Pneumonia is the second leading cause of disability-adjusted life-years lost worldwide and the eighth leading cause of death in the United States. Traumatic brain injury (TBI) patients have classically been considered immunosuppressed, but recent research reported that mild head trauma patients have reduced incidence of pneumonia compared to blunt trauma patients. Using our mild TBI model followed by bacterial pneumonia, we investigated the effect of neuronal signaling on innate immune function. To test whether any mild injury primes host immune responses to pneumonia, we generated a mild tail trauma (TT) model. mTBI mice showed protection from bacterial pneumonia while TT mice did not. Using an FDA-approved neurokinin-1 receptor (NK1R) antagonist, aprepitant, we confirmed our previous findings that substance P (SP) is a key mediator of enhanced resistance to pneumonia. Blocking NK1R showed that mTBI-induced release of SP augments pulmonary neutrophil recruitment and microbicidal activity to pulmonary bacterial pathogens. In TT mice, NK1R agonism enhanced the same neutrophil functions, further supporting the hypothesis. No differences were found between mTBI and TT neutrophils’ ability to phagocytose, generate oxidative burst, or acidify phagosomes. However, neutrophils from mTBI mice produced more neutrophil extracellular traps in response to bacterial challenge. These studies show that neurokinin signaling in our model contributes to enhanced bacterial clearance. Cholinergic anti-inflammatory pathway signaling though the α7 nicotinic acetylcholine receptor (α7 nAChR) is also a critical component of improved survival. Blockade of α7 nAChR abrogated the mTBI survival benefit. Mimicking cholinergic signaling using α7 nAChR agonist recapitulated the mTBI reduced pro-inflammatory cytokine production and improved survival. No physiologic differences emerged within 24h following pneumonia, but mTBI and α7 agonist treated mice had significantly lower TNFα in bronchoalveolar fluid, suggesting reduced injurious pulmonary inflammation. However, replacing early TNFα during pneumonia did not increase mortality. Western blot analysis showed downregulation of HMGB1 release in mTBI mice, suggesting that vagal cholinergic signaling reduces late mediators of organ damage. Our experiments show that mTBI enhances resistance to pneumonia by activating the vagus nerve signaling through neurokinin and cholinergic pathways. Translation of these findings could be innovative solutions to fighting or preventing infections.

Através do presente trabalho investigou-se a expressão do comportamento doentio e a atividade de neutrófilos sanguíneos de camundongos adultos, de meia idade e idosos, após o tratamento com lipopolissacarídeo de bactéria gram negativa (Escherichia coli). O comportamento doentio foi avaliado através da ingestão de alimentos e do peso corpóreo. Nos aparatos comportamentais Campo Aberto e Labirinto em cruz elevado, o comportamento doentio foi avaliado através da atividade geral, da exploração e dos níveis de ansiedade. A atividade de neutrófilos sanguíneos foi estudada através de citometria de fluxo, analisando-se a intensidade e porcentagem de neutrófilos que realizaram fagocitose e da intensidade e porcentagem de neutrófilos que realizaram burst oxidativo, ambos induzidos pelo estímulo in vitro da bactéria Staphylococcus aureus. Os animais foram tratados com solução salina ou LPS (na dose de 200 µg/kg) avaliações foram realizadas 2 horas após o tratamento. No caso da ingestão de alimentos e do peso corpóreo, as avaliações foram realizadas durante 3 dias anteriores ao experimento, e durante 7 dias posteriores ao experimento. Os resultados demonstraram que animais idosos apresentaram diferenças na expressão do comportamento doentio, sendo que houve uma maior motivação em explorar os aparatos comportamentais. Apesar da manutenção da exploração no Campo Aberto e Labirinto em Cruz elevado, a redução da ingestão de alimentos e do peso corpóreo apresentou-se mais acentuada nos camundongos de meia idade e idosos, após tratamento com LPS. A atividade de neutrófilos sanguíneos, avaliadas pela fagocitose e burst oxidativo, apresentou-se aumentada em camundongos idosos após tratamento com LPS. A menor migração de neutrófilos sanguíneos à cavidade peritoneal parece ser responsável