The dynamics of T cell responses have been extensively studied during single virus infection of naïve mice. During a viral infection, viral antigen is presented in the context of MHC class I molecules on the surface of infected cells. Activated CD8 T cells that recognized viral antigens mediate clearance of virus through lysis of these infected cells. We hypothesize that the balance between the replicating speed of the virus and the efficiency at which the T cell response clears the virus is key in determining the disease outcome of the host. Lower T cell efficiency and delayed viral clearance can lead to extensive T cellmediated immunopathology and death in some circumstances. To examine how the efficiency of the immune response would impact immunopathology we studied several viral infection models where T cell responses were predicted to be less than optimal: 1. a model of co-infection with two viruses that contain a crossreactive epitope, 2. a viral infection model where a high dose infection is known to induce clonal exhaustion of the CD8 T cell response, 3. a neonatal virus infection model where the immune system is immature and 4. A model of beneficial heterologous immunity and T cell crossreactivity where mice are immunized as neonates when the T cell pool is still developing. Model 1. Simultaneous co-infections are common and can occur from mosquito bites, contaminated needle sticks, combination vaccines and the simultaneous administration of multiple vaccines. Using two distantly related arenaviruses, lymphocytic choriomeningitis virus (LCMV) and Pichinde virus (PICV), we questioned if immunological T cell memory and subsequent protection would be altered following a simultaneous co-infection, where two immune responses are generated within the same host at the same time. Coinfection with these two viruses, which require CD8 T cell responses to clear, resulted in decreased immune protection and enhanced immunopathology after challenge with either virus. After primary co-infection, each virus-specific immune response impacted the other as they competed within the same host and resulted in several significant differences in the CD8 T cell responses compared to mice infected with a single virus. Co-infected mice had a dramatic decrease in the overall size of the LCMV-specific CD8 T cell response and variability in which virus-specific response dominated, along with skewing in the immunodominance hierarchies from the normal responses found in single virus infected mice. The reduction in the number of LCMV-specific CD8 memory T cells, specifically cells with an effector memory-like phenotype, was associated with higher viral loads and increased liver pathology in co-infected mice upon LCMV challenge. The variability in the immunodominance hierarchies of co-infected mice resulted in an enhanced cross-reactive response in some mice that mediated enhanced immune-mediated fat pad pathology during PICV challenge. In both viral challenge models, an ineffective memory T cell response in co-infected mice facilitated increased viral replication, possibly leading to enhanced and prolonged accumulation of secondary effector T cells in the tissues, thereby leading to increased immune pathology. Thus, the magnitude and character of memory CD8 T cell responses in simultaneous co-infections differed substantially from those induced by single immunization. This has implications for the design of combination vaccines and scheduling of simultaneous immunizations. Model 2. The balance between protective immunity and immunopathology often determines the fate of the virus-infected host. Several human viruses have been shown to induce a wide range of severity of disease. Patients with hepatitis B virus (HBV), for example, show disease progression ranging from acute resolving infection to a persistent infection and fulminant hepatitis. Certain rapidly replicating viruses have the ability to clonally exhaust the T cell response, such as HBV and hepatitis C virus (HCV) in humans and the clone 13 strain of LCMV in mice. How rapidly virus is cleared is a function of initial viral load, viral replication rate, and efficiency of antigen-specific T cells. By infecting mice with three different inocula of LCMV clone 13, we questioned how the race between virus replication and T cell responses could result in different disease outcomes. A low dose of LCMV generated efficient CD8 T effector cells, which cleared the virus with minimal lung and liver pathology. A high dose of LCMV resulted in clonal exhaustion of T cell responses, viral persistence and little immunopathology. An intermediate dose only partially exhausted the CD8 T cell responses and was associated with significant mortality, and the surviving mice developed viral persistence and massive immunopathology, including necrosis of the lungs and liver. This was a T cell-mediated disease as T cell-deficient mice had no pathology and became persistently infected like mice infected with a high dose of LCMV clone 13. This suggests that for non-cytopathic viruses like LCMV, HCV and HBV, clonal exhaustion may be a protective mechanism preventing severe immunopathology and death. Model 3. Newborns are more susceptible to infections due to their lack of immunological memory and under-developed immune systems. Passive maternal immunity helps protect neonates until their immune systems have matured. We questioned if a noncytolytic virus that produces strong T cell responses in adult mice would also induce an equally effective response in neonatal mice. Neonates were infected with very low doses of LCMV Armstrong and surprisingly the majority succumbed to infection between days 7-11, which is the peak of the T cell response in adult mice infected with LCMV. Death was caused by T cell-dependent pathology and not viral load as 100% of T cell deficient neonates survived with minimal lung and liver pathology. This is similar to the adult model of medium dose LCMV clone 13, but T cell responses in neonates were not partially clonal exhausted. Furthermore, surviving neonates were not persistently infected, clearing virus by day 14 post infection. In adult mice direct intracranial infection leads to LCMV replication and CD8 T cell infiltration in the central nervous system (CNS), causing CD8 T cell-mediated death. However, this does not occur in adults during LCMV intraperitoneal (ip) infections. We questioned if unlike adults LCMV could be gaining access to the CNS in neonates following ip infection. Replicating LCMV was found in the brain of neonates after day 5 post infection along with virus-specific CD8 T cells producing IFNγ at day 9 post infection. Neonates lacking perforin had complete survival when followed until day 14 post infection, suggesting perforin-mediated T cell-dependent immunopathology within the CNS of neonates was causing death after LCMV infection. Passive immunity from LCMV-immune mothers also protected 100% of pups from death by helping control viral load early in infection. We believe that the maternal antibody compensates for the immature innate immune response of neonates and controls viral replication early so the neonatal T cell response induced less immunopathology. Neonates are commonly thought to have less functional immune systems, but these results show that neonates are capable of producing strong T cell responses that contribute to increased mortality. Model 4. Due to their enhanced susceptibility to infection neonatal and infant humans receive multiple vaccines. Several non-specific effects from immunizations have been observed, for example, measles or Bacillus Calmette- Guerin (BCG) vaccines have been linked to decreased death of children from infections other than measles virus or tuberculosis. These studies mirror the concepts of beneficial heterologous immunity, where previous immunization with an unrelated pathogen can result in faster viral clearance. LCMV-immune mice challenged with vaccinia virus (VV) have lower viral loads then naïve mice and survive lethal infections, but some mice do develop fat pad immunopathology in the form of panniculitis or acute fatty necrosis (AFN). We questioned how immunological T cell memory formed during the immature neonatal period would compare to memory generated in fully mature adults during a heterologous viral challenge. Mice immunized as neonates had comparable reduction in VV load and induction of AFN, indicating that heterologous immunity is established during viral infections early in life. Interestingly, the LCMV-specific memory populations that expanded in mice immunized as neonates differed from that of mice immunized as adults. In adult mice 50% of the mice have an expansion of LCMVNP205- specific CD8 T cells while the majority of neonates expanded the LCMVGP34- specific CD8 T cell pool. This alteration in dominant crossreactivities may be due to the limited T cell receptor repertoire of neonatal mice. In naïve neonatal mice we found altered Vβ repertoires within the whole CD8 T cell pool. Furthermore, there was altered Vβ usage within virus-specific responses compared to adult mice and a wide degree of variability between individual neonates, suggesting enhanced private specificity of the TCR repertoire. Beneficial heterologous immunity is maintained in neonates, but there was altered usage of crossreactive responses. As neonatal mice were found to be so sensitive to LCMV infection we questioned if neonates could control another arena virus that did not replicate as efficiently in mice, PICV. Unlike LCMV infection, neonatal mice survived infection with PICV even with adult-like doses. However, viral clearance was protracted in neonates compared to adults, but was cleared from fat pad and kidney by day 11 post infection. The peak of the CD8 T cell response was similarly delayed. PICV infected neonates showed dose-dependent PICV-specific CD8 T cell responses, which were similar to adult responses by frequency, but not total number. As with LCMV infection there were changes in immunodominance hierarchies in neonates. Examination of the immunodominance hierarchies of PICV-infected neonates showed that there were adult-like responses to the dominant NP38- specific response, but a loss of the NP122-specific response. Six weeks post neonatal infection mice were challenged with LCMV Armstrong and there was a strong skewing of the PICV immunodominance hierarchy to the crossreactive NP205-specific response. These data further support the hypothesis that heterologous immunity and crossreactivity develop following neonatal immunization, much as occurs in adults, although TCR repertoire and crossreactive patterns may differ. Changing the balance between T cell efficiency and viral load was found to altered the severity of the developing immunopathology after viral infection.

