A sepse é uma síndrome de resposta inflamatória sistêmica decorrente de um processo infeccioso, a qual acarreta alta taxa de mortalidade. Relatos da literatura tem demonstrado que pacientes e animais de experimentação que sobrevivem à sepse desenvolvem quadro de imunossupressão tardia, o qual contribui com a maior sucetibilidade destes a infecções secundárias. Nosso grupo demonstrou que as células T reguladoras (Tregs) participam ativamente do desenvolvimento desta imunossupressão. O Fator de Necrose Tumoral (TNF) é uma citocina pleotrópica responsável por diversas funções durante a resposta inflamatória, apresentando dois receptores responsáveis pelas suas atividades: o TNFR1 e o TNFR2. Foi demonstrando que o TNF exerce um importante papel na atividade de Tregs, induzindo a proliferação, estabilização do fenótipo e aumentando sua atividade imunossupressora, sugerindo que tais atividades sejam atribuidas ao TNFR2. Desta forma, nosso objetivo foi avaliar a participação dos receptores de TNF no desenvolvimento da imunossupressão pós-sepse. Para isso animais WT, TNFR1-/- e TNFR1/2 -/- foram submetidos à sepse grave, induzida por CLP e tratados com um suporte básico (reposição hidríca e antibioticoterapia). Inicialmente avaliamos a participação dos receptores de TNF na fase aguda da sepse. Demonstramos que nesta fase os receptores de TNF, principalmente TNFR1, apresentam um papel prejudicial na migração de neutrófilos, no controle do processo infeccioso e nas lesões de orgãos decorrentes da sepse. Posteriormente, os animais sobreviventes foram infectados com um dose subletal de L. pneumophila i.n 15 dias após a CLP. Avaliamos a participação dos receptores TNF na sucetibilidade à infecção secundária induzida por L. pneumophila em animais sobreviventes à sepse. Observamos que animais TNFR1-/- sobreviventes à sepse são mais suscetíveis, ao passo que animais TNFR1/2-/- sobreviventes à sepse são resitentes à infecção secundária em relação aos animais WT sobreviventes à sepse. Avaliamos então, a expansão de Tregs no baço destes animais sobreviventes à sepse e, observamos que animais TNFR1-/- apresentam aumento da expansão de Tregs, ao passo que os animais TNFR1/2-/- não apresentaram expansão de Tregs comparados ao WT. Observamos também que as Tregs apresentam maior densidade de receptores de TNF do que as células T convencionais e, que durante a sepse ocorre aumento da densidade destes receptores nas Tregs. Sugerimos então que possivelmente o TNFR1 seja um regulador negativo, enquanto o TNFR2 possa assumir um papel na regulação positiva na expansão de Tregs após a sepse, durante o desenvolvimento da imunossupressão. / Sepsis is a systemic inflammatory response syndrome resulting from infectious process, resulting in high mortality rate. It has been shown that septic mice and patients that survived from sepsis develop a late immunosuppression, which contributes to greater susceptibility to these secondary infections. Our group has shown that regulatory T cells (Tregs) actively participate in the development of this immunosuppression. The Tumor Necrosis Factor (TNF) is pleiotropic cytokine responsible for several processes in the inflammatory response. Two receptors are responsible for the various activities of TNF: TNFR1 and TNFR2. It have shown that TNF plays an important role in the activity of Tregs, inducing proliferation, stabilization of phenotype and increasing their immunosuppressive activity. The authors also suggested that these activities are TNFR2-mediated. Thus, our objective was to evaluate the role of TNF receptors in the acute phase of sepsis and also in the development of immunosuppression post-sepsis. For that, TNFR1-/ -, TNFR1/2 -/ - and WT mice were underwent to severe sepsis induced by CLP and treatment with basic support (hydration and antibiotics). Initially we evaluated the participation of TNF receptors in the acute phase of sepsis. We suggest that at this stage the TNF receptor, TNFR1 mainly exert a deleterious role in the migration of neutrophils in control of the infectious process and the tissue damage resulting from sepsis. In addition, the survivors from the septic event were intranasaly infected with L. pneumophila in the 15th day after sepsis induction. We evaluated the participation of these receptors in susceptibility to secondary infection induced by L. pneumophila in survivors from sepsis. Comparing the animals that survived from sepsis, we observed that TNFR1/2-/- , like WT mice, are not susceptible to the secondary infection, while TNFR1-/- survivors are more susceptible to it. We also observed that TNFR1-/ - animals show increased expansion of Tregs in the spleen, different of TNFR1/2-/- mice, that did not show expansion of Tregs compared to WT. We also observed Tregs have a higher density of receptors for TNF than conventional T cells, whereas during sepsis occurs increased expression of this receptor in Tregs. Altogether, the results suggest that TNFR1 is a negative regulator, whereas TNFR2 may play a role in the upregulation during expansion of Tregs, in development of sepsis-induced imunossupression.

