Replication-deficient adenovirus (Ad) and modified vaccinia virus Ankara (MVA) vectors expressing single Plasmodium falciparum antigens can induce potent T cell and antibody responses and have entered clinical testing using a heterologous prime-boost immunisation approach (Ad_MVA). This thesis describes a number of pre-clinical approaches aimed at enhancing the efficacy of these viral vectored vaccines targeting the blood-stage of malaria. First, the development of a highly efficacious malaria vaccine is likely to require a multi-antigen and/or multi-stage subunit vaccine. The utility of an Ad_MVA immunisation regime combining vaccines expressing the 42kDa C-terminus of the blood- stage antigen merozoite surface protein 1 (MSP142) and the pre-erythrocytic antigen circumsporozoite protein (CSP) in the P. yoelii mouse model was investigated. It was found that vaccine co- administration leads to maintained antibody responses and efficacy against blood-stage infection, but reduced secondary CD8+ T cell responses and efficacy against liver-stage infection. CD8+ T cell interference can be minimised by co-administering the MVA vaccines at separate sites, resulting in enhanced liver-stage efficacy. The mechanisms of CD8+ T cell interference were explored. Second, Ad_MVA regimes expressing blood-stage antigens that can protect against P. chabaudi and P. yoelii blood-stage infection were tested against P. berghei, but did not confer protection. Similarly, IgG from rabbits immunised against P. falciparum MSP1 (PfMSP1) could not protect mice from a chimeric P. berghei parasite expressing PfMSP1. Third, two molecular adjuvants, the C4bp α-chain oligomerisation domain (IMX108/313) and the Fc fragment of murine IgG2a, were tested for their ability to enhance immunogenicity of recombinant adenoviruses when fused at the C-terminus of a blood-stage antigen. IMX108/313 was found to adjuvant T cell responses of small (< 80kDa) antigens and this was associated with antigen oligomerisation. However, the Fc fragment did not adjuvant responses. Finally, it was found that using a strong early promoter to drive antigen expression enhances the immunogenicity of single administration MVA vaccines, but that this did not enhance post-boost immunogenicity in an Ad_MVA regime.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

L’adénovirus a été étudié dans l’optique de développer de nouveaux traitements pour différentes maladies. Les vecteurs adénoviraux (AdV) sont des outils intéressants du fait qu’ils peuvent être produits en grandes quantités (1X1012 particules par millilitre) et de par leur capacité à infecter des cellules quiescentes ou en division rapide. Les AdVs ont subi bon nombre de modifications pour leur permettre de traiter des cellules tumorales ou pour transporter des séquences génétiques exogènes essentielles pour le traitement de maladies monogéniques. Toutefois, les faibles niveaux d’expression du récepteur primaire de l’adénovirus, le CAR (récepteur à l’adénovirus et au virus coxsackie), réduit grandement l’efficacité de transduction dans plusieurs tumeurs. De plus, certains tissus normaux comme les muscles n’expriment que très peu de CAR, rendant l’utilisation des AdVs moins significative. Pour pallier à cette limitation, plusieurs modifications ont été générées sur les capsides virales. L’objectif de ces modifications était d’augmenter l’affinité des AdVs pour des récepteurs cellulaires spécifiques surexprimés dans les tumeurs et qui seraient exempts dans les tissus sains avoisinant. On peut mentionner dans les approches étudiées: l’utilisation de ligands bispécifiques, l’incorporation de peptides dans différentes régions de la fibre ou la substitution par une fibre de sérotypes différents. Notre hypothèse était que les domaines d’interaction complémentaire (K-Coil et ECoil) permettraient aux ligands de s’associer aux particules virales et d’altérer le tropisme de l’AdV. Pour ce faire, nous avons inclus un domaine d’interaction synthétique, le K-Coil,dans différentes régions de la fibre virale en plus de générer des mutations spécifiques pour abolir le tropisme naturel. Pour permettre la liaison avec les récepteurs d’intérêt dont l’EGF-R, l’IGF-IR et le CEA6, nous avons fusionné le domaine d’interaction complémentaire, le E-Coil, soit dans les ligands des récepteurs ciblés dont l’EGF et l’IGF-I, soit sur un anticorps à un seul domaine reconnaissant la protéine membranaire