Das Humane Cytomegalievirus (HCMV) ist ein ubiquitäres Pathogen, welches den Metabolismus der Wirtszelle auf vielfältige Weise manipuliert, um seine eigene Vermehrung zu begünstigen. In der vorliegenden Arbeit konnte nachgewiesen werden, dass auch das Ubiquitin-Proteasom-System in die HCMV-Replikation involviert ist. So konnte zunächst gezeigt werden, dass die Chymotrypsin-ähnliche (CT-L) Aktivität des konstitutiven Proteasoms in HCMV-infizierten Zellen signifikant erhöht ist. Wurde die CT-L Proteasomaktivität durch Proteasominhibitoren (PI) blockiert, so hatte dies die Hemmung der HCMV-Replikation zur Folge. Die Charakterisierung des Einflusses von PI auf die virale Proteinexpression ergab, dass bei niedriger MOI (MOI 0.1) deutlich verringerte Mengen der sehr frühen Proteine vorlagen, dieser Effekt jedoch bei hoher MOI (ab MOI 1) aufgehoben war. Die Expression früher Proteine war MOI-unabhängig reduziert. Hingegen war die Expression der späten Proteine MOI-unabhängig vollständig unterdrückt. Studien mit dem Nukleosidanalogon BrdU ergaben zudem, dass die de novo Synthese viraler DNA blockiert war. Um erste Hinweise auf den Wirkungsmechanismus von PI zu erhalten, wurde untersucht, ob der Transkriptionsfaktor NF-kappaB oder zelluläre Transkriptionsrepressoren wie z.B. hDaxx am anti-HCMV-Effekt beteiligt sind. Durch die Charakterisierung einer Virusmutante mit Deletion der NF-kappaB-Bindestellen im MIE-Enhancer/Promotor konnte gezeigt werden, dass der antivirale Effekt von PI nicht auf der Hemmung der Aktivierung von NF-kappaB beruht. Experimente mit hDaxx-knockdown Zellen ergaben hingegen, dass die Stabilisierung des Transkriptionsrepressors hDaxx partiell zum anti-HCMV-Effekt von PI beiträgt. Darüber hinaus müssen jedoch weitere virale oder zelluläre Zielproteine existieren, deren Beeinflussung durch PI kritisch für die Virusreplikation ist. Zusammenfassend stellt das Proteasom somit einen neu identifizierten potentiellen Angriffspunkt für die anti-HCMV-Therapie dar. / The Human Cytomegalovirus (HCMV) is a ubiquitous pathogen that manipulates many aspects of the host cell metabolism to enhance viral replication. This work demonstrates that the ubiquitin-proteasome system is also involved in HCMV replication. First of all, the chymotrypsin-like (CT-L) activity of the constitutive proteasome was significantly increased in HCMV infected cells. In the presence of proteasome inhibitors (PI) viral replication was efficiently blocked. Characterisation of the influence of PI on viral protein expression showed that immediate early protein expression was clearly reduced at low MOI (MOI 0.1); however, this effect was abolished at high MOI (starting from MOI 1). Expression of early proteins was significantly decreased independently of the MOI used for infection. In contrast, late protein expression was completely suppressed at both low and high MOI. Additionally, studies using the nucleoside analogue BrdU showed that PI block the de novo synthesis of viral DNA. In order to gain insight into the working mechanism of PI the involvement of the transcription factor NF-kappaB and cellular repressors of transcription (e.g. hDaxx) in the antiviral effect of PI was examined. Studies using a mutant virus carrying deletions of the NF-kappaB binding sites in the MIE-enhancer/promoter revealed that the anti-HCMV effect of PI is not due to inhibition of NF-kappaB activation. Analyses using hDaxx-knockdown cells showed that stabilisation of the transcriptional repressor hDaxx partially contributes to the antiviral effect of PI. However, the existence of additional viral or cellular target proteins of PI is very likely. In summary, the proteasome thus represents a newly identified and promising target for anti-HCMV therapy.

