Morphine has been and continues to be one of the most potent and widely used drugs for the treatment of pain. Clinical and animal models investigating sex differences in pain and analgesia demonstrate that morphine is a more potent analgesic in males than in females; indeed, we report the effective dose of morphine for female rats is twice that of male rats. In addition to binding to the neuronal mu opioid receptor, morphine binds to the innate immune receptor toll-like receptor 4 (TLR4) on microglia. Morphine action at TLR4 initiates a neuroinflammatory response and directly opposes morphine analgesia. Our recent studies demonstrate that administration of chronic morphine activates microglia within the ventrolateral periaqueductal gray (vlPAG), a critical brain region for the antinociceptive effects of morphine, while blockade of vlPAG microglia increases morphine analgesia and suppresses the development of tolerance in male rats. Despite increasing evidence of the involvement of microglia in altering morphine efficacy, no studies have examined sex differences in microglia within the PAG. The present experiments seek to characterize the distribution and activity of vlPAG microglia in males and females using behavioral, immunohistochemical and molecular techniques, while demonstrating the sufficiency and necessity of vlPAG microglia to produce sex differences in morphine analgesia using site-specific pharmacological manipulation of TLR4. We also investigate a novel pharmacokinetic mechanism underlying the sexually dimorphic effects of morphine administration on microglial activity. Here, we address a fundamental gap in our current understanding of sex differences in morphine analgesia and establish a mechanistic understanding of how the activation of vlPAG microglia sex-specifically influences morphine analgesia.

Mutation, whether spontaneous or induced, is the premier tool for understanding gene function. One approach is to create mutations in a specific gene, and then use the resulting cell or organism to search for a phenotype. An alternative is to create mutations at random, and focus first on the identification of phenotypes. The mutation that underlies a phenotype can then be tracked down, forming the foundation of testable hypotheses. Using random chemical mutagenesis in mice, I have identified 20 heritable phenotypes affecting either the innate or adaptive branches of immunity. The genetic basis of 18 of these phenotypes was solved, caused by mutations in at least 16 unique genes. Five of these genes were not previously known to be involved in immunity, and a detailed analysis of four of them is provided in this thesis. These include genes encoding the following proteins: the inactive rhomboid protease iRhom2, which is specifically required for the secretion of tumour necrosis factor alpha; the hypothetical phospholipid flippase ATP11C, required for B cell development in the adult bone marrow; the folliculin-interacting protein FNIP1, also required for B cell development; and the zinc finger transcription factor ZBTB1, essential for the development of all lymphocyte lineages. These findings uncover new entry points for the understanding of mammalian immunity, and highlight the value of mouse forward genetics in the understanding of mammalian phenomena in general.

Memoria para optar al título de Químico Farmacéutico / El daño ocasionado por la ocurrencia de un infarto cardiaco es complejo, generando la pérdida de viabilidad de las células cardiacas entre otros efectos deletéreos ocurridos tanto en el periodo isquémico de falta de oxígeno y nutrientes, así como también en la posterior reperfusión sanguínea. Frente a esta condición patológica los fibroblastos cardiacos (FC) son capaces de reaccionar, secretando y renovando la matriz extracelular; lo que los convierte en elementos celulares claves en la cicatrización y remodelamiento del tejido cardiaco dañado post-infarto al miocardio. Esto hace necesario el intentar regular la viabilidad de estas células para una correcta cicatrización y mantención de la función cardiaca. En relación a esto se ha reportado el efecto cardioprotector ejercido por el empleo de LPS en condiciones de daño celular causado por isquemia/reperfusión (I/R). Sin embargo, dicho efecto ha sido descrito principalmente en cardiomiocitos, por lo que su efecto en FC es aún desconocido. Nuestro trabajo estudió la capacidad cito-protectora ejercida por LPS sobre FC de ratas neonatas sometidos a un modelo de I/R in vitro e indagó las vías transduccionales implicadas en este efecto. El tratamiento de los FC con LPS (1 μg/mL) durante la isquemia y reperfusión previno la pérdida de viabilidad inducida por I/R. Sin embargo, en el pre-condicionamiento con LPS durante 24 o 16 h, y en el tratamiento con LPS durante la isquemia o reperfusión, no se observó el efecto cito-protector. En esta misma línea, demostramos que el efecto