T cell development in the thymus produces multiple lineages of cells, including conventional naïve CD4+ and CD8+ T cells, regulatory T cells, and innate T cells. Innate T cells encompass γδ T cells, invariant natural killer (iNKT) cells, mucosal-associated invariant T (MAIT) cells, and H2-M3-restricted cells (Berg, 2007). Although they are a minor subset of all thymocytes, innate T cells develop in the thymus and share characteristics of the innate and adaptive immune systems (Berg, 2007). These lymphocytes undergo antigen receptor rearrangement and are able to exert their effector function immediately upon ex vivo stimulation (Berg, 2007). However, in several strains of mice harboring mutations in T cell signaling proteins or transcriptional regulators, conventional CD8+ T cells develop as innate cells that share characteristics with memory T cells (Atherly et al., 2006b; Broussard et al., 2006; Fukuyama et al., 2009; Gordon et al., 2011; Verykokakis et al., 2010b; Weinreich et al., 2010). One of these signaling proteins, inducible T cell kinase (Itk) is a nonreceptor protein tyrosine kinase that signals downstream of the T cell receptor (TCR) (Berg et al., 2005). Upon TCR activation, Itk is activated and recruited to the TCR signaling complex, where Itk interacts with Src homology 2 (SH2) domain-containing leukocyte phosphoprotein of 76 kDa (SLP-76), linker for activation of T cells (LAT), and phospholipase C γ1 (PLCγ1) (Berg et al., 2005). Thus, in Itk-deficient mice, TCR signaling is disrupted, which results in mature CD4- CD8+ (CD8SP) thymocytes that are CD44high, CD62Lhigh, CD122+, and CXCR3+ and that express high levels of the transcription factor, Eomesodermin (Eomes) (Atherly et al., 2006b; Broussard et al., 2006; Weinreich et al., 2010). Recently, it was determined that the development of these innate CD8SP thymocytes in itk-/- mice is dependent on IL-4 produced in the thymic environment by a poorly characterized subset of CD3+ thymocytes expressing the transcriptional regulator, promyelocytic leukemia zinc finger (PLZF) (Gordon et al., 2011; Verykokakis et al., 2010b; Weinreich et al., 2010). Here we show that a sizeable proportion of mature CD4+ CD8- (CD4SP) thymocytes in itk-/- mice also develop as Eomesodermin+ innate T cells. These Eomes+ innate CD4+ T cells are CD44high, CD62Lhigh, CD122+, and CXCR3+ (Atherly et al., 2006b; Broussard et al., 2006; Dubois et al., 2006; Weinreich et al., 2010). Surprisingly, neither CD4SP nor CD8SP innate thymocytes in itk-/- mice are dependent on γδ T cells for their development as was previously hypothesized (Alonzo and Sant'Angelo, 2011). Instead, both subsets of innate itk-/- T cells require the presence of a novel PLZF-expressing, SAP-dependent thymocyte population that is essential for the conversion of conventional CD4+ and CD8+ T cells into Eomesodermin-expressing innate T cells with a memory phenotype. This novel subset of PLZF-expressing SAP-dependent innate T cells preferentially home to the spleen and mesenteric lymph nodes and have a restricted TCR repertoire. Thus, we have christened this subset as CD4+ PLZF + MAIT-like cells. We have characterized multiple subsets of innate T cells that expand in the absence of Itk. Therefore, we were interested in how innate T cells respond to infection. Although Itk KO mice have defects in cytolytic function and cytokine production during an acute infection, these mice are able to clear viral infections (Atherly et al., 2006a; Bachmann et al., 1997). Hence, we hypothesized that Itk-deficient memory CD8+ T cells would be able to provide protection upon a challenge infection. Conversely, we found this not to be true although Itk-deficient memory CD8+ T cells were present in similar frequencies and cell numbers as WT memory CD8+ T cells at 42 days post-infection. Furthermore, Itk-deficient memory CD8+ T cells were able to produce IFNγ and exert cytolytic function upon stimulation. Although the function of Itk-deficient memory CD8+ T cells appeared to be intact, we found that these cells were unable to expand in response to a challenge infection. Remarkably, conventional memory CD8+ T cells lacking Itk were able to expand and form protective memory responses upon challenge. Thus, the inability of Eomes+ innate CD8+ T cells to form protective memory responses does not appear to be intrinsic to cells deficient in Itk. This thesis is divided into six major chapters. The first chapter will provide an introduction to T cell development and the role of Itk in T cell development. Additionally, it will introduce a variety of innate T cell subsets that will be discussed throughout this thesis and will provide an overview of CD4+ and CD8 + T cell differentiation during infection. This section will explain the role of Itk in CD4+ helper T cell differentiation and describe how Itk-deficient CD8+ T cells respond to acute infection. The introduction will also discuss the generation of conventional memory CD8+ T cells. The second chapter will provide the details of the experimental procedures used in this thesis. The third chapter will describe the characterization and development of Eomes+ innate CD4+ T cells that develop in the absence of Itk. Additionally, this chapter will address the subset of PLZF+ innate T cells that induce the expression of Eomes in innate T cells. The fourth chapter will further characterize and explore the development of itk-/- CD4+ PLZF+ MAIT-like T cells. The fifth chapter will examine the role of Eomes + innate CD8+ T cells in protective memory responses. Chapters three through five will display work that is in preparation to be submitted to a peer-reviewed journal. The sixth chapter will discuss the results of this thesis and their implications.