A sepse é uma síndrome de resposta inflamatória sistêmica decorrente de um processo infeccioso, a qual acarreta alta taxa de mortalidade. Relatos da literatura tem demonstrado que pacientes e animais de experimentação que sobrevivem à sepse desenvolvem quadro de imunossupressão tardia, o qual contribui com a maior sucetibilidade destes a infecções secundárias. Nosso grupo demonstrou que as células T reguladoras (Tregs) participam ativamente do desenvolvimento desta imunossupressão. O Fator de Necrose Tumoral (TNF) é uma citocina pleotrópica responsável por diversas funções durante a resposta inflamatória, apresentando dois receptores responsáveis pelas suas atividades: o TNFR1 e o TNFR2. Foi demonstrando que o TNF exerce um importante papel na atividade de Tregs, induzindo a proliferação, estabilização do fenótipo e aumentando sua atividade imunossupressora, sugerindo que tais atividades sejam atribuidas ao TNFR2. Desta forma, nosso objetivo foi avaliar a participação dos receptores de TNF no desenvolvimento da imunossupressão pós-sepse. Para isso animais WT, TNFR1-/- e TNFR1/2 -/- foram submetidos à sepse grave, induzida por CLP e tratados com um suporte básico (reposição hidríca e antibioticoterapia). Inicialmente avaliamos a participação dos receptores de TNF na fase aguda da sepse. Demonstramos que nesta fase os receptores de TNF, principalmente TNFR1, apresentam um papel prejudicial na migração de neutrófilos, no controle do processo infeccioso e nas lesões de orgãos decorrentes da sepse. Posteriormente, os animais sobreviventes foram infectados com um dose subletal de L. pneumophila i.n 15 dias após a CLP. Avaliamos a participação dos receptores TNF na sucetibilidade à infecção secundária induzida por L. pneumophila em animais sobreviventes à sepse. Observamos que animais TNFR1-/- sobreviventes à sepse são mais suscetíveis, ao passo que animais TNFR1/2-/- sobreviventes à sepse são resitentes à infecção secundária em relação aos animais WT sobreviventes à sepse. Avaliamos então, a expansão de Tregs no baço destes animais sobreviventes à sepse e, observamos que animais TNFR1-/- apresentam aumento da expansão de Tregs, ao passo que os animais TNFR1/2-/- não apresentaram expansão de Tregs comparados ao WT. Observamos também que as Tregs apresentam maior densidade de receptores de TNF do que as células T convencionais e, que durante a sepse ocorre aumento da densidade destes receptores nas Tregs. Sugerimos então que possivelmente o TNFR1 seja um regulador negativo, enquanto o TNFR2 possa assumir um papel na regulação positiva na expansão de Tregs após a sepse, durante o desenvolvimento da imunossupressão. / Sepsis is a systemic inflammatory response syndrome resulting from infectious process, resulting in high mortality rate. It has been shown that septic mice and patients that survived from sepsis develop a late immunosuppression, which contributes to greater susceptibility to these secondary infections. Our group has shown that regulatory T cells (Tregs) actively participate in the development of this immunosuppression. The Tumor Necrosis Factor (TNF) is pleiotropic cytokine responsible for several processes in the inflammatory response. Two receptors are responsible for the various activities of TNF: TNFR1 and TNFR2. It have shown that TNF plays an important role in the activity of Tregs, inducing proliferation, stabilization of phenotype and increasing their immunosuppressive activity. The authors also suggested that these activities are TNFR2-mediated. Thus, our objective was to evaluate the role of TNF receptors in the acute phase of sepsis and also in the development of immunosuppression post-sepsis. For that, TNFR1-/ -, TNFR1/2 -/ - and WT mice were underwent to severe sepsis induced by CLP and treatment with basic support (hydration and antibiotics). Initially we evaluated the participation of TNF receptors in the acute phase of sepsis. We suggest that at this stage the TNF receptor, TNFR1 mainly exert a deleterious role in the migration of neutrophils in control of the infectious process and the tissue damage resulting