cito-protector ejercido por LPS es mediado a través del receptor TLR4 vía PI3K/Akt y ERK1/2, ya que el empleo de TAK-242, Ly29002 y PD98059, inhibidores del receptor y de las vías transduccionales respectivamente, bloquearon completamente el efecto cito-protector. La activación de TLR4 por LPS previno, además, el procesamiento de la procaspasa 8 y 3 inducido por I/R. Conjuntamente, demostramos que las vías PI3K/Akt y ERK1/2 participaban en la prevención del procesamiento de la procaspasa 8 ejercido por LPS, pero no tuvieron efecto en la activación de la caspasa 3. Nuestros resultados dan cuenta del efecto cito-protector y antiapoptótico ejercido por LPS a través de TLR4 vía PI3K/Akt y ERK1/2 frente a la muerte de FC inducida por I/R / The damage caused by a myocardial infarct is complex, causing cardiac cell viability loss, among other deleterious effects that occur during the ischemia period, such as lack of oxygen and nutrients; as well as the posterior reperfusion with blood. In this situation, cardiac fibroblasts react by secreting proteins and renewing the extracellular matrix. These properties make them a key element in the scar and remodeling process of the injured cardiac tissue. Thus, the viability of these cells are required to preserve the correct functioning of the heart. In this regard, the use of LPS as a cytoprotector agent in cardiac Ischemia/reperfusion (I/R) has been reported. However such effect has been described mostly in cardiomyocytes cells, whereas its role in cardiac fibroblasts remains unknown. Our work studied the LPS cytoprotector effect in neonate cardiac fibroblast exposed to an in vitro model of I/R, and transductional pathways involved in this process were explored. Incubation with LPS (1μg/mL) during both ischemia and reperfusion periods prevented the I/R-induced cell loss. However, LPS used only during preconditioning, ischemia or reperfusion did not induced cytoprotection. Furthermore we demonstrated that the LPS-dependent protective effects were completely abolished when TLR4 receptor (TAK-242), and PI3K/Akt and ERK1/2 (Ly29002 and PD98059, respectively) inhibitors were used. These data suggest that LPS-dependent cytoprotector effects are mediated through TLR4 receptor activation and PI3K/Akt and ERK1/2 signalling pathways. Additionally the activation of TLR4 by LPS prevented the cleave of procaspases 3 and 8 induced by I/R. Both PI3K/Akt and ERK1/2 were necessary for the prevention of the caspase 8 activation, but not of caspase 3. Our results conclude that LPS protects cardiac fibroblasts from I/R apoptosis by the activation of TLR4 and both PI3K/Akt and ERK1/2 signalling pathways / FONDECYT

肥大細胞是過敏和炎症的主要效應細胞，其激活機制包括了IgE依賴性和非IgE依賴性的激活。IgE依賴性激活是指抗原與IgE的高親和力受體FcεRI上的IgE結合，促使FcεRI受體交聯而引起變態反應。其它的肥大細胞促分泌素如神經肽P物質，能夠激活百日咳毒素（PTX）敏感性的G蛋白而介導非IgE依賴性的細胞激活。最近的研究指出，肥大細胞表達Toll樣受體家族，提示肥大細胞也積極參與固有免疫反應。本研究主要探討Toll樣受體2激動劑肽聚糖（PGN）和合成激動劑Pam3CSK4對人類肥大細胞的影響，及其對抗原和P物質引起的肥大細胞激活的調控。 / Toll樣受體2激動劑本身不引起人類肥大細胞脫顆粒，但抑制抗原和P物質引起的肥大細胞脫顆粒。鈣動員是引起肥大細胞脫顆粒的關鍵因素。Pam3CSK4通過抑制抗原和P物質鈣動員來抑制肥大細胞脫顆粒。PGN只抑制抗原鈣動員，卻對P物質沒有影響。 / PGN和Pam3CSK4皆刺激人類肥大細胞釋放白細胞介素8(IL-8)和腫瘤壞死因子α（TNF-α）。Pam3CSK4通過激活G₀蛋白，Erk，Ca²⁺/calcineurin/NFAT和TAK信號通路引起肥大細胞釋放IL-8。其間，Go蛋白的激活介導Erk和Ca²⁺/calcineurin/NFAT信號通路的活化。與Pam3CSK4不同，PGN通過激活JNK, Erk, PI3K和TAK信號通路引起肥大細胞釋放IL-8。此外，雖然PTX敏感性G蛋白不影響PGN刺激引起的IL-8釋放，它卻抑制PGN刺激引起的Erk激活。 / Pam3CSK4與抗原協同作用刺激肥大細胞釋放IL-8和TNF-α，PGN與抗原卻並無協同作用。PGN與P物質協同作用刺激肥大細胞釋放IL-8和TNF-α，Pam3CSK4卻幹擾P物質的作用。在Pam3CSK4與抗原的協同作用中，Erk，Ca²⁺/calcineurin/NFAT和TAK信號通路起重要作用。PGN與P物質的協同作用則通過Erk, Ca²⁺/calcineurin/NFAT，NF-κB，PI3K和TAK這五條信號通路。 / 本研究表明，不同的Toll樣受體2激動劑能通過不同的作用機制介導和調控人類肥大細胞的反應。同時，我們首次發現G₀蛋白參與人類肥大細胞Toll樣受體2信號的激活。由於Toll樣受體2與感染和炎症息息相關，繼續研究Toll樣受體2激活對人類肥大細胞的調控機制，有助於促進開發抗感染和炎症藥物，意義深遠。 / Mast cells are activated by IgE-dependent and -independent mechanisms and play a pivotal role in both allergic and inflammatory responses. The classical IgE-dependent mechanism involves the binding of antigens to the receptor-bound IgE and crosslinking of the high-affinity receptor for IgE (FcεRI). For the poly-basic secretagogues, such as the neuropeptide substance P, they can directly stimulate pertussis toxin (PTX)-sensitive G proteins in mast cells in an IgE-independent manner. Recent studies also discover the expression of the Toll-like receptors on mast cells, indicating that mast cells are active players in innate immunity against a wide variety of pathogens. In this study, we investigated the effects of Toll-like receptor 2 (TLR2) ligands peptidoglycan (PGN) and Pam3CSK4 on human mast cell line LAD2 cells activation and the modulatory effects of these TLR2 ligands on LAD2 cells activities in response to anti-IgE and substance P. / TLR2 ligands did not cause significant degranulation on their own, but inhibited anti-IgE and substance P induced degranulation. Pam3CSK4 acted through TLR2, while the inhibitory effect of PGN involved other non-TLR2 related mechanisms. Pretreatment of Pam3CSK4 inhibited calcium