A pandemia Hiv/ Aids já resultou em mais de 34 milhões de pessoas infectadas pelo vírus no mundo até o momento. Causada pelo HIV, de caráter crônico que evolui para um quadro clínico de imunodeficiência (Aids), pode tornar o indivíduo susceptível a infecções oportunistas potencialmente letais. Diferentes fatores foram identificados por ativar o sistema imune, incluindo genótipos do hospedeiro (HLAB-27, HLA-B57, CCR5delta32), co-infecções (GBV-C) e alguns fatores virais como a capacidade de replicação (fitness) e tropismo celular. O HIV-1 possui diversidade genética extensa e dinâmica. Considerando a variabilidade genética dentro do cenário da epidemia no Brasil, as clades do HIV-1 predominantes são B, F e C, além de formas recombinantes. Contudo, ainda não foi completamente estabelecido se essa diversidade genética possa influenciar o curso clínico da doença. O objetivo deste trabalho foi avaliar o perfil de ativação celular induzido encontrado em indivíduos infectados por subtipos virais C e Não- C do HIV-1, durante o primeiro ano de infecção (analisando as fases recente e estabelecida). A análise comparativa dos dois grupos (subtipos C vs. Não-C), identificou no grupo do subtipo-C uma maior frequência de células T CD4+ totais ativadas, como também uma maior frequência e ativação nas subpopulações de células T CD4+ de memória, principalmente memória efetora e efetora terminal, na fase estabelecida. Em relação às células T CD8+, deparamos na fase estabelecida com uma maior frequência de células T CD8+ de memória efetora e ativação das mesmas no grupo do subtipo-C em relação ao grupo do subtipo Não-C. Investigamos também a presença de células T CD4+ que se diferenciaram em células T reguladoras, e foi encontrada uma frequência diminuída dessas células no grupo do subtipo C em relação ao Não- C tanto na fase recente como na fase estabelecida. Na análise comparativa das fases recente e estabelecida, o grupo do subtipo Não-C apresentou um declínio tanto na quantidade de células T CD4+ como na frequência de células T CD8+ ativadas após um ano de infecção. Com base nos resultados encontrados, os dois grupos apresentaram perfis de ativação e diferenciação celular diferentes no primeiro ano de infecção pelo HIV-1, o que aponta para diferentes histórias naturais quando comparamos infecção por clades virais distintas / The Hiv/ Aids pandemic has affected more than 34 million people worldwide, reaching men, women and children. Caused by the HIV virus, a chronic infection that develops into a clinical picture of immunodeficiency (Aids), it can make the individual susceptible to opportunistic infections and result in death. Different factors were identified by activating the immune system, including host genotypes (HLAB-27, HLA-B57, CCR5delta32), co-infections (GBV-C) and some viral factors such as fitness and cellular tropism. The HIV-1 presents an extensive and dynamic genetic diversity, favoring the production of variants with molecular differences. Considering the genetic variability within the scenario of the epidemic in Brazil, the predominant subtypes of HIV-1 are B, F and C. However, it has not yet been completely established if this genetic diversity can impact the clinical course of the disease. The objective of this study was to evaluate the induced cellular activation profile found in HIV-1 C and non-C viral subtypes groups in the first year of infection (analyzing the recent and established phases). The comparative analysis of the two groups (subtypes C vs. Non-C) identified a higher frequency of activated CD4+ T cells in the C-subtype group, as well as a higher frequency and activation in CD4+ T-cell subsets of memory, mainly effector memory and terminal effector on the established phase. About CD8+ T cells, we found in the established phase a higher frequency and activation in the effector memory subset in the C- subtype group compared to the non- C subtype group. We also investigated the presence of CD4+ T cells differentiated into regulators T cells, and a decreased frequency of these cells was found in the subtype C group over non- C in both the recent and established phases. In the recent and established phase comparative analysis evidenced that the non-C subtype group presented a decline in both the number of CD4+ T cells and the CD8+ T-cell activated frequency after 1 year of infection, however, it presented a positive correlation between the viral load and frequency of activated CD4+ and CD8+ T cells in both phases. Based on the results found, the two groups presented different activation and differentiation profiles in the first year of HIV-1 infection, which points to different natural histories when comparing infection with different viral clades

A pandemia Hiv/ Aids já resultou em mais de 34 milhões de pessoas infectadas pelo vírus no mundo até o momento. Causada pelo HIV, de caráter crônico que evolui para um quadro clínico de imunodeficiência (Aids), pode tornar o indivíduo susceptível a infecções oportunistas potencialmente letais. Diferentes fatores foram identificados por ativar o sistema imune, incluindo genótipos do hospedeiro (HLAB-27, HLA-B57, CCR5delta32), co-infecções (GBV-C) e alguns fatores virais como a capacidade de replicação (fitness) e tropismo celular. O HIV-1 possui diversidade genética extensa e dinâmica. Considerando a variabilidade genética dentro do cenário da epidemia no Brasil, as clades do HIV-1 predominantes são B, F e C, além de formas recombinantes. Contudo, ainda não foi completamente estabelecido se essa diversidade genética possa influenciar o curso clínico da doença. O objetivo deste trabalho foi avaliar o perfil de ativação celular induzido encontrado em indivíduos infectados por subtipos virais C e Não- C do HIV-1, durante o primeiro ano de infecção (analisando as fases recente e estabelecida). A análise comparativa dos dois grupos (subtipos C vs. Não-C), identificou no grupo do subtipo-C uma maior frequência de células T CD4+ totais ativadas, como também uma maior frequência e ativação nas subpopulações de células T CD4+ de memória, principalmente memória efetora e efetora terminal, na fase estabelecida. Em relação às células T CD8+, deparamos na fase estabelecida com uma maior frequência de células T CD8+ de memória efetora e ativação das mesmas no grupo do subtipo-C em relação ao grupo do subtipo Não-C. Investigamos também a presença de células T CD4+ que se diferenciaram em células T reguladoras, e foi encontrada uma frequência diminuída dessas células no grupo do subtipo C em relação ao Não- C tanto na fase recente como na fase estabelecida. Na análise comparativa das fases recente e estabelecida, o grupo do subtipo Não-C apresentou um declínio tanto na quantidade de células T CD4+ como na frequência de células T CD8+ ativadas após um ano de infecção. Com base nos resultados encontrados, os dois grupos apresentaram perfis de ativação e diferenciação celular diferentes no primeiro ano de infecção pelo HIV-1, o que aponta para diferentes histórias naturais quando comparamos infecção por clades virais distintas / The Hiv/ Aids pandemic has affected more than 34 million people worldwide, reaching men, women and children. Caused by the HIV virus, a chronic infection that develops into a clinical picture of immunodeficiency (Aids), it can make the individual susceptible to opportunistic infections and result in death. Different factors were identified by activating the immune system, including host genotypes (HLAB-27, HLA-B57, CCR5delta32), co-infections (GBV-C) and some viral factors such as fitness and cellular tropism. The HIV-1 presents an extensive and dynamic genetic diversity, favoring the production of variants with molecular differences. Considering the genetic variability within the scenario of the epidemic in Brazil, the predominant subtypes of HIV-1 are B, F and C. However, it has not yet been completely established if this genetic diversity can impact the clinical course of the disease. The objective of this study was to evaluate the induced cellular activation profile found in HIV-1 C and non-C viral subtypes groups in the first year of infection (analyzing the recent and established phases). The comparative analysis of the two groups (subtypes C vs. Non-C) identified a higher frequency of activated CD4+ T cells in the C-subtype group, as well as a higher frequency and activation in CD4+ T-cell subsets of memory, mainly effector memory and terminal effector on the established phase. About CD8+ T cells, we found in the established phase a higher frequency and activation in the effector memory subset in the C- subtype group compared to the non- C subtype group. We also investigated the presence of CD4+ T cells differentiated into regulators T cells, and a decreased frequency of these cells was found in the subtype C group over non- C in both the recent and established phases. In the recent and established phase comparative analysis evidenced that the non-C subtype group presented a decline in both the number of CD4+ T cells and the CD8+ T-cell activated frequency after 1 year of infection, however, it presented a positive correlation between the viral load and frequency of activated CD4+ and CD8+ T cells in both phases. Based on the results found, the two groups presented different activation and differentiation profiles in the first year of HIV-1 infection, which points to different natural histories when comparing infection with different viral clades

The present study has considered cellular and molecular requirements in T cell responses. The central role of T cell growth factors (TCGF) in T cell responses prompted us to study the regulatory events directing TCGF production in lectin stimulated cultures. It was found that normal spleen cells, activated with Concanavalin A for 24 h, develop suppressive cells that block de novo TCGF production by fresh spleen cells. The induction time for effector suppressor cells (nonadherent, Lyt-2-positive T cells) was found to be 18 h and to parallel the termination of TCGF production in situ. The suppressive mechanism is neither iji situ absorption of TCGF produced at control rates nor killing of TCGF producing cells. These results suggest that suppression of TCGF production is an active process which directly and reversibly blocks TCGF-producing cells. This study also indicated that ConA induced a very limited proliferation of Lyt-2- T helper cells (TH) in unselected T cell populations. The activation and growth requirements of Lyt-1+ TH cells were directly investigated and compared with those of Lyt-2+ cytotoxic T lymphocytes (CTL), as defined by the selective expression of Lyt differentiation antigens and functional activities. This analysis revealed a profound difference in activation and growth requirements between these T cell subsets. Thus, while Lyt-2+ CTL precursors can be induced to TCGF reactivity by soluble lectins, in the absence of specialized accessory cells,; Lyt-2" TH cell precursors show a strict accessory cell requirement both for activation and proliteration. Finally, the low level of TH cell effector function, detected in a primary responses to allo-MHC-antigens or lectins, appears to be due to the development of suppressive Lyt2+ T cells. The functional relevance of Lyt-2 antigens expressed on CTL membranes was further assessed in the last part of this study. Two distinct activation systems were used, namely MHC-antigens, provided as UV-irradiated stimulator cells or polyclonal induction by a 4 h pulse, with lectins. Both procedures were shown to selectively induce Lyt-2+ CTL precursors into TCGF reactivity without leading to mitosis, unless TCGF was added. In both cases it was found that monoclonal anti-Lyt-2 antibodies inhibited the two antigen- dependent phases of CTL responses namely, the initial induction step and target cytolysis. The analogy observed between antigen specific and lectin mediated indueton and target cytolysis, with regard to the susceptibility of inhibition by anti-Lyt-2 antibodies has lead to a general hypothesis on CTL activation. / <p>[4] s., s. 1-58: sammanfattning, s. 59-130, [12] s.: 6 uppsatser</p> / digitalisering@umu

Taquizoítos de T. gondii esterilizados por radiação ionizante é uma vacina interessante para induzir uma imunidade semelhante à infecção, mas sem a formação de cistos. Neste estudo avaliamos as populações celulares do sangue e do baço induzidas pela imunização, a resposta imune humoral, celular e a proteção após desafio com parasitas viáveis. Camundongos foram imunizados com taquizoítos de T. gondii irradiados por v.o. ou i.p.. Os animais foram desafiados com 10 cistos da cepa ME-49 ou VEG por via oral e apresentaram altos níveis de proteção com baixa carga parasitária. Camundongos imunizados por i.p. e v.o. apresentaram anticorpos específicos no soro e o aumento das populações de células B, plasmócitos, células TCD4+ e TCD8+ tanto no sangue como no baço. As células esplênicas de camundongos imunizados por i.p. mostraram a produção de IL-10, IFN-&#947; e IL-4. Células TCD4+ e células B do baço de camundongos imunizados por i.p. proliferaram após a estimulação com antígeno. A imunização com esse modelo vacinal induziu uma resposta imune mediada com células B, TCD4+ e TCD8+, com aumento da resposta imune humoral e celular que são necessárias para proteção do hospedeiro após uma infecção. Essa resposta imune induzida é uma resposta semelhante a uma infecção natural, sendo assim o desenvolvimento de vacinas utilizando a radiação ionizante como uma ferramenta, pode ser um modelo atrativo e eficiente para testar novos imunógenos no futuro. / Tachyzoites of T. gondii sterilized by ionizing radiation is an interesting vaccine for inducing immunity to infection similarly but without the formation of cysts. In this study we evaluated the cell populations from blood and spleen induced by immunization, the humoral immune response, cellular and protection after challenge with viable parasites. Mice were immunized with irradiated tachyzoites of T. gondii by v.o. or i.p.. The animals were challenged with 10 cysts of the ME-49 or VEG strain orally and showed high levels of protection with low worm burden. Immunized mice by i.p. and v.o. present specific antibodies in the serum and increased populations of B cells, plasma cells, CD4+ and CD8+ T cells in blood and spleen. The spleen cells of immunized mice by i.p. showed the production of IL-10, IFN-&#947; and IL-4. CD4+ T cells and B cells in the spleen of immunized mice i.p. proliferated upon stimulation with antigen. The immunization with this vaccine model induced an immune response mediated by B cells, CD4+ and CD8+ with increased humoral and cellular immune response are necessary for host protection after infection. This induced immune response is a response similar to natural infection, therefore the development of vaccines using ionizing radiation as a tool, can be an attractive and efficient model for testing new immunogens in the future.