from sepsis. In addition, the survivors from the septic event were intranasaly infected with L. pneumophila in the 15th day after sepsis induction. We evaluated the participation of these receptors in susceptibility to secondary infection induced by L. pneumophila in survivors from sepsis. Comparing the animals that survived from sepsis, we observed that TNFR1/2-/- , like WT mice, are not susceptible to the secondary infection, while TNFR1-/- survivors are more susceptible to it. We also observed that TNFR1-/ - animals show increased expansion of Tregs in the spleen, different of TNFR1/2-/- mice, that did not show expansion of Tregs compared to WT. We also observed Tregs have a higher density of receptors for TNF than conventional T cells, whereas during sepsis occurs increased expression of this receptor in Tregs. Altogether, the results suggest that TNFR1 is a negative regulator, whereas TNFR2 may play a role in the upregulation during expansion of Tregs, in development of sepsis-induced imunossupression.

OBJECTIVE: Tumor necrosis factor-alpha (TNF-α) is a multifunctional proinflammatory cytokine that plays a critical role in mediating inflammatory and immunological responses. TNF-α has been shown to elicit both beneficial and detrimental biological effects by acting through its two receptors, TNFR1/p55 and TNFR2/p75. Previous studies from this laboratory have shown that TNF-TNFR2/p75 signaling plays a critical role in ischemia-induced neovascularization in muscle and heart tissues. However, the role of TNF-TNFR2/p75 signaling in ischemia induced inflammation and muscle regeneration remains to be characterized. METHODS: To evaluate ischemia induced inflammation responses, young wild type (WT) and young TNFR2/p75 knockout (p75KO) mice were subjected to unilateral hind limb ischemia (HLI) surgery. Operated hind limb tissue samples were collected at 1, 3, 7, and 10 days post-HLI surgery and studied for neutrophil (myeloperoxidase-1 positive cells) and macrophage (F4/80 positive cells) infiltration as well as satellite-cell activation (neural cell adhesion molecule positive cells) at each time point. To determine possible synergistically negative roles of tissue aging and the absence of TNFR2/p75 in either the tissue or bone marrow (BM), two chimeric BM transplantation (BMT) models were generated where young Green Fluorescent Protein (GFP) positive (+) p75KO and WT BM-derived cells were transplanted into adult p75KO mice. HLI surgery was performed one month post-BMT, after confirming complete engraftment of the recipient BM with GFP donor cells. Operated hind limb tissue samples were evaluated up to 28 days post-surgery to examine proliferation and apoptosis of BM-derived cells in ischemic tissue. RESULTS: Ischemia induced significant and long-lasting inflammation associated with a considerable decrease in satellite-cell activation in p75KO muscle tissue 1-10 days post-HLI surgery. For the BMT studies, in adult p75KO with the WT-BMT, proliferative (Ki67+) cells were detected only by day 28 and were exclusively GFP (+), suggesting delayed contribution of young WT-BM cell to adult p75KO ischemic tissue recovery. No GFP (+) young p75KO BM cells survived in adult p75KO tissue. CONCLUSION: The data demonstrate that: (1) ischemia-induced recovery in skeletal muscle tissue is impaired in young p75KO mice; (2) inflammatory responses are significantly increased and long-lasting in p75KO mice; (3) in the absence of TNFR2/p75 signaling, satellite-cell activation is affected in p75KO mice; (4) during post-ischemic recovery, tissue aging combined with decreased/absent TNFR2/p75 signaling may have synergistically negative roles on survival and proliferation in the damaged tissue.