Das Immediate-Early Protein 2 (IE2) des humanen Zytomegalievirus ist ein essentieller Regulationsfaktor des lytischen Infektionszyklus. Es aktiviert verschiedene early Promotoren, autoreprimiert seine eigene Expression und besitzt darüber hinaus auch zellzyklusregulatorische Aktivitäten. Um einzelne Funktionen des IE2 Proteins gezielt analysieren zu können, ist eine genaue Kenntnis seiner regulatorischen Domänen unabdingbar. Im Rahmen dieser Arbeit wurde daher eine Struktur-Funktionsanalyse des IE2 Proteins durchgeführt mit dem Ziel, seine funktionellen Domänen genauer zu charakterisieren. Hierfür wurden verschiedene IE2-Mutanten hergestellt und ihre Aktivität im Hinblick auf Transaktivierung, Autorepression und DNA-Bindung sowie Zellzylusarrestinduktion bestimmt. Die Untersuchungen ergaben, dass innerhalb einer Core-Region im C-Terminus des Proteins (AS 450-544) die regulatorischen Domänen der untersuchten Funktionen überlappen und hier schon kleinere Mutationen zu einem Funktionsverlust führen. Im Gegensatz dazu ist der Bereich N-terminal des Core deutlich weniger sensitiv gegenüber Mutationen. Hier konnten Sequenzen identifiziert werden, die spezifisch für einzelne Funktionen wie die Transaktivierung oder die Zellzyklusarrestinduktion erforderlich sind. Darüber hinaus hat sich gezeigt, dass eine im bisherigen Verständnis essentielle putative Zinkfingerdomäne außerhalb des Core liegt und für die Funktionalität des Proteins, vor allem für seine DNA-Bindung, nicht benötigt wird. Somit ist der Bereich, in dem die regulatorischen Domänen der untersuchten Funktionen überlappen, deutlich kleiner, als bisher angenommen. Vor diesem Hintergrund lässt sich eine Strategie für die Erstellung von diskriminierenden Virusmutanten ableiten, bei der Einzelfunktionen von IE2 im Viruskontext eliminiert und somit im Sinne ihrer physiologischen Relevanz analysierbar werden. / The Immediate Early Protein 2 (IE2) of human cytomegalovirus is an essential regulatory factor of the viral replicative cycle. It fulfills several functions including transactivation, negative autoregulation and cell cycle regulation. In order to analyse the physiological significance of each of the IE2 functions a precise knowledge of the regulatory protein domains is needed. Therefore, a structure-function analysis of the IE2 protein was performed in this work. Different sets of IE2 mutants were tested in parallel with regard to transactivation, DNA-binding, autoregulation and cell cycle regulation. We found the IE2 protein to contain an unexpectedly clear-cut core domain (amino acids (aa) 450-544) that is defined by its absolute sensitivity to any kind of mutation. In contrast, the region adjacent to the core (aa 290-449) generally displays greater tolerance towards mutations. Although specific sequences correlate with distinct IE2 activities none of the mutations analysed completely abolished any particular function. The core is separated from the adjacent region by the putative zinc finger (428-452) which was found to be entirely dispensable for any function tested. Our work supports the view that the 100 amino acids of the core domain hold the key to most functions of IE2. A systematic, high-density mutational analysis of this region may identify informative mutants which discriminate between various IE2 functions. Such mutants could then be tested in a viral background.

HINTERGRUND: Die Reaktivierung des Humanen Cytomegalievirus (HCMV) ist immer noch eine häufige Ursache für Morbidität und Mortalität unter immunsupprimierten Patienten. Eine effiziente T-Zell-Antwort vermag die unkontrollierte Ausbreitung des Virus zu verhindern. Vieles über diese T-Zell-Antwort ist aber noch unklar. Im Rahmen dieser Studie wurden daher bei HCMV-seropositiven herz- (n = 17) und lungentransplantierten (n = 3) Patienten Epitope in zwei wichtigen T-Zell-Zielen, den HCMV-Proteinen IE-1 (UL123) und pp65 (UL83), identifiziert, die Frequenzen der für diese Epitope spezifischen T-Zellen gemessen und die Klonalität ausgewählter starker CD8+ T-Zell-Antworten untersucht. METHODEN: Dazu wurden Pentadecapeptide, die die gesamte Aminosäure-Sequenz von IE-1 bzw. pp65 umfassten und sich um jeweils 11 Aminosäurereste überlappten, in Pools von 25 bis 30 Peptiden so zusammengefasst, dass jedes Peptid in einer einzigartigen Kombination von drei Pools enthalten war. PBMC der Patienten wurden dann mit den Peptid-Pools stimuliert und die resultierenden T-Zell-Reaktionen durch Färbung von intrazellulär zurückgehaltenem Interferon-gamma durchflusszytometrisch sichtbar gemacht. Immunogene Peptide konnten anhand der jeweiligen drei Pools, die zu IFN-gamma-Produktion führten, eindeutig identifiziert werden. Einige dieser T-Zell-Populationen wurden durch einen IFN-gamma-Sekretions-Assay, magnetische Zellseparation und durchflusszytometrische Feinsortierung aus PBMC isoliert und ihre Klonalität mit Hilfe einer Polymerase-Kettenreaktion zum Nachweis klonal expandierter gamma-T-Zell-Rezeptor-Rearrangements (TCR-PCR) und anschliessender Fragmentanalyse fluoreszenzmarkierter PCR-Amplifikate untersucht. ERGEBNISSE: Bei den Patienten bestanden grosse Unterschiede hinsichtlich des jeweils immundominanten Proteins, der Dominanz von CD4+ bzw. CD8+ T-Zell-Subpopulation, der antigenen Determinanten, der gemessenen Peptid-spezifischen T-Zell-Frequenzen sowie der Anzahl der identifizierten Epitope. Zehn zuvor noch nicht beschriebene Epitope wurden eben-falls identifiziert und die präsentierenden HLA-Allele der meisten in der Patientengruppe identifizierten Epitope bestimmt. Die mittels TCR-PCR untersuchten CD8+ T-Zell-Reaktionen waren auf einen oder wenige Klone fokussiert. Die Korrelation der experimentellen Daten mit den klinischen Verläufen der Patienten hinsichtlich HCMV-Reaktivierung und -Erkrankung erbrachte jedoch keine Hinweise auf einen konkreten Zusammenhang. SCHLUSSFOLGERUNGEN: Zusammenfassend ermöglichen die hier vorgestellten Methoden die Untersuchung des Langzeitverlaufes der CD4+ und CD8+ T-Zell-Antwort gegen immundominante Proteine auf Epitop-Ebene nach initialer Identifizierung der antigenen Determinanten, die direkte Bestimmung der Frequenzen der Epitop-spezifischen T-Zellen sowie die Untersuchung der Klonalität dieser Reaktionen aus ca. 2 x 20 ml Blut. Die Langzeit-Untersuchung von Patienten mit hohem Risiko für HCMV-Reaktivierung und -Erkrankung