Une tumeur est un environnement complexe comprenant à la fois des composants immunitaires et non immunitaires. Dans notre équipe, nous avons démontré précédemment le rôle des structures lymphoïdes tertiaires (TLS) dans les cancers du poumon, dans la génération de réponses anti-tumorales protectrices. Cependant, les tumeurs peuvent se développer en utilisant des mécanismes d’immunosuppression tels que l’infiltration des cellules T régulatrices (Tregs) dans le microenvironnement tumoral. Cette thèse a étudié le mécanisme présumé des Tregs dans la régulation des réponses immunitaires dans le cancer du poumon. Cette étude démontre la présence de Tregs FoxP3+ dans les TLS aussi bien que dans les autres régions tumorales. Les Tregs infiltrant la tumeur (Ti-Tregs) présentent un phénotype de lymphocytes T à mémoire centrale, et effecteur mémoire. Ces cellules expriment un vaste répertoire de molécules d’activation et de « chekpoints » immunologiques. L’analyse de l’expression des gènes et des résultats de cytométrie en flux a montré que les Tregs expriment des marqueurs de co-stimulation et de co-inhibition. Une forte densité de Ti-Tregs dans les TLS ou les autres régions tumorales, est associée à une faible survie des patients. Lorsqu’on combine ce résultat avec la densité de DC matures ou lymphocytes B associés aux TLS ou CD8+, un groupe de patients présentant de faible densités de ces cellules mais de fortes densités en Tregs a le pronostic le moins favorable avec le plus grand risque de décès. Les Tregs créent un environnement immunosuppresseur dans les cancers pulmonaires. Ce mécanisme pourrait être une explication de la réduction observée de la survie de ces patients. / Tumor comprise complex niche of the immune and non-immune components. The complex interaction between the tumor cells with its environment turns into either eradication or the growth and metastasis of the tumors. We have previously demonstrated the role of TLS (tertiary lymphoid structures) in lung tumors, in protective anti-tumor responses. Despite of this, tumors do develop via exploiting the regulatory mechanisms, particularly includes, infiltration of the Tregs (regulatory T cells). The aim of thesis was to study the putative role of Tregs in regulating the immune responses in lung cancer. This study strongly demonstrates the presence of FoxP3+ Tregs in the TLS as well as non-TLS areas of the lung tumors. Tregs mainly exhibit central and effector memory phenotype expressing vast repertoire of the activation and immune checkpoint molecules. The gene expression and flow cytometry data showed that Tregs express the co-stimulatory and inhibitory markers which are known to be involved in the their activation and immune suppression. The high density of the Ti-Tregs either in TLS or in nonTLS areas is associated with the poor survival of the NSCLC patients. When combined with the density of TLS mature DC or B cells or CD8+ T cells, a group of patients with the low DC, B cells and CD8+ T cells but high Tregs densities, had the worst clinical outcome. This allowed, to identify the NSCLC patients with highest risk of death. Thus, it be concluded that the Tregs create the immunosuppressive environment in the lung tumors by acting in both TLS and nonTLS areas of the tumors and thus could be possible reason for the reduced survival of the lung cancer patients.

