Epstein-Barr virus (EBV) is associated with a spectrum of benign and malignant lymphoproliferative disorders, including acute infectious mononucleosis (IM), Burkitt's lymphoma (BL) and immunosuppression-associated B cell lymphoproliferative disease (LPD). Immunosurveillance mediated by virus-specific cytotoxic T lymphocytes is believed to protect immunocompetent hosts from EBV-associated lymphoma and LPD. Due to the lack of an adequate animal model, however, the precise immunologic mechanisms which provide this protection have not been directly demonstrated in vivo. Human peripheral blood mononuclear cell-reconstituted C.B.-17-scid/scid mice (hu-PBMC-SCID mice) develop EBV-positive LPD following intraperitoneal injection of PBMC from EBV-seropositive donors. The SCID mouse disease mirrors human EBV-associated LPD in morphology, presence of the EBV genome, clonality, and patterns of expression of latent viral cellular differentiation antigens. The hu-PBMC-SCID mouse provides a unique small animal model of EBV+ LPD, and it was used in this study to examine the role of CD8+ CTL in controlling LPD. Survival time increase significantly when EBV-specific cytotoxic T-cell lines (CTL) are adoptive transferred into hu-PBMC-SCID mice, demonstrating suppression of LPD in vivoby a CTL-mediated virus-specific mechanism. Survival time also increases significantly with administration of alloreactive CTL lines, suggesting that a non-virus-specific mechanism also contributes to control of EBV-associated LPD by CTL. NOD-SCID mice reconstituted with PBMC from donors with latent EBV infection develop EBV+ LPD with significantly less frequency than do C.B.17-SCID mice reconstituted with PBMC from the same donors. Administration of anti-CD8 mAb to these mice depletes human CD8+ cells and increases the incidence of LPD to 100%, demonstrating that CD8+ T cells are neccessary for protection from EBV-associated LPD. Adoptive transfer of human CD8+ T cells, but not CD4+ T cells, prevents LPD in CD8-depleted NOD-SCID mice. In vivo depletion of CD4+ T cells prevents engraftment of human T cells, and LPD does not develop in most mice after CD4+ cell depletion. These studies are the first to directly demonstrate both the protective role of CD8+ T cells and a requirement for CD4+ T cells in EBV -associated LPD in an in vivo model.

O objetivo deste estudo foi analisar a expressão e o padrão de distribuição de linfócitos citotóxicos (LCs) e linfócitos T regulatórios (LTregs) no tecido gengival de pacientes com doença periodontal através de análise imunoistoquímica. Foram selecionados 30 pacientes (10 por grupo) com diagnóstico de periodontite agressiva (PA), periodontite crônica (PC) e gengiva clinicamente saudável (controle); dos quais foi colhida uma amostra de tecido gengival. A distribuição das células (epitélio e córion) foi identificada usando os imunomarcadores CD56, CD57, Granzima B e Perforina (LCs); CD4, CD25, FOXP3 (LTregs). A imunoexpressão foi avaliada, utilizando representação de imagem por meio de um sistema computadorizado, constituído por microscópio de luz, adaptado a uma câmera de alta resolução. Contagens independentes de 10 campos separados para cada caso foram feitas. Two-way ANOVA e posterior teste de Fisher foram utilizados para observar diferenças entre os diagnósticos e os marcadores; e teste t de Student para observar diferenças entre epitélio e córion (p<0.05). Os resultados indicaram que pacientes com PA e PC apresentaram um número significantemente maior de células CD56+ e CD57+, em relação ao grupo controle, porém sem diferenças entre si; um número significantemente maior de células CD56+ e CD57+ foi observado em relação às células Granzima B+ e Perforina+ em todos os pacientes. Em relação aos LTregs, o número de células CD25+ e FOXP3+, foi significativamente diferente entre PA, PC e controle, aparecendo em maior número na PC. Células CD4+ foram observadas em número similar em pacientes com PA e PC, diferindo significantemente do grupo controle; em pacientes com PA e PC, foi observado um número significantemente maior de CD4+, em relação às células CD25+ e FOXP3+. Pacientes com PA e PC tem maior número de LCs no tecido gengival em relação ao grupo controle sugerindo a participação destas células na patogênese da PA e PC. Pacientes com PA apresentaram menor número de LTregs no tecido gengival em comparação aos pacientes com PC, sugerindo que estas células podem estar envolvidas no mecanismo de regulação do processo inflamatório e reabsorção óssea. / This project aims to observe the expression and distribution of cytotoxic lymphocytes (LCs) and regulatory T lymphocytes (LTregs) in gingival tissue from periodontal disease affected patients through immunohistochemical analysis. 