kann so zu einem besseren Verständnis der komplexen HCMV-spezifischen T-Zell-Anwort und damit möglicherweise auch zur Verbesserung von Diagnose, Prophylaxe und Therapie dieser Patienten beitragen. / BACKGROUND: Human cytomegalovirus (HCMV) reactivation is still a leading cause of morbidity and mortality among immunosuppressed patients. Uncontrolled viral spread is prevented by an efficient T-cell response. However, little is known about the nature of this T-cell response. In this study we identified epitopes in two immunodominant HCMV-proteins, IE-1 (UL123) and pp65 (UL83), measured the frequencies of T-cells specific for these, and studied the clonotypic composition of selected T-cell responses in a group of HCMV-seropositive heart (n = 17) and lung (n = 3) transplant patients. METHODS: For both proteins overlapping pentadecapeptides covering the entire respective amino acid sequences were arranged in pools of 25 peptides each in such a way that every peptide was contained in exactly 3 pools. PBMC were stimulated with the resulting 15 pools for IE-1 or 16 pools or pp65, respectively, as well as with pools containing all peptides of the corresponding protein. Individual peptides leading to a positive T-cell response were identified by flow cytometric detection of intracellular interferon-gamma, each single peptide corresponding to a unique combination of 3 peptide pools. Selected T-cell populations specific for the previously identified single peptides were purified by performing an IFN-gamma secretion assay prior to magnetic cell separation and subsequent fluorescence-activated cell sorting. The clonality of these highly purified peptide-specific T-cell populations was then investigated by a T-cell receptor-gamma rearrangement-PCR and subsequent fragment analysis of fluorescence-labelled PCR amplificates. RESULTS: We observed broad heterogeneity among the patients in terms of the immunodominant protein, number of epitopes, predominance of CD4 or CD8 T-cell responses, and epitope-specific T-cell frequencies. 10 previously unknown epitopes were identified, and the HLA-restriction of most of the identified epitopes could be determined. The investigated T-cell responses showed a high degree of clonal focussing. These data were correlated to the patients episodes of HCMV reactivation, but a correlation between differences in the T-cell responses and a different clinical outcome in terms of HCMV-reactivation could not be established. CONCLUSIONS: In summary, this novel approach allows the rapid identification of epitopes contained in a given protein, direct determination of T-cell frequencies, and investigation of the T-cell clonality in the CD4 and CD8 T-cell subsets from as little as 2 times 20 ml of blood. Long-term follow-up of patients at risk for HCMV reactivation and disease may thus allow a more detailed insight into the complexity of the T-cell response to HCMV and may thus lead to improved diagnosis, prophylaxis and therapy.

Chez la souris, les cellules dendritiques plasmacytoïdes (pDC) et natural killer (NK) contribuent à la résistance contre les infections systémiques par les virus herpétiques tels que le cytomégalovirus murin (MCMV). Les pDC représentent la source majeure d’interférons de type I (IFN-I) lors d’une infection par le MCMV. Cette réponse est dépendante de MyD88 et des récepteurs de type Toll 7 et 9. D’autre part, les cellules NK, qui expriment le récepteur d’activation Ly49H, peuvent détecter et lyser les cellules infectées par le MCMV. La perte de l’une de ces réponses augmente la sensibilité à l’infection. Cependant, la façon dont ces réponses antivirales interagissent est mal connue. Chez l’homme, bien que les réponses dépendantes des IFN-I soient essentielles, MyD88 semble superflu pour l’immunité antivirale. Cependant, les mécanismes susceptibles de compenser l’absence de MyD88 chez l’homme sont inconnus. Il a été supposé que les souris déficientes pour MyD88 ne parvenaient pas à monter de réponse protectrice dépendante des IFN-I lors d’infections par le MCMV. Afin d’évaluer cela, nous avons comparé la résistance de souris déficientes pour MyD88, les récepteurs aux IFN-I (IFNAR) et/ou Ly49H lors de cette infection. La déplétion sélective des pDC ou l’absence de MyD88 diminue drastiquement la production d’IFN-I, mais n’empêche pas l’établissement d’une forte réponse aux IFN-I dans la rate. De plus, l’absence de MyD88, mais pas celle d’IFNAR, peut être compensée par l’activité antivirale des cellules NK dépendant de Ly49H. Par conséquent, chez la souris, MyD88 est redondant pour l’établissement d’une réponse splénique aux IFN-I lors d’une infection systémique par le MCMV. / In mice, plasmacytoid dendritic cells (pDC) and natural killer (NK) cells both contribute to resistance to systemic infections with herpes viruses including mouse Cytomegalovirus (MCMV). pDCs are the major source of type I IFN (IFN-I) during MCMV infection. This response requires pDC-intrinsic MyD88-dependent signaling by Toll-Like Receptors 7 and 9. Provided that they express appropriate recognition receptors such as Ly49H, NK cells can directly sense and kill MCMV-infected cells. The loss of any one of these responses has been reported to increase susceptibility to infection. However, the relative importance of these antiviral immune responses and how they are related remain unclear. In humans, while IFN-I responses are essential, MyD88 appears to be dispensable for antiviral immunity. However, the mechanisms that could compensate MyD88 deficiency in humans have not been elucidated. Moreover, it has been assumed, but not proven, that MyD88-deficient mice fail to mount protective IFN-I responses to systemic herpes virus infections. To address these issues, we compared resistance to MCMV infection between mouse strains deficient for MyD88, the IFN-I receptor (IFNAR) and/or Ly49H. We show that selective depletion of pDC or genetic deficiencies for MyD88 drastically decreased production of IFN-I, but not the protective antiviral responses mediated by these cytokines. Moreover, MyD88, but not IFNAR, deficiency could be compensated by Ly49H mediated antiviral NK cell responses. Thus, contrary to the current dogma, but consistent with the situation in humans, we conclude that, in mice, MyD88 is redundant for splenic IFN-I responses against a systemic herpes virus infection.

