Pas de résumé en français / Pas de résumé en anglais

Orientador: Angelo Pires do Prado / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-04T02:54:00Z (GMT). No. of bitstreams: 1 Varzim_FernandaLemeSilvaBastos_M.pdf: 508840 bytes, checksum: 2bd2ba617e44c3b8c752cd6fa3883eb3 (MD5) Previous issue date: 2005 / Resumo: A bioterapia com larvas consiste na aplicação de larvas vivas de moscas em ferimentos de difícil cicatrização, apresentado como finalidade desbridar o tecido necrosado e promover o crescimento de novos tecidos. A bioterapia poderá ser seguramente utilizada, quando larvas estéreis, são obtidas com a criação e manutenção das moscas em laboratório. A esterilização dos ovos são fatores significantes na obtenção de larvas estéreis para utilização na bioterapia. No presente estudo moscas Chrysomya putoria (Calliphoridae), foram capturas, criadas e mantidas em laboratório sob condições apropriadas para esterilização dos ovos. Foi avaliada a viabilidade das larvas de C. putoria, utilizando oito substâncias químicas esterilizantes que foram previamente diluídos em concentrações variadas, onde ovos de C. putoria foram testados em variados tempos de exposição. Os esterilizantes testados foram Formoldeído, Hipoclorito de sódio Permanganato de potássio®, Digluconato de Clorexidina, Farmasept 500®, Farmasept 800®, Farmaseptplus ® e Ultrasept®. Todos esses esterilizantes testados com exceção do Digluconato de Clorexidina, resultaram larvas viáveis, com números de sobreviventes satisfatórios para bioterapia, mas somente o Hipoclorito de sódio 0,5%, Formaldeído 1% e Farmasept-plus na concentração de 1/4000 foram eficazes microbiologicamente e podem ser utilizadas com segurança / Abstract: The therapy with larvae on biotherapy, consists of applying live fly larvae to nonhealing wounds for the purpose of unbridling the necrotic tissue and promoting the growth of healthy tissue. The biotherapy could surely be used, when larvae, are obtained by rearing and maintenaning flies in the laboratory. The sterilization of eggs is a significant factor in the attainming larvae to be used in biotherapy. In the present study Chrysomya putoria flies (Diptera: Calliphoridae), are been captured, and kept in laboratory under appropriate conditions to obtain the eggs use in the experiments. The viability of the larvae of Chrysomya putoria was evaluated, using eight sterile chemical substances that had previously been diluted in different concentrations, the eggs of Chrysomya putoria were tested in different exposition times. The tested sterilizing substances whith Formaldehyde, Sodium hypochlorite, Potássium Permanganate, Chlorexidine Digluconate, Farmasept 500®, Farmasept 800®, Farmasept-plus® and Ultrasept®. All the tested substances with the exception of the of Chlorexidine Digluconate, had not affected the viability of the, resulting in satisfactory numbers of live larvae. However only sodium hypochlorite 0.5%, Formaldehyde 1% and Farmasept-plus® in the concentration of 1/4000 were efficient icrobiolologically and can be safety used. / Mestrado / Parasitologia / Mestre em Parasitologia

No / Larval biotherapy is a debridement tool used in wound management. The mechanism of action involves degradation of eschar by serine proteases including chymotrypsin within the alimentary fluids of first instar Lucilia sericata. With the rationale of obviating some limitations of biotherapy, including cost, complexity of use, and patient reticence, the present study describes a mobile hydrogel formulation containing freeze-dried recombinant L. sericata chymotrypsin designed for topical application. Neither freeze-drying nor formulation into the hydrogel significantly attenuated the measured activity of released enzyme compared to fresh-frozen enzyme in aqueous solution. Gel electrophoresis confirmed qualitatively that the chymotrypsin/hydrogel formulation both with and without supplementary urea at 10% w/v degraded human chronic wound eschar ex vivo. Mindful that the hallmark of intractability of chronic wounds is aberrant biochemistry, the pH activity profile for the enzyme/hydrogel formulation was compared with exudate pH in chronic wounds of mixed aetiology in a cohort of 48 hospital in-patients. Five patients' wounds were acidic, however, the remainder were predominantly alkaline and coincided with the pH optimum for the insect enzyme. Thus, a recombinant L. sericata chymotrypsin and hydrogel formulation could represent a pragmatic alternative to larval therapy for the management of chronic wounds.