30 patients (10 per group) diagnosed with aggressive periodontitis (PA), chronic periodontitis (PC) and clinically healthy gingiva (control) were selected; from which a sample of gingival tissue was collected. The distribution of cells (epithelium and chorion) was identified using the immunomarkers CD56, CD57, Granzyme B, Perforin (LCs); CD4, CD25, FOXP3 (LTregs). The immunoexpression was assessed using image representation by a computer system, comprising a light microscope adapted to a high resolution camera. Independent counts of 10 separate fields for each case were done. Two-way ANOVA and posterior Fisher´s Test were used to observe differences between diagnostics and immunomarkers; and unpaired Student t test to observe differences between epithelium and chorium (p<0.05). The results indicates that patients with PA and PC presented a significantly higher number of CD56+ and CD57+ cells, in relation to control, but without differences between each other; a significantly higher number of CD56+ and CD57+ cells was observed in relation to Granzyme B and Perforine cells in all patients. Related to the LTregs, the number of CD25+ and FOXP3+ cells was significantly different between PA, PC and control, appearing in greater number in PC. CD4+ cells were observed in similar number in patients with PA and PC, it was observed a significantly higher number of CD4+, in relation to CD25+ and FOXP3+ cells. Patients with PA and PC have a greater number of LCs in gingival tissue in relation to control group - suggesting the participation of this cells in the pathogenesis of PA and PC. Patients with PA presented less LTregs in gingival tissue when compared to PC patients, suggesting that this cells may be involved in the regulatory mechanism of the inflammatory process and bone resorption.

Les données de la littérature ont récemment souligné l’importance du dialogue réciproque qui s’instaure entre les cellules Natural Killer (NK) et les cellules dendritiques (DC) au cours des phases précoces de la réponse immune pour l’initiation des réponses T spécifiques. La présentation croisée d’antigènes (Ag), processus qui permet aux DC de présenter des Ag exprimés par d’autres cellules aux lymphocytes T CD8+, est requise pour le développement d’une immunité cellulaire spécifique dans la plupart des infections par des pathogènes intracellulaires et des tumeurs. L’étude des mécanismes physiologiques impliqués dans la régulation de cette fonction suscite donc un intérêt majeur. Ce travail a permis de mettre en lumière une coopération entre les cellules NK et les DC humaines pour la présentation croisée d’un Ag exprimé par des cibles tumorales. Dans ce contexte, nous avons montré que la lyse de ces cibles par les cellules NK n’est pas nécessaire à la capture de leurs Ag par les DC. Au contraire, la sécrétion d’IFN-γ et de TNF-α par les cellules NK activées au contact des cibles tumorales joue un rôle prépondérant dans l’induction de la présentation croisée d’Ag. Ainsi, nous avons identifié une nouvelle fonction « helper » des cellules NK à l’interface entre l’immunité innée et adaptative. Le ciblage de cette fonction pourrait offrir de nouvelles perspectives en immunothérapies anti-tumorales dont le but ultime est le développement d’une immunité cellulaire spécifique / Recent reports have demonstrated the importance of the reciprocal crosstalk between natural killer (NK) cells and dendritic cells (DC) occurring during early phase of immune response for shaping downstream T cell immunity. Antigen (Ag) cross-presentation, a process by which DC present Ag from neighboring cells to CD8+ T lymphocytes is a prerequisite for the developpment of specific cellular immunity against most intracellular pathogens and tumors. A more detailed understanding of the mechanisms that regulate this specific DC function is thus a major challenge for immunologists. Here, we highlight the cooperation between NK and DC for tumor cell-derived Ag cross-presentation. In this context, we show that the NK cell-mediated lysis of target cells is not required for Ag capture by DC. In contrast, both IFN-γ and TNF-α produced by NK cells upon recognition of tumor cells play a critical role in the induction of Ag cross-presentation. These findings define a novel « helper» function of NK cells bridging innate and adaptive immunity. This novel function could be harnessed in cancer immunotherapy for inducing Ag-specific cellular immunity

