L’allergie ou l’hypersensibilité de type I est une réponse inappropriée du système immunitaire à une substance étrangère à l’organisme, nommée « allergène ». L’immunothérapie allergénique (ITA) est actuellement le seul traitement sur le marché qui permet de traiter l’étiologie de la maladie allergique par opposition aux traitements symptomatiques qui diminuent temporairement les manifestations allergiques. Son action consiste à réduire la sensibilité de l’organisme vis-à-vis de l’allergène en modulant progressivement la réponse immunitaire dirigée contre ce dernier. L’objectif de cette thèse était de définir des biomarqueurs d’efficacité clinique utilisables dans le cadre des traitements de l’ITA. La stratégie de recherche est basée sur une hypothèse qui consiste à suggérer que les cellules dendritiques (DCs) sont impliquées dans le succès de l’immunothérapie. En particulier, nous supposons que le traitement induit une baisse des DCs de type 2 (DC2), qui induisent des lymphocytes T auxiliaires de type 2 (TH2), et une augmentation des DCs régulatrices (DCreg), qui induisent des lymphocytes T régulateurs. La première partie de cette thèse a consisté à mettre au point des conditions de culture induisant des DC2. Pour cela, un criblage de molécules biologiques et pharmacologiques a été entrepris sur les DCs dérivées des monocytes afin d’induire in vitro des DC2 et a conduit à la mise au point d’un mélange de plusieurs molécules, dont certaines sont impliquées dans les mécanismes de l’allergie. Le phénotype des DC2 obtenu a été étudié ainsi que la polarisation des lymphocytes T induite après co-cultures en comparaison avec des DCs de type 1 (DC1) et des DCreg.La deuxième partie de cette thèse a consisté à analyser, à l’échelle moléculaire, les différents types de DCs induites (DC1, DC2 et DCreg). Pour cela, deux techniques ont été utilisées, une analyse transcriptomique par puces à ADN et une analyse protéomique par spectrométrie de masse sans marquage, pour comparer le transcriptome et le protéome des DCs induites. Le différentiel d’expression des marqueurs les plus pertinents a été validé au niveau transcriptionnel et protéique.Dans la troisième partie de cette thèse, le suivi des marqueurs dans des cellules du sang de patients allergiques traités ou non par ITA lors d’une étude clinique randomisée, contrôlée, en double aveugle, a permis de définir six nouveaux candidats biomarqueurs d’efficacité de l’immunothérapie, dont trois spécifiques des DC2 et trois autres spécifiques des DCreg. Ces marqueurs pourront être suivis lors des traitements d’ITA pour distinguer les patients répondeurs des non-répondeurs. / Allergy or type I hypersensitivity is an inappropriate response of the immune system to a foreign substance in the body, called "allergen". Allergen immunotherapy (AIT) is currently the only treatment on the market that can handle the etiology of allergic disease versus symptomatic treatments that temporarily reduce allergic manifestations. Its action is to reduce the sensitivity of the body against allergens.The aim of this thesis was to define biomarkers of clinical efficacy of AIT. The research strategy is based on the following hypothesis: dendritic cells (DCs) are involved in the success of immunotherapy. In particular, we assume that the treatment induces a decrease in DCs type 2 (DC2), which induce type 2 helper T cells, and an increase of regulatory DCs (DCreg), which induce regulatory T cells.First, we defined optimal culture conditions inducing the polarization of in vitro immature monocyte-derived DCs (MoDCs) toward a DC2 pattern. After screening several biological and pharmaceutical agents, we selected a cocktail of six molecules with some of them are pro-allergenic molecules. The phenotype of those DC2 cells and the CD4+ T cell polarization induced after coculture were characterized extensively in comparison with type 1 DC (DC1) and DCreg.In a second part, we compared the transcriptomes and the proteomes of MoDCs polarized into DC1, DC2 and DCreg by using cDNA microarrays together with label-free mass spectrometry. The differential expression of the most relevant markers was confirmed at the transcriptional and protein level. In the third part, markers were also followed in the peripheral blood from allergic patients enrolled in a randomized, double-blind, placebo-controlled AIT study. The expression of three DC2 markers was down-regulated and of three DCreg markers was up-regulated in patients who responded to the treatment and correlated with clinical efficacy. These markers could be used as follow-up read-outs of AIT efficacy in order of to discriminate responders from nonresponders.