Les lymphomes B sont des cancers du système lymphatique se développant à partir des cellules B. Il devient évident que le développement des cellules B malignes dépend d’interactions avec les cellules immunes dans leur microenvironnement. Nous avons étudié la caractérisation des lymphocytes T intra tumoraux afin de comprendre leur contribution dans la lymphomagenèse et leur potentiel thérapeutique dans les lymphomes B comme le lymphome diffus à grandes cellules B (DLBCL), le lymphome folliculaire (FL) et le lymphome Hodgkinien classique (cHL)Nous avons mis en évidence une différence importante, quantitative et qualitative, entre la composition immunitaire de différents lymphomes B, notamment au niveau des lymphocytes T intra tumoraux. Le FL se caractérise par une accumulation des lymphocytes T régulateurs (Tregs) exprimant ICOS, pouvant supprimer les cellules B lymphomateuses. La génération des Tregs ICOS+ est favorisée par le contact avec les cellules B lymphomateuses exprimant ICOSL. Quant à lui, le DLBCL a beaucoup de lymphocytes TCD8 coexprimant PD1 et TIM3 possédant un état de dysfonctionnement dit « épuisement », lymphocytes dont la proportion est corrélée à leur niveau de dysfonctionnement et à leur capacité de réponse au blocage des récepteurs inhibiteurs. Enfin, dans certains lymphomes B, en particulier le cHL, nous avons découvert une sous population de TCD8, dite « TFH-like » pour leur similarité phénotypique et fonctionnelle avec les lymphocytes T auxiliaires folliculaires (TFH). Ces données indiquent l’hétérogénéité des composants immunitaires entre différents lymphomes B et sont une piste pour une future thérapie ciblée dans le traitement du lymphome. / B-cell lymphomas represent a heterogeneous group of cancers that affect B cells in the lymphatic system. It has become evidence that malignant B cells depend on various interactions with microenvironmental immune cells for their development. Our study focuses on characterization of intra-tumoral T cells in order to understand their contribution in pathogenesis and their therapeutic potentials in the most frequent B cell-lymphoma such as Diffuse large B-cell lymphoma (DLBCL), Follicular lymphoma (FL) and classical Hodgkin lymphoma (cHL).During this work, we have demonstrated a significant quantitative and qualitative difference between different B-cell lymphoma immune composition, especially between their intra-tumoral T cells. FL is characterized by the accumulation of regulatory T cells (Tregs) expressing ICOS, with ability to suppress lymphoma B cells. Generation of Tregs ICOS+ is prompted by cell contact with the lymphoma B cells expressing ICOSL. On the other hand, DLBCL have high level of TCD8 coexpressing PD1 and TIM3 displaying an exhaustion state, which proportion is correlated with their dysfunction level and with their responsiveness to inhibitor receptors blockade. Finally, in some B-cell lymphoma cases, especially cHL, we found the existence of a TCD8 subset, called TFH-like due to their phenotypic and functional similarity with follicular helper T cells (TFH).These data show heterogeneity of immune components between the different B lymphomas, and give opportunity for targeted therapy in lymphoma treatment

Neste estudo são comparados os níveis de citocinas plasmáticas circulantes e as populações periféricas de células Treg CD4+CD25+, com base na expressão de FOXP3 e CTLA-4, e de células dendríticas (DCs) em indivíduos infectados por P. falciparum, P.vivax ou co-infectados por ambas as espécies e em controles saudáveis, porém expostos à malária, provenientes de uma área de transmissão instável na Amazônia brasileira. Amostras sangüineas de 76 pacientes infectados e de 18 controles expostos foram coletadas e processadas para a obtenção de células mononucleares. As populações celulares foram avaliadas por citometria de fluxo e os níveis de citocinas circulantes, pela técnica de ELISA de captura. A infecção aguda induziu aumento no percentual de células CD4+CD25+FOXP3+CTLA-4+ (p=0,0029; teste de Kruskal-Wallis) e redução no número absoluto de DCs (p=0,0008; teste de Kruskal-Wallis); mas esses efeitos ocorreram independente da espécie do parasito infectante. Entre os pacientes com malária vivax, 35-40% apresentaram baixa proporção de DCs que expressam a molécula co-estimulatória CD86. A única variável associada à baixa proporção de DCs CD86+ foi a proporção de células CD4+CD25+FOXP3+ que expressam CTLA-4. Em relação aos níveis de citocinas circulantes observou-se aumento