La théorie actuelle de l'immunosurveillance des cancers établit l'existence d'un système dynamique d'interaction entre le système immunitaire et les cellules tumorales. Plusieurs expériences majeures ont démontré l'importance du système immunitaire et en particulier des lymphocytes T dans la surveillance des cancers et dans l'efficacité des thérapies antitumorales. Certains traitements utilisés contre le cancer peuvent en effet stimuler ou inhiber la réponse immunitaire antitumorale. En plus de leur effet cytotoxique sur les cellules cancéreuses ces médicaments, tel que le Sorafenib, peuvent inhiber des cellules immunosuppressives telles que les Treg et les MDSC. D'autres chimiothérapies, telle que l'Oxaliplatine, peuvent induire une mort cellulaire immunogène nécessaire à leur efficacité clinique. L'Oxaliplatine est également connue pour ajouter des groupements alkyles sur les bases puriques de l'ADN à l'origine de mutations. Parallèlement, la caractérisation de nombreuses mutations immunogènes a été menée au cours des dernières années sans que le rôle des traitements dans l'apparition de celle-ci n'ait été recherché. Les mutations spécifiques des agents alkylants correspondent à une modification des bases AG, GG et de la base en S' de groupe AG ou GG. Ces mutations permettraient de diversifier le répertoire antigénique en créant des néoantigènes reconnus par les lymphocytes T. L'objectif principal de ce travail a été d'identifier de nouveaux épitopes immunogènes issus d'antigènes de tumeurs en utilisant une stratégie d'immunologie inverse. La première partie a permis l'identification de trois néoépitopes immunogènes restreints par le CMH-II et potentiellement impliqués dans la rémission complète d'un patient atteint d'un hépatocarcinome métastatique traité par Sorafenib. L'immunogénicité de ces trois néoépitopes issus des protéines HELZ2, MLL2 et IL-1β mutées a été validée après stimulation in vitro des lymphocytes T du patient. La seconde partie, portant sur l'identification de néoantigènes induits par Oxaliplatine a permis de poursuivre la caractérisation des mutations chimioinduites et d’identifier 26 néoépitopes potentiellement présentés par les CMH de classe I.Ces travaux renforcent le lien entre système immunitaire et l’efficacité des chimiothérapies. Ils suggèrent pour la première fois que les chimiothérapies pourraient augmenter l’immunogénicité des tumeurs, en augmentant le répertoire des néoantigènes. / The current theory of cancer immunosurveillance establishes the existence of a dynamic system o interaction between the immune system and tumor cells. Several major experiments have demonstrated th importance of the immune system and in particular T cells in cancer surveillance and the effectiveness of anti tumor therapies. Treatments used against cancer can stimulate or inhibit the immune response to tumor. I addition to their cytotoxic effect on cancer cells, these drugs, such as Sorafenib, can inhib' immunosuppressive cells such as Treg and MDSC. Other chemotherapies, such as Oxaliplatin, can induce a immunogcnic cell death required for its efficacy. Oxaliplatin is a1so known to add alkyl groups on the puri bases that cause DNA mutations. At the same titne, the characterization of many immunogenic mutations ha been carried out in recent years without evaluating the role of treatments in the appearance of suc immunogenic mutations. The specific mutations of the alkylating agents correspond to a modification of th AG, GG bases and 5' base of the AG or GG motif. These mutations would diversify the antigenic repertoire b creating neo-antigens recognized by T cells. The main objective of this work was to identify new immunogenic epitopes derived from tumor antigens using a reverse immunology strategy. The first part identified three immunogenic neoepitopes restricted by MHC-11 and potentially involved in the complete remission of a patient with metastatic hepatocarcinoma treated with Sorafenib. The immunogenicity of these three neoepitopes derived from mutated HELZ2, MLL2 and IL-1The main objective of this work was to identify new immunogenic epitopes derived from tumor antigens using a reverse immunology strategy. The first part identified three immunogenic neoepitopes restricted by MHC-11 and potentially involved in the complete remission of a patient with metastatic hepatocarcinoma treated with Sorafenib. The immunogenicity of these three neoepitopes derived from mutated HELZ2, MLL2 and IL-1β proteins was validated after in vitro stimulation of the patient's T cells. The second pati, dealing with the identification of neoantigens induced by Oxaliplatin, made it possible to characterize chemoinduced mutations and to identify 26 neoepitopes potentially presented by MHC-I. This work reinforces the link between the immune system and the effectiveness of chemotherapy. The suggest for the first time that chemotherapy could increase tumor immtmogenicity by increasing the repertoir of neo-antigens. proteins was validated after in vitro stimulation of the patient's T cells. The second pati, dealing with the identification of neoantigens induced by Oxaliplatin, made it possible to characterize chemoinduced mutations and to identify 26 neoepitopes potentially presented by MHC-I. This work reinforces the link between the immune system and the effectiveness of chemotherapy. The suggest for the first time that chemotherapy could increase tumor immtmogenicity by increasing the repertoir of neo-antigens.