por esse aumento de atividade dos neutrófilos de camundongos idosos. Esses resultados sugerem que a expressão do comportamento doentio de camundongos idosos é diferente, com manutenção do comportamento de exploração, e que esses camundongos seriam mais susceptíveis aos efeitos do choque endotóxico, devido à presença de maior quantidade de neutrófilos ativados no sangue. / Through the present work, it has been investigated the expression of sickness behavior and blood neutrophils activity in adult, middle-aged and aged mice, after gram negative (Escherichia coli) lipopolysaccharide treatment. Sickness behavior was evaluated through food ingestion and body weight. On the behavioral apparatus Open Field and Elevated Plus Maze, sickness behavior was evaluated through general activity, exploration and anxiety levels. Blood neutrophils activity was studied through flow cytometric analysis, assessing neutrophil\'s intensity and percentage of phagocytosis and neutrophil\'s intensity and percentage of oxidative burst, both induced by in vitroM stimulus of Staphylococcus aureus bacteria. Animals were treated either with saline solution or LPS (in the 200 µg/kg dose) and analysis were done 2 hours after treatment. In the case of food ingestioin and body weight, analysis were done through 3 days before experiment, and during 7 days after experiment. Results demonstrated that aged animals showed differences in sickness behavior expression, with a greater motivation to explore behavioral apparatus. Despite maintenance of Open Field and Elevated Plus Maze exploration, reduction in food ingestion and body weight were more pronounced in middle-aged and aged mice, after LPS treatment. Blood neutrophils activity, analysed through phagocytosis and oxidative burst, were higher in aged mice after LPS treatment. Lesser blood neutrophils migration to peritoneal cavity seems to be responsible for this enhancement in neutrophil activity. These results suggest that the expression of sickness behavior in aged mice is different, with maintenance of exploratory behavior, and that these mice would be more susceptible to endotoxic effects, due to the presence of higher quantity of activated neutrophils in blood.

O setor avícola apresenta o maior crescimento em volume produzido dentre todos os setores cárneos no Brasil. A grande participação dos produtos avícolas na alimentação humana somada ao risco do desenvolvimento de resistência bacteriana, levaram a União Européia (UE) a abolir utilização de antimicrobianos como aditivos e de forma profilática na ração de animais. A remoção dos aditivos associada ao sistema de criação intensivo acabaram por fazer que doenças, até então consideradas controladas, se tornassem reemergentes. A enterite necrótica aviária (NE) é considerada um exemplo. De forma geral, condições estressoras predispõem ao desenvolvimento de doenças, sendo o calor um dos estressores mais comuns que ocorrem em granjas aviárias. Este estudo enfoca o efeito do estresse térmico por calor (35±1ºC) sobre o desenvolvimento da NE em frangos de corte. Para isso, 60 frangos de corte machos foram divididos em 6 grupos experimentais: 1 Grupo Controle; 2 Grupo Controle Estressado (C/HS35); 3 Grupo Tioglicolato (T); 4 Grupo Tioglicolato Estressado (T/HS35); 5 Grupo Infectado (I); 6 Grupo Infectado Estressado (I/HS35). A infecção experimental com Clostridium perfringens foi feita por via oral, com a bacteria em meio de cultura misturada a ração, do 15º ao 21º dia de vida nos grupos I e I/HS35. O estresse por calor (35±1º C) foi realizado do 14º ao 21º dia de vida das aves dos grupos estressados. Durante todo período experimental os animais foram mantidos em isoladores. Em relação aos animais não estressados, os animais submetidos ao estresse por calor apresentaram: 1- menor escore lesional macro e microscópico no intestino delgado; 2- maior concentração de IgA no lavado intestinal do duodeno; 3 - menor concentração de IgA no jejuno; 4 - redução dos níveis séricos de IgA e IgY; 5 - maior concentração sérica de IgM; 6 - diminuição qualitativa evidente dos heterofilos intestinais em relação aos animais infectados e estressados. Portanto, mostrou-se que o estresse por calor apresentou efeito imunomodulador importante, ao reduzir a inflamação intestinal. Este achado associa-se provavelmente à diminuição