Uterine NK (uNK) cells are a distinct subset of NK cells in the decidua of humans and rodents during pregnancy, which are essential for remodelling of the spiral arteries supplying the feto-placental unit. Similarly to peripheral NK cells, uNK cells express Natural Killer receptors (NKRs) that engage MHC class I molecules. Evidence from human genetic association studies suggests that, in the presence of allogeneic cognate paternal MHC class I ligands, inhibitory uterine NKRs are associated with disorders of pregnancy arising from impaired decidual vascular remodelling. Conversely, enhancement of human uNK cell activity through activating NKRs is associated with high birth weight. Evidence from mouse models corroborates that uNK cell activity is modulated by interactions between NKRs and MHC class I, but has largely focussed on the effect of paternal MHC. In this study, the contribution of maternal immunogenetic regulation of NK cell function to reproductive outcome was assessed independently of parental MHC disparity in mice. To evaluate the role of NKR genes in isolation, I used congenic B6.BALB-TC1 (TC1) mice that differ from C57BL/6 (B6) mice only within the region of chromosome six encoding NKRs that recognise MHC class I. Absence of a major inhibitory NKR for self-MHC, Ly49I, in TC1 mice causes a compensatory shift in the NKR repertoire expressed and preserves a majority subpopulation of educated NK cells. B6 and TC1 splenic and uterine NK cells are similarly functionally reactive and mature, and no significant differences could be detected in spiral arterial remodelling or fetal growth between these strains in MHC-syngeneic matings. This supports data from human immunogenetic studies showing that maternal uterine NKRs are not associated with differences in pregnancy outcome in the absence of novel paternal MHC class I ligands, and highlights the importance of maternal and paternal co-regulation of uNK cell activity during pregnancy. No mouse models of uNK cell activation are currently available with which to corroborate human immunogenetic associations between activating uterine NKRs and high birth weight. Male m157-transgenic (m157-Tg) mice, which ubiquitously express viral m157 glycoprotein ligands for the activating NKR Ly49H, were mated with B6 females. Exclusive expression of m157 glycoprotein by trophoblast improved placental efficiency, but did not enhance fetal growth. Some fertility clinics surmise that uNK cell activation initiates the pathogenesis of spontaneous abortion. It has been suggested that this may occur due to reduced expression by human uNK cells of miR-483-3p, which stimulates endogenous insulin-like growth factor (IGF)-1 production and uNK cell cytotoxicity in vitro. It is demonstrated here that neither miR-483-3p nor IGF-1 regulate murine NK cell development, maturation or function. No discernible reproductive phenotype is evident in miR-483 deficient females. It can be inferred that post-transcriptional control by miR-483 is not biologically relevant to murine NK cell function. Although m157-Tg mice may provide an interesting model to further study uNK cell-mediated placental adaptations, it remains important to identify a murine model of enhanced uNK cell function to corroborate human immunogenetic associations with high birth weight and to challenge the supposition that uNK cell activation is harmful to pregnancy.