CEA6, l’AFAI. Suite à la construction des différents ligands de même que des différentes fibres virales modifiées, nous avons determiné tout d’abord que les différents ligands de même que les virus modifiés pouvaient être produits et que les différentes composantes pouvaient interagir ensemble. Les productions virales ont été optimisées par l’utilisation d’un nouveau protocole utilisant l’iodixanol. Ensuite, nous avons démontré que l’association des ligands avec le virus arborant une fibre modifiée pouvait entraîner une augmentation de transduction de 2 à 21 fois dans différentes lignées cellulaires. À cause de la difficulté des adénovirus à infecter les fibres musculaires occasionnée par l’absence du CAR, nous avons cherché à savoir si le changement de tropisme pourrait accroître l’infectivité des AdVs. Nous avons démontré que l’association avec le ligand bispécifique IGF-E5 permettait d’accroître la transduction autant dans les myoblastes que dans les myotubes de souris. Nous avons finalement réussi à démontrer que notre système pouvait induire une augmentation de 1,6 fois de la transduction suite à l’infection des muscles de souriceaux MDX. Ces résultats nous amènent à la conclusion que le système est fonctionnel et qu’il pourrait être évalué dans des AdVs encodant pour différents gènes thérapeutiques. / Adenoviruses have been studied as a way to develop new treatments for different diseases. Adenoviral vectors (AdV) are considered interesting tools for this propose, because they can be produced at high titers (1X1012 particles per millilitre) in laboratory and they have the capacity to infect non-dividing and dividing cells. AdV have been often modified in order to obtain the ability to kill tumour cells or to deliver exogenous genetic sequences essential to treat monogenic disease. However, weak expression of the primary adenovirus receptor, the CAR (Coxsackie and adenovirus receptor) reduces greatly the transduction efficiency of AdV for the tumour cells. Moreover, some normal tissues express low amount of CAR, like the skeletal muscle, reducing the appeal of using AdV as a gene delivery vehicle for this tissue. To address this problematic, many modifications were done on the adenoviral capsid. The goal of these modifications were to generate an AdV able to target specific cellular receptors that were expressed in tumour cells but not in normal cells. Several approaches were done to modify the tropism of AdV, such as incubation with a bispecific ligands, incorporation of peptides within the adenoviral fiber structure or substitution of the viral fiber with a different serotype fiber. The hypothesis of my project was to determine if an interaction domain fused within a ligand could bind the complementary domain incorporated on a virus and change the tropism of the AdV. The first step was to include a synthetic interaction domain, the K-Coil, within specific region of the adenoviral fiber, as well as inserting two point mutations to abolish the natural tropism. To target the EGF-R, IGF-IR and the CEA6, we fused the complementary interaction domain, the E-Coil, to the respective ligand known as the EGF and the IGF-I or to a single domain antibody (known as AFAI) that bind specifically to CEA6. The specific interaction between the E-Coil and K-Coil was used to associate the ligand with the fiber in order to retarget the AdV toward the selected receptor. We showed that the different ligands as well as the modified fibers could be produced and that both E-Coil and K-Coil expressing partners could interact together. We optimized the viral production by using an iodixanol purification protocol. More importantly, we clearly demonstrated that the ligand association with the fiber could increase the transduction efficiency between 2 to 21 fold against various tumour cells. The difficulty of adenovirus to infect muscle cells because of the lack of CAR expression brought us to evaluate the potential of our retargeted AdV to increase the transduction for the tissue. We showed that the use of IGF-E5 could increase the transduction efficiency in myoblasts as wells as in myotubes. We finally demonstrated that our retargeting system could increase the transduction efficiency for skeletal muscle by 1,6 fold in new born MDX mice. In conclusion, our results show that the retargeting system is indeed functional. This system could be assessed using vectors that express therapeutic genes.

