Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Thesis (Ph.D.)--University of Alabama at Birmingham, 2007. / Title from PDF title page (viewed on Sept. 16, 2009). Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 2005. / Vita. Includes bibliographical references (leaves 92-100).

Masters of Science / Background: Infection with HIV results in gradual loss of immunologic functions, especially those mediated by CD4+T helper cells with consequent impairment of the immune response leading to severe manifestations of periodontal disease. The lower the CD4+T lymphocyte cell count or the higher the level of immunosuppression, the higher the incidence of periodontal disease in those patients will be. Putative periodontopathic bacteria namely Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia, commonly referred to as "red complex", and many other bacterial species have been implicated in the initiation and progression of periodontal disease. Objective: The present study tests the association between different CD4+T lymphocyte levels and "red complex" pathogens using BANA, in HIV-positive patients with chronic inflammatory periodontal disease (CIPD). Methods: 120 HIV-positive patients from the infectious disease clinic at Tygerberg hospital participated in the study with a mean age of 33.3 years. The CD4+T lymphocyte counts were obtained from patient's medical records. The six Ramjford teeth were used for evaluating periodontal clinical parameters such as plaque index, gingival index, periodontal probing depth and clinical attachment loss. Subgingival plaque samples were collected and analyzed by the enzymatic BANA test for the detection of the "red complex". Results: The CD4+T lymphocyte mean level was 293.43cells/mm3. Statistically significant associations were found between CD4+T cell counts and probing depth (p= 0.0434) and clinical attachment loss (p= 0.0268). Significant associations were found between BANA with all the clinical indices (p= <0.05). However no association was found between CD4+T cell counts and BANA. Conclusion: HIV-positive patients show a high prevalence of "red complex" pathogens subgingivally. Immunosuppression seems to favour the colonization of these species, resulting in periodontal disease manifestations.

Made available in DSpace on 2015-10-06T13:03:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-08-23. Added 1 bitstream(s) on 2015-10-06T13:18:56Z : No. of bitstreams: 1 000819087.pdf: 1423284 bytes, checksum: a89857bcef9822e82a34c2b6424c6064 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A leishmaniose visceral é uma doença que causa manifestações clínicas variadas em cães, que podem apresentar desde alterações subclínicas a desordens generalizadas, incluindo alterações neurológicas. Há evidências do comprometimento das barreiras encefálicas, como a presença de infiltrado inflamatório com predomínio de linfócitos T CD3+ no sistema nervoso central. Deste modo, o objetivo deste trabalho foi determinar e comparar os imunofenótipos de linfócitos T no sangue periférico e no liquor e avaliar as lesões encefálicas em cães infectados. Verificou-se que os linfócitos T presentes em maior quantidade no liquor foram os duplos negativos (DN) e os duplos positivos (DP), com predomínio de TCRαβ. Também verificou-se que as células sanguíneas não diferiram das células do liquor em quantidade, o que indica que pode estar havendo um comprometimento da barreira hematoliquórica, permitindo que as células do sangue migrem para o liquor. Ocorreu também o predomínio de infiltrado linfohistioplasmocitário no encéfalo, principalmente em leptomeninges. Porém, não houve correlação entre a inflamação nessa área e as células T. Além disso, a correlação positiva entre a inflamação no subepêndima e as células T DN do liquor indica que essas células chegam no encéfalo também pelos vasos subependimários. Em conjunto, os resultados contribuem para explicar a inflamação observada no encéfalo de cães com leishmaniose, sendo que as células T DN podem ser responsáveis pela progressão neurológica da doença / Visceral leishmaniasis (VL) is a disease causing several clinical manifestations in dogs, that can present from subclinical to generalized disorders, including neurological disorders. There are evidences of cerebral barriers involvement, such as the presence of inflammatory infiltrate with predominance of CD3+ T cells in the brain of infected dogs. Therefore, the aim of this study was to determine and to compare the immunophenotypes of T lymphocytes in the peripheral blood and in the cerebrospinal fluid (CSF) of dogs with VL and evaluate the brain lesions. It was detected that the double negative (DN) and double positive (DP) T cells were present in higher percentage in the CSF, with predominance of TCRαβ. Besides, the amount of blood T cells did not differ from those observed in the CSF, indicating that the blood-CSF barrier may be damaged, allowing the migration of cells from the blood to the CSF. Moreover, inflammatory infiltrate with predominance of lymphohistioplasmacytic cells was observed, mainly in leptomeninges. However, there was no correlation between the intensity of the inflammation in this area and the T cells. Furthermore, the positive correlation between intensity of the inflammation in the subependimal area and DN T cells in the CSF indicates that these cells also may reach the brain through the subependymal vessels. Together, the results contribute to explain the inflammation observed in the brain of dogs with VL, where the DN T cells may contribute to the neurological progression of the disease