nos níveis de IFN-<font face=\"Symbol\">&#947 na infecção por P. falciparum (p=0,0050; teste de Kruskal-Wallis). Apesar da concentração de IL-10 estar elevada em todos os indivíduos infectados em relação aos controles expostos (p<0,0001; teste de Kruskal-Wallis) esses níveis foram bem mais expressivos em indivíduos com malária vivax. Plasmodium falciparum e P. vivax parecem estimular diferentes padrões de resposta imune no hospedeiro, mesmo quando a comparação envolve somente indivíduos com malária não-complicada expostos a níveis semelhantes de transmissão de malária. / This study compares levels of circulating cytokines and peripheral-blood populations of CD4+CD25+ Treg cells, based on the expression of FOXP3 and CTLA-4, and dendritic cells (DCs) in individuals infected with P. falciparum, P. vivax or co-infected with both species and in healthy controls living in an area of unstable transmission of malaria in the Brazilian Amazon. Blood samples from 76 malaria patients and 18 malaria-exposed but non-infected controls were collected and processed to obtain mononuclear cells. Cell populations were characterized by flow cytometry and levels of circulating cytokines were measured by capture ELISA. Acute infection induced an increase in the proportion of CD4+CD25+FOXP3+CTLA-4+ cells (p= 0.0029, Kruskal-Wallis) and a decrease in the absolute number of DCs (p= 0.0008, Kruskal-Wallis), being both effects independent of the infecting parasite species. 35-40% of the P. vivax-infected subjects (but none in the other groups of subjects) had few circulating DCs expressing the co-stimulatory molecule CD86, a putative marker of DC activation. The only variable associated with a low proportion of CD86+ DCs was the proportion of CD4+CD25+FOXP3+ expressing CTLA-4. Analysis of circulating cytokine levels revealed increased levels of IFN- <font face=\"Symbol\">&#947 in P. falciparum infection (p= 0.0050, Kruskal-Wallis); although IL-10 levels were high in all infected individuals, compared with exposed controls (p<0.0001, Kruskal-Wallis), the increase was much more pronounced in vivax malaria. Plasmodium falciparum and P. vivax</i. appear to stimulate different patterns of immune response in humans, even when comparisons are limited to individuals with uncomplicated malaria exposed to similar levels of malaria transmission.

Les travaux antérieurs du laboratoire ont démontré le rôle du CD47 dans la fonction des cellules dendritiques ainsi que dans l’induction des lymphocytes T régulateurs (Tregs) chez l’humain in vitro. Notre premier objectif était de déterminer le rôle de CD47 sur la fonction des DCs in vivo. Nos travaux démontrent que le CD47 contrôle sélectivement la migration des DCs au travers des vaisseaux lymphatiques et des barrières cellulaires endothéliales in vivo sans interférer avec celle des lymphocytes T et B. Des expériences de migration compétitive et d’ immunisation active avec des DCs myéloïdes démontrent que la migration des DCs est dépendante de l’expression du CD47 sur les DCs et non sur les cellules endothéliales. Ce défaut de migration est corrélé avec l’absence de DCs spléniques dans la zone marginale chez nos souris CD47-/-. Notre second objectif était de déterminer le rôle de CD47 dans l’homéostasie et la fonction des Tregs. Nous démontrons que l’expression du CD47 contrôle sélectivement l’homéostasie d’une sous-population de Tregs CD103+ à l’état de base. La proportion de cellules activées/mémoires (CD44hi CD62Llo ) Foxp3+ CD103+ augmente rapidement au cours du vieillissement chez nos souris CD47-/- comparée aux souris CD47+/+ du même âge, tandis que le pourcentage de cellules (CD44loCD62Lhi) Foxp3+ CD103- reste comparable entre les deux souches de souris. En conclusion, le CD47 inhibe la prolifération excessive des Tregs CD103+ empêchant ainsi l’accumulation de ces cellules en absence d’inflammation. Les DCs et les Tregs sont étroitement régulées de manière reciproque. Cette régulation croisée contribue au maintien d’un équilibre entre l’immunité protectrice et la tolérance. La perspective de nos travaux est d’approfondir nos connaissances sur le rôle du CD47 et de ses ligands dans la régulation des DCs par les Tregs et vice et versa. Les DCs et les Tregs étant impliqués dans la pathogenèse de multiples maladies telles que le cancer, les maladies infectieuses et les maladies auto-immunes. Par conséquent, nos études pourraient ouvrir des portes à de nouvelles stratégies thérapeutiques. / Previous work in the laboratory have demonstrated