Adoptive cell transfer techniques identify and isolate patient anti-tumor lymphocytes in vitro followed by ex vivo expansion of these tumor specific T cells. Identification and isolation of lymphocytes from patient tumors allows for the selection of anti-tumor lymphocytes that are highly specific for individual tumor antigens. Furthermore, recombinant technology allows for engineering of chimeric antigen receptors (CARs) which allow these T cells to target multiple tumor antigens. Techniques involving ex vivo growth lead to a 1,000- to 5,000-fold increase in numbers of lymphocytes. Cultured lymphocytes can then be infused via IV and growth maintained with administration of exogenous IL-2. Cancer patients are then monitored for both immunological activity as well as any adverse cytokine reactions. We looked at several trial studies for the application of adoptive cell transfer in metastatic melanoma compare the efficacy of the regimen to other established melanoma treatments. Adoptive transfer has proven to be effective for patients with late stage melanoma, however, the aim of this study was to examine some of the challenges in creating an effective standard protocol for adaptation in clinical settings, including difficulty in obtaining significant cell populations from tumors, challenges in the proliferation of these tumor-infiltrating lymphocytes (TIL) and determination of antigen-specificity, i.e. facilitation of a simplified and quicker approach to the therapy.

Asynchronous Transfer Mode (ATM) can provide deterministic channels as required for real time signals, as well as statistical multiplexing. For this reason, ATM has been chosen as the underlying technology for providing a Broadband Integrated Services Digital Network (B-ISDN). Two main classes of services are expected to be supported over a B-ISDN. These classes are real-time services and data services. Data services include computer communications (Local Area Network (LAN) interconnections) and general non-real time traffic, such as file transfer and small transactions.The provision of data services over ATM are better served with statistical multiplexing, provided that the service is loss-free. For multiplexing to be loss-free and still statistical, while the maximum service rate is fixed, the multiplexer tributaries must be controlled in flow, to assure no overflow of the multiplexing buffer. Provision of a service over ATM is accomplished by an ATM layer. Transfer Capability (ATC).This thesis investigates and reports on the operating characteristics of an ATM layer Transfer Capability proposed to the International Telecommunications Union (ITU), and called Controlled Cell Transfer (CCT). CCT uses credit window based flow control on links and a quota based control in switches, and will give loss free statistical multiplexing for data. Other ITU defined ATCs are examined in regard to data service provision and compared with CCT. It is found that only CCT can provide a fast and at the same time efficient data service.The thesis also examines the impact that support of the CCT capability would have on an ATM switch, through determination of required functionality, and mapping of the required functions into a switch design. Finally, an architecture and implementation of an ATM switch is described that would support the CCT as well as the Deterministic Bit Rate (DBR) ++ / transfer capability, and would provide efficient data and real-time services.

<p>Dysregulated inflammation underlies the pathogenesis of a myriad of human diseases ranging from cancer to autoimmunity. As coordinators, executers and sentinels of host immunity, T cells represent a compelling target population for immune-modulation. In fact, the antigen-specificity, cytotoxicity and promise of long-lived of immune-protection make T cells ideal vehicles for cancer immunotherapy. Interventions for autoimmune disorders, on the other hand, aim to dampen T cell-mediated inflammation and promote their regulatory functions. Although significant strides have been made in targeting T cells for immune-modulation, current approaches remain less than ideal and leave room for improvement. In this dissertation, I seek to improve on current T cell-targeted immunotherapies, by identifying and preclinically characterizing their mechanisms of action and in vivo therapeutic efficacy.</p><p>CD8+ cytotoxic T cells have potent antitumor activity and therefore are leading candidates for use in cancer immunotherapy. The application of CD8+ T cells for clinical use has been limited by the susceptibility of ex vivo-expanded CD8+ T cells to become dysfunctional in response to immunosuppressive microenvironments. To enhance the efficacy of adoptive cell transfer therapy (ACT), we established a novel microRNA-targeting approach that augments CTL cytotoxicity and preserves immunocompetence. Specifically, we screened for miRNAs that modulate cytotoxicity and identified miR-23a as a strong functional repressor of the transcription factor Blimp-1, which promotes CTL cytotoxicity and effector cell differentiation. In a cohort of advanced lung cancer patients, miR-23a was upregulated in tumor-infiltrating CD8+ T cells, and its expression correlated with impaired antitumor potential of patient CD8+ T cells. We determined that tumor-derived TGF-&#946; directly suppresses CD8+ T cell immune function by elevating miR-23a and downregulating Blimp-1. Functional blockade of miR-23a in human CD8+ T cells enhanced granzyme B expression; and in mice with established tumors, immunotherapy with just a small number of tumor-specific CD8+ T cells in which miR-23a was inhibited robustly hindered tumor progression. Together, our findings provide a miRNA-based strategy that subverts the immunosuppression of CD8+ T cells that is often observed during adoptive cell transfer tumor immunotherapy and identify a TGF&#946;-mediated tumor immune-evasion pathway.