La transplantation allogénique de cellules souches hématopoïétiques (ASCT) est couramment utilisée pour traiter différents cancers hématologiques. Malheureusement, l’effet bénéfique de cette technique est limité par la réaction du greffon contre l’hôte (GVHD) qui demeure la cause principale de mortalité post-greffe. La GVHD endommage différents organes et retarde la reconstitution immunitaire des lymphocytes T (LT) ce qui augmente les risques d’infection et de rechute. Le développement de nouveaux traitements permettant d’accélérer la reconstitution immunitaire augmenterait donc les chances de survie des patients greffés. Il existe deux façons de régénérer des LT: via la thymopoïèse qui consiste à produire de nouveaux LT, ou par la prolifération homéostatique (PH) qui implique l’expansion rapide des LT matures retrouvés dans le greffon. La PH requiert deux signaux essentiels: l’interleukine-7 (IL-7) et la présentation d’antigènes du soi par les cellules dendritiques (DC) via le complexe majeur d’histocompatibilité (CMH) I pour les LT CD8+ et le CMH II pour les LT CD4+. Dans un contexte d’ASCT, la chimiothérapie et la GVHD endommagent le thymus rendant la thymopoïèse inefficace. Par conséquent, la reconstitution immunitaire repose presque entièrement sur la PH des LT. L’objectif de cette thèse était de comprendre comment la GVHD affecte la reconstitution des LT. Grâce à un modèle murin, nous avons démontré que la PH des LT CD4+ est absente durant la GVHD et ce, dû à de faibles niveaux d’IL-7 et une diminution du nombre de DC. La perte des DC est en grande partie causée par des niveaux réduits de stromal derived factor-1α (SDF-1α) et par l’absence de progéniteurs de DC dans la moelle osseuse des souris en GVHD. Le traitement des souris en GVHD avec du SDF-1α permet d’augmenter le nombre de DC, et lorsqu’administré avec l’IL-7, améliore significativement la PH des LT CD4+. Contrairement aux LT CD4+, l’administration d’IL-7 seule est suffisante pour restaurer la PH des LT CD8+ durant la GVHD et ce, même en absence des DC. Ces différences s’expliquent pour deux raisons : 1) l’expression du CMH I, contrairement au CMH II, n’est pas limitée aux DC mais est également exprimée par les cellules stromales du receveur ce qui est suffisant pour induire la PH des LT CD8+ et 2) les LT CD8+ répondent à des concentrations plus faibles d’IL-7 systémique comparativement aux LT CD4+. En conclusion, l’ensemble de ces résultats permettra de mettre en place des études translationnelles sur le potentiel thérapeutique du SDF-1α et de l’IL-7 dans la reconstitution immunitaire des patients greffés. / Hematological cancers are currently treated with allogeneic hematopoietic stem cell transplantation (ASCT). Unfortunately, graft-versus-host disease (GVHD) greatly limits the health benefits of this procedure, as it is the main cause of mortality post-ASCT. GVHD damages various organs and delays the immune reconstitution of T lymphocytes (TL), which increases the risk of infections and relapse. Thus, developing new treatments modulating the immune reconstitution following ASCT would greatly enhance survival of the transplanted patients. TL can be regenerated by two ways: de novo production of TL by thymopoiesis; or homeostatic proliferation (HP), which consists of rapidly expanding mature TL already present in the graft. HP requires two crucial signals: interleukin-7 (IL-7) and self-antigen presentation by dendritic cells (DC) via the major histocompatibility complex (MHC) I for CD8+ TL and MHC II for CD4+ TL. During ASCT however, chemotherapy and GVHD induce damage to the thymus making thymopoiesis inefficient, and thus immune reconstitution relies almost entirely on HP of TL. The objective of this thesis was to understand how GVHD affects TL reconstitution. Using a mouse model, we demonstrate that CD4+ TL fail to undergo HP when transferred in GVHD hosts due to low levels of IL-7 and reduced numbers of DCs. Moreover, the loss of DCs is mostly caused by reduced levels of Stromal Derived Factor-1 alpha (SDF-1α) and the absence of DC progenitors in the bone marrow of mice suffering from GVHD. Treating GVHD hosts with SDF-1α resulted in increased DC counts and, when administered in combination with IL-7, significantly improved HP of CD4+ TL. Unlike CD4+ TL, administration of IL-7 alone was sufficient to restore HP of CD8+ TL in GVHD mice and this, regardless of the presence of DCs. These differences could be explained by two reasons: 1) MHC I expression is not limited to DCs but is expressed by stromal cells from the recipient, which is sufficient to promote HP in CD8+ TL and 2) CD8+ TL respond to lower doses of systemic IL-7 in comparison to CD4+ TL. In conclusion, these results can lead to future translational studies on the therapeutic potential of SDF-1α and IL-7 in the immune reconstitution of grafted patients.

