Les nouveaux immunosuppresseurs utilisés en transplantation rénale depuis le début des années 2000 :mycophenolate mofetil (MMF), tacrolimus, Neoral (nouvelle formulation de la cyclosporine-Sandimmun) et les inhibiteurs du mTOR ont amélioré le contrôle du risque de rejet, ainsi que la survie du greffon. Ces progrès sont contrebalancés par un risque accru d’infections. Nous avons évalué l'impact des nouveaux immunosuppresseurs sur les défenses humorales anti-infectieuses en 2 parties. Pour la première partie, nous avons étudié les réponses humorales primaires contre des antigènes protéiques. La 1ère étude montre que les réponses après l’administration d’un anticorps monoclonal anti-CD3 (OKT3) en induction sont profondément et additionnellement inhibées par le MMF comparé à l'AZA, et par le Neoral comparé au Sandimmun, ce qui empêche la neutralisation de ce puissant immunosuppresseur. La 2ème étude analyse les réponses au vaccin adjuvanté contre l’influenza H1N1 pandémique de 2009. Seuls 44% des transplantés rénaux ont développé une séroconversion, contre 57% de patients hémodialysés et 90% de contrôles sains. Nous observons aussi que le MMF limite l’augmentation des titres d’anticorps après vaccination par rapport à l’AZA. <p>Pour la seconde partie, nous observons l’évolution de composants de l’immunité humorale et innée au cours de la 1ère année de greffe. La 3ème étude montre que l’incidence de l’hypogammaglobulinémie atteint 45% à 3 mois de greffe, et est encore de 30% à 1 an. Les taux de MBP diminuent progressivement ce qui augmente le risque de sepsis et d’infection virale (CMV), tandis que l’hypogammaglobulinémie combinée :IgG + [IgA ou IgM] est corrélée avec une incidence élevée d’infections précoces (86%, RR :2, P=0.048), surtout d’origine respiratoire. La 4ème étude, indique que les immunosuppresseurs diminuent intensément les titres en Ac spécifiques induits avant la greffe :les Ac anti-pneumococciques, de nature polysaccharidique (Ac T-indépendants) et surtout les Ac anti-Anatoxine tétanique, de nature protéique (Ac T-dépendants). L’ensemble de notre observation conclut que les immunosuppresseurs actuels, et plus particulièrement le Mycophenolate diminuent fortement la production et le maintien des immunoglobulines, et ont un impact infectieux important. Il en découle que les stratégies de vaccination recommandées méritent d'être appliquées et que la vigilance à l'égard des pathogènes doit être implémentée. <p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

Magister Scientiae - MSc / This study shows that herbs can be effectively screened for potiential bio-activity using in vitro methods. Further studies will be needed to better explore Artemisia afra&rsquo;s effect on immunoregulation, particularly long term effects of the herb on the immune system and its effect on other disease states. / South Africa

La réponse humorale aux antigènes (Ag) thymo-indépendants (TI) tels que les polysaccharides (PS) bactériens ne nécessite pas l’intervention des lymphocytes T mais requiert un dialogue entre lymphocytes B et cellules présentatrices d’Ag (APC). La singularité des Ag TI est qu’ils peuvent générer une réponse anticorps (Ac) in vivo en l’absence de signal danger exogène. Nous avons postulé que les PS bactériens sont capables d’induire un état de compétence des APC leur permettant d’exercer leur fonction auxiliaire vis à vis de la différenciation des lymphocytes B induite par les Ag TI. Notre travail a consisté, d’une part, à identifier la nature de l’APC et à documenter l’état de compétence des APC induit par un PS capsulaire d’une souche de pneumocoque (PS3). Nos résultats montrent que les macrophages et les cellules dendritiques peuvent tous deux exercer une fonction auxiliaire vis-à-vis de la réponse Ac aux Ag TI via la sécrétion de deux cytokines, BAFF et APRIL. Nos données montrent également que ce PS bactérien inhibe différentes réponses impliquant les cellules T (réponse humorale à un Ag thymo-dépendant, hypersensibilité retardée induite par un haptène fort). L’analyse phénotypique et fonctionnelle de cellules dendritiques exposées au PS3 nous conduit à proposer que le PS induit la différenciation des cellules dendritiques en cellules tolérogènes. L’ensemble de nos données suggèrent que l’état de compétence des APCs liée à leur fonction auxiliaire dans la réponse Ac aux Ag TI est équivalent à la fonction tolérogène, déjà documentée dans la littérature. Cette dualité des APCs induite par le PS (stimulatrices vis à vis de la réponse Ac, tolérogènes vis à vis des réponses cellulaires) pourrait jouer un rôle physiologique important au niveau de la muqueuse intestinale. / The humoral immune response against thymus-independent (TI) antigens (Ag) such as bacterial capsular polysaccharides (PS) does not require the help from T lymphocytes but needs a dialog between B cells and antigen presenting cells (APC). The particularity of TI Ag is their ability to generate an antibody response in vivo in the absence of exogenous danger signals. We have postulated that bacterial PS induce a competence status of the APC enabling them to act as auxiliary cells towards the B cells differentiation induced by TI Ag. In the present study, we have indentified the nature of the APC and explored the competence status induced by a capsular PS from S. pneumoniae (PS3). Our results show that both macrophages and dendritic cells (DC) can exert an auxiliary function towards the humoral response to TI Ag by secreting two major cytokines, BAFF and APRIL. We have also shown that bacterial PS suppress different responses involving T cells as humoral response to a thymus-dependent Ag and delayed hyper-sensitivity induced by a potent hapten. The phenotypical and functional analysis of DC exposed to PS3 led us to postulate that PS induces the differentiation of DC into tolerogenic cells. Altogether our findings suggest that the APC’s competence status enabling them to provide help to B cells against TI Ag is their tolerogenic function. This double function of the APC induced by PS (stimulatory towards antibody response and tolerogenic towards cellular responses) could be important in the intestinal mucosal sites.