da imunidade inata por redução da migração de heterófilos para a mucosa intestinal, desta forma prevenindo a manifestação de um um quadro clínico mais grave de NE, fato associado à diminuição das lesôes desencadeadas pelo processo inflamatório heterofílico. / The poultry sector presented the highest growth in the volume of production among all meat sectors in Brazil. The great participation of poultry products on human diet together with the risk of food and environmental contamination by resistant bacteria led the European Union (EU) countries to abolish the use of antibiotics as feed additives in animal production. This fact associated with the intensive farming system are being reported as responsible for the re-emergence of some already controlled diseases. The avian necrotic enteritis (NE) exemplify such an effect. Generally, stressful conditions are predisponent factors for disease development; heat stress is one of the most common stressor in poultry farms. This study focuses on the effects of heat stress (35 ± 1 º C) on the development of NE in broilers. For this purpose, 60 male broilers were divided into 6 groups: 1 - control group, 2 - stressed control group (C/HS35) 3 - thioglycolate group (T) 4 - thioglycolate stressed group (T/HS35); 5 - infected group (I) 6 - infected stressed group (I/HS35). Experimental infection with Clostridium perfringens, grown in thioglycollate broth medium, was given through the feed to the birds of groups I and I/HS35 from the 15th to 21st days of life. The heat stress (35 ± 1 °C) was induced continuously from the 14th to the 21st day of life in birds of the stressed groups. Throughout the experimental period the animals were kept in isolators. Compared to non-stressed animals, broilers subjected to heat stress showed: lower gross and microscopic score lesions in the small intestine; increased concentrations of IgA in duodenal lavage and decreased IgA concentrations in the jejunum; smaller concentrations of serum IgA and IgY; increased concentration of serum IgM; reduction in gut number of heterophils in the thioglycolate treated and in the infected groups. Therefore, this experimental model showed that heat stress presented a significant immunomodulatory role on the induced NE, most probably because it reduced intestinal inflammation via decrease in heterophils migration to the intestinal mucosa, which in turn might had reduced tissue damage during infamation, hence preventing the development of a more severe form of NE.

Através do presente trabalho investigou-se a expressão do comportamento doentio e a atividade de neutrófilos sanguíneos de camundongos adultos, de meia idade e idosos, após o tratamento com lipopolissacarídeo de bactéria gram negativa (Escherichia coli). O comportamento doentio foi avaliado através da ingestão de alimentos e do peso corpóreo. Nos aparatos comportamentais Campo Aberto e Labirinto em cruz elevado, o comportamento doentio foi avaliado através da atividade geral, da exploração e dos níveis de ansiedade. A atividade de neutrófilos sanguíneos foi estudada através de citometria de fluxo, analisando-se a intensidade e porcentagem de neutrófilos que realizaram fagocitose e da intensidade e porcentagem de neutrófilos que realizaram burst oxidativo, ambos induzidos pelo estímulo in vitro da bactéria Staphylococcus aureus. Os animais foram tratados com solução salina ou LPS (na dose de 200 µg/kg) avaliações foram realizadas 2 horas após o tratamento. No caso da ingestão de alimentos e do peso corpóreo, as avaliações foram realizadas durante 3 dias anteriores ao experimento, e durante 7 dias posteriores ao experimento. Os resultados demonstraram que animais idosos apresentaram diferenças na expressão do comportamento doentio, sendo que houve uma maior motivação em explorar os aparatos comportamentais. Apesar da manutenção da exploração no Campo Aberto e Labirinto em Cruz elevado, a redução da ingestão de alimentos e do peso corpóreo apresentou-se mais acentuada nos camundongos de meia idade e idosos, após tratamento com LPS. A atividade de neutrófilos sanguíneos, avaliadas pela fagocitose e burst oxidativo, apresentou-se aumentada em camundongos idosos após tratamento com LPS. A menor migração de neutrófilos sanguíneos à cavidade peritoneal parece ser responsável por esse aumento de atividade dos