O transplante renal é atualmente o tratamento de escolha para pacientes com doença renal crônica em estágio 5, devido aos seus melhores resultados na morbimortalidade e melhor qualidade de vida dos pacientes, quando comparado com o tratamento dialítico. No entanto, apesar desses resultados positivos, a sobrevida dos enxertos renais em longo prazo não se modificou. As principais causas de falências tardias do transplante renal são as alterações crônicas do enxerto, caracterizadas por componentes de rejeição crônica e efeitos nefrotóxicos relacionados aos inibidores da calcineurina. O desenvolvimento de estratégias visando modular o sistema imunológico, interferindo no balanço entre mecanismos efetores e reguladores, capazes de induzir a aceitação do órgão (tolerância) seria a melhor alternativa para este cenário. No entanto, os mecanismos imunológicos envolvidos no processo da imunorregulação são pouco compreendidos, o que dificulta a identificação de casos tolerantes e a definição de estratégias para a sua modulação. Dentre as possíveis moléculas envolvidas no processo de imunomodulação, destacam-se a Forkhead Box P3 (FOXp3), marcador de células reguladoras e a enzima indoleamina 2,3 dioxigenase (IDO), reconhecida recentemente como tendo função central na tolerância materno-fetal. No presente estudo, foram utilizadas técnicas de imunohistoquímica para identificar linfócitos T efetores (CD3+), FOXp3 e IDO em biópsias de aloenxerto renal e correlacionar sua expressão com a evolução clínica do enxerto 12 meses após a biópsia. A relação entre células reguladoras e efetoras foi avaliada pelas relações FOXp3/CD3 e IDO/CD3. Devido à limitação do reconhecimento e do diagnóstico de casos de tolerância, só foi possível analisar a expressão destes marcadores em 1 único caso de paciente tolerante. Por outro lado, o estudo do perfil da expressão destes marcadores em outras situações clínicas deve contribuir para a melhor compreensão dos mecanismos envolvidos. Neste contexto, no presente estudo foram analisadas 63 biópsias de enxerto renal em diferentes situações clínicas: enxerto Sem Rejeição (SemRA; n=13), Rejeição Aguda (RA; n=21) e lesões crônicas (LC; n=29) além de 1 caso de paciente com diagnóstico clínico de tolerância operacional (Tolerante; n=1). Este paciente evoluiu com disfunção do enxerto, reiniciou terapia dialítica com a descontinuação do tratamento imunossupressor e após 2 anos em programa de hemodiálise, recuperou a função do enxerto, sendo, então, submetido a biópsia do enxerto renal. As biópsias incluídas foram subdivididas de acordo com a Classificação de Banff-09. As rejeições agudas mediadas por linfócitos T foram classificadas em RA-Banff I (n=15) e RA-Banff II (n=6). Os casos com Lesões Crônicas também foram subdivididos de acordo com a Classificação de Banff-09 em Fibrose intersticial/Atrofia tubular (FIAT; n=15) e Rejeição Crônica Ativa (RCA; n=14). RESULTADOS: analisado isoladamente, o caso Tolerante apresentou um número expressivo de células CD3+ (814 cel/mm2) e FOXp3+ (100,9 cel/mm2), assim como elevada relação FOXp3/CD3 (12,4x102).No entanto, apresentou uma baixa expressão de IDO (0,41% área marcada).Nos casos do grupo RA o número de células CD3+. foi significativamente maior que em LC e SemRA (973±127 cel/mm2; 242±43 cel/mm2 e 0,7 ± 0,4 cel/mm2, respectivamente; p<0,001 vs LC e p<0,0001 vs SemRA). Células CD3+ foram detectadas em todos os compartimentos estudados: interstício, túbulos, vasos, e glomérulos no grupo RA e no grupo LC. Comparando os grupos, houve predomínio de células CD3+ no interstício (p<0,0001) do grupo RA. Na subanálise segundo a Classificação de Banff-09, não houve diferença entres os subgrupos de RA na análise de células CD3+ por compartimentos. Por outro lado, na análise do grupo LC, no subgrupo RCA foram detectadas significativamente mais células CD3+ que em FIAT no interstício (322±66 cel/mm2 vs 145±32 cel/mm2; p<0,05) e nos túbulos (30,7±10 cel/mm2 vs 6±2 cel/mm2; p<0,05). O número de células FOXp3+ foi significativamente maior nos casos do grupo RA (43±10 cel/mm2) comparado com LC e SemRA (20±4 cel/mm2 e 0,1±0,1 cel/mm2, respectivamente; p<0,05 vs LC e p<0,0001 vs SemRA). Na distribuição por compartimentos, tanto em RA quanto em LC houve a predominância de células FOXp3+ no interstício, porém não houve diferença estatística entre os 2 grupos. Na análise de células FOXp3+ por compartimentos do grupo LC segundo a Classificação de Banff-09, não houve diferença entres os subgrupos. A relação FOXp3/CD3 foi significativamente maior no grupo LC que no RA (17±5 vs 5±1; p<0,05). Na análise do grupo LC, a relação FOXp3/CD3 foi significativamente maior em FIAT que em RCA (25±8 vs 8±2; p<0,05). A análise da expressão de IDO não revelou diferença na comparação dos grupos SemRA, RA e LC. Não houve diferença também na expressão de IDO, tanto entre os grupos Banff I e Banff II, quanto entre os grupos FIAT e RCA. A relação IDO/CD3, foi significativamente maior no grupo LC do que no grupo RA (18±6 vs 3±1; p<0,05). Apesar da presença de células FOXp3+ ter sido maior nos casos com diagnóstico de rejeição aguda como descrito na literatura, não houve correlação da sua expressão com uma maior função do enxerto na análise de 12 meses após a biópsia, nem com a sobrevida do enxerto em 12 meses. Nos casos com diagnóstico de lesões crônicas, a maior relação FOXp3/CD3 se correlacionou negativamente com a função do enxerto 12 meses após a biópsia. A expressão de IDO também não se correlacionou com uma melhor função, nem com a sobrevida do enxerto na análise em 12 meses após a biópsia. A análise dos resultados apresentados sugere o envolvimento dos marcadores estudados na resposta inflamatória ocasionada pelo aloreconhecimento, uma vez que estão presentes em cenários imunológicos distintos, aparentemente, mediando o dano tecidual no microambiente do aloenxerto. No entanto, não há dados o suficiente para apontar para um papel das células FOXp3+ e da IDO no desenvolvimento de tolerância ao aloenxerto no presente estudo. Concluindo, ainda não está claro o quanto a presença de Tregs e IDO limitam os processos de rejeição/cronificação ou participam desses processos, sendo sua presença ainda controversa / Currently, kidney transplantation is choice therapy for patients with chronic kidney disease in stage 5, due to their good results in morbidity and improved quality of life compared with dialysis treatment. However, despite these positive results, renal grafts survival in the long term has not changed. The major cause of failures in long-term in kidney transplant are chronic graft changes, characterized by chronic rejection and components related to the nephrotoxic effects of calcineurin inhibitors. The development of strategies to modulate the immune system interfering with the balance between regulatory and effector mechanisms, capable of inducing organ acceptance (tolerance), would be the excellent alternative in this scenario. However, the immunological mechanisms involved in the immunoregulation are poorly understood, hindering to identify cases tolerant as well as developing strategies for their modulation. Within the possible molecules involved in immunomodulation, stand out the Forkhead Box P3 (FOXp3), a marker of regulatory cells, and the enzyme indoleamine 2,3 dioxygenase (IDO), recently recognized by their role in maternal-fetal tolerance. In this present study, we used immunohistochemical techniques to identify T lymphocytes (CD3+), FOXp3 and IDO in renal allograft biopsies and to correlate its expression with graft function 12 months after the biopsy procedure. The relationship between regulatory and effector cells was