La détection de lymphocytes T (LT) CD8+ infiltrant les tumeurs (TIL), est généralement associée à un bon pronostic chez des patients atteints du cancer. A l’inverse, l'infiltration des tumeurs par des LT CD4+ régulateurs (Treg), est quant à elle, souvent corrélée à un mauvais pronostic. Plusieurs vaccins « thérapeutiques » capables d’induire des réponses T CD8+ spécifiques d’antigènes tumoraux ont été développés. Cependant, à ce jour, les résultats cliniques obtenus par ces vaccins restent décevants. Dans un premier travail, nous avons développé puis testé un vaccin thérapeutique composé de trois longs peptides synthétiques (LSP) dérivés de la protéine survivine (SVX). La survivine est une protéine surexprimée dans la majorité des cancers humains, mais absente dans les tissus adultes sains, ce qui fait d’elle une cible thérapeutique privilégiée pour les vaccins anti-tumoraux. Nous avons démontré l'efficacité thérapeutique élevée du vaccin SVX contre diverses tumeurs murines. Ceci a été associé à l'induction de réponses T spécifiques de la survivine, un prolongement de la survie et la génération de réponses mémoires antitumorales. De plus, SVX a induit à la fois des LT CD8+ cytotoxiques spécifiques et LT CD4+ auxiliaires de type 1 multifonctionnelles, dans la rate et au sein des tumeurs. Il a aussi induit une diminution des Treg, favorisant ainsi une réponse immunitaire très efficace. Enfin, une étude préliminaire menée chez des patients atteints de différents types de cancers, nous a révélé la présence de taux élevés de précurseurs spontanés de LT spécifiques du vaccin SVX. Ces résultats suggèrent que SVX pourrait potentiellement stimuler l'activation de ces précurseurs spécifiques. Ces résultats constituent une preuve de concept pour amener ce vaccin comme un produit de première génération en essai clinique chez l’homme. Dans le but d’étudier plus en détails la cinétique des réponses immunitaires T spécifiques, associées aux vaccins LSP, nous avons étudié dans un second travail, l’efficacité d’un vaccin LSP dérivé de la protéine Ovalbumine (OVA). Nous avons montré dans plusieurs modèles de tumeurs murines, que la combinaison du vaccin LSP-OVA à un adjuvant approprié, induisait une forte régression de la croissance tumorale, l’expansion des cellules spécifiques T CD4+ et T CD8+ dans les organes lymphoïdes, ainsi que leur migration vers les tumeurs. De plus, le vaccin a induit des cellules T spécifiques fonctionnelles, comme le témoignent les niveaux élevés de cytokines cytotoxiques mesurées. De manière intéressante, le vaccin n’a pas induit de Treg spécifiques d’OVA ou de Treg polyclonaux et ce, malgré la présence de la tumeur. Enfin, lorsque LSP-OVA ne parvenait pas à induire une régression complète de la tumeur, celle-ci était infiltrée par des TIL CD4+ conventionnels et CD8+ exprimant fortement les récepteurs inhibiteurs (PD-1, TIM-3 et TIGIT). Nos résultats suggèrent que pour optimiser ce vaccin LSP, une association à des anticorps bloquant un ou plusieurs de ces récepteurs inhibiteurs, devrait être envisagée. / The presence of tumor-infiltrating CD8+ T lymphocytes (TIL) is generally associated with a good prognosis in cancer patients. Conversely, the infiltration of tumors by CD4+ regulators T cells (Treg), is often associated with poor prognosis. Several "therapeutic" vaccines able to induce tumor-specific CD8+ T cell responses have been developed. However, to date, the clinical results of these vaccines remain insufficient. In a first work, we developed and analyzed the immunogenicity and therapeutic efficacy of a new survivin vaccine (SVX) composed of three long synthetic peptides (LSP) containing several CD4 and CD8 T-cell epitopes. Survivin is over-expressed by most human cancers, but absent in healthy adult tissues, making it an interesting therapeutic target for cancer vaccines. We demonstrated the high therapeutic efficacy of SVX vaccine against various established murine tumor models, associated with its capacity to generate both specific cytotoxic CD8+ and multifunctional Th1 CD4+ T-cell responses but also effective memory T-cell responses for long-term protection against relapses. Treatment with SVX vaccine was also found to strongly increase the tumor infiltration of both CD4+ and CD8+ T cells over Treg cells therefore tipping the balance toward a highly efficient immune response. Finally, a preliminary study in patients with different types of cancer revealed the presence of high levels of SVX-specific spontaneous T-cell precursors. This suggests that SVX can potentially stimulate the activation of these specific precursors. Altogether, our results strongly suggest that SVX is a promising cancer vaccine and warrants its further clinical development. In order to study the kinetics of tumor-specific immune responses associated with LSP vaccines, we studied the efficacy of a LSP vaccine derived from the Ovalbumin (OVA) protein. We showed in two tumor models that the combination of LSP-OVA with a suitable adjuvant induced a strong tumor regression, an important expansion of both OVA-specific CD4+ and CD8+ T cells in the lymphoid organs, as well as their migration to the tumor. In addition, the vaccine induced functional specific T cells, as shown by the high levels of cytotoxic cytokines. Interestingly, the vaccine did not induce either OVA-specific or polyclonal Treg, despite the presence of the tumor. Finally, when LSP-OVA failed to induce a complete depletion of the tumor, we observed an important expression of inhibitory receptors (PD-1, TIM-3 and TIGIT) on conventional CD4+ and CD8+ TIL. Our results suggest that to optimize this LSP vaccine, a combination with one or more immune checkpoint blockade agents should be considered.

