Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2015-11-12T12:16:48Z No. of bitstreams: 2 Tese - Sabrina Sgambatti - 2015.pdf: 2847998 bytes, checksum: 069ae0ef61790cc3dd2564c3e7fa9120 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-11-12T12:21:22Z (GMT) No. of bitstreams: 2 Tese - Sabrina Sgambatti - 2015.pdf: 2847998 bytes, checksum: 069ae0ef61790cc3dd2564c3e7fa9120 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-11-12T12:21:22Z (GMT). No. of bitstreams: 2 Tese - Sabrina Sgambatti - 2015.pdf: 2847998 bytes, checksum: 069ae0ef61790cc3dd2564c3e7fa9120 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2015-07-17 / Background. Anticipating the introduction of the 10-valent pneumococcal conjugate vaccine (PCV10) on childhood National Immunization Program (NIP), an active population-based surveillance on pneumonia hospitalizations was conducted as a baseline, enabling a vaccination impact study. The objectives of the present research were: (i) to assess the reliability of the Hospital Information System of the Unified Health System (SIH-SUS) as a data source for assessing PCV10 impact on pneumonia; (ii) to measure the impact of vaccination with PCV10 in reducing the incidence of clinical and X-Ray confirmed pneumonia, in children residing in Goiânia municipality. Methods. In this study, we conducted an active prospective population-based surveillance on pneumonia in the post PCV10 vaccination period (2011-2013), in all 17 pediatric hospitals of Goiânia, with similar methodology used in the previous pneumonia surveillance during the pre vaccination period (2007-2009). Children aged 2-35 months of age, admitted to hospitalization with suspected diagnosis of pneumonia, were elegible for the survey. Clinical pneumonia and X-Ray confirmed pneumonia were the outcomes. The intervention was the PCV10, introduced in June 2010 in Goiania. Probabilistic linkage was performed between the SIH-SUS database (secondary data) and the active population surveillance (primary data) for the year 2012, to measure the agreement of case identification on pneumonia hospitalization rates between both data sources. To assess the impact of PCV10, annual incidence of clinical pneumonia and X-Ray confirmed pneumonia (per 100,000 population) and respective 95% confidence interval (95%CI) was estimated for the post vaccinations period and compared to the rates obtained for the pre vaccination period. The relative risk for pneumonia and respective 95%CI were calculated based on Poisson distribution. The percentage change in rates (1-relative risk) between pre and post vaccination periods was calculated. Results. Pneumonia incidence rates obtained by the SIH-SUS were statistically similar to those obtained by active population surveillance for children 2-23meses (p = 0.184). On the PCV10 impact evaluation study, the rates of hospitalization for clinical and RXT confirmed pneumonia in children under 24 months decreased 13.1% (from 5,728/100,000 to 4,976/100,000) and 25.4% (from 2,497/100,000 to 1,862/100,000), respectively, after routine immunization. / Introdução. Antecipando a introdução da vacina pneumocócica conjugada 10-valente (PCV10) no calendário de vacinação infantil do Programa Nacional de Imunizações (PNI), um estudo de vigilância de base populacional ativa foi conduzido como linha de base, possibilitando, assim, avaliar o impacto da vacinação nas hospitalizações por pneumonia. Assim, os objetivos desta investigação foram: (i) avaliar a confiabilidade do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS) como fonte de dados para estudos de avaliação de impacto da PCV10 nas pneumonias; (ii) avaliar o impacto da vacinação com a PCV10 na redução da incidência de hospitalizações de crianças com pneumonia clínica e confirmada por Raio-X de tórax (RXT), residentes no município de Goiânia. Métodos. Neste estudo, conduzimos uma vigilância populacional prospectiva, ativa, de pneumonias no período pós vacinal (2011-2013) em 17 hospitais pediátricos de Goiânia, com metodologia similar à conduzida em estudo anterior, no período pré vacinal (2007-2009). Foram elegíveis para o estudo crianças de 2 a 35 meses de idade, admitidas com com diagnóstico inicial de pneumonia. Os desfechos foram pneumonia clínica e pneumonia confirmada por RXT. A intervenção foi a PCV10, introduzida em junho de 2010 em Goiânia. A técnica de linkage probabilístico foi utilizada para vincular o banco de dados do SIH-SUS (dados secundários) e o da vigilância populacional ativa (dados primários) referentes ao ano de 2012, e desta forma, avaliar