In this thesis, I examined the expression of CD1d on respiratory epithelial cells (REC) in human and explored its potential role in mucosal immunity in the lungs. Hitherto, there have been no published reports of CD1d expression on REC though it has been observed on other epithelial surface (notably intestinal epithelial cells). This observation, and work in my supervisor’s laboratory demonstrating CD1d-restricted natural killer T cells (iNKT) cells as early players in the lungs of influenza A virus (IAV)–infected mice prompted my interest in this area. I hypothesized that CD1d is expressed on REC and that it contributes to activation of iNKT cells in the lungs via presentation of endogenous or pathogenic glycolipids. I asked following questions – i) is CD1d expressed on REC ii) can this expression be regulated and iii) does CD1d expression on REC have a function. This thesis provides the first evidence for CD1d expression on human RECs (in cell lines and primary RECs) and also presence of alternatively spliced variants. CD1d expression was inducible by viral-associated signals in vitro and despite being non-professional antigen presenting cells, RECs can present glycolipid (α–GC) to, and activate iNKT cells in a CD1d-dependent process resulting in production of both Th1 and Th2 cytokines. Using whole genome expression profiling, I then showed that iNKT cells expressed a distinct profile of genes while in direct contact with α–GC-bound CD1d on RECs compared to cells separated by transwell membrane. Here early biological pathways were dominated by cytokine and chemokine related genes (JAK-STAT signaling pathways, cytokine-responsive elements and cytokine/chemokine genes) and apoptosis-related genes. This suggested that glycolipid-bound CD1d on REC was capable of inducing a programme of immune activation in iNKT cells. I concluded my work by examining if CD1d expression on RECs influenced its active role in immunity. Using wild type and CD1d-deficient transgenic mice challenged with IAV, I showed that CD1d expression is induced on REC in vivo after viral challenge, and in the absence of CD1d, mice showed worse outcome. RECs isolated from CD1d-deficient mice had a much stronger gene expression profile for pro-inflammatory genes. This suggested that CD1d expression on REC could have a bi-directional effect – on the RECs that expressed CD1d (preventing excessive immune-related genes activation) and on the iNKT cells that it engaged (activation, with pro-immunity effects). The thesis concludes with discussion of the potential implications of these findings and future work to examine hypotheses generated from this work.

Aspergillus fumigatus is a filamentous fungus and the main pathogen responsible for the often fatal respiratory condition, aspergillosis. Airway epithelial cells (AECs) are likely to be the first line of host defence that come into contact with the inhaled conidia of A. fumigatus. Recent evidence strongly suggests that the response of the airway epithelium to inhaled pathogens is pivotal in orchestrating immune responses by inducing phagocytic-like reactions and the secretion of inflammatory cytokines and antimicrobial peptides. However, the majority of previous work investigating A. fumigatus-host interactions has been performed using macrophages and neutrophils, thereby neglecting the epithelium. AECs have been shown to secrete inflammatory cytokines in response to A. fumigatus although these studies predominantly used transformed AEC lines that lack tight junctions and do not fully differentiate. Furthermore, most studies used culture filtrate or extract of A. fumigatus rather than live, whole organism and as a result, the direct interaction of the germinating fungus and the airway epithelium has been overlooked. During the early germination and growth period, the cell wall composition of A. fumigatus is dynamic, with various antigens exposed at different morphological stages. The aim of this thesis was to determine whether AECsare able to alter the germination and growth rate of A. fumigatus, and, conversely, if A. fumigatus affects AECs in terms of the secretion of inflammatory mediators. These studies used live, germinating A. fumigatus, and human primary differentiated AECs to obtain a more realistic in vitro model than those used in previous studies. Data showed that AECs are able to significantly inhibit the germination and growth of A. fumigatus, although this effect was less pronounced in differentiated primary AEC than in transformed AEC lines. A. fumigatus also significantly inducedthe expression and secretion of the inflammatory cytokines, IL-6 and IL-8, probably via the interaction of fungal cell wall β-glucans, and as of yet unidentified AEC receptor. The A1160pyrG+ strain of A. fumigatus secreted factors capable of inducing cytokine secretion whereas Af293 strain did not, highlighting diverse mechanisms of action for different strains. Upregulation of both cytokines was dependent on the stage of A. fumigatus growth with induction synchronous with germination. Despite being associated with fungal sensitisation in asthmatics, AEC-derived cytokines associated with this disease, namely TSLP, IL33 and IL25,did not appear to be upregulated by transformed AECs in response to A. fumigatus. Similarly, A. fumigatus did not seem to induce synthesis and secretion of the acute phase response protein, fibrinogen above baseline levels. The data presented in this thesis confirms the importance of the airway epithelium in directing anti-A. fumigatus immunity and the involvement of complex ligand-receptor interactions.

