella, Cytomegalovirus et Herpes) est la plus connue pour induire des infections congénitales. Cependant d’autres virus moins connus ou émergents sont aussi capables d’infecter les interfaces mère-fœtus et de causer des complications graves pouvant être fatales pour la mère et le fœtus. Parmi ces virus, on retrouve notamment le virus de l’Hépatite E (VHE) et le virus Zika (ZIKV). C’est dans ce contexte que s’insèrent mes travaux de thèse qui s’articulent autour de trois axes. Dans la première partie de ma thèse, nous nous sommes intéressés à la pathogenèse du VHE et du ZIKV à l’interface mère-fœtus en identifiant les cibles cellulaires des virus et en caractérisant les conséquences fonctionnelles de l’infection. Dans la seconde partie, nous avons étudié la fonction des cellules Natural Killer déciduales (dNK), qui représentent 30% des cellules de la decidua basalis. Ces cellules dNK ne sont pas cytotoxiques durant une grossesse physiologique mais elles sécrètent de nombreux facteurs solubles essentiels au bon déroulement de la grossesse. Nous avons démontré que les fonctions effectrices des cellules dNK sont directement régulées et dictées par le microenvironnement décidual. De plus, nous avons découvert que les cellules dNK sont capables de détecter et de limiter l’infection des cellules stromales déciduales par le ZIKV. Enfin, dans la dernière partie, nous nous sommes intéressés à la pathogenèse de l’infection par le VHE dans un autre groupe de patients à haut risque de formes graves, les personnes âgées. Nous avons alors mis en évidence que le développement de formes sévères est associé à l’émergence d’une population de lymphocytes T CD8 caractérisée par un fort état d’activation associé à des défauts fonctionnels. En conclusion, mes travaux de thèse ont permis de mieux comprendre la pathogenèse du VHE et du ZIKV durant la grossesse et au-delà. De plus, ils ont participé à prouver l’importance du microenvironnement local dans le contrôle de la plasticité des cellules immunitaires. / During pregnancy, the fetus is isolated from the mother by the placenta, which constitutes an efficient protective barrier. However, this barrier is not completely impermeable and allows various exchanges (nutrients, hormones, wastes …) in specific areas called maternal-fetal interfaces. In these areas, fetal cells are in direct contact with maternal blood and tissues. Among these interfaces, we can distinguish the decidua basalis (gestating endometrium wall) where the placental chorionic villi are deeply anchored, and the intervillous space where the floating villi bathe in the maternal blood. The access to the placenta is a process tightly regulated by different mechanisms. However, some pathogens that infect the mother can subvert these mechanisms, cross the placental barrier, and spread to the fetus. The family of TORCH pathogens (Toxoplasmosis, Others, Rubella, Cytomegalovirus and Herpes) is best known for inducing such congenital infections. Alternatively, other less known or emerging viruses like Hepatitis E virus (HEV) and Zika virus (ZIKV) are also able to infect the maternal-fetal interface and cause severe outcomes that can be lethal for both the mother and the fetus. It’s in this context that fit my thesis work, articulated around three research axes. In the first part of my work, we focused on the pathogenesis of HEV and ZIKV at the maternal-fetal interface by identifying the cellular targets of the viruses and deciphering the functional consequences of their infection. Then, we studied the role of the decidual Natural Killer (dNK) cells, which account for 30% of total cells within the decidua basalis. These dNK cells are devoid of cytotoxic function in healthy conditions but they rather secrete various soluble factors that are essential for the success of pregnancy. In the second part of my work, we demonstrated that the decidual microenvironment dictates and regulates the effector functions of dNK cells. Moreover, we found that dNK cells are able to detect and limit the infection of decidual stromal cells by ZIKV. Finally, in a last part, we investigated the pathogenesis of HEV infection in another group of patients at high risk of developing serious forms, the elderly people. Thus, we highlighted that the development of severe forms is associated with the emergence of a population of CD8 T cells characterized by a high activation status associated with functional defects. In conclusion, my thesis work has shed light on the pathogenesis of HEV and ZIKV during pregnancy and beyond. In addition, they helped to demonstrate the importance of the local microenvironment in controlling the plasticity of immune cells.