Die genaue Implikation natürlicher Killer(NK)-zellen und Neutrophile in Autoimmunerkrankungen des zentralen Nervensystems (ZNS) ist nach wie vor ungeklärt und wurde daher im Mausmodell der multiplen Sklerose (MS), der experimentellen Autoimmunenzephalomyelitis (EAE), sowie bei MS und Neuromyelitis optica (NMO) Patienten untersucht. Bei MS Patienten konnte eine mit der Krankheitsaktivität korrelierende, reduzierte Zahl zirkulierender CX3CR1+NK Zellen festgestellt werden. Daher wurden die NK Zell-Dynamiken und der Einfluss von CX3CR1 auf diese im EAE Mausmodell untersucht. Hierbei konnte in Wildtyp(WT) sowie auch CX3CR1-defizienten EAE Mäusen eine Rekrutierung peripherer NK Zellen in das ZNS beobachtet werden. Anders als bei WT EAE Mäusen wiesen die NK Zellen bei CX3CR1-defizienten Mäusen einen primär unreifen Phänotyp auf, der möglicherweise als ursächlich für die erhöhte Krankheitsaktivität dieser Tiere gemutmaßt werden kann. Der Transfer reifer NK Zellen vor Immunisierung CX3CR1-defizienter Tiere zeigte folglich protektive Effekte und lässt schlussfolgern, dass die CX3CR1-vermittelte Rekrutierung reifer NK Zellen die EAE Neuroinflammation limitiert. Die Diskriminierung der MS von der klinisch ähnlichen NMO stellt nach wie vor eine Herausforderung dar. Neutrophile in ZNS-Läsionen und der Cerebrospinalflüssigkeit(CSF) können bei NMO, nicht aber MS Patienten nachgewiesen werden, weshalb Neutrophile aus dem Blut von NMO und MS Patienten hier vergleichend untersucht wurden. Die Neutrophile beider Patientengruppen wiesen einen aktivierten Phänotyp im Vergleich zu gesunden Kontrollen auf. Im Gegensatz dazu zeigte sich eine von Medikation und neurologischen Defiziten der Patienten unabhängige, kompromittierte Funktionalität der NMO verglichen mit MS Neutrophilen im Hinblick auf Migration, oxidativen Burst und Degranulierung. Die Neutrophilenfunktionalität könnte entsprechend potentiell als diagnostisches Diskriminierungskriterium zwischen der MS und der NMO dienen. / The implication of natural killer (NK) cells and neutrophils in autoimmune disorders of the central nervous system (CNS) remains elusive, and therefore was investigated in a mouse model for multiple sclerosis (MS), experimental autoimmune encephalomyelitis (EAE), and in patients with MS and neuromyelitis optica (NMO), respectively. In MS, a decreased frequency of circulating CX3CR1+NK cells correlating with the patient disease activity has been reported. Therefore, the pattern of NK cell mobilization and the contribution of CX3CR1 to NK cell dynamics in response to neuroinflammatory insult were investigated in the EAE model. Here, NK cells similarly mobilized from the periphery and accumulated in the CNS in both wild-type (WT) and CX3CR1-deficient mice during EAE. However, in mice lacking CX3CR1 the infiltrated NK cells displayed an immature phenotype contrasting with the mature infiltrates in the WT counterparts, apparently contributing to EAE exacerbation in those animals since transfer of mature WT NK cells prior to immunization of CX3CR1-deficient mice exerted a protective effect. Together, these data suggest that the CX3CR1-mediated recruitment of mature CX3CR1+NK cells limits EAE neuroinflammation. Due to clinical similarities, the discrimination between MS and NMO is still challenging. In contrast to MS, neutrophil accumulations were found in CNS lesions and the cerebrospinal fluid (CSF) of NMO patients wherefore a comparative analysis of peripheral blood neutrophils in NMO and MS patients was performed. The results revealed an activated neutrophil phenotype in NMO and MS when compared to healthy individuals. In contrast, analysis of neutrophil migration, oxidative burst activity and degranulation showed a compromised neutrophil functionality in NMO compared to MS, which was not influenced by the treatment regime and clinical parameters of the patients. Thus, neutrophil functionality may represent a new diagnostic tool to discriminate between NMO and MS.