The oldest-old (people aged 80 or older) constituted 5 % of the population in Sweden in 2000, an increase from 1.5 % fifty years earlier. The immune system undergoes dramatic changes at high age, sometimes referred to as “immunosenescence”. However, the natures of these changes, and in particular, their clinical consequences are incompletely understood. In a previous longitudinal study, a set of immune parameters were identified and termed immune risk phenotype (IRP) because of an association with increased mortality. The IRP consists of changes in the T lymphocyte compartment, in particular an inverted CD4/CD8 ratio. The IRP was found to be associated with cytomegalovirus (CMV) infection, which through expansions of cytolytic anti-viral CD8 cell responses was ascribed a role in the development of IRP. The general aim of this thesis was to increase the knowledge of changes in the immune system and their clinical consequences in the oldest-old. The population-based random sample of the longitudinal NONA-Immune Study (n = 138, mean age 90 years at baseline) was used for all investigations. In paper I, the effects on sample size of various exclusion protocols for immune studies of the elderly was examined. The commonly used SENIEUR protocol, selecting individuals representing ‘normal ageing’, excluded 90 % of nonagenarians. Based on different protocol criteria, individuals were grouped into ‘very healthy’, ‘moderately healthy’ or ‘frail’. The prevalence of CMV was similar across the groups. Further, differentiated CD8 populations associated with CMV, i.e. those expressing CD56, CD57 and CD45RA while lacking expression of CD27 and CD28, were equally distributed across the groups of the oldest-old, but were, as expected, significantly increased in the elderly compared to a middle aged control group. The findings showed that lymphocyte subsets associated with IRP might serve as significant biomarkers of ageing independent of the overall health status, also supporting the notion that immunological studies of the oldest-old should be done in population-based non-selected populations. The IRP and the presence of low-grade inflammation, for example increase of   IL-6 in plasma, constitute major predictors of 2-year mortality in the oldest-old. In paper II, the CD4/CD8 ratio and IL-6 were found to predict 97 % of observed survival and 57 % of deaths over 2 years. The impact of IRP and IL-6 on 2-year survival was independent of age, sex and several diseases. The longitudinal design allowed temporal evaluations, suggesting a sequence of events starting with IRP and leading to inflammation in the decline state.                                      Four-year mortality in the oldest-old (paper III) was found to be mainly related to markers of inflammation and IRP. Individuals with both inverted CD4/CD8 ratio and high IL-6 level had significantly higher 4 year mortality (82 %) compared to individuals with CD4/CD8 ratio ³ 1 and low IL-6 level (29 %) at baseline. The presence of IRP and increased IL-6 level showed some associations with presence of diseases; in particular, IL6 was associated with the presence of cognitive impairment. However, despite being strong predictors of mortality, IRP and IL-6 could not be linked to any specific cause of death, probably due to the multi-factorial nature of these factors.                                                                                                                             The prevalence of antinuclear antibodies (ANA) in the oldest-old was higher compared to younger controls (paper IV). The difference across age was most pronounced in men, showing low levels at younger age, whereas the prevalence among the oldest-old men reached a similar level as in women. There was no association between the presence of ANA and IRP, CMV status or health status in the oldest-old.

