Bibliography: leaves 211-260 / xvii, 260 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Pathology, 1986

Diss. (sammanfattning) Stockholm : Karol inst., 2003. / Härtill 6 uppsatser. ISBN tilldelat efter tryckningen.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 6 uppsatser.

B lymphocytes play a significant role in autoimmune arthritis, with their function stretching beyond autoantibody production to cytokine secretion and presentation of autoantigen. However, the involvement and activation of different B-cell subset in the autoimmune response is not fully clear. The main focus of this thesis has been to understand the contribution of marginal zone (MZ) B cells in the induction of collagen-induced arthritis (CIA), a mouse model for rheumatoid arthritis (RA). We show that MZ B cells in the spleen of naïve mice display a natural self-reactivity to collagen type II (CII), the autoantigen used for immunization of CIA. The CII-reactive MZ B cells expand rapidly following immunization with CII, and produce IgM and IgG antibodies to CII. They also very efficiently present CII to cognate T cells in vitro and in vivo. Moreover, absence of regulatory receptors such as CR1/2 or FcγRIIb on the MZ B cells increases their proliferation and cytokine production in response to toll-like receptor, but not B-cell receptor, activation. Further, FcγRIIb-deficient MZ B cells present CII to T cells more efficiently than wild-type MZ B cells. We additionally demonstrate for the first time the existence of a small population of nodal MZ B cells in mouse lymph nodes. Similar to splenic MZ B cells, the nodal MZ B cells expand after CIA induction, secrete IgM anti-CII antibodies and can present CII to cognate T cells. Finally, we show that mast cells, associated with ectopic B cell follicles in inflamed RA joints, in coculture with B cells promote their expansion, production of IgM and IgG antibodies as well as upregulation of CD19 and L-selectin. Coculture with mast cells further causes the B cells to upregulate costimulators and class II MHC, important molecules for antigen-presenting function. In summary, my findings suggest that splenic and nodal self-reactive MZ B cells participate in breaking T-cell tolerance to CII in CIA. B-cell intrinsic regulation is needed to keep such autoreactive B cells quiescent. Mast cells can potentiate B-cell responses locally in the arthritic joint, thus feeding the autoimmune reaction.

La polyarthrite Rhumatoïde (PR) et le syndrome de Sjögren primitif (pSS) sont des deux maladies auto-immunes invalidantes pour lesquelles il n’existe à ce jour pas de traitement permettant la guérison des patients. Bien que les lymphocytes B soient impliqués dans le développement ces pathologies, l’existence de lymphocytes B capables de réguler l’inflammation est maintenant largement reconnue. Ces lymphocytes B régulateurs (Bregs) sont capables à la fois d’induire des lymphocytes T régulateurs et d’empêcher le développement de lymphocytes T pro-inflammatoires. In vivo, le transfert de ces Bregs est protecteur dans de nombreux modèles murins de maladies auto-immunes suggérant ainsi que promouvoir ces Bregs serait prometteur pour traiter les patients atteints de PR ou pSS. Cependant, il n’existe à ce jour pas de marqueur spécifique des Bregs, ce qui complique leur étude. Comme leurs fonctions régulatrices sont principalement médiées par l’IL-10, une cytokine anti-inflammatoire, les Bregs peuvent être définis par leur capacité à produire de l’IL-10 après activation par des composés bactériens, notamment CpG, motifs mimant l’ADN microbien. Ces Bregs sont appelés B10+. Toutefois, les fonctions de ces B10+ ne sont pas bien définies chez l’homme. Ainsi, nous ignorons si la seule production d’IL-10 est suffisante pour définir les Bregs.Cette thèse a donc