Le développement d’une réponse innée est essentiel pour lutter contre les infections virales. Elle se traduit par la production de cytokines antivirales, parmi lesquelles les interférons-alpha (IFN-). Les cellules dendritiques plasmacytoïdes (pDC) sont les principales cellules productrices d’IFN-Nous avons démontré que les virus libres d’HTLV-1 induisaient une réponse innée se traduisant par une forte production d’IFN-. Les pDC non stimulées sont dans un état de quiescence avec des taux du ligand pro-apoptotique TRAIL (TNF-Related Apoptosis Inducing Ligand) intracellulaire très élevés, rapidement mobilisés à la surface des pDC sous activation de la voie du Toll-like receptor 7. Les pDC acquièrent alors un phénotype de cellules tueuses, les IKpDC (Interferon producing killer pDC). C’est la première fois qu’une réponse innée induite par les particules libres d’HTLV-1 a été mise en évidence.Il a été montré que des taux sériques d’IFN- apparaissaient dans les phases tardives du SIDA, suggérant un rôle de l’IFN- dans la pathologie du VIH. La voie d’apoptose régulée par TRAIL/DR5 est impliquée dans la déplétion massive des LTCD4+ des patients infectés par le VIH. Les patients « HIV Controllers » (HIC) sont des patients infectés par le VIH mais qui contrôlent la charge virale et la mort de leurs LTCD4+. Nous avons alors étudié la voie IFN/TRAIL/DR5 chez ces patients. Notre analyse protéique et génomique de DR5 a révélé un défaut d’expression de DR5 à la surface des LTCD4+ des patients HIC par rapport aux patients virémiques. Le séquençage du gène DR5 a révélé l’existence d’une substitution homozygote dans l’exon 1 du gène des HIC. Cette substitution génomique a pour conséquence le changement d’un acide aminé dans la région leader de la protéine DR5 entrainant la séquestration intracellulaire de DR5. Cette mutation associée au profil des patients HIC pourrait expliquer le maintien du nombre de leurs LTCD4+, ainsi que la non-progression vers la phase SIDA. / Innate immune response which is characterized by antiviral cytokines such as interferon-alpha (IFN-, is essential during viral infections. Plasmacytoid dendritic cells (pDC) are the main IFN- producer cells. We demonstrated that HTLV-1 free viruses induced a strong IFN- production by pDC. Unstimulated pDC were in fact dormant cells stocking intracellular proapoptotic ligand TRAIL (TNF-Related Apoptosis Inducing Ligand), which was quickly mobilized at the cell surface of pDC after Toll-like receptor 7 activation. Then, pDC acquire a new killer phenotype, the IKpDC (Interferon producing killer pDC). This is the first demonstration that HTLV-1 free viruses can induce an innate immune response by pDC.Plasma levels of IFN- have been found in HIV-1-infected patients, suggesting a role of IFN- in HIV-associated disease. We hypothesized in our HIV in vitro model the implication of TRAIL/DR5 pathway in CD4 T cells massive depletion observed in HIV-1-infected patients.A population of HIV-infected patients, called « HIV Controllers » (HIC), do not progress to AIDS despite HIV infection, control their viral load and their CD4 T cells depletion. We have then study IFN/TRAIL/DR5 pathway of these patients. Our proteomic and genomic analysis revealed a default of DR5 expression at the cell surface of CD4 T cells from HIV controllers in contrast to progressor patients. DNA sequencing revealed a homozygous substitution in the exon 1 of DR5 gene from HIC. The consequence of this substitution is the change of one amino-acid in the leader region of DR5 protein. Thus, DR5 is uncleaved and is sequestrated in the intracellular copartements in CD4 T cells. The lack of DR5 cell surface expression in HIV Controllers may explain the maintain of CD4+ T cells count and thus the non progression to AIDS.