We performed a retrospective study in 185 patients with myelogenous leukemias who had received hematopoietic cells from unrelated donors. The aim of this study was to answer the question wether the benefit of KIR ligand incompatibility seen in haploidentical tranplantations can also be seen using unrelated donors. We could not detect a significant difference in survival between patients with a KIR ligand incompatibility and those with either fully matched or partially mismatched unrelated donors in this patient cohort. / In der Therapie von Leukämien ist die Knochenmark- bzw. Stammzelltransplantation eine tragende Säule. Für den Transplantationserfolg ist eine Übereinstimmung der Haupthistokompatibilitätsantige (HLA-Antigene der Klassen I und II) zwischen Spender und Empfänger von zentraler Bedeutung. Diese Notwendigkeit ergibt sich aus der sogenannten MHC-Restriktion in der T-Zellrezeptorerkennung. Ob auch NK-Zellrezeptoren und deren Liganden in der Spenderauswahl berücksichtigt werden sollten, ist bisher unzureichend untersucht. Insbesondere trifft das für die KIR-Rezeptoren zu, die wie die T-Zellrezeptoren ebenfalls HLA-Antigene als Liganden besitzen. Velardi et al. haben 2002 erstmalig gezeigt, daß in der Therapie myeloischer Leukämien die Transplantation von Blutstammzellen verwandter Spender mit KIR-Liganden-Inkompatibilität von klinischem Vorteil ist. Ob KIR-Liganden-Inkompatibilität auch bei Knochenmark-/ Stammzelltransplantationen Unverwandter Bedeutung erlangen könnte, war zu Studienbeginn offen und blieb auch infolge diskrepanter Untersuchungsergebnisse von verschiedenen Arbeitsgruppen im Verlauf der Studie widersprüchlich. Im Rahmen dieser Arbeit wurde diese Fragestellung, die auch Teil einer internationalen Studie war, an 185 Spender-Empfänger-Paaren retrospektiv untersucht. Dabei wurde bei den Paaren einerseits die KIR-Liganden-Kompatibilität auf der Grundlage der HLA-C-Supertypen erschlossen (nach Velardi et al.). Andererseits konnte sie im internationalen Studienprogramm direkt aus dem KIR-Genotyp des Spenders und dem HLA-C-Supertyp des Empfängers ermittelt werden. Die Untersuchungen ergaben folgende Resultate: bei Vorliegen von KIR-Liganden-Inkompatibilität hat die Verwendung von ATG als Bestandteil der GvHD-Prophylaxe keinen Einfluß auf das klinische Ergebnis. Die Vermutungen von Giebel et al. wurden damit nicht gestützt. Die Bestimmung des KIR-Liganden-Status mit Hilfe der Rückschlußmethode allein aus dem HLA-Typ ist unzuverlässig. Für eine exakte Differenzierung ist die gleichzeitige KIR-Genotypisierung erforderlich. KIR-Liganden-Inkompatibilität ist bei unverwandten Knochenmark-/ Stammzelltransplantationen nicht von klinischem Vorteil. Auch ein gezieltes Aussuchen HLA-C-inkompatibler Spender auf der Grundlage einer KIR-Genotypisierung stellt derzeit keine therapeutische Option dar.

Invariant natural killer T (iNKT) cells are a versatile subclass of T lymphocytes which recognize glycolipid antigens. iNKT cells are capable of rapidly producing a broad array of cytokines in response to stimulation; thus, they play an important role in the early regulation of a variety of immune responses. It was hypothesized that iNKT cells express functional Toll-like receptors (TLRs) and that stimulation of TLRs by their ligands modulates iNKT cells responses. In the first objective, it was revealed that upon stimulation with anti-CD3 monoclonal antibody and interferon (IFN)-α, expression of TLRs was enhanced in iNKT cells. Furthermore, stimulation of iNKT cells with TLR ligands led to a significant increase in the expression of several cytokines. In the second objective, the mechanisms behind the modulatory effects of the TLR9 ligand (CpG-ODN) on iNKT cells were determined. Altogether, these findings suggest a direct role for TLRs in iNKT cell activation. / Ontario Graduate Scholarship

Die vorliegende Arbeit beinhaltet die Generierung und Evaluation von Natürlichen Killerzellen, die EGFRvIII-positive und SDF-1alpha sekretierende primäre Glioblastomzellen aufspüren, erkennen und effizient abtöten können. Die Kombination der gelenkten Zytotoxizität mit einer optimierten Migration von Effektorzellen des Immunsystems wird auf Grundlage der in dieser Arbeit gewonnenen Daten als ein vielversprechender Ansatz für eine zukünftige Therapie des primären Glioblastoms vorgeschlagen.

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

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.

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

Clinical application of natural killer (NK) cells against leukemia is an area of intense investigation. In human leukocyte antigen-mismatched allogeneic hematopoietic stem cell transplantations (HSCT), alloreactive NK cells exert powerful anti-leukemic activity in preventing relapse in the absence of graft-versus-host disease, particularly in acute myeloid leukemia patients. Adoptive transfer of donor NK cells post-HSCT or in non-transplant scenarios may be superior to the currently widely used unmanipulated donor lymphocyte infusion. This concept could be further improved through transfusion of activated NK cells. Significant progress has been made in good manufacturing practice (GMP)-compliant large-scale production of stimulated effectors. However, inherent limitations remain. These include differing yields and compositions of the end-product due to donor variability and inefficient means for cryopreservation. Moreover, the impact of the various novel activation strategies on NK cell biology and in vivo behavior are barely understood. In contrast, reproduction of the thirdparty NK-92 drug from a cryostored GMP-compliant master cell bank is straightforward and efficient. Safety for the application of this highly cytotoxic cell line was demonstrated in first clinical trials. This novel ‘off-theshelf’ product could become a treatment option for a broad patient population. For specific tumor targeting chimeric-antigen-receptor-engineered NK-92 cells have been designed.