neutrófilos de camundongos idosos. Esses resultados sugerem que a expressão do comportamento doentio de camundongos idosos é diferente, com manutenção do comportamento de exploração, e que esses camundongos seriam mais susceptíveis aos efeitos do choque endotóxico, devido à presença de maior quantidade de neutrófilos ativados no sangue. / Through the present work, it has been investigated the expression of sickness behavior and blood neutrophils activity in adult, middle-aged and aged mice, after gram negative (Escherichia coli) lipopolysaccharide treatment. Sickness behavior was evaluated through food ingestion and body weight. On the behavioral apparatus Open Field and Elevated Plus Maze, sickness behavior was evaluated through general activity, exploration and anxiety levels. Blood neutrophils activity was studied through flow cytometric analysis, assessing neutrophil\'s intensity and percentage of phagocytosis and neutrophil\'s intensity and percentage of oxidative burst, both induced by in vitroM stimulus of Staphylococcus aureus bacteria. Animals were treated either with saline solution or LPS (in the 200 µg/kg dose) and analysis were done 2 hours after treatment. In the case of food ingestioin and body weight, analysis were done through 3 days before experiment, and during 7 days after experiment. Results demonstrated that aged animals showed differences in sickness behavior expression, with a greater motivation to explore behavioral apparatus. Despite maintenance of Open Field and Elevated Plus Maze exploration, reduction in food ingestion and body weight were more pronounced in middle-aged and aged mice, after LPS treatment. Blood neutrophils activity, analysed through phagocytosis and oxidative burst, were higher in aged mice after LPS treatment. Lesser blood neutrophils migration to peritoneal cavity seems to be responsible for this enhancement in neutrophil activity. These results suggest that the expression of sickness behavior in aged mice is different, with maintenance of exploratory behavior, and that these mice would be more susceptible to endotoxic effects, due to the presence of higher quantity of activated neutrophils in blood.

<p>An estimated twenty-five percent of the fifty-seven million annual deaths worldwide can be directly attributed to infectious disease. Mammals contain both adaptive and innate immune systems to deal with invading pathogens. The genetic model organism <em>Caenorhabditis elegans</em> lacks an adaptive immune system, which makes it a powerful model organism to study the innate immune system without the added complexity of an adaptive immune system. Multiple human pathogens can cause lethal infections in <em>C. elegans</em> and several <em>C. elegans</em> innate immune pathways have been identified that are conserved with mammals and protect the nematode from infection. The goal of this work was to identify novel bacterial virulence factors and innate immune defenses against pathogens by using the genetic model organism <em>C. elegans</em>. We established <em>C. elegans</em> as a model for <em>Yersinia pestis</em> infection and used this model to identify novel bacterial virulence factors that were also important for virulence in a mammalian model of infection. Previous studies demonstrated that <em>C. elegans</em> can identify bacterial pathogens using sensory neurons and activate an avoidance response that requires components of G-protein signaling pathways. We screened forty <em>C. elegans</em> strains containing mutations in chemosensory G-protein coupled receptors for altered survival on pathogen and identified <em>npr-1</em> to be required for full <em>C. elegans</em> defense against pathogens. We found that activation of the NPR-1 nervous circuit enhances host susceptibility to microbial infection while inhibition of the circuit boosts innate immunity. This data provides the first evidence that innate immunity in <em>C. elegans</em> is directly linked to the nervous system and establishes the nematode as a novel system to study neuroimmunology. From this work, we have identified <em>Y. pestis</em> virulence-related genes and <em>C. elegans</em> innate immune effector genes required for innate immunity to human bacterial pathogens.</p> / Dissertation

No abstract available / ix, 115 leaves : ill. (some col.) ; 29 cm.

Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for multiple sclerosis (MS) with now more than 600 documented cases in the medical literature. Long-term remission can be achieved with this therapy, but when is it justified to claim that a patient is cured from MS? In attempt to answer this question, the outcome of the Swedish patients is described, mechanisms behind the therapeutic effect are discussed and new tools for demonstration of absence of disease have been developed. In Swedish patients treated with HSCT for aggressive MS, disease free survival was 68 % at five years, and no patient progressed after three years of stable disease. Presence of gadolinium enhancing lesions prior to HSCT was associated with a favorable outcome (disease free survival 79 % vs 46 %, p=0.028). There was no mortality and no patient required intensive care. The immune system of twelve of these patients was investigated further. In most respects HSCT-treated patients were similar to healthy controls, demonstrating normalization. In the presence of a potential antigen, leukocytes from HSCT-treated patients ceased producing pro-inflammatory IL-17 and increased production of the inhibitory cytokine TGF-β1 suggesting restoration of tolerance. Cytokine levels and biomarkers of tissue damage were investigated in cerebrospinal fluid from a cohort of MS patients. The levels were related to clinical and imaging findings. A cytokine signature of patients with relapsing-remitting MS could be identified, characterized by increased levels of CCL22, CXCL10, sCD40L, CXCL1 and CCL5 as well as down-regulation of CCL2. Further, we could demonstrate that active inflammation in relapsing-remitting MS is a tissue damaging process, with increased levels of myelin basic protein and neurofilament light. Importantly, relapsing-remitting MS patients in remission displayed no tissue damage. In secondary progressive MS, moderate tissue damage was present without signs of active inflammation. From a clinical vantage point, it seems that we confidently can claim cure of relapsing-remitting MS patients after five years absence of disease activity. The new tools for evaluation of disease can strengthen this assertion and may enable earlier prediction of outcome.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A Neuromielite Óptica (NMO), anteriormente considerada como um subtipo de Esclerose Múltipla, é uma doença autoimune, inflamatória do sistema nervoso central, na qual o sistema imune ataca a mielina dos neurônios localizados nos nervos ópticos e medula espinhal, produzindo, então, mielite e neurite óptica simultânea ou sequenciais. A patogênese da neuromielite óptica é influenciada pela combinação de fatores genéticos e ambientais, incluindo agentes infecciosos. Diferentes doenças infecciosas podem tanto desencadear como exacerbar a autoimunidade. Portanto, o objetivo do presente estudo foi de analisar a responsividade imune in vitro a Escherichia coli, Staphylococcus aureus e Candida albicans em pacientes com NMO recorrente-remitente, e a correlacionar ao nível de incapacidade neurológica. Nesse contexto, a extensão da linfoproliferação e perfil de citocinas em resposta a S. aureus e C. albicans, em culturas de células mononucleares do sangue periférico (CMSP) foram similares entre pacientes com NMO e indivíduos saudáveis. Entretanto, maior proliferação de células T associada à elevada liberação de IL-1&#946;, IL-6 e IL-17 foi observada em culturas de células derivadas de pacientes com NMO quando estimuladas com E. coli. Ademais, nessas culturas, a produção de IL-10 foi significativamente menor quando comparada ao grupo controle. Ensaios conduzidos em culturas de CMSP depletadas de diferentes subtipos de linfócitos demonstraram que, enquanto células T CD4+ e T CD8+ produzem IL-6 em resposta a E. coli, a produção de IL-17 foi praticamente restrita às células T CD4+. Os níveis de IL-6 e IL-17 in vitro induzidos por E. coli foram correlacionados positivamente às incapacidades neurológicas. Essa maior tendência a produzir citocinas relacionadas ao perfil Th17 foi diretamente associada aos níveis de IL-23 produzidos por monócitos ativados com LPS. De modo interessante, níveis elevados de LPS foram quantificados no plasma de pacientes com NMO e estes foram correlacionados aos níveis plasmáticos de IL-6. Em conclusão, nossos resultados sugerem que uma maior responsividade a E. coli poderia estar envolvida na patogênese da NMO. Esse tipo de investigação é muito importante pois inibidores da ligação ou sinalização do TLR poderiam ser considerados terapias com grande potencial como adjuvantes no tratamento de pacientes com NMO. / Neuromyelitis optica (NMO), once considered as a subtype of Multiple Sclerosis, is an autoimmune, inflammatory disorder of the central nervous system in which