</p><p>Having established that miR-23a-inhibition can enhance the quality and functional-resilience of anti-tumor CD8+ T cells, especially within the immune-suppressive tumor microenvironment, we went on to interrogate the translational applicability of this strategy in the context of chimeric antigen receptor (CAR)-modified CD8+ T cells. Although CAR T cells hold immense promise for ACT, CAR T cells are not completely curative due to their in vivo functional suppression by immune barriers &#8210; such as TGF&#946; &#8210; within the tumor microenvironment. Since TGF&#946; poses a substantial immune barrier in the tumor microenvironment, we sought to investigate whether inhibiting miR-23a in CAR T cells can confer immune-competence to afford enhanced tumor clearance. To this end, we retrovirally transduced wildtype and miR-23a-deficient CD8+ T cells with the EGFRvIII-CAR, which targets the PepvIII tumor-specific epitope expressed by glioblastomas (GBM). Our in vitro studies demonstrated that while wildtype EGFRvIII-CAR T cells were vulnerable to functional suppression by TGF&#946;, miR-23a abrogation rendered EGFRvIII-CAR T cells immune-resistant to TGF&#946;. Rigorous preclinical studies are currently underway to evaluate the efficacy of miR-23a-deficient EGFRvIII-CAR T cells for GBM immunotherapy. </p><p>Lastly, we explored novel immune-suppressive therapies by the biological characterization of pharmacological agents that could target T cells. Although immune-suppressive drugs are classical therapies for a wide range of autoimmune diseases, they are accompanied by severe adverse effects. This motivated our search for novel immune-suppressive agents that are efficacious and lack undesirable side effects. To this end, we explored the potential utility of subglutinol A, a natural product isolated from the endophytic fungus Fusarium subglutinans. We showed that subglutinol A exerts multimodal immune-suppressive effects on activated T cells in vitro: subglutinol A effectively blocked T cell proliferation and survival, while profoundly inhibiting pro-inflammatory IFN&#947; and IL-17 production by fully-differentiated effector Th1 and Th17 cells. Our data further revealed that subglutinol A might exert its anti-inflammatory effects by exacerbating mitochondrial damage in T cells, but not in innate immune cells or fibroblasts. Additionally, we demonstrated that subglutinol A significantly reduced lymphocytic infiltration into the footpad and ameliorated footpad swelling in the mouse model of Th1-driven delayed-type hypersensitivity. These results suggest the potential of subglutinol A as a novel therapeutic for inflammatory diseases.</p> / Dissertation

Alzheimer’s disease (AD) and Parkinson’s disease (PD) are defined by neurodegeneration and accumulations of misfolded proteins that spread through the brain in a well characterized manner. In AD these accumulations consist mainly of β-amyloid (Aβ) and tau, while in PD, α-synuclein (α-syn) make up the characteristic lewy pathology.     The general aim of this thesis was to investigate mechanisms associated with neurotoxic peptide activity by Aβ, tau and α-syn in relation to cellular degradation and transfer with a cell-to-cell transfer model system.    We found that intercellular transfer of oligomeric Aβ occurs independently of isoform. However, the amount of transfer correlates with each isoforms ability to resist degradation or cellular clearance. The Aβ1-42 isoform showed particular resistance to clearance, which resulted in higher levels of cell-to-cell transfer of the isoform and lysosomal stress caused by accumulation.    As Aβ accumulations can inhibit the proteasomal degradation we investigated how reduced proteasomal degradation affected neuron-like cells. We found increased levels of phosphorylated tau protein, disturbed microtubule stability and impaired neuritic transport after reduced proteasomal activity. These changes was partly linked to c-Jun and ERK 1/2 kinase activity.    We could also show that α-syn transferred from cell-to-cell in our model system, with a higher degree of transfer for the larger oligomer and fibrillar species. Similar to Aβ, α-syn mainly colocalized with lysosomes, before and after transfer.     Lastly, we have developed our cell-to-cell transfer system into a model suitable for high throughput screening (HTS). The type of cells have been upgraded from SH-SY5Y cells to induced pluripotent stem cells (iPSCs), with a differentiation profile more similar to mature neurons. The next step will be screening a small molecular library for substances with inhibitory effect on cell-to-cell transfer of Aβ peptides.     The importance of the degradative systems in maintaining protein homeostasis and prevent toxic accumulations in general is well known. Our findings shows the importance of these systems for neurodegenerative diseases and also highlight the link between degradation and cell-to-cell transfer. To restore or enhance the degradative systems would be an interesting avenue to treat neurodegenerative diseases. Another way would be to inhibit the transfer of misfolded protein aggregates. By using the HTS model we developed, a candidate substance with good inhibitory effect on transfer can hopefully be found.