Les maladies allergiques sont devenues un enjeu de santé publique majeur en raison d’une prévalence en constante augmentation ces dernières années, d’un risque accru de choc anaphylactique et de l’absence de traitement curatif existant. Les allergies alimentaires sont caractérisées par une évolution fréquente vers le choc anaphylactique. Les lymphocytes T régulateurs (Treg), cellules permettant le maintien de l’homéostasie immunitaire et le contrôle des réponses, sont au centre du processus de régulation des réponses allergiques. Il a été démontré qu’il existait un déficit quantitatif et qualitatif de ces cellules chez les patients allergiques et que les manifestations allergiques étaient exacerbées en l’absence de Treg. L’induction, in vivo, de ces cellules semble donc être une alternative thérapeutique prometteuse afin de prévenir et traiter les maladies allergiques en particulier, l’allergie alimentaire. L’interleukine-2 (IL-2), cytokine du système immunitaire permettant la survie, l’expansion et la différenciation des lymphocytes, notamment les Tregs lorsqu’elle est utilisée à faible dose, constitue une avancée thérapeutique majeure. L’objectif de cette thèse a été d’évaluer le potentiel thérapeutique de l’IL-2 faible dose dans l’allergie alimentaire. L'IL-2 faible dose induit l’expansion et l’activation de Treg permettant la mise en place d’une protection contre les manifestations cliniques d'allergie alimentaire dans deux modèles de souris avec l'ovalbumine et l'arachide. L’abolition de cet effet clinique chez les souris dont les Treg ont été éliminés démontre la contribution majeure des Treg dans l'efficacité de la thérapie IL-2. Les mécanismes associés à la protection peuvent être corrélés à une modification locale de la balance Th1 / Th2 et une inhibition du recrutement et de l'activation des mastocytes. Nous avons démontré que l’IL-2 induit une protection clinique durable, supérieure à 7 mois, aussi bien lorsqu’elle est administrée de façon préventive (avant la phase de sensibilisation), que curative (après la sensibilisation ou le déclenchement de l’allergie). Cette protection à long terme est également dépendante des Treg dans la mesure où leur déplétion entraine la perte de protection de souris. Ces résultats, combinés à l’absence visible d’augmentation des Treg en fin de protocole, nous ont conduits à caractériser les mécanismes immunorégulateurs inhérents à ce contrôle effectif à distance et sur le long terme après traitement, en analysant notamment les sous populations de cellules régulatrices particulièrement efficace pour contrôler les réponses allergiques. Les résultats préliminaires obtenus, qu’il conviendra de reproduire, ne nous permettent pas de conclure clairement quant à la sélection des Treg spécifiques de l’allergène, ou de sous population de Treg, réputées protectrices dans l’allergie. Toutefois, nos résultats constituent la preuve de concept de l’utilisation de l’IL-2 faible dose dans l’allergie alimentaire. De même l’IL-2 a également montré son efficacité dans un modèle murin d’allergie respiratoire (ovalbumine). Nous avons aussi démontré que des voies d’administration alternatives étaient possibles, notamment la voie orale. De ce fait, un essai clinique de phase II testant l’administration d’IL-2 faible dose dans la rhinoconjonctivite va prochainement être mise en place par notre centre d’investigation clinique. Ainsi, nous espérons développer une nouvelle biothérapie, sûre, efficace et peu coûteuse, dans la prise en charge thérapeutique des allergies. / Regulatory T cells (Treg) are pivotal for maintenance of immune self-tolerance, and also regulate immune responses to exogenous antigens, including allergens. Both decreased Treg number and function have been reported in allergic patients, offering new therapeutic perspectives. The in vivo induction of these cells therefore, appears to be a promising therapeutic option in order to prevent and treat allergic diseases in particular, food allergy. Interleukin-2 (IL-2), allowing the survival, expansion and differentiation of lymphocytes, especially Treg when used at low doses, is a major therapeutic advance. Here, we evaluated the ability of low