Thesis (M.S.)--University of Toledo, 2009. / Typescript. "Submitted as partial fulfillment of the requirements for The Master of Science in Biology." "A thesis entitled"--at head of title. Bibliography: leaves 88-97.

published_or_final_version / Paediatrics and Adolescent Medicine / Doctoral / Doctor of Philosophy

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Thesis (M.Med.(Haematology)), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Introduction Regulatory T cells (Tregs) are increasingly being recognized as key immunological players in immunosuppression and have been seen to be permissive for certain infections. Aim This study aimed to elucidate the role that Tregs play in symptomatic infection with Mycobacterium tuberculosis (TB), both with and without co-infection with human immunodeficiency virus type 1 (HIV 1) by quantification of these cells at ex vivo. It was then attempted to characterise the behaviour of FoxP3 positive cells in culture with stimulation. Methods Peripheral blood mononuclear cells were purified from uninfected controls, patients with active TB, patients with HIV infection and patients with HIV infection and active TB. The frequencies of Tregs were assessed by flow cytometry at ex vivo and again after four days of culture with stimulation with anti-CD3, Purified protein derivative, tetanus toxoid and HIV peptide superpools (gag and nef). These frequencies were compared between the four groups of patients. The ability of Tregs and effector T cells to proliferate was also assessed. Interferon-γ secretion was used as a measure of effector T cell response to stimulation. vi Results Frequencies of Tregs were significantly reduced in patients with active TB as compared with HIV infected patients and uninfected controls. Co-infected individuals showed a broad range of frequencies which were not significantly different from controls. These frequencies remained stable in culture with the exception of those individuals infected with HIV who showed a decline in the frequency of those cells expressing FoxP3 over the period. Cells expressing FoxP3 were not anergic and responded to stimulation. HIV specific proteins, in addition, resulted in specific effects on the Tregs with a positive interferon response to gag correlating with increased Treg frequencies and FoxP3 expression in CD4+ T cells correlated with the proliferative response of CD4+ T cells to Nef in HIV infected individuals. Conclusions This study shows significant differences of frequencies of FoxP3 positive producing cells in the peripheral blood at ex vivo in patients with active TB. The function of these cells in this population is uncertain and further functional data and long-term clinical follow-up is required. In addition, the frequencies of these cells remained constant over time and showed proliferative response to stimuli (most notably CD3) suggesting that these cells may be generated in the periphery.

CD4 T helper (Th) cells differentiate into distinct effector or regulatory subsets as needed during the course of an infection. Ikaros is a transcription factor that is necessary for proper thymic T cell development. In order to study the role of Ikaros in peripheral CD4 T-cell differentiation and function, a novel Ikaros conditional knockout mouse in which Ikaros is deleted in mature T-cells (CKO mice) was developed. In this thesis, this model is characterized and used to evaluated how absence of Ikaros affects lymphocyte and myeloid populations in vivo, and CD4 T-cell differentiation into T helper 17 (Th17) and inducible regulatory T cell (iTreg) subsets in vitro. CKO mice had normal thymocyte development and normal percentages of T-cells and B-cells in the spleen. However, they had increased percentages of myeloid cells, and an abnormal population of "naive-like" CD4 T-cells that expressed low levels of CD62L and CD44, markers that identify naive and memory T cell populations. CKO CD4 T-cells cultured under Th17 polarizing conditions showed normal expression of the Th17 factors, RORγt and IL-17A, but overexpressed the pro-inflammatory factors T-bet, IFNγ and GM-CSF. CKO CD4 T-cells had a decreased ability to become iTregs as shown by significantly less Foxp3+ CD4+ T-cells in polarizing cultures, and overexpress T-bet, IFNγ and GM-CSF. Therefore, T-cells that lack Ikaros do not properly differentiate into either Th17 or iTreg lineages, but instead become cells with altered pro-inflammatory characteristics. In conclusion, the data highlights new roles of Ikaros in maintaining proper CD4 T-cell populations in the periphery and in suppressing abnormal pro-inflammatory responses.