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-03-02T15:00:57Z No. of bitstreams: 1 michelefernandesrodrigues.pdf: 2239638 bytes, checksum: a1bfd99261016639937e0a5a3ee8fb49 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-04-24T01:36:07Z (GMT) No. of bitstreams: 1 michelefernandesrodrigues.pdf: 2239638 bytes, checksum: a1bfd99261016639937e0a5a3ee8fb49 (MD5) / Made available in DSpace on 2016-04-24T01:36:07Z (GMT). No. of bitstreams: 1 michelefernandesrodrigues.pdf: 2239638 bytes, checksum: a1bfd99261016639937e0a5a3ee8fb49 (MD5) Previous issue date: 2013-04-10 / A tuberculose (TB) é uma doença de importância mundial. Os bacilos que causam a tuberculose entram no organismo principalmente pelas vias aéreas e a interação inicial nos pulmões é com os macrófagos alveolares, que servem como células hospedeiras. A morte dos macrófagos infectados por apoptose constitui uma alternativa de defesa do hospedeiro capaz de remover o ambiente de suporte para o crescimento bacteriano. No entanto, cepas virulentas de micobactérias parecem ser capazes de modular este processo. Alguns estudos tem destacado a importância do fator de necrose tumoral alpha (TNF-α) na modulação da apoptose de macrófagos infectados. O TNF-a exerce suas atividades biológicas através de dois receptores de superfície celular, TNFR1 e TNFR2, cujos domínios extracelulares podem ser clivados por proteólise formando receptores solúveis (sTNFR-1 e sTNFR-2). A sinalização através do TNFR1 desencadeia a maioria das funções biológicas do TNF-a, resultando em sobrevivência ou morte celular, enquanto que o TNFR2 induz a sobrevivência da célula. O objetivo deste estudo foi avaliar a influência do TNF e seus receptores na modulação da apoptose de macrófagos alveolares durante a fase inicial de infecção por cepas atenuada e virulenta de Mycobacterium bovis, bem como, a possível interferência da micobactéria na sinalização TNF-TNFR. Para tal, camundongos C57BL/6 foram infectados, via intratraqueal, com as cepas atenuada (BCG Moreau) ou virulenta (ATCC19274) de M. bovis. Após 3 e 7 dias de infecção, os seguintes parâmetros foram avaliados: (1) expressão de receptores de TNF (TNFR1 e TNFR2) na superfície de macrófagos alveolares, (2) expressão gênica dos receptores TNFR1 e TNFR2, (3) níveis dos receptores solúveis sTNFR1 e sTNFR2 no lavado broncoalveolar e níveis de TNF-a no pulmão (4) freqüência da apoptose de macrófagos alveolares e (5) número de bacilos nos macrófagos alveolares. Além disso, o efeito do bloqueio da sinalização TNF-TNFR1 na modulação da apoptose de macrófagos foi avaliado em camundongos deficientes em TNFR1 infectados com M. bovis BCG. Um aumento significativo da apoptose e da expressão superficial de TNFR1 foram observadas em macrófagos alveolares 3 e 7 dias após a infecção com M. bovis atenuado, mas apenas no 7º dia de infecção com o M. bovis virulento. Baixa expressão superficial de TNFR1 e aumento dos níveis de sTNFR1 no 3º dia após a infecção pela cepa virulenta foram associados com reduzidas taxas de macrófagos apoptóticos. Além disso, uma redução significativa da apoptose de macrófagos alveolares foi observada em camundongos TNFR1-/- no 3º dia após a infecção com BCG. Estes resultados sugerem um papel potencial do TNFR1 na apoptose de macrófagos durante a infecção pela micobactéria. Neste contexto, a clivagem do TNFR1 parece contribuir para a modulação da apoptose de macrófagos. / Tuberculosis (TB) is a disease of worldwide importance. The tubercle bacilli enter the organism mainly via respiratory tract and initial interaction in the lungs is with the alveolar macrophages, which serve as host cells. Apoptosis of the infected macrophages constitutes a host defense alternative capable of removing the environment supporting bacterial growth. However, virulent strains of mycobacteria appear to be capable of modulate this process. Some studies have highlighted the importance of tumor necrosis factor-a (TNF-α) in the modulation of apoptosis of infected macrophages. TNF-a exerts its biological activities via two distinct cell surface receptors, TNFR1 and TNFR2, whose extracellular domain can be released by proteolysis forming soluble TNF receptors (sTNFR-1 and sTNFR-2). The signaling through TNFR1 initiates the majority of the biological functions of TNF-a, leading to either survival or cell death, whereas TNFR2 induces survival. The aim of this study was to evaluate the influence of TNF-TNFR signaling in the modulation of