Mit zunehmendem Alter verringert sich die Fähigkeit des menschlichen Organismus Infektionen erfolgreich zu bekämpfen und, z.B. nach Impfung, einen protektiven Schutz aufzubauen. Es wird vermutet, dass die Alterung des Immunsystems eine Rolle dabei spielt. Wichtige Ergebnisse liefern dazu vor allem tierexperimentelle Studien, welche jedoch die Komplexität menschlicher Immunität nur bedingt abbilden. Nur ansatzweise erforscht ist der Einfluss immunologischer Alterungsprozesse auf die primäre Immunantwort im Menschen. Um ein besseres Verständnis über primäre Immunantworten im Alter zu erlangen, haben wir junge (n=11, Med=26 Jahre) und ältere (n=12, Med=60 Jahre) Erwachsene mit einem viralen Erreger experimentell infiziert und die akute Immunreaktion und Entwicklung langlebiger Protektion eingehend untersucht. Dafür verwendeten wir den attenuierten Lebendimpfstoff gegen Gelbfieber, der ein hervorragendes Modelsystem darstellt um anti-virale Primärantworten im Menschen zu erforschen. Wir konnten zeigen, dass ältere Impflinge weniger Gelbfiebervirus-(GFV)-neutralisierende Antikörper produzierten, schwächere GFV-spezifische CD8+ T-Zellantworten erzeugten und quantitativ als auch qualitativ veränderte GFV-spezifische CD4+ T-Zellantworten generierten. Zudem wiesen ältere Impflinge häufiger eine vergleichsweise späte Virämie auf. Unsere systembiologische Untersuchungen zeigten, dass die niedrige Zahl von frisch aus dem Thymus ausgewanderten naiven CD4+ T Zellen, sogenannten CD4+ Recent thymic emigrants, sowie der Mangel an dendritischen Zellen vor bzw. am Beginn der Infektion ausschlaggebend für die schlechtere Immunreaktion und niedrigere Langzeit-Immunität bei Älteren war. Daraus schließen wir, dass in älteren Menschen die Verfügbarkeit eines breiten Repertoires naiver CD4+ T-Zellen und eine effektive Induktion des angeborenen Immunsystems in der frühen Phase einer primären Infektion kritisch für die akute Abwehr viraler Erreger und die Ausbildung protektiver Immunität ist. / The immunological competence to fight infections and to generate protective immunity, for example upon vaccination, progressively declines with advancing age. Although the aged immune system has been extensively studied at steady state and in aged animal models, there is only rudimentary understanding on how aging affects the immune response to a primary infection in humans. Involving complex individual systemic immune properties, such investigations have been very challenging particularly with the given restrictions of experimental infections in humans. In our study, we explored age-related changes in human immunity during experimental, primary immunization with live-attenuated yellow fever (YF) vaccine. In 11 young (median age: 26 years) and 12 elderly (median age: 60 years) vaccinees, we assessed individual viral burden and compared humoral and cellular immunity by advanced flow cytometric analysis over the entire course of the acute infection and up to 3 years after it. We discovered that aged subjects developed fewer neutralizing antibodies, mounted diminished YF-specific CD8+ T-cell responses and showed quantitatively and qualitatively altered YF-specific CD4+ T-cell immunity. A comparatively late peak in YF viremia suggested impaired infection control and viral clearance in the elderly. Among numerous immune signatures, low in vivo numbers of naive CD4+ recent thymic emigrants (CD4+ RTE) prior immunization and peripheral dendritic cells (DCs) in the early phase of the innate response phase were indicative for reduced acute responsiveness and altered long-term persistence of human cellular immunity to YF vaccination in the elderly. Thus, we reveal by this study that essential elements of immune responses such as CD4+ RTEs and DCs affect productive immunity in the elderly, explaining conclusively diminished responsiveness to vaccination with neo-antigens and infection with de novo pathogens in aged people.

