Thesis (Ph.D. in Immunology) -- University of Colorado, 2006. / Typescript. Includes bibliographical references (leaves 277-285). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

Each individual experiences many sequential infections throughout the lifetime. An increasing body of work indicates that prior exposure to unrelated pathogens can greatly alter the disease course during a later infection. This can be a consequence of a phenomenon known as heterologous immunity. Most viruses invade the host through the mucosa of a variety of organs and tissues. Using the intranasal mucosal route of infection, the thesis focused on studying modulation of lymphocytic choriomeningitis virus (LCMV)-specific memory CD8 T cells upon respiratory vaccinia virus (VV) infection and the role of these memory CD8 T cells in heterologous immunity against VV and altered immunopathology in the lung. The VV infection had a profound impact on memory T cells specific for LCMV. The impact included the up-regulation of CD69 expression on LCMV-specific CD8 memory T cells and the activation of their in vivoIFN-γ production and cytotoxic function. Some of these antigen-specific memory T cells selectively expanded in number, resulting in modulation of the original LCMV-specific T cell repertoire. In addition, there was a selective organ-dependent redistribution of these LCMV-specific memory T cell populations in secondary lymphoid tissue (the mediastinal lymph node and spleen) and the non-lymphoid peripheral (the lung) organs. The presence of these LCMV-specific memory T cells correlated with IFN-γ-dependent enhanced VV clearance, decreased mortality and marked changes in lung immunopathology. Thus, the participation of pre-existing memory T cells specific for unrelated agents can alter the dynamics of mucosal immunity. This is associated with an altered disease course in response to a pathogen. The roles for T cell cross-reactivity and cytokines in the modulation of memory CD8 T cells during heterologous memory CD8 T cell-mediated immunity and immunopathology were investigated. Upon VV challenge, there were preferential expansions of several LCMV-specific memory CD8 T cell populations. This selectivity suggested that cross-reactive responses played a role in this expansion. Moreover, a VV peptide, partially homologous to LCMV NP 205, stimulated LCMV-NP205 specific CD8 T cells, suggesting that NP205 may be a cross-reactive epitope. Poly I:C treatment of LCMV-immune mice resulted in a transient increase but no repertoire alteration of LCMV-epitope-specific CD8 T cells. These T cells did not produce IFN-γ in vivo. These results imply that poly I:C, presumably through its induced cytokines, was assisting in initial recruitment of LCMV-specific memory CD8 T cells in a nonspecific manner. VV challenge of LCMV-immune IL-12KO mice resulted in activation and slightly decreased accumulation of LCMV-specific CD8 T cells. Moreover, there was a dramatic reduction of in vivoIFN-γ production by LCMV-specific IL-12KO CD8 T cells in the lung. I interpreted this to mean that IL-12 was important to augment IFN-γ production by memory CD8 T cells upon TCR engagement by antigens and to induce further accumulation of activated memory CD8 T cells during the heterologous viral infection. This thesis also systematically examined what effect the sequence of two heterologous virus challenges had on viral clearance, early cytokine profiles and immunopathology in the lung after infecting mice immune to one virus with another unrelated viruses. Four unrelated viruses, [LCMV, VV, influenza A virus or murine cytomegalovirus (MCMV)], were used. There were many common changes observed in the acute response to VV as a consequence of prior immunity to any of three viruses, LCMV, MCMV or influenza A virus. These included the enhanced clearance of VV in the lung, associated with enhanced TH1 type responses with increased IFN-γ and suppressed pro-inflammatory responses. However, immunity to the three different viruses resulted in unique pathologies in the VV-infected lungs, but with one common feature, the substitution of lymphocytic and chronic mononuclear infiltrates for the usual acute polymorphonuclear response seen in non-immune mice. Immunity to influenza A virus appeared to influence the outcome of subsequent acute infections with any of the three viruses, VV, LCMV and MCMV. Most notably, influenza A virus-immunity protected against VV but it actually enhanced LCMV and MCMV titers. This enhanced MCMV replication was associated with enhanced TH1 type response and pro-inflammatory cytokine responses. Immunity to influenza A virus appeared to dramatically enhance the mild lymphocytic and chronic mononuclear response usually observed during acute infection with either LCMV or MCMV in non-immune mice, but LCMV infection and MCM infection of influenza A virus-immune mice each had its own unique features. Thus, the specific sequence of virus infections controls the outcome of disease.