analysed by FOXp3/CD3 and IDO/CD3 ratios. Due to limited recognition and diagnosis of tolerance cases, only was possible to analyze the expression of these markers in one single case of tolerant patient. On the other hand, the study of the expression of these markers in other clinical situations, should contribute to a better understanding of the mechanisms involved. In this context, the present study analyzed 63 renal allograft biopsies in different clinical situations: no graft rejection (NR, n = 13), acute rejection (AR, n = 21) and chronic injury (CI, n = 29). In addition, one patient with clinical operational tolerance diagnosis (tolerant, n = 1) was analyzed. This patient developed graft dysfunction, restarted dialysis discontinuation of immunosuppressive treatment. After 2 years on dialysis therapy, recovered graft function and then was submitted to renal allograft biopsy. The biopsies included in this study were subdivided according to the Banff-09 classification. The acute rejection mediated by T lymphocytes was classified in Banff I (n = 15) and Banff II (n = 6). Cases that showed chronic injury were also subdivided according to the Banff-09 classification in Interstitial Fibrosis/Tubular Atrophy (IFTA, n = 15) and Chronic Rejection (CR, n = 14). Results: Analyzed separately, the tolerant case showed an expressive number of CD3+ cells (814 cells/mm2) and FOXp3+ cells (100.9 cells/mm2). Also, expressive FOXp3/CD3+ ratio (12,4x102) and low IDO expression (0.41% area).In AR group the number of CD3+ cells was significantly higher compared with CI and NR groups (973 ± 127 cells/mm2; 242 ± 43 cells/mm2 and 0.7 ± 0.4, cells/mm2, respectively; p<0.001 vs CI and p <0.0001 vs NR). In AR and CI groups CD3+ cells were detected in all compartments studied: interstitium, tubules, vessels and glomeruli. Comparing the groups, there was a predominance of CD3+ cells in the interstitium (p<0.0001) of AR group. No difference was observed between Banff I and Banff II subgroups analysis of CD3+ in the compartments. On the other hand, in the CR subgroup analysis was detected in significantly higher of CD3+ cells in the interstitium compared with IFTA (322 ± 66 cells/mm2 vs. 145 ± 32 cells/mm2, p<0.05) and in tubules (30,7±10 cells/mm2 vs. 6±2 cells/mm2, respectively; p<0.05). The number of FOXp3+ cells was significantly higher in the AR group (43±10 cells/mm2) compared with CI and NR (20±4 cells/mm2 and 0.1±0.1 cells/mm2, respectively; p<0,05 vs CI and p<0,0001 vs NR). The distribution of compartments, both AR and in CI predominated FOXp3+ cells in the interstitium, but there was no statistical difference between the 2 groups. In the FOXp3+ cells analysis, CI do not showed difference between subgroups in the compartments. The relationship FOXp3/CD3 was significantly higher in AR group compared in the CI group (17 ± 5 vs. 5 ± 1; p<0.05). In the CI group analysis, FOXp3/CD3 ratio was significantly higher in IFTA compared with CR (25±8 vs 8±2; p<0.05). IDO expression analysis shows no difference when compared NR, AR and CI groups. No difference in IDO expression analysis in Banff I compared with Banff II, and IFTA compared with CR was observed. The relationship of IDO/CD3, was significantly higher in the CI group when compared with AR group (18±6 vs 3±1, p<0.05). Despite the presence of FOXp3+ cells was higher in cases with a diagnosis of acute rejection as described in the literature, there was no correlation of its expression with improved graft function in the 12 months analysis after the biopsy procedure, as well as with graft survival in 12 months. In cases with a diagnosis of chronic injuries, FOXp3/CD3 ratio was negatively correlated with graft function 12 months after the biopsy procedure. The analysis of these results led us to speculate about the involvement of these markers in the inflammatory response, mediating the tissue damage in the microenvironment of the graft, once it is immunological distinct scenarios, however, in this study, there is no enough data to point to a role in development of tolerance. In conclusion, it is unclear how the presence of Tregs and IDO limit the allograft rejection/chronicity or participate in this process, and their presence is still controversial

Em diversos tipos de neoplasias já foi demonstrado que diferenças no perfil do infiltrado imune tumoral têm relação com prognóstico e resposta ao tratamento. Esta relação aparece intimamente correlacionada ao perfil de expressão imunoistoquímica do tumor. A presença de linfócitos T citotóxicos(CTLs) no microambiente do tumor sugere uma característica biológica crucial para a modulação da resposta imunológica antitumoral. Por outro lado, as células T regulatórias (Tregs) são importantes na manutenção da homeostase imune, em virtude da sua capacidade em inibir a resposta imunológica. Defeitos na função ou uma diminuição do número das Tregs tem sido documentado em doenças auto-imunes, ao passo que no câncer esta população ainda pode ser mais bem estudada. Sendo estabelecido que o câncer pode ser promovido e / ou agravado pela inflamação e infecções e considerando que a superexpressão de componentes do controle da resposta inflamatória específicos de Tregs e CTLs podem representar um potente mecanismo para o processo de progressão e/ou regressão de carcinoma papilífero de tireoide (CPT), o objetivo deste estudo foi identificar e caracterizar as Tregs e CTLs , bem como avaliar e investigar a relação e o papel dessas células implicado na patogênese da resposta imune em pacientes acometidos com CPT associado ou não com a presença de Tireoidite de Hashimoto (TH), relacionando-as com fatores prognósticos clínico-patológicos. Foram selecionados 36 casos estratificados em 3 grupos (12 casos em cada grupo): CPTS correspondeu aos casos de CPT sem associação com quadro de tireoidite, CPTL aos casos de CPT associados á tireoidite linfocitica (CPTL) e CPTH, casos aonde o CPT estava associado á tireoidite de Hashimoto (CPTH) os quais foram submetidos á técnica de imunoistoquímica para os marcadores CD4, CD8, CD25, CD56, FOXP3 e Gran B e os resultados avaliados pelo método quantitativo. Os dados clínicos foram obtidos dos prontuários médicos. As leituras das células marcadas foram feitas nas regiões de carcinoma papilífero (denominadas intratumorais), nas áreas de parênquima tireoidiano de interface ao tecido neoplásico (denominadas peritumorais) e em áreas subsequentes de tecido tireoidiano normal (denominadas distantes). O número de células T do infiltrado 9 inflamatório foi expresso pela média aritmética da contagem das células dos cinco campos distintos em cada área. Foram feitas análise de variância de Medidas Repetidas Modelo Mixto e calculado o coeficiente de correlação de Pearson para as variáveis CD4 com CD8 e FOXP3 com GranB. Adicionalmente, apesar da avaliação dos CPT divididos segundo seus parâmetros clínico-patológicos não ter se apresentado significante, verificamos que em CPTH as imunovariáveis CD4 e FOXP3 (marcadores para Tregs) apresentaram maior marcação em tumores > 4,1 cm. Nesse mesmo grupo CD8 e Gran B (marcadores para CTLs) se apresentaram com maior imunomarcação em tumores não metastáticos, de estádio menor e sem recorrência. No geral, o infiltrado de células imunes entre os grupos CPTH, CPTL e CPTS, apresentou-se com diferentes densidades entre as áreas estudadas (intratumoral, peritumoral e distante). Linfócitos infiltrando o tecido de forma difusa (CPTS e CPTL) ou em agregados linfoides (CPTH) foram mais abundantes em áreas peritumorais e distantes e a proporção das células CD4+ e CD8+ variou substancialmente entre os grupos, de maneira que todos apresentaram