PTEN ist als Phosphatase an zahlreichen Signalwegen, z.B. von Wachstumsfaktoren beteiligt. Mutationen im PTEN-Gen führen zur Entstehung vieler sporadischer Tumore sowie dem kongenitalen PTEN-Hamartom-Tumor-Syndrom (PHTS). Eine kausale Therapie für PHTS steht derzeit nicht zur Verfügung. Diese Arbeit beschreibt einen experimentellen Sirolimustherapieversuch bei einem Kind mit PHTS, welches sich unter anderem mit Thymushyperlasie, abdomineller Lipomatose und Kachexie präsentierte. Unter Behandlung zeigten sich eine Verbesserung des Allgemeinzustandes und des Größenwachstums des Patienten, sowie eine transiente Verkleinerung des Thymusvolumens. Die massive Lipomatose wurde im Wachstum gehemmt, nahm aber nicht an Volumen ab. Ein erneutes Thymuswachstum nach 19-monatiger Therapie ließ eine Resistenzentwicklung gegen Sirolimus vermuten. Bei Untersuchungen des PI3K/AKT/mTOR-Signalweges zeigten sich Hinweise für einen möglichen Resistenzmechanismus. Insulin-like growth factor binding protein 2, wird als Biomarker für den Therapieerfolg der Sirolimusbehandlung diskutiert. Dies erwies sich bei unserem Patienten allerdings nicht als geeignet zur Nutzenbewertung der Therapie. In vitro Studien an primären Zellkulturen aus Lipom-Gewebe des Patienten zeigten eine Hemmung von Proliferation und Differenzierung durch Sirolimus, jedoch keine Induktion der Apoptose. Inhibitoren von PI3K und AKT zeigten im Bezug auf Proliferationshemmung und Apotoseinduktion stärkere Effekte. Vor allem der AKT-Inhibitor Perifosin könnte für Patienten mit schwerem PHTS als Therapieoption in Betracht gezogen werden.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Les premières cellules progénitrices lympho-myéloïdes (LMPP) entrent dans le thymus et commencent leur processus de différenciation au stade double négatif (DN, CD4-CD8-). Après un réarrangement fonctionnel de la chaine bêta de leur récepteur des cellules T (RCT), les cellules reçoivent des signaux de différenciation, de prolifération, de survie et de sélection et passent au stade double positif (DP, CD4+CD8+). Ensuite, la chaine alpha du RCT est réarrangée et testée via les sélections positive et négative. Si le RCT reçoit un signal ni trop fort, ni trop faible, les cellules passent au stade simple positif où elles exprimeront soit la molécule CD4 ou CD8. ERK3, une MAPK non-conventionnelle, joue un rôle important dans le développement thymique. Des études précédentes ont démontré qu’une déficience en ERK3 diminue de 50 % la cellularité thymique et de 75% le nombre de cellules simples positives CD4 (CD4SP). Nous avons posé comme hypothèses qu’il y a une augmentation de l’apoptose chez les thymocytes DP de souris Erk3-/- et que cette déficience chez les thymocytes DP affecterait la sélection positive des cellules DP, réduisant ainsi le nombre de thymocytes CD4SP. Afin de vérifier la première hypothèse, nous avons regardé les niveaux d’apoptose grâce à la cytométrie en flux et par immunohistochimie. Dans les deux cas, nous étions incapables de détecter une différence du niveau d’apoptose chez les thymocytes DP entre les souris Erk3+/+ et Erk3-/-. Ensuite, nous nous sommes posés la question suivante : La demi-vie des thymocytes DP Erk3-/- était-elle plus courte que le type sauvage? La demi-vie des thymocytes DP a été mesurée à l’aide de l’étude des réarrangements secondaires de la chaine alpha du RCT par PCR semi-quantitatif et à l’aide de cultures de thymus fœtaux. En effet, ERK3 semble important pour prolonger la demi-vie des thymocytes DP. Ensuite, nous avons utilisé des marqueurs cellulaires différentiels (CD69, CD5 et RCT) pour regarder si les thymocytes DP sont capables de passer la sélection positive. En effet, il y a moins de thymocytes DP Erk3-/- qui sont CD69fort, CD5fort et RCTfort. Finalement, nous voulons savoir si les fonctions de ERK3 passent par MK5, son seul partenaire d’interaction connu à ce jour. Après la caractérisation du thymus de la souris Mk5-/-, nous observons que seulement la réduction du nombre de thymocytes CD4SP est identique à celle des thymocytes CD4SP de la souris Erk3-/-. En conclusion, ces résultats révèlent des fonctions importantes pour la molécule ERK3 lors du processus de sélection positive, le maintient de la demi-vie des thymocytes DP et lors de la régulation de développement thymique de manière MK5-dépendante et -indépendante. / Early thymic progenitor cells (ETP) enter the thymus and begin their differentiation process at the double negative (DN) stage, having no CD4 and CD8 expression. After a functional rearrangement of the beta chain of the T-cell receptor (TCR), the cells receive differentiation, proliferation, survival, and selection signals and pass to