pour premier objectif de définir les fonctions les B10+ stimulés par CpG chez les individus sains et chez les patients, afin de déterminer si la production d’IL-10 était un bon marqueur des Bregs. Nous avons montré que les B10+ induits par CpG étaient capables d’induire des lymphocytes T régulateurs (Tregs et Tr1) mais ne diminuaient pas la proportion de lymphocytes T pro-inflammatoires (Th1 et LT-TNFα+). Chez les patients PR et pSS, les B10+ induisaient des Tregs et Tr1 mais chez les patients PR, ils induisaient également des Th1. Ces résultats suggèrent que la production d’IL-10 seule ne suffit pas à récapituler toutes les fonctions régulatrices des Bregs, et que le stimulus CpG impacte probablement leur fonctions.Pour mieux comprendre les mécanismes contrôlant la production d’IL-10 des lymphocytes B et pouvoir proposer d’autres stimuli pour les générer, nous avons étudié l’effet de l’acétate, un composé produit par les bactéries commensales, sur la génération des B10+. L’acétate était capable d’induire des B10+ chez la souris et chez l’homme. D’autre part, nous avons également étudié le métabolisme cellulaire de ces B10+. Nous avons montré que la glutamine était un nutriment essentiel à la génération des B10+ et à leurs fonctions régulatrices. En définitive, ce travail a permis de définir les fonctions des B10+ induits par CpG, de caractériser leur métabolisme et de proposer de un stimulus alternatif pour générer les B10+. / Rheumatoid arthritis (RA) and primary Sjögren's syndrome (pSS) are two debilitating autoimmune diseases. There is currently no treatment to cure patients. Although B lymphocytes are involved in the development of these pathologies, the existence of B cells capable of regulating inflammation is now widely recognized. These regulatory B cells (Bregs) are able of both inducing regulatory T cells and preventing the development of pro-inflammatory T cells. In vivo, the transfer of these Bregs is protective in many mouse models of autoimmune diseases thus suggesting that promoting these Bregs would be promising for treating patients with RA or pSS. However, there is currently no specific marker for Bregs, which largely hinders their study. Since their regulatory functions are mainly mediated by IL-10, an anti-inflammatory cytokine, Bregs can be defined by their ability to produce IL-10 after activation by bacterial compounds, including CpG. Those Bregs are called B10+ cells. However, the functions of these B10+ cells are not well defined in humans. We do not know whether IL-10 production is a sufficient marker to define Bregs.The main goal of this thesis was to define CpG-induced B10+ cell functions in healthy individuals and patients, to determine whether IL-10 production was a good marker for Bregs. We showed that CpG-induced B10+ cells were able to induce regulatory T cells (Tregs and Tr1) but did not decrease the proportion of pro-inflammatory T cells (Th1 and LT-TNFα +). In RA and pSS patients, B10+ cells induced Tregs and Tr1 but in RA patients they also induced Th1. These results shows that IL-10 production alone does not recapitulate all the Breg functions and that CpG stimulation might impact their functions.To better understand the mechanisms controlling IL-10 production by B cells, and to be able to propose other stimuli to generate them, we studied the effect of acetate, a compound produced by commensal bacteria, on B10+ cells generation. Acetate was able to induce B10+ cells in mice and humans. Besides, we studied B10+ cell metabolism. We have showed that glutamine was an essential nutrient for B10+ cell generation and for their regulatory functions. This work has made it possible to define the CpG-induced B10+ cell functions, to characterize their metabolism and to propose an alternative stimulus to generate B10+ cells.