The maintenance of the airway/respiratory epithelium during adult homeostasis and repair and its construction during embryonic development require tightly regulated cell fate decisions. This regulation takes the form of complex transcription factor and signalling cascades, much of which are unknown, particularly in human lung development. Multiciliogenesis describes the process of specification/differentiation of airway epithelial progenitors/stem cells into mature multiciliated cells (MCCs). Here, I have identified 2 novel transcription factors, Fank1 and Jazf1 which form part of the transcription factor cascade regulating multiciliogenesis in adult and embryonic mouse tracheas. Mouse tracheal epithelium is representative of epithelium lining the entire human airway and it is possible that we will also be able to extrapolate these findings to the human airway. It is not until we fully understand the regulation of multiciliogenesis that it will be possible to look at ways of pushing basal cells towards a MCC fate for purposes of cell replacement therapy, for example in patients with mucociliary disease. As well as exploring cell fate decisions in the mouse upper airway epithelium using embryonic tracheal explants and mouse tracheal epithelial cell (MTEC) cultures, I have also explored the regulation of cell fate decisions in distal human lung epithelium at the pseudoglandular stage of development. At this stage SOX9+ distal tip cells are self-renewing and multipotent and give rise to SOX2+ stalk descendents, which differentiate into airway epithelium. The regulation of SOX9+ lung tip cell multipotency and migration of SOX2+ stalk descendents during human lung development is poorly understood. I have compared human tip (SOX9+) versus stalk (SOX2+) transcriptomes using gene ontology (GO), which has highlighted some key signalling pathways enriched in tip cells which could be important in maintaining distal tip cell multipotency. These pathways have been utilised in optimising conditions for propagating self-renewing tip-derived organoids. These organoids have the potential to be differentiated into bronchiolar and alveolar fates and as such are an invaluable research tool for studying human lung epithelial development, whilst minimising the use of human embryos and its associated ethical implications. I have also performed human tip versus mouse tip transcriptome GO analysis which highlights that although there are many similarities, there are also differences between human and mouse lung epithelium development, emphasising the need for research on human tissue.

La recrudescence des infections respiratoires impliquant des facteurs virulents d’origine bactérienne est devenue un problème majeur de santé publique. Mieux caractériser la réponse des cellules respiratoires dans la phase initiale d’exposition à des toxines bactériennes est important sur les plans physiopathologiques et thérapeutiques. Le but de ce travail est de décrypter les mécanismes cellulaires et moléculaires impliqués lors de l’exposition des cellules épithéliales respiratoires à l’adénylate cyclase (CyaA), une toxine produite par Bordetella pertussis, l’agent responsable de la coqueluche. CyaA a été choisie car elle dispose de multiples moyens qui lui permettent d’envahir un grand nombre de cellules eucaryotes. Elle est notamment capable de transloquer son domaine catalytique directement dans la cellule cible puis d’utiliser la calmoduline endogène pour augmenter le taux d’AMPc à des niveaux supraphysiologiques. Cependant l’effet de ces changements sur la signalisation mécano-chimique (mécanotransduction) a été très peu décrit alors qu’elle affecte les fonctions et l’intégrité cellulaires. Nous proposons donc d’évaluer les fonctions cellulaires et les propriétés mécaniques et d’adhésion des cellules épithéliales respiratoires exposées à CyaA dans le but de déceler des modifications fondamentales dans les processus de mécanotransduction.Nous avons tout d’abord mené une étude préliminaire visant à définir les concentrations physiopathologiques de CyaA utilisées dans nos expériences. Nous avons ainsi déterminé le degré de viabilité cellulaire en fonction