Diss. (sammanfattning) Umeå : Umeå universitet, 2010.

Variation in the sequence of T cell epitopes between dengue virus (DENV) serotypes is believed to alter memory T cell responses during second heterologous infections contributing to pathology following DENV infection. We identified a highly conserved, novel, HLA-B57-restricted epitope on the DENV NS1 protein, NS126-34. We predicted higher frequencies of NS126-34-specific CD8+ T cells in PBMC from individuals undergoing secondary, rather than primary, DENV infection due to the expansion of memory CD8+T cells. We generated a tetramer against this epitope (B57-NS126-34TET) and used it to assess the frequencies and phenotype of antigen-specific T cells in samples from a clinical cohort of children with acute DENV infection established in Bangkok, Thailand. High tetramer-positive T cell frequencies during acute infection were seen in only 1 of 9 subjects with secondary infection. B57-NS126-34-specific, other DENV epitope-specific CD8+ T cells, as well as total CD8+ T cells, expressed an activated phenotype (CD69+ and/or CD38+) during acute infection. In contrast, expression of CD71 was largely limited to DENV-specific CD8+ T cells. In vitro stimulation of CD8+ T cell lines, generated against three different DENV epitopes, indicated that CD71 expression was differentially sensitive to stimulation by homologous and heterologous variant peptides with substantial upregulation of CD71 detected to peptides which also elicited strong functional responses. CD71 may therefore represent a useful marker of antigenspecific T cell activation. During the course of our analysis we found substantial binding of B57-NS126-34 TET to CD8- cells. We demonstrated that the B57-NS126-34 TET bound KIR3DL1, an inhibitory receptor on natural killer (NK) cells. NK sensitive target cells presenting the NS126-34 peptide in the context of HLA-B57 were able to dampen functional responses of only KIR3DL1+ NK cells. Analysis of the activation of an NK enriched population in our Thai cohort revealed peak activation during the critical time phase in patients with severe dengue illness, dengue hemorrhagic fever, compared to people with mild illness. Our data identified CD71 as biologically useful marker to study DENV-specific CD8+ T cell responses and highlighted the role of viral peptides in modulating NK cell activation through KIR-MHC class I interactions during DENV infection.

The fatty acid amides, a structurally diverse endogenous congener of molecules active in cell signaling, may prove to have diverse activity due to their interface with a number of receptor systems, including, but not limited to cannabinoid receptor 2 (CB2) and PPARγ. Select extracts of Echinacea spp. contain the fatty acid amides known as alkylamides. These extracts were a previously popular remedy relied on by U.S. physicians, one of the top sellers in the natural products industry and are currently a frequently physician prescribed remedy in Germany. In the series of experiments contained within, Galenic ethanolic extracts of Echinacea spp. root were used for the quantification, identification, degradation and bioactivity studies. On extraction, depending on the ratio of plant to solvent and fresh or dry, the data indicate that there is variability in the alkylamide classes extracted. For example the acetylene alkylamides appear to extract under different concentrations, as well as degrade faster than the olefinic alkylamides. In addition, the alkylamides are found to degrade significantly in both cut/sift and powdered forms of echinacea root. Human liver microsome oxidation of the major alkylamide dodeca-2E,4E,8Z,10Z-tetraenoic acid isobutylamide generate hydroxylated, caboxylated and epoxidized metabolites. The carboxylated metabolite has, thus far, shown different immune activity than the native tetraene isobutylamide. Bioactivity studies, based on cytokine modulation of the alkylamides have been assumed to be due to a classic CB2 response. However, the results of experiments contained herein suggest that IL-2 inhibition by the alkylamide undeca-2E-ene-8,10-diynoic acid isobutylamide, which does not bind to CB2, is due to PPARγ activation. These data, combined with data generated by other groups, suggest that the alkylamides of Echinacea spp. are polyvalent in effect, in that they modulate multiple biochemical pathways.