a concordância no diagnóstico e nas taxas de hospitalização por pneumonia entre as duas fontes de dados. Para avaliar o impacto da PCV10, calculou-se a incidência anual de pneumonia clínica e confirmada por RXT (por 100.000 habitantes) e respectivos intervalos de 95% de confiança (IC95%) para o período pós vacinal, e comparou-se com as taxas do período pré vacinal. O risco relativo para pneumonia e respectivos IC95% foram calculados com base na distribuição de Poisson. O percentual de mudança entre as taxas pré e pós vacinal foi calculado como 1-risco relativo. Resultados. As taxas de pneumonia obtidas pelo SIH-SUS foram estatisticamente similares às obtidas por vigilância populacional ativa para as crianças de 2-23meses (p=0,184). No estudo de avaliação do impacto da PCV10, as taxas de hospitalização por pneumonia clínica e confirmada por RXT em crianças menores de 24 meses reduziram 13.1% (de 5,728/100,000 para 4,976/100,000) e 25.4% (de 2,497/100,000 para 1,862/100,000), respectivamente, após a vacinação de rotina. Conclusões. Dados do SIH-SUS podem ser utilizados para avaliar o impacto da PCV10 nas hospilazações por pneumonia na infância. Após 3 anos de vacinação com a PCV10 em Goiânia, observou-se significante queda das taxas de hospitalização por pneumonia clinica e confirmada por RXT em crianças alvo do PNI.

Les pneumonies chez l’enfant de moins de 5 ans restent à l’heure actuelle un enjeu majeur de santé publique. Afin d’étudier les agents étiologiques des pneumonies chez les enfants de moins de 5 ans dans les pays à revenu faible ou intermédiaire, une étude cas-témoins a été réalisée entre 2010 et 2014 dans cette population par le réseau Global Approach for Biological Research on Infectious Epidemics in Low Income Countries (GABRIEL). Notre travail s’est attaché à décrire la distribution des sérotypes de Streptococcus pneumoniae retrouvés dans la population de l’étude, d’évaluer la prévalence du virus infuenza et d’évaluer l’effet du virus sur la gravité de la pneumonie, et enfin d’étudier la fréquence des co-détections bactériennes et virales au niveau nasopharyngé ainsi que leur effet sur le risque de pneumonie. Les résultats montraient que la majorité des sérotypes pneumococciques retrouvés étaient inclus dans le vaccin pneumococcique conjugué 13-valent (PCV13) et suggèraient que les souches de S. pneumoniae retrouvées au niveau nasopharyngé et au niveau sanguin étaient identiques chez un même individu atteint de pneumonie. L’importance du virus influenza, et particulièrement d’influenza A H1N1 a été soulignée. Enfin, de nombreuses co-détections nasopharyngées de microorganismes étaient observées chez les cas mais aussi chez les témoins. Leur pathogénicité semblait différer selon les espèces et pourrait dépendre des interactions avec le microbiome du tractus respiratoire. Les résultats suggèraient que la mise en œuvre de campagnes de vaccination par PCV13 pourrait être efficace dans les pays étudiés. Néanmoins, de nouvelles études précisant le rôle des co-détections entre bactéries et virus dans la physiopathologie de la pneumonie sont nécessaires pour guider les décisions de santé publique de façon optimale / Pneumonia remains a public health issue in children under 5 years old. In order to study the etiological agents of pneumonia in this population, a case-control study was carried out between 2010 and 2014 by the Global Approach for Biological Research on Infectious Epidemics in Low Income Countries (GABRIEL) Network in 9 study sites located in 8 low or middle-income countries. The objectives of the present work were to describe the distribution of Streptococcus pneumoniae serotypes, to assess the burden of influenza virus and its effect on the severity of pneumonia, and to study bacterial/viral co-detection in nasopharyngeal samples and their effect on the risk of pneumonia. Results showed that most of S. pneumoniae serotypes detected were included in the pneumococcal 13-Valent conjugate vaccine (PCV13) and confirmed the assumption that the isolate carrying or causing disease in an individual were of the same serotype. The importance of the burden of influenza virus in pneumonia cases, and particularly A H1N1 influenza, was highlighted. Finally, numerous nasopharyngeal co-detections were found both in pneumonia cases and in control subjects. Pathogenicity of microorganisms differs between species and might depend of the interactions with the microbiome of the respiratory tract. Results suggested that the implementation of PCV13 vaccination policies might be effective in the study population. Nevertheless, further studies focused on the most important co-detections of micro-organisms are needed to improve the understanding of their role in the pathogenesis of pneumonia and to guide appropriate public health interventions