de 3 concentrations de CyaA (0.5 ; 5 ; 10 nM), ce qui a montré que la concentration 0.5 nM n’affectait pas la viabilité cellulaire tout en induisant des niveaux supraphysiologiques d’AMPc en moins d’une heure.Nous avons ensuite cherché à évaluer les effets de CyaA sur la migration et la réparation cellulaires, le battement ciliaire et la perméabilité cellulaire de cellules épithéliales représentatives des différents niveaux de l’arbre aérien. CyaA induit une diminution de la migration et de la réparation cellulaires, ainsi qu’une augmentation de la perméabilité cellulaire traduisant un affaiblissement des jonctions latérales.Une étude en immunoflorescence a ensuite été conduite sur les structures intracellulaires et interfaciales des cellules épithéliales alvéolaires exposées aux 3 concentrations de CyaA. Cette étude a montré que CyaA est capable d’induire un remodelage du cytosquelette d’actine ainsi qu’une diminution du nombre des adhérences focales. Enfin, une analyse complète des propriétés mécaniques et des paramètres d’adhésion a été conduite sur les mêmes cellules au moyen de 2 techniques de micro/nanomanipulation revisitées pour permettre à la fois l’évaluation des liens multiples et de la rigidité cellulaire (Microscopie à Force Atomique (AFM) avec indentation et Magnétocytométrie (MTC)). Pour évaluer le rôle de l’AMPc sur les changements observés, les cellules épithéliales respiratoires ont été testées avec la forme active de CyaA et la forme enzymatiquement inactive de la toxine : CyaAE5, qui ne permet pas de synthétiser l’AMPc.Les expériences AFM ont révélé que le principal effet de CyaA est de diminuer le nombre de liens intégrine-ligand associés (une altération du clustering) alors qu’à la plus faible concentration de CyaA, nous observons une augmentation de la rigidité cellulaire, accompagnée d’un renforcement des liens individuels, évolutions confirmées par les résultats MTC. CyaAE5 ne parvient pas à produire ces mêmes effets.L’ensemble des résultats suggère que CyaA affecte de façon précoce la mécanotransduction des cellules exposées et ceci en cohérence avec les effets attendus de l’augmentation d’AMPc (remodelage du CSQ, altération des jonctions latérales, inhibition de l’expression de Rac1), ce qui apporte une nouvelle vision de la cytotoxicité induite par l’adénylate cyclase. / The increase in respiratory infections involving virulent factors of bacterial origin has become a major public health issue. A better knowledge of the cell respiratory response in the course of the initial cell invasion by bacterial toxins is important from the pathophysiological and therapeutical point of views.The purpose of this work is to decipher the cellular and molecular mechanisms involved in the exposition of respiratory epithelial cells to the adenylate cyclase toxin (CyaA) produced by Bordetella pertussis which is the whooping cough agent. We have chosen this toxin for its multiple capacities of penetrating a wide range of eukaryotic cells. Indeed, this toxin enables direct translocation of its catalytic domain across the plasma membrane of target cells using the endogen calmoduline to increase the cAMP rate at supraphysiological levels. However, the effects of these changes on mechano-chemical signaling (mechanotransduction) pathways remain largely unknown while it affects cellular functions and cell integrity. So, we perform an evaluation of cellular functions as well as mechanical and adhesion properties of respiratory epithelial cells exposed to CyaA toxin in order to detect some critical modifications in the mechanotransduction processes.In a preliminary study aiming at defining physiopathological concentrations of CyaA toxin used in our experiments, we determined the cell viability degree for 3 concentrations of CyaA toxin (0.5; 5 and 10 nM). We found that the smallest concentration (0.5 nM) did not affect cell viability whereas inducing supraphysiological cAMP levels in less than one hour.Then, we assessed the effects of CyaA toxin on cell migration and repair phenomenon, on ciliary beating and on cell permeability of epithelial cells representative of the different levels of the respiratory tract. The toxin