Les lymphocytes T (LT) doivent analyser efficacement un nombre important de cellules présentatrices d'antigène (CPA) afin de détecter un antigène spécifique et d'initier une réponse immunitaire adaptée. La reconnaissance par le récepteur des cellules T (TCR) d'un peptide spécifique associé au complexe majeur d'histocompatibilité (pMHC) doit donc être extrêmement sensible et rapide. Alors que les voies de signalisation en aval du TCR sont largement étudiées, la cinétique de la discrimination des ligands par le TCR et de l'activation initiale du LT reste mal connue. Des surfaces solides recouvertes de ligands du TCR nous ont permis d'étudier les événements cellulaires initiés par la détection d'un antigène. L'utilisation de la microscopie a fluorescence par réflexion totale interne (TIRFM) et la microscopie interférentielle (IRM) nous a permis de montrer que l'interaction initiale entre surface et LT est attribuable à des microvillosités mobiles. La stimulation du TCR active en quelques secondes un mouvement de rétraction de ces microvillosités. Ces mouvements actifs sont régulés par l'activation de la PLC- γ1 et sont dépendants des myosines (IIA, Ic et Ig), de la cofiline et de l'ezrine. Après cette phase d'analyse de l'environnement extracellulaire, la stimulation du TCR entraîne l'étalement rapide et actif de la cellule. L'amplitude et la vitesse d'étalement reflètent l'efficacité activatrice du ligand reconnu par le TCR. En moins de 5 minutes différents pMHC, ayant des propriétés biophysiques proches, sont donc discriminés par les LT et capables d'induire une première réponse cellulaire spécifique. / T lymphocytes need to efficiently probe a large number of antigen-presenting cell (APC) in order to detect an agonist antigen and to initiate an effective immune response. Therefore, engagement of the T-cell receptor (TCR) by peptide-bound major histocompatibility complex (pMHC) is a highly sensitive and rapid process. While signaling pathways downstream the TCR are extensively studied, little is known about antigen discrimination kinetic and initial T-cell response.Model planar surfaces coated with TCR ligand allowed us to study cellular events initiated by antigen detection. Using TIRFM (total internal reflexion microscopy) and IRM (interference reflexion microscopy) we showed that T-cell initial contacts with the surface were mediated by mobile microvilli. TCR engagement triggers a pulling motion of T cell surface microvilli within seconds. Active microvilli movements are dependent on PLC-γ1 activation and on the presence of myosins (IIA, Ic and Ig) as well as cofilin and ezrin. After this extracellular environment probing period, TCR stimulation triggered a rapid and active cell spreading. Cell spreading amplitude and speed reflect the ligand activating efficacity. In less than 5 minutes pMHC with different biophysical properties were discriminated by T-cells and triggered a first specific cellular response.

A persistência de células T de memória funcionais é importante para garantir uma imunidade protetora na infecção pelo Vírus da Imunodeficiência Humana (HIV). As células T de memória têm sido subdivididas em memória central (TCM), memória efetora (TEM) e memória efetora altamente diferenciada (TEMRA) com base na expressão de moléculas de superfície como CCR7 e CD45RA, e na capacidade de produzir citocinas e proliferar. Recentemente, identificamos 18 peptídeos derivados de seqüências do consenso B do HIV-1, ligadores de múltiplas moléculas HLA-DR e amplamente reconhecidos por linfócitos T de sangue periférico de pacientes infectados pelo HIV. Diante disso e considerando a importância das células T de memória na manutenção da resposta imune específica, nosso objetivo foi caracterizar fenotípica e funcionalmente as subpopulações de células T de memória de indivíduos infectados pelo HIV envolvidas no reconhecimento in vitro desses epitopos. Foram incluídos 14 indivíduos controles sadios e 61 pacientes HIV+ com contagem de linfócitos T CD4+ maior que 250 células/mm3. Os pacientes HIV+ foram divididos em seis diferentes grupos clínicos de acordo com o estágio da infecção, carga viral (CV) plasmática e uso de terapia anti-retroviral (ART): não progressores por longo tempo (LTNP), avirêmicos em uso de ART (AV-ART), virêmicos em uso de ART (VI-ART), virêmicos sem uso de ART (VI sem ART), virêmicos recéminfectados sem uso de ART (VI-RI) e controladores. Células mononucleares do sangue periférico dos indivíduos do estudo foram estimuladas com o conjunto de peptídeos do HIV-1 e com um conjunto de peptídeos do Citomegalovírus (CMV). A freqüência de células de memória produtoras de IFN- e IL-2 e a proliferação celular antígeno-específica foram detectadas por citometria de fluxo de multiparâmetros. Nossos resultados mostraram que o conjunto de peptídeos do HIV-1 foi capaz de ativar subpopulações funcionais de memória TCM, TEM e TEMRA secretoras de IFN- e IL-2 em 100% dos pacientes HIV+ dos diferentes grupos clínicos. O conjunto de peptídeos do HIV-1 também induziu proliferação das subpopulações de linfócitos T de memória. As freqüências de TEMRA CD4+IFN-+, TEMRA CD4+IFN-+ total, TCM CD8+IFN-+, TCM