the double positive (DP) stage and acquire the expression of CD4 and CD8 molecules. Then, the TCR alpha chain is rearranged and the fully composed TCR is tested through positive and negative selection. If the TCR receives a signal that is just right (not too strong or too weak), the cells pass to the single-positive stage by acquiring either the CD4 or CD8 molecule. ERK3, an unconventional MAPK, plays an important role in thymic development. Previous studies have shown that a deficiency in ERK3 decreases by 50% the total thymic cellularity and by 75% the number of CD4 single- positive cells (CD4SP). We hypothesized that there is an increase in apoptosis in DP thymocytes of Erk3-/- mice for and that this deficiency would affect the positive selection of DP cells, resulting in a reduced number of CD4SP. To test the first hypothesis, we looked at apoptosis levels by flow cytometry and immunohistochemistry. In both cases, we were unable to detect a difference in the level of apoptosis in DP thymocytes from Erk3+/+ and Erk3-/- mice. We then made a second assumption, that the half-life of Erk3-/- DP thymocytes for was shorter, which was measured by secondary rearrangements of the RCT alpha chain by semi-quantitative PCR and cultures of fetal thymi. Indeed, ERK3 seems important to extend the half- life of DP thymocytes. Next, we used differential cell markers (CD69, CD5, and TCR) to see if the DP thymocytes are able to pass positive selection. Indeed, there are less DP thymocytes Erk3-/- that are CD69hi, CD5hi, and TCRhi. Finally, we wanted to know whether the functions of ERK3 passes through MK5, its only interacting partner known to date. After characterization of the thymus of Mk5-/- mice, we observe that only the reduction of CD4SP thymocytes is identical to that of CD4SP thymocytes of Erk3-/-mice. In conclusion, these results reveal important functions for the molecule ERK3 for maintaining the half-life of DP thymocytes, for the process of positive selection and for regulating T-cell development in a MK5-dependent and - independent manner.

PTEN ist als Phosphatase an zahlreichen Signalwegen, z.B. von Wachstumsfaktoren beteiligt. Mutationen im PTEN-Gen führen zur Entstehung vieler sporadischer Tumore sowie dem kongenitalen PTEN-Hamartom-Tumor-Syndrom (PHTS). Eine kausale Therapie für PHTS steht derzeit nicht zur Verfügung. Diese Arbeit beschreibt einen experimentellen Sirolimustherapieversuch bei einem Kind mit PHTS, welches sich unter anderem mit Thymushyperlasie, abdomineller Lipomatose und Kachexie präsentierte. Unter Behandlung zeigten sich eine Verbesserung des Allgemeinzustandes und des Größenwachstums des Patienten, sowie eine transiente Verkleinerung des Thymusvolumens. Die massive Lipomatose wurde im Wachstum gehemmt, nahm aber nicht an Volumen ab. Ein erneutes Thymuswachstum nach 19-monatiger Therapie ließ eine Resistenzentwicklung gegen Sirolimus vermuten. Bei Untersuchungen des PI3K/AKT/mTOR-Signalweges zeigten sich Hinweise für einen möglichen Resistenzmechanismus. Insulin-like growth factor binding protein 2, wird als Biomarker für den Therapieerfolg der Sirolimusbehandlung diskutiert. Dies erwies sich bei unserem Patienten allerdings nicht als geeignet zur Nutzenbewertung der Therapie. In vitro Studien an primären Zellkulturen aus Lipom-Gewebe des Patienten zeigten eine Hemmung von Proliferation und Differenzierung durch Sirolimus, jedoch keine Induktion der Apoptose. Inhibitoren von PI3K und AKT zeigten im Bezug auf Proliferationshemmung und Apotoseinduktion stärkere Effekte. Vor allem der AKT-Inhibitor Perifosin könnte für Patienten mit schwerem PHTS als Therapieoption in Betracht gezogen werden.:INHALTSVERZEICHNIS: 1 ABKÜRZUNGSVERZEICHNIS 2 BIBLIOGRAPHISCHE BESCHREIBUNG 3 VORBEMERKUNGEN 4 EINFÜHRUNG IN DIE THEMATIK 5 1. PTEN im biochemischen Kontext 5 2. Klinische Bedeutung von PTEN 6 3. Gezielte Therapie für PHTS – Beeinflussung der Signalwege 7 4. Der Patient M.W. als Ausgangspunkt der Arbeit 8 5. Gewinnung von Zellkulturen 10 6. IGFBP-2 als Marker für erfolgreiche Sirolimustherapie 10 7. Fragestellung 11 8. Ergebnisse und Ausblick 11 PUBLIKATIONSMANUSKRIPT 13 ZUSAMMENFASSUNG DER ARBEIT 21 LITERATURVERZEICHNIS 25 ANLAGEN 28 I. Ergänzungsunterlagen zur wissenschaftlichen Publikation 28 Supplement 1 - Additional methodological descriptions 28 Supplement 2 - Video clip of 3D-MRI reconstruction 28 II. Charakterisierung der Lipom-Zellkulturen 29 II.a Lipom-Zellen in Langzeitkultur 29 II.b Veränderung im PI3K-Signalweg 30 III. Erklärung über die eigenständige Abfassung der Arbeit 32 IV. Danksagungen 33

