Humoral immunity provides protection against subsequent infections. Antigen-specific, high-affinity, class-switched antibodies are produced by B cells through rounds of proliferation, B cell receptor rearrangement and selection in the germinal centres (GC). T cells play an essential and indispensable role in this process and in the recent years the term T follicular helper cells (TFH) was coined to describe this cell subset. The aim of my thesis is to investigate whether there is more than one type of T cells within the TFH population and whether it has important functional consequences. Firstly, I use sheep red blood cell immunisation (SRBC) and Salmonella enterica infection to show phenotypical differences between TFH expressing high and low level of surface molecule PD-1. In order to investigate the relationship between different TFH populations gene profiling was carried out on the microarray platform. Detailed transcriptome analysis revealed the discrete nature of isolated TFH cell subsets and provided an overview of their genetic landscape. Secondly, I have investigated the dependence of TFH subsets on cognate interactions with B cell in SRBC model by generating BM chimeras. I have demonstrated that generation of PD-1HI TFH, but not of PD-1LO TFH, depends on antigen presentation by B cells. Furthermore, I have shown that provision of wild-type but not MHC II knock-out B cells rescues PD-1HI formation in BM chimeras after SRBC immunisation. Finally, I have explored plasticity within TFH subsets and showed that none of the populations is in a terminally differentiated state, as they can convert into one another. Thirdly, experiments with S. enterica model revealed that the absence of PD- 1HI TFH is independent of the splenic architecture disruption present within the first week of the response. Surprisingly, co-immunisation studies showed that PD-1HI population is not only present but even enhanced in the group which received both SRBC and S. enterica when compared to single immunisations. The work presented in the thesis documents that there is a significant and previously unappreciated heterogeneity within TFH subset. This knowledge is important for designing optimal vaccine strategies and treating autoimmune diseases, as in both processes the antibody production plays a crucial role and its manipulation (either enhancing or blocking antibody production, respectively) can significantly improve clinical interventions.

Breast cancer (BC) is the most common cancer in women. It is a highly heterogeneous disease in terms of histology, therapeutic response and patient outcomes. Early and accurate detection of breast cancer is crucial as the patient prognosis varies greatly depending on the diagnosis of the disease. Patient outcomes have been linked to the presence of tumor infiltrating lymphocytes (TIL) in solid tumors. In human BC, higher TIL infiltration is associated with a better prognosis and also predicts relevant responses to pre-operative chemotherapy. TIL are primarily composed of T cells, albeit around 20% of BC patients (pts) show significant B cell infiltration, and can organize in tertiary lymphoid structures (TLS) located in the peritumoral stroma, which are associated with survival in HER2+ and triple negative BC patients. Further, these studies revealed that CD4+ follicular helper T (Tfh) cells producing CXCL13 were specifically associated with peritumoral TLS. CXCL13 is an important B cell chemoattractant whose function is to recruit B cells to the germinal center (GC) in secondary lymphoid organs and TLS, where they can mature and differentiate into memory or antibody-producing B cells. The principal objective of this thesis project was to investigate the role of CXCL13 and Tfh cells play in the development and/or maintenance of GC-like structures in BC-associated TLS.Further understanding of the factors that promote TLS formation in vivo could provide important insight for treatment decisions in BC. CXCL13 expression was originally identified as an important signal associated with TLS that was predictive for patient outcomes. We investigated factors capable of inducing CXCL13 expression in CD4+ T cells isolated from peripheral blood, using flow cytometry analysis. Treatment with TGFβ1 alone, or together with several cytokines (IL12, IL21, and in particular IL2 blockade), increased CXCL13 expression in activated CD4+ T cells. Similar to our characterization of Tfh TIL in fresh tumor tissues, these CXCL13-producing CD4+ T cells were CXCR5 negative and expressed the Tfh markers PD-1 and ICOS. The positive correlation, in treated cells and fresh TIL, between CXCL13-producing CD4+ T