correlação positiva (CPTH r=0,67; CPTL r=0,7 e CPTS r=0,35) crescente entre as variáveis. Em conclusão, estes resultados indicam que nos CPTs o microambiente imune parece ter uma relação com carcterísticas patológicas de progressão do tumor. Nosso estudo mostrou que em CPTH a densidade do infiltrado tumoral e peritumoral por linfócitos Tregs e T citotóxicos está inversamente relacionada. Corroborando com a importância do microambiente imune na evolução dos CPTs, os Tregs exerceram atividade pró-tumoral, favorecendo tumores mais agressivos e os CTLs, atividade antitumoral, favorecendo características de menor agressividade. / It has already been shown that differences in tumoral immune infiltrate profile are related to prognosis and response to treatment in several types of neoplasias. This relationship is closely correlated to the tumor immunohistochemical expression profile. The presence of cytotoxic T lymphocytes (CTLs) in the tumor microenvironment suggests a crucial biological feature for the modulation of the antitumor immune response. On the other hand, regulatory T cells (Tregs) are important in maintaining immune homeostasis, because of their ability to inhibit the immune response. Defects in function or a decrease in the number of Tregs has been documented in autoimmune diseases, nevertheless in cancer this population may still be better studied. With the establishment that cancer can be promoted and / or aggravated by inflammation and infections and considering that overexpression of components of the inflammatory response specific for Tregs and CTLs may represent a potent mechanism for the progression and / or regression of thyroid papilary carcinoma (CPT). The objective of this study was to identify and characterize the Tregs and CTLs, as well as to evaluate and investigate the relationship and the role of these cells involved in the pathogenesis of the immune response in patients with CPT associated or not with the presence of Hashimoto\'s thyroiditis (HT) besides relating them to clinical-pathological prognostic factors. Thirty-six stratified cases were selected in 3 groups (12 cases per group): CPTS corresponded to TLC without thyroiditis association, CPTL to cases of TLC with lymphocytic thyroiditis associated (CPTL) and CPTH was considered cases which CPT was associated to Hashimoto thyroiditis (CPTH). These three groups were submitted to the immunohistochemical technique for the CD4, CD8, CD25, CD56, FOXP3 and Gran B markers and the results was evaluated by the quantitative method. Clinical data were obtained from medical records. Stained cells readings were made in the regions of papillary carcinoma (termed intratumoral area), in the areas of the thyroid parenchyma interface to the neoplastic tissue (termed peritumoral) and in subsequent areas of normal (distal) thyroid tissue. The number of T cells of the inflammatory infiltrate was expressed by the arithmetic mean of cells counted in five distinct fields. The variance analysis of Mixed Model Repeated 11 Measurements and the Pearson correlation coefficient for the CD4 and CD8 and FOXP3 variables with GranB were calculated. In addition, although the CPT divided according to clinical-pathological parameters did not present a significant difference, we found that the CD4 and FOXP3 immunoglobulins (Tregs markers) showed higher marking in tumors> 4.1cm. In this same group, CD8 and Gran B (markers for CTLs) presented a higher immunolabeling in nonmetastatic tumors, in smaller stage and in cases without recurrence. In general, the infiltrate of immune cells between the CPTH, CPTL and CPTS groups, presented different densities between the studied areas (intratumoral, peritumoral and distant). Lymphocytes infiltrating diffuse tissue (CPTS and CPTL) or lymphoid aggregates (CPTH) were more abundant in peritumoral and distal areas and the proportion of CD4 + and CD8 + cells varied substantially between groups, so that all groups presented positive correlation (CPTH r = 0.67, CPTL r = 0.7 and CPTS r = 0.35), increasing among the variables. In conclusion, these results indicate that in the CPTs the immune microenvironment seems to have a relation with pathological characteristics of tumor progression. Our study showed that in CPTH the density of tumor and peritumoral infiltrate by Tregs and T cells is inversely related. Corroborating with the importance of the immune microenvironment in the evolution of CPTs, Tregs exerted pro-tumor activity, favoring more aggressive tumors. While CTLs exerted an antitumor activity, favoring characteristics of lower aggressiveness.

A Imunodeficiência Comum Variável (ICV) é a imunodeficiência primária sintomática mais comum em adultos. Pacientes ICV frequentemente apresentam diversas alterações de linfócitos B, número reduzido de células Treg e ativação imune crônica, bem como infecções recorrentes, alta incidência de doenças autoimunes e um risco aumentado de doenças malignas. Testamos a hipótese de que a frequência de células B10 estaria diminuída nos pacientes ICV, já que elas desempenham um importante papel no desenvolvimento de células Treg, no controle da ativação de células T e na autoimunidade. Para tanto, nós avaliamos a frequência de células B10 em pacientes ICV buscando correlacioná-la com as diferentes manifestações clínicas e imunológicas associadas à doença. Quarenta e dois (42) pacientes com diagnóstico de ICV e 17 indivíduos saudáveis foram convidados a participar do estudo. A partir das CMSP criopreservadas foram realizados testes de perfil de ativação celular, presença de células T reguladoras (Treg) e caracterização das células B10. Os níveis de sCD14 no plasma foram determinados por ELISA. A produção de IL-10 foi determinada por ELISA em sobrenadante de cultura de células B. Pacientes ICV apresentam frequência diminuída de células B CD24hiCD38hi produtoras de IL-10 em diferentes condições de cultura celular e frequência diminuída de células B CD24hiCD27+ em cultura celular estimulada por CpG+PIB. No entanto, a produção de IL-10 por células B não demonstrou diferença significativa entre pacientes ICV e controles. A frequência de células B10 não teve correlação com a presença de autoimunidade, ativação celular ou frequência de células Treg em pacientes ICV. Este trabalho sugere que pacientes ICV têm um comprometimento na subpopulação de células B reguladoras, mas que não está correlacionado com as características clínicas e imunológicas apresentadas por esses indivíduos / Common variable immunodeficiency (CVID) is the most prevalent symptomatic primary immunodeficiency in adults. CVID patients often present changes in the frequency and function of B lymphocytes, reduced number of Treg cells, chronic immune activation, recurrent infections, high incidence of autoimmunity and increased risk for malignancies. We hypothesized that the frequency of B10 cells would be diminished in CVID patients because these cells play an important role in the development of Treg cells and in the control of T cell activation and autoimmunity. Therefore, we evaluated the frequency of B10 cells in CVID patients and correlated it with the different clinical and immunological characteristics of this disease. Forty-two CVID patients and 17 healthy controls were recruited for this study. Cryopreserved PBMCs were used for analysis of T cell activation, frequency of Treg cells and characterization of B10 cells by flow cytometry. Plasma sCD14 levels were determined by ELISA. IL-10 production was determined in supernatant by ELISA after culture of B cells. We found that CVID patients presented a decreased frequency of IL-10-producing CD24hiCD38hi B cells in different cell culture conditions and decreased frequency of IL-10-producing CD24hiCD27+ B cells stimulated with CpG+PIB. However, the B cells secretion of IL-10 was similar between CVID patients and healthy controls. The frequency of B10 cells had no correlation with autoimmunity, immune activation and Treg cells in CVID patients. This work suggests that CVID patients have a compromised regulatory B cell compartment which is not correlated with clinical and immunological characteristics presented by these individuals