L'hépatite chronique virale C est associée à une défaillance du système immunitaire. Nous nous sommes intéressés aux cellules NK et aux lymphocytes Treg, partenaires de la réponse immunitaire innée. Le nombre des NK, particulièrement les CD56dim, est significativement diminué chez les patients infectés, dans le foie plus que dans le sang, et s'accentue avec la fibrogenèse. Le nombre de CD3-CD56+brightNKG2A+ circulantes est corrélé à la sévérité de l'inflammation et de la fibrose et celui des CD3-CD56+dimNKG2A+ inversement corrélé à la charge virale. Les NK sont fonctionnelles, en capacité de produire de l'IFN-γ et d'engager un processus de cytolyse. L'expression de CD158 est significativement diminuée à la surface des NK hépatiques mais conservée dans les NK circulantes. L'expression de NKG2A,C,D dans les NK circulantes et hépatiques est identique à celles de patients non infectés. Les Treg intrahépatiques FoxP3+ sont quasi-exclusivement de phénotype CD4+. En analyse multivariée, le nombre de FoxP3+ est indépendamment associé à celui de CD8+, surtout dans les lésions nécrotico-inflammatoires et une corrélation forte est observée entre les transcrits CD8, FoxP3, IL-10 et TGF-β, suggérant que les Treg bloquent l'expansion et la cytotoxicité des TCD8 par contact cellulaire ou par le biais de cytokines immunosuppressives. L'équilibre entre FoxP3 et CD8 est rompu dans les grades et stades Métavir A>2 et F>3, avec un effondrement du rapport FoxP3/CD8. L'inflammation hépatique chronique s'accompagne de fibrose, aboutissant à la cirrhose, principale cause de CHC. Dans les cirrhoses virales C avec ou sans CHC, les lymphocytes CD3+, CD4+, CD8+, CD20+, CD56+, TCRγδ +, FoxP3+ sont plus nombreux dans la fibrose que dans le parenchyme. Le nombre de CD20+, CD3+, CD4+, CD8+ et l'expression d'IFN-γ et RANTES sont plus élevés dans les cirrhoses qui développent un CHC. En analyse multivariée, CD8 est le seul facteur indépendament associé à la récidive tumorale et à une diminution de la survie sans récidive à 5 ans. Les CD20+, CD3+, CD4+, CD8+, CD56+, TCRγδ+, FoxP3+ sont significativement moins nombreux dans le CHC que dans la cirrhose. Mais les FoxP3+ sont significativement plus nombreux et les CD56+ moins nombreux dans le CHC que dans le nodule parenchymateux, sans modification des LT, conduisant à une augmentation du rapport FoxP3/CD8 dans la tumeur. Les CD56+ diminuent de la cirrhose au CHC. Aucune corrélation n'est observée entre la densité intra-tumorale des lymphocytes étudiés et la récidive carcinomateuse. Conclusion. Un infiltrat inflammatoire dense au sein de la cirrhose C, particulièrement riche en CD8, favorise le développement et/ou la récidive du CHC. / Chronic hepatitis C is associated with the failure of the immune system. We were interested to NK cells and Treg cells, partners in the innate immune response. The number of NK, particularly the CD56+dim, is significantly reduced in infected patients, in the liver more than in the blood, and increases during the process of fibrogenesis. The number of circulating CD3- CD56+brightNKG2A+ correlates with the severity of inflammation and fibrosis and that of CD3- CD56+dimNKG2A+ inversely correlates with viral load. The NK functional capacity to produce IFN-γ and initiate a process of cytolysis is maintened. The CD158 expression is significantly reduced on the surface of intrahepatic NK, whereas NKG2A,C,D expression in circulating and hepatic NK is identical to that of non-infected patients. The intrahepatic Treg FoxP3+ are almost exclusively CD4+ phenotype. In multivariate analysis, the number of FoxP3+ is independently associated with that of CD8+, especially in