apoptosis of alveolar macrophages during early stage of infection by virulent and attenuated strains of Mycobacterium bovis, as well as the possible interference of mycobacteria in this signaling. C57BL/6 mice were intratracheally infected with attenuated (BCG Moreau) or virulent (ATCC19274) strains of M. bovis. After 3 and 7 days of infection, the following parameters were assessed: (1) expression of TNF receptors (TNFR1 and TNFR2) on the surface of alveolar macrophages, (2) expression mRNA for TNF receptors, (3) levels of soluble receptors sTNFR1 e sTNFR2 in BAL and levels of TNF-a in lung (4) frequency of apoptosis alveolar macrophage and (5) number of bacilli in alveolar macrophages. Furthermore, the effect of abrogation of TNF-TNFR1 signaling in the modulation of macrophage apoptosis was assessed in TNFR1 deficient mice infected with M. bovis BCG. A significant increase of apoptosis and high expression of TNFR1 were observed in alveolar macrophages at 3 and 7 days after infection with attenuated M. bovis but only on day 7 in infection with the virulent M. bovis. Low surface expression of TNFR1 and increased levels of sTNFR1 on day 3 after infection by the virulent strain were associated with reduced rates of apoptotic macrophages. In addition, a significant reduction in apoptosis of alveolar macrophages was observed in TNFR1-/- mice at day 3 after BCG infection. These results suggest a potential role of TNFR1 in macrophage apoptosis during infection by mycobacteria. In this context, the shedding of TNFR1 appears to contribute to the modulation of macrophage apoptosis.

Type I diabetes (T1D) is an autoimmune disease characterized by the destruction of insulin-producing β cells in the pancreas. Destruction of the body's own proteins, cells, and tissues is precipitated by the dysfunction of cytokine production, protein modification, and signaling pathways in immune cell subtypes. Tumor Necrosis Factor α (TNFα) and its receptors Tumor Necrosis Factor 1 (TNFR1) also known as p55 and TNFRSF1A, and Tumor Necrosis Factor 2 (TNFR2) also known as P75 and TNFRSF1B play a crucial role in this autoimmune process. TNFα has been shown to stimulate cell death through TNFR1 signaling by the caspase system, while promoting cell survival through TNFR2 signaling using the Nuclear Factor Kappa-Light-Chain-Enhancer of Activated B cells (NF-𝜅B) pathway. Recent findings show a defect in immuno-proteasomes found in autoreactive T cells in people with T1D. This defect causes improper signaling transduction when TNFα binds to TNFR2. The inability to save the cell by activating the NF-𝜅B pathway eventually leads instead to apoptosis using the caspase system. A decrease in TNFα or increase in soluble TNFα receptors might be an explanation for these autoreactive T cells to evade the host immune system, and allow them to cause destruction of the pancreas. We hypothesize that patients with T1D will show abnormal distribution of TNFα and its receptors at basal levels, as well as when stimulated with interleukins, cytokines, and bacteria such as interleukin-2 (IL-2), lipotechoic acid (LTA), granulocyte macrophage-colony stimulating factor (GM-CSF), and Bacillus Calmette-Guérin (BCG). To test this hypothesis, we obtained peripheral blood from T1D patients (n=102) and controls (n=89) and performed in vitro stimulation assays. After a 48-hour incubation, tissue culture supernatants were collected and analyzed for TNF and its receptors production by ELISA, as well as densities of cell membrane receptors by flow cytometry. The data from this study showed significant differences in basal levels of TNFα, TNFR1, and TNFR2 on both the membrane and in the serum between patients and controls. Patients contained a greater percentage of CD4, 8, and 14 - TNFR2 and not TNFR1 double positive cells than their healthy control counterparts. Patient's sera also contained higher levels of all three markers, sTNFα, sTNFR1, and sTNFR2 than the controls. However, no significant differences were found between patient and controls when stimulated with the various compounds listed above.