Made available in DSpace on 2016-08-17T18:39:30Z (GMT). No. of bitstreams: 1 2145.pdf: 2206472 bytes, checksum: 5295597725f34bdf5560d6cda8af7446 (MD5) Previous issue date: 2008-03-27 / Financiadora de Estudos e Projetos / Streptococcus pneumoniae (pneumococo) is a pathogenic bacterium that causes several infections which are aggravated by the increase of serotypes with antibiotics resistance. The development of an effective vaccine against this pathogen is crucial for the prevention of the neumococcal illnesses. Conjugated vaccines, consisting of the capsular polysaccharide joined to a carrier protein, are more efficient in the stimulation of the immunologic memory. The capsular polysaccharide (PS) is present in the capsule that involves the cell. Thus, the conjugated vaccine elaboration involves bacterial cells cultivation for its production. As the organism is cultivated in the oxygen absence, the lactate production is inevitably high, leading to growth inhibition due to lactate accumulation in the medium. To minimize the inhibitory effects of the lactate accumulation and to increase the PS production it is necessary to monitor the process and adequately control the addition of supplementary medium along with the withdrawal of saturated medium. This kind of operation can be performed by carrying out a fed-bath cultivation in a bioreactor connected to a perfusion system. The success on the monitoring, control and optimization of this bioprocess depends on the efficiency of the modeling and simulation resources employed. This research work considers the uses intelligent computational techniques, specifically the technique of heuristical search called simulated annealing (SA) combined with neural networks for the state inference and the optimization of S. pneumoniae cultivations. The proposal was implemented as a computational system that: a) uses the SA for the identification of the values for a set of parameters associated to unstructured models and; b) uses neural networks (individually and grouped as a committee) for the state inference of a culture. The work presents and discusses the results of the system for data sets experimentally obtained and highlights the importance of the proposal for achieving a higher efficiency in the culture control processes. / Streptococcus pneumoniae (pneumococo) é uma bactéria patogênica causadora de várias infecções que são agravadas pelo aumento de cepas com resistência aos antibióticos. O desenvolvimento de uma vacina efetiva contra este patógeno é crucial para a prevenção das doenças pneumocócicas. Vacinas conjugadas, constituídas pelo polissacarídeo capsular ligado a uma proteína carregadora, são mais eficientes no estímulo da memória imunológica. O polissacarídeo capsular (PS) está presente na cápsula que envolve a célula e, desta forma, a elaboração de vacinas conjugadas envolve o cultivo da bactéria para a produção do mesmo. Como o microrganismo é cultivado na ausência de oxigênio, a produção de lactato é inevitavelmente elevada e o seu acúmulo no meio provoca a inibição do crescimento. Para minimizar os efeitos inibitórios da acumulação de lactato e aumentar a produção de PS é necessário monitorar o processo e controlar adequadamente a adição de meio suplementar e a retirada de meio saturado em cultivos operados em batelada alimentada, utilizando biorreatores acoplados a sistema de perfusão. O sucesso no monitoramento, no controle e na otimização deste bioprocesso depende da utilização de recursos de modelagem e de simulação que sejam eficientes. Este trabalho de pesquisa propõe o uso de técnicas computacionais inteligentes, especificamente a técnica de busca heurística chamada de simulated annealing (SA) aliada a redes neurais, para a inferência de estado e a otimização de cultivos de S. pneumoniae. A proposta foi concretizada via desenvolvimento de um sistema computacional que: a) faz uso do SA para a identificação do conjunto de valores de parâmetros associados a modelos não estruturados e; b) usa redes neurais (individualmente e em regime de comitê) para a inferência de estado de um cultivo. O trabalho apresenta e discute os resultados do sistema em conjuntos de dados obtidos experimentalmente e evidencia a importância da proposta para uma maior eficiência no controle de processos de cultivo.