Magister Scientiae - MSc / "The aim of the study was to use in vitro human whole blood cultures to screen the water samples collected from the Eerste/Plankenbrug river system for cytotoxicity and inflammatory activity and for the first time investigate the impact on the cell- mediated and humoral immune pathways. Water samples were collected fronm the sites during the dry summer season and rainy winter season. Blood was collected from the healthy male volunteers and diluted with RPMI 1640. For cytotoxicity and inflammatory activity 2.5ul of blood for 18-20 hrs at 37 C... This study shows that waster from the Plankenbrug River is heavily polluted by contaminants from both the agricultural area and informal settlement of Kayamandi. These contaminants can be potentially immunotoxic during the summer season and they can result in inflammatory diarrheal disease and immunosuppression in exposed individuals..."

Les lymphocytes B (LB) et les plasmocytes (PC) émergent comme des cellules importantes dans la surveillance immunitaire des tumeurs, même si leur rôle pro- ou anti-tumoral reste activement débattu. Nous avons émis l’hypothèse que cette dualité fonctionnelle de la réponse B pourrait être dictée par l'identité des sous-populations de LB infiltrant la tumeur et/ou par la nature des anticorps (Ac) qu’ils produisent. Dans ce contexte, nous avons montré que les tumeurs du sein et de l’ovaire sont souvent infiltrées par des LB mémoires et des PC exprimant/produisant principalement des IgG ou des IgA. Les IgA sont fortement enrichis dans les tumeurs mammaires in situ, plus précoces, et dans 15-20% des tumeurs invasives, suggérant un rôle différentiel des IgG et des IgA dans la progression tumorale. Les IgA, pouvant être monomériques ou dimériques dans les tumeurs, ciblent en général des antigènes (Ags) différents de ceux des IgG. Nous montrons de plus que les Ags ciblés par les IgA et les IgG sont souvent impliqués dans des fonctions de développement des tissus et d’interaction avec l’ADN, et sont parfois partagés entre patients et entre les types de tumeurs, suggérant leur importance dans la réponse anti-tumorale. En parallèle, grâce à l’étude des tumeurs de patientes souffrant d’un syndrome neurologique paranéoplasique, nous avons pu montrer que l’induction concomitante de PC à IgG et de LT CD8+ cytotoxiques dans la tumeur était liée à des amplifications et/ou des mutations dans les gènes des Ags tumoraux. Ces résultats mettent en évidence l’important des LB et des Ig dans la réponse anti-tumoral, et ouvre des pistes pour rechercher des cibles thérapeutiques en immunothérapie / B and plasma cells are rising as crucial cells in the immune surveillance of tumors, even though their pro- or anti-tumor role is still debated. We argue that this dual functionality of B cells could depend on the identity of tumor-infiltrating B cell subsets and/or by the nature of the antibodies they produce. With that knowledge, we showed that breast and ovarian tumors are usually infiltrated by memory B cells and plasma cells that express and/or produce mainly IgG or IgA. This last class of Ig in highly enriched in in situ carcinomas of the breast, corresponding to earlier tumors, and in 15-20% of invasive tumors, suggesting a differential role of IgG and IgA in tumor progression. IgA, that can be monomeric or dimeric in tumors, often target antigens that differ from those targeted by IgG. We also show that antigens targeted by IgA and IgG in the tumor are often involved in functions related to the development of tissues and DNA interactions, and can be share amongst patients and between breast and ovarian tumors, suggesting their importance in the anti-tumor immune response. In parallel, using tumors from patients suffering from a paraneoplastic neurological syndrome, we established that the concomitant induction of IgG PC and CD8+ cytotoxic T cells in the tumor is associated wth amplifications and/or mutations in the genes of tumor antigens. These results highlight the importance of B cells and Ig in the anti-tumor immune response and give leads to look for new targets in immunotherapy