Prostate cancer is the second leading cause of cancer death in men in Europe and the US. In the context of previous preclinical experiments and clinical studies there are certain assumptions predicating successful application of immunotherapy in the treatment of patients with prostate cancer. Promising results have been achieved by a combination of different treatment modalities which provide a synergistic antitumor effect. One of these combinatorial options is the use of antitumor vaccines and adoptive T cell transfer. The topic of this thesis is to provide a fresh insight into the past and current trends following the long-term candidate's department program in the field of anti-tumor immunotherapy. The experimental part of this thesis revolves around our own results published in this field. The introductory chapter delivers a basic overview of cellular mechanisms of anti-tumor immunity and the role of individual immune components in these processes. Following chapters are dedicated to current immunotherapeutic approaches with emphasis on the adoptive T cell transfer and implication of this technology in the treatment of prostate cancer. The results section describes the establishment of our protocol for adoptive T cell transfer as well as the protocol for ex vivo enrichment of human T cell...

Les macrophages sont une cible particulièrement importante de l’infection par le VIH-1 et jouent un rôle crucial dans la physiopathologie de l’infection. Lorsqu’ils sont infectés, leur capacité de survie dans les tissus leur permet de jouer un rôle essentiel dans la dissémination virale et l’établissement de réservoirs viraux au niveau des différents territoires tissulaires. In vitro, les étapes précoces et tardives du cycle de réplication virale dans les macrophages ont été analysées dans le cadre de l’infection par des virus libres. Cependant, les modalités d’infection des macrophages lors d’une transmission intercellulaire reste largement inexplorées. Les travaux présentés ici ont permis d’établir un modèle de transmission intercellulaire du VIH-1 de lymphocytes T infectés vers les macrophages. Nous avons montré que les lymphocytes T infectés sont capables d’interagir étroitement avec les macrophages, conduisant ainsi à la fusion cellulaire de ces deux cellules et permettant le transfert de matériel viral dans les macrophages cibles. Ce transfert viral par fusion cellulaire, rapide et efficace, est restreint aux virus utilisant le corécepteur CCR5 et dépend de l’interaction entre l’enveloppe virale et le récepteur CD4. Les virus transférés sont alors stockés au sein de compartiment cytoplasmique des cellules fusionnées mais nous observons également des évènements précoces d’assemblage et de bourgeonnement du VIH-1 à la membrane plasmique des cellules fusionnées résultant de la fusion des membranes des lymphocytes T infectés et des macrophages cibles. Ces cellules fusionnées acquièrent alors la capacité de fusionner avec les macrophages non infectés environnants permettant la dissémination du VIH-1. L’ensemble de ces résultats met en évidence un nouveau mécanisme de transmission intercellulaire entre lymphocytes T et macrophages via un mécanisme de double fusion cellulaire dépendant de l’enveloppe virale et des récepteurs CD4 et CCR5. Ces évènements successifs de fusion entre lymphocytes T et macrophages puis entre macrophages permettent la formation de cellules géantes multinucléés capables de produire de grande quantité de virus infectieux. Ces cellules multinculées pourraient correspondre aux macrophages multinuclées observés in vivo dans les organes lymphoïdes et le système nerveux central de patients infectés par le VIH-1 ou de singes infectés par le SIV. Ce mécanisme représente donc un modèle de transmission intercellulaire original permettant la dissémination virale et la formation de macrophages réservoirs durant l’infection par le VIH-1. / Macrophages are important targets of HIV-1 and play crucial roles in physiopathology of infection. Because of their long time survival capacity, infected macrophages participate in virus dissemination and establishment of persistent virus reservoirs in numerous tissues. In vitro, macrophages infection and analysis of the different steps of the virus cycle have been largely documented using cell-free virus infection. However, there is a paucity in knowledge of the mechanisms that control infection and dissemination to macrophages by cell-to-cell transfer. In the work presented here, we establish a model of HIV-1 cell-to-cell transfer from infected T cells to macrophages. We observed that infected T cells are able to interact with macrophages leading to cell fusion for transfer of viral material to macrophages targets. This cell-to-cell fusion transfer, very fast and efficient, is restricted to CCR5-tropic viruses, and mediated by viral envelope-receptor interactions. Transferred viruses can then accumulate in cytoplasmic compartments of newly lymphocyte/macrophages fused cells but we also observed early viral assembly and budding events at the plasma membrane of these fused cells, resulting from the merge of viral material between infected T cells and macrophages. These cells then acquire the ability to fuse with neighboring non-infected macrophages for virus dissemination. Together, these two-sequential envelope-dependent cell fusion process lead to the formation of highly virus-productive multinucleated giant cells reminiscent of the infected multinucleated giant macrophages detected in vivo in lymphoid organs and the central nervous system of HIV-1 infected patients and simian immunodeficiency virus-infected macaques. These mechanisms may represent an original mode of virus transmission for viral spreading and formation of macrophage virus reservoirs during HIV-1 infection.