Les vecteurs nanoparticulaires comme systèmes de relargage contrôlé pour des applications vaccinales font l’objet d’intenses recherches, notamment dans le domaine du VIH1. Une approche novatrice consiste à co-administrer des molécules immuno-stimulatrices avec les antigènes d’intérêt, afin d’amplifier le recrutement et l’activation des cellules dendritiques (DCs). Un tel vecteur vaccinal stimulerait l’intensité de la réponse immunitaire et une immunité au niveau des muqueuses vaginales et anales pourrait être obtenue après vaccination. Des nanoparticules de poly(acide lactique) (NP-PLA) ou de chitosane/sulfate de dextrane (NP-CSD) ont été utilisées comme véhicules et adjuvants de protéines du VIH1, gp140 et p24. Le poly(I:C), ligand de TLR3 est la molécule immuno-stimulatrice retenue pour ses propriétés adjuvantes. Les NP-PLA et NP-CSD présentent un potentiel équivalent pour l’adsorption de protéines. Par contre, si les NP-CSD permettent l'adsorption du poly(I:C) (95%), elle est moins reproductible sur les NP-PLA. Pour chaque formulation, la capacité à induire in vitro la maturation des DCs a été évaluée en suivant les marqueurs CD25, CD80, CD83, par cytométrie en flux. L’adsorption de poly(I:C) sur les NP-PLA ou les NP-CSD amplifie les capacités de maturation de ces nanoparticules, un effet synergique étant observé avec les NP-CSD. Nos travaux montrent que la co-adsorption d’un TLR ligand, avec des antigènes protéiques du VIH sur des nanoparticules biodégradables, est possible et confère à la formulation vaccinale un effet immuno-stimulant in vitro. In vivo, les formulations vaccinales contenant du poly(I:C) induisent de très forts taux d’anticorps sériques chez la souris. / Use of nanoparticulate vectors in vaccination as controlled release systems based on biodegradable polymers has been widely studied, particularly for HIV vaccine research. An innovative approach is to co-administer antigens of interest with immuno-stimulatory molecules to amplify the recruitment and activation of dendritic cells (DCs). Such a vaccine candidate could boost the intensity of the immune response, and mucosal immunity in vaginal and anal secretions could be obtained after vaccination.We used nanoparticles of poly(lactic acid) (NP-PLA) or chitosan / dextran sulfate (NP-CSD), as vehicles and adjuvants for HIV-1 proteins, gp140 and p24. Poly (I:C), TLR3 ligand molecule, is the immuno-stimulatory molecule chosen for its adjuvant properties. The NP-PLA and NP-CSD have shown their great potential as carriers of proteins. By cons, if NP-CSD allows the adsorption of poly(I:C) with a yield of 95%, the adsorption is less reproducible on NP-PLA. For each formulation, the ability to induce in vitro maturation of DCs was evaluated by following the marker CD25, CD80, CD83, by flow cytometry. Adsorption of poly(I:C) on the NP-PLA or the NP-CSD amplifies the maturation abilities of particles and has a synergistic effect with the NP-CSD.Our work shows that co-adsorption of a TLR ligand with HIV protein antigens onto biodegradable nanoparticles is possible and gives an immuno-stimulant effect to the vaccine formulation in vitro. In vivo, vaccine formulations containing poly(I:C) induce very high levels of serum antibodies in mice.

Dendritic cells (DCs) comprise a distinct lineage of potent antigen-presenting mononuclear phagocytes that serve as both mediators of innate immune responses and key facilitators of the adaptive immune response. DCs play both immunogenic and tolerogenic roles through their dual ability to elicit pathogen-specific T cell immunity as well as induce regulatory T cell (Treg) responses to promote tolerance in the steady state. The aim of the work presented here is to examine the normal regulatory mechanisms of DC development and function, starting with the dissection of mechanisms behind an aberrantly activated developmental pathway, followed by the exploration of new mechanisms governed by two candidate transcription factors. The first chapter of the thesis focuses on the growth factor receptor Flt3, an essential regulator of normal DC development in both mice and humans, and concurrently one of the most commonly mutated proteins found in acute myeloid leukemia (AML). We investigated the effect of its most common activating mutation in AML, the Flt3 internal tandem duplication (Flt3-ITD), and found that this mutation caused a significant cell-intrinsic expansion of all DC populations. This effect was associated with an expansion of Tregs and the ability to dampen self-reactivity, with an inability to control autoimmunity in the absence of Tregs. Thus, we describe a potential mechanism by which leukemia can modulate T cell responses and support Treg expansion indirectly through DCs, which may compromise immunosurveillance and promote leukemogenesis. The subsequent chapters explore the basic molecular mechanisms of DC development by using Flt3 expression as a guide to uncover new candidates involved in the DC transcriptional program. We show that Myc family transcription factor, Mycl1, is largely dispensable for DC development and function, contrary to recent published findings that propose a role in proliferation and T cell priming. On the other hand, we find that conditional deletion of our second candidate gene, an Ets family transcription factor, has diverse effects on DC development, monocyte homeostasis, and cytokine production. Overall, our studies highlight an unexpected molecular link between DC development and leukemogenesis, and elucidate novel mechanisms controlling DC differentiation and function.