Pim (Provirus Integration site for Moloney murine leukemia virus) kinases are a family of three serine/threonine kinases involved in cell cycle, survival and metabolism. These kinases were first identified in malignant cells and are most often associated with their role in cancer. Their role in immunity and lymphocytes is less well known. To date, it has been shown that Pim 1 and/or Pim 2 are important for T lymphocyte survival and activation when the Akt signaling pathway is inhibited by rapamycin. In addition, our laboratory has shown that Pim 2 is critical for BLyS-mediated naive B lymphocyte survival in the presence of rapamycin. This thesis extends the role(s) for Pim 1 and/or 2 to include functions during B cell activation and the generation of immune responses. We found that during in vitro activation of purified resting splenic B cells from wild type mice with a variety of activators that use multiple signaling pathways, including the BCR, TLR and CD40 receptors, both Pim 1 and 2 kinases were induced by 48 hours post-activation, suggesting that they could play a role in B cell activation and differentiation to antibody secreting or memory B cells. Immunization of Pim 1-/-2-/- knockout mice with T cell dependent antigens showed impairment in antibody and antibody secreting cell generation as well as lack of germinal center formation clearly demonstrating an involvement of Pim 1 and/or 2 in the immune response. FACS examination of B cell populations from naive Pim 1-/-2-/- knockout mice revealed normal levels of splenic marginal zone and follicular B cells and T cells, however, decreased numbers of all peritoneal B cell populations and decreased B cells in Peyer's Patches was seen. An examination of serum antibody found in naive Pim 1-/-2-/- knockout mice showed decreased levels of natural antibody, which is likely due to loss of the peritoneal B1 cells but does not explain the significantly decreased TD immune response. To determine whether the defect was B cell intrinsic or a more complex interaction between B and T cells, we determined whether Pim 1-/-2-/- mice would respond to T cell independent, TI-1 and TI-2, antigens. Antibody production and antibody secreting cell formation were also significantly decreased in these mice supporting our notion of a B cell intrinsic defect. To further examine the B cell response problem, we attempted to establish chimeric mice using either bone marrow derived cells or fetal liver cells from WT or Pim 1-/-2-/- donors so that the B cells were derived from Pim 1-/-2-/- mice and the T cells would be WT. Unfortunately, we were not able to consistently engraft and develop mature Pim 1-/-2-/- B cells, which indicate that there is a stem cell defect in these knockout mice that requires further investigation. Because one of the major failures in activated Pim 1-/-2-/- B cells is the generation of antibody secreting cells, an analysis of the expression of transcription factors IRF-4 and BLIMP-1, known to play a role in this process was carried out. Although IRF-4 induction was not affected by the loss of Pim 1 and 2, the number of cells able to increase BLIMP-1 expression was significantly decreased, revealing a partial block in the generation of ASCs. Taken together the data presented in this thesis reveals a new and critical role for Pim 1 and 2 kinases in the humoral immune response.