necroinflammatory lesions and a strong correlation is observed between CD8, FoxP3, IL-10 and TGF-β, suggesting that Treg could inhibit CD8 expansion and cytotoxicity by cell contact or through immunosuppressive cytokines. The balance between FoxP3 and CD8 is broken in the most severe stages of the disease (METAVIR A>2 and F>3), which results in a drop in the FoxP3/CD8 ratio. Chronic inflammation is accompanied by liver fibrosis, leading to cirrhosis, the main cause of HCC. In viral C cirrhosis with or without HCC, CD3+, CD4+, CD8+, CD20+, CD56+, TCR γδ+, FoxP3+ lymphocytes are more numerous in fibrosis than in parenchyma. The number of CD3+, CD4+, CD8+, CD20+ and the expression of IFN-γ and RANTES were higher in cirrhosis developing HCC. In multivariate analysis, CD8 is the only independent predictor of tumor recurrence and is associated with a significant decrease in the 5 years disease free survival. The CD3+, CD4+, CD8+, CD20+, CD56+, TCR γδ+, FoxP3+ tumor infiltrating lymphocytes were significantly lower than in distant cirrhosis. However, FoxP3+ are significantly higher and CD56+ significantly lower in HCC than in parenchymatous nodules, without LT changes, leading to an increase in the FoxP3/CD8 ratio into the tumor. The number of CD56+ decreases from cirrhosis to HCC. No correlation was found between the density of studied tumor infiltrating lymphocytes and HCC recurrence. Conclusion. A dense inflammatory infiltrate in viral C cirrhosis, particularly rich in CD8, promotes HCC development and/or recurrence.

Made available in DSpace on 2014-12-17T15:32:21Z (GMT). No. of bitstreams: 1 EdilmarMS_DISSERT.pdf: 790528 bytes, checksum: 570c185c018d55b199d467de6ca18465 (MD5) Previous issue date: 2012-02-09 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The most common malignant neoplasm of the oral cavity and oropharynx are squamous cell carcinoma. Injuries to the same stage and subjected to the same treatment protocol have sometimes different evolutionary courses. The scope of this study was to investigate, through a retrospective cohort, associations between the number of CD8 + T cells and natural killer, identified immunohistochemically in the inflammatory infiltrate in a series of cases of oral squamous cell carcinoma and orofaringeano, and the level of tumor response to radiotherapy and chemotherapy, overall survival and relapse-free survival of patients. We identified 54 patients with unresectable disease were treated exclusively with radiotherapy and chemotherapy. The median follow-up was 22 months. The sample was characterized by the predominance of male subjects, median age 60 years, all were smokers. The most frequent site was the tongue and 81.5% were in stage IV. Patients with disease in the oral cavity had a worse response to treatment (p = 0.006), worse relapse-free survival (p = 0.007), worse overall survival (p = 0.007). The advanced T stage was shown a negative prognostic factor (p= 0.006) for the clinical treatment response made. Immunohistochemistry was performed to select CD8 + cells (anti-CD8) and NK cells (anti-CD57). Lymphocytes positive and negative markings were counted using the program ImageJ ?. Two groups were created for each marking evaluated: Group I patients with more than 50% cells positive, Group II: less than 50% of labeled cells. For CD8 + cells detected in 38 (70.3%) of Group I were CD8 + and 16 (29.7%) Group II CD8 +. For NK cells, 26 (48.15%) Group I NK and 28 (51.85%) Group II NK. Regarding the clinical response to treatment, we observed that 39% of patients achieved a complete response and 25.9% remained without recurrence at the end of follow-up. These results were