A atopia caracteriza-se pela tendência de um indivíduo a produzir IgE em quantidade elevada, em resposta a um alérgeno específico, levando ao desenvolvimento de asma, rinite ou eczema. Todavia, a manifestação do fenótipo da alergia depende da interação de fatores genéticos e exposição a alérgenos ambientais. Desta forma, o alérgeno é processado e apresentado aos linfócitos T, que desenvolvem uma resposta imune Th2, exacerbada característica da atopia. A principal célula que está envolvida na comunicação entre a imunidade inata e adaptativa é a célula dendrítica (DC) cuja função é capturar, processar e apresentar o antígeno aos linfócitos. As DCs imaturas capturam o antígeno e migram do tecido para o órgão linfóide periférico, onde elas se diferenciam em DCs maduras e apresentam o antígeno aos linfócitos T naive. Assim, os linfócitos T naive podem se diferenciar em subtipos de linfócitos efetores como: linfócitos Th1 e Th2. Esses linfócitos auxiliam na produção de anticorpos pelos linfócitos B na resposta imune humoral contra patógenos específicos. O sistema imune humoral compreende cinco classes de imunoglobulinas: IgG, IgM, IgD, IgE e IgA e sua produção sofre influência da imunidade celular. Desta forma, alérgenos provenientes de ácaros como, Dermatophagoides pteronyssinus, podem levar à inflamação alérgica, alterando a produção de anticorpos. Tendo em vista evidências que demonstram a interação das DCs com anticorpos, propomos investigar sua influência na apresentação dos principais alérgenos da poeira domiciliar e sua modulação sobre a resposta imune em indivíduos alérgicos e não alérgicos. / Atopy is characterized by the trend of an individual to produce high amounts of IgE in response to a specific allergen, leading to the development of asthma, rhinitis or eczema. However, the manifestation of the allergy phenotype depends on the interaction of genetic factors and exposure to environmental allergens. In this way, the allergen is processed and presented to the T lymphocytes, which develop a Th2 immune response, exacerbated characteristic of atopy. The main cell that is involved in the communication between innate and adaptive immunity is the dendritic cell (DC) whose function is to capture, process and present the antigen to lymphocytes. Immature DCs capture the antigen and migrate from the tissue to the peripheral lymphoid organ, where they differentiate into mature DCs and present the antigen to naive T lymphocytes. Thus, naive T lymphocytes can differentiate into subtypes of effector lymphocytes such as Th1 and Th2 lymphocytes. These lymphocytes assist in the production of antibodies by B lymphocytes in the humoral immune response against specific pathogens. The humoral immune system comprises five classes of immunoglobulins: IgG, IgM, IgD, IgE and IgA and their production is influenced by cellular immunity. In this way, allergens from mites such as Dermatophagoides pteronyssinus, can lead to allergic inflammation, altering the production of antibodies. In view of evidence demonstrating the interaction of DCs with antibodies, we propose to investigate their influence on the presentation of the main house dust allergens and their modulation on the immune response in allergic and non-allergic individuals.

Os cães são afetados por doenças inflamatórias e neoplásicas que compartilham diversas similaridades com as desordens em humanos, assim seu estudo representa um importante modelo animal para as condições humanas. As células dendríticas (DCs) representam a população mais potente de células apresentadoras de antígenos. As DCs representam também um novo alvo promissor de imunoterapia em cães; no entanto o uso terapêutico de DC caninas é restrito, dentre outros fatores, devido a falta de padronização nas técnicas de isolamento e limitado numero de informações específicas da espécie a esse respeito. Este projeto tem por finalidade avaliar a geração de células dendríticas caninas geradas in vitro e ativadas por diferentes estímulos biológicos na presença e ausência de extrato tumoral de melanoma canino. Os resultados demonstraram que as DCs caninas geradas na presença de extrato tumoral em grandes concentrações apresentavam atividade funcional semelhante as DCs maduras / Dogs are affected by inflammatory and neoplastic diseases that share many similarities with the disorders in humans, so their study is an important animal model for the human condition. Dendritic cells (DCs) are the most potent population of antigen presenting cells. DCs also represent a promising new target for immunotherapy in dogs; However, the therapeutic use of canine DC is restricted among others factors due to lack of standardization in isolation techniques and limited number of species-specific information in this regard. This project aims to assess the generation of canine dendritic cells generated in vitro and activated by different biological stimuli in the presence and absence of tumor extract of canine melanoma. The results showed that the canine DCs generated in the presence of high concentrations tumor extract showed similar functional activity of mature DCs