Les adénovirus sont des virus non enveloppés. Afin de pouvoir se répliquer ils doivent entrer dans leur cellule hôte et être transportés jusqu’au noyau pour pouvoir initier l’expression du génome viral. Pour ce faire le virus utilise les composants de sa capside. Parmi ses composants, la protéine VI, une protéine interne de capside, induit la rupture de l’endosome grâce à son hélice amphipatique en N-terminal de la protéine. Récemment, une autre fonction de cette protéine a été décrite durant l’entrée du virus, impliquant cette fois-ci le motif conservé PPxY de la protéine VI. En effet la mutation de ce motif conservé : mutant M1 (PPxYPGAA), diminue de 20 fois l’infection du virus par rapport au virus sauvage. Cette baisse d’infectiosité est liée à un défaut de transport et d’accumulation du virus au niveau du centre organisateur des microtubules (MTOC). Il se trouve que la mutation du motif PPxY conduit à une perte d’interaction de la protéine VI avec les ubiquitines ligase de la famille Nedd4, mais également à un défaut d’ubiquitylation de la protéine VI. Nous avons ainsi entrepris d’étudier le rôle de cette modification post-traductionnelle lors de l’entrée du virus dans la cellule, mais aussi, de manière plus générale, le rôle de la protéine VI. Ainsi nous avons mis en évidence le rôle de la protéine VI et de son motif PPxY dans l’activation du génome viral. Par ailleurs, nous avons identifié une lysine ubiquitylée de la protéine VI et produit un mutant : mutant M6, pour étudier le rôle de cette ubiquitylation. Nous avons enfin entrepris de caractériser l’entrée du virus en produisant et en utilisant des adénovirus mutants, dont le nouveau mutant M6 / Adenoviruses are non-enveloped viruses. In order to replicate they have to enter their host cell and be transported toward the nucleus to initiate the viral gene expression. This requires the involvement of viral capsids components. Among these components, protein VI, an inner capsid protein, can induce endosomal rupture, thanks to its amphipathic helix located at the N-terminus part of the protein. Recently, the involvement of a conserved PPxY motif in the Protein VI has also been described in viral entry. Indeed, mutation of this motif (PPxY  PGAA) reduced infectivity of the mutant virus (M1 mutant) 20 folds compared to the wild type virus. This reduction of infectivity is related to a defect of transport and accumulation of viruses at the microtubule organizing center (MTOC) during virus entry. The mutation of PPxY motif leads to a loss of interaction between the protein VI and ubiquitin ligases from the Nedd4 family, and to a lack of protein VI ubiquitylation. The aim of this study was therefore to investigate the role of this posttranslational modification during virus entry, but also more generally the role of protein VI. In this work, we highlight the role of protein VI and its PPxY motif in the activation of the viral genome. Moreover, to investigate the ubiquitylation during virus entry we identify a lysine mutant of protein VI that lack ubiquitylation without altering the potential for interaction with ubiquitin ligases: the mutant M6. We then proceed to characterize the entry of the virus by producing and using mutant viruses, including this new mutant.

A destruição funcional das vias de controle do ciclo celular constituem um evento comuns em todos os tumores humanos. Muitos estudos associam mutações em p53 com mau prognostico no tratamento do câncer. Nesse trabalho, visamos a geração e caracterização de linhagens isogênicas portando diferentes mutantes de p53 como modelo de estudo para remediação simultânea de p53 e p16 na presença de mutantes hotspots específicos. Os mutantes R175H e R248Q não geraram alterações na cinética de proliferação da linhagem H358, mas levaram a um aumento de 27,5% na eficiência de plaqueamento e, no caso de R248Q, ao dobro de eficiência na formação de colônias em suspensão. Os resultados do tratamento das linhagens isogênicas com adenovírus Adp16 e Adp53 mostraram que os mutantes não interferiram no parada do ciclo celular em G1 induzida por p16. / Alterations of the cell cycle pathway are a common event in all human tumors. Several studies have shown a correlation between hotspot mutations and an unfavorable profile for cancer therapies. Hence, this study aims the generation and characterization of isogenic cell lines, harboring p53 mutants, as model to investigate the replacement of p53 and p16 genes on these mutant H358 cell lines. Our data identified that neither p53R175H nor p53R248Q mutants accelerated cell cycle progression. However, both leads to a 27,5% increased plate efficiency while R248Q leads to a two-fold increases in the number of colonies formed in soft agar. Our data also showed that the mutants did not affect the efficiency of p16 replacement.