A pandemia de AIDS é um dos principais problemas de saúde pública no mundo e demanda o desenvolvimento de uma vacina eficaz. Uma abordagem vacinal ideal, baseada em resposta celular contra o HIV-1, deveria induzir uma resposta imune mediada tanto por células T CD4+ quanto CD8+. A diversidade genética do HIV-1 é uma grande preocupação para o desenvolvimento de uma vacina e sequências consenso têm sido utilizadas a fim de contornar a barreira imposta por essa diversidade. A escolha apropriada dos antígenos a comporem as construções vacinas também é relevante, visto que proteínas como Gag e Vif têm se mostrado bastante imunogênicas, enquanto alguns trabalhos têm demonstrado que Env possui características imunossupressoras e que respostas celulares contra esse antígeno podem ser danosas aos indivíduos vacinados. Nosso grupo demonstrou que uma vacina de DNA (HIVBr18) codificando 18 peptídeos para linfócitos T CD4+, promíscuos (capazes de se ligarem a múltiplas moléculas HLA-DR) e conservados na sequência consenso do subtipo B do HIV-1 foi capaz de induzir uma resposta celular ampla, polifuncional e de longa duração em camundongos BALB/c e transgênicos para moléculas HLA. Neste trabalho identificamos 34 peptídeos potencialmente reconhecidos por linfócitos T CD4+, promíscuos e conservados na sequência consenso dos consensos do grupo M do HIV-1. Uma vacina de DNA (HIVBr27) codificando 27 dos 34 peptídeos (exceto os 7 peptídeos de Env identificados) induziu uma resposta mais ampla e de maior magnitude que a vacina HIVBr18 em camundongos BALB/c. Além disso, a vacina HIVBr27 induziu maior frequência de linfócitos T CD4+ e CD8+ polifuncionais, capazes de proliferar e produzir as citocinas IFN-gama e TNF-alfa. Desenvolvemos também uma vacina de DNA (HIVenv7) codificando os 7 peptídeos de Env do HIV-1 identificados. A co-imunização de HIVenv7+HIVBr27 reduziu a amplitude da resposta celular contra peptídeos codificados pela vacina HIVBr27. Além disso, a co-imunização reduziu a magnitude da resposta e a frequência de linfócitos T CD4+ e CD8+ polifuncionais contra o pool de 27 peptídeos codificados por essa vacina. A vacina HIVBr27, desenhada para induzir uma resposta de linfócitos T CD4+ ampla e intensa contra peptídeos promíscuos e conservados da sequência consenso dos consensos do grupo M do HIV-1, é mais imunogênica e mais completa que a vacina HIVBr18, tendo potencial de conferir, em grande cobertura populacional, imunidade contra os diversos subtipos circulantes do vírus. O fenômeno observado na co-imunização com HIVenv7 sugere que a inclusão do envelope em imunógenos contra o HIV-1 possa ser prejudicial. Por outro lado, isto faz desse plasmídeo um alvo promissor para terapias imunológicas que visem indução de imunossupressão / The AIDS pandemic is a worldwide major public health problem and requires the development of an effective vaccine. An ideal vaccine approach based on cellular immune responses against HIV-1 should induce an immune response mediated by both CD4+ and CD8+ T cells. HIV-1 genetic diversity is a major concern for developing a vaccine and consensus sequences have been used to circumvent the barrier posed by this diversity. The appropriate choice of antigens to compose the vaccines is also relevant, since proteins such as Gag and Vif have been shown to be immunogenic, while some studies have shown that Env has immunosuppressive characteristics and cellular responses against this antigen can be harmful to vaccinated individuals. Our group has demonstrated that a DNA vaccine (HIVBr18) encoding promiscuous multiple HLA-DR binding, conserved B-subtype HIV-1 CD4+ T cell epitopes was able to induce a broad, polyfunctional and long lasting T cell response in BALB/c and HLA transgenic mice. In this work we identified 34 promiscuous and conserved sequences within the group M HIV-1 consensus of the consensus sequence, potentially recognized by CD4+ T cells. A DNA vaccine (HIVBr27) encoding 27 of the 34 peptides (except the 7 Env identified peptides) induced a broader and higher magnitude T cell response than HIVBr18 vaccine in BALB/c mice. Moreover, the vaccine HIVBr27 induced a higher frequency of polyfunctional CD4+ and CD8+ T cells, able to proliferate and produce the cytokines IFN-gama and TNF-alfa. We also developed a DNA vaccine (HIVenv7) encoding the 7 HIV-1 Env identified peptides. Co-immunization with HIVenv7+HIVBr27 reduced the breadth of the cellular immune response against the HIVBr27 encoded peptides. Besides, co-imunization reduced the magnitude of the response and the frequency of polyfunctional CD4+ and CD8+ T cells against the pool of 27 peptides encoded by this vaccine. The HIVBr27 vaccine, designed to induce a broad and intense CD4+ T cell response against promiscuous and conserved peptides within the group M HIV-1 consensus of the consensus sequence, is more immunogenic and more complete than the vaccine HIVBr18, having the potential to provide, with wide population coverage, immunity against various circulating subtypes of the virus. The phenomenon observed in the co-immunization with HIVenv7 suggests that the inclusion of the envelope in immunogens against HIV-1 may be harmful. On the other hand, these results suggest that HIVenv7 is a promising target for immune therapies aimed at inducing immunosuppression