cells and FoxP3-expressing regulatory CD4+ T cells, and the diminished chemokine production upon depletion of the latter population, suggest a possible positive relationship between regulatory CD4+ T cells and CXCL13-producing CD4+ T cells.We then derived a GC-associated B cell gene signature for integration in our previously published Tfh cell gene signature, including CXCL13 gene. The combined GC gene signature was tested for its ability to sensitively detect BC-associated TLS using a qRT-PCR-based assay on two different cohorts, a primary BC set (n=83) and a retrospective series (n=52) of formalin-fixed paraffin-embedded (FFPE) BC tissues. These data revealed a correlation between gene signature expression and the extent of TLS scored by trained pathologists on dual-immunohistochemistry stained (CD3+CD20 for T and B cells, respectively) FFPE tissue sections. In addition, the high GC signature expression predicted better overall and disease-free survival of BC pts in our retrospective BC cohort, as well as in public microarray data.This thesis research has demonstrated that CXCL13-producing CD4+ T cells lacking CXCR5 differentiate and exert their function in IL-2-limited but TGF-β1-rich conditions. Furthermore, we developed a GC-associated gene signature able to detect TLS in BC and predict BC pts better survival. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

Les LT CD4 folliculaires (TFH) forment un lignage distinct de LT contrôlant spécifiquement les lymphocytes B (LB) et la mise en place de la mémoire B. Alors que ces cellules étaient considérées comme des cellules effectrices uniquement, récemment il a été identifié, chez l'Homme et la souris, l'existence de TFH mémoires. Les TFH mémoires en tant que LT CD4 mémoires sont nécessaires, en cas de nouvelle rencontre avec l'antigène (Ag), à la mise en place d'une réponse Anticorps (Ac) rapide, efficace et de forte affinité. En effet, leur présence est corrélée à la génération et le maintien à long terme d'Ac de forte affinité lors d'infections virales. De plus, des études récentes montrent que l'analyse des TFH mémoires dans le sang périphérique peut fournir des indices pour comprendre le mode d'action des vaccins ainsi que la pathogenèse de maladies auto-immunes. Par ailleurs, dans le contexte de nombreuses maladies, de récents travaux suggèrent que l'évaluation de la fréquence et du phénotype des TFH mémoires dans le sang périphérique pourrait servir de bio-marqueur à l'établissement de diagnostique. Tout comme les cellules B mémoires qui sont subdivisées en différentes sous-populations en fonction de leur localisation et de la nature de leur Ac, différentes populations de TFH mémoires ont été récemment identifiées. Certaines se situent dans les organes lymphoïdes secondaires (OLS) drainants le site d'immunisation, de vaccination ou d'infection, ou circulantes dans les OLS non-drainants ou à proximité des plasmocytes à longue durée de vie dans la MO. Ces observations soulèvent donc la question majeure de leurs phénotypes, différences fonctionnelles et interactions face aux différentes populations de cellules B mémoires. L'objectif de mes travaux de Thèse a consisté à étudier l'hétérogénéité phénotypique et fonctionnelle présente entre ces différentes populations de TFH mémoires aux localisations diverses. De plus au vu de l'hétérogénéité existante au sein des LB mémoires (nœuds lymphatiques ou rate) et plasmocytes à longue durée de vie (MO), nous avons aussi évalué l'interaction cellulaire et fonctionnelle qui a lieu entre ces populations mémoires. Dans ce contexte, nous avons développé un modèle expérimental unique de vaccination protéique chez la souris sauvage non modifiée. / T Helper Follicular (TFH) cells form a distinct lineage of helper T cells and they specifically control B cells and memory B cell generation. While these cells were considered as effector cells, recently it was identified in Human and in mouse, the existence of memory TFH cells. Memory TFH cells, as CD4 memory T cells, are necessary in case of antigen (Ag) rechallenge to establish a fast, efficient and high affinity Antibody (Ab) response. Indeed, their presence is correlated with the generation and the long-term maintenance of high affinity Ac during viral infections. Moreover, recent studies have shown that analysis of memory TFH cells in the blood may provide clues to understanding the mode of action of vaccines and the pathogenesis of autoimmune diseases. In addition, in the context of many diseases, recent works have also suggested that the frequency and phenotype of memory TFH cells in the blood could serve as a biomarker for diagnosis. Likewise to memory B