O melanoma maligno é uma forma de câncer com alto índice de morte devido, em parte, à falta de tratamentos eficazes e à sua tendência de formar metástases. Nosso grupo tem desenvolvido vetores virais para a transferência gênica de fatores anti-tumorais e, inicialmente, foi construído um vetor adenoviral, AdPG, no qual a expressão do transgene é controlada por p53, um supressor de tumor e fator de transcrição. Sendo que aproximadamente 90% dos casos de melanoma retêm p53 selvagem, foi proposto que isto pudesse ser utilizado como uma ferramenta para dirigir a expressão do transgene codificado pelo vetor AdPG, um mecanismo apoiado por resultados anteriores de nosso grupo. Por exemplo, a transdução de células B16 (melanoma de camundongo, p53-selvagem, deleção de p19Arf) com vetores AdPG portadores de p19Arf ou interferon-<font face=\"Symbol\">b (IFN<font face=\"Symbol\">b) resultou em morte celular maciça enquanto a transferência de apenas um destes fatores isolados não causou o mesmo efeito. O trabalho descrito aqui inclui dois avanços tecnológicos críticos em comparação com trabalhos anteriores do grupo. Primeiramente, os transgenes de interesse (eGFP, p19Arf e IFN<font face=\"Symbol\">b) foram inseridos num vetor adenoviral que apresenta o tripetídeo RGD na sua proteína fibra. Essa modificação no vetor permite a eficiente transdução de um amplo espectro de células alvos sem a dependência do receptor viral do adenovírus selvagem, CAR. Além disso, foi construído um vetor bicistrônico, que contém a combinação de ambos os genes terapêuticos, como forma de garantir a transferência dos dois fatores ao mesmo tempo para as células-alvo. A inclusão de p19Arf, um supressor de tumor e inibidor de MDM2, como um gene terapêutico deve complementar as atividades do p53 celular endógeno e, como consequência, atuar na promoção da expressão a partir do vetor e também na inibição da proliferação das células tumorais. Porém, a transferência de p19Arf sozinho acarretaria efeito somente nas células que foram transduzidas e, então, seu efeito seria limitado. Por este motivo, descreve-se, além do p19Arf, a utilização de IFN<font face=\"Symbol\">b, uma proteína secretada com funções anti-tumorais, incluindo inibição de angiogênese, indução de apoptose e ativação da resposta imunológica. A estratégia do projeto contemplou vários níveis relacionados ao mecanismo do processo de transferência, incluindo a eficiência da transdução, o mecanismo de controle da expressão dos transgenes e as atividades dos transgenes. Assim, foi proposto que a combinação de p19Arf e IFN<font face=\"Symbol\">b pudesse ser uma estratégia interessante para induzir morte no tumor primário e uma resposta imunológica contra as células metastáticas. Com este projeto, foi iniciada a construção destes novos vetores aprimorados para transferência gênica nas células de melanoma. / Malignant melanoma is a type of cancer with high death rates, in part, because of a lack of efficient treatments and its tendency to generate metastases. Our group has developed viral vectors for the gene transfer of anticancer factors and, initially, we constructed an adenoviral vector, AdPG, in which transgene expression is controlled by p53, a tumor suppressor and transcription factor. As 90% of melanoma cases maintain wild-type p53, it was proposed that this could be used as a tool to drive transgene expression encoded by the AdPG vector, as evidenced by previous studies from our group. For example, transduction of B16 cells (mouse melanoma, wild-type p53, p19Arf-null) with vectors encoding p19Arf or interferon-<font face=\"Symbol\">b (IFN<font face=\"Symbol\">b) resulted in massive death cell, while transfer of just one of these factors alone did not cause the same effect. The work described here includes two critical technologic advances in comparison with our previous work. First, transgenes of interest (eGFP, p19Arf and IFN<font face=\"Symbol\">b) were inserted into an adenoviral vector which presents the RGD tripeptide in its fiber. This vector modification allows efficient transduction in a wide range of target cells without dependence on the wild type adenovirus receptor, CAR. In addition, a bicistronic