Introdução: Uma proporção significante de pacientes infectados por HIV-1 (pacientes HIV-1+) tratados com inibidores de protease (IPs) desenvolve mutações de resistência. Estudos recentes têm mostrado que células T CD8+ de pacientes HIV- 1+ reconhecem epitopos de Pol incluindo mutações selecionadas por drogas. Nenhum epitopo CD4+ da protease foi descrito na base de dados de Los Alamos. Objetivo: Considerando que a protease de HIV-1 é alvo de terapia antiretroviral e que essa pressão pode selecionar mutações, nós investigamos se mutações selecionadas por IPs afetariam o reconhecimento de epitopos da protease de HIV-1 por células T CD4+ em pacientes tratados com IPs. Nós investigamos o reconhecimento de três regiões da protease preditas de conter epitopos de células T CD4+ bem como mutações induzidas por IPs por células T CD4+ em pacientes HIV- 1+ tratados com IPs. Materiais e Métodos: Quarenta pacientes HIV-1+ tratados com IPs foram incluídos (30 em uso de Lopinavir/ritonavir, 9 em uso de Atazanavir/Ritonavir e 1 em uso exclusivo de Atazanavir). Para cada paciente determinou-se a seqüência endógena da protease de HIV-1, genotipagem viral e tipagem HLA classe II. Utilizamos o algoritmo TEPITOPE para selecionar peptídeos promíscuos, ligadores de múltiplas moléculas HLA-DR, codificando as três regiões da protease de HIV-1 cepa HXB2 (HXB2 4-23, 45-64, e 76-95) e 32 peptídeos adicionais contidos nas mesmas regiões incorporando as mutações induzidas por IPs mais freqüentes no Brasil. Os 35 peptídeos foram sintetizados. Respostas proliferativas de células T CD4+ e CD8+ aos peptídeos foram determinadas por ensaios de proliferação com diluição do corante CFSE. Ensaios de ligação a alelos HLA classe II foram realizados para confirmar a promiscuidade desses peptídeos e avaliar a habilidade de se ligarem a moléculas HLA presentes em cada paciente. Resultados: Todos os peptídeos foram reconhecidos por pelo menos um paciente e respostas proliferativas de células T CD4+ e CD8+ a pelo menos um peptídeo da protease de HIV-1 foram encontradas em 78% e 75% dos pacientes, respectivamente. A terceira região (Protease 76 95) foi a mais freqüentemente reconhecida. Ao compararmos as respostas de células T às seqüências da protease do HIV-1 endógeno, observamos que a maioria dos pacientes não foi capaz de reconhecer peptídeos idênticos às essas seqüências, porém reconheceram peptídeos variantes diferentes das mesmas regiões. Apenas sete pacientes responderam às seqüências endógenas. Verificamos que diversos peptídeos endógenos que não foram reconhecidos apresentaram ausência de ligação a alelos HLA portados por estes pacientes, sugerindo que mutações selecionadas por pressão imune tenham levado ao escape de apresentação de antígeno e evasão de resposta de linfócitos T CD4+. Alternativamente, isso poderia ser explicado pela presença de um vírus replicante distinto presente no plasma uma vez que somente foram obtidas seqüências provirais. Conclusão: Epitopos selvagens e mutantes da protease do HIV-1 reconhecidos por células T CD4+ foram identificados. Também verificamos que a maior parte dos pacientes não reconheceu as seqüências da protease endógena enquanto que reconheceram seqüências variantes. O reconhecimento de seqüências não-endógenas poderia ser hipoteticamente conseqüência de alvo de populações HIV-1 minoritárias; protease de HERV que contém regiões de similaridade com a protease do HIV-1; ou seqüências de HIV-1 presentes apenas em parceiros virêmicos. A falha de reconhecimento de seqüências endógenas seria mais provável devido ao escape imune, do que ao nível de apresentação ou reconhecimento por células T. Isso implica em uma conseqüência patofisiológica na evasão de respostas de células T contra a protease de HIV-1 e no fato de ser tradicionalmente considerada uma proteína pouco antigênica / Introduction: A significant proportion of protease inhibitor (PI)-treated HIV-1 infected (HIV-1+) patients develop resistance mutations. Recent studies have shown that CD8+ T cells from HIV-1 patients can recognize antiretroviral drug-induced mutant Pol epitopes. No HIV-1 protease CD4 epitopes are described in the Los Alamos database. Aims: Given that the protease of HIV-1 is a target of antiretroviral therapy and this pressure may lead to the selection of mutations, we investigated whether PI-induced mutations affect the recognition of HIV-1 protease epitopes by CD4 + T cells in PI-treated patients. We investigated the recognition of three protease regions predicted to harbor CD4+ T cell epitopes as well as PI-induced mutations by CD4+ T cells of PI-treated HIV-1+ patients. Methods: Forty PI-treated HIV-1+ patients were included (30 undergoing Lopinavir/ritonavir, 9 undergoing Atazanavir/ritonavir and 1 undergoing exclusively Atazanavir treatment). For each patients, the endogenous HIV-1 protease sequence, viral genotype and HLA class II typing were determined. We used the TEPITOPE algorithm