Given that Streptococcus pneumoniae can cause life-threatening pulmonary and systemic infection, an apparent paradox is that the bacterium resides, usually harmlessly, in the nasopharynx of many people. Humoral immunity is thought to be the primary defense against serious pneumococcal infection, and we hypothesized that nasopharyngeal colonization of mice results in the generation of an antibody response that provides long-term protection against lung infection. We found that survival of of C57L/6 mice after intranasal inoculation with wild-type serotype 4 strain TIGR4 pneumococci required B cells but not T cells, suggesting that nasopharyngeal colonization elicited a protective humoral immune response. In fact, intranasal inoculation resulted in detectable pneumococcal-specific antibody responses, and protected mice against a subsequent high-dose S. pneumoniae pulmonary challenge. B cells were required for this response, and transfer of immune sera from i.n. colonized mice, or monoclonal antibodies against phosphorylcholine, a common surface antigen of S. pneumoniae, was sufficient to confer protection. IgA, which is thought to participate in mucosal immunity, contributed to but was not absolutely required for protection from pulmonary challenge. Protection induced by i.n. colonization lasted at least ten weeks. Although it was partially dependent on T cells, depletion of CD4+ T cells at the time of challenge did not alter protection, suggesting that T cells did not provide essential help in activation of conventional memory cells. Peritoneal B1b cells and radiation-resistant, long-lived antibody secreting cells have previously been shown to secrete anti-pneumococcal antibodies and mediate protection against systemic infection following immunization with killed bacteria or capsular polysaccharide [1, 2]. We found that peritoneal cells were not sufficient for colonization-induced protection, but sub-lethally irradiated mice largely survived pulmonary challenge. Thus, our results are consistent with the hypothesis that nasopharyngeal colonization, a common occurrence in humans, is capable of eliciting extended protection against invasive pneumococcal disease by generating long-lived antibody-secreting cells.

No description available.

ANGLICKÝ ABSTRAKT Functional study of the putative nucleotidase encoded by spr1057 gene in Streptococcus pneumoniae, a likely homolog of Escherichia coli protein YjjG. Bacterial cells are constantly exposed to innumerable toxic substances, either in their external environment or by by-products of their own metabolism. For these reasons, the bacterial cells evolved several mechanisms to cope with this challenge. These mechanisms are represented by: blocking the uptake, export by specific transporters as well as specific inactivation of these substance by enzymes. A particular group of these toxic substances are noncanonica nucleotides, which can directly inhibit bacterial cell DNA replication or can result in increased mutation rate. Enzymes recognizing these modified derivatives are known as "house-cleaning" nucleotide phsphateses, which can inactivate the potentially mutagenic nucleotides and prevent their incorporation into DNA and RNA. Some of the "house- cleaning" enzymes belong to a group of haloacid dehalogenase enzymes (haloacid dehalogenase-like hydrolase superfamily), which are found in many bacterial species. This thesis is focused on the function of hypothetical protein Spr1057 of Streptococcus pneumoniae with an unknown function. Sequence comparison revealed that Spr1057 has a significant...