vector was constructed which contains the combination of both therapeutic genes, ensuring the transfer of both factors to the target cells at the same time. Use of p19Arf, a tumor suppressor and MDM2 inhibitor, as a therapeutic gene should complement endogenous p53 activities and, as a consequence, promote expression from the AdPG vector and inhibit tumor cell proliferation. However, p19Arf gene transfer alone should have an effect only in transduced cells and, therefore, its effect would be limited. For this reason, we describe, in addition to p19Arf, the application IFN<font face=\"Symbol\">b, a secreted protein with antitumor functions, including inhibition of angiogenesis, induction of apoptosis and activation of immunologic response. This strategy involves several mechanistic levels related with the gene transfer process, including transduction efficiency, control over transgene expression and transgene activity. Therefore, it was proposed that the combination of p19Arf and IFN<font face=\"Symbol\">b could be an interesting strategy to induce primary tumor death and an immunologic response against metastatic cells. In this project, the construction of new vectors optimized for gene transfer in melanoma cells was initiated.

O melanoma representa menos de 5% de todos os cânceres de pele, porém, quando em estádio metastático possui prognóstico ruim. Entretanto, o genótipo dos melanomas pode prover uma oportunidade para intervenção terapêutica pelo fato de 90% dos casos de melanoma possuem p53 selvagem e grande parte destes possuem deleção na região cromossômica codificadora de interferon beta. Em prévios estudos, desenvolvemos o vetor adenoviral AdRGD-PG que fornece expressão do transgene em resposta à p53 através do promotor PG e ainda o tripeptídeo RGD, que possibilita que o adenovírus transduza uma maior gama de células pela alteração de seu mecanismo de entrada. Temos utilizado este vetor para entrega da versão murina de interferon beta em modelos de terapia gênica e imunoterapia de melanoma murino, revelando uma significativa habilidade do interferon beta em inibir a proliferação celular in vitro e in vivo e promover resposta imune antitumoral. No presente trabalho, os esforços se aplicam em adaptar essa estratégia em modelo de melanoma humano para observar se a mesma interação é encontrada. O vetor AdRGD-PGhIbeta, portador do cDNA de interferon beta humano (hIbeta) foi construído e expressão do transgene observada após transdução das linhagens estabelecidas de melanoma humano SK-MEL-05 e SK-MEL-147 (ambas p53 selvagem). Foi observado um robusto efeito antitumoral in vitro onde transferência de hIbeta promoveu acumulo de células hipodiploides (mais que 80% da população celular 96 horas após transdução) e evidências de morte por apoptose (exposição de fosfatidilserina e atividade de caspases 3/7) em ambas as linhagens. Nas duas linhagens, o efeito bystander foi demonstrado quando a presença de poucas células transduzidas (ex., 10%) foi suficiente para promover o acumulo significativo de células hipodiploides (mais que 40% neste exemplo). Em modelo de terapia gênica in situ utilizando células SK-MEL-147, também foi observado forte efeito antitumoral da hIbeta com total remissão do tumor de todos os animais tratados sem recidiva durante noventa dias. A presença de hIbeta na circulação dos animais foi confirmada 48h após o tratamento com AdRGD-PG hbeta mas presente em somente dois de sete animais 90 dias após o tratamento, sugerindo que o tratamento inicial e não um efeito off target foi responsável pela resposta. Com a finalidade de investigar efeitos colaterais do sequestro do vetor adenoviral pelo fígado, observamos a concentração circulante das enzimas aminotransferase de aspartate e aminotransferase de alanine (AST e ALT, respectivamente), que se mostrou não alterada quando comparadas entre animais que receberam injeção do vetor tratamento, vetor controle e solução salina. Com nossos resultados concluímos que vetores adenovirais carreando interferon-beta humano são capazes de transduzir a linhagem de melanoma SK-MEL-147 in vitro e in vivo, promovendo efeito bystander e remissão tumoral sem indução de efeitos adversos / Melanoma