to select promiscuous, multiple HLA-DR-binding peptides encoding 3 regions of HIV-1 HXB2 strain protease (HXB2 4-23, 45-64, and 76-95) and 32 additional peptides contained in the same regions, but encompassing the most frequent PI-induced mutations in Brazil. The 35 peptides were thus synthesized. Proliferative responses of CD4+ and CD8+ T cells against peptides were determined by the CFSE dilution assay. HLA class II binding assays were made to confirm the promiscuity of these peptides and evaluate their ability to bind the HLA molecules carried by each patient. Results: All tested peptides were recognized by at least one patient and proliferative responses of CD4+ and CD8+ T cells against at least one HIV-1 protease peptide were found in 78% and 75% patients, respectively. The third region (Protease 76-95) was the most frequently recognized. By comparing T-cell responses to HIV-1 endogenous protease sequences, we found that most patients failed to recognize identical peptides of those sequences, but recognized different variant peptides of the same region. Only seven patients responded to endogenous sequences. We found that several endogenous peptides that failed to be recognized showed no binding to the HLA alleles carried by that given patient, suggesting that mutations selected by immune pressure have led to escape of antigen presentation, as well as direct escape of the CD4+ T cell response. Alternatively, it could have been due to the presence of a different replicating virus in the plasma-since we only obtained proviral sequences. Conclusion: Wild-type and mutant HIV-1 protease epitopes recognized by CD4+ T cells were identified. We also found that most patients failed to recognize their endogenous protease sequences, while they recognized variant sequences. The recognition of non-endogenous sequences could hypothetically be a consequence of targeting a minor HIV-1 population; HERV protease, that contains regions of similarity with HIV-1 protease; or HIV-1 sequences present only in viremic partners. The failure to recognize endogenous sequences is most likely due to immune escape, either at the level of presentation or direct T cell recognition. This may have a pathophysiological consequence on evasion of T cell responses against protease and the fact that it has been considered traditionally a poorly antigenic HIV-1 protein.

Introdução: A resistência a infecção pelo HIV-1 depende de fatores virais, genéticos e imunológicos do hospedeiro, incluindo os componentes da resposta imune inata e adaptativa. As células Natural Killer (NK) e as células T CD8+ são as principais células efetoras que medeiam atividade citotóxica contra células transformadas ou infectadas, que exercem importante papel protetor nos indivíduos expostos e não infectados por HIV-1 (ENI). Objetivo: Avaliar a expressão de receptores de ativação e inibição/exaustão nas células NK e T CD8+, e a capacidade das células NK em secretar citocinas e componentes citotóxicos após estimulação via receptores Toll-like (TLRs), e a resposta de células T CD8+ a peptídeos da Gag do HIV-1 em indivíduos ENI e seus parceiros infectados por HIV-1. Resultados: No grupo ENI foi observado aumento da frequência de células NK CD56bright que expressam moléculas de ativação NKG2D e CD95 na população CD56dim, enquanto no grupo HIV-1 foi mais prevalente a expressão de MIC A/B em ambas populações de células NK, com redução da expressão de NKG2D na população CD56dim. Além disto, foi observado expansão da população de células NK CD56dim que expressam CD94, NKG2C e principalmente de CD57 foi mais prevalente nos indivíduos ENI, com correlação positiva com títulos de anticorpos IgG anti-citomegalovírus humano. Nos indivíduos ENI foi observado que a ativação via TLR-3, TLR-7 ou TLR-7/8 foi capaz de potencializar a expressão de marcadores de desgranulação e de citotoxicidade, CD107a e granzima B, principalmente na população CD56dim, e de IFN-y e TNF nas populações CD56bright e CD56dim. Além disto, somente o grupo ENI, foi detectado aumento da freqüência de células NK secretoras de CD107a, granzima B, IFN-y e TNF, após estimulação com acetato de miristato de forbol e ionomicina. A frequência de expressão de alelos de KIR (killer cell immunoglobulin-like receptors) foi similar entre os grupos analisados. Elevada frequência de células T CD8+ CD38+ e CD8+PD-1+ (programmed cell death protein 1) foi detectado nos grupos ENI e HIV-1, cuja alteração foi observada em todas as fases de maturação celular. Os indivíduos ENI mostraram presença de resposta antígeno-específica de células T CD8+ secretoras de CD107a, granzima B, IFN-y e TNF, semelhante ao grupo HIV-1. Conclusão: Os resultados mostraram que no grupo ENI, as células NK expressam um perfil de ativação, com potente resposta aos estímulos de resposta inata e células NK com perfil de memória. Presença de células TCD8+ antígeno-específica foi evidenciada no grupo ENI, com perfil semelhante, mas de menor magnitude ao detectado no grupo infectado por HIV. Em conjunto, os achados mostraram que no grupo ENI a resposta inata está potencialmente ativa, e que em associação