京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13277号 / 論医博第2185号 / 新制||医||1039(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 生田 宏一, 教授 河本 宏, 教授 杉田 昌彦 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

The interrogation of T cell signaling over the past fifty years has led to the discovery of amazingly intricate cascade networks and elaborate descriptions of individual proteins' domains and functions. A complex landscape has been rendered in which proteins relay messages from the extracellular ligation of the TCR by a cognate peptide loaded MHC via changes in sub-cellular location, phosphorylation, and binding affinities and partners to enact nuclear localization of three key transcription factors required for cellular effector function and proliferation: AP-1, NF-AT, and NF-κB. Dogma has favored activation of each of these transcription regulating elements to be a linear and parallel activity, thus very little interaction between pathways has been highlighted by previous findings in the molecular immunology community. The focus of this dissertation explores the role of NF-κB in T cell signaling with emphasis on subunits p50, cRel, IκBα, and IKKβ, and with respect to NF-κB’s ability to modulate calcium and NF-AT signaling, proximal TCR phosphorylation, and CRAC and purinergic calcium channel proteins. The role of NF-κB in T cells can be a difficult thing to establish, as this thirteen member family innervates almost every cellular process from homeostasis to activation, and even functions in the opposing processes of survival and apoptosis. To convolute the investigation further, many family members also fulfill redundant tasks, as a result of their high evolutionarily conserved sequence homology. To this end, we discovered the best way to evaluate the function of NF-κB in the activation of T cells was to knockdown two family members: p50 and cRel. In doing this, we rendered mice that were viable (unlike knockdown of RelA) and fertile, but possessed T cells that were highly unresponsive to strong stimulation (anti CD3/CD28) or foreign antigen (OVA) presented to mice bearing the correct transgenic TCRs (OT-1) by professional antigen presenting cells (APC). Through in vitro assays, we discovered that in addition to the specific defects in NF-κB activation, NF-AT signaling was also greatly disrupted in these cells, sequela to retarded calcium influx and signaling. This was of great interest, as while several studies have shown that calcium signaling has the ability to amplify and fine tune NF-κB activation, there is a dearth of studies and publications highlighting the effect of an activated NF-κB pathway on calcium influx and signaling leading to the activation of NF- AT. Another fascinating discovery, that explicated the calcium reduction and NF-AT inhibition, was that ablation of p50 and cRel led to decreases in mRNA and protein levels of two additional NF-κB family members: IKKβ and IKKγ. The results presented here suggest that it is the reduction in IKKβ and IKKγ that leads to impaired phosphorylation of the key TCR proximal proteins: Zap70 and PLC&gamma1, and it is the decrease in activated PLCγ1 that renders less IP3 and ultimately abrogates calcium signaling. Overall, this thesis highlights the ability of IKKβ to enhance general proximal TCR protein phosphorylation (and specifically Zap70) leading to a greater influx of calcium (perhaps aided by IKKβ also augmenting the function of the CRAC protein, STIM1) which leads to superior activation of NF- AT, and amplifies downstream cellular effector functions such as IL-2 production and proliferation. Moreover, this work demonstrates that NF-κB subunits likely form supermolecular clusters, and ablation of certain subunits (i.e. p50 and cRel) can lead to instability and decreased levels of other family members (i.e. IKKβ and IKKγ.)

京都大学 / 新制・課程博士 / 博士(医科学) / 甲第23110号 / 医科博第121号 / 新制||医科||8(附属図書館) / 京都大学大学院医学研究科医科学専攻 / (主査)教授 濵﨑 洋子, 教授 竹内 理, 教授 上野 英樹 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

B-cell chronic lymphocytic leukemia (B-CLL) is the most common leukemia among the adult population in western countries and accounts for 30-40% of all leukemias. With survival time ranging from months to decades, the clinical course of individual CLL patients is highly variable. This heterogeneity and in the end the need for means to identify the patients with less favorable disease has encouraged the search for biomarkers that can predict the prognosis. Telomeres are repetitive structures protecting the chromosomal endings and shorten at each cell division. Telomere length (TL) has been indicated as a prognostic factor both in hematological malignancies and solid tumors. In B-CLL, TL is associated with mutation status of the immunoglobulin heavy chain variable (IGHV) gene and with clinical course. In the present thesis the main aim was to evaluate TL as a biomarker in B-CLL using a quantitative PCR-based method for TL determination. In paper I, TL was shown to be a prognostic factor for stage A and stage B/C patients, whereas IGHV mutation status predicted outcome only in stage A patients. Moreover, IGHV mutated CLL cases were subdivided by TL into two groups with different prognosis, a subdivision not seen for unmutated cases. Interestingly, the IGHV-mutated group with short telomeres had en overall survival close to that of the unmutated cases. Thus, a combination of IGHV mutation status and telomere length gave an improved subclassification of CLL identifying previously unrecognized patient groups with different outcomes. TL correlates with cellular origin of B-cell malignancies in relation to the germinal center (GC). In paper II different B-cell lymphoma/leukemia subtypes were analyzed. Shortest telomeres were found in IGHV unmutated CLLs, differing significantly from IGHV mutated cases. Contrary to this, mantle cell lymphomas (MCL) demonstrated similar TL regardless of IGHV mutation status. TL differed significantly between GC-like and non-GC-like diffuse large B-cell lymphomas (DLBCL) and follicular lymphomas (FL) had shorter telomeres than GC-like DLBCL. Hairy cell leukemias, which display Ig gene intraclonal heterogeneity, had longer telomeres than FLs and non-GC-DLBCL, but shorter than GC-DLBCL. In conclusion, TL seemed not to simply correlate with GC origin. Paper III presents a B-CLL cohort assessed for TL, genomic aberrations, IGHV mutation status, CD38 and ZAP-70 expression. An inverse correlation existed between TL and IGHV homology, CD38 and ZAP-70 expression. The presence of genomic aberrations was similar among patients regardless of TL. In contrast, 13q deletion, a favorable biomarker, was more frequent in patients with long telomeres, while 11q and 17p deletions (markers of less favorable outcome) were more frequent in the subgroup with short telomeres. In paper IV a large group of mainly indolent CLL cases from a population based cohort was studied again showing an association between TL and prognosis, especially in “good” prognosis cases as defined by other biomarkers. Multivariate analysis indicated a strong connection between IGHV mutation status, lipoprotein lipase (LPL) expression and TL. A comparison of TL in diagnostic and follow up samples demonstrated a significant correlation, and also in the follow samples TL constituted a significant biomarker for survival.