represents less than 5% of all cases of skin cancer, although, when metastatic, prognosis is dire. However, the genotype of melanomas might provide an opportunity for therapeutic intervention since 90% of melanoma cases possess wild-type p53 and a great portion of these possess deletion of the chromosomal region encoding interferon beta. In previous studies, we developed the adenoviral vector AdRGD-PG that supplies expression of the transgene in response to p53 through the PG promoter and that utilizes the RGD tripeptide, allowing the adenovirus to transduce a wider range of cells due to the alterated mechanism of entrance. We have used this vector to deliver the murine version of interferon beta in murine models of melanoma gene therapy and immunotherapy, revealing a significant ability of interferon beta to inhibit cellular proliferation in vitro and in vivo and promote an anti-tumor immune response. In the present project, we aimed to adapt this strategy for a human melanoma model in order to reveal if the same impact will be observed. The AdRGD-PGhIbeta vector encoding the human interferon beta (hIbeta) cDNA was constructed and expression of the transgene confirmed after transduction of the established human melanoma cell lines SK-MEL-05 and SK-MEL-147 (both wild-type p53). A striking anti-tumor effect was observed in vitro where the transfer of hIbeta promoted an accumulation of hypodiploid cells (over 80% of the cellular population 96 hours after transduction) and evidence of death by apoptosis (exposure of phosphatidylserine and activity of caspases 3/7) in both cell lines. In these cell lines, a bystander effect was demonstrated when the presence of few transduced cells (ex., 10%) was enough to promote significant accumulation of hypodiploid cells (over 40% in this example). In a model of in situ gene therapy using SK-MEL-147 cells, hIbeta induced a strong anti-tumor effect including total tumor remission in all treated animals without relapse during ninety days. The presence of hIbeta in the circulation of the animals was confirmed 48h after treatment with AdRGD-PGhIbeta, but was present in only two of the seven animals 90 days post-treatment, suggesting that the initial treatment, not off target effects, was responsible for the response. With the goal of investigating collateral effects of adenoviral sequestration by the liver, we assayed the circulating concentration of aspartate aminotransferase and alanine aminotransferase (AST and ALT, respectively), which showed no alteration when compared with animals that received the treatment with a control vector or saline solution. We conclude that our adenoviral vector carrying human interferon-beta is capable of transducing the human melanoma cell line SK-MEL-147 in vitro and in vivo, promoting a bystander effect and tumor remission without inducing adverse effects

Introdução: Cistite Hemorrágica (CH) é uma grave complicação do Transplante de Células-Tronco Hematopoiéticas (TCTH) Alogênico. Sua incidência varia de 12 a 25,5%. A forma precoce desenvolve-se devido aos efeitos tóxicos de certos quimioterápicos usados no regime de condicionamento, especialmente Ciclofosfamida. Já a CH tardia ocorre a partir do terceiro dia após o TCTH e sua etiologia é multifatorial. Vários fatores de risco para o desenvolvimento de CH tardia foram descritos, incluindo Doença do Enxerto Contra o Hospedeiro (DECH) aguda, doador não relacionado, infecções por vírus urotrópicos, sexo masculino e condicionamento mieloablativo. Materiais e Métodos: O presente estudo tem como objetivos descrever a incidência de CH em pacientes adultos e pediátricos submetidos a TCTH alogênico e identificar fatores de risco associados ao desenvolvimento de CH nesta população. Foram analisados dados de prontuário de 347 pacientes submetidos a TCTH Alogênico no Hospital de Clínicas de Porto Alegre no período de Janeiro de 2001 a Dezembro de 2014. Resultados: CH ocorreu em 42 pacientes (12,1%, IC: 8,9 - 16%), em uma média de 53.4 dias após o procedimento (desvio padrão: 28.1 dias). Apenas 1 paciente (2,4%) desenvolveu CH precoce, com início dos sintomas no D+1. Entre os 41 pacientes que desenvolveram CH tardia, BK vírus