CD8+IFN-+ total, TEM CD8+IFN-+, TEM CD8+IFN-+ total e TEMRA CD8+IFN-+ correlacionaram-se negativamente com a carga viral do HIV em pacientes virêmicos. Esses dados sugerem que essas subpopulações de memória funcionais são importantes no controle da viremia. Comparando as respostas HIV e CMVespecíficas observamos freqüências mais elevadas de células T de memória produtoras de IL-2, IFN-/IL-2 e IFN- em respostas ao pool de peptídeos do HIV. Esses dados sugerem que esse conjunto de peptídeos derivados de seqüências do HIV-1 ativa respostas polifuncionais de subpopulações de linfócitos T de memória. Nossos resultados mostraram que o conjunto de peptídeos do HIV-1 foi capaz de estimular diferentes subpopulações distintas de linfócitos T de memória produtores de IFN-, IFN-,/IL-2 e IL-2 de indivíduos em diferentes estágios da infecção pelo HIV e sugerem o envolvimento de subpopulações de memória funcionais no controle da viremia. Estes achados fortalecem a possibilidade de uso desses peptídeos em uma formulação vacinal bem-sucedida em humanos / The persistence of functional memory T cell is important to ensure a protective immunity to Human Immunodeficiency Virus (HIV) infection. Memory T cells have been subdivided into central memory (TCM), effector memory (TEM) and highly differentiated effector memory (TEMRA) based on the expression of surface molecules such as CCR7 and CD45RA, and the ability to produce cytokines and proliferate. Recently, we identified 18 peptides derived from B consensus sequences of HIV-1 that bind to multiple HLA-DR molecules and are widely recognized by peripheral blood T lymphocytes from HIV-infected patients. Given this and considering the importance of memory T cells in the maintenance of specific immune response, our objective was to characterize phenotypic and functionally memory T cell subsets from HIV-infected individuals involved in the recognition of these epitopes in vitro. The study included 14 healthy control subjects and 61 HIV+ patients with CD4+ lymphocytes counts higher than 250 cells/mm3. The HIV+ patients were divided into six different clinical groups according to the stage of infection, plasma viral load (VL) and antiretroviral therapy use (ART): long-term non-progressors (LTNP), aviremic under ART (AV-ART), viremic under ART (VI-ART), viremic without using ART (VI without ART), recently infected viremic without using ART (VI-RI) and controllers. Peripheral blood mononuclear cells from study subjects were stimulated with HIV-1 peptide pool and with a cytomegalovirus (CMV) peptide pool. The frequencies of IFN- and IL-2 producing memory cells and antigenspecific cell proliferation were detected by multiparametric flow cytometry. Our results showed that the HIV-1 set of peptides was able to activate TCM, TEM and TEMRA functional memory subsets that secrete IFN- and IL-2 in 100% of the HIV patients from the different clinical groups. The HIV-1 set of peptides also induced memory T lymphocyte subsets proliferation. TEMRA CD4+IFN-+, total TEMRA CD4+IFN-+, TCM CD8+IFN-+, total TCM CD8+IFN-+, total TEM CD8+IFN-+, TEM CD8+IFN-+ and TEMRA CD8+IFN- + frequencies negatively correlated with HIV viral load in viremic patients. These data suggest that these functional memory subsets are important to control the viremia. When comparing the HIV and CMV-specific responses we observed higher frequencies of IL-2, IFN-/IL-2 and IFN- producing memory T cells in response to HIV peptide pool. These data suggest that this set of HIV sequence derived peptides activates polyfunctional response of memory T lymphocyte subsets. Our results showed that the HIV-1 peptide set was able to stimulate different IFN-, IFN-/IL-2 e IL-2 producing memory T lymphocytes from individuals in different stages of HIV infection and suggest the involvement of functional memory subsets in the control of viremia. These findings strengthen the possibility of using these peptides in a successful vaccine formulation in humans

Em 1993, a Organização Mundial da Saúde declarou a tuberculose (TB) como uma emergência global devido à sua relevância epidemiológica e a necessidade de seu controle. Atualmente, a TB ainda é considerada um problema de saúde pública e requer o desenvolvimento de vacinas e terapias que sejam mais eficazes na sua prevenção e tratamento. Nesse sentido, o Laboratório de Vacinas Gênicas da Faculdade de Medicina de Ribeirão Preto estuda há mais de dez anos a eficácia da vacina gênica DNAhsp65 na profilaxia e terapia da TB. Com o intuito de complementar o conhecimento existente sobre os mecanismos imunes desencadeados pela vacina DNAhsp65, assim como sua associação às drogas convencionais utilizadas no tratamento da TB, objetivou-se neste trabalho a caracterização de células natural killer (NK), T natural killer (NKT), e T ?? na imunoterapia da tuberculose experimental com a vacina DNAhsp65, no tratamento com as drogas rifampicina (RIF) e isoniazida (INH), e na associação DNAhsp65-drogas. Inicialmente, camundongos BALB/c foram infectados com Mycobacterium tuberculosis (Mtb) cepa H37Rv no dia 0 e nos dias 1, 7, 15, 30 e 70 após a infecção, foi promovida a eutanásia dos animais infectados ou não (controle) para análise das células T não convencionais no pulmão por citometria de fluxo. No dia 30 após a infecção, os animais infectados receberam os diferentes tratamentos: vacina DNAhsp65, vetor pVAX1, drogas RIF e INH, ou as drogas em associação à vacina. Dez dias após o fim dos tratamentos, foi promovida a eutanásia dos animais para análise das populações celulares no pulmão e linfonodo por citometria de fluxo, imunohistoquímica e PCR em tempo real. Os animais somente infectados com Mtb apresentaram aumento significativo no número das células NK (CD3-CD49b+), NKT (CD3+CD49b+) e T ?? (CD3+??