mobilization induced by anti-IgE and substance P. However, pretreatment of PGN only inhibited calcium mobilization induced by anti-IgE, but failed to demonstrate similar effect on substance P. / Both TLR2 ligands triggered the release of IL-8 and TNF-α from LAD2 cells in TLR2-dependent manner. G protein, MAPKs, Ca²⁺/calcineurin/NFAT, PI3K/Akt and TAK pathways were differentially activated by PGN and Pam3CSK4. Release of IL-8 induced by Pam3CSK4 required the involvement of G₀ protein, Erk, Ca²⁺/calcineurin/ NFAT and TAK signaling pathways, but not PI3K/Akt and NF-κB. Meanwhile, G₀ protein was required for the upstream regulation of Erk and Ca²⁺/calcineurin/NFAT signaling cascades activated by Pam3CSK4. In contrast to Pam3CSK4, IL-8 release induced by PGN required the activation of JNK, Erk, PI3K and TAK signaling pathways, but not Ca²⁺ /calcineurin/NFAT and NF-κB. PTX-sensitive Gi/o protein was also involved in PGN induced Erk phosphorylation without influencing IL-8 release. / Pam3CSK4 acted in synergy with anti-IgE to augment the release of IL-8 and TNF-α, but PGN failed to demonstrate similar effect. In contrast, PGN acted in synergy with substance P, while co-stimulation of Pam3CSK4 with substance P failed to demonstrate similar synergism. Erk, Ca²⁺/calcineurin/NFAT and TAK signaling pathways were required for the synergistic action of Pam3CSK4 combined with anti-IgE, while synergistic release of IL-8 induced by PGN and substance P required the activation of Ca²⁺/calcineurin/NFAT, Erk, NF-κB, PI3K, and TAK signaling networks and was enhanced by Ca²⁺/calcineurin/NFAT and NF-κB signaling cascades in LAD2 cells, although NF-κB was not required for IL-8 release induced by PGN or substance P. / These ndings suggest that activation of human mast cells LAD2 can be differentially modified by different TLR2 ligands via distinct signaling pathways. We identify for the first time the involvement of G₀ protein in TLR2 signaling transduction in human mast cells. Further studies of the regulation of mast cells by Toll-like receptors will provide important opportunities for the therapeutic manipulation of infection and allergic diseases. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Yu, Yangyang. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 205-233). / Abstract also in Chinese. / Abstract (English) --- p.i / Abstract (Chinese) --- p.iv / Acknowledgements --- p.vi / Publication --- p.vii / Abbreviations --- p.viii / Contents --- p.x / Chapter 1 --- Introduction --- p.1 / Origin of mast cells --- p.1 / Cytokines and growth factors required for mast cells development --- p.3 / Mediators release from mast cell --- p.7 / Mast cells activation by classical IgE-dependent pathway --- p.13 / Substance P and mast cells --- p.20 / Mast cells in host defense --- p.23 / Toll-like receptors and mast cells --- p.25 / Aims --- p.31 / Chapter 2 --- Materials and Methods --- p.33 / Materials --- p.33 / Methods --- p.42 / LAD2 mast cells culture --- p.42 / Degranulation assay --- p.43 / IL-8 and TNF-α measurement --- p.44 / Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) --- p.44 / Western Blotting --- p.46 / Calcium mobilization assay --- p.47 / Flow cytometry assay --- p.48 / siRNA Transfection --- p.48 / Statistical analysis --- p.49 / Chapter 3 --- Functional Studies of Toll-Like Receptor 2 on Human Mast Cells Activation --- p.51 / Experimental conditions --- p.56 / Results --- p.57 / Discussions --- p.62 / Chapter 4 --- Modulatory Effects of Toll-Like Receptor 2 on Human Mast Cells in Response to Anti-IgE and the Signaling Pathways Involved in the Events --- p.80 / Experimental conditions --- p.92 / Results --- p.93 / Discussions --- p.102 / Chapter 5 --- Modulatory Effects of Toll-Like Receptor 2 on Human Mast Cells Activation in Response to Substance P and Signaling Pathways Involved in the Event --- p.136 / Experimental conditions --- p.140 / Results --- p.141 / Discussions --- p.152 / Chapter 6 --- General Discussion --- p.188 / Chapter 7 --- References --- p.205

A doença de Behçet tem sua fisiopatologia caracterizada por hiperatividade neutrofílica, particularmente em relação à quimiotaxia, e períodos de atividade da doença podem ser desencadeados por exposição a estreptococos. Uma vez que células do sistema imune inato são ativadas pelo ácido lipoteicoico (LTA) de bactérias gram-positivas via receptor toll-like (TLR) 2 e CD14, cujas expressões são reguladas pelos fatores estimulantes de colônias de granulócitos (G-CSF) e granulócitos-macrófagos (GM-CSF), o objetivo principal deste estudo foi determinar se há hiperexpressão de TLR2 em neutrófilos de DB ativa e se a quimiotaxia de polimorfonucleares (PMN) neutrófilos na DB poderia ser hiperestimulada pelo LTA. Além do TLR2, foram medidas as expressões de TLR4, CD14, CD114 (receptor de G-CSF) e CD116 (receptor de GM-CSF) nos neutrófilos e nos monócitos de pacientes com doença de Behçet (DB), as concentrações