Painful conditions having the origin within the musculoskeletal system is a common cause for people to seek medical care. Between 20-40% of all visits to the primal care in Sweden are coupled to pain from the musculoskeletal system. Muscle pain and impaired muscle function can be caused by muscles being repetitively overused and/or via heavy load. Skeletal muscle is a dynamic tissue which can undergo changes in order to fulfill what is best for optimal function. However, if the load is too heavy, morphological changes including necrosis, as well as pain can occur. The extension of the skeletal muscle is the tendon. Tendinopathy refers to illness and pain of the tendon. The peritendinous tissue is of importance in the features related to tendon pain. Common tendons/origins being afflicted by tendinopathy/pain are the Achilles tendon and the extensor origin at the elbow region.    Tumor necrosis factor alpha (TNF-alpha) is a cytokine that is involved in several biological processes. It is well-known for its involvement in the immune system and is an important target for inflammatory disorders such as rheumatoid arthritis. It is not known to what extent the TNF-alpha system is involved in the process of muscle inflammation and damage due to overuse.    Studies were conducted on rabbit and human tissue, tissues that either had undergone an excessive loading activity or tissue that was removed with surgery due to painful conditions. The tissues were evaluated via staining for morphology, in situ hybridization and immunofluorescence.    Unilateral experimental overuse of rabbit muscle (soleus muscle) led to morphological changes in the soleus muscle tissue bilaterally. The longer the experiment extended, the more was the tissue affected. This included infiltration of white blood cells in the tissue (myositis) and abnormal muscle fiber appearances. TNF-alpha mRNA was seen in white blood cells, in muscle fibers interpreted to be in a reparative stage and in white blood cells that had infiltrated into necrotic muscle fibers.  There was an upregulation in expressions of TNF receptor type 1 (TNFR1) and TNF receptor type 2 (TNFR2) in muscles that were markedly overused, with expressions in white blood cells, fibroblasts, blood vessel walls and muscle fibers. Immunoreactions for the receptors were seen in nerve fascicles of markedly overused muscles but only occasionally in normal muscles. The upregulations were seen for both experimental and contralateral sides. Overall the two receptors showed somewhat different expression patterns. Tendinopathy is associated with an increase in blood flow and infiltration of white blood cells in the tissue adjacent to the tendon. It is called the peritendinous tissue and is also richly innervated. The white blood cells and the blood vessels walls in this tissue were showing immunoreaction for TNFR1 and TNFR2. Two types of nerve fascicles were found in this tissue, one normally appearing when staining for nerve markers and one type with signs of axonal loss. The latter had clearly strong immunoreactions for TNFR1 and TNFR2.    The findings suggest that the TNF-alpha system is involved in both myopathies occurring due to overuse and in features in the peritendinous tissue in the tendinopathy situation. TNF-alpha and its receptors seem to be involved in degeneration but also in regeneration and healing of the tissue. The findings also suggest that TNF-alpha has effects on nerves showing axonal loss. The changes in the TNF-alpha system were seen both on the experimental side and contralaterally. / Smärta och funktionsbortfall från rörelseapparaten är vanligt förekommande. Mellan 20-40% av alla besök i primärvården är kopplade till smärta från rörelseapparaten. Det är också en vanlig orsak till sjukfrånvaro. Överansträngning inklusive repetitivt enformigt muskelarbete kan leda till muskelsmärta och bristande muskelfunktion (ex nedsatt styrka