+) logo na primeira semana após a infecção, e esta diferença em relação aos animais controle permaneceu em até 70 dias após a infecção. Entre as células NK presentes no pulmão, observou-se predominância da subpopulação CD11bhighCD27low em todos os animais. Nos animais infectados, verificou-se aumento significativo das subpopulações de NK: CD11bhighCD27high e CD11blowCD27high, nos dias 7 e 15 e somente no dia 15 após a infecção, respectivamente. Entre a população de células T ?? presentes no pulmão, houve predomínio do fenótipo CD27- em animais controles e infectados nos diferentes tempos experimentais. Quanto aos animais infectados com Mtb e tratados com DNAhsp65, verificou-se aumento significativo de células T ?? produtoras de IFN-? e IL-17 no pulmão, e apesar de não ter sido observada diferença na freqüência de células NK e NKT neste grupo, as células NK apresentavam maior expressão da molécula FasL relacionada à morte celular induzida por apoptose. Nos grupos drogas e DNAhsp65-drogas observou-se aumento da freqüência de células T ?? no pulmão, assim como aumento de células NK produtoras de IL-10 e que expressavam o marcador de ativação CD69. Os resultados deste trabalho mostram mais uma vez a eficácia da vacina DNAhsp65 e da associação DNAhsp65- drogas no tratamento de animais infectados com Mtb e sugerem que células T não convencionais como as células NK, NKT e T ?? podem participar na modulação da resposta immune na TB. Estes achados devem ser levados em consideração no desenho de novas estratégias terapêuticas e também profiláticas para a TB. / In 1993, the World Health Organization declared tuberculosis (TB) as a global emergence due to its epidemical relevance and the need to improve its control. Nowadays, TB still remains a public health problem and requires the development of more effective vaccines and therapies. In this sense, the Laboratory of Genetic Vaccines from the School of Medicine of Ribeirão Preto studies, for more than ten years, the efficiency of the genetic vaccine DNAhsp65 in TB prophylaxis and therapy. In order to complement the knowledge about the immune mechanisms triggered by DNAhsp65 vaccine and by its association with conventional drugs used in TB, our aim in this work was to characterize natural killer (NK), natural killer T (NKT) and gamma-delta (??) T cells in the immunotherapy of experimental tuberculosis with the DNAhsp65 vaccine, in the treatment with rifampicin and isoniazid drugs and in the association DNAhsp65-drugs. Initially, BALB/c mice were infected with Mtb strain H37Rv on day 0, and on days 1, 7, 15, 30 and 70 after infection, infected animals or not (control) were euthanized for lung cell analysis by flow cytometry. On day 30 after infection, infected animals received the following treatment: DNAhsp65 vaccine, pVAX1 vector, rifampicin and isoniazid drugs, or drugs in association with DNAhsp65. Ten days after the end of treatment, animals were euthanized for lung and lymph node cell analysis by flow cytometry, immunohistochemistry and real time PCR. Infected animals showed a significant increase of NK (CD3-CD49b+), NKT (CD3+CD49b+) and ?? (CD3+??+) T cells in the first week of infection and this difference compared to control animals remained until 70 days after infection. Within the lung NK cell population, we observed a predominance of CD11bhighCD27low phenotype in all animals. In infected animals, we verified a significant increase of the following NK cell subpopulations: CD11bhighCD27high and CD11blowCD27high on days 7 and 15, and only on day 15 after infection, respectively. Within the lung ?? T cell population, there was a predominance of CD27- ?? T cell in control and infected animals in the different experimental times. In infected animals and subsequently vaccinated with DNAhsp65, we verified a significant increase in ?? T cells producing IFN-? and IL-17 in the lungs. Although we have not seen any differences in NK and NKT cells in this group, NK cells showed higher expression of FasL molecule related to induced cell death by apoptosis. In DNAhsp65-drugs and drugs groups, we observed an increase in lung ?? T cells frequency, as well as increase in NK cells producing IL-10 and expressing CD69, an activation marker. Our results confirm the effectiveness of DNAhsp65 vaccine and its association with drugs in Mtb infected animals and suggest a modulation in the immune response through unconventional T cells such as NK, NKT and ?? T cells. These findings should be taken into consideration in the design of new therapeutic and prophylactic strategies for TB.