the immune system attacks myelin of the neurons located at the optic nerves and spinal cord, thus producing a simultaneous or sequential optic neuritis and myelitis. The pathogenesis of neuromyelitis optica (NMO) is influenced by a combination of genetic and environmental factors, including infectious agents. Different infectious diseases can both trigger or exacerbate autoimmunity. Therefore, the objective of the present work was to evaluate the in vitro immune responsiveness to Escherichia coli, Staphylococcus aureus and Candida albicans in remittent-recurrent NMO patients, and correlate it to the level of neurological disability. In this context, the extent of lymphoproliferation and cytokine profile in response to S. aureus- and C. albicans-stimulated peripheral blood mononuclear cells (PBMC) cultures was similar between NMO patients and healthy individuals. Nevertheless, a higher in vitro T cell proliferation associated with elevated IL-1&#946;, IL-6 and IL-17 release was observed in NMO-derived E. coli-stimulated cell cultures. Additionally, in these cultures, the IL-10 production was significantly lower as compared with control group. Experiments performed with PBMC cultures depleted with different lymphocytes subsets demonstrated that, while both CD4+ and CD8+ T cells produced IL-6 in response to E. coli, the IL-17 production was mainly depended with CD4+ T cells.The in vitro E.coli-induced IL-6 and IL-17 levels were positively related with neurological disabilities. This higher tendency in producing Th-17-related cytokines was directly associated with IL-23 levels produced by LPS-activated monocytes. Interestingly, elevated LPS levels were quantified in the plasma of NMO patients and they were related to plasmatic levels of IL-6. In conclusion, our results suggest that a higher Th17-responsiveness to E. coli could be involved in the NMO pathogenesis. This kind of investigation is very important because inhibitors of TLR binding or signaling could be considered as great potential therapeutics as adjuvant in the treatment of NMO patients.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A Neuromielite Óptica (NMO), anteriormente considerada como um subtipo de Esclerose Múltipla, é uma doença autoimune, inflamatória do sistema nervoso central, na qual o sistema imune ataca a mielina dos neurônios localizados nos nervos ópticos e medula espinhal, produzindo, então, mielite e neurite óptica simultânea ou sequenciais. A patogênese da neuromielite óptica é influenciada pela combinação de fatores genéticos e ambientais, incluindo agentes infecciosos. Diferentes doenças infecciosas podem tanto desencadear como exacerbar a autoimunidade. Portanto, o objetivo do presente estudo foi de analisar a responsividade imune in vitro a Escherichia coli, Staphylococcus aureus e Candida albicans em pacientes com NMO recorrente-remitente, e a correlacionar ao nível de incapacidade neurológica. Nesse contexto, a extensão da linfoproliferação e perfil de citocinas em resposta a S. aureus e C. albicans, em culturas de células mononucleares do sangue periférico (CMSP) foram similares entre pacientes com NMO e indivíduos saudáveis. Entretanto, maior proliferação de células T associada à elevada liberação de IL-1&#946;, IL-6 e IL-17 foi observada em culturas de células derivadas de pacientes com NMO quando estimuladas com E. coli. Ademais, nessas culturas, a produção de IL-10 foi significativamente menor quando comparada ao grupo controle. Ensaios conduzidos em culturas de CMSP depletadas de diferentes subtipos de linfócitos demonstraram que, enquanto células T CD4+ e T CD8+ produzem IL-6 em resposta a E. coli, a produção de IL-17 foi praticamente restrita às células T CD4+. Os níveis de IL-6 e IL-17 in vitro induzidos por E. coli foram correlacionados positivamente às incapacidades neurológicas. Essa maior tendência a produzir citocinas relacionadas ao perfil Th17 foi diretamente associada aos níveis de IL-23 produzidos por monócitos ativados com LPS. De modo interessante, níveis elevados de LPS foram quantificados no plasma de pacientes com NMO e estes foram correlacionados aos níveis plasmáticos de IL-6. Em conclusão, nossos resultados sugerem que uma maior responsividade a E. coli poderia estar envolvida na patogênese da NMO. Esse tipo de investigação é muito importante pois inibidores da ligação ou sinalização do TLR poderiam ser considerados terapias com grande potencial como adjuvantes no tratamento de pacientes com NMO. / Neuromyelitis optica (NMO), once considered as a subtype of Multiple Sclerosis, is an autoimmune, inflammatory disorder of the central nervous system in which the immune system attacks myelin of the neurons located at the optic nerves and spinal cord, thus producing a simultaneous or sequential optic neuritis and myelitis. The pathogenesis