A Artrite Reumatóide (AR) é uma doença autoimune associada a poliartropatia inflamatória que acomete principalmente as articulações periféricas. Cerca de 1% da população mundial é afetada, sendo duas a três vezes mais prevalente em mulheres. Apresenta uma patogênese complexa e multifatorial. A sinóvia das articulações afetadas é infiltrada por linfócitos T e B, macrófagos e granulócitos. A sinóvia reumatóide adquire características proliferativas, formando o pannus, e invade a cartilagem articular e o osso, levando à destruição da arquitetura normal da articulação e perda de função. Em vários modelos de doenças autoimunes, a ausência ou diminuição da expressão de proteínas reguladoras do complemento tem sido observada, associada com o agravamento dos sintomas clínicos, sendo que, muitos destes casos, a superativação do sistema complemento pode ser a causa da exacerbação da doença. O presente artigo tem por objetivo revisar os principais aspectos relacionados à regulação do sistema complemento na artrite reumatóide, a fim de propiciar uma melhor compreensão do potencial papel desse sistema na fisiopatologia da doença. / Rheumatoid arthritis (RA) is an autoimmune disease associated with polyarticular inflammatory synovitis that affects mainly the peripheral joints. About 1% of the world population is affected, and it is two to three times more prevalent in women. RA has a complex and multifactorial pathogenesis. The rheumatoid synovium acquires proliferative characteristics, forming the pannus, and invades cartilage and bone, leading to the destruction of normal architecture and loss of function. In several models of autoimmune diseases, the absence or decreased expression of complement regulatory proteins has been observed, associated with worsening of the clinical symptoms, and many of these cases the over-activation of the complement system is the cause of disease exacerbation. This article aims to review the main aspects related to regulation of the complement system in rheumatoid arthritis in order to provide a better understanding of the potential role of this system in the pathophysiology of the disease.

The Diploma thesis entitled Situation of People with Rheumatoid Arthritis in the Context of Legislative Changes deals with a topic which is not sufficiently resolved in the Czech society. Attention paid to the new Act no. 329/2011 Coll., on Provision of Subsidies to People with Disabilities and on Amendment to Related Acts, is not at a sufficient level either. The theoretical part of the Diploma thesis deals, at a general level, with rheumatoid arthritis. This is followed up by a focus on psychosocial aspects of the life of subjects with rheumatoid arthritis, on the social security system in the Czech Republic and on the Act no. 329/2011 Coll. Qualitative research was selected to achieve specified objectives of the practical part of the Diploma thesis. Interviews were used to obtain all necessary data. The technique for acquisition of necessary data was based on semi-controlled interviews. The interviews consisted in a list of questions which were discussed within the framework of the interview. The basic file for data collection was formed of people with rheumatoid arthritis. The selective file consisted of clients of the Rheumatology League of the Southern Bohemia Region. Altogether 20 interviews were made. The main aim of the Diploma thesis was to identify the impacts of changes implying from the Act no. 329/2011 Coll., on Provision of Subsidies to People with Disabilities, on the situation of people with rheumatoid arthritis. This objective was followed up by another three partial objectives, namely to find out how people with rheumatoid arthritis perceive the change in the subsidy payment site for handicapped people; to find out the impacts of the change in concepts of subsidy for mobility on people with rheumatoid arthritis; and to find out how people with rheumatoid arthritis perceive their obligation to provide data on incomes for justification of their entitlement for a special device. Survey questions were formulated on the basis of the Diploma thesis objectives as follows: 1. Did the frequency of transport decrease for people with rheumatoid arthritis in connection with the change in the amount of the subsidy for mobility? 2. Do people with rheumatoid arthritis perceive any benefits in unification of the subsidy payment place at the Labour Office? It implies from the results of the survey that the impacts of changes resulting from the Act no. 329/2011 Coll. did not have any impact on the situation of people with rheumatoid arthritis. During fulfilment of the objective of finding out how people with rheumatoid arthritis perceive the change in the subsidy payment place, two respondents pointed out that the issuing of the cards marking a vehicle transporting a person suffering from heavily impaired mobility pursuant to the Act no. 361/2000 Coll., on Road Traffic, which is closely interrelated with these issues, is performed at the Municipal Authority at the Department of Social Affairs. It has been furthermore found out on the basis of the survey that the change in the concepts of the subsidy for mobility has not had any impact on people with rheumatoid arthritis yet. And finally, the last conclusion of this Diploma thesis is the fact that people with rheumatoid arthritis do not mind the obligation to provide data on incomes while proving their entitlement for a special device. One of the aims of this Diploma thesis is to contribute to understanding of the entire situation of people with rheumatoid arthritis in the context of legislative changes. The results obtained from the survey could be useful for the general scientific public. An Annex to this Diploma thesis is a presentation which can facilitate orientation in the new Act. This presentation will be used as a material accompanying a lecture held in the Rheumatology League Association in České Budějovice.