O timo é um órgão de grande importância imunológica durante a vida fetal e no período neonatal, para que o indivíduo se torne imunocompetente. É considerado, anatomicamente, o maior órgão com alta atividade linfopoiética no indivíduo jovem. O timo dos gatos apresenta duas porções, torácica e cervical, onde cada uma delas apresenta um lobo direito e esquerdo em sua maioria. A maior contribuição vascular origina-se da artéria torácica interna esquerda e do tronco braquiocefálico. Possui coloração rósea-pálido, localizado em região de mediastino cranial, entre os pulmões e na base do coração a porção torácica, e a porção cervical estende-se além das costelas em sentido cranial localizada ventralmente a traquéia. Foram utilizados 12 fetos de gatos domésticos, sem raça definida, machos e fêmeas, divididos em três grupos. Os timos foram processados para o estudo da microscopia de luz, e as análises estereológicas foram realizadas utilizando o método disector físico associado com o princípio de ConnEuler. As variações de volume, comprimento, espessura e largura de maneira geral apresentaram aumento conforme o desenvolvimento dos animais, com diferenças entre os sexos. As medidas estereológicas relativas a densidade numérica vascular (Nv(vasc)) apresentam-se maiores nas fêmea, ocorrendo uma diminuição gradativa e o número total de vasos no órgão (N(vasc)) apresentou valores maiores nos machos com uma diminuição gradual. A estimação da densidade do comprimento do vaso (Lv) e da densidade de superfície de área (Sv) apresentaram diminuição aos 45 dias de idade, e a densidade do comprimento do vaso (Lv) apresentou valor maior nos machos de 35 e 55 dias, enquanto que na densidade de superfície de área (Sv) os valores variaram entre os sexos. / During the phoetal life and neonatal period, the thymus has a great importance to became an individual healthy. Anatomically is the largest organ with high limphopoietic activity in young individual. The cat thymus presents two portions, thoracic and cervical, where each one of them presents a right and left lobe at the most. The major contribution initiates from the inner thoracic artery and from braquicephalicus trunk. The organ presents pink-pale color, located in region of cranial mediastine, between lungs and at the base of the heart; the thoracic portion and the cervical extend beyond the ribs located ventrally to the trachea. For this study were used twelve fetus of the mongrel domestic cats, males and females, divided into three groups. The thymus were processed for the light-microscopy, and the stereological analyses were done using the physical disector method associated with the ConnEuler principle. The volume of the organ, lenght, thickness and wide increased gradually with the development, with diferences between sex. The stereological variables related to vascular number density (Nv(vasc)) were greater in females, decreasing gradually and the vascullar total number (N(vasc)) were greater in males decreasing gradually. The lenght density (Lv) and the surface area density showed decreasing at forty-five days old, and the lenght density were greater in males ate thirty-five and fifty-five days old, while the surface area density the values were varied between sex.