Apesar da forte ativação do sistema imune que ocorre durante a infecção pelo Plasmodium, a memória imunológica à infecção é restrita a pacientes residentes em áreas endêmicas. Dessa forma é importante a geração de métodos capazes de induzir uma resposta imune eficaz e duradoura contra o parasito. Nesse contexto o direcionamento de antígenos para células centrais do sistema imune tem se apresentado como uma alternativa promissora. Produzimos e caracterizamos um anticorpo híbrido específico para a molécula DEC205, um receptor endocítico presente nas células dendríticas, acoplado à proteína MSP-1(19) de P. chabaudi, para fins de imunização e análise da resposta imune celular e humoral. Ensaios de imunização mostraram a indução de resposta humoral em camundongos imunizados com anticorpo híbrido e seu controle isotípico, caracterizada pela produção de IgM. Nossos resultados prévios indicam que o direcionamento de antígenos aliado a outras estratégias de imunizações podem resultar na ativação da resposta imune específica ao parasita. / Despite the strong activation of the immune system that occurs during infection by Plasmodium, the immunological memory to infection is restricted to patients residing in endemic areas. Thus it is important to the generation of methods to induce an effective immune response against the parasite. In this context, the targeting of antigens to the central cells of the immune system has emerged as a promising alternative. We produce and characterize a hybrid antibody molecule specific for DEC205, an endocytic receptor present on dendritic cells, coupled to protein MSP-1(19) of P. chabaudi, for immunization and analysis of cellular and humoral immune response. Immunization tests showed the induction of humoral response in mice immunized with hybrid antibody and isotype control, characterized by production of IgM. Our previous results indicate that targeting antigens combined with other strategies for immunization may result in the activation of specific immune response to the parasite.

Helicobacter pylori are unique in their ability to colonise the human gastric mucosa. They persist lifelong in untreated individuals despite the presence of a continuous and specific immune response being mounted against it. H. pylori O-antigen is thought to be involved in immune-evasion and subversion by the bacteria and expression has been shown to facilitate colonisation and exacerbate pathology in murine models. This study investigates immuno-relevant roles of H. pylori O-antigen as a pathogen-associated molecular pattern (PAMP) and its interaction with two pattern recognition receptors (PRRs); galectin-3 and DC-SIGN. These PRRs possess distinct carbohydrate recognition domain (CRD) structures and binding affinities. Despite this, we have demonstrated that they compete for adhesion to both Lewis antigen glycoconjugates and whole cell H. pylori 26695 in solid phase binding assays. Galectin-3 significantly reduces DC-SIGN adhesion at a 2:1 stoichiometric ratio in both Lex glycoconjugate and whole cell H. pylori 26695 assays, and abrogates carbohydrate-specific binding in Lex glycoconjugate assays at a 22:1 ratio. These results suggest that galectin-3 may play a role in inhibiting or modulating the interaction between H. pylori O-antigen and DC-SIGN in vivo. Supporting this, we have shown that galectin-3 secreted by AGS cells during competitive infection with H. pylori 26695 is sequestered by H. pylori O-antigen. We have demonstrated that competitive infection of the O-antigen deficient mutant H. pylori 26695 galE in DC-SIGN expressing THP-1 cells reveals a significant reduction in intracellular survival at 8 hours compared to H. pylori 26695 Wt. Co-incubation of H. pylori 26695 Wt with 10 µg ml-1 galectin-3 reduced intracellular survival to the levels of H. pylori 26695 galE at 8 hours. Furthermore, H. pylori 26695 galE displayed rapid association of the endocytic markers Rab5 and Rab7 at 15 minutes compared to H. pylori 26695 Wt. Monoclonal antibody-mediated blocking of DC-SIGN in H. pylori 26695 Wt-THP-1 infections resulted in rapid association of the endocytic markers Rab5 and Rab7, corresponding to that of H. pylori 26695 galE, indicating that DC-SIGN-O-antigen interactions alters intracellular processing of the bacteria and reduces the rate at which these markers are recruited. Together these results elucidate novel mechanisms of H. pylori O-antigen and its interaction with galectin-3 and DC-SIGN that warrant further investigation in vivo. The identification of two PRRs competing for the same PAMP is unconventional and inspires a re-evaluation of PRRs in innate immune recognition.