Les cellules présentatrices d'antigènes (APCs) présentes dans les muqueuses comptent parmi les première cibles du VIH-1 et participent à sa dissémination dans l'organisme. Durant ma thèse, j'ai étudié le transfert du VIH des macrophages (Mφ) et des cellules dendritiques (DCs) aux lymphocytes T. J'ai montré que ces APCs transfèrent efficacement le virus aux lymphocytes par le biais de différents mécanismes: transfert direct en trans dans les coculture Mφ/T, et transfert en cis (suite à la production de nouveaux virions) dans les DCs/T. Ces deux modes de transfert sont inhibés par les anticorps neutralisants (AcN). De manière intéressante, certains AcN anti-gp120 inhibaient plus efficacement le transfert du VIH dans les cocultures Mφ/T que dans les cocultures DCs/T et l'infection des cellules T par le virus libre. Ces résultats suggèrent que les APCs participent activement au transfert et à la dissémination du VIH et que les AcN sont capable d'inhiber ces différents modes de transfert. / Antigen-presenting cells (APCs) present at mucosal sites are among the first HIV-1 target cells and contribute to the spread of infection. During my thesis, I studied HIV transfer from macrophages (Mφ) and dendritic cells (DCs) to CD4-T lymphocytes. I showed that APCs were able to efficiently transfer HIV particles to lymphocytes, but through different mechanisms: Mφ rapidlytransferred HIV by direct trans-transfer, whereas DCs were mainly implicated in cistransfer (after production of de novo HIV). Moreover, I have demonstrated that these two modes of transfer were inhibited by neutralizing antibodies (NAb) in both type ofcocultures. Very interestingly, I showed that anti-gp120 NAb inhibit more efficiently HIV transfer in Mφ/T than in DCs/T cocultures and T cells infection by free viral particles. These findings highlight the major contributions of various mucosal target cells in HIV transfer and demonstrate the potent role of NAb on inhibition of cell-to-cell transfer.

La transmission mère-enfant du VIH-1 (TME) représente le principal mode d’infection chez l’enfant et se produit durant la grossesse (in utero, IU), l’accouchement (intrapartum, IP) ou l’allaitement (postpartum, PP). Les mécanismes qui sous-tendent le passage du VIH-1 à travers le placenta et les muqueuses intestinales du nouveau-né sont encore très peu décrits. « Dendritic cell-specific ICAM-grabbing non-integrin » (DC-SIGN) et son homologue DC-SIGN « related » (DC-SIGNR) sont des récepteurs d’antigènes exprimés au niveau du placenta et capables de capter et de transmettre le VIH-1 aux cellules adjacentes. Ils pourraient donc participer au passage trans placentaire du VIH-1 et le polymorphisme génétique affectant l’expression ou modifiant l’interaction avec le virus aurait une influence sur la TME du VIH-1. Afin d’explorer cette hypothèse, nous avons procédé à une analyse exhaustive du polymorphisme de DC-SIGN et DC-SIGNR dans la population du Zimbabwe. Par la suite, nous avons déterminé l’association entre le polymorphisme de DC-SIGN et DC-SIGNR et la TME du VIH-1 dans une cohorte d’enfants nés de mères VIH-positives à Harare, au Zimbabwe. Enfin, nous avons défini l’impact fonctionnel des mutations associées. Les enfants homozygotes pour les haplotypes H1 et H3 dans le gène de DC-SIGNR sont 4 à 6 fois plus à risque de contracter le VIH-1 par voie IU et IP. H1 et H3 contiennent la mutation du promoteur p-198A et la mutation de l’intron 2, int2-180A, et des études fonctionnelles nous ont permis de démontrer que p-198A diminue l’activité transcriptionnelle du promoteur de DC-SIGNR et l’expression des transcrits d’ARNm dans le placenta, alors que int2-180A modifie le répertoire d’isoformes de DC-SIGNR vers une proportion diminuée d’isoformes membranaires. Les enfants porteurs des haplotypes H4 et H6 de DC-SIGN sont 2 à 6 fois plus à risque de contracter le VIH-1 par voie IU. Ces haplotypes contiennent deux mutations du promoteur (p-336T/C et p-201C/A) et quatre mutations codant pour un changement d’acide aminé dans l’exon 4 (R198Q, E214D, R221Q ou L242V) associées à un risque augmenté de transmission IU, IP et PP du VIH-1. Des études fonctionnelles ont démontré que les mutations du promoteur diminuent l’expression de DC-SIGN dans les macrophages placentaires. Toutefois, l’exposition IU au