och uthållighet, inskränkt rörlighet). Muskelvävnad är en dynamisk vävnad som kan ändras utefter vilka påfrestningar den utsätts för och därigenom vilka behov den ställs inför. Men om belastningen blir för hård, alternativt återhämtningen blir för kort, kan negativa förändringar i vävnadsstrukturen uppstå, inklusive celldöd och vävnadsskada. Förlängningen av muskeln är senan. Senan är den vävnad som förbinder muskeln med skelettet. Tendinopati innefattar smärtsamma sjukdomstillstånd i senan. När sjukdom i en sena uppstår, exempelvis en smärtande hälsena, har man sett att den lösa bindväven som omger senan är av betydelse. Den genomgår morfologiska förändringar och man tror att det är den som är med och bidrar till smärtan vid tillståndet. Akillessenan och ”tennis-armbåge” är vanliga ställen för tendinopati. Akillessenan förbinder den trehövdade vadmuskeln med hälbenet. Tennis-armbåge omfattar ett område för flera musklers ursprung vid armbågen. Dessa muskler ansvarar framför allt för att sträcka i handleden. TNF-alfa är en signalsubstans som är involverad i flertalet biologiska processer. Den är känd för sin del i immunförsvaret och den är ett viktigt mål för behandling av autoimmuna sjukdomar som exempelvis reumatoid artrit. Det är inte känt om TNF-alfa är inblandad i processen som uppstår vid muskelinflammation/muskelskada efter kraftig överansträngning. TNF-alfa har flera receptorer, i det här arbetet har utbredning av TNFR1 och TNFR2 analyserats. Studier har utförts på djur (kaniner) och människa. Kaniner har genomgått ett träningsexperiment, där de utsatts för repetitiva muskelkontraktioner som lett till överansträngningsskador och muskelinflammation. Den muskel som studerats är soleus-muskeln, en del i den trehövdade vadmuskeln. Vävnadsprover har tagits från patienter med smärta i Akillessenan eller tennisarmbåge. Vävnadsproverna från kanin och människa har analyserats med färgningar för morfologi, immunohistokemi för detektering av TNF-alfa och dess receptorer samt för in situ hybridisering för detektion av mRNA i TNF-alfa systemet. Parallellt med färgningar för faktorerna i TNF-alfa systemet har uttryck för andra faktorer studerats. Ensidig överbelastning hos kaniner ledde till samma morfologiska förändringar på båda sidor, det vill säga även i muskeln i det ben som inte hade genomgått träningsexperimentet. Ju längre experimentet pågick, desto större blev de morfologiska förändringarna. TNF-alfa sågs i vita blodkroppar, TNF-alfa mRNA sågs även i förändrade muskelfibrer. Resultatet av parallella dubbelfärgningar tolkades som att dessa muskelfibrer antingen var i en regenererande process eller i en destruktiv process. TNFR1 och TNFR2 uttrycktes i större utsträckning ju längre experimentet pågick och ju mer muskelvävnaden var påverkad av inflammation. TNF receptorer sågs i vita blodkroppar, fibroblaster, muskelfibrer och nervstrukturer hos experimentdjuren. Det såg lika ut på båda sidor, inklusive det ben som inte ingått i experimentet. De två receptorerna skilde sig åt i uttryck. Vävnad från patienter med smärtande senor/smärta vid muskelursprungs-region genomgick också färgningar för faktorer i TNF-alfa systemet. Man kunde se att den lösa bindväven runt senan (den peritendinösa vävnaden) innehöll mycket blodkärl och nerver. De nerver som sågs i denna vävnad var av två typer, en som såg normal ut och en typ som uppvisade tecken på förlust av axoner. Den senare varianten hade en tydlig uppreglering av båda TNF receptorerna. Dessa resultat tyder på att TNF-alfa systemet är involverat i muskelsjukdomar som rör muskelinflammation till följd av kraftig överansträngning och i processerna i bindväven vid smärtande senor. TNF-alfa och dess receptorer verkar vara inblandade i både nedbrytning och uppbyggnad av muskelvävnad, samt påverka nerver som visar tecken på förlust av axoner. Förändringarna i TNF-alfa systemet sågs både på experimentsidan och kontralateralt.