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

Made available in DSpace on 2014-06-11T19:32:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-03-31Bitstream added on 2014-06-13T18:44:46Z : No. of bitstreams: 1 sartori_r_dr_arafo.pdf: 1126976 bytes, checksum: b952e5d8db014ff996192d8476649c74 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Embora a doença periodontal tenha origem infecciosa, ela se caracteriza por uma complexa resposta imune-inflamatória, com a participação de células residentes e não-residentes, produzindo diversas citocinas e mediadores biológicos. A principal característica da doença periodontal destrutiva é a reabsorção do osso alveolar, a qual é uma consequência frequentemente irreversível do processo patológico e das citocinas produzidas pela resposta do hospedeiro. Citocinas específicas atuam diretamente no controle da remodelação óssea, denominadas RANKL (Receptor activator of NF-kB ligand) e OPG (Osteoprotegerin,). RANKL é uma proteína produzida por fibroblastos, osteoblastos, condrócitos, células mesenquimais e células T e B ativadas e sua ligação com o seu receptor RANK (Receptor activator of NF-kB) em células precursoras de osteoclastos é necessário e suficiente para a ativação, diferenciação e sobrevivência de osteoclastos maduros. OPG, a outra proteína envolvida nesta modulação, serve como um falso receptor para RANKL, impedindo dessa forma a ligação RANKL-RANK e levando a uma menor ativação de osteoclastos. Assim, o balanço entre RANKL e OPG é o atual paradigma para a modulação da remodelação óssea. FK-506 (tacrolimo) é uma droga imunossupressora usada para prevenir rejeição de enxertos afetando a ativação de linfócitos T por meio da modulação da via da calcineurina, inibindo a ativação de NFAT e de NF-kB. Estudos prévios demonstraram que o uso de tacrolimo em ratos diminui a resposta inflamatória e reabsorção óssea em modelo experimental de indução de doença periodontal. A proposta deste estudo foi avaliar os efeitos da administração sistêmica do tacrolimo sobre a expressão de RANKL e OPG na doença periodontal induzida em ratos e determinar in vitro, se o tratamento de células residentes do periodonto com tacrolimo... / Periodontitis is a well-characterized infectious disease with a complex immune-inflammatory response. In response to the bacterial presence, many resident and non-resident cells into the peridontium produce many cytokines and biologic mediators, causing tissue destruction and alveolar bone loss. These cytokines are the key-factor in osteoclast-mediated bone resorption. The expression ratio between two cytokines is fundamental to bone resorption process: RANKL (Receptor activator of NF-kB ligand) that is necessary to osteoclast differentiation, activation and survival, and OPG (Osteoprotegerin) that acts as the endogenous inhibitor of RANKL by functioning as its decoy receptor. RANKL is expressed by fibroblasts, osteoblasts, chondrocytes, mesenchymal cells and T and B lymphocytes. OPG is secreted primarily by osteoblastic cells, bone marrow stromal celss and fibroblasts and it counter regulates the excessive bone loss antagonizing the RANKL-binding to its receptor RANK in osteoclast precursor cells. The ratio between RANKL and OPG is the current paradigm for modulation of coupled bone turnover. FK-506 is an immunossupressive drug used to reduce and to prevent the risk of organ transplant rejections. It acts affecting T lymphocyte activation by calcinaurin pathway modulation inhibiting NFAT and NF-kB translocation to the nucleus. Previous studies showed that animals with experimental periodontitis treated with FK-506 exhibited less bone resorption and inflammatory infiltrate. The purpose of this study was evaluated effects of FK-506 systemic administration over RANKL and OPG expression in animals with experimental periodontitis; and determines if FK-506-treated periodontium resident cells can affect IL-1- and LPS-induced RANKL and OPG expression. In the in vivo study, two experimental periodontitis models were used (LPS and ligature) in rats. In the test group the animals received dail... (Complete abstract click electronic access below)

Epstein-Barr virus (EBV) is a ubiquitous human herpesvirus which causes acute infectious mononucleosis and is etiologically associated with malignant lymphoproliferative disorders including Burkitt's lymphoma, nasopharyngeal carcinoma, B-cell lymphomas in immunocompromised hosts, Hodgkin's disease, T cell lymphomas, and smooth muscle tumors in allograft recipients. The medical significance of EBV is underscored by its potent growth transforming effects on human B-lymphocytes in-vitro and the potentially oncogenic consequences of infection in-vivo. The majority of EBV-associated malignancies occur in the setting of chronic infection and strong virus-specific humoral immunity, suggesting that cellular immunity is primarily responsible for preventing the outgrowth of EBV-transformed B cells in-vivo. Similarly, primary EBV infection in adolescents and adults stimulates an intense cytotoxic-T-lymphocyte (CTL) response which