L’axe adénosinergique est au cœur de divers processus pathophysiologiques. L’enzyme CD73 joue un rôle pivot dans la génération de l’adénosine en catalysant la déphosphorylation de l’adénosine monophosphate. L’adénosine contribue à un éventail large de processus biologiques et pathologiques, principalement via l’activation de récepteurs transmembranaires. L’adénosine est principalement reconnue pour son activité régulatrice des cellules immunitaires et CD73 pour son rôle dans l’accumulation de l’adénosine dans le microenvironnement tumoral. En effet, en altérant la réponse immunitaire anti-tumorale via l’inhibition des fonctions effectrices de divers types de cellules immunes, CD73 et l’adénosine sont fréquemment associés à la progression tumorale et s’inscrivent comme cibles thérapeutiques intéressantes. Les rôles de CD73 et l’adénosine dans d’autres processus immunitaires physiologiques ne sont pas tous aussi bien compris, notamment concernant les processus d’immunisations. En utilisant un modèle murin d’immunisation contre le pneumocoque, cette thèse démontre un rôle positif, mais non essentiel, de CD73 et de l’adénosine dans la commutation isotypique des lymphocytes B et la génération d’une immunité protectrice contre l’infection au S. pneumoniae. Cette découverte est pertinente au développement de stratégies thérapeutiques afin d’augmenter l’efficacité d’immunisation dépendante des cellules B, plus particulièrement chez les populations à risque en bas âge. Ensuite, alors que la modulation de l’axe adénosinergique, notamment via l’inhibition de CD73, est une avenue thérapeutique étudiée dans divers contextes de tumeurs solides, ce potentiel thérapeutique demeure largement inexploré dans des modèles de néoplasmes sanguins. En utilisant un modèle de souris transgénique de leucémie spontanée, cette thèse démontre un rôle pro-tumorigénique, avec un biais sexuel, de CD73 dans la leucémie lymphoïde chronique des lymphocytes B (LLC), via l’altération de l’immunité anti-tumorale. Enfin, alors que les rôles immunosuppressifs de CD73 et l’adénosine sont bien décrits, leurs activités pro-tumorigéniques qui s’étendent au-delà de l’immunité anti-tumorale sont peu connues. En accord avec la littérature, cette thèse explore plusieurs hypothèses selon lesquelles CD73 module l’activité métabolique mitochondriale des cellules cancéreuses. Les résultats présentés dans cette thèse suggèrent un rôle pro-tumorigénique à l’enzyme CD73, indépendant de la signalisation adénosinergique et de l’inhibition de l’immunité anti-tumorale, qui favorise la flexibilité métabolique et plus particulièrement la respiration mitochondriale des cellules cancéreuses, via la voie de récupération de la biosynthèse du nicotinamide (NAD+). En résumé, cette thèse apporte plusieurs précisions quant aux rôles biologiques de l’enzyme CD73 qui sont pertinents à l’immunisation dépendante des lymphocytes B, à la pathogénèse de la LLC ainsi qu’à la régulation de l’activité métabolique des cellules cancéreuses. Cette thèse offre de nouvelles pistes de réflexion quant au potentiel thérapeutique que renferme l’axe adénosinergique et plus particulièrement CD73, en approfondissant nos connaissances quant à l’éventail de ses fonctions. / The adenosinergic axis is central to a plethora of pathophysiological processes. The enzyme CD73 is key to the generation of adenosine by catalyzing the dephosphorylation of adenosine monophosphate. Adenosine’s contribution to biological and pathological processes is mainly carried through the activation of transmembrane receptors. Adenosine is mostly appreciated for its regulatory activity on a variety of immunes cells whereas CD73 is often referred to the enzyme responsible for adenosine accumulation within tumor microenvironment. Thus, by hindering antitumoral immune responses, CD73 and adenosine are frequently associated with cancer progression and targeting these offers great therapeutic potential in clinic. CD73 and adenosine’s role in other immune physiological processes are not fully understood, notably regarding immunization processes. Using a murine model of pneumococcal immunization, this thesis herein demonstrates a positive, but non-essential, role for CD73 and adenosine in B cells’ isotype class switching required to protective immunity against S. pneumoniae. This finding is particularly relevant to the development of novel strategies aimed at enhancing B cell-dependent immunization in high-risk populations such as young infants. While targeting the adenosinergic axis, particularly CD73, was extensively proven efficient in restoring antitumor immunity in many solid tumor contexts, its therapeutic potential in blood neoplastic malignancies remain largely unexplored. Using a transgenic mouse model of spontaneous leukemia, this thesis identifies a sex-oriented pro-tumorigenic role for CD73 in favoring B cells chronic lymphocytic leukemia (CLL) progression, through the inhibition of antitumor immunity. Finally, while immunosuppression by CD73 and adenosine is well described in cancer, other immune-independent pro-tumorigenic roles of CD73 are poorly understood. In accordance with literature, this thesis explores various hypotheses by which CD73 regulates cancer cells’ mitochondrial metabolic activity. Results presented herein suggest an immune- and adenosine signaling-independent pro-tumorigenic function for CD73 in favoring cancer cells’ metabolic flexibility and more particularly mitochondrial respiration through the nicotinamide (NAD+) salvage biosynthesis pathway. In sum, this thesis brings many insights into CD73’s biological functions relevant to B cells-dependent immunization, in CLL pathogenesis and in cancer cells’ metabolic activity. By expanding our knowledge of the extend of CD73’s biological functions, this thesis further discusses novel potential therapeutic opportunities.