a resposta T CD8+ antígeno-específica podem contribuir para a resistência a infecção pelo HIV-1 / Introduction: Resistance to human immunodeficency virus 1 (HIV-1) is dependent on viral, genetic and immunological host factors, including components of innate and adaptive immune response. Natural Killers cells (NK) and CD8+ T cells are main effectors cells mediating cytotoxic role against transformed or infected cells, playing a crucial role in HIV-1 exposed uninfected individuals (EU). Aim: To evaluate the expression of activation and inhibitory/exhaustion receptors on NK cells and CD8+ T-cells, and to determine the NK cells ability to cytokines and cytotoxic molecules secretion upon Toll-like receptors (TLRs) pathway activation as well as CD8+ T-cells response to HIV Gag peptides in EU individuals and HIV-1 infected partner. Results: Increased frequency of NK CD56bright cells expressing NKG2D and CD95 on CD56dim cells have been observed in EU group, while HIV-1 group was more prevalent MIC A/B expression in both NK cells subsets, with reduced expression of NKG2D in CD56dim cells. Moreover, expansion of NK CD56dim cells expressing CD94, NKG2C, and CD57 was prevalent on ENI group, which positive correlation with anti-human cytomegalovirus IgG serum titers. EU individuals showed that TLR-3, TLR-7 or TLR-7/8 pathway activation was able to enhance CD107a and granzyme B expression in CD56dim cells, and IFN-y and TNF expressions levels in both CD56bright and CD56dim NK cells. Moreover, only in EU group, high frequency of NK cells expressing CD107a, granzyme B, IFN-y and TNF were detected upon phorbol myristate acetate and ionomicyn stimulation. Frequency of KIR alleles (killer cell immunoglobulin-like receptors) was similar between groups. High frequency of CD8+CD38+ and CD8+PD-1+ (programmed cell death protein 1) T-cells were observed in EU and HIV-1 groups, in all stages of cellular differentiation. EU subjects showed presence of antigen-specific response by CD8+ T-cells secreting CD107a, granzyme B, IFN-y and TNF similar to HIV-1 group. Conclusion: The results showed that NK cells in EU subjects express activating profile, with potent ability to innate immune stimuli, as well as NK cells with memory profile. Presence of antigen-specific CD8+ T-cells was detected in EU group, with similar profile, but in less magnitude than HIV-1 group. Taken together, the findings showed an enhanced innate immune response in EU subjects, in association with antigen-specific CD8+ T-cell response can contribute to resistance to HIV-1 infection

Orientadores: Marcos Tadeu Nolasco da Silva, Maria Marluce dos Santos Vilela / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T12:56:55Z (GMT). No. of bitstreams: 1 Ferreira_JosianeFrancisca_M.pdf: 1674494 bytes, checksum: 65421fb00fd3ba43536a3c494f244ecd (MD5) Previous issue date: 2012 / Resumo: INTRODUÇÃO: A adoção da Terapia Antirretroviral Combinada (TARC), proporcionou uma dramática melhora na sobrevida, na qualidade de vida e no controle clínico da infecção por HIV em pediatria. Em consequência do controle efetivo da replicação viral, observa-se reconstituição do sistema imune, que contribui para a redução da incidência dos quadros infecciosos. Neste contexto, a determinação da reconstituição imune em estudos observacionais pode fornecer marcadores para a avaliação da resposta à TARC. OBJETIVOS: Determinar a prevalência de recuperação imunológica associada à introdução da TARC em uma população pediátrica acompanhada em serviço de referência, bem como fatores associados à obtenção desta meta. MÉTODO: Estudo observacional, analítico, do tipo coorte histórico. Em 127 pacientes em TARC pelo período mínimo de 1 ano, avaliou-se a reconstituição imune, caracterizada por uma porcentagem de linfócitos T CD4+ 'maior ou igual' 25% ou valor absoluto considerado normal para a idade. RESULTADOS: Dos 127 pacientes avaliados, 117 (92,12%) obtiveram reconstituição ou preservação imune. Nos indivíduos com reconstituição ou preservação imune, a idade ao início da TARC foi significativamente inferior (p = 0,007), e os escores-z de peso e IMC foram significativamente superiores (p = 0,028 e 0,032, respectivamente). Em relação às categorias clínicas, observou-se uma proporção significativamente superior de indivíduos nas categorias N, A e B no grupo com reconstituição ou preservação imune (p = 0,05). As porcentagens de linfócitos T CD4+ e a relação CD4 / CD8, bem como a proporção de indivíduos nas categorias imunológicas 1 e 2, foram superiores no grupo com reconstituição ou preservação imune (p = 0,019, 0,018 e 0,005, respectivamente). CONCLUSÃO: Pudemos observar que, em crianças e adolescentes infectados por HIV em TARC, a reconstituição ou preservação imune estiveram associadas a uma idade mais jovem e à maior preservação imunológica e clínica ao início da terapia / Abstract: INTRODUCTION: The adoption of Highly Active Antiretroviral Therapy (HAART) provided a dramatic improvement in survival, quality of life and clinical management of HIV infection in children. As a result the effective control of viral replication, it is observed