séricas de CD14 solúvel (CD14s) e as respostas quimiotáxicas dos PMNs de DB sob diferentes estímulos. A expressão dos receptores foi medida pela citometria de fluxo, as concentrações séricas por ELISA e as respostas quimiotáxicas foram avaliadas em câmara de Boyden. Nos PMNs, os receptores foram igualmente expressos nos dois grupos e, estimulados com LTA, suas respostas quimiotáxicas também foram similares. Somente à incubação com plasma os PMNs de DB desenvolveram hiperquimiotaxia em relação aos PMNs controles. A expressão do TLR2 foi maior em monócitos de DB em relação aos controles, e a concentração de CD14s sérica, de origem monocitária, foi maior nos pacientes com DB ativa. Em conjunto, os resultados demonstram que PMNs de DB, isoladamente, não reagem exacerbadamente ao LTA, e suas respostas migratórias são estritamente dependentes de fatores estimulantes solúveis. / Expressions of toll-like receptor (TLR) 2, TLR4, CD14, CD114 and CD116 were assessed on polymorphonuclear (PMN) neutrophils and monocytes of patients with Behçets disease (BD). PMN chemotactic responses under different stimulations were also measured. The objective was to determine if BD PMN chemotaxis may be overstimulated by lipoteichoic acid (LTA) from gram-positive bacteria. Receptor expressions were measured by flow cytometry and PMN chemotaxis was assessed in a Boyden chamber. Only TLR2 expression was higher on monocytes of the BD group than in control group. On PMNs, however, TLR2 expression was similar in both groups and, when stimulated with LTA, BD PMN cells showed chemotactic responses similar to the controls. These cells only exhibited increased chemotaxis when incubated with plasma. In conclusion, isolated BD PMN did not overreact to LTA, and its hyperchemotaxis is strictly dependent on soluble stimulating factors

INTRODUÇÃO: O Sarcoma de Kaposi (SK) é a neoplasia mais frequente dos doentes com Aids. É causada pelo herpes-vírus 8 (HHV-8). As células dendríticas plasmocitóides (CDp) são especializadas na produção de interferon tipo 1 e participam da resposta imune aos vírus. Os receptores \"toll-like\" são os principais receptores de reconhecimento de padrão, sendo que os receptores toll-like (TLR) 3 e 9 têm função no reconhecimento de vírus. O D2-40 é o anticorpo que reconhece a podoplanina, uma proteína transmembrana, presente no endotélio linfático e que tem função na imunidade. OBJETIVO: Demonstrar e comparar os componentes da imunidade inata: CDp e TLR 3 e 9, nas lesões cutâneas de SK associado a Aids e esporádico. Identificar a presença do HHV-8 nas CDp. Verificar o componente endotelial linfático na progressão das lesões de SK e comparar a expressão dos elementos da imunidade inata estudados, nas lesões com menor e maior componente endotelial linfático. MÉTODOS: Estudo retrospectivo de 50 biopsias de pacientes com diagnóstico de SK, todos com comprovação pelo exame histopatológico e demonstração do antígeno nuclear associado à latência (LANA) do HHV-8. Foram avaliados 11 biopsias de SK da forma clássica (SKc), 22 lesões de doentes com Aids (SK-Aids) e de 17 de doentes com Aids submetidos a tratamento com terapia antirretroviral altamente eficaz (SK-Aids/HAART). Os espécimes foram submetidos a exame por técnica imuno-histoquímica para evidenciar a presença de CDp (anticorpo CD303/BDCA-2), a expressão de TLR 3 e 9, bem como de podoplanina (anticorpo D2-40). Foi realizada também técnica de dupla marcação com CD303 e LANA, objetivando a identificação de CDp infectadas pelo HHV-8.Vinte e três espécimes de granuloma piogênico constituíram o grupo controle. A população de CDp e expressão de TLR 3 e TLR 9 também foi comparada nas lesões cutâneas de SK de doentes com e sem comprometimento visceral pela neoplasia; lesões não tumorais (máculo-papulares/placas) foram comparadas às lesões tumorais (nodulares) e de acordo com níveis sanguíneos de linfócitos T CD4+ (menor e igual ou maior que 350 células/mm3). RESULTADOS: As CDp foram mais numerosas nos espécimes de SK-Aids quando comparado com o granuloma piogênico. Foram identificadas CDp infectadas pelo HHV-8. A expressão de TLR 3 foi menor nas lesões de SK, independente da forma epidemiológica, do que no granuloma piogênico. Para todas as outras comparações da densidade de CDp e expressão de TLR 3 e de TLR 9 não houve diferença entre os grupos. Não houve diferença no componente endotelial linfático das lesões máculo-papulares/placas e tumorais do SK, assim como na expressão dos elementos da imunidade inata estudados entre as lesões com maior e menor componente endotelial linfático. CONCLUSÕES: Demonstrou-se pela primeira vez a presença de CDp e a expressão de TLR 3 e 9 em lesões cutâneas do Sarcoma de Kaposi, bem como a infecção de CDp pelo HHV-8 \"in situ\" nos tumores. Os resultados obtidos sugerem a participação das células CDp e do TLR 3 na patogênese das lesões cutâneas do Sarcoma de Kaposi, independente da presença