the role of CD47 in the function of dendritic cells and in the induction of regulatory T cells in humans. Here, we show that the ubiquitous self-marker CD47 selectively regulates DC, but not T and B cell trafficking across lymphatic vessels and endothelial barriers in vivo. Competitive DC migration assays and active immunization with myeloid DCs demonstrate that CD47 expression is required on DCs but not on the endothelium and not vice and versa for efficient DC trafficking and T-cell responses. This migratory defect correlates with the quasi-disappearance of splenic marginal zone DCs in non manipulated CD47-deficient mice. Our data reveal that CD47 on DCs is a critical factor in controlling migration and efficient initiation of the immune response. Mutual or reciprocal regulation exists between DCs and Tregs. For instance, DCs efficiently induce Tregs in vivo. We here examine how CD47 deficiency that selectively decrease myeloid DCs impact on Treg homeostasis. We here show that CD47 expression, selectively regulated CD103+Foxp3+ Treg homeostasis. The proportion of effector/memory-like (CD44highCD62Llow) CD103+ Foxp3+ Tregs rapidly augmented with age in CD47-deficient mice (CD47-/-) as compared with age-matched control littermates. Yet, the percentage of quiescent (CD44lowCD62Lhigh) CD103-Foxp3+ Tregs remained stable. Thus, sustained CD47 expression throughout life is critical to avoid an excessive expansion of CD103+ Tregs that may overwhelmingly inhibit Ag specific T cell responses. DCs and Tregs are closely regulated to maintain the balance between protective immunity and tolerance. When that balance is broken, several diseases such as cancer, infectious diseases and autoimmune diseases may develop. Our ultimate goal is to understand how CD47 regulates DCs and Tregs function. Manipulation of the two cells types may open to the door to unexplored therapeutic avenues.

Type 1 diabetes (T1D) is an autoimmune disease leading to destruction of insulin-secreting pancreatic -cells. Environmental factors e.g. exposures to infections, dietary components play a substantial role in etiopathogenesis of T1D and are responsible for rapid increase of T1D incidence in past decades, preferentially in developed countries. Despite long record of T1D research no causative cure or efficient prevention exists. While gluten displays proinflammatory properties, gluten-free diet (GFD) has been documented by several studies as a strong diabetes- preventive environmental factor in spontaneous animal models of T1D, mostly in NOD mouse. The aim of this thesis is to better characterize effects of GFD on the immune system of NOD mouse. Using flow cytometry, we compared effects of GFD vs standard (STD) Altromin diets on NK cell subsets, Tregs, as well as other regulatory cell subsets and their cytokine profile in prediabetic SPF NOD females that were exposed to the diets since "in utero". A reference diabetes incidence in NOD females in our SPF facility kept on STD and GFD was recorded. Diabetes-preventive capacity of GFD were tested by using the NOD-SCID model of diabetes transfer, in which splenocytes from at-onset NOD females kept on GFD or STD were transferred to NOD-SCID recipients....

Allergy is one of the most common diseases. Identification of early prognostic markers pointing to an increased risk of allergy development is therefore of increasing importance. Cord blood represents an easily attainable clinical material for searching for prognostic markers signalizing future allergy development. Proportions of Th1 cytokines, Th2 cytokines and regulatory cytokines were tested in cord blood of children of allergic mothers (children in relatively high risk of allergy development) in comparison with cord blood of children of healthy mothers (low risk children). Also the activities of lymphocytes, dendritic cells (DC) and regulatory cells (Tregs) were compared in children of healthy and allergic mothers. The generally increased activity of both in vitro stimulated and non-stimulated mononuclear cord blood leukocytes was proved in children of allergic mothers in comparison with low risk children. The increased activity of DC of high risk children was detectable only after polyclonal stimulation. Significantly less pronounced functional properties of cord blood Tregs were found in children of allergic mothers when compared with children of healthy mothers. The increased reactivity of lymphocytes and DC together with the decreased activity of Tregs can support an easier...