Detection of evolutionarily conserved pathogen motifs by pattern recognition receptors (PRRs), particularly on dendritic cells (DCs), is crucial for adequate immune responses. Defects in DC function are known to be associated with inflammatory bowel disease (IBD). The endocannabinoid system (ECS) is the system through which exocannabinoids such as Δ⁹-tetrahydrocannabinol and cannabidiol signal. Regarding inflammation, cannabinoids generally exert anti-inflammatory effects, including on experimental colitis. However, most work has been performed in animal models and less is known about the function of this system in human immune cells, particularly DCs. Monoacylglycerol lipase (MGLL) is the key enzyme for hydrolysis of the endocannabinoid 2-arachidonoylglycerol, and a member of the serine hydrolase enzyme superfamily. This thesis defines the activity of serine hydrolase enzymes for the first time in human DCs upon stimulation by NOD2/TLR2 ligands using activity-based protein profiling (ABPP). MGLL is shown to be ubiquitously upregulated upon stimulation of DCs and in monocyte-derived macrophages. Through pharmacological inhibition studies, MGLL is demonstrated to regulate cellular and secreted lipids, not limited to endocannabinoids. However, overall DC function is independent of this enzyme suggesting that the effects of lipid modulation may be on bystander cells. Challenging the current literature, MGLL inhibition with a novel inhibitor worsens murine Citrobacter rodentium colitis. Finally, ABPP demonstrates a rich serine hydrolome in colonic tissue from human IBD with many enzymes previously undefined in this disease. Gene expression of ECS components suggests the enzymes ABHD12 and DAGLα/β may be potential markers of field change in IBD.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease where failure to remove apoptotic cells, due to a defect in phagocytic cells, or deficient opsonisation, leads to secondary necrosis and the release of DNA and chromatin. The nuclear constituents from apoptotic cells are targeted by autoantibodies, which form immune complexes. Immune complex-mediated TLR9 activation of plasmacytoid dendritic cells (pDCs) and subsequent secretion of interferon (IFN-α) is thought to drive inflammation in SLE. It is currently believed that pDCs do not normally respond to apoptotic cells, as self-DNA is hidden from TLR9. However, DNA and chromatin expressed on membrane bound apoptotic bodies is essential for inducing IL-10 secreting regulatory B cells through TLR9 stimulation. The overall objective of this thesis was to understand how apoptotic cells influence immune responses in health and in patients with SLE. Splenic mouse pDCs were activated with the synthetic TLR7 agonist R848 and TLR9 agonists CpGB and CpGA and were co-cultured with apoptotic cells, or with freeze-thawed necrotic cells. PDCs co-cultured with apoptotic cells down-regulated the expression of CD40 and CD86. When pDCs were activated by R848 or CpGB, IL-10, IFN-γ and IL-6 secretion was significantly induced in the presence of apoptotic cells. PDCs so cultured induced T cells to secrete immune-regulatory IL- 10. In contrast, co-culturing apoptotic cells with pDCs activated by CpGA, augmented IFN-α secretion. These cytokine responses by pDCs were only stimulated by DNA on whole apoptotic cells; not by free nucleic acids derived from necrotic cells. This data demonstrates that the inflammatory context in which pDCs sense whole apoptotic cells is crucial to determining the threshold of tolerance to apoptotic self. It questions the perception that pDCs see all apoptotic cells and their necrotic cellular debris as dangerous and suggests that there may be something intrinsically different about SLE apoptotic cells, which causes inflammation. SNPs near ATG5, a protein of the cell survival pathway autophagy, have been linked to SLE susceptibility, but the role of autophagy in SLE pathogenesis is unclear. We hypothesised that dysfunctional autophagy is linked to abnormal apoptosis of SLE lymphocytes. Western blotting revealed that ATG5-ATG12 protein complex expression was significantly reduced in SLE lymphocytes and they failed to convert LC3-I to LC3- II, the hallmark of a functioning autophagy pathway, which caused accelerated secondary necrosis. Apoptotic SLE lymphocytes had an impaired ability to stimulate IL-10 secreting regulatory B cells and they induced pro-inflammatory cytokine secretion by monocyte-derived macrophages. Phagocytosis of apoptotic SLE lymphocytes by healthy macrophages was also impaired; however this was independent of ATG5 protein expression. The novel findings of this thesis suggest SLE apoptotic lymphocytes are intrinsically pro-inflammatory, which may be caused by diminished autophagy leading to an inability of lymphocytes to correctly execute apoptosis. Furthermore, inefficient clearance of SLE apoptotic cells results from a defect in the apoptotic cell, rather than the phagocytic cell.