coincides with a marked reduction in the number of infected B cells in the peripheral blood. Evidence of previous EBV infection can be confirmed by the presence of EBV-specific, HLA-restricted memory T cells in the peripheral blood which inhibit the outgrowth of newly EBV-transformed B cells and efficiently lyse established autologous B-lymphoblastoid cell lines. Worldwide, EBV is responsible for substantial morbidity, comparable to measles, mumps and hepatitis virus, for which vaccines exists. Accordingly, the potential public health impact of an EBV vaccine has reinforced our efforts to identify the immunodominant virus-encoded T-cell epitopes which stimulate naive CTL effectors during acute infection and maintain memory CTL surveillance during convalescence. The EBV-encoded antigens against which the memory CTL response is directed have been partially defined, and include most of the EBV latent proteins (EBNA-2, 3a, 3b, 3c, LP, and LMP-l, 2a, 2b) consistently expressed by in-vitro EBV-transformed B lymphocytes (type-III latency). Importantly, all EBV-associated malignancies express EBNA-1, and as yet no EBNA-1-specific memory CTL have been convincingly demonstrated. Additionally, many EBV-specific CTL lines and clones have been described which do not recognize any of the known latent proteins or other EBV protein antigens tested thus far. Thus while much is known about CTL-mediated immunity against EBV, our knowledge of EBV-derived CTL epitopes remains incomplete. In contrast to the EBV-specific memory CTL response, very little is known about the source of viral epitopes recognized during the primary CTL response to EBV. In this regard, acute infectious mononucleosis represents an ideal model system to study virus-specific, cell-mediated immunity. Acute IM is a self-limited illness characterized by the appearance of "atypical" lymphocytes (CD3+/CD8+/HLADR+), including both virus-specific and alloreactive CTL, which undoubtedly contribute to virus elimination and provide CTL precursors for life-long immunity to EBV. Like other herpesvirus, EBV can undergo either lytic or latent cycle replication. During primary EBV infection many lytic cycle genes are expressed which are likely responsible for stimulating the intense cellular immune response associated with acute infectious mononucleosis. During convalescence a minor population of circulating B cells remain latently infected, harbor multiple EBV episomes, and express only EBNA-1 and possibly LMP-2a (type-I latency). Thus, latency type-I infected B cells in-vivo express a much more restricted spectrum of latent proteins and are therefore not subject to elimination by the same virus-specific CTL as are type-III EBV latently infected cells. Accordingly, many mechanisms have been proposed to explain EBV persistence including; restricted expression of EBV latent genes, reduced levels of cellular adhesion molecules, downregulation of MHC class-I molecules, absence of EBNA-1 T-cell-epitopes, and most recently, EBNA-1-mediated inhibition of antigen processing. While these mechanisms may contribute to ineffective T cell surveillance against latency type-I EBV- infected cells, B cells expressing the full spectrum of latent proteins (type-III) also exist transiently in vivoand maintain detectable humoral and CTL responses to most latent proteins. Our first goal was to identify the virus-encoded immunodominant antigens recognized by in-vivoactivated MHC class-I restricted CTL isolated from college students experiencing primary EBV infection, manifested as acute IM. Following a prodromal period of several weeks, newly EBV infected patients present with signs and symptoms of acute IM, including elevated numbers of activated CD8+ T cells in their peripheral blood, many of which, like memory CTL, are EBV-specific and HLA-restricted. In order to address the issue of EBV persistence and the immune control of EBV-induced lymphoproliferation, we also studied the long-term EBV-specific memory CTL response in these same individuals. Blood from acute IM patients and healthy EBV seropositive donors served as a source of peripheral blood lymphocytes to generate bulk CTL cultures and autologous target cells. The infecting strain of EBV was determined for each patient by DNA-PCR amplification of virus from saliva. Lymphocytes were isolated from whole blood by Ficoll-Paque density centrifugation and T- and B-cell enriched populations were obtained by AET-sheep red cell rosette selection. Autologous B cell blasts served as a source of target cells and recombinant vaccinia virus constructs were used to introduce individual EBV latent genes into target cells. Expression of individual EBV genes in target cells was confirmed by both western blot and immunofluorescence. Primary CTL responses to EBV were evaluated in standard 5lCr release assays using freshly isolated, T-cell enriched PBL from acute IM patients as effector cells. EBV-specific memory CTL responses were evaluated with bulk CTL culture generated by in-vitro restimulation with autologous B-LCLs. FACS analyses were routinely performed on