dose IL-2 (intraperitoneal route to control) allergy in an experimental model of food allergy. Low dose IL-2 (ld-IL-2) induced Treg expansion and activation that elicited protection against clinical manifestations of food allergy in two mouse models with ovalbumin and peanut. This clinical effect was lost in Treg-depleted mice demonstrating the major contribution of Treg in ld-IL-2 efficacy. Also, protection from allergy could be explained by a Treg-dependent local modification of the Th1/Th2 balance and an inhibition of mast cell recruitment and activation. Then, preventive and therapeutic effects of ld-IL-2 were observed over a 7-month period, highlighting its long-term efficacy. This long-term protection is also dependent on Treg insofar as their depletion results in the loss of protection of mice. These results, with the loss of increase of Treg at the end of the protocol, led us to better characterize the immunoregulatory mechanisms involved in the ld-IL2 long term efficacy, in particular by analyzing subpopulations of Treg particularly effective in controlling allergic responses. The preliminary results obtained, which should be reproduced, do not allow us to conclude clearly to the selection of allergen-specific Treg, or Treg subpopulation involved in the regulation of allergic responses. However, our results demonstrate the proof of concept of the use of low-dose IL-2 in food allergy. Similarly IL-2 has also shown its efficacy in a mouse model of asthma (ovalbumin). Alternative routes of administration were also demonstrated, including oral route. As a result, a clinical trial testing low-dose IL-2 in rhinoconjunctivitis will soon be initiated by our center. The present data show for the first time the therapeutic potential of ld-IL-2 for the treatment of food allergy, and should prompt hope, in the therapeutic management of allergies. Patients will be offered the first curative treatment developed in food allergies to improve their quality of life. Keywords: Allergy, Interleukin 2, biotherapy, therapeutic option, allergen-specific Treg, peripheral Treg.

La mucoviscidose est une maladie génétique due à des mutations du gène CFTR (Cystic Fibrosis Transmembrane conductance Regulator), conduisant à un défaut d'adressage de la protéine CFTR à la membrane apicale des cellules épithéliales, ou à un déficit de sa fonction de canal à ions chlorure. Ce travail a consisté à étudier les vésicules extracellulaires (EV), microvésicules (MV) et exosomes (Exo), comme vecteurs de la protéine CFTR et de son ARN messager. La preuve de concept du transfert de matériel biologique d'intérêt par l'intermédiaire d'EV, d'abord apportée sur un modèle de cellules animales (CHO), a été validée en cellules humaines. Les EV ont été isolées à partir de surnageant de Calu-3, cellules exprimant la protéine CFTR de manière endogène, et de A549 transduites par le vecteur adenoviral Ad5-GFP-CFTR, surexprimant la protéine de fusion GFP-CFTR. Les cellules cibles choisies, A549 et CF15, étaient déficientes en CFTR. Le transfert s'est révélé plus efficace en système homologue (A549/A549) qu'en système hétérologue (A549/CF15). Par ailleurs, l'utilisation d'inhibiteurs métaboliques suggère que les EV ne suivent pas une voie d'internalisation cellulaire unique, mais que plusieurs mécanismes sont mis en jeu, dont l'endocytose clathrine dépendante et la macropinocytose. Les deux types d'EV sont capables de rétablir la fonction canal associée au CFTR dans les cellules CF15 de façon dose-dépendante, mais avec un effet de seuil minimum. L'activité CFTR reste stable pendant 3 jours, et à un niveau encore détectable après 5 jours. Notre travail démontre l'intérêt potentiel des MV et Exo comme vecteurs de biothérapie de pathologies génétiques / Cystic fibrosis is a genetic disease in which its prognosis depends on the lung damage. It is caused by mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR), resulting in a dysfunctional CFTR protein normally located at the plasma membrane of epithelial cells. This thesis is a study of a novel therapeutic approach to use extracellular vesicles (EVs), microvesicles and exosomes, as transfer vectors for CFTR mRNA and protein