immune reconstitution, which contributes to reducing the incidence of infectious. In this context, the determination of immune reconstitution in observational studies can provide markers for assessing response to HAART. Objective: To determine the prevalence of immune recovery or preservation associated with the introduction of HAART in a pediatric population followed in a reference service, as well as factors associated with the attainment of this goal. Methods: Observational study, analytic, historical cohort. In 127 patients on HAART for at least one year, we evaluated the immune reconstitution or preservation, characterized by a of CD4+ cell percentage 'more or equal' 25% or absolute values considered normal for their age. Results: Of the 127 patients evaluated, 117 (92.12%) had immune reconstitution or preservation. In individuals with immune reconstitution or preservation, the age at first HAART was significantly lower (p = 0.007), and weight and BMI z-scores for age were significantly higher (p = 0.028 and 0.032, respectively). With respect to clinical categories, there was a significantly higher proportion of individuals in N, A and B categories in the immune reconstitution or preservation group (p = 0.05). The CD4+ cell percentages and CD4/CD8 ratios and the proportion of individuals in immunological categories 1 and 2, were higher in the group with immune reconstitution or preservation (p = 0.019, 0.018 and 0.005, respectively). Conclusion: In our cohort of HIV-infected children and adolescents, on HAART, the preservation of immunocompetence or immune reconstitution were associated to an earlier age and better immune and clinical preservation at the beginning of therapy / Mestrado / Saude da Criança e do Adolescente / Mestra em Saúde da Criança e do Adolescente

Previously, our lab demonstrated that heterologous immunity could result in either gain or loss of protective immunity and alteration in immune pathology following infection by a second un-related pathogen. One of the prototypical models to study T cell-mediated heterologous immunity involves two distantly related arenaviruses, namely lymphocytic choriomeningitis virus (LCMV) and Pichinde virus (PV). Each virus encodes a cross-reactive CD8 epitope that has six out of eight in amino acid (aa) similarity with respect to its counterpart at the position 205-212 of the nucleoprotein (NP205). Heterologous challenge between LCMV and PV results in 1) expansion of the cross-reactive NP205-specific CD8 T cell responses and alteration of the immunodominance hierarchy and 2) partial protective immunity (heterologous immunity). Our lab showed that cross-reactive NP205-specific CD8 T cell receptor (TCR) repertoires become extremely narrowed following a heterologous challenge between LCMV and PV. Therefore, I questioned if LCMV NP205 epitope escape variants could be isolated during a dominant but narrowed crossVI reactive NP205-specific CTL response. In the first part of my thesis, I describe the isolation of a LCMV NP-V207A CTL escape variant in vivo using PV-immune animals challenged with LCMV clone 13. The LCMV NP-V207A variant contains a point mutation, which results in the switching of valine to alanine at the third non-anchoring residue of the LCMV NP205 CD8 epitope. Immunization of mice with the LCMV NP-V207A variant results in a significantly diminished cross-reactive NP205-specific CD8 T cell response. This suggests that the point mutation is responsible for the loss in the immunogenicity of the LCMV NP205 CD8 epitope. In addition, an in vitrorescued(r) recombinant LCMV variant (r/V207A) that encodes the original mutation also induces a highly diminished cross-reactive NP205-specific CD8 T cell response in mice. In agreement with the result obtained from the intracellular cytokine assays (ICS), MHC-Ig dimers loaded with the LCMV NP205 (V-A) peptide could only detect a minute population of cross-reactive NP205-specific CD8 T cells in mice infected with r/V207A variant virus. All the data indicate that the point mutation results in a significant loss in immunogenicity of the LCMV NP205 CD8 epitope. So far, no direct link between the cross-reactive NP205-specific CD8 T cells and heterologous immunity had been established in this system. Therefore, we immunized mice with either LCMV WT or the LCMV NP-V207A variant virus and showed that a significant loss of heterologous immunity is associated with the group immunized with LCMV NP-V207A variant virus. Again, r/V207Aimmune animals also displayed a significant loss in heterologous immunity following PV challenge. This suggests that the cross-reactive NP205-specific CD8 T cells mediate the majority of heterologous immunity between LCMV and PV in vivo. In comparison to the PV-immune control group, PV clearance kinetics mediated by the cross-reactive NP205-specific CD8 T cells were significantly delayed. Finally, these data also suggest that bystander activation plays very little role in heterologous immunity between LCMV and PV. Many studies in murine systems and humans suggest that cross-reactive T cells are often associated with immune