induces a decrease in cell migration and repair, an increase in cell permeability suggesting a weakening of lateral cell-cell junctions.Immunostaining was performed on intracellular and interfacial structures of alveolar epithelial cells exposed to the 3 concentrations of CyaA toxin. Results show that CyaA toxin is able to induce cytoskeleton remodeling and a decrease in the number of focal adhesions. Finally, a refined analysis of mechanical properties and adhesion parameters was performed on the same cells by 2 techniques of micro/nanomanipulation modified to permit at the same time, an evaluation of cell adhesion and cell rigidity (Atomic Force Microscopy with indentation and force spectroscopy to characterize the number of bond during adhesion reinforcement and multiscale Magnetic Twisting Cytometry). To evaluate the role of cAMP on cellular and molecular changes, we tested the enzymatically inactive form of CyaA toxin called CyaAE5 which could not permit to increase the intracellular cAMP rate.The AFM experiments have revealed that the main effect of CyaA toxin is to decrease the number of associated integrin-ligand bounds (meaning an alteration of clustering) while, at the smallest concentration of CyaA toxin, we observe an increase in cell rigidity with an individual bound reinforcement, a result consistent with MTC results. Nevertheless, CyaE5 does not exhibit such cellular effects. On the whole, these results suggest that CyaA toxin affects the mechanotransduction pathways of cells exposed to the toxin, a result which is in agreement with the expected effects of cAMP increase (notably cytoskeleton remodeling, lateral junction alteration and inhibition of Rac1 expression) what brings a new vision of the cytotoxicity induced by the adenylate cyclase toxin.

No / To investigate whether there are differences between members of the Burkholderia cepacia complex in their ability to invade human respiratory epithelial cells, 11 strains belonging to genomovars I-V were studied in an antibiotic protection assay using the A549 cell line. Strains belonging to genomovars II and III were more invasive than those of genomovars I, IV and V. There was also intra-genomovar variation in invasiveness. No correlation between invasiveness and other putative virulence factors of importance in B. cepacia infection in individuals with cystic fibrosis, cable pilus and B. cepacia epidemic strain marker was identified.

Alguns estudos sugerem que as pequenas vias aéreas têm um papel importante na fisiopatologia da lesão pulmonar aguda/ síndrome do desconforto respiratório agudo (LPA/SDRA). O epitélio respiratório que reveste as vias aéreas é capaz de liberar mediadores inflamatórios e está relacionado ainda com a produção de surfactante nas vias aéreas. Até o presente momento, existem poucos estudos que avaliaram se estas funções do epitélio que reveste as pequenas vias aéreas encontram-se alteradas na SDRA. No presente estudo, nós mensuramos a expressão da proteína de surfactante (PS) A e PS-B, a expressão de citocinas inflamatórias interleucina (IL)-6 e IL-8, e um índice de apoptose do epitélio que reveste as pequenas vias aéreas de pacientes com SDRA que foram submetidos a autópsia e comparamos estes resultados com os de indivíduos controle. Foram incluídos no estudo pulmões de autópsia de 31 pacientes com SDRA (PaO2/FiO2200, 45±14 anos, 16 homens) e 11 controles (52±16 anos, 7 homens). A expressão de IL-6, IL-8, PS-A e PS-B no epitélio das pequenas vias aéreas (diâmetro2.0mm) foi verificada através de reações de imunohistoquímica e análise de imagem. O índice de apoptose epitelial das vias aéreas foi avaliado através do método de TUNEL e da expressão de FAS/FASL. Avaliou-se ainda a densidade de células inflamatórias positivas para IL-6 e IL-8 na parede das pequenas vias aéreas. As vias aéreas dos pacientes com SDRA apresentaram maior expressão epitelial de IL-8 (p=0,006) e maior densidade de células inflamatórias expressando IL-6 (p=0,004) e IL-8 (p<0,001) quando comparadas com o grupo controle. Não houve diferenças na expressão epitelial de PS-A e PS-B ou no índice de apoptose epitelial entre os grupos SDRA e controle. Nossos