We comparatively analyzed the natural killer (NK) cell response against HCMV-infected pro-inflammatory (M1) and anti-inflammatory (M2) M[Fi] derived from autologous monocytes. M1 M[Fi] were more resistant to infection, secreting TNF-[alfa], IL-6, IL-12 and type I IFN. By contrast, in HCMV-infected M2 M[Fi] the production of proinflammatory cytokines, type I IFN and IL-10 was limited, and IL-12 undetectable. NK cell degranulation was triggered by interaction with HCMV-infected M1 and M2 M[Fi] and was partially inhibited by specific anti-NKp46, anti-DNAM-1 and anti-2B4 mAbs, thus supporting a dominant role of these activating receptors. By contrast, only HCMV-infected M1 M[Fi] efficiently promoted NK cell-mediated IFN-[gamma] secretion, an effect partially related to IL-12 production. These observations reveal differences in the NK cell response triggered by distinct HCMV-infected monocyte-derived cell types, which may be relevant in the pathogenesis of this viral infection. HCMV infection has been proposed to contribute to the development of atherosclerosis, a chronic inflammatory process in which M[Fi] play a key role. The contribution of HCMV to vascular disease may depend on features of the immune response not reflected by the detection of specific antibodies. Persistent HCMV infection in healthy blood donors has been associated with changes in the distribution of NK cell receptors (NKR). The putative relationship among HCMV infection, NKR distribution, subclinical atherosclerosis and coronary heart disease was assessed. An association of overt and subclinical atherosclerotic disease with LILRB1+ NK and T cells was observed, likely reflecting a relationship between the immune challenge by infections and cardiovascular disease risk, without attributing a dominant role for HCMV. / Hem analitzat la resposta de la cèl•lula NK als macròfags proinflamatoris (M1) i antiinflamatoris (M2) derivats de monòcits autòlegs infectats pel citomegalovirus humà (HCMV). Els macròfags M1 son més reistents a la infecció i secreten TNF-[alfa], IL-6, IL-12 i IFN de tipus I. Per altra banda, en els macròfags M2 infectats per HCMV la producció de citoquines proinflamatories, IFN de tipus I i IL-10 es limitada i la IL-12 indetectable. La cèl•lula NK degranula al interaccionar amb els macròfags M1 i M2 infectats. Aquesta degranulació s’inhibeix parcialment al bloquejar amb anticossos específics anti-NKp46, anti-DNAM-1 i anti-2B4, això indica que aquests receptors tenen un rol important en el procés. En canvi, només els macròfags M1 infectats amb HCMV promouen de manera eficient la producció d’IFN-[gamma] per part de la cèl•lula NK, degut parcialment a la producció de IL-12. Aquestes observacions posen de manifest diferències en la resposta de la cèl•lula NK a diferents tipus de macròfags infectats per HCMV que pot ser relevant en la patogènesis d’aquesta infecció viral. S’ha proposat que la infecció per HCMV contribueix al desenvolupament de l’aterosclerosis, un procés inflamatori crònic en el que els macròfags tenen un paper clau. La contribució del HCMV a la malaltia cardiovascular pot dependre de la resposta immune. La infecció per HCMV en donants de sang sans s’ha associat a canvis en la distribució dels receptors de les cèl•lules NK. S’ha evaluat la possible relació entre la infecció per HCMV, la distribució dels receptors de les cèl•lules NK i l’infart agut de miocardi. S’ha observat una associació de l’infart agut de miocardi i l’aterosclerosi subclínica tant amb les cèl•lules NK LILRB1+ com amb les cèl•lules T LILRB1+. Això possiblement reflexa la relació entre la pressió que les infeccions exerceixen en el sistema immunitari i el risc cardiovascular sense atribuir un paper principal al HCMV.

Made available in DSpace on 2015-07-22T20:49:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-09-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: Isolados clínicos do Citomegalovirus (CMV) são facilmente propagados in vitro resultando em comprometimento da monocamada celular onde o vírus foi inoculado, evidenciando assim a presença ou ausência de infecção. A cultura celular é um método clássico para detecção do CMV e foi bastante utilizada no passado. O ensaio de antigenemia, que detecta o antígeno viral pp65 do CMV, é o método mais utilizado atualmente na prática clínica, por ser mais rápido e específico para detecção da infecção ativa. Recentemente a técnica de PCR em tempo real tem sido empregada no monitoramento da infecção por meio da quantificação da carga viral por ser um método de alta sensibilidade e especificidade ao DNA viral. Sendo assim, o objetivo do estudo foi empregar testes usados no diagnóstico e monitoramento da infecção clínica à cepa padrão do CMV como protocolo para implantação em experimentos in vitro. Métodos: Monocamada de células fibroblásticas humanas confluentes e em quiescência foram inoculadas com amostras de células infectadas pela cepa adaptada em laboratório do CMV AD169. O efeito do vírus sobre a cultura foi monitorado 1 hora, 24 horas, 48 horas e 72 horas após a infecção (h.p.i) através da observação do efeito citopático. As mesmas amostras foram analisadas por antigenemia estimando-se a média de células positivas em 2x105 células e por PCR em tempo real estimando-se a média de cópias de DNA viral/Log10 presente nas amostras. Resultados: Efeito citopático foi observado pela primeira vez 24 h.p.i, evidenciando que o início das mudanças morfológicas ocorreu precocemente. Esse efeito tornou-se mais intenso após 72h. O ensaio de antigenemia evidenciou presença de infecção ativa pelo padrão de marcação do antígeno viral pp65 encontrado no núcleo das células infectadas, enquanto que a PCR em tempo real evidenciou o número de cópias de DNA viral nos diferentes tempos de infecção. Antigenemia apresentou uma média 57 ±56 células