VIH-1 module le niveau d’expression de DC-SIGN, résultant en des niveaux d’expression similaires entre les macrophages des porteurs des allèles sauvages et mutés. Les mutations de l’exon 4 augmentent l’affinité de DC-SIGN pour le VIH-1 et sa capacité à capturer et à transmettre le virus aux lymphocytes T, favorisant possiblement la dissémination du VIH-1 à travers le placenta. L’association entre les mutations de DC-SIGN et la transmission IP et PP du VIH-1 suggèrent qu’il aurait aussi un rôle à jouer dans les muqueuses intestinales de l’enfant. Notre étude démontre pour la première fois l’implication de DC-SIGN et DC-SIGNR dans la TME du VIH-1. L’augmentation des capacités de capture et de transmission de DC-SIGN résulte en une susceptibilité accrue de l’enfant à l’infection au VIH-1 et concorde avec un rôle dans la dissémination transplacentaire. Toutefois, la diminution préférentielle des transcrits membranaires de DC-SIGNR au placenta augmente la TME du VIH-1 et laisse croire à son implication via un autre mécanisme. Ces mécanismes pourraient aussi s’appliquer à d’autres pathogènes reconnus par DC-SIGN et DC-SIGNR et transmis de la mère à l’enfant. / Mother-to-child transmission (MTCT) is the main cause of HIV-1 infection in children worldwide. MTCT of HIV-1 can occur during pregnancy (in utero, IU), delivery (intrapartum, IP) or breastfeeding (postpartum, PP). Dendritic cell-specific ICAM-grabbing non-integrin (DC-SIGN) and its homolog DC-SIGN related (DC-SIGNR) are attachment receptors for HIV-1 and are expressed in the placenta. They have been implicated in viral capture and transmission to T cells. To investigate the potential role of DC-SIGN and DC-SIGNR in MTCT of HIV-1, we carried out a genetic association study in a well-characterized cohort of 197 HIV-infected mothers and their infants recruited in Harare, Zimbabwe. Infants harbouring two copies of DC-SIGNR H1 and/or H3 haplotypes (H1-H1, H1-H3, H3-H3) had a 4-fold increased risk of IU and 6-fold increased risk of IP HIV-1 infection after adjusting for a number of maternal factors. The implicated H1 and H3 haplotypes share two single nucleotide polymorphisms (SNPs) in promoter region (p-198A) and intron 2 (int2-180A) that were associated with increased risk of both IU and IP HIV-1 infection. The promoter variant reduced transcriptional activity in vitro. In homozygous H1 infants bearing both the p-198A and int2-180A mutations, we observed a 4-fold decrease in the level of placental DC-SIGNR transcripts, disproportionately affecting the expression of membrane-bound isoforms compared to infant noncarriers. Infants carrying H4 and H6 haplotypes in DC-SIGN gene were more likely to be HIV-1-infected during pregnancy. These haplotypes contain promoter variants (p-336T/C and p-201C/A) and exon 4 variants (R198Q, E214D, R221Q and L242V) that were all significantly associated with increased risk of MTCT of HIV-1. Compared with wild-type sequence, the promoter variants reduced both the DC-SIGN transcription in vitro and expression (2-fold) in placental macrophages of HIV-1-unexposed infants. However, in HIV-1-exposed infants, the level of DC-SIGN expression in placental macrophages was similar in infants carrying either the promoter wild-type or variant sequences. Exon 4 variants increased HIV-1 capture and transmission to T cells in vitro. Association between DC-SIGN SNPs and HIV-1 IP and PP infection also suggests that DC-SIGN plays an important role in intestinal mucosa. This is the first study reporting on functional impact of DC-SIGN and DC-SIGNR natural polymorphisms on HIV-1 transmission from mother-to-child. Decreased levels of expression of membrane DC-SIGNR isoforms at the placental endothelial cell surface increased child susceptibility to HIV-1. Presence of DC-SIGN variants increasing its affinity for the virus augmented child susceptibility to HIV-1 and may favour viral dissemination across the placental barrier. This study provides compelling evidence to support an important role of DC-SIGN and DC-SIGNR in various modes of MTCT of HIV-1 and shed light on the possible mechanisms involved in HIV-1 passage from mother-to-infant. These findings raise the possibility that similar mechanisms may operate with other human pathogens known to interact with DC-SIGN and DC-SIGNR.