bulk cultures of effector CTL populations in order to more clearly characterize their phenotype. Lastly, monoclonal antibody blocking studies and cold target competition assays were performed in order to accurately identify the viral antigen and MHC components responsible for target cell recognition. Our results based upon evaluation of 35 acute IM patients and 32 convalescent patients demonstrate that the virus-specific primary CTL response is broadly directed against the full spectrum of latent proteins, including EBNA1 and the viral coat glycoprotein gp350, while the memoryCTL response, which essentially lacks EBNA1 reactivity, is directed primarily against the EBNA 3 family of proteins (3A, 3B, 3C). Importantly, the immunodominant response by both primary and memory CTL was directed against the EBNA3 proteins. CTL from 7 of the 35 acute IM patients evaluated recognized EBNA1 expressing targets, and in 4 of these 7 patients, EBNA1 was an immunodominant antigen. Similarly, CTL from 7 of 35 acute IM patients recognized gp350 transfected targets, while no gp350-specific memory CTL responses were observed. While the phenotype of in-vivo primed CTL effectors were CD8+/HLA-DR+/CD11b+, the major subpopulation of memory CTL were CD8+/HLA-DR+/CD11b-. The CD11b "memory marker" reached peaked levels on the first sample day for all patients and gradually declined to baseline levels over a period of several months. In contrast, the CD11b marker was quickly shed from in vitropropogated CTL, over a period of 5-10 days. Target cell lysis by in-vivoactivated CTL was almost completely blocked by antibody directed againt [against] class-I molecules (BBM.1), whereas the effect of blocking target cell lysis by anti-CD8 mAb varied between 40-75%. These findings are consistent with an absolute need for class-I restricted antigen presentation, and imply that CD8 was variably required, likely for the lower affinity TCR/ Ag combinations. Cell lysis mediated by in-vitro-restimulated memory CTL was also largely inhibited by anti-class-I mAb, while anti-CD8 mAb was only mild/moderately effective in blocking target cell lysis, in keeping with the concept that memory CTL bear higher avidity TCR which can recognize antigen independent of CD8. Our detection of only one EBNA1-specific memory CTL response among the 32 patients tested supports the theory that latently infected B cells in-vivo, expressing only EBNA1, escape CTL recogition and thus might serve as a reservoir for viral persistence and/or reactivation. The rare ability to detect an EBNA1-specific memory CTL responses remains a relatively unexplained phenomenon and may involve a number of tolerizing mechanisms including the induction of anergy by presentation of EBNA-1 in the absence of costimulation, clonal deletion of low affinity T cells, the absence of dominant T cell epitopes within EBNA1 or a result of the recently described inhibiting properties of EBNA-1 on antigen processing and presentation. Alternatively, the absence of detectable EBNA1-specific memory CTL may be the result of insufficient or inappropriate restimulation of memory CTL in vitro. We addressed this possibility by attempting to selectively restimulate and expand EBNA1-specific CTL from acute IM patients by using EBNA1 expressing B cells blasts as a stimulus. Effector cells generated in this manner killed target cells in an MHC class-I restricted manner but were specific for an unspecified vaccinia antigen. Interestingly, the phenotype of the effector cells was predominantly CD3+/CD4-/CD8-/γδ T cells. In summary, our findings suggest that a multitude of previously unrecognized, EBV-specific CTL are present in the peripheral blood during acute IM, and include EBNA-1-specific CTL. The importance of accurately defining the in-vivo immune response to EBV is underscored by the ever-growing list of EBV associated malignancies. In addition to providing insights into the oncogenesis and potential treatment of NPC, a newly described link between precursor lesions and EBV infection raises the possibility that heightened immunity to EBV or EBV-infected cells may prevent the development of NPC. An obvious expectation would include extension of such knowledge to other EBV associated malignancies such as B and T cell lymphomas, Hodgkin's lymphomas, and smooth muscle tumors. First however, existing gaps in knowledge regarding the immune response to EBV and EBV-associated malignancies must be closed. Details about the viral gene products which are involved in stimulating a broadly protective, virus-specific immune response in a large number of individuals is fundamental to the design of an effective EBV vaccine. Since the presence of activated CD8+ T cells correlates with the rapid decline of EBV infected B cells in the peripheral blood, a concise description of the EBV-specific CTL response in the setting of acute infection will be necessary for the rational design of an effective acute IM vaccine. Increased understanding of viral escape mechanisms is also likely to contribute to therapeutic modalities to treat autoimmune disorders.