Resumo: A leishmaniose visceral é uma doença que causa manifestações clínicas variadas em cães, que podem apresentar desde alterações subclínicas a desordens generalizadas, incluindo alterações neurológicas. Há evidências do comprometimento das barreiras encefálicas, como a presença de infiltrado inflamatório com predomínio de linfócitos T CD3+ no sistema nervoso central. Deste modo, o objetivo deste trabalho foi determinar e comparar os imunofenótipos de linfócitos T no sangue periférico e no liquor e avaliar as lesões encefálicas em cães infectados. Verificou-se que os linfócitos T presentes em maior quantidade no liquor foram os duplos negativos (DN) e os duplos positivos (DP), com predomínio de TCRαβ. Também verificou-se que as células sanguíneas não diferiram das células do liquor em quantidade, o que indica que pode estar havendo um comprometimento da barreira hematoliquórica, permitindo que as células do sangue migrem para o liquor. Ocorreu também o predomínio de infiltrado linfohistioplasmocitário no encéfalo, principalmente em leptomeninges. Porém, não houve correlação entre a inflamação nessa área e as células T. Além disso, a correlação positiva entre a inflamação no subepêndima e as células T DN do liquor indica que essas células chegam no encéfalo também pelos vasos subependimários. Em conjunto, os resultados contribuem para explicar a inflamação observada no encéfalo de cães com leishmaniose, sendo que as células T DN podem ser responsáveis pela progressão neurológica da doença / Abstract: Visceral leishmaniasis (VL) is a disease causing several clinical manifestations in dogs, that can present from subclinical to generalized disorders, including neurological disorders. There are evidences of cerebral barriers involvement, such as the presence of inflammatory infiltrate with predominance of CD3+ T cells in the brain of infected dogs. Therefore, the aim of this study was to determine and to compare the immunophenotypes of T lymphocytes in the peripheral blood and in the cerebrospinal fluid (CSF) of dogs with VL and evaluate the brain lesions. It was detected that the double negative (DN) and double positive (DP) T cells were present in higher percentage in the CSF, with predominance of TCRαβ. Besides, the amount of blood T cells did not differ from those observed in the CSF, indicating that the blood-CSF barrier may be damaged, allowing the migration of cells from the blood to the CSF. Moreover, inflammatory infiltrate with predominance of lymphohistioplasmacytic cells was observed, mainly in leptomeninges. However, there was no correlation between the intensity of the inflammation in this area and the T cells. Furthermore, the positive correlation between intensity of the inflammation in the subependimal area and DN T cells in the CSF indicates that these cells also may reach the brain through the subependymal vessels. Together, the results contribute to explain the inflammation observed in the brain of dogs with VL, where the DN T cells may contribute to the neurological progression of the disease / Orientador: Gisele Fabrino Machado / Banca: Valéria Marçal Felix de Lima / Banca: Antonio Carlos Alessi / Mestre

Cytotoxicity is the capacity for immune cells to kill infected or malignant cells in order to eliminate pathogens and tumours through different mechanisms including the exocytosis of perforin-containing cytosolic granules. This crucial property is usually restricted to specialized innate and adaptive lymphocytes such as natural killer (NK) cells and CD8 T cells. T lymphocytes differentiate in the thymus and are delivered to the peripheral blood as naive T cells committed to either the CD8 or the CD4 lineage. CD8 T cells are programmed to acquire cytotoxic effector functions under the control of the transcription factor (TF) Runx3. The fate of CD4 T cells is to acquire multiple helper functions through the action of the TF ThPOK that promotes CD4 helper functions and restricts the CD8 cytotoxic program. However, this restriction is not absolute as cytotoxic CD4 (CD4CTX) T cells differentiate in vivo, indicating that the multipotency of human naive CD4 T cells includes the ability to acquire perforin expression and potent cytotoxicity in vitro and ex vivo. This cytotoxic potential correlates with outcome in human pathology and mediates protection against viral challenge and tumour eradication in murine models. CD4CTX T cells are terminally differentiated effector memory T cells that accumulate during cytomegalovirus chronic infection and ageing. They are phenotypically and functionally related to T helper type 1 (Th1)-effector memory cells. However, whether they belong to the Th1 pathway or constitute a separate specialized helper T cell subset is unknown. In this work, we show that CD4CTX T cell differentiation is an integral part of the Th1 pathway. Indeed, CD4 T cells acquire cytotoxic potential early in the memory differentiation process as central memory Th1 but not Th2 and Th17 cells are epigenetically primed to develop a cytotoxic program. The expression of perforin and other cytotoxic genes present a stepwise increase profile that is specific of the Th1 differentiation pathway. This profile has been recapitulated in an in vitro model of effector CD4 T cell differentiation in which naive CD4 T cells acquire cytotoxicity one to two weeks after polyclonal stimulation when cultured in presence of Th1 cytokines. The molecular regulation of CD4CTX T cells is poorly understood and most available data have been generated in mice. These data include the observation of intraepithelial CD4CTX T cells in the mouse gut after loss of ThPOK expression and subsequent up-regulation of a Runx3-dependent cytotoxic program. Other candidate regulators of CD4 T cell cytotoxic function include the TF regulating Th1 and CD8CTX T cells differentiation such as Runx3, T-bet and Eomesodermin (Eomes). We show that the transcriptional program of human CD4CTX T cells is enriched in CD8-lineage genes. However, by contrast to CD4CTX T cells from the mouse intestine, human circulating CD4CTX T cells maintain the expression of ThPOK and even up-regulate this TF upon differentiation from naive CD4 T cells. Surprisingly, this sustained expression of ThPOK was compatible with the establishment of a T-bet- and Runx3-dependent cytotoxic transcriptional program. The specific knockdown of T-bet or Runx3 but not Eomes resulted in impaired cytotoxic differentiation whereas ThPOK knockdown enhanced perforin expression and cytotoxicity. We propose that CD4CTX T cells constitute the terminal stage of Th1 memory differentiation and that ThPOK, Runx3 and T-bet co-regulate this process by instructing a cytotoxic transcriptional network largely shared with CD8CTX T cells. The modulation of this network is a potential target for novel immunotherapeutic strategies in viral infections and cancer. / Doctorat en Sciences médicales (Médecine) / info:eu-repo/semantics/nonPublished

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