resultados mostram que as pequenas vias aéreas participam da inflamação pulmonar de pacientes com SDRA, caracterizada pelo aumento na expressão de interleucinas próinflamatórias tanto em células inflamatórias da parede da via aérea quanto no epitélio. Nossos resultados sugerem ainda que a apoptose não é um mecanismo importante de morte de células epiteliais das vias aéreas de pacientes com SDRA / Recent studies suggest a role for distal airway injury in the pathophysiology of human ALI/ARDS. The epithelium lining the airways modulates airway function secreting a large number of molecules such as surfactant components and inflammatory mediators. So far, there is little information on how these secretory functions of the small airways are altered in ARDS. In the present study we assessed the airway expression of surfactant protein (SP) A and SP B, the expression of inflammatory cytokines IL-6 and IL-8, and an index of airway epithelial apoptosis of patients with ARDS submitted to autopsy and compared the results with those of control subjects. We studied autopsy lungs of 31 ARDS patients (PaO2/FiO2200, 45±14 years, 16 males) and 11 controls (52±16 years, 7 males). Using immunohistochemistry and image analysis, we quantified the expression of IL-6, IL-8 and SP-A and SP-B in the epithelium of small airways (diameter2.0mm). Airway epithelial apoptosis index was obtained with the TUNEL assay and FAS/FASL expression. We also quantified the density of inflammatory cells expressing IL-6 and IL-8 within the small airway walls. ARDS airways showed an increase in the epithelial expression of IL-8 (p=0.006) and an increased density of inflammatory cells expressing IL-6 (p=0.004) and IL-8 (p<0.001) when compared to controls. There were no differences in SP-A and SP-B epithelium expression or in epithelial apoptosis index between ARDS and controls. Our results show that the distal airways are involved in ARDS lung inflammation with higher expression of pro-inflammatory interleukins in both airway epithelial and inflammatory cells. Our results also suggest that apoptosis is not a major mechanism of airway epithelial cell death in ARDS

Alguns estudos sugerem que as pequenas vias aéreas têm um papel importante na fisiopatologia da lesão pulmonar aguda/ síndrome do desconforto respiratório agudo (LPA/SDRA). O epitélio respiratório que reveste as vias aéreas é capaz de liberar mediadores inflamatórios e está relacionado ainda com a produção de surfactante nas vias aéreas. Até o presente momento, existem poucos estudos que avaliaram se estas funções do epitélio que reveste as pequenas vias aéreas encontram-se alteradas na SDRA. No presente estudo, nós mensuramos a expressão da proteína de surfactante (PS) A e PS-B, a expressão de citocinas inflamatórias interleucina (IL)-6 e IL-8, e um índice de apoptose do epitélio que reveste as pequenas vias aéreas de pacientes com SDRA que foram submetidos a autópsia e comparamos estes resultados com os de indivíduos controle. Foram incluídos no estudo pulmões de autópsia de 31 pacientes com SDRA (PaO2/FiO2200, 45±14 anos, 16 homens) e 11 controles (52±16 anos, 7 homens). A expressão de IL-6, IL-8, PS-A e PS-B no epitélio das pequenas vias aéreas (diâmetro2.0mm) foi verificada através de reações de imunohistoquímica e análise de imagem. O índice de apoptose epitelial das vias aéreas foi avaliado através do método de TUNEL e da expressão de FAS/FASL. Avaliou-se ainda a densidade de células inflamatórias positivas para IL-6 e IL-8 na parede das pequenas vias aéreas. As vias aéreas dos pacientes com SDRA apresentaram maior expressão epitelial de IL-8 (p=0,006) e maior densidade de células inflamatórias expressando IL-6 (p=0,004) e IL-8 (p<0,001) quando comparadas com o grupo controle. Não houve diferenças na expressão epitelial de PS-A e PS-B ou no índice de apoptose epitelial entre os grupos SDRA e controle. Nossos resultados mostram que as pequenas vias aéreas participam da inflamação pulmonar de pacientes com SDRA, caracterizada pelo aumento na expressão de interleucinas próinflamatórias tanto em células inflamatórias da parede da via aérea quanto no epitélio. Nossos resultados sugerem ainda que a apoptose