La sous-unité catalytique p110 de la phosphatidylinositol-4,5-biphosphate 3-kinase (PI3K) est exprimée spécifiquement dans les leucocytes, et possède un rôle central dans la biologie des lymphocytes. Des mutations germinales dominantes gain-de-fonction de PI3KCD (codant p110 ) ont été identifiées récemment chez des patients présentant une immunodéficience combinée caractérisée par une présentation clinique hétérogène incluant des infections récurrentes des voies respiratoires et des lymphoproliférations associées à une virémie EBV et/ou CMV élevée, connue sous le nom de syndromes APDS. L’hétérogénéité des présentations cliniques suggère l’existence de facteurs secondaires, génétiques ou environnementaux. Au cours de ma thèse de doctorat, j’ai rapporté le cas de deux nouveaux patients présentant des anomalies génétiques affectant la voie PI3K. Le premier patient, né dans une famille consanguine, présentait une mutation gain- de-fonction de PIK3CD déjà décrite. Par séquençage de l’exome du patient, nous avons identifié une seconde mutation homozygote non-sens de SEC14L2, un régulateur connu de la voie PI3K. Nous avons analysé le phénotype et la fonctionnalité des lymphocytes du patient, et avons mis en évidence in vitro certains mécanismes de régulation de l’activation lymphocytaire par SEC14L2. Enfin, nous avons réalisé une étude de transcriptome afin d’identifier les voies de régulation dérégulées chez notre patient. Dans l’ensemble, ces résultats ont permis d’identifier le premier co-facteur génétique associé au syndrome APDS. Le second patient est également né dans une famille consanguine et présentait des infections sévères des voies respiratoires et un syndrome d’infection chronique à l’EBV (CAEBV) fatal. Par séquençage de l’exome du patient, nous avons identifié une mutation homozygote rare dans PIK3CD. Une modélisation de la structure de la protéine a montré que l’acide aminé muté se situe dans le domaine catalytique de p110 , dans une boucle phylogénétiquement conservée interagissant avec la sous-unité régulatrice p85↵ de la PI3K, et que la mutation conduisait à la perte de cette interaction. In vitro, la mutation de p110 cause la perte de l’activité PI3K, et les lymphocytes T du patient présentaient une diminution de phosphorylation d’AKT et de p70 S6K, deux cibles de la PI3K. Les lymphocytes T du patient présentaient également une production diminuée d’IFN- et de TNF↵, et un excès de prolifération et de flux calcium suite à la stimulation du TCR. Des lignées cellulaires Jurkat déficientes pour PIK3CD générées par CRISPR/Cas9 ont également présenté un défaut de phosphorylation d’ATK et un excès de prolifération et de flux calcium. L’expression de la version sauvage de p110 dans ces cellules, mais pas de la version mutée, a permis une restauration des réponses normales, prouvant l’implication de la mutation dans les phénotypes cellulaires identifiés. De manière intéressante, nous avons mis en évidence l’existence d’un équilibre entre l’activité PI3K et PLC- 1 lors de l’activation T, qui pourrait être expliqué par une compétition pour l’accès à leur substrat commun, le PIP2. Enfin, nous avons identifié chez notre patient une seconde mutation homozygote délétère dans le gène TNFRSF9. Cette mutation est également retrouvée chez la sœur saine du patient, qui présentait une réplication persistante de l’EBV dans le sang, suggérant que cette mutation pourrait agir comme facteur génétique secondaire. Dans l’ensemble, cette étude à permis l’identification de la première immunodéficience associée à des mutations perte-de-fonction de PIK3CD. / The pathway p110 catalytic subunit of phosphatidylinositol-4,5-biphosphate 3-kinase (PI3K) is selectively expressed in leukocytes and has a central role in lymphocytes biology. Gain-of-function dominant germline mutations of PIK3CD (encoding p110 ) have been recently described in patients presenting a heterogeneous combined immunodeficiency associated with respiratory tract infections, lymphadenopathy and high EBV and/or CMV viremia. The heterogeneous clinical presentation suggests the existence of genetic or environmental modifying factors. In my thesis I report two new patients with different genetic defects causing CID. The first patient, born from a consanguineous family, presented a known gain-of- function mutation of PIK3CD. His clinical presentation was partially compatible with the already described patients. By whole exome sequencing, we identified a homozygous nonsense mutation in SEC14L2, a known regulator of PI3K pathway. We further analyzed the phenotype and functions of patient’s lymphocytes, and performed a transcriptome analysis to better characterize the implication of SEC14L2 mutation in the pathology. The second patient was born from consanguineous family and presented recurrent severe respiratory tract infections and a fatal Chronic Active EBV disease (CAEBV). By Whole Exome Sequencing, we identified a homozygous rare missense mutation in PIK3CD. 3D structure modelization showed that the mutated amino acid is located in p110 catalytic domain, in an evolutionarily conserved loop that interacts with alpha-helix of PI3K regulatory subunit p85a, which interaction is lost in mutated p110 . Phenotyping of patient’s circulating lymphocytes showed increased CD8+ T cells and reduced NK and CD4+ T cells. The mutation in PI3KCD resulted in impaired PI3K activity in vitro and in vivo. Moreover, patient’s T cells exhibited reduced activation-induced phosphorylation of AKT and p70-S6K, two indirect targets of p110 , that we restored by expressing wild type p110 . Patient’s T cells also showed a decreased induction of IFN- and TNF-↵ and an increased proliferation and calcium flux after TCR stimulation. By CRISPR CAS9 technology, we generated Jurkat T- cell lines expressing wild type or mutated PI3K. Jurkat cells expressing mutant PI3K showed decreased AKT phosphorylation and increased calcium flux and proliferation after TCR stimulation, confirming the implication of PIK3CD mutation in patient’s cells phenotype. Interestingly, we highlighted the existence of a balance between PI3K and PLC- 1 activity during T cell activation, that may be due to a competition for access to their shared substrate, the PIP2. Finally, we identified in our patient a second deleterious mutation in TNFRSF9 that is shared by his healthy sister, who also presented persistent EBV replication in blood, suggesting that this additional mutation may act as a modifying genetic factor. Taken together, the results presented in this thesis identified the first loss-of-function mutation in PIK3CD causing CID.