Les lymphocytes T sont au coeur du système immunitaire adaptatif et leur dérégulation est à la base de pathologies. Les cellules T se développent dans le thymus et passent par de nombreuses étapes de maturations identifiables par l'expression des corécepteurs CD4+/CD8+ à la surface des cellules. À leur sortie du thymus, les cellules T sont divisées en deux sous-types principaux: les cellules T auxiliaires CD4+ spécifique aux antigènes présentés sur complexe majeur d'histocompatibilité (CMH) de classe II et les cellules T cytotoxiques CD8+ reconnaissant un antigène présenté sur un CMH-I. Toutes les cellules T proviennent d’un précurseur commun. Leur différenciation en cellule T CD4+ et T CD8+ est influencée par l'intensité et la durée de la signalisation du récepteur des cellules T (RCT) et des cytokines. Cette signalisation résulte en l’expression des facteurs de transcription ThPOK pour la différenciation de cellule T CD4+ et Runx3 pour les cellules T CD8+. Il a été démontré que ThPOK est à la fois nécessaire et suffisant pour le développement des lymphocytes T CD4+, puisque le gain et la perte de la fonction de ThPOK favorise le développement de cellules lymphocytes T CD4+ et CD8+, respectivement. Ma thèse vise à approfondir notre compréhension du choix de la lignée CD4+/CD8+ en explorant les mécanismes moléculaires de la voix de signalisation de ThPOK et du RCT. Dans cette étude, nous avons étudié l'impact d'un gain-de-fonction de ThPOK sur la différenciation des thymocytes, en utilisant trois lignées transgéniques exprimant des niveaux variables de ThPOK. Une analyse approfondie de ces transgènes chez des souris dont le RCT est restreint soit au CMH de classe I ou de classe II, a démontré que, comparés aux thymocytes restreints au CMH-II, les thymocytes restreints au CMH-I requéraient des niveaux plus importants de ThPOK pour se différencier en CD4+. L’introduction d’un transgène exprimant un niveau moins élevé de ThPOK comparé aux deux autres transgènes, mais un niveau plus élevé de ThPOK par rapport au niveau endogène dans les cellules CD4+ WT, n'induit qu'une réorientation partielle des cellules T CD8+ en CD4+, ce qui a mené à la génération, à la fois de lymphocytes T CD4+, DN (doubles négatifs) et CD8+ matures. L'analyse génotypique, plus précisément celle des cellules DN chez les souris porteuses du transgène ThPOK et dont le RCT est restreint au CMH-I, a révélé que l’inhibition des gènes spécifiques à la lignée CD8+ 2 nécessitait des niveaux d'expression différents de ThPOK comparés à ceux requis pour l’induction des gènes spécifiques à la lignée CD4+. En effet, cette étude nous a permis de démontrer que l’intensité du signal dérivé du RCT ainsi que sa spécificité pour un CMH donné jouent un rôle essentiel dans le choix de différentiation CD4+/CD8+ induit par ThPOK. Ainsi, la réorientation CD8+/CD4+ chez les souris exprimant le transgène ThPOK-H est significativement augmentée par l'amplification de l’intensité du signal dérivé du RCT dans les cellules spécifiques aux CMH-I. De plus, la fréquence des cellules CD4+ était plus élevée lorsqu’une quantité identique de ThPOK était exprimée dans des lymphocytes T spécifiques au CMH-II, suggérant qu’il existe un aspect qualitatif quant à la régulation de la différenciation des lymphocytes T CD4+ par la signalisation induite par le RCT. Nous avons également tenté d’étudier la voie de différenciation CD4+ en l’absence de ThPOK, à la suite de la perturbation physiologique de la voie de signalisation induite par le RCT, par rapport à la perte de fonction de ThPOK. Bien que nous ayons observé une réorientation des thymocytes spécifiques au CMH-II vers la lignée CD8+, aussi bien à la suite d'une délétion de Thpok, qu’à la perturbation de la signalisation RCT les deux modes de redirections semblent toutefois être différents. En effet, notre investigation a démontré qu’en l’absence de ThPOK, la signalisation induite par le RCT dans les cellules restreintes au CHM-II induit l’activation de certains gènes, suggérant ainsi leur implication dans la voie de différenciation CD4+. Ces résultats suggèrent également que la contribution de la signalisation du RTC dans la différenciation des thymocytes restreints au CMH-II ne se limitait pas à l'induction de ThPOK. Étonnamment, seul un effet synergique limité a été observé sur la différenciation des thymocytes restreints au CMH-I, lorsque Gata3, un autre facteur de transcription également induit dans les thymocytes restreints au CMH-II, et ThPOK étaient surexprimés en même temps dans ces cellules, suggérant peu de chevauchement fonctionnel entre ces deux facteurs de transcription. L’ensemble de ces résultats indique que ThPOK et la signalisation induite par le RCT fonctionnent en synergie durant le développement des lymphocytes T CD4+. / T