better in Group I CD8 + (p = 0.2). Identified that 72.2% of patients progressed to death, this finding had no association with the immunohistochemical data. There was no statistically significant differences between the number of CD8 + and NK cells and the ability of tumor response to radiotherapy and chemotherapy, or with overall survival and relapse-free survival of patients. However, especially in relation to a learned response, we found that this group of patients with advanced disease have a low count of CD8 + T cells active. Believing in the role that the immune response plays in the local fight against neoplastic cells, however, our results do not support the use of quantitative analysis of CD8 + T cells and NK cells as a prognostic factors for oral squamous cell carcinoma and oropharynx / A neoplasia maligna mais frequente da cavidade oral e da orofaringe ? o carcinoma epiderm?ide. Les?es com o mesmo estadiamento e submetidas ao mesmo protocolo terap?utico apresentam, por vezes, cursos evolutivos diferentes. O escopo do presente trabalho foi investigar, atrav?s de um coorte retrospectivo, associa??es entre a quantidade de c?lulas TCD8+ e natural killer, identificadas imuno-histoquimicamente no infiltrado inflamat?rio de uma s?rie de casos de carcinoma epiderm?ide oral e orofaringeano, e o n?vel de resposta tumoral ao tratamento radioter?pico e quimioter?pico, a sobrevida global e sobrevida livre de recidiva dos pacientes. Foram identificados 54 pacientes com doen?a irressec?vel, tratados exclusivamente com radioterapia e quimioterapia. A mediana de seguimento foi de 22 meses. A amostra se caracterizou pelo predom?nio de indiv?duos masculinos, com idade mediana de 60 anos; todos eram tabagistas. O s?tio mais frequente foi a l?ngua oral e 81,5% encontravam-se no est?dio IV. Os pacientes com doen?a na cavidade oral tiveram uma pior resposta ao tratamento (p=0,006), pior sobrevida livre de recidiva (p=0,007), pior sobrevida global (p=0,007). O est?dio T avan?ado se demonstrou um fator progn?stico negativo (p=0,006) para a resposta ao tratamento cl?nico efetuado. Foi realizada imuno-histoqu?mica para marcar c?lulas CD8+ (anti-CD8) e c?lulas NK (anti-CD57). Os linf?citos positivos e negativos para as marca??es foram contados atrav?s do programa ImageJ?. Dois grupos foram criados para cada marca??o avaliada: Grupo I: pacientes com mais de 50% das c?lulas positivas; Grupo II: menos de 50% das c?lulas marcadas. Para as c?lulas CD8+ detectamos que 38 (70,3%) eram do Grupo I CD8+ e 16 (29,7%) do Grupo II CD8+. Para as c?lulas NK, 26 (48,15%) Grupo I NK e 28 (51,85%) Grupo II NK. Em rela??o ? resposta cl?nica ao tratamento, observamos que 39% dos pacientes obtiveram resposta completa e 25,9% permaneceram sem recidiva ao final do seguimento. Esses resultados foram melhores no Grupo I CD8+ (p=0,2). Identificamos que 72,2% dos pacientes evolu?ram para o ?bito, esse achado n?o teve associa??o com os dados imuno-histoqu?micos. N?o se observou diferen?as estatisticamente significantes entre a quantidade de c?lulas CD8+ e NK e a capacidade de resposta tumoral ao tratamento radioter?pico e quimioter?pico, nem com a sobrevida global e sobrevida livre de recidiva dos pacientes. Contudo, principalmente em rela??o a resposta adquirida, detectamos que este grupo de pacientes com doen?a avan?ada tem uma baixa contagem de c?lulas TCD8+ ativas. Acreditando no papel fundamental que a resposta imune exerce no combate local ?s c?lulas neopl?sicas; no entanto, nossos resultados n?o suportam a utiliza??o da an?lise quantitativa das c?lulas TCD8+ e NK como um dos fatores progn?sticos para o carcinoma epiderm?ide oral e de orofaringe