positivas 1h.p.i. O pico da infecção foi alcançado 24h.p.i com um aumento significativo da média para 2.381 ±168 (P<0.05 versus 1h.p.i), mantendo-se elevado 48h.p.i, mostrando uma média de 2.012 ±352. Entretanto, os níveis de antigenemia diminuem significativamente 72h.p.i para 262 ±5 (P<0.05 versus 48h.p.i). Assim como na antigenemia, observou-se aumento significativo da carga viral de 1 h.p.i para 24 h.p.i, sendo uma média de DNA viral detectado 11.30 ±0.30 e 11.96 ±0.09, respectivamente (P<0.05 versus 1h.p.i). Os níveis de DNA viral se mantêm elevados 48h.p.i, sendo detectada uma média de 12.33 ±0,26. Após esse período, carga viral cai significativamente para 11.57 ±0.06 (P<0.05 versus 48h.p.i). Não foi encontrada correlação entre os métodos quantitativos de antigenemia e PCR em tempo real. Conclusão: Os três métodos utilizados, isolamento viral, antigenemia e PCR em tempo real evidenciaram o sucesso da infecção “in vitro” pelo CMV por meio de mudanças cito-morfológicas, detecção de antígeno viral específico e carga viral por detecção do DNA viral, respectivamente. A técnica de PCR se mostrou a mais sensível na detecção viral em relação às demais técnicas. Embora sejam métodos sensíveis e específicos, consideramos a necessidade da titulação viral em quaisquer ensaios experimentais in vitro. / Introduction: Clinical isolates of Cytomegalovirus (CMV) are easily spread in vitro resulting in impairment of the monolayer cell where the virus was inoculated, thus evidencing the presence or absence of infection. The cell culture is a classic method for detection of CMV and it was widely used in the past. Antigenemia assay, which detects CMV pp65 antigen, is the method most used currently in clinical practice, because it is faster and specific for detection of the active infection. Recently, the real-time PCR has been used in monitoring of the infection through the quantification of viral load for being a high sensitivity and specificity method to viral DNA. Therefore, the aim of the study was employing tests used in diagnosis and monitoring of infection to the standard CMV strain as a protocol for implantation in experiments in vitro. Methods: Quiescent human fibroblasts in confluent monolayer were inoculated with samples of infected cells by the adapted CMV AD169 strain. The effect of the virus on culture was monitored at 1 hour, 24 hours, 48 hours and 72 hours post infection (h.p.i) by observation of cytopathic effect. The same samples were analyzed by antigenemia being estimate the mean of positive cells in 2x105 cells and by real-time PCR being estimate the mean of copies of viral DNA/Log10 present in samples. Results: Cytopathic effect was first noticed 24 h.p.i, showing that the initiation of morphological changes occurred early. This effect became more intense after 72 h.p.i. Antigenemia assay showed the presence of active infection through pattern of labeling of the pp65 viral antigen found on nucleus of infected cells, while the real-time PCR showed the number of copies of viral DNA in different times of infection. Antigenemia showed an mean of 57 ±56 positive cells 1h.p.i. The peak of the infection was reached 24h.p.i with a significant increase in the mean 2.381 ±168 (P<0.05 versus 1h.p.i) and remained high 48h.p.i, showing an mean of 2.012 ±352 positive cells. However, the mean of antigenemia decrease 72h.p.i to 262 ±5 (P<0.05 versus 48h.p.i). As well as in antigenemia, a significant increase of th viral load was observed of 1h.p.i to 24h.p.i, being the mean of viral DNA detected 11.30 ±0.30 and 11.96 ±0.09, respectively (P<0.05). The levels of viral DNA stayed high 48h.p.i, being detected a mean of 12.33 ±0.26. After this period, viral load decreased significantly to 11.57 ±0.06 (P<0.05 versus 48h.p.i). No correlation was found between the quantitative methods of antigenemia and real-time PCR. Conclusion: The three methods, virus isolation, antigenemia and real-time PCR, showed the success of the CMV infection “in vitro” by cyto-morphological changes, detection of viral antigen specific and viral load by virus DNA detection, respectively. PCR method was more sensitive in detecting virus in relation the other methods. Although sensitive and specific, we consider the need for viral titration in any experimental studies in vitro. / TEDE / BV UNIFESP: Teses e dissertações

L’infection par le cytomégalovirus est le plus souvent asymptomatique chez les sujets immunocompétents mais entraine une morbidité et une mortalité importantes chez les patients immunocompromis et en cas d’infection congénitale.<p>Après l’infection primaire, le virus persiste tout au long de la vie à l’état latent mais peut se réactiver de manière intermittente. Ceci est associé à l’expansion de lymphocytes T CD4+ fortement différenciés ayant des fonctions auxiliaires et cytolytiques. L’infection primaire est, par contre, caractérisée par une réplication virale intense qui dure plusieurs mois. Il a été montré que l’exposition prolongée à des concentrations élevées d’antigènes entraine une perte progressive de fonction par les lymphocytes T appelée épuisement et caractérisée par l’expression de récepteurs inhibiteurs. L’impact de la réplication virale intense observée au cours de l’infection primaire par le CMV sur la fonction des lymphocytes T CD4+ n’est pas bien connu.<p>La fonctionnalité des lymphocytes T CD4+ a été explorée chez l’humain et le singe rhésus au cours de l’infection primaire et comparée à celle de sujets porteurs chroniques du virus.<p>Les résultats montrent que l’infection primaire par le CMV est associée à la détection de lymphocytes T CD4+ circulants ayant une faible capacité de prolifération et de production de cytokines et d’IL-2 en particulier.