lymphocytes are at the core of the adaptive immune system and their dysfunction is associated with several disorders and pathologies, which are at times fatal. The two main types of T-cells in mice and man are: the major histocompatibility complex (MHC) class-II-restricted CD4+ helper T-cells, and the MHC-I-restricted CD8+ cytotoxic T-cells. Developmental stages of the two types of T-cells occurs in the thymus in multiple sequential maturation stages that are identified by cell-surface CD4+/CD8+ co-receptor expression. Differentiation of the two types of T-cells in the thymus from a common precursor is influenced by the intensity and duration of signals derived from the T-cell receptor (TCR) and cytokines secreted by the thymic stromal cells. These signals lead to the activation of ThPOK or Runx/CBF transcription factors, which control the transcriptional network regulating CD4+ and CD8+ lineage fate, respectively. Studies have demonstrated that ThPOK is both necessary and sufficient for CD4+ T-cell development as gain- and loss-of-ThPOK function redirects positively selected MHC-I- and MHC-II-restricted thymocytes into CD4+ and CD8+ T-cell lineage fate, respectively. However, the role of TCR signaling and the extent to which ThPOK expression influences CD4+ lineage choice remains to be investigated. My thesis aims to elucidate the fundamental basis the CD4+/CD8+ lineage choice by exploring the molecular mechanism of action of ThPOK and TCR signaling in CD4+ lineage fate of MHC-I- and MHC-II-specific thymocytes. In this study, we have characterized gain-of-function of ThPOK in three independent transgenic mouse lines expressing varying amounts of ThPOK. Extensive analysis of the three ThPOK transgenic lines expressing MHC-I- and MHC-II-specific monoclonal TCR indicated that MHC-I-restricted, compared to MHC-II-restricted, thymocytes required significantly more ThPOK for efficient differentiation into the CD4+ lineage. Interestingly, the founder line with the lowest transgene expression, despite expressing significantly higher amounts of ThPOK compared to the endogenous levels in WT CD4+ T cells, induced a partial CD8+ to CD4+ redirection of MHC-I-restricted cells, leading to the generation of mature CD4+, DN and CD8+ T-cells in the same mouse. Lineage specific gene expression analysis, specifically in DN mature T cells from ThPOK transgenic mice expressing MHC-I-specific TCR, showed that, compared to induction of helper program, suppression of cytotoxic program required lower amount of ThPOK. Further investigation showed that TCR signal strength and MHC specificity of 4 developing thymocytes played a critical role in determining ThPOK-induced CD4+ lineage fate. While increase in TCR signal strength augmented the efficiency of ThPOK-induced CD4+ lineage choice of MHC-I-restricted thymocytes in part via endogenous ThPOK induction, it appeared to have ThPOK independent function as well as judged by significantly different CD4+ T-cell frequencies in OTI mice expressing the same amount of ThPOK but transduced quantitatively different TCR signal. Importantly, the efficiency of CD4+ lineage choice of MHC-I-specific thymocytes with augmented TCR signal strength was still significantly lower compared to the efficiency of CD4+ lineage choice of MHC-II-restricted thymocytes expressing only the transgene-encoded ThPOK suggesting a qualitative role for TCR signaling as well in CD4+ lineage choice. We then evaluated CD4+ lineage fate decision in the absence of ThPOK induction in physiologically relevant alteration in TCR signaling versus loss of ThPOK function. While we observed CD4+ to CD8+ lineage redirection of MHC-II-specific thymocytes due to Thpok-deficiency as well as lack of ThPOK induction due to disruption of TCR signaling, the two modes of lineage redirection appeared to be due to different mechanisms. Our investigation demonstrates that TCR signaling in MHC-II-restricted thymocytes induces the expression of select genes in loss-of-function of ThPOK model suggesting potential role for these genes in establishing the CD4+ helper program. These results also suggest that the contribution of MHC-II-specific TCR signaling in driving CD4+ lineage choice is not limited to Thpok induction. Interestingly, only a limited synergistic effect was observed when both Gata3, which is also induced in MHC-II-signaled thymocytes, and ThPOK were overexpressed in MHC-I-restricted thymocytes suggesting a limited functional overlap between the two transcription factors. Collectively, these data indicate that ThPOK and TCR signaling work synergistically to promote the development of CD4+ T-cells with some ThPOK independent function for TCR signaling.