Peu d’hommes sont touchés par les maladies auto-immunes (MAI), maladies où la réponse immune est très forte et attaque l’hôte. La polyarthrite rhumatoïde (PR), une maladie inflammatoire chronique, suit cette règle avec 3 femmes pour 1 homme atteint. Dans cette thèse, nous analysons les différences en fonction du sexe et les raisons d’un tel biais. D’après des observations chez l’animal, nous nous sommes demandés si les rares hommes atteints de PR ont une augmentation du nombre de copies d’un gène impliqué dans la réponse immune et porté par le chromosome (Chr) X. Contrairement aux femmes, les hommes n’ont qu’un Chr X et de ce fait qu’une copie de ce gène. Cependant, nous avons montré par différentes techniques, que ces patients avaient 10% de cellules portant 2 copies de ce gène, et que cette augmentation venait de cellules ayant 2 Chr X. Nos recherches soulignent l’importance du Chr X dans l’auto-immunité et ouvrent un nouveau champ d'investigation pour les hommes atteints de MAI. / Few men are affected by autoimmune diseases (AID), diseases where the immune response is very strong and attacks the host. Rheumatoid arthritis (RA), a chronic inflammatory disease, follows this rule with 3 women affected for 1 man. In this thesis, we analyse gender differences and the reasons for such bias. Based on observations in animals, we wondered whether the rare men with RA have an increased copy number of a gene involved in the immune response and carried by the X chromosome (Chr). Unlike women, men have only one X Chr and one copy of this gene. However, we showed by different techniques that these patients had 10% of cells carrying 2 copies of this gene, and that this increase came from cells with 2 X Chr. Our research emphasizes the importance of the X Chr in autoimmunity and opens up a new field of investigation for men with AID.

Fundação de Amparo a Pesquisa no Estado do Rio Grande do Sul / Gout attack is characterized severe joint pain and inflammation with concomitant accumulation of monosodium urate (MSU) crystals. However, gout and the mechanisms responsible for the acute attacks are poorly understood, leading to improper treatment of the patient and reducing the quality of life. Polyamines (putrescine, spermidine and spermine) are involved in inflammatory nociceptive processes and have not been investigated to date. Therefore, the aim of the present study was to investigate the involvement of polyamines in the development of acute gout attack. Arthritis score, a compound measure of joint compromise that considers edema formation, erythema and paw position, mechanical hyperalgesia and inflammatory parameters were measured in an acute gout attack model in male mice induced by intra-articular (i.a.) injection of MSU, H2O2, phorbol 12-myristate 13-acetate (PMA), L-ornithine or polyamines (putrescine, spermidine, spermine). All these algogenic agents increased arthritis score in a dose-dependent manner with ED50 of 0.73 (0.4-1.1) mg/site for MSU, 2.3 (1.5-3.5) μmol/site for H2O2, 3.5 (2.1-5.6) nmol/site for PMA, 0.6 (0.3-1.1) μmol/site for L-ornithine, 0.8 (0.4-1.7) μmol/site for putrescine, 3.6 (2.6-5.1) μmol/site for spermidine and 0.1 (0.06-0.2) μmol/site for spermine. All tested algogenic agents caused joint edema and nociception, except putrescine, which increased only arthritis score. α-Difluoromethylornithine (DFMO; ornithine decarboxylase ODC - inhibitor, i.a.) prevented MSU-, H2O2-, PMA-, L-ornithine-induced nociception, but not edema. On the other hand, DFMO did not prevent spermine-induced edema and nociception. DFMO prevented MSU-induced increase of ODC activity. Our results indicate that polyamines contribute to acute gout attacks, suggesting that inhibitors of polyamine synthesis may be potential therapeutic agents for the treatment and prophylaxis of gout. / O ataque agudo de gota é caracterizado por dor intensa e inflamação combinados com o acúmulo de cristais de urato monossódico (MSU). No entanto, a gota e os mecanismos