pathology. We showed that in mice that were sequentially immunized with PV and LCMV (PV+LCMV WT double immune mice), there was a development of a high incidence and high level of immune pathology known as acute fatty necrosis (AFN) following a final PV challenge. The data suggest that these cross-reactive NP205-specific CD8 T cells might play an important role in immune pathogenesis. Therefore, we asked if the cross-reactive NP205-specific CD8 T cells play a role in immune pathogenesis by comparing the incidence of AFN between the (PV+LCMV WT) and the (PV+LCMV NP-V207A) double immune mice following a final PV challenge. In agreement with our hypothesis, the result showed the (PV+LCMV NP-V207A) double immune mice developed a significantly lower incidence of AFN compared to the (PV+LCMV WT) double immune mice. However, linear correlation studies comparing the frequency of different antigen-specific CD8 T cell populations within the (PV+LCMV WT) double immune mice before challenge and the severity of AFN following the PV challenge suggest that two opposing antigen-specific CD8 T cell populations are involved in determining the final outcome of the immune pathology. The PV NP38-45-specific CD8 T cell response (PV NP38) appears to be more protective than the cross-reactive NP205-specific CD8 T cell response. In addition, a positive linear correlation between the ratio of cross-reactive NP205 to PV NP38 and the severity of AFN seem to suggest that these cross-reactive populations are important contributors to immune pathogenesis. Peptide titration studies examining the functional avidities to different antigenic specificities suggest that both populations consist of high avidity TCR and peptide MHC (TCR:pMHC) interactions. However, skewing within the cross-reactive NP205 specific CD8 T cell response towards the LCMV NP205 epitope response in one of the (PV+LCMV WT) double immune mice suggests that cross-reactive NP205 specific CD8 T cells could constitute a sub-optimal response to a PV challenge. In summary, I questioned what might be some of the immunological consequences of heterologous immunity in this model. First of all, we have established a direct link between the cross-reactive NP205-specific CD8 T cell response and heterologous immunity in LCMV and PV. Second of all, I demonstrated that a LCMV NP205 epitope escape variant could be selected in vivo under the conditions of heterologous immunity. In addition, I showed that PV clearance kinetic was significantly delayed in cross-reactive NP205-mediated heterologous immunity as compared to homologous challenge. Finally, we demonstrated that cross-reactive NP205-specific CD8 T cells could play an important role in immune pathogenesis in this model. However, correlation data indicate that two opposing antigen-specific CD8 T cell populations could ultimately decide the outcome and magnitude of immune pathology in each individual mouse. All the data presented above strongly suggest that the cross-reactive NP205 CD8 T cells play a crucial role in immune pathology in this model system by 1) interfering with the regular establishment of immunodominance hierarchy orders, or 2) exhibiting a sub-optimal protective immunity due to the nature of the cross-reactive epitope.

The Tec family tyrosine kinase, Itk, plays an important role in signal transduction following T cell receptor engagement. Several prior studies have established the importance of Itk in immune system processes, such as T cell development and T cell activation. Additional biochemical studies have found that Itk specifically functions within a multi-molecular signalosome complex, which ultimately functions to provide a platform by which Itk can phosphorylate and activate PLC-γ1, a crucial step in T cell activation. To further study how Itk regulates distinct immune outcomes via T cell effector processes within the peripheral immune system, and to further understand how Itk functions in T cells in response to a physiological ligand-receptor interaction, I crossed Itk-deficient mice to mice transgenic for a TCR specific for a moth cytochrome C peptide. My studies have established a unique role for Itk in several important aspects of T cell function. Following T cell activation, I identified an imperative role for Itk in activation-induced cell death via FasL, a mechanism of immune homeostasis. Furthermore, I found Itk plays a unique role in the process of T cell differentiation, where Itk positively regulates the induction of cytokine genes, such as IL-4, while negatively regulating the induction of T-bet, a transcription factor important for Th1 differentiation. Lastly, following T cell differentiation, I found that Itk mRNA and protein are up-regulated during Th2 differentiation, while Rlk, a related Tec kinase, disappears rapidly from Th2 cells, indicating a critical role for Itk in Th2 cell function. Collectively, my thesis work has more clearly defined an important function for Itk not only in TCR signaling, but also in immune processes such as T cell differentiation and activation-induced cell death that are required for proper immune function.