do vírus da imunodeficiência humana. A imunomarcação de SK com o anticorpo D2-40, tanto nas fases precoce como tardia das lesões, confirma a natureza endotelial linfática das células neoplásicas. Esta parece não ter relação com a expressão dos elementos da imunidade inata estudados / Introduction: Kaposi\'s sarcoma (KS) is the most common Aids-associated malignancy. It is caused by human herpesvirus-8. Plasmacytoid dendritic cells (pDC) are professional interferon producing cells, and participate in the immune response against viruses. Toll-like receptors (TLR) are the main pattern recognition receptors, and TLR 3 and TLR 9 participate in the recognition of viruses. Podoplanin, recognized by antibody D2-40, is a transmembrane protein identified on lymphatic endothelial cells with functions inimmunity. Objective: Demonstrate and compare some innate immunity components: pDC, TLR 3 and TLR 9, in cutaneous lesions of Aids-associated Kaposi\'s sarcoma and classic Kaposi\'s sarcoma. Identify the infection of pDC by HHV-8. Compare the lymphatic endothelial component in the course of tumor progression and compare the expression of innate immunity elements in lesions with a predominance of lymphatic endothelial components or not. Methods: Retrospective study of 50 biopsies diagnosed as Kaposi\'s sarcoma withpositive staining for latency-associated nuclear antigen (LANA) of HHV-8. Eleven classic KS, 22 Aids-associated KS and 17 Aids-associated KS from patients undergoing highly active antiretroviral therapy (HAART) were assessed. Paraffinembedded tissue was submitted to immunohistochemistry technique in order to demonstrate pDC (CD303/BDCA-2 antibody), expression of TLR 3, TLR 9 and podoplanin (D2-40 antibody). We performed double staining with CD303 and LANA in order to identify pDC infection with HHV-8. Twenty-three pyogenic granuloma(PG) specimens were analyzed as a control group. Plasmacytoid dendritic cells population, TLR 3 and TLR 9 expressions were compared between patients with and without visceral disease, nodular stageandpatch/plaque stage and according to bloodlymphocytes T CD4 count(=350 cells/mm3). Results: Plasmacytoid dendritic cells density in Aids-associated SK was higher than in PG. We could identify pDC infection by HHV-8. The expression of TLR 3 in all forms of KS was less extensive than PG. All others comparisons about pDC density, TLR 3 and 9expressions were similar. We found no difference in D2-40 expression between nodular and patch/plaque stages. When comparing tumors with extensive expression of D2-40 (>= 50% of cells) and tumors with less expression (<50% of cells), we found no differences in density of pDC and expression of TLR 3 and TLR 9. Conclusion: This is the first time that pDC, TLR 3 and TLR 9 have been demonstrated in skin lesions of KS, as well as the infection of pDC in the lesions. Our results suggest that pDC and TLR 3 participate in the pathogenesis of KS, independently of HIV presence. The positive staining with D2-40 antibody, in all the stages of KS, confirmsthe lymphatic nature of neoplastic cells. It seems that podoplanin is not related to the innate immunity elements studied here

É bem estabelecido que respostas imunes possam ser influenciadas pelo sistema nervoso. O neuropeptídeo, peptídeo liberador de gastrina (GRP) tem sido detectado na produção e liberação de citocinas, em modelo animal e em humanos com doenças inflamatórias e sabe-se que o antagonista do receptor de GRP, RC-3095 modula a resposta de citocinas pro-inflamatórias em macrófagos ativados por lipopolissacarídeo (LPS) molhando a sobrevivência em modelo animal de sepse induzida por ligação e perfuração cecal (CLP). Neste contexto, neste estudo avaliamos o efeito modulatório de GRP em modelos animais de doenças inflamatórias agudas: injúria pulmonar associada à pleurisia induzida por carragenina e sepse induzida por CLP e adicionalmente, em pacientes sépticos através da correlação dos seus níveis com o desfecho clínico. Para esta proposta, no Capítulo 1 avaliamos em pleurisia induzida por carragenina os seguintes parâmetros: migração celular, atividade da lactato desidrogenase, conteúdo de proteínas totais, concentração de nitrito/nitrato e níveis de TNF-α e IL- β no exsudato pleural e atividade da mieloperoxidade e marcadores de dano oxidativo em lipídios e proteínas no tecido pulmonar. Assim, o RC-3095 exibiu significante ação anti-inflamatória através da inibição do influxo de leucócitos e bloqueio da mieloperoxidade, conteúdo de nitrito/nitrato e níveis de citocinas. Além disso, os resultados mostraram que RC-3095 exerce ação contra o dano oxidativo em lipídios e proteínas, bem como o aumento na viabilidade celular. Isto sugere que RC- 3095 tem propriedades anti-inflamatórias que podem estar relacionadas com a redução do dano oxidativo. No Capítulo 2, entretanto, nós seguimos no modelo animal de sepse onde buscamos o entendimento do papel