of neuromyelitis optica (NMO) is influenced by a combination of genetic and environmental factors, including infectious agents. Different infectious diseases can both trigger or exacerbate autoimmunity. Therefore, the objective of the present work was to evaluate the in vitro immune responsiveness to Escherichia coli, Staphylococcus aureus and Candida albicans in remittent-recurrent NMO patients, and correlate it to the level of neurological disability. In this context, the extent of lymphoproliferation and cytokine profile in response to S. aureus- and C. albicans-stimulated peripheral blood mononuclear cells (PBMC) cultures was similar between NMO patients and healthy individuals. Nevertheless, a higher in vitro T cell proliferation associated with elevated IL-1&#946;, IL-6 and IL-17 release was observed in NMO-derived E. coli-stimulated cell cultures. Additionally, in these cultures, the IL-10 production was significantly lower as compared with control group. Experiments performed with PBMC cultures depleted with different lymphocytes subsets demonstrated that, while both CD4+ and CD8+ T cells produced IL-6 in response to E. coli, the IL-17 production was mainly depended with CD4+ T cells.The in vitro E.coli-induced IL-6 and IL-17 levels were positively related with neurological disabilities. This higher tendency in producing Th-17-related cytokines was directly associated with IL-23 levels produced by LPS-activated monocytes. Interestingly, elevated LPS levels were quantified in the plasma of NMO patients and they were related to plasmatic levels of IL-6. In conclusion, our results suggest that a higher Th17-responsiveness to E. coli could be involved in the NMO pathogenesis. This kind of investigation is very important because inhibitors of TLR binding or signaling could be considered as great potential therapeutics as adjuvant in the treatment of NMO patients.

Alors que le rôle dans la protection contre des pathogènes par le système immunitaire est bien compris, son rôle dans la progression tumoral est bien plus complexe avec certains mécanismes protecteurs tandis que d’autres sont néfastes. Le principal rôle physiologique du cerveau est lui de percevoir et intégrer les stimuli physiques et sociaux, d’intégrer ces signaux et de moduler l’activité des processus physiologiques de l’organisme pour s’adapter à ces conditions. Bien que les systèmes nerveux et immunitaires aient longtemps été considérés comme fonctionnant indépendamment, de multiples études cliniques et précliniques ont formellement démontré que ces deux systèmes pouvaient se réguler réciproquement. Bien que de nombreuses études visent à mieux comprendre les interactions entre les systèmes nerveux et immunitaire, de nombreuses questions restent sans réponses. Alors que les études cliniques ont prouvé un rôle positif dans la progression tumorale du bien-être, les mécanismes moléculaires ne sont pas encore compris. De plus, de nombreuses études ont essayé de trouver si les cytokines pouvaient être utilisées comme biomarqueurs diagnostic ou prédictif de la réponse au traitement dans les maladies psychiatriques, aucune cytokine étudiée à cette date n’a été démontrée comme suffisamment sensible ou spécifique pour être utilisée comme test diagnostique. Au cours de mes travaux de thèses, j’ai travaillé sur deux projets distincts étudiant les relations entre systèmes nerveux et immunitaires. Le but de mon premier projet a été d’identifier des mécanismes par lesquels un environnement enrichi (EE) associé à une meilleure activité sensorielle, cognitive et motrice pouvait impacter la progression métastatique chez la souris. Nous avons découvert que l’EE avait un effet protecteur dans la prise métastatique pulmonaire. Cette protection est associée à une diminution du niveau de corticostérone sérique, une augmentation de l’inflammation pulmonaire après extravasation de cellules tumorales circulantes. Cette protection est abolie en absence de signalisation sur récepteur aux glucocorticoïdes dans les monocytes inflammatoires. Alors que les monocytes inflammatoires sont généralement décrits comme favorisant la progression tumorale, ils peuvent aussi avoir une action antitumorale, suggérant que leur rôle est bien plus complexe qu’actuellement décrit. Nos résultats ont mis en avant un mécanisme antitumoral de reprogrammation dépendant des glucocorticoïdes des monocytes inflammatoires inhibant la progression métastatique. Mon second projet avait pour but d’identifier des biomarqueurs de la réponse aux traitements de patients ayant un premier épisode psychotique (FEP). Nous avons eu la possibilité d’accéder une cohorte de sérums et données cliniques de 325 patients FEP, tous les patients ont été traités avec le même antipsychotique. Nous avons d’abord utilisé une approche de clustering