responsáveis pelos ataques agudos ainda estão mal compreendidos, levando ao tratamento inadequado dos pacientes e reduzindo a qualidade de vida. As poliaminas (putrescina, espermidina e espermina) estão envolvidas em processos nociceptivos inflamatórios, e não foram investigadas até o momento, por conseguinte, o objetivo do presente estudo foi investigar o envolvimento das poliaminas no desenvolvimento do ataque de gota aguda em camundongos. Para isso, o escore de artrite (conjunto de somatórios de medidas que considera a formação de edema, eritema e posição da pata tratada do animal), hiperalgesia mecânica e parâmetros inflamatórios foram medidos em um modelo de ataque agudo de gota em camundongos machos, induzidos por uma injeção intra-articular de (i.a.) MSU, H2O2, forbol 12-miristato 13-acetato (PMA), L-ornitina ou poliaminas (putrescina, espermidina, espermina). Todos os agentes algogênicos aumentaram o escore de artrite de um modo dose dependente com um DE50 de 0,73 (0,4-1,1) mg/sitio de MSU, 2,3 (1,5-3,5) μmol/sitio de H2O2, 3,5 (2,1-5,6) nmol/sitio para PMA, 0,6 (0,3-1,1) μmol/sitio para a L-ornitina, 0,8 (0,4-1,7) μmol/sitio para a putrescina, 3,6 (2,6-5,1) μmol/sitio para a espermidina e 0,1 (0,06-0,2) μmol/sitio para espermina. Todos os agentes algogênicos testados causaram edema articular e nocicepção, exceto a putrescina, que aumentou apenas o escore de artrite. α-Difluorometilornitina (DFMO; inibidor da ornitina descarboxilase - ODC) preveniu a nocicepção induzida por: MSU, H2O2, PMA, L-ornitina, mas não o edema. Por outro lado, DFMO não preveniu a nocicepção e o edema induzido por espermina. DFMO preveniu o aumento da atividade da ODC induzido por MSU. Os nossos resultados indicam que as poliaminas estão envolvidas no ataque agudo de gota, sugerindo que os inibidores da síntese de poliaminas podem ser potenciais agentes terapêuticos para o tratamento e profilaxia da gota.

Le criblage virtuel est largement employé pour la recherche de nouveaux médicaments.La sélection de structures pour les méthodes de criblage virtuel basées sur la structure reste problématique. Nous avons montré que les propriétés physico-chimiques du site de liaison, critères simples et peu coûteux en temps de calcul, pouvaient être utilisées pour guider celle-ci.L’évaluation des méthodes de criblage virtuel, critique pour vérifier leur fiabilité, repose sur la qualité de banques d’évaluation. Nous avons construit la NRLiSt BDB, n’incluant que des données vérifiées manuellement et prenant en compte le profil pharmacologique des ligands. Une étude à l’aide du logiciel Surflex-Dock montre qu’elle devrait devenir la base de données de référence, pour l’évaluation des méthodes de criblage virtuel et pour rechercher de nouveaux ligands des récepteurs nucléaires. L’application d’un protocole hiérarchique de criblage in silico/in vitro, a permis d’identifier de nouveaux composés inhibiteurs de l’IL-6, potentiellement utilisables dans le traitement de la polyarthrite rhumatoïde. Les résultats in vitro devront être confirmés par des tests in vivo. / Virtual screening is widely used in drug discovery processes.Structure selection in structure-based virtual screening methods is still problematic. We showed that simple and “low cost” binding site physico-chemical properties could be used to guide structure selection.The evaluation of virtual screening methods, necessary to ensure their reliability, relies on benchmarking databases quality. We created the NRLiSt BDB, gathering only manually curated data and taking into account ligands pharmacological profiles. A study using Surflex-Dock showed that the NRLiSt BDB should become the reference, both for the evaluation of virtual screening methods and for the identification of new ligands of the nuclear receptors.The use of a in silico/invitro hierarchical approach screening allowed to identify new IL-6 inhibitors, that could be used in rheumatoid arthritis treatment. In vitro results should be confirmed in vivo.