<p>L’impact de la différenciation sur la fonction des lymphocytes a été exploré en détail chez l’humain. Il a été observé qu’un degré de différenciation plus élevé des lymphocytes T CD4+ spécifiques du CMV joue un rôle dans la production réduite d’IL-2. Toutefois, la fraction moins différenciée (exprimant la molécule CD28) présente également une sécrétion d’IL-2 moindre au cours de l’infection primaire. Ceci fait partie d’une diminution globale de la production de cytokines au cours de l’infection primaire qui affecte également la sécrétion d’IFNγ et TNFα, entraine une polyfonctionnalité réduite et est indépendante de la différenciation. L’épuisement des lymphocytes T CD4+ spécifiques du CMV contribue à leur fonctionnalité moindre comme l’indique l’expression accrue du récepteur inhibiteur PD-1 et l’augmentation des réponses prolifératives en présence d’anticorps bloquant PD-1.<p>Le lien entre excrétion virale et fonction lymphocytaire a été étudié chez le macaque rhésus. L’infection par le CMV est observée chez les singes juvéniles et adultes mais pas chez les nourrissons. L’excrétion urinaire et salivaire est significativement plus fréquente et intense chez les singes juvéniles par rapport aux adultes. Comme chez l’humain au cours de l’infection primaire, les lymphocytes T CD4+ spécifiques du virus sont moins<p>polyfonctionnels et prolifèrent moins efficacement chez les singes juvéniles par rapport aux singes adultes. Ceci est associé à l’expression accrue du récepteur inhibiteur PD-1 chez les singes juvéniles. La réponse proliférative des lymphocytes T CD4+ est accrue en présence d’anticorps bloquant PD-1 ou d’IL-2 exogène. Enfin, une association inverse entre fonction lymphocytaire et excrétion urinaire a été mise en évidence chez les macaques adultes.<p>Ces résultats indiquent que l’infection par le CMV présente des caractéristiques semblables chez l’humain et le singe rhésus. L’infection primaire est associée à la détection de lymphocytes T CD4+ ayant une fonctionnalité moindre qu’au cours de l’infection chronique. L’expression du récepteur inhibiteur PD-1 typique des cellules épuisées est l’un des mécanismes impliqués et pourrait être la cible de stratégies immunomodulatrices visant à améliorer les fonctions lymphocytaires et le contrôle de la réplication virale. Les résultats présentés indiquent que l’infection naturelle chez le singe rhésus constitue un modèle potentiellement utile à l’étude de la réponse immune au CMV humain et à l’évaluation de stratégies immunomodulatrices.<p>/<p>Cytomegalovirus infection is mostly asymptomatic in immunocompetent hosts but leads to severe morbidity and mortality in immunocompromised subjects and foetuses.<p>After primary infection, CMV establishes lifelong persistence but can reactivate intermittently. This is associated with the expansion of highly differentiated CD4+ T lymphocytes exhibiting helper functions and cytolytic activity.<p>Primary infection is characterised by an intense viral replication lasting several months. It has been shown that prolonged exposure to elevated antigen concentrations induces a progressive loss of function by T lymphocytes called exhaustion. This state of functional impairment is associated to the expression of inhibitory receptors. The consequence of the intense viral replication seen in primary CMV infection on CD4+ T cell function is unknown.<p>CD4+ T cell function has been studied in human and rhesus macaque during primary CMV infection. Chronic CMV carriers have been used as controls.<p>The results show that primary CMV infection is associated to the detection of circulating CD4+ T lymphocytes exhibiting weak proliferative capacities and reduced cytokine production affecting IL-2 in particular.<p>The impact of differentiation on lymphocyte function has been explored in detail in human. An increased proportion of terminally differentiated CD4+ T cells (CD28-) is observed during primary infection. These lymphocytes are unable to secrete IL-2 in response to CMV antigens. Interestingly, CD28+ CMV-specific CD4+ T cells also exhibit reduced IL-2 production during primary infection. This is part of a global reduction of cytokine production affecting IFNγ and TNFα as well. The impaired cytokine production is associated to reduced polyfunctionality and is independent of differentiation. Exhaustion of CMV-specific CD4+ T lymphocytes contributes to the reduced functionality as shown by an increased expression of the inhibitory receptor PD-1 and improved proliferative responses in the presence of PD-1 blocking antibodies.<p>The relationship between viral replication and lymphocyte function has been explored in rhesus macaques. CMV infection is observed in juvenile and adult monkeys but not in newborns. Excretion in urine and saliva is significantly more frequent and intense in juvenile monkeys than adults. As in primary infection in human, CMV-specific CD4+ T lymphocytes are less polyfunctional and have lower proliferative capacities in juveniles as compared to adults. This is associated with an increased expression of PD-1 in juvenile monkeys. CD4+ T cell proliferative responses are increased when PD-1 blocking antibodies or exogenous IL-2 are added to the culture medium. Finally, an inverse association between lymphocyte function and urinary excretion has been observed in adult macaques.<p>These results indicate that CMV infection shares common features in human and rhesus macaque. Primary infection is associated to the detection of CD4+ T lymphocyte displaying lower functional capacities as compared to chronic infection. Exhaustion contributes to the functional impairment and the inhibitory receptor PD-1 could be targeted by immunomodulatory strategies aiming at improving lymphocyte functions and controlling viral replication. Natural CMV infection in rhesus macaque might be useful as a model to evaluate the efficacy and safety of immunomodulatory approaches. / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