Le neuroblastome (NB) est la tumeur extra-crânienne la plus fréquente du jeune enfant. Malgré une thérapie multimodale très agressive, 40% des patients atteints de NB à haut risque rechutent. Le traitement de ces patients consiste à éliminer la tumeur par chirurgie, radiothérapie et chimiothérapie, à reconstituer la moelle osseuse par une greffe de cellules souches autologues et enfin à éliminer la maladie résiduelle (MRD) par une immunothérapie visant l’antigène GD2 exprimé par les neuroblastes. Notre étude préclinique a examiné l’efficacité de deux stratégies de traitements qui visent à potentialiser les thérapies actuelles et réduire leur toxicité. La première consiste à réduire la masse tumorale par la radiothérapie ciblée combinée à des radiosensibilisants. La deuxième approche est basée sur l’activation des cellules natural killer (NK) pour potentialiser l’effet de l’immunothérapie anti-GD2 et éliminer la MRD. L’autophagie est un processus catabolique qui élimine les protéines et organelles endommagées par différents stress incluant les irradiations. Par conséquent, inhiber l’autophagie pourrait sensibiliser les neuroblastes aux irradiations. Or, nous avons montré qu’étant très radiosensibles, les neuroblastes ne sont pas davantage éliminés par les irradiations quand ils sont traités avec un inhibiteur de l’autophagie. De plus, l’absence d’un inhibiteur efficace de l’autophagie à usage thérapeutique ne permet pas actuellement d’adopter cette approche. Notre étude a également permis de révéler une nouvelle approche de stimulation des cellules NK par les cellules dendritiques plasmacytoïdes (pDC) activées par un ligand du récepteur Toll-like, capable d’éradiquer la MRD et prévenir les rechutes de NB. Nos résultats ont permis, d’une part, d’élucider les mécanismes impliqués dans la lyse des cellules NK activées par les pDC contre les neuroblastes et, d’une autre part, de démontrer que l’axe pDC-NK chez le patient est fonctionnel, augmente l’efficacité de l’anti-GD2 et élimine efficacement les neuroblastes. Ainsi, l’immunothérapie par les cellules NK est une stratégie très prometteuse pour traiter le NB. Cette étude préclinique servira de base à l’élaboration d’un essai clinique pour traiter les enfants atteints de NB au CHU Sainte Justine. / Neuroblastoma (NB) is the most common extracranial solid tumor in childhood. Despite aggressive multimodal therapy, 40% of patients with high-risk NB relapse. The current therapy comprises an induction treatment with chemotherapy and surgery, a consolidation treatment including radiotherapy and high-dose chemotherapy followed by bone marrow rescue with autologous hematopoietic stem cell transplantation and finally anti-GD2 immunotherapy targeting the disialoganglioside (GD2) antigen expressed by neuroblasts to treat minimal residual disease (MRD). Our preclinical study proposes two treatment strategies to potentiate current therapies and reduced toxicities. The first aim to reduce tumor mass by targeted radiotherapy combined with radiosensitizers. The second approach is based on the activation of natural killer (NK) cells to potentiate the effect of anti-GD2 therapy and eliminate MRD. Autophagy is a catabolic process that recycle damaged proteins and organelles, induced under various conditions of cellular stress including irradiation. Therefore, inhibiting autophagy could sensitize neuroblasts to irradiation. However, our study showed that neuroblasts were highly sensitive to irradiation and autophagy inhibitor failed to increase neuroblasts sensitization to irradiation. In addition, the absence of a potent autophagy inhibitor for therapeutic use does not allow this approach to be adopted. Our preclinical study demonstrated a novel approach based on NK cell stimulation with Toll-like activated plasmacytoid dendritic cells (pDC) that enhances the efficacy of anti-GD2 immunotherapy and prevent NB relapse. We elucidated the mechanisms involved in pDC-activated NK cells killing of neuroblasts. We further demonstrated that neuroblasts were efficiently killed by patient’s NK cells after stimulation by activated pDC. This is further increased by the addition of anti-GD2 antibody. Altogether, our study demonstrates that NK cell-based immunotherapy has a real potential to enhance anti-GD2 immunotherapy effect and prevent NB relapse. This preclinical study will serve as a basis for the development of a clinical trial to treat children with NB at CHU Sainte Justine.