T lymphocytes are essential components of the immune system and as such are continually regulated by a variety of factors. Every step of their development, survival and function is tightly monitored to ensure their ability to recognize most foreign agents and mount adaptive immune responses during pathogenic infections, while remaining tolerant to self-antigens. Among the many factors that participate in the regulation of T cell development and function are the cytokines. Cytokines that signal through the common gamma (γс) chain and the Janus kinase 3 (Jak3) include IL-2, -4, -7, -9, -15, and -21 and have been implicated in the regulation of every stage in the life of a T cell. Therefore, it is not surprising that mutations in the γс chain or Jak3 lead to a SCID condition in humans and mice. Specifically, Jak3-deficient mice are characterized by a reduction in thymic cellularity and dysregulated T cell homeostasis. They have an expansion of memory-like CD4+ mature T cells and an almost complete absence of mature CD8+ T cells. By investigating the TCR repertoire of CD4+ T cells in the thymus and spleen of Jak3-/- mice, I deduced that the CD4+ T cell activation and expansion is TCR-specific and takes place in the periphery of the mice. After crossing Jak3-deficient mice to Bcl-2 transgenic mice I showed that the developmental block observed in Jak3-/- mice could not be rescued by the anti-apoptotic factor, despite the fact that its expression did increase, slightly, the total numbers of developing thymocytes. The enforced expression of Bcl-2 was also not sufficient to revert the dysregulation of T cell homeostasis in Jak3-/- mice. Finally, in order to further understand the role played by γс cytokines during T cell function, I investigated the ability of mature Jak3-/- CD8+ T cells to become activated and differentiate into effector cells in response to a viral infection. My results indicate that CD8+ T cells are activated and proliferate in response to a viral infection, but their survival, as well as their ability to proliferate and differentiate into effector cells are greatly impaired, resulting in the inability of Jak3-deficient mice to mount a protective response.

Japanese encephalitis virus (JEV) and West Nile virus (WNV) are closely related Flaviviruses that are important arthropod-borne human pathogens. Both of these viruses can cause encephalitis with significant morbidity and mortality after infection. Flaviviruses co-circulate in many areas of the world, which raises the risk for sequential infection between heterologous viruses. Sequential infection between dengue virus serotypes can lead to cross-protection, but in some cases, it leads to a severe outcome, dengue hemorrhagic fever. Previous work in hamsters and non-human primates demonstrated that prior JEV immunity protects against a lethal WNV infection. However, the ability of prior WNV immunity to protect against a lethal JEV infection has been inconclusive. WNV-immune hamsters were fully protected from JEV viremia, but in non-human primates, prior WNV-immunity only reduced disease severity, with symptoms of encephalitis still observed. These differences in cross-protection led to further investigation on the directionality as well as the underlying mechanisms for this phenomenon. Previous work in our lab found that JEV-immune C57BL/6J (B6) mice were fully protected against a lethal WNV infection, and JEV-immune CD4+ and CD8+ T cells were required for this cross-protection. In other mouse models, memory cross-reactive CD4+ and CD8+ T cell responses may induce protection or immunopathology upon secondary heterologous viral challenge. We hypothesize that JEV/WNV cross-reactive CD4+and CD8+ T cells preferentially expand upon 2o infection and contribute to cross-protection. To elucidate the potential role of T cells in sequential flavivirus infection, we identified and characterized cross-reactive CD4+ and CD8+ T cell responses between JEV and WNV. A previously reported WNV NS4b CD8+ T cell epitope and its JEV variant elicited CD8+ T cell responses in both JEV- and WNV-infected mice. Despite similarities in viral burden for pathogenic JEV and WNV viruses, CD8+ T cells from pathogenic JEV-infected mice exhibited functional and phenotypic profiles similar to those seen for the attenuated JEV strain. We believe the differences in the CD8+ T cell responses during primary JEV and WNV infection are due at least in part to the low levels of peripheral replication seen in JEV-infected mice compared to WNV-infected mice. We also found that WNV-immune B6 mice were protected against a lethal JEV infection. Cross-reactive CD8+ T cells in JEV-immune mice rapidly expanded after WNV infection. Even though WNV-immune mice had higher frequencies of memory CD8+ T cells, cross-reactive CD8+ T cells did not expand after secondary JEV infection. Neutralizing antibodies to JEV were detected in WNV-immune mice; however, cross-reactive CD8+ T cells did not expand even in the absence of these cross-reactive neutralizing antibodies. We did not detect any differences in the CD8+ T cell repertoires between JEV- and WNV-infected mice nor were WNV-immune CD8+ T cells functionally exhausted. In fact, proliferation of memory CD8+ T cells did not correlate with the ability of WNV-immune CD8+ T cells to restrict recombinant vaccinia viruses expressing the cross-reactive epitope or lyse peptide-coated targets. These data suggest that the higher frequency of memory CD8+ T cells and cross-reactive antibodies in WNV-immune mice are better able to prevent neuroinvasion following 2o JEV infection.