La transmission mère-enfant du VIH-1 (TME) représente le principal mode d’infection chez l’enfant et se produit durant la grossesse (in utero, IU), l’accouchement (intrapartum, IP) ou l’allaitement (postpartum, PP). Les mécanismes qui sous-tendent le passage du VIH-1 à travers le placenta et les muqueuses intestinales du nouveau-né sont encore très peu décrits. « Dendritic cell-specific ICAM-grabbing non-integrin » (DC-SIGN) et son homologue DC-SIGN « related » (DC-SIGNR) sont des récepteurs d’antigènes exprimés au niveau du placenta et capables de capter et de transmettre le VIH-1 aux cellules adjacentes. Ils pourraient donc participer au passage trans placentaire du VIH-1 et le polymorphisme génétique affectant l’expression ou modifiant l’interaction avec le virus aurait une influence sur la TME du VIH-1. Afin d’explorer cette hypothèse, nous avons procédé à une analyse exhaustive du polymorphisme de DC-SIGN et DC-SIGNR dans la population du Zimbabwe. Par la suite, nous avons déterminé l’association entre le polymorphisme de DC-SIGN et DC-SIGNR et la TME du VIH-1 dans une cohorte d’enfants nés de mères VIH-positives à Harare, au Zimbabwe. Enfin, nous avons défini l’impact fonctionnel des mutations associées. Les enfants homozygotes pour les haplotypes H1 et H3 dans le gène de DC-SIGNR sont 4 à 6 fois plus à risque de contracter le VIH-1 par voie IU et IP. H1 et H3 contiennent la mutation du promoteur p-198A et la mutation de l’intron 2, int2-180A, et des études fonctionnelles nous ont permis de démontrer que p-198A diminue l’activité transcriptionnelle du promoteur de DC-SIGNR et l’expression des transcrits d’ARNm dans le placenta, alors que int2-180A modifie le répertoire d’isoformes de DC-SIGNR vers une proportion diminuée d’isoformes membranaires. Les enfants porteurs des haplotypes H4 et H6 de DC-SIGN sont 2 à 6 fois plus à risque de contracter le VIH-1 par voie IU. Ces haplotypes contiennent deux mutations du promoteur (p-336T/C et p-201C/A) et quatre mutations codant pour un changement d’acide aminé dans l’exon 4 (R198Q, E214D, R221Q ou L242V) associées à un risque augmenté de transmission IU, IP et PP du VIH-1. Des études fonctionnelles ont démontré que les mutations du promoteur diminuent l’expression de DC-SIGN dans les macrophages placentaires. Toutefois, l’exposition IU au VIH-1 module le niveau d’expression de DC-SIGN, résultant en des niveaux d’expression similaires entre les macrophages des porteurs des allèles sauvages et mutés. Les mutations de l’exon 4 augmentent l’affinité de DC-SIGN pour le VIH-1 et sa capacité à capturer et à transmettre le virus aux lymphocytes T, favorisant possiblement la dissémination du VIH-1 à travers le placenta. L’association entre les mutations de DC-SIGN et la transmission IP et PP du VIH-1 suggèrent qu’il aurait aussi un rôle à jouer dans les muqueuses intestinales de l’enfant. Notre étude démontre pour la première fois l’implication de DC-SIGN et DC-SIGNR dans la TME du VIH-1. L’augmentation des capacités de capture et de transmission de DC-SIGN résulte en une susceptibilité accrue de l’enfant à l’infection au VIH-1 et concorde avec un rôle dans la dissémination transplacentaire. Toutefois, la diminution préférentielle des transcrits membranaires de DC-SIGNR au placenta augmente la TME du VIH-1 et laisse croire à son implication via un autre mécanisme. Ces mécanismes pourraient aussi s’appliquer à d’autres pathogènes reconnus par DC-SIGN et DC-SIGNR et transmis de la mère à l’enfant. / Mother-to-child transmission (MTCT) is the main cause of HIV-1 infection in children worldwide. MTCT of HIV-1 can occur during pregnancy (in utero, IU), delivery (intrapartum, IP) or breastfeeding (postpartum, PP). Dendritic cell-specific ICAM-grabbing non-integrin (DC-SIGN) and its homolog DC-SIGN related (DC-SIGNR) are attachment receptors for HIV-1 and are expressed in the placenta. They have been implicated in viral capture and transmission to T cells. To investigate the potential role of DC-SIGN and DC-SIGNR in MTCT of HIV-1, we carried out a genetic association study in a well-characterized cohort of 197 HIV-infected mothers and