cells that are subdivided into different cell populations based on their location and the nature of their Ab, different populations of memory TFH cells have recently been identified. Some are in secondary lymphoid organs (SLO) draining the site of immunization, vaccination or infection, or circulating in the non-draining SLO or near the long-lived plasma cells (PC) in bone marrow (BM). These observations raise the question of their phenotypes, functional differences and interactions with the different subsets of memory B cells. The aim of my thesis was to study the phenotypic and functional heterogeneity between the different subsets of memory TFH cells. Due to the heterogeneity of memory B cells (draining lymph nodes or non-draining spleen) and long-lived PCs (BM), we also evaluated the cellular and functional interaction that occurs between these different memories populations. In this context, we have developed a unique experimental model of protein vaccination in unmodified wild-type mice. Specifically, after immunization, we evaluated the development of memory TFH cells and memory B cells specific for the same Ag in the draining SLO and circulating in the spleen and BM. We demonstrated that local memory TFH cells (that reside in the draining SLO) exhibit a more polarized phenotype than their circulating counterparts (present in non-draining SLO).

Le syndrome de Sjögren primitif (SJp) est une pathologie auto-immune caractérisée par une sécheresse occulobuccale, un infiltrat lymphocytaire des glandes salivaires, ainsi qu'une production d'auto-anticorps. Les cellules épithéliales salivaires (SGEC) des patients atteints de SSp expriment les molécules impliquées dans les réponses immunitaires et jouent le rôle des cellules présentatrices d’antigènes. Les lymphocytes T folliculaires (LTf) jouent un rôle important en activant les lymphocytes B via la sécrétion d’interleukine (IL)-21. Une augmentation de la proportion de LTf est observée dans le sang des patients ayant un SJp. Nous avons fait l’hypothèse que les SGECs des patients pouvaient induire la différenciation des lymphocytes T naïfs (LTn) en LTf. Nous avons montré que les SGECs sont capables d’induire la différenciation des LTn en LTf via des facteurs solubles tel l’IL-6. La sécrétion d’IL-21 par les LTf nécessite un contact cellulaire impliquant en partie ICOSL.La voie de costimulation OX40/OX40L est impliquée dans plusieurs maladies autoimmunes. Les polymorphismes d’OX40L sont une prédisposent au SJp. Nous avons étudié le rôle pathogène de la voie OX40/OX40L chez les patients SJp. Notre résultats ont montrés une surexpression d’OX40L et d’OX40 dans les glandes salivaires des patients atteint de SJp. Les cocultures des LTn avec les SS SGECs ou contrôle SGECs augmentent l'expression d’OX40 par les LT. Les SS SGECs favorisent la survie et la prolifération des LT via la voie d’OX40/OX40L. Ces résultats démontrent l'implication d’OX40 et d’OX40L dans la pathogénie du SJp et confirment le rôle important des SGECs dans l’épithelite auto-immune du SJp. / The primary Sjögren's syndrome (pSS) is an autoimmune disease characterized by dry mouth and dry eyes. Salivary gland epithelial cells (SGECs) of patients with pSS express the molecules involved in immune responses and act as antigen presenting cells. Follicular helper T cells (Tfh) secrete IL-21 whose augmented secretion is a hallmark of several autoimmunediseases. Here we investigated whether SGECs were capable to induce Tfh differentiation. We report that IL-6 and ICOSL expression by SGECs contributes to naïve CD4+ T differentiation into Tfh cells, as evidenced by their acquisition of a specific phenotype, characterized by Bcl-6, ICOS and CXCR5 expression and IL-21 secretion, but also but by their main functional feature: the capacity to enhance B lymphocytes survival. OX40/OX40L interaction is a pivotal costimulatory pathway. Polymorphisms of OX40L are involved in the genetic predisposition to pSS. We therefore investigated the pathogenic role of OX40/OX40L pathway in pSS. We demonstrated that the proportion of circulating CD4+ T cells expressing OX40 was elevated in patients with pSS and correlated with systemic disease activity. In salivary glands of patients with pSS, epithelial cells overexpressed OX40L and the expression of OX40L and OX40 was respectively evidenced on infiltrating B and T cells. Coculture of T cells with SGECs increased the expression of OX40 by CD4+ T cells promoted T cell survival and proliferation through OX40/OX40L interaction. These studies demonstrate emphasizes unknown pathogenic roles of SGECs and suggests that Tfh, IL-21 and OX40L might be therapeutic targets in pSS.