protetor que exerce o RC-3095. Vários estudos sugerem o envolvimento de TLR-4 como um importante elemento de defesa do hospedeiro durante a infecção, e importantes eviências indicam que esses receptores também possuem um papel na patofisiologia da sepse, onde camundongos deficientes de TLR-4 não apresentam falência na migração de neutrófilos para a cavidade peritoneal durante a sepse polimicrobiana induzida por CLP letal, e como conseqüência, foram mais resistentes para sepse que controles. Nossos resultados indicam que este efeito protetor pode ser atribuído para uma atenuação de sinalização de TLR-4 em cultura de células RAW 264.7 estimuladas por LPS e tecido pulmonar em ratos CLP, levando a uma diminuição de citocinas proinflamatórias as quais a via de ativação de GRPR mostra seletividade como verificado no Capítulo 3, possibilitando a explicação dos baixos níveis de citocinas pro-inflamatórias em pacientes sépticos tratados com RC-3095. Esta atenuação favorece a infiltração de neutrófilos, resultando na diminuição de bacteremia preservando o controle da infecção no local melhorando o desfecho da sepse. Nossos resultados ainda mostram que níveis plasmáticos de GRP podem predizer o desfecho na sepse, mas não em pacientes SIRS sugerindo que GRP exerce funções diferenciais nas duas condições e sugere que o antagonismo de GRPR modula a inflamação incontrolada por agir em respostas mediadas por TLR-4 e funcionalidade imunoregulatória. Em conclusão, os presentes resultados indicam que o antagonista de GRPR exerce um papel na inflamação aguda e pode ser utilizado como uma nova terapia alternativa para sepse bacteriana Gram-negativa. / It is well established that immune responses may be influenced by the nervous system. The neuropeptide gastrin-releasing peptide (GRP) has been detected on the production and release of cytokines, both in animal models and humans with inflammatory diseases and reported that the GRP receptor antagonist RC-3095 modulates the response of proinflammatory cytokines in activated macrophages by lipopolysaccharide and improved the survival in an animal model of sepsis induced by cecal ligation and puncture (CLP). Within this context, in this work we evaluate the GRP modulatory effect in animal models of acute inflammatory illnesses: lung injury associated with carrageenan-induced pleurisy, and in CLP-induced sepsis and additionally in septic patients through the correlations of its levels with the clinical outcome. For this purpose, in Chapter 1 we evaluated in carrageenan-induced pleurisy the following parameters: cell migration, lactate dehydrogenase activity, total protein content, nitrite/nitrate concentration, TNF-α and interleukin-1β (IL-1β) levels in pleural exudates; myeloperoxidase activity and lipid and protein oxidative damage markers in lung tissue. Thus, RC-3095 exhibited pronounced anti-inflammatory actions by inhibition of leukocyte influx and blockade of myeloperoxidase, nitrite/nitrate content and cytokine levels. Moreover, the results showed that RC-3095 elicits action against oxidative damage in lipids and proteins, as well as increases cell viability. These suggest that RC-3095 has anti-inflammatory properties that can be related with the reduction of oxidative damage. In Chapter 2, however, we follow the animal model of sepsis where we search the agreement of the protective role that RC-3095 exerts. Increasing evidences suggest the evolvement of TLR-4 as an important element of host defense during an infection, a growing body of evidence indicates that these receptors also may play a role in the pathophysiology of sepsis where TLR-4 defective mice did not present failure of neutrophil migration to the peritoneal cavity during polymicrobial sepsis induced by lethal CLP, and as consequence, they were more resistant to sepsis than controls Our results further indicate that this protective effect can be attributed to an attenuation of TLR-4 signaling in RAW 264.7 cell culture stimulated by LPS and lung tissue in CLP rats, leading to a decrease of release of proinflammatory cytokines which the pathway of activation of GRPR shows selectivity as verified in Chapter 3, and can additionally explain the lower levels of the proinflammatory cytokine in RC-3095-treated septic patients. This attenuation favors neutrophil infiltration, resulting in decreased bacteremia preserving the control of infection in situ improving sepsis outcome. Our finding still show that plasma GRP levels could predict outcome in sepsis but not SIRS patients suggesting that GRP plays different roles in the two conditions and suggest that GRPR antagonism modulates uncontrolled inflammation by targeting TLR-4-mediated responses and immunoregulatory functionality. Taken together, the present results indicate that a GRPR antagonist plays a role in acute inflammation and could be developed as a new alternative therapy for Gram-negative bacterial sepsis.