Long-term renal graft acceptance still requires long-term immunosuppressive therapy, which is accompanied by many adverse effects. Contrarily insufficient immunosuppression could lead to graft rejection and its failure. Therefore, research continues for biomarkers that reflect a patient's immunological status and thus allowing for individualized immunosuppressive therapy. In our study we showed lower incidence of acute rejection in kidney transplant recipients treated with rabbit anti-thymocyte globulin (rATG) or basiliximab induction within the first three months after transplantation. The rATG induction caused profound decrease of recipient's peripheral blood T and NK cells, as well as transcripts that are exclusively expressed by these cell types together with expansion of regulatory T cells (Tregs) among CD4+ T cells. In rATG group the increase of two transcripts associated with rejection (MAN1A1 and TLR5) was also observed in early post-transplant period. After the basiliximab induction we transiently detected CD4+CD25low/-FoxP3+ cell population along with disappearance of CD4+CD25+FoxP3+ Tregs. Basiliximab induction resulted in a transient increase in CD4+FoxP3+ Tregs, accompanied by the highest peripheral expression levels of markers associated with operational tolerance (FOXP3 and TCAIM)....

Prediction of clinical outcome in cancer is usually achieved by histopathological evaluation of tissue samples obtained during surgical resection of the primary tumor. Traditional tumor staging (AJCC/UICC-TNM classification) summarizes data on tumor burden (T), presence of cancer cells in draining and regional lymph nodes (N) and evidence for metastases (M). However, it is now recognized that clinical outcome cansignificantly vary among patients within the same stage. Data collected from largecohorts of human cancers has demonstrated the impact of immune-classification, which has a prognostic value that may add largely to the significance of the AJCC/UICC TNM-classification. In our study we examined the immune cells that infiltrated the tumor tissues of colorectal and ovarian cancer patients. In a cohort of newly diagnosed colorectal cancer patients we examined the correlations between the KRAS mutational status, patterns of tumor-infiltrating immune cells and the presence of tumor recurrence. Our data suggest that colorectal cancer patients with low levels of tumor-infiltrating lymphocytes, a high CD1a/DC-LAMP tumor-infiltrating dendritic cells ratio, and a KRAS mutation in codon 13 are at a high risk of disease recurrence. In ovarian cancer patients we focused on the dynamics of the tumor-infiltrating...

Regulatorische T-Zellen (Tregs) spielen eine entscheidende Rolle bei der Regulation atopischer Erkrankungen. Die Voraussetzungen für eine allergische Reaktionslage werden schon während der intrauterinen Entwicklung geschaffen. Über den Einfluss der intrauterinen Umgebung auf die Tregs zur Geburt ist bisher wenig bekannt. In der vorliegenden Arbeit sollte in der prospektiven Geburtskohorten-Studie LINA (Einfluss von Lebensstil und Umweltfaktoren auf das Allergierisiko Neugeborener) geklärt werden, inwiefern der Immunstatus der werdenden Mutter, eine atopische Familienanamnese sowie Umweltexpositionen während der Schwangerschaft den Immunstatus der Neugeborenen beeinflussen. Ein besonderer Schwerpunkt wurde dabei auf Tregs gelegt. Weiterhin sollte die Relevanz der Tregs zur Geburt für das Allergierisiko im ersten Lebensjahr des