Durante a vida fetal e no período neonatal, o timo é órgão de grande importância imunológica e, anatomicamente é o maior órgão linfático e com alta atividade linfopoiética, constando como precursor da linfopoiese. No que diz respeito à irrigação do timo em cães, a literatura é escassa, visto que os autores quando se reportam ao assunto fazem-no na sua maioria de maneira genérica. Com isso, aspectos morfológicos como número de vasos, tamanho do órgão foram estudados considerando as variáveis sexo e faixas etárias. Para este estudo, foram utilizados 24 fetos de cães domésticos, sem raça definida, machos e fêmeas, divididos em quatro grupos etários. Os timos foram processados para o estudo da microscopia de luz, e as análises estereológicas foram realizadas utilizando o método do disector físico associado com o princípio de ConnEulor. O volume do órgão (Vref), comprimento, espessura e largura aumentaram gradativamente com o desenvolvimento, sendo maior nos machos do que nas fêmeas. As variáveis estereológicas analisadas (densidade de comprimento do vaso - Lv, comprimento do vaso - L, densidade de superfície de área - Sv, superfície de área - S, estimação da densidade numérica vascular ? Nv(vasc) número total de vasos no órgão - N (vasc) ), tiveram um aumento gradativo, sendo que o Lv foi maior nas fêmeas e as demais os machos apresentaram maior valor. Aumento na Nv(vasc) e N (vasc) foi observado nos animais do grupo IV. / During phoetal life and neonatal period, the thymus is the organ that has a wide immunological relevance and, anatomically speaking is the largest lymphoid organ presenting high limphopoietic activity presented as the predecessor of limphopoiesis. The literature about thymus irrigation in dogs is scarce, becouse most authors refer to the subject in a general way. Then, morphological aspects as number, shape, size, irrigation, and quantitative were study considering sexy and differents ages of development of the dogs. To the study, were used twenty-four fetus of the mongrel domestics dogs, males and females, divided into four different well defined aged groups (fetus 30, 40, 50 and 60 days). The thymus were processed for the light microscopy study, and the stereological analyses were done using the physical disector method associated with the ConnEulor principle. The volume of the organ, length, thickness and wide increased gradually with the development, in males is great that female. The stereological variables analysed (length density ? Lv, length od vascullar ? L, surface area density ? Sv, surface area ? S, vascullar number density ? N.v(vasc) , and vascullar total number - N. (vasc) ), had the gradual high, the Lv was more in female and the others variables were more in males. The rise of N.v(vasc) and N. (vasc) was observed on the group four animals.

Entre as síndromes de deleção do cromossomo 22q.11, a Síndrome de DiGeorge foi descrita em 1967 como uma imunodeficiência primária caracterizada por: malformações cardíacas, hipoparatireoidismo e ausência de timo. A incidência estimada é de 1: 3000 nascidos vivos e apesar disto seu reconhecimento ainda apresenta dificuldades devido à grande variabilidade fenotípica e diferentes nomenclaturas. Para o diagnóstico é necessário a presença do número de células T circulantes diminuído ou normal, número de células B circulantes normais e níveis séricos de imunoglobulinas diminuídos ou normais associado com os seguintes achados: hipoparatireoidismo, malformações cardíacas conotruncais, dismorfismo facial e detecção da deleção do cromossomo 22q.11. Os pacientes com Síndrome de DiGeorge apresentam graus variados de comprometimento tímico e há a necessidade de avaliação da função tímica objetiva e eficaz para este grupo de pacientes. Recentemente, a mensuração do TREC tem sido considerada adequada para avaliar a função tímica. O objetivo deste estudo foi avaliar a função tímica em pacientes com esta síndrome através de dados clínicos e laboratoriais associados à mensuração do TREC em células mononucleares periféricas. Os objetivos secundários foram descrever as características fenotípicas, as alterações imunológicas incluindo a quantificação de subpopulações de linfócitos T e sua ativação. A quantificação do TREC foi feita através de PCR quantitativo em tempo real e as subpopulações de linfócitos T e dos marcadores de ativação CD28+ e HLA-DR+, através de citometria de fluxo. Nesta casuística foram incluídos 14 pacientes, oito masculinos, com idade entre 8m a 18a11m. Todos os pacientes preencheram os critérios diagnósticos e em dois não foi detectada a deleção do 22q11.2. O achado mais freqüente foi o acometimento cardíaco em 12 pacientes, prevalecendo a tetralogia de Fallot. O dismorfismo facial foi observado em 11 pacientes, sendo as alterações orofaciais as mais comuns. Hipocalcemia esteve presente em cinco pacientes e em um deles havia associação com hipotireoidismo neonatal. Depressão foi observada em dois pacientes e atualmente nenhum paciente apresenta quadro de infecção de repetição. À avaliação da imunidade humoral, detectou-se cinco pacientes com concentrações séricas de IgM abaixo dos valores normais para a idade e na avaliação da anticorpogênese somente três pacientes