foi o principal agente viral identificado. CH ocorreu em 12.8% dos pacientes que receberam condicionamento mieloablativo e em 10.5% dos restantes (P = 0,704). Dos 197 pacientes que apresentaram DECH aguda, 35 (17,8%) desenvolveram CH e somente 7 (4,9%) apresentaram CH na ausência de DECH aguda (P < 0,001). CH foi mais frequente também em pacientes do sexo masculino (P = 0,027). Conclusão: A incidência de CH em nossa amostra foi semelhante à encontrada em outros trabalhos. DECH aguda e sexo masculino estiveram associados a um maior risco de desenvolvimento de CH. / Introduction: Hemorrhagic cystitis (HC) is a serious complication of Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) afecting 12 to 25.5% of the patients. The early-onset form of HC develops during or until 72 hours after the conditioning regimen containing high doses of certain chemotherapy drugs such as Busulfan and especially Cyclophosphamide. Late-onset HC occurs from the third day on after HSCT and its etiology is multifactorial. Several risk factors for the late-onset form have been reported including graft-versus-host disease (GVHD), unrelated donor, urotropic infections, male gender and myeloblative conditioning regimen. Methods: This study aims to evaluate the incidence of HC in adult and pediatric patients undergoing Allogeneic HSCT and to identify risk factors associated with the development of HC in this population. Medical records of 347 patients who underwent Allogeneic HSCT at Hospital de Clínicas, Porto Alegre, Brazil, from January 2001 to December 2014 were analyzed. Results: HC occurred in 42 patients (12.1% CI: 8.9 - 16%) at an average of 53.4 days after the procedure (standard deviation: 28.1 days). Only one of them developed early-onset HC, with onset of symptoms on D+1. Among the 41 patients who developed late-onset HC, BKV was the main identified viral agent. HC developed in 12.8% of the patients treated with myeloablative conditioning and in 10.5% of the remaining patients (P = 0.704). Of the 197 patients with acute GVHD, 35 (17.8%) developed HC and only 7 (4.9%) showed HC in the absence of GVHD (P<0.001). HC was also more frequent in males than females (P = 0.027). Conclusion: The incidence of HC in our sample was similar to that found in other studies. In our cohort of patients being male and having acute GVHD increased the risk of developing HC.

Spinal muscular atrophy (SMA) is a neuromuscular disease caused by reduced levels of the survival motor neuron (SMN) protein. SMA results in degeneration of motor neurons, progressive muscle atrophy, and death in severe forms of the disease. Currently, there is a lack of inexpensive, readily accessible, accurate biomarkers to study the disease. Furthermore, the current FDA approved therapeutic is neither 100 % effective nor accessible for all patients, thus more research is required. Tiny cell derived vesicles known as exosomes have been evaluated in an attempt to identify novel biomarkers for many disease states and have also shown therapeutic promise through their ability to deliver protein and nucleic acid to recipient cells. The research presented herein investigates whether (1) the level of SMN protein in exosomes isolated from the medium of cells, and serum from animal models and patients of SMA is indicative of disease, to serve as a biomarker for monitoring disease progression and therapeutic efficacy; (2) SMN-protein loaded exosomes can be utilized to deliver SMN protein to SMN-deficient cells; (3) adenoviral vectors are effective at creating SMN protein-loaded exosomes in situ for body wide distribution of SMN protein. This research has shown SMN protein is naturally released in extracellular vesicles, and the level of exosomal SMN protein is reflective of the disease state. Exosomes can also be modified to hold enhanced levels of SMN protein and deliver them to both the cytoplasm and nucleus of SMN-deficient cells. Furthermore, adenoviral vectors expressing luciferase-tagged SMN1 cDNA, targeted to the liver, results in SMN protein-loaded exosomes and detectable luciferase activity, body-wide. Thus, exosomes present as an effective biomarker and potentially a novel approach to treat SMA.