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Les lymphocytes T régulateurs (Treg) jouent un rôle majeur dans la modulation de l’alloréactivité après allogreffe de cellules souches hématopoïétiques et permettent notamment de contrôler la réaction du greffon contre l’hôte (GVH) dans des modèles expérimentaux. Le potentiel thérapeutique des Treg est donc très important dans ce domaine, mais aussi dans l’auto-immunité ou en cancérologie. Cependant, de nombreuses barrières rendent difficile l’élaboration de stratégies thérapeutiques reposant sur le transfert adoptif de Treg chez l’homme et une meilleure compréhension des facteurs et mécanismes contrôlant la prolifération et les capacités suppressives de ces cellules permettrait de les cibler directement et si possible spécifiquement in vivo.Dans ce travail, après avoir élaboré un nouveau système d’évaluation clinique de la GVH chez la souris et démontré sa simplicité, sa reproductibilité et sa performance, nous avons pu montrer que l’action suppressive des Treg dans la GVH dépendait de l’interaction entre le TNFα produit par les lymphocytes T conventionnels (Tconv) du donneur et le récepteur TNFR2 exprimé par les Treg. En effet, en bloquant cette interaction de 3 façons différentes, à savoir par un anticorps monoclonal bloquant anti-TNFR2, ou en utilisant soit des Treg n’exprimant pas TNFR2 soit des Tconv ne produisant pas de TNFα, nous avons à chaque fois montré que l’effet protecteur des Treg était aboli en l’absence du signal TNF. Le récepteur TNFR2 étant exprimé préférentiellement par les Treg par rapport aux Tconv, nos résultats ouvrent la voie au ciblage des Treg in vivo via TNFR2, soit pour activer ce récepteur par un agoniste et donc stimuler les Treg afin de contrôler la GVH, soit à l’inverse pour bloquer l’axe TNFα/TNFR2 par un antagoniste et ainsi inhiber les Treg, ce qui permettrait alors de lever un frein à l’alloréactivité dans les situations où l’on cherche à la stimuler pour renforcer l’effet anti-tumoral, comme par exemple dans le cas des rechutes post-allogreffe. / Regulatory T cells (Tregs) are key players involved in the modulation of alloreactivity after hematopoietic stem cell transplantation. Indeed, Tregs can prevent graft-versus-host disease (GVHD) in experimental models. Therefore, the therapeutic potential of these cells in GVHD is substantial, as it is in other fields like auto-immunity or oncology. However, many obstacles still make the application of cellular therapy strategies based on the adoptive transfer of Tregs in humans quite complicated. A better understanding of factors and mechanisms that control the proliferation and suppressive capacities of Tregs could allow for a direct and specific targeting of these cells in vivo.In this work, after designing a new clinical grading system for murine GVHD and demonstrating its ease of use, reproducibility and performance, we have shown that the suppressive action of Tregs in GVHD depends on the interaction between TNFα produced by donor conventional T cells (Tconvs) and TNFR2 expressed by Tregs. Using 3 different ways to block this interaction, i.e. with an anti-TNFR2 blocking monoclonal antibody, or Tregs that do not express TNFR2 or donor Tconvs that cannot produce TNFα, we were able to show in each situation that blocking TNF signaling resulted in a loss of protection by Tregs. TNFR2 being highly expressed by Tregs as compared with Tconvs, our results pave the way for in vivo targeting of Tregs through TNFR2, either to activate this receptor with an agonist and therefore stimulate Tregs to control GVHD, or to block the TNFα/TNFR2 axis with an antagonist and in this case inhibit Tregs, which could boost alloreactivity, as expected in some particular settings like post-transplant relapse.