responderam com títulos protetores para a o esquema vacinal completo para hepatite B e quatro para sarampo. A quantificação do número de TREC realizada em 12 pacientes mostrou-se reduzida em relação aos controles com uma significância estatística (p = 0,002). O número de linfócitos totais estava dentro dos valores normais, mas, os valores de CD3+ estavam diminuídos em nove, CD4+ em um e CD8+ em cinco pacientes. Observou-se maior expressão de marcadores de ativação linfocitária no grupo de pacientes que nos controles (p = 0, 002). Conclusão: Este estudo revelou que os pacientes avaliados apresentaram alteração tanto da imunidade celular como humoral em especial em relação à anticorpogênese pós vacinal e redução da subpopulação de linfócitos T. A reduzida quantidade de TREC em relação aos controles pode indicar uma disfunção tímica embora tenha sido observado normalidade linfocitária nestes pacientes / Among the syndromes of 22q.11 deletion, the DiGeorge Syndrome was first described in 1967 as a primary immunodeficiency characterized by: heart defects, hypoparathyroidism and absence of thymus. The estimated incidence is 1: 3000 live births and despite this, its recognition still presents difficulties due to large variability and different nomenclatures. For the diagnosis it is necessary the presence of the decreased or normal number of circulating T cells, normal number of circulating B cells and decreased or normal levels serum of immunoglobulins associated with the following findings: hypoparathyroidism, conotruncal heart defects, facial dimorphism and detection of 22q.11 deletion. Patients with DiGeorge syndrome have varying degrees of thymic commitment and there is a necessity for an objectively and effectively evaluation of thymic function to this group of patients. Recently, the measurement of TREC has been considered adequate to evaluate the thymic function. The aim of this study was to evaluate the thymic function in patients with this syndrome through clinical and laboratory data associated with the measurement of TREC in peripheral blood mononuclear cells. The secondary objectives were to describe the phenotypic characteristics, immune disorders including quantification of subpopulations of T lymphocytes and their activation. Quantification of TREC was performed by quantitative PCR in real time and the subpopulations of T lymphocytes and activation markers CD28+ and HLA-DR+, by flow cytometry. In this case series included 14 patients, eight male, aged 8m to 18y11m. All patients met the diagnostic criteria and two did not detect the 22q11.2 deletion. The most common finding was cardiac involvement in 12 patients, with prevalence of tetralogy of Fallot. The facial dimorphism was observed in 11 patients with orofacial changes being the most common. Hypocalcaemia was present in five patients and one of them was associated with neonatal hypothyroidism. Depression was observed in two patients and now, no patient presents recurrent infections. In the humoral immunity, we have found five patients with serum IgM below normal for age and only three patients responded with protective levels of antibodies to the complete vaccine schedule for hepatitis B and four for measles. The measurement of the number of TREC was performed in 12 patients and it was reduced compared to controls with a statistical significance (p = 0, 002). The total number of lymphocytes were within the normal range, but the values of CD3+ were decreased in nine, CD4+ in one and CD8+ in five patients. It was found a higher expression of markers of lymphocyte activation in the group of patients than in controls (p = 0, 002). Conclusion: This study revealed that in the patients studied both humoral and cellular immunity was compromised, in particular in relation to vaccinal response and reduction the subpopulation of T lymphocytes. The reduced amount of TREC when compared to controls may indicate a thymic dysfunction despite the normal lymphocytes in these patients

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

Entre as síndromes de deleção do cromossomo 22q.11, a Síndrome de DiGeorge foi descrita em 1967 como uma imunodeficiência primária caracterizada por: malformações cardíacas, hipoparatireoidismo e ausência de timo. A incidência estimada é de 1: 3000 nascidos vivos e apesar disto seu reconhecimento ainda apresenta dificuldades devido à grande variabilidade fenotípica e diferentes nomenclaturas. Para o diagnóstico é necessário a presença do número de células T circulantes diminuído ou normal, número de células B circulantes normais e níveis séricos de imunoglobulinas diminuídos ou normais associado com os seguintes achados: hipoparatireoidismo, malformações cardíacas conotruncais, dismorfismo facial e detecção da deleção do cromossomo 22q.11. Os pacientes com Síndrome de DiGeorge apresentam graus variados de comprometimento tímico e há a necessidade de avaliação da função tímica objetiva e eficaz para este grupo de pacientes. Recentemente, a mensuração do TREC tem sido considerada adequada para avaliar a função tímica. O objetivo deste estudo foi avaliar a função tímica em pacientes com esta síndrome através de dados clínicos e laboratoriais associados à mensuração