Kindes analysiert werden. Die Messung der Anzahl und Funktionalität der Tregs im Blut der werdenden Mutter in der 34. Schwangerschaftswoche und im Nabelschnurblut erfolgte sowohl durchflusszytometrisch in einer Subkohorte (n=24 Mutter-Kind Paare), als auch durch eine methylspezifische qPCR in der gesamten Kohorte der LINA-Studie (n=346 Mutter-Kind Paare). Die Ergebnisse dieser Arbeit deuten erstmals darauf hin, dass mütterliche Tregs möglicherweise einen regulatorischen Einfluss hinsichtlich der Programmierung des fötalen Immunsystems haben (Hinz et al., Clin Exp Allergy 2010). Die durchflusszytometrische Charakterisierung der Tregs der Mutter-Kind Paare zeigte beim Vergleich der Expression von CD4, CD25, CD127 und FOXP3, dass der Anteil der CD4+CD25high Tregs im Nabelschnurblut deutlich höher war, der Anteil FOXP3 positiver Zellen innerhalb der CD4+CD25high Tregs Population war zur Geburt jedoch signifikant geringer, verglichen mit den werdenden Müttern. Weiterhin war eine geringe Anzahl mütterlicher Tregs während der Schwangerschaft und eine erhöhte Produktion der TH2-Zytokine IL-4, IL-5 und IL-13 mit erhöhten Gesamt-IgE-Spiegeln im Nabelschnurblut verbunden (Hinz et al., 2010). Durch die Quantifizierung der Tregs auf Basis des TSDR-Methylierungsstatus` im FOXP3 Gen, einer spezifischen und zuverlässigen Methode zum Nachweis stabiler Tregs, konnte der Zusammenhang zwischen einer Vielzahl pränataler Faktoren, Tregs zur Geburt und dem Allergierisiko in der gesamten Geburtskohorte geklärt werden (Hinz et al., Allergy 2011). Das männliche Geschlecht des Kindes, die Atopie der Eltern, Rauchen und Desinfektionsmittel-Exposition während der Schwangerschaft sowie eine erhöhte mütterliche Produktion von IFN-γ, IL-13 und IL-17E war mit einer geringeren Treg-Anzahl im Nabelschnurblut assoziiert. Für Kinder mit einer geringeren Treg-Anzahl im Nabelschnurblut war das Risiko für eine atopische Dermatitis und einer Sensibilisierung gegen Nahrungsmittelallergene im ersten Lebensjahr signifikant höher (Hinz et al., 2011).:Bibliografische Beschreibung II Abkürzungsverzeichnis IV 1. Einleitung 1 1.1. Hintergrund der Untersuchungen 1 1.2. Historischer Hintergrund/Definition „Allergie“ 1 1.3. T-Zellpopulationen mit Relevanz für die Entwicklung allergischer Erkrankungen 2 1.4. Regulatorische T-Zellen 5 1.5. Bedeutung des Immunstatus zur Geburt - prädiktive Marker für die Allergieentstehung 8 1.6. Ursachen der frühkindlichen Allergieentstehung – genetische Prädisposition und pränatale Umgebung 10 1.7. Die LINA-Studie 13 2. Zielstellung 15 3. Originaldateien 16 4. Diskussion 34 4.1. Unterschiede im Phänotyp und der Funktion der Tregs in der Schwangerschaft und zur Geburt 36 4.2. Zusammenhang zwischen dem Immunstatus der werdenden Mutter und dem des Kindes zur Geburt 37 4.3. Geschlechtsspezifische Unterschiede in der Anzahl der Tregs zur Geburt 41 4.4. Zusammenhänge zwischen der familiären Prädisposition und der Anzahl der Tregs im Nabelschnurblut 42 4.5. Zusammenhänge zwischen Umweltfaktoren während der Schwangerschaft und der Anzahl der Tregs im Nabelschnurblut 44 4.6. Zusammenhang zwischen der Anzahl der Tregs zur Geburt, Sensibilisierung und allergischen Erkrankungen im ersten Lebensjahr des Kindes 46 4.7. Stärken und Schwächen der Untersuchungen 47 5. Zusammenfassung 49 6. Literaturverzeichnis 52 Anlage – Supplemental Materials 66 Hinz et al., Clin Exp Allergy 2010 66 Hinz et al., Allergy 2011

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