Malgré les programmes de dépistage mis en place et le vaste arsenal thérapeutique disponible, 8,2 millions de décès dans le monde ont été attribués au cancer pour l'année 2012 (données Globocan 2012, OMS). L'immunothérapie antitumorale est en plein essor et consiste notamment à exploiter le système immunitaire de l'hôte pour obtenir une réponse contre la tumeur. L'utilisation de vecteurs bactériens, capables de délivrer un message antigénique et de stimuler de manière concomittante l'immunité innée, fait partie des approches de vaccination antitumorale prometteuses. Parmi ces vecteurs, une bactérie Pseudomonas aeruginosa mise au point par notre laboratoire présente l'intérêt de pouvoir injecter in vivo des antigènes de tumeur, via son système de sécrétion de type III (SST3), directement dans le compartiment intracellulaire des cellules présentatrices d'antigènes. La voie de présentation du CMH I est ainsi favorisée et permet la génération d'une réponse des lymphocytes T cytotoxiques vis-à-vis de la tumeur exprimant l'antigène. Cependant, la poursuite des études précliniques et cliniques paraît délicate, en raison du risque infectieux lié à une bactérie pathogène, quand bien même atténuée. Lors de ce travail, nous avons donc développé une nouvelle souche de P. aeruginosa Killed But Metabolically Active (KBMA), incapable de se répliquer, mais toujours apte à jouer son rôle de vecteur. Une analyse de la réponse immune antitumorale, suite à l'immunisation par différents vecteurs, a permis de mettre en évidence une forte infiltration de la tumeur par des lymphocytes T CD8+ spécifiques de l'antigène, mais également une protection à long terme liée à la présence d'un pool majoritaire de lymphocytes T CD8+ spécifiques effecteurs mémoires. Enfin nous avons cherché à appliquer cette technologie à l'antigène de tumeur anhydrase carbonique 9 (AC9), exprimé par de nombreuses tumeurs solides chez l'homme. / Despite cancer screening programs and the available therapeutic armamentarium, 8.2 million deaths worldwide were due to cancer in 2012 (data Globocan 2012, WHO). The antitumor immunotherapy is booming and aims at using the immune system of the host as a response against the tumor. The use of bacterial vectors, able to deliver an antigenic message and concomitantly stimulate innate immunity, is one of the most promising approaches to antitumor vaccination. Among these vectors, the bacterium Pseudomonas aeruginosa developed by our laboratory has the advantage of being able to inject in vivo tumor antigens via its type III secretion system (T3SS) directly in the intracellular compartment of antigen-presenting cells. The MHC I presentation pathway is thus favored and allows the generation of a cytotoxic T lymphocytes response against antigen-expressing tumors. However, further preclinical and clinical studies remain difficult, because of the risk of infection related to a bacterial pathogen, even if attenuated. In this work, we have developed a new strain of P. aeruginosa Killed But Metabolically Active (KBMA) unable to replicate, but still able to play its role as a vector. An analysis of the antitumor immune response following immunization with different vectors, allowed to demonstrate a strong tumor infiltration by antigen-specific CD8+ T lymphocytes, but also a long-term protection related to the presence of a major pool of antigen-specific effector memory CD8+ T cells. Finally we are seeking to apply this technology to the tumor antigen carbonic anhydrase 9 (CA9), expressed by many solid tumors in humans.

Made available in DSpace on 2014-12-17T15:32:20Z (GMT). No. of bitstreams: 1 AnaLDLA_DISSERT.pdf: 3287914 bytes, checksum: 244a318f2c60d05b41aef3b1d3d6d2a0 (MD5) Previous issue date: 2012-02-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Periapical lesions are chronic inflammatory conditions of periradicular tissues considered direct consequences of infectious diseases resulting from pulp necrosis and subsequent progression to periapical region. The participation of the immune response and bone resorption in the formation of these lesions has been investigated, so that different cell types and cytokines have been identified as contributors to this process. In this perspective, this study aimed to evaluate the immunohistochemical expression of IL-17, TGF-?1 and FoxP3 in periapical granulomas (PGs), radicular cysts (RCs) and residual radicular cysts (RRCs), seeking a better understanding of the etiopathogenesis these periapicopatias. To this end, we selected 20 cases of GPs, 20 CRs and 10 RRCs to undergo morphological analysis and immunohistochemistry for biomarkers above, the latter being performed quantitatively using scores and average percentages of immunostaining for the analysis of IL-17 and TGF- ?1, while for the FoxP3 were counted only the positive lymphocytes. The results showed statistically significant differences between TGF-?1 and FoxP3 imunoexpressions, in relation to the periapical lesions studied (p = 0.002, p <0.001, respectively) but not between IL-17 and these (p = 0.355). Furthermore, the analysis of lymphocytes FoxP3-positive revealed significant statistical differences in that refers to the intensity of inflammatory infiltrate (p = 0.003) and also regarding thickness of