hiérarchique non supervisé pour stratifier les 325 patients dans 4 sous-groupes en utilisant uniquement leur symptomatologie. Un sous-groupe (C1A) après comparaison avec le reste de la cohorte, montre une symptomatologie plus sévère ainsi qu’un taux de réponse le plus faible après 4 semaines de traitement. Le groupe C1A montre aussi une augmentation du niveau de plusieurs biomarqueurs sériques pro-inflammatoire permettant une validation externe de cette stratification. L’utilisation de 6 variables biologiques (IL-15, protéine c-réactive, CXCL-12, niveaux d’IgG anti CMV et anti Toxoplasma gondii) et de 2 variables cliniques (Âge et utilisation de drogues récréationnelle) a permis de prédire la réponse après traitement. La précision de prédiction après validation croisée est très bonne avec une aire sous courbe moyenne de 81.0% (± 0.05). Une confirmation de ces résultats dans d’autres essais cliniques pourrait amener le développement d’une nouvelle approche basée sur le dosage de biomarqueurs sériques dans le choix du traitement chez les patients psychotiques. / While the immune system is well known for its protective role against infectious pathogens, its role in cancer progression is more complex with some immune mechanisms being protective while others are detrimental. The primary physiological role of the brain is to perceive external physical and social conditions, assess their implications for organismal well-being and modulate the activity of internal physiological processes to optimally adapt to those external conditions. Immune and the nervous systems have long been considered to operate independently from each other, many preclinical and clinical studies have clearly demonstrated that these two systems interact and regulate each other. Despite more and more studies aim at investigating the interactions between the nervous and the immune systems, important issues remain to be elucidated. For example, while human studies have demonstrated a positive impact of well-being on cancer progression, the underlying molecular mechanisms have not been elucidated. On another topic, and while many investigators have investigated whether cytokines could be used as diagnosis or prognosis biomarkers is psychiatric diseases, none of the cytokine studied to date have proven to possess the sensitivity and specificity expected for an accepted diagnostic test value. During my PhD, I have worked on two different projects both related to the interactions between the nervous and the immune system. The goal of my first project was to elucidate the mechanisms by which enriched environment conductive to enhanced sensory, cognitive and motor stimulation impact metastatic progression in mice. We have found that mice housed in enriched environment were protected from lung metastasis. Protection was associated with lower serum corticosterone levels, increased lung inflammation following extravasation of circulating tumour cells, and rapid killing of early infiltrating tumour cells. Protection was abolished when inflammatory monocytes were deficient in glucocorticoid receptor signalling. Thus, while inflammatory monocytes have been shown to promote cancer progression, our results disclosed a novel anti-tumour mechanism whereby glucocorticoid receptor-dependent reprogramming of inflammatory monocytes can inhibit cancer metastasis. The goal of my second project was to identify immune-related biomarkers of remission in first-episode psychotic (FEP) patients. To this aim, we have taken advantage of our privileged access to clinical data and serum samples from 325 FEP patients who have all been treated with an atypical antipsychotic. We have first used a hierarchical unsupervised clustering approach to stratify 325 FEP patients into four subtypes based on their clinical symptoms. Compared to the rest of the cohort, one subtype (C1A) exhibited more severe positive and negative symptoms and were the most at risk of being non-remitters following treatment for 4 weeks. C1A patients also exhibited higher levels of several pro-inflammatory biomarkers therefore providing an external validation to our clustering approach. Most importantly, six biological variables (serum levels of IL-15, C reactive protein, CXCL-12, anti- cytomegalovirus and anti-Toxoplasma immunoglobulins) and two clinical variables (age, recreational drug use), predicted early remission following treatment with Amisulpride in C1A patients. Prediction accuracy assessed by cross-validation calculated by 10,000 iterations of 4-fold cross-validation was very good with a mean area under the curve (AUC) of 81.0% ± 0.05. Further validation of our results in future clinical trials would pave the way for the development of a blood-based assisted clinical decision support system for the choice of treatment in psychotic patients.