não é um mecanismo importante de morte de células epiteliais das vias aéreas de pacientes com SDRA / Recent studies suggest a role for distal airway injury in the pathophysiology of human ALI/ARDS. The epithelium lining the airways modulates airway function secreting a large number of molecules such as surfactant components and inflammatory mediators. So far, there is little information on how these secretory functions of the small airways are altered in ARDS. In the present study we assessed the airway expression of surfactant protein (SP) A and SP B, the expression of inflammatory cytokines IL-6 and IL-8, and an index of airway epithelial apoptosis of patients with ARDS submitted to autopsy and compared the results with those of control subjects. We studied autopsy lungs of 31 ARDS patients (PaO2/FiO2200, 45±14 years, 16 males) and 11 controls (52±16 years, 7 males). Using immunohistochemistry and image analysis, we quantified the expression of IL-6, IL-8 and SP-A and SP-B in the epithelium of small airways (diameter2.0mm). Airway epithelial apoptosis index was obtained with the TUNEL assay and FAS/FASL expression. We also quantified the density of inflammatory cells expressing IL-6 and IL-8 within the small airway walls. ARDS airways showed an increase in the epithelial expression of IL-8 (p=0.006) and an increased density of inflammatory cells expressing IL-6 (p=0.004) and IL-8 (p<0.001) when compared to controls. There were no differences in SP-A and SP-B epithelium expression or in epithelial apoptosis index between ARDS and controls. Our results show that the distal airways are involved in ARDS lung inflammation with higher expression of pro-inflammatory interleukins in both airway epithelial and inflammatory cells. Our results also suggest that apoptosis is not a major mechanism of airway epithelial cell death in ARDS

Objectifs : Ce travail a pour but de développer un larynx artificiel composé de 2 structures : 1) une structure inamovible en titane poreux prolongeant la trachée; 2) une double valve remplissant la fonction de sphincter. Matériels et Méthodes : L’intégration de la prothèse en remplacement trachéal a été testée in vitro et in vivo sur les modèles animaux rats, lapins et brebis. Suite à l’ensemble de ces résultats, nous avons réalisé la première application clinique du larynx artificiel. Résultats : 1) L’ajout d’un tube de silicone endoprothétique améliore la survie chez le gros animal; 2) l’intégration tissulaire de la prothèse de trachée associée à un matériel polymérique biodégradable était supérieure à celle des prothèses en titane poreux nu; 3) la vitesse de colonisation des prothèses en titane poreux était accélérée lorsque l’on diminuait la taille des billes. Un premier patient a été implanté avec une prothèse de larynx artificiel avec des résultats satisfaisants à 9 mois. Conclusions : Nos études concernant l’intégration de prothèses de trachées in vitro et in vivo ont permis de contribuer à l’aboutissement de la première application clinique de larynx artificiel. / Background: The aim of this work is the design of an artificial larynx made of 2 elements: 1) a non-removable bio-integrable structure designed to provide a connection with the remaining trachea; 2) a double valve that fulfills the sphincter function. Materials and Methods: In vitro and in vivo tests (rat, rabbit and sheep model) were performed to achieve the tracheal prosthesis integration. Following all these results, we carried out the first clinical application of an artificial larynx. Results: i) The long-term survival of the animals was improved when an endoprosthetic silicon calibration tube was used; ii) tissue integration of the prostheses in porous titanium filled with biodegradable polymer was better than the bare porous titanium; iii) prosthesis integration was improved when pore size was decreased. A first patient was implanted with an artificial functional larynx with satisfactory results after 9 months of implantation. Conclusion: The whole in vivo and in vitro studies concerning the integration of the tracheal prosthesis has contributed to the success of the first clinical application of the artificial larynx.