to target cells. The proof of concept for the transfer of CFTR mRNA and protein was first done in the CHO hamster model. To validate this concept on human cells, we used human bronchial Calu-3 cells, which express the endogenous CFTR protein, and A549 lung epithelial cells transduced by the adenoviral vector Ad5-GFP-CFTR to overexpress the fusion exogenous protein GFP-CFTR. We show that EVs produced by these cells could transfer a new functionality to CF15 target cells carrying the CFTRdeltaF508 mutation and the transfer seems to be more efficient in a homologous cell system versus a heterologous system. Interestingly, the exosomes seem to be more efficient in CFTR transfer than the microvesicles. A study of the mechanism of EVs cellular uptake show that it is temperature dependent and that endocytosis and macropinocytosis are implicated. Collectively, this study demonstrates the potential application of EVs for CFTR transfer and functional correction of the genetic defect in human CF cells

Les microparticules (MPs) sont des vésicules dérivées de la membrane plasmique lors de la vésiculation par les cellules stimulées. Les MPs interviennent dans l'inflammation, les communications intercellulaires et la coagulation. Tout d'abord, nous avons standardisé une méthode pour caractériser et quantifier des MPs par cytométrie en flux dans le plasma.L'implication des MPE est suggérée dans le psoriasis notamment par le rôle central du TNF-a qui est un puissant inducteur de vésiculation. Nous avons comparé les valeurs de MPs chez des patients psoriasiques à celles de donneurs sains. Les MPE étaient plus élevées chez les patients notamment les MPs de petite taille. Les MPs diminuaient sous traitements anti-TNF-a.Les MPs agissent sur la progression tumorale des cancers. Les MPs tumorales ou des cellules de l'hôte peuvent modifier les propriétés invasives de la tumeur par des propriétés transférées. Les MPs peuvent aussi interagir avec les cellules du système immunitaire. Dans le mélanome, le risque de thrombose est accru. Or, la libération de MPs conduit à un état d'hypercoagulabilité. Les MPP et les MPE étaient augmentés dans chaque stade de la maladie par rapport à une population témoin. De plus, les MPs des patients atteints de mélanome possédaient des propriétés procoagulantes. L'étude des MPs en Dermatologie permet d'appréhender de nouveaux angles de la physiopathologie des maladies inflammatoires ou en carcinogenèse. Le dosage des MPs pourrait devenir un outil intéressant de monitoring des biothérapies dans le psoriasis. Dans le mélanome, des études complémentaires permettront de déterminer si les taux de MPs constituent un facteur pronostique intéressant / Microparticles (MPs) are vesicles derived from the plasma membrane during vesiculation by the stimulated cells. MPsare involved in inflammation, intercellular communications and coagulation. First, we standardised a method tocharacterise and quantify MPs in plasma by flow cytometry.The implication of endothelial microparticles (EMPs) is suggested in psoriasis, in particular by the central role of TNF-a which is a powerful inducer of vesiculation. We compared the values of MPs in psoriatic patients to the values inhealthy donors. EMPs were higher in the patients, especially MPs of small size. MPs were reduced under anti-TNF-atreatments.MPs have an action on the tumoral development of cancers. Tumoral MPs or the host's cells can modify the invasiveproperties of the tumour through transferred properties. MPs can also interact with the cells of the immune System. Inmelanoma, the risk of thrombosis is increased, but the release of MPs leads to a state of hypercoagulability. Plateletsmicroparticles (PMPs) and EMPs were increased at each stage of the disease compared to a control population. Inaddition, MPs of patients with melanoma had procoagulant properties.The study of MPs in Dermatology allows to apprehend new approaches of the physiopathology of inflammatorydiseases or in carcinogenesis. The dosage of MPs could become an interesting tool in the monitoring of biotherapies inpsoriasis. In melanoma, additional studies will show if MPs rates are an interesting prognostic factor.