their infants recruited in Harare, Zimbabwe. Infants harbouring two copies of DC-SIGNR H1 and/or H3 haplotypes (H1-H1, H1-H3, H3-H3) had a 4-fold increased risk of IU and 6-fold increased risk of IP HIV-1 infection after adjusting for a number of maternal factors. The implicated H1 and H3 haplotypes share two single nucleotide polymorphisms (SNPs) in promoter region (p-198A) and intron 2 (int2-180A) that were associated with increased risk of both IU and IP HIV-1 infection. The promoter variant reduced transcriptional activity in vitro. In homozygous H1 infants bearing both the p-198A and int2-180A mutations, we observed a 4-fold decrease in the level of placental DC-SIGNR transcripts, disproportionately affecting the expression of membrane-bound isoforms compared to infant noncarriers. Infants carrying H4 and H6 haplotypes in DC-SIGN gene were more likely to be HIV-1-infected during pregnancy. These haplotypes contain promoter variants (p-336T/C and p-201C/A) and exon 4 variants (R198Q, E214D, R221Q and L242V) that were all significantly associated with increased risk of MTCT of HIV-1. Compared with wild-type sequence, the promoter variants reduced both the DC-SIGN transcription in vitro and expression (2-fold) in placental macrophages of HIV-1-unexposed infants. However, in HIV-1-exposed infants, the level of DC-SIGN expression in placental macrophages was similar in infants carrying either the promoter wild-type or variant sequences. Exon 4 variants increased HIV-1 capture and transmission to T cells in vitro. Association between DC-SIGN SNPs and HIV-1 IP and PP infection also suggests that DC-SIGN plays an important role in intestinal mucosa. This is the first study reporting on functional impact of DC-SIGN and DC-SIGNR natural polymorphisms on HIV-1 transmission from mother-to-child. Decreased levels of expression of membrane DC-SIGNR isoforms at the placental endothelial cell surface increased child susceptibility to HIV-1. Presence of DC-SIGN variants increasing its affinity for the virus augmented child susceptibility to HIV-1 and may favour viral dissemination across the placental barrier. This study provides compelling evidence to support an important role of DC-SIGN and DC-SIGNR in various modes of MTCT of HIV-1 and shed light on the possible mechanisms involved in HIV-1 passage from mother-to-infant. These findings raise the possibility that similar mechanisms may operate with other human pathogens known to interact with DC-SIGN and DC-SIGNR.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-11-29T20:46:26Z No. of bitstreams: 1 Jorge Sadao Nihei Estudo da migracao... 2005.pdf: 58998863 bytes, checksum: 723e59711f41bac163f89f23858f2c34 (MD5) / Made available in DSpace on 2012-11-29T20:46:26Z (GMT). No. of bitstreams: 1 Jorge Sadao Nihei Estudo da migracao... 2005.pdf: 58998863 bytes, checksum: 723e59711f41bac163f89f23858f2c34 (MD5) Previous issue date: 2005 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / Foi anteriormente demonstrado que as células NK (Natural Killer) estão relacionadas às bases para resistência à infecção por Trypanosoma cruzi, pois a depleção de células positivas para NK1.1+ resulta em alta parasitemia de camundongos C57BI/6 infectados pelo T. cruzi. Estudos de nossa equipe indicaram ainda que as células T NKH-t- poderiam induzir a formação de células T efetoras/nnemória, e que a resistência à infecção foi correlacionada com a quantidade de células T CD4-<- CD45RB"®^ presentes antes da infecção. No presente estudo avaliamos a função regulatória de células T NK1.1+ durante a infecção experimental pelo T. cmzi, na ausência de linfócitos B. Utilizamos os seguintes animais: C57BI/6 controles, ^MT C57BI/6, nMT reconstituídos (com células B de C57BI/6 ou B de C67BI/6 IL-10KO) ou tratados com imunoglobulinas. Neste modelo experimental, observamos que os animais p.MT apresentaram menores números de células T efetoras/memória no baço comparados aos controles (C57BI/6), na fase aguda de infecção. A reconstituição com células B ou o tratamento com Ig em animais ^iMT infectados resultou em aumento de células T efetoras/memória, comparado ao