A doença de Behçet tem sua fisiopatologia caracterizada por hiperatividade neutrofílica, particularmente em relação à quimiotaxia, e períodos de atividade da doença podem ser desencadeados por exposição a estreptococos. Uma vez que células do sistema imune inato são ativadas pelo ácido lipoteicoico (LTA) de bactérias gram-positivas via receptor toll-like (TLR) 2 e CD14, cujas expressões são reguladas pelos fatores estimulantes de colônias de granulócitos (G-CSF) e granulócitos-macrófagos (GM-CSF), o objetivo principal deste estudo foi determinar se há hiperexpressão de TLR2 em neutrófilos de DB ativa e se a quimiotaxia de polimorfonucleares (PMN) neutrófilos na DB poderia ser hiperestimulada pelo LTA. Além do TLR2, foram medidas as expressões de TLR4, CD14, CD114 (receptor de G-CSF) e CD116 (receptor de GM-CSF) nos neutrófilos e nos monócitos de pacientes com doença de Behçet (DB), as concentrações séricas de CD14 solúvel (CD14s) e as respostas quimiotáxicas dos PMNs de DB sob diferentes estímulos. A expressão dos receptores foi medida pela citometria de fluxo, as concentrações séricas por ELISA e as respostas quimiotáxicas foram avaliadas em câmara de Boyden. Nos PMNs, os receptores foram igualmente expressos nos dois grupos e, estimulados com LTA, suas respostas quimiotáxicas também foram similares. Somente à incubação com plasma os PMNs de DB desenvolveram hiperquimiotaxia em relação aos PMNs controles. A expressão do TLR2 foi maior em monócitos de DB em relação aos controles, e a concentração de CD14s sérica, de origem monocitária, foi maior nos pacientes com DB ativa. Em conjunto, os resultados demonstram que PMNs de DB, isoladamente, não reagem exacerbadamente ao LTA, e suas respostas migratórias são estritamente dependentes de fatores estimulantes solúveis. / Expressions of toll-like receptor (TLR) 2, TLR4, CD14, CD114 and CD116 were assessed on polymorphonuclear (PMN) neutrophils and monocytes of patients with Behçets disease (BD). PMN chemotactic responses under different stimulations were also measured. The objective was to determine if BD PMN chemotaxis may be overstimulated by lipoteichoic acid (LTA) from gram-positive bacteria. Receptor expressions were measured by flow cytometry and PMN chemotaxis was assessed in a Boyden chamber. Only TLR2 expression was higher on monocytes of the BD group than in control group. On PMNs, however, TLR2 expression was similar in both groups and, when stimulated with LTA, BD PMN cells showed chemotactic responses similar to the controls. These cells only exhibited increased chemotaxis when incubated with plasma. In conclusion, isolated BD PMN did not overreact to LTA, and its hyperchemotaxis is strictly dependent on soluble stimulating factors

B lymphocytes play important roles in antibody production, cytokine production, and antigen presentation to T cells. Ligation of Toll-like receptors (TLRs) on B cells stimulates cellular activation and B cell effector functions. Synergistic activation of other receptors such as CD40 or the B cell receptor (BCR) with TLR ligation further enhances B cell activation and effector functions. The tumor necrosis factor receptor associated factor (TRAF) family of proteins act as cytoplasmic signaling adaptor molecules and moderate downstream signaling from both the tumor necrosis factor receptor (TNFR) superfamily of proteins, including CD40, and the IL-1R/TLR superfamily of proteins. To date, only TRAFs 3 and 6 have been shown to be involved in TLR signaling, with TRAF6 providing positive regulation and TRAF3 providing negative regulation of TLR signaling in B cells. Deficiency in another TRAF family member, TRAF5, has been implicated in the development of atherosclerosis, a disease developed in part due to TLR dysregulation. Here, we addressed the hypothesis that TRAF5 is a negative regulator of TLR signaling. We found that TRAF5 negatively regulated TLR-mediated cytokine and antibody production in B lymphocytes. The enhanced cytokine production seen in TLR-stimulated TRAF5 KO B cells was not attributable to altered cellular survival or proliferation, but instead more cytokine was produced on a per-cell basis, likely due to enhanced MAPK pathways after TLR ligation. Additionally, TRAF5 deficiency did not dramatically affect cytokine production in TLR-stimulated bone marrow-derived macrophages or dendritic cells, suggesting that TRAF5 plays a greater role in TLR signaling in lymphoid versus myeloid cells. TRAF5 associated with the TLR signaling proteins MyD88 and TAB2, and negatively