Objetivos: Os objetivos deste estudo foram: 1) determinar a eficácia da transferência gênica do vetor de adenovírus sorotipo 5, carreando o gene do receptor do fator de crescimento endotelial vascular (VEGF) solúvel humano (sVEGFR1) para a glândula lacrimal (GL); 2) investigar se a expressão de sVEGFR1 interfere na neovascularização da córnea (NVC), induzida por queimadura alcalina; 3) avaliar a segurança do procedimento. Métodos: Trinta e dois ratos Wistar foram submetidos à queimadura central da córnea direita com solução de hidróxido de sódio (NaOH) 1 M. Os animais foram divididos em três grupos e injetados diretamente em sua GL direita 25 ?l de vetores virais AdVEGFR1 (1x1010 pfu) (12 animais), 25 ?l do vetor AdNull (1x1010pfu) (10 animais), ou 25 ?l de solução salina (Controle). Após sete dias, a NVC foi observada e fotografada na lâmpada de fenda. A secreção lacrimal foi medida com fenol. A presença do sVEGFR1 na GL foi testada por qPCR (quantitative polymerase chain reaction) e a coloração, por imunofluorescência. O qPCR foi também utilizado para comparar o RNA mensageiro (RNAm) de ilterleucina-1beta (IL-1?), ilterleucina-6 (IL-6) e fator de necrose tumoral alfa (TNF-?) na GL e no gânglio do trigêmeo (GT). Resultados: O vetor AdVEGFR1 transfectou 83% dos ratos. O sVEGFR1 estava presente nas células acinares da GL. A NVC foi prevenida em nove de doze animais do grupo AdVEGFR1, em comparação com o grupo Ad-Null (3:10) e o grupo Controle (1:10) (p=0,0317). A secreção lacrimal e o RNAm das citocinas na GL e no GT foram semelhantes nos três grupos (p>0,05). Conclusões: A transferência gênica do vetor adenoviral para a GL demonstrou expressão local do sVEGFR1 humano, e evitou a NVC na maioria dos olhos expostos a queimaduras alcalinas, se mostrando seguro para a estrutura e função da GL. / Purpose: The aims of this study were: 1) to determine the efficacy of adenovirus vector serotype 5 (Ad) encoding human soluble VEGF receptor 1 (sVEGFR1) gene transfer to the lacrimal gland (LG); 2) to investigate whether expression of sVEGFR1 acts in corneal neovascularization (CNV), induced by alkali burn and; 3) to evaluate the safety of the procedure. Methods: AdVEGFR1viral vectors (25 ?l, 1x1010pfu) were injected in the right LG of rats and compared with AdNull vector (25 ?l, 1x1010pfu) or 25?l saline (Control) before cornea alkali burn with 1 M NaOH. After seven days, CNV was observed and photographed in the slit lamp. Tear secretion was measured with phenol red thread. The animals were tested for human VEGFR1 mRNA and protein in the LG by qPCR and immunofluorescence staining, respectively. qPCR was also used to compare the mRNA of IL-1?, IL-6, and TNF-? in LG and ipsilateral trigeminal ganglion (TG). Results: Ad-VEGFR1 transfected 83% of the rats. VEGFR1 was present in LG acinar cells. CNV was prevented in 9 of 12 animals of Ad-VEGFR1 group, compared to Ad-Null (3:10) and Control (1:10) (p=0.0317). The tear secretion and the cytokines mRNA in LG and TG were similar all three groups (p>0.05). Conclusion: Adenoviral vector gene transfer to LG as the has shown local expression of human sVEGFR1, as It prevented CNV in most of the eyes exposed to alkali burn and was safe for LG structure and function.