Les lymphomes B sont des cancers du système lymphatique se développant à partir des cellules B. Il devient évident que le développement des cellules B malignes dépend d’interactions avec les cellules immunes dans leur microenvironnement. Nous avons étudié la caractérisation des lymphocytes T intra tumoraux afin de comprendre leur contribution dans la lymphomagenèse et leur potentiel thérapeutique dans les lymphomes B comme le lymphome diffus à grandes cellules B (DLBCL), le lymphome folliculaire (FL) et le lymphome Hodgkinien classique (cHL)Nous avons mis en évidence une différence importante, quantitative et qualitative, entre la composition immunitaire de différents lymphomes B, notamment au niveau des lymphocytes T intra tumoraux. Le FL se caractérise par une accumulation des lymphocytes T régulateurs (Tregs) exprimant ICOS, pouvant supprimer les cellules B lymphomateuses. La génération des Tregs ICOS+ est favorisée par le contact avec les cellules B lymphomateuses exprimant ICOSL. Quant à lui, le DLBCL a beaucoup de lymphocytes TCD8 coexprimant PD1 et TIM3 possédant un état de dysfonctionnement dit « épuisement », lymphocytes dont la proportion est corrélée à leur niveau de dysfonctionnement et à leur capacité de réponse au blocage des récepteurs inhibiteurs. Enfin, dans certains lymphomes B, en particulier le cHL, nous avons découvert une sous population de TCD8, dite « TFH-like » pour leur similarité phénotypique et fonctionnelle avec les lymphocytes T auxiliaires folliculaires (TFH). Ces données indiquent l’hétérogénéité des composants immunitaires entre différents lymphomes B et sont une piste pour une future thérapie ciblée dans le traitement du lymphome. / B-cell lymphomas represent a heterogeneous group of cancers that affect B cells in the lymphatic system. It has become evidence that malignant B cells depend on various interactions with microenvironmental immune cells for their development. Our study focuses on characterization of intra-tumoral T cells in order to understand their contribution in pathogenesis and their therapeutic potentials in the most frequent B cell-lymphoma such as Diffuse large B-cell lymphoma (DLBCL), Follicular lymphoma (FL) and classical Hodgkin lymphoma (cHL).During this work, we have demonstrated a significant quantitative and qualitative difference between different B-cell lymphoma immune composition, especially between their intra-tumoral T cells. FL is characterized by the accumulation of regulatory T cells (Tregs) expressing ICOS, with ability to suppress lymphoma B cells. Generation of Tregs ICOS+ is prompted by cell contact with the lymphoma B cells expressing ICOSL. On the other hand, DLBCL have high level of TCD8 coexpressing PD1 and TIM3 displaying an exhaustion state, which proportion is correlated with their dysfunction level and with their responsiveness to inhibitor receptors blockade. Finally, in some B-cell lymphoma cases, especially cHL, we found the existence of a TCD8 subset, called TFH-like due to their phenotypic and functional similarity with follicular helper T cells (TFH).These data show heterogeneity of immune components between the different B lymphomas, and give opportunity for targeted therapy in lymphoma treatment