Die bakterielle Meningitis (BM) ist trotz antibiotischer Therapie eine Erkrankung mit einer hohen Mortalität und Morbidität. Kopfschmerzen und Meningismus sind Hauptsymtome und ein klinischer Hinweis für die Aktivierung trigeminaler Fasern. Ziel dieser Arbeit war es zu prüfen ob die freigesetzten Neuropeptide einen proinflammatorischen Effekt auf zerebrale Endothelzellen, einen wesentlichem Bestandteil der Blut-Hirn-Schranke haben. Wir verwendeten primär kultivierte zerebrale Kapillarendothelzellen (BMEC) der Ratte und als Stimulus Neuropeptide und/oder Pneumokokkenzellwände (PCW). Beide Neuropeptide, CGRP mehr als SP, verstärken den Effekt von PCW auf die mRNA Expression und Freisetzung von TNF-alpha, IL-1beta, IL-6, IL-10 und MIP-2 aus den BMEC. CGRP und SP haben nur eine geringe Wirkung. PCW regulieren die Dichte der CRLR (CGRP1-R) bzw. NK-1 Rezeptoren und erklären damit die kostimulatorische Wirkung. Zudem untersuchten wir den Effekt von PCW und/oder CGRP auf die Adrenomedullin (AM)- Synthese. AM ist ein vasodilatorisch wirkendes Peptid, dass vorwiegend in Endothelzellen konstitutiv gebildet wird und am CRLR Rezeptor wirkt. PCW und CGRP verstärken die Synthese von AM. Mit dieser Arbeit konnte gezeigt werden, dass PCW zur Hochregulation von Neuropeptidrezeptoren führt und CGRP und SP über diese Rezeptoren einen modulatorischen Effekt auf die Zytokinproduktion in BMEC haben. Ein genaues Verständnis dieser Interaktionen könnte die Entwicklung immunmodulatorischer Interventionen und damit eine Verbesserung der Prognose der bakteriellen Meningitis bewirken. / Despite antibiotic treatment bacterial meningitis is still associated with a high mortality and morbidity. Headache and meningismus as key symptoms, provide clear evidence for the activation of trigeminal nerve fibers. Aim of the study was to test whether the released neuropeptides have a proinflammatory effect in cerebral endothelial cells the major compartment of the blood brain barrier. We used primary brain microvascular endothelial cells of the rat (BMEC) which were stimulated with CGRP, SP and/or pneumococcal cell walls (PCW). Both neuropeptides CGRP more than SP enhanced PCW-induced mRNA expression and the release of TNF-alpha, IL-1-beta, IL-6, IL-10 and MIP-2. Neuropeptides alone were not able to induce these cytokines. PCW upregulate the density of CRLR receptor and regulate the NK-1 receptor and therefore may explain the costimulatory effect. Furthermore the effect of PCW and/or CGRP on adrenomedullin synthesis in BMEC was investigated. Adrenomedullin is a vasodilatatory peptide, which is constitutivly produced by endothelial cells and act on the CRLR receptor. PCW as well as CGRP enhance the synthesis of AM. Our data suggest that PCW upregulate neuropeptide receptors and modulate via these specific receptors the cytokine production. A detailed understanding of these interactions may open new immunmodulatory interventions and therefore may contribute to a better prognosis of bacterial meningitis.