INTRODUÇÃO: Líquen plano (LP) é uma doença mucocutânea de natureza inflamatória crônica de etiologia ainda desconhecida. A estimulação da imunidade inata via os receptores Toll-like (TLRs) podem influenciar as células dendríticas e direcionar a resposta de células T CD4+ e CD8+ efetoras, assim como também favorecer o estado inflamatório do LP. OBJETIVOS: Avaliar o perfil fenotípico de células dendríticas mielóides (mDCs) e plasmocitóides (pDCs) e de linfócitos T CD4+ e CD8+ após estímulo com agonistas de TLRs no sangue periférico de pacientes com LP. Além disto, avaliar a frequência, perfil de maturação e os subtipos de células T CD4+ e TCD8+ reguladores. MÉTODOS: Foram selecionados 18 pacientes com LP (15 mulheres, 3 homens), com 41,57 ± 4,73 anos de idade e um grupo controle com 22 indivíduos sadios (18 mulheres, 4 homens), com 43,92 ± 7,83 anos de idade. As células mononucleares (CMNs) de sangue periférico foram avaliadas por citometria de fluxo quanto à: 1) Produção de TNF-? em mDCs e de IFN-? em pDCs em CMNs ativadas por agonistas de TLR 4, 7, 7/8 e 9; 2) Análise de células T CD4+ e CD8+ monofuncionais e polifuncionais após estímulo com agonistas de TLR 4, 7/8, 9 e enterotoxina B de Staphylococcus aureus (SEB); 3) Avaliação de células Th17 e Th22/Tc22 em CMNs após estímulo com SEB; 4) Frequência, perfil de maturação e subtipos de células T CD4+ e CD8+ reguladoras. RESULTADOS: 1) Nos pacientes com LP foi demonstrado um aumento na frequência de mDCs TNF-alfa+ após estímulo com agonistas de TLR4/LPS e TLR7-8/CL097, mas com imiquimode/TLR7 houve diminuição da expressão de CD83. Já nas pDCs do grupo LP, o imiquimode foi capaz de diminuir a expressão de CD80 e o CpG/TLR9 diminuiu a expressão de CD83 no LP. 2) As células T CD4+ secretoras de IL-10 mostraram aumento da frequência nos níveis basais, que diminuiu após estímulo com LPS e SEB. Em contraste, a produção de IFN-y aumentou em resposta ao LPS enquanto diminuiu para CpG. As células T CD4+ polifuncionais, secretoras de 5 citocinas simultâneas (CD4+IL-17+IL-22+TNF+IL-10+IFN-y+) diminuíram no LP após estímulo com CL097 e CpG. Entretanto, na ausência de IL-10, houve aumento da frequência de células CD4+IL-17+IL-22+TNF+IFN-y+ em resposta ao LPS. Um aumento na polifuncionalidade foi observado em células TCD4+ que expressam CD38, marcador de ativação crônica e na ausência de IL-10. Similarmente, às TCD4+, uma diminuição de células T CD8+ IFN-y+ e TNF+ foram detectadas após estímulo com CpG. 3) As células Th22/Tc22 nos níveis basais e após estímulo com SEB se mostraram aumentadas. As células Th17 não mostraram diferenças entre os grupos. 4) A frequência das células T CD4+ e CD8+ reg totais (CD25+Foxp3+CD127low/-) está elevada no LP. Quanto aos perfis de maturação, há aumento na frequência de células TCD4+ de memória efetora enquanto que para as células T CD8+ há predomínio das células de memória central. Quanto aos subtipos, há aumento nas células T CD4+ regs periféricas (pT reg). CONCLUSÕES: O estado de ativação das mDCs após ativação das vias de TLRs 4 e 7/8 pode influenciar na geração de resposta T efetoras no LP. O perfil de resposta monofuncional e polifuncional aos estímulos TLRs reflete a ativação destas células no sangue periférico. Além disso, o aumento de Th22/Tc22 e das células T regs indicam uma relação entre regulação e células efetoras no sangue periférico evidenciando que existem alterações extracutâneas no LP / BACKGROUND: Lichen planus (LP) is a mucocutaneous disease of chronic inflammatory course of unknown etiology. Stimulation of the innate immune system via Toll-like receptors (TLRs) may influence the dendritic cells and targeting the CD4+ and effector CD8+ T cell responses, as well as promoting inflammatory status of the LP. OBJECTIVES: To evaluate the phenotypic profile of myeloid dendritic cells (mDCs), plasmacytoid (pDCs) and CD4+ and CD8+ T lymphocytes after stimulation with TLR agonists in peripheral blood of patients with LP. Moreover, to evaluate the frequency, maturation profile and subtypes of CD4+ and CD8+ T regulators cells. METHODS: We selected 18 patients with LP (15 women, 3 men) with 41.57 ± 4.73 years old and a control group of 22 healthy subjects (18 women, 4 men), with 43.92 ± 7, 83 years old. Mononuclear cells from peripheral blood (PBMCs) were assessed by flow cytometry for: 1) mDC TNF-alfa production and pDCs IFN-alfa production in PBMCs activated by agonists of TLR 4, 7, 7/8 and 9; 2) Analysis of monofunctional and polyfunctional CD4+ and CD8+ T cells after stimulation with TLR 4 agonists, 7/8, 9 and Staphylococcus aureus enterotoxin B (SEB); 3) Evaluation of Th17 and Th22/ Tc22 cells in PBMCs after stimulation with SEB; 4) Frequency, maturation profile and subtypes of regulatory CD4+ and CD8+ T cells. RESULTS: 1) Patients with LP showed an increased frequency of TNF-alfa+ mDCs after stimulation with agonists of TLR4/LPS and TLR7-8 /CL097, whereas with imiquimod /TLR7 induced a decreased CD83 expression. Already in the pDCs of LP group the imiquimod was able to decrease the CD80 expression and CpG/TLR9 decreased CD83 expression. 2) CD4+ T cells secreting IL-10 demonstrated an increased frequency at the baseline levels, which decreased after stimulation with LPS and SEB. In contrast, the production of IFN-y increased in response to LPS while decreased to CpG. Polyfunctional CD4+ T cells secreting simultaneously 5 cytokines (CD4+IL-17+IL-22+TNF+IL-10+IFN-y+) decreased in the LP after stimulation with CpG and CL097. However, in the absence of IL-10, occurred an increased frequency of CD4+IL-17+IL-22+IFN-y+TNF+ in response to LPS. An increase in the polyfunctional response was seems in CD4+ T cells expressing CD38, a chronic activation marker, in the absence of IL-10. Similarly to the CD4+ T cells, a decreased CD8+ T cells secreting IFN-? and TNF was observed in LP, after stimulation with CpG. Polyfunctional CD8+ T cells from LP group showed decreased response with 3 and 4 cytokines at baseline condition, and upon SEB and CL097 stimulations, occurred an increased frequency of these cells. In LP group, T cells CD8+CD38+ polyfunctional showed low capacity, such as CD4+CD38+ cells. 3) The Th22/Tc22 cells already at baseline and after stimulation with SEB showed increased frequency. The Th17 cells showed no differences between groups. 4) The frequency of CD4+ and CD8+ total reg (CD25+Foxp3+CD127low/-) is increased in LP. The profiles of maturity, an increase in the frequency of CD4+ effector cells whereas for memory CD8+ T cells there is a predominance of central memory cells. As for the subtypes, there is an increase in CD4+ peripheral T regs cells (pT reg). CONCLUSIONS: The activation state of mDCs after activation of the pathways of TLRs 4 and 7/8 can influence the response and generation of effector T cells in the LP. The monofunctional and polyfunctional response profile for TLRs stimuli reflects the activation of these cells in peripheral blood. Furthermore, the increase of Th22/Tc22 and T regs cells indicate a relationship between regulatory and effector cells in peripheral blood showing that there are extra-cutaneous alterations in the LP