CAR-T-Zell-Therapie ist eine vielversprechende neuartige Behandlungsform für Patienten mit aggressiven B-Zell Non-Hodgkin-Lymphomen (B-NHL). In dieser Arbeit wurde die anti-CXCR5 CAR-T-Zell-Therapie als Alternative zur anti-CD19 CAR-T-Zell-Therapie für die Behandlung von reifen B-NHLs untersucht. CXCR5 ist ein B-Zell-homing Rezeptor, der von reifen B Zellen und follikulären T-Helferzellen (TFH Zellen) exprimiert wird. TFH Zellen wurden als tumor-unterstützend in chronisch lymphatischer Leukämie (CLL) und im follikulären Lymphom (FL) beschrieben. Dieses Expressionsmuster erlaubt es, auf einzigartige Weise zeitgleich die malignen Zellen und die tumorunterstützende Mikroumgebung mithilfe von CAR-T-Zell-Therapie gerichtet gegen einen Chemokinrezeptor anzugreifen. Die wichtigsten Ergebnisse dieser Arbeit waren, dass (1) die anti-CXCR5 CAR T-Zellen zielgerichtet CXCR5 positive reife B-NHL Zelllinien und Patientenproben in vitro eliminierten und eine starke anti-Tumor Reaktivität in einem immundefizienten Xenotransplantationsmausmodell zeigten, (2) die anti-CXCR5 CAR T-Zellen zielgerichtet die tumorunterstützenden TFH Zellen in CLL und FL Patientenproben in vitro erkannten und dass (3) CXCR5 ein sicheres Expressionsprofil zeigte. CXCR5 war stark und häufig auf B-NHL exprimiert und die Expression auf gesundem Gewebe war auf lymphoide Zellen beschränkt. Zusammenfassend lässt sich sagen, dass die anti-CXCR5 CAR-T-Zell-Therapie eine neue Behandlungsmöglichkeit für Patienten mit reifen B-NHL darstellt, indem durch die anti-CXCR5 CAR-T Zellen sowohl der Tumor als auch ein Anteil der tumorunterstützende Mikroumgebung eliminiert werden. Im zweiten Teil der Arbeit wurde das Eμ-Tcl1 murine CLL Lymphommodell genutzt um die Auswirkung der Lymphomentwicklung auf die CXCR5+ T Zellen zu untersuchen. Mittels RNA-Einzelzell-Sequenzierung konnte ein profunder Einfluss des Lymphomwachstums auf das T Zell-Kompartiment der Mäuse, denen Eμ-Tcl1 Zellen gespritzt wurden, gezeigt werden. / CAR T cell therapy is a promising new treatment option for patients suffering from aggressive B non-Hodgkin lymphomas (NHLs). In CAR T cell therapy, patient-derived T cells are genetically modified to express a chimeric receptor commonly directed towards a surface antigen expressed by neoplastic cells. In this thesis, anti-CXCR5 CAR T cell therapy was investigated as an alternative to anti-CD19 CAR T cell therapy for the treatment of mature B-NHLs. CXCR5 is a B cell homing receptor expressed by mature B cells and follicular helper T (TFH) cells. TFH cells were described to support the tumor cells in chronic lymphocytic leukemia (CLL) and follicular lymphoma (FL). This expression pattern allows simultaneous targeting of the malignant cells and the tumor-supporting microenvironment by CAR T cell therapy against a chemokine receptor in an unprecedented manner. Main findings included that (1) anti-CXCR5 CAR T cells targeted specifically CXCR5 expressing mature B-NHL cell lines and patient samples in vitro and showed strong in vivo anti-tumor reactivity in an immunodeficient xenograft mouse model, (2) anti-CXCR5 CAR T cells targeted tumor-supportive TFH cells derived from CLL and FL patient samples in vitro and (3) CXCR5 showed a safe expression profile. CXCR5 was strongly and frequently expressed by B-NHLs and its expression on healthy tissue was restricted to lymphoid cells. In summary, anti-CXCR5 CAR T cell therapy presents a novel treatment option for patients suffering from mature B-NHLs by eliminating the tumor and part of the tumor-supportive microenvironment. The second part of the project, the Eμ-Tcl1 murine lymphoma model, which mimics human CLL, was used to study the impact of lymphomagenesis on CXCR5+ T cells. Using single cell RNA sequencing, a profound influence of lymphoma growth on the T cell compartment in Eμ-Tcl1 tumor-challenged mice could be shown.