regulated the association of TAB2 with its binding partner TRAF6. Furthermore, we manipulated B cell activation via ligation of various TLRs, CD40, and/or the BCR in order to activate the cells to effectively present antigen. Activated B cells pulsed with antigen served as an effective cellular vaccine and offered protection against both an infectious pathogen (Listeria monocytogenes) and a model of murine melanoma. We identified two candidate activation criteria for B cell vaccines (Bvacs): stimulation through the BCR and TLR7, and stimulation through CD40 and TLR4. Additionally, we found that high IL-6 production by the activated Bvac was essential for inducing optimal CD8+ T cell memory. These B cell activation protocols offer significant advantages over those currently being tested for clinical use. Understanding B cell activation through TLRs is a critical step in developing new therapies against cancer and infectious disease.

Neutrophils, essential innate immune cells, recognize danger signals through receptors on their surface. Upon receptor ligation, neutrophils may undergo priming, a process involving limited reactive oxygen species (ROS) generation and partial degranulation. Priming facilitates neutrophil migration and prepares the cell for an enhanced response to a secondary stimulus, including a spike in ROS generation by NADPH oxidase 2 (NOX2). It is well established that NOX2-derived oxidants are involved in pathogen killing and that off-target effects can cause host tissue damage; however, several lines of recent evidence also support an anti-inflammatory function for NOX2 oxidants. First, patients with chronic granulomatous disease exhibit sterile inflammatory phenomena. Second, neutrophils lacking NOX2 function (genetically or pharmacologically) have an inflammatory phenotype under resting conditions. Finally, NOX2-deficient mice exhibit enhanced localized inflammation in several disease models. The goals of this thesis were to investigate an anti-inflammatory function for NOX2 during systemic inflammation and to further elucidate mechanisms of neutrophil priming, with particular focus on priming through Toll-like receptor 2 (TLR2). Using a murine model of sterile systemic inflammatory response syndrome (SIRS), we observed that NOX2-deficient mice had dramatically increased mortality compared to WT mice. While both genotypes developed SIRS, characterized by hypothermia, hypotension, and leukopenia, the WT mice recovered within 48 h whereas the NOX2-deficient mice did not. Moreover, NOX2 function limited the extent of pulmonary pathology as significant lung injury was noted in the NOX2-deficient mice compared to the WT mice. Plasma analysis revealed that several inflammatory cytokines were persistently elevated in the NOX2-deficient mice, likely contributing to the ongoing inflammatory response. One of the complications seen in human SIRS patients is the development of multiple organ dysfunction syndrome (MODS). Thus, we next investigated the role of NOX2 in the progression from SIRS to MODS. Cellular analysis revealed continued neutrophil recruitment to the peritoneum and lungs of the NOX2-deficient mice and altered activation states of both neutrophils and macrophages. Histology showed multiple organ pathology indicative of MODS in the NOX2-deficient mice, and several inflammatory cytokines were elevated in lungs of the NOX2-deficient mice. Overall, these data suggest that NOX2 function protects against the development of MODS and is required for normal resolution of systemic inflammation. As we utilized a TLR2/6 agonist (zymosan) to induce SIRS in our in vivo model, we wanted to investigate neutrophil priming through TLR2 in an in vitro model. Notably, we determined that a TLR2/6 agonist, FSL-1, primed neutrophils from all donors to a similar extent, evidenced by direct and primed ROS generation, MAPK signaling, limited degranulation, and cytokine secretion. Surprisingly, Pam3CSK4, a TLR2/1 agonist, primed neutrophils from a subset of donors to a much greater extent than neutrophils from other donors. We demonstrated that the different neutrophil priming responses were the consequence of a common TLR1 polymorphism. In sum, the data presented here significantly advance our understanding of the roles of NOX2 and TLR2 signaling in host inflammation and neutrophil priming. This research could advance the development of therapies that target pathogenic neutrophil subsets in inflammatory conditions without compromising innate immune function