controle (jiMT infectado). Da mesma maneira e até fase crônica de infecção, a transferência adotiva de células B em animais ^MT causa persistência de células T efetoras/memória no baço. Como a molécula de CD1 (encontrada sobre células B e dendríticas) é reconhecida por células NK1.1, a expressão desta molécula foi também avaliada durante a infecção. Após a infecção, houve diminuição de células CD1+ no baço de animais C57BI/6, e ausência destas células nos jxMT. A recuperação desta população celular no baço de {aMT infectados após reconstituição com linfócitos B foi concomitante á reposição de células T CD4+ NK1.1 no músculo esquelético destes mesmos animais. Houve ainda aumento de CD4+NK1.1 também no músculo esquelético dos animais ^MT reconstituídos com linfócitos B provenientes de C57BI/6 IL-10KO. De modo interessante, a depleção de NK1.1 durante a fase crônica, causou aumento de células T efetoras/memória encontradas no músculo esquelético de animais |uMT. Esses resultados estão relacionados aos dados de histopatologia, onde foi evidenciado maior infiltrado inflamatória no tecido HfKiscular de animais fxMT tratados com anti-NK1.1, durante a fase crônica da infecção. Nossos resultados indicam desse modo que a presença da célula B estaria ligada à formação de células T CD45RB"^ na fase aguda e manutenção/aumento de memória imune na fase crônica de infecção, conferindo ao grupo de animais reconstituídos com células 6, maior sobrevida. Sugere-se, portanto que as células T CD4+ NK1.1+ poderiam ser regulatórias no sentido de apresentar atividade antiinflamatória e que as células aP+NK1.1+ exerceriam função auxiliar na geração de células T efetoras/memória em nosso sistema experimental. / We have previously demonstrated that NK (Natural Killer) cells have been related to resistance to T. cruzi infection and the depletion of NK1.1+ cells resulted in high mortality and increased parasitemia in C57BI/6 Infected mice. Recently, we suggested that the NK1.1 T cells were involved on memory T cell generation, and resistance to infection was correlated with increased numbers of 004^“'*''^ CD45RB"®^®“'^ T cells, present before infection. In this study we evaluated the regulatory function of NK1.1+ T cells during 7. cruzi infection in ^iMT C57BI/6 infected mice. The following mice were used; C57BI/6, ^MT C57BI/6 and nMT C57BI/6 Imunoglobulin (lg)-treated or adoptively transferred with B cells (obtained from C57BI/6 or from C57BI/6 IL-10KO). In this experimental model. yMT infected mice have show decreased numbers of effector memory T cells, compared to C57BI/6 infected controls, during acute infection. The adoptive transfer of B cells or the treatment with immunoglobulins (Igs), induced increased numbers of effector memory splenic T cells, compared to C57BI/6 controls. Furthermore, Ig administration to p,MT uninfected mice is able to increase ap+NK1.1+ splenic cell population. As NK1.1 cells recc^nize C01 molecule which is expressed on B and dendritic cells, CD1 expression was evaluated in spleens of nMT and C57BI/6 mice to estimate whether the expression of CD1 was modified after infection. When compared to uninfected controls, CD1-presenting cells decreased from both nMT and C57BI/6 mice and were increased following B cell-transfer to laMT recipient mice. Interestingly, the depletion of NK1.1 cells also increased effector memory T cells found on skeletal muscles infiltrates from jiMT, and this was correlated to the increased inflammatory response found in these ^iMT NK1.1-depleted mice, during the chronic phase of infection. In this inflammatory compartment, ^iMT infected mice presented low numbers of CD4+NK1.1 T cells, when compared to C67BI/6. Previous observations from our laboratory suggest that CD4+NK1.1+ T cells (which are decreased in skeletal muscle from infected laMT mice), may be related to the enhanced inflammatory response during the early chronic infection. Finally, these studies suggest that CD4+NK1.1+ T cells may be regulatory with an antiinflammatory activity and that ap+NK1.1+ T cells may be involved on effector memory T cell-generation in our experimental system.