do TREC em células mononucleares periféricas. Os objetivos secundários foram descrever as características fenotípicas, as alterações imunológicas incluindo a quantificação de subpopulações de linfócitos T e sua ativação. A quantificação do TREC foi feita através de PCR quantitativo em tempo real e as subpopulações de linfócitos T e dos marcadores de ativação CD28+ e HLA-DR+, através de citometria de fluxo. Nesta casuística foram incluídos 14 pacientes, oito masculinos, com idade entre 8m a 18a11m. Todos os pacientes preencheram os critérios diagnósticos e em dois não foi detectada a deleção do 22q11.2. O achado mais freqüente foi o acometimento cardíaco em 12 pacientes, prevalecendo a tetralogia de Fallot. O dismorfismo facial foi observado em 11 pacientes, sendo as alterações orofaciais as mais comuns. Hipocalcemia esteve presente em cinco pacientes e em um deles havia associação com hipotireoidismo neonatal. Depressão foi observada em dois pacientes e atualmente nenhum paciente apresenta quadro de infecção de repetição. À avaliação da imunidade humoral, detectou-se cinco pacientes com concentrações séricas de IgM abaixo dos valores normais para a idade e na avaliação da anticorpogênese somente três pacientes responderam com títulos protetores para a o esquema vacinal completo para hepatite B e quatro para sarampo. A quantificação do número de TREC realizada em 12 pacientes mostrou-se reduzida em relação aos controles com uma significância estatística (p = 0,002). O número de linfócitos totais estava dentro dos valores normais, mas, os valores de CD3+ estavam diminuídos em nove, CD4+ em um e CD8+ em cinco pacientes. Observou-se maior expressão de marcadores de ativação linfocitária no grupo de pacientes que nos controles (p = 0, 002). Conclusão: Este estudo revelou que os pacientes avaliados apresentaram alteração tanto da imunidade celular como humoral em especial em relação à anticorpogênese pós vacinal e redução da subpopulação de linfócitos T. A reduzida quantidade de TREC em relação aos controles pode indicar uma disfunção tímica embora tenha sido observado normalidade linfocitária nestes pacientes / Among the syndromes of 22q.11 deletion, the DiGeorge Syndrome was first described in 1967 as a primary immunodeficiency characterized by: heart defects, hypoparathyroidism and absence of thymus. The estimated incidence is 1: 3000 live births and despite this, its recognition still presents difficulties due to large variability and different nomenclatures. For the diagnosis it is necessary the presence of the decreased or normal number of circulating T cells, normal number of circulating B cells and decreased or normal levels serum of immunoglobulins associated with the following findings: hypoparathyroidism, conotruncal heart defects, facial dimorphism and detection of 22q.11 deletion. Patients with DiGeorge syndrome have varying degrees of thymic commitment and there is a necessity for an objectively and effectively evaluation of thymic function to this group of patients. Recently, the measurement of TREC has been considered adequate to evaluate the thymic function. The aim of this study was to evaluate the thymic function in patients with this syndrome through clinical and laboratory data associated with the measurement of TREC in peripheral blood mononuclear cells. The secondary objectives were to describe the phenotypic characteristics, immune disorders including quantification of subpopulations of T lymphocytes and their activation. Quantification of TREC was performed by quantitative PCR in real time and the subpopulations of T lymphocytes and activation markers CD28+ and HLA-DR+, by flow cytometry. In this case series included 14 patients, eight male, aged 8m to 18y11m. All patients met the diagnostic criteria and two did not detect the 22q11.2 deletion. The most common finding was cardiac involvement in 12 patients, with prevalence of tetralogy of Fallot. The facial dimorphism was observed in 11 patients with orofacial changes being the most common. Hypocalcaemia was present in five patients and one of them was associated with neonatal hypothyroidism. Depression was observed in two patients and now, no patient presents recurrent infections. In the humoral immunity, we have found five patients with serum IgM below normal for age and only three patients responded with protective levels of antibodies to the complete vaccine schedule for hepatitis B and four for measles. The measurement of the number of TREC was performed in 12 patients and it was reduced compared to controls with a statistical significance (p = 0, 002). The total number of lymphocytes were within the normal range, but the values of CD3+ were decreased in nine, CD4+ in one and CD8+ in five patients. It was found a higher expression of markers of lymphocyte activation in the group of patients than in controls (p = 0, 002). Conclusion: This study revealed that in the patients studied both humoral and cellular immunity was compromised, in particular in relation to vaccinal response and reduction the subpopulation of T lymphocytes. The reduced amount of TREC when compared to controls may indicate a thymic dysfunction despite the normal lymphocytes in these patients