the epithelial lining (p = 0.009). Finally, it was observed in the case of PGs, strong positive correlation between the amount of FoxP3- positive lymphocytes and the immunohistochemical expression of TGF-?1 (r = 0.755, p<0.001), as well as moderate positive correlation between IL-17 and TGF-?1 imunoexpressions (r = 0.503, p = 0.024). Thus, we can conclude that interactions between Th17 and Treg cells seem to be established at the site of injury, suggesting the involvement of both pro-inflammatory and immunoregulatory cytokines in the pathogenesis of periapical lesions / Les?es periapicais cr?nicas s?o condi??es inflamat?rias dos tecidos perirradiculares consideradas sequelas diretas de processos infecciosos resultantes da necrose pulpar e consequente progress?o para a regi?o periapical. A participa??o da resposta imunol?gica e da reabsor??o ?ssea na forma??o destas les?es tem sido bastante investigada, de modo que diversos tipos celulares e citocinas foram apontados como colaboradores deste processo. Nesta perspectiva, o presente estudo objetivou avaliar a express?o imuno-histoqu?mica da IL- 17, TGF-?1 e FoxP3 em granulomas periapicais (GPs), cistos radiculares (CRs) e cistos radiculares residuais (CRRs), buscando um melhor entendimento sobre a etiopatog?nese destas periapicopatias. Para tanto, foram selecionados 20 casos de GPs, 20 de CRs e 10 de CRRs para serem submetidos ? an?lise morfol?gica e imuno-histoqu?mica para os biomarcadores supracitados, sendo esta ?ltima realizada quantitativamente atrav?s de escores e percentuais m?dios de imunomarca??o para a an?lise da IL-17 e do TGF-?1, enquanto que para o FoxP3 foram contados apenas os linf?citos positivos. Os resultados demonstraram diferen?as estatisticamente significativas entre as imunoexpress?es do TGF-?1 e do FoxP3 em rela??o as les?es periapicais pesquisadas (p = 0,002; p < 0,001, respectivamente), mas n?o entre a IL-17 e estas (p = 0,355). Al?m disso, a an?lise dos linf?citos FoxP3-positivos revelou diferen?as estat?sticas significativas no que se refere ? intensidade do infiltrado inflamat?rio (p = 0,003) e tamb?m quanto ? espessura do revestimento epitelial (p = 0,009). Por fim, observou-se nos casos de GPs, forte correla??o positiva entre a quantidade de linf?citos FoxP3-positivos e a imunoexpress?o do TGF-?1 (r = 0,755; p < 0,001), assim como moderada correla??o positiva entre as imunoexpress?es da IL-17 e do TGF-?1 (r = 0,503; p = 0,024). Destarte, pode-se concluir que intera??es entre c?lulas Th17 e Treg parecem ser estabelecidas no local da agress?o, sugerindo a participa??o de citocinas tanto pr?inflamat?rias como imunorregulat?rias na patogenia das les?es periapicais

A Enfuvirtida(ENF), único inibidor de fusão disponível, representa uma opção interessante aos pacientes com infecção pelo HIV quando utilizada em combinação com outros antirretrovirais, principalmente no tratamento de multiexperimentados com falha virológica e poucas opções terapêuticas. Sua eficácia já comprovada em ensaios clínicos esbarra nas barreiras impostas por sua administração parenteral. Impulsionado por estes dados, avaliamos durante 48 semanas a resposta virológica, a evolução de células T CD4 a possível resistência primária a ENF e o impacto para a adesão do uso subcutâneo da droga em dez pacientes que fazem acompanhamento ambulatorial no Hospital Universitário Pedro Ernesto e que tinham história de mais de dez anos de infecção pelo HIV e uso de ENF no seu esquema terapêutico sugerido por teste de resistência. Todos os pacientes alcançaram ao final do seguimento sucesso terapêutico, mantendo carga viral não detectada, e um incremento médio significativo de linfócitos T CD4. Em relação a uma possível resistência primária, em nenhum dos testes, genotipagem da glicoproteína 41, foi visualizado mutações naturais que pudessem diminuir a ação da ENF. Sobre o manejo do medicamento, preparo e aplicação, observamos que é imprescindível um apoio multidisciplinar para que não haja descontinuação na sua utilização / Enfuvirtide (ENF) is the only fusion inhibitor available. It is an interesting option for patients with HIV infection when used in combination with other antiretroviral drugs, especially in the treatment of multi-experienced patients with virological failure and few therapeutic options. Its effectiveness confirmed in clinical trials finds the barriers in its parenteral administration. Using these data, we evaluated, for 48 weeks, the virological response, evolution of CD4 T cells, the possible primary resistance to ENF and the impact to the subcutaneous use of the drug in ten patients undergoing outpatient monitoring at Hospital Universitário Pedro Ernesto with a history of more than ten years of HIV infection and use of ENF in their therapy, as suggested by resistance testing. All patients have successfully completed the therapy by the end of follow-up with an undetected viral load and a significant average increase of CD4 T lymphocytes. As for a possible primary resistance, neither the genotyping nor the glycoprotein 41 revealed natural mutations that could diminish the effect of ENF. Concerning the management, preparation and application of the drug, we found that a multidisciplinary support is essential to avoid that the drug be discontinued