INTRODUCTION: Acute infusion reactions from antineoplastic agents can include hypersensitivity reactions, anaphylaxis, and cytokine release infusion reactions. Severe acute infusion reactions happen in about 5% of the oncology patient population and nurses are responsible for assessment and management of the reaction. This is a high-stress task for a nurse magnified by the lack of exposure. This project explores nursing knowledge and perceived comfort level of acute infusion reactions caused by antineoplastic agents. METHODOLOGY: An original survey was created to test nursing knowledge and assess comfort level. Nursing knowledge was broken down into six subscales: general knowledge of acute infusion reactions, signs and symptoms of hypersensitivity, anaphylaxis, and cytokine release infusion reaction, and drugs most likely to cause hypersensitivity and anaphylactic reactions and cytokine release infusion reactions. Comfort questions were asked on a 6-point Likert scale from extremely uncomfortable to extremely comfortable. There was an additional section in the survey related to nurses’ distress and support in situations with acute infusion reactions. The questions were presented using a 6-point Likert scale ranging from strongly disagree to strongly agree. There were two open-ended questions that were designed to allow the nurses to share any additional information about their experiences with acute infusion reactions. Oncology nurses working with adults and pediatric populations were invited to participate. Descriptive statistics were used to analyze the survey results. T tests were used to compare groups and Pearson R statistics were used to examine relationships between total knowledge, knowledge subscale score, and comfort level. RESULTS: 20 nurses completed the survey. 12 were from the adult nurse population and 8 were from the pediatric nurse population. The typical participant was forty-four years of age, had sixteen years experience as a Registered Nurse, and thirteen years experience in the oncology setting. The average total knowledge score was a 56% based on 84 possible points. The basic knowledge section and the anaphylactic signs and symptoms were the highest scoring subscales, both scoring a 62%. Cytokine release infusion reaction signs and symptoms was the lowest scoring subscale with a 45%. There were no significant differences in knowledge between groups. The nurses chose an overwhelming agree/strongly agree when asked to choose the signs and symptoms related to each type of infusion reaction. The total comfort level score indicated that nurses were very comfortable managing acute reactions. There was no significant difference between the adult and pediatric setting comfort level scores. There was no statistically significant relationship between total knowledge score and total comfort level score. DISCUSSION: The knowledge score showed knowledge deficits while the comfort score indicated confidence in management of acute infusion reactions. The high frequency of agree/strongly agree for all three subscales of signs and symptoms indicates that the nurses at least know what to look for even if they cannot assign the specific sign and symptom to the type of infusion reaction. Knowledge about signs of specific types of drug reactions may not be necessary as long as a basic understanding of what to look for and how to manage a reaction is present.

No / The resurgence of larval biotherapy as a debridement tool in wound management has been accompanied by several clinical reports highlighting concomitant tissue regeneration. Studies employing in vitro cell motility assays have found that purified excretory/secretory (ES) products from Greenbottle larvae (blowfly, Lucilia sericata) are motogenic for human dermal fibroblasts when used as a supplement in culture media. The objective of the present study was to determine whether ES delivered using a prototype hydrogel wound dressing induced similar motogenic effects on fibroblastic (3T3) and epithelial cells (HaCaTs) comprising a scratched-monolayer wound model. Quantitative analysis by MTT assay failed to detect significant mitogenic effects of ES on either cell type. Quantitative image analysis revealed that ES exposure markedly accelerated wound closure through a motogenic effect on both fibroblasts and keratinocytes. Quantitative histochemical analysis detected significantly higher phosphotyrosine (pTyr) expression in ES-exposed cell cultures than in controls; moreover immunocytochemistry revealed conspicuously raised levels of pTyr expression in cells located at the wound margin. By attenuation with a panel of enzyme inhibitors these effects were attributed to the protease components of ES. The present results suggest that controlled delivery of ES as a follow-up to maggot debridement therapy may be an effective therapeutic option for stimulation of tissue regeneration in wound management.

Human biotherapy (HBT) or fecal transplants have been shown to be an effective treatment for patients with recurrent Clostridium difficile infection (CDI). This study examines the microbial populations present in CDI patients pre- and post-HBT by extracting bacterial DNA from stool samples and performing pyrosequencing of the 16S rRNA gene. We then compared these microbial populations to those of the donors. We examined 19 pairs of patient samples, of which 14 were clinically cured of CDI, and 5 patients were failures. The successful treatment of CDI was associated with an increase in diversity and richness of the patient's fecal microbiome. The majority of those cured showed an increase in the proportion of Firmicutes and decrease in the proportion of Proteobacteria, although varying antibiotic exposure and innate variability between patients was observed. / MSc thesis / NSERC, CIHR, St. Joseph's Healthcare Hamilton