Les anticorps à réactivité croisée sont caractérisés par leur capacité à reconnaitre des épitopes différents de ceux qui ont causé leur induction. Cela se produit lorsque des similitudes structurales entre les deux déterminants antigéniques deviennent suffisantes pour permettre une liaison spécifique. Nous rapportons ici pour la première fois la présence, à une haute fréquence, d'anticorps dans des échantillons de sang provenant de sujets vivant en France avec une protéine de Trypanosoma cruzi. Nous avons appelé ces anticorps ''Trypanosoma cruzi Cross-reactive antibodies'' ou TcCRA. Nos résultats montrent une forte séroprévalence des anticorps à réaction croisée, suggérant qu'ils sont induits par un immunogène largement répandu, acquis dès l’enfance et qui ne semble pas être associé à des agents pathogènes communs en clinique humaine. Les recherches effectuées in silico orientent vers un virus de la famille des Herpesviridae. Cette hypothèse est renforcée par la documentation d’un profil sérologique de séroconversion chez un patient qui a subi une transplantation de cellules souches allogéniques. Ce premier travail va servir de base à la mise en oeuvre d’investigations cliniques rétrospectives et prospectives destinées à élucider l’étiologie et l’importance clinique du biomarqueur TcCRA / Cross-reactive antibodies are characterized by their recognition of antigens that are different from the trigger immunogen. This happens when the similarity between two different antigenic determinants becomes adequate enough to enable a specific binding. Here, we report for the first time the presence, at an ‘‘abnormal’’ high frequency in blood samples from French human subjects, of antibodies that cross-react with a protein of Trypanosoma cruzi. We called these antibodies ‘‘Trypanosoma cruzi Cross-Reactive Antibodies’’ or TcCRA. Our findings show a large seroprevalence of cross-reactive antibodies and suggest that they are induced by a widely spread immunogen, acquired during childhood. Furthermore TcCRA serology does not seem to be associated with commonly known pathogens in clinical routine. Our hypothesis of the implication of a viral agent in the induction of TcCRA was further put forward when we documented a seroconversion pattern in a patient after allogenic stem cell transplantation. This initial exploratory work will serve as the basis for organizing prospective and retrospective clinical investigations, where we will pursue the analysis of TcCRA in order to elucidate its etiology and clinical importance

Die Selektion klonal expandierender Zellen mit einzigartigen, somatisch rekombinierten Anti-gen-Rezeptoren und die Langlebigkeit der daraus hervorgehenden Gedächtniszellen sind definierende Eigenschaften adaptiver Immunität. Dahingegen ist das angeborene Immunsystem da-rauf programmiert, mittels einer breiten Palette konservierter Rezeptoren möglichst schnell auf Pathogene zu reagieren und wird dabei auf Populationsebene epigenetisch geprägt. In dieser Arbeit möchte ich dieses Paradigma auf der Basis von Natürlichem Killer (NK) Zell-Gedächtnis an das humane Zytomegalievirus (HCMV) als Beispiel für Pathogen-spezifische Anpassung innerhalb des angeborenen Immunsystems herausfordern. Indem wir multiparametrische Einzel-zellanalysen zur Kartierung von ex vivo NK Zellen mit endogenen Barcodes in Form von soma-tischen Mutationen in mitochondrialer DNA (mtDNA) verknüpfen, können wir drastische klonale Expansionen adaptiver NK Zellen in HCMV+ Spendern nachweisen. NK-Zell-Klonotypen waren durch eine ihnen gemeinsame, inflammatorische Gedächtnissignatur mit AP1 Motiven gekennzeichnet, die eine Reihe einzigartiger Chromatin-Regionen mit Klon-spezifischer Zugänglichkeit überlagerte. NK-Zell-Klone wurden über einen Zeitraum von bis zu 19 Monaten stabil aufrechterhalten und behielten dabei ihre charakteristischen, Klon-spezifischen epigenetischen Signaturen, was die entscheidende Rolle klonaler Vererbung von Chromatin-Zugänglichkeit für die Prägung des epigenetischen Gedächtnis-Repertoires unterstreicht. Insgesamt identifiziert diese Arbeit zum ersten Mal klonale Expansion und Persistenz innerhalb des angeborenen Immunsystems im Menschen und deutet daraufhin, dass diese zentralen Mechanismen zur Ausbildung von immunologischem Gedächtnis evolutionär unabhängig von diversifizierten Antigen-Rezeptoren entstanden sind. / A hallmark of adaptive immunity is the clonal selection and expansion of cells with somatically diversified receptors and their long-term maintenance as memory cells. The innate immune system, in contrast, is wired to rapidly respond to pathogens via a broad set of germline-encoded receptors, acquiring epigenetic imprinting at the population level. The presented work challenges this paradigm by studying Natural Killer (NK) cell memory to human Cytomegalovirus (HCMV) infection as an example of pathogen-specific adaptation within the innate immune system. Leveraging single-cell multi-omic maps of ex vivo NK cells and somatic mitochondrial DNA (mtDNA) mutations as endogenous barcodes, we reveal drastic clonal expansions of adaptive NK cells in HCMV+ individuals. NK cell clonotypes were characterized by a convergent inflammatory memory signature driven by AP1 transcription factor activity, superimposed on a private set of clone-specific accessible chromatin regions. Strikingly, NK cell clones were stably maintained in their specific epigenetic states for up to 19 months, revealing that clonal inheritance of chromatin accessibility shapes the epigenetic memory repertoire. Together, this work presents the first identification of clonal expansion and persistence within the human innate immune system, suggesting these central mechanisms of immune memory have evolved independently of antigen-receptor diversification.