Soybean oil (SBO), menhaden fish oil (FO), chicken fat (CF) or hydrogenated soybean oil (HSBO) were incorporated at 5% of the total diet to study changes in the immunological status of both Japanese quail (JAP) and Bobwhite quail (BOB). The SBO diet, in which 66% of the total fatty acids were polyunsaturated fatty acids (PUFA), was rich in linoleic acid (LA 18:2 n-6), alpha-linolenic acid (ALA 18:3 n-3) and low in saturated fatty acid (SFA). The FO diet which contained about 50% PUFA, had only 40% n-6 fatty acids and 8% n-3 PUFA. The trans fatty acid isomers and other monounsaturated fatty acids (MUFA) were high in the HSBO diet. The diet containing CF provided a relatively balanced fatty acid composition with 18% SFA, 31% MUFA and 50% PUFA. Plasma fatty acid and hepatic fatty acid profiles consistently reflected their respective dietary lipid treatments. There were no differences in the fatty acid profile between blood and liver within respective dietary treatments in the two species. Dietary fatty acids had no effect on antibody titers against sheep red blood cells (SRBC) at 1, 2 and 8 months following the start of dietary lipid treatment in JAP. However, female JAP fed FO had a significantly (p< 0.05) higher antibody production compared to the other dietary lipid treatments at 4 months following the start of fatty acids supplementation. BOB fed either FO or SBO diets had a higher immunoglobulin G production compared to birds fed the CF diet. The total antibody titer was significantly higher in BOB fed SBO compared to CF. Dietary fatty acids had a significant effect on cell-mediated immunity (CMI) as accessed by toe web thickness 24 hours post intradermal injection of phytohemagglutinin-P (PHA) in both JAP and BOB. In general, birds fed a FO diet had a significantly higher CMI response than those fed HSBO. A diet high in n-3 PUFA increased the index of cutaneous basophil hypersensitivity (CBH), while the high trans fatty acid isomers suppressed the CBH response. By observing a CBH response over a 72-hour period in JAP, it was concluded that quail fed CF or SBO had a different peak response time (12 hours post PHA challenge) and amplitude compared with those fed FO or HSBO (24 hours post PHA challenge). Phagocytic ability was not affected by dietary lipid treatments in BOB while the quail fed FO diet had a faster carbon clearance rate. The FO fed JAP had a significantly higher response (p< 0.05) to concanavalin A ensiformis (CONA) compared to HSBO fed birds. There was no difference in B lymphocyte proliferation stimulated by lipopolysacchride (LPS) in female JAP, whereas it was significantly higher in male JAP fed SBO compared to those fed FO and HSBO. Phorbol 12-myristate 13-acetate/ionomycin calcium salt (PMA/ION) was used to nonspecifically stimulate cell proliferation by increasing chromosome mitosis. Dietary FO or HSBO suppressed cell proliferation stimulated by PMA/ION. However, JAP fed SBO or CF had a significantly higher PMA/ION stimulated lymphocyte proliferation compared those fed FO or HSBO. In male BOB, the FO fed birds had the highest response to all mitogens. In contrast, female BOB did not show any dietary effects by lymphocyte proliferation. Consistent with JAP, BOB fed HSBO had depressed lymphocytes proliferation in response to various mitogens stimulation. In general, female birds had a higher plasma total protein (PTP) and lower pack cell volume (PCV) compared to their males counterparts in both BOB and JAP. In summary, in in vivo experiments, feeding a diet high in menhaden fish oil that is rich in n-3 PUFA enhanced the CMI. There was a minimal effect on antibody production caused by feeding n-3 PUFA in JAP since a significant treatment effect was only found at one sampling period, while BOB were more sensitive to dietary lipid manipulation and had a higher antibody production with SBO or FO treatments. Dietary lipids exerted different effects in the two species in in vitro experiments. While both BOB and JAP fed FO had higher lymphocyte proliferation to CON A mitogen compared to those fed HSBO, only male BOB showed a higher proliferation to LPS. Feeding HSBO that contained a higher content of trans fatty acid isomers, MUFA, but lower PUFA content resulted in the lowest lymphocyte proliferation to various mitogens in both BOB and JAP. / Ph. D.

Importance: Immunological response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is important, especially in people with multiple sclerosis (pwMS) on immunosuppressive therapies. Objective: This study aims to determine whether adjuvanted protein-based vaccine NVX-CoV2373 is able to induce an immune response to SARS-CoV-2 in pwMS with inadequate responses to prior triple mRNA/viral vector vaccination. Design, setting, and participants: We conducted a single-center, prospective longitudinal cohort study at the MS Center in Dresden, Germany. In total, 65 participants were included in the study in accordance with the following eligibility criteria: age > 18 years, immunomodulatory treatment, and insufficient T-cellular and humoral response to prior vaccination with at least two doses of SARS-CoV-2 mRNA (BNT162b2, mRNA-1273) or viral vector vaccines (AZD1222, Ad26.COV2.S). Interventions: Intramuscular vaccination with two doses of NVX-CoV2373 at baseline and 3 weeks of follow-up. Main outcomes and measures: The development of SARS-CoV-2-specific antibodies and T-cell responses was evaluated. Results: For the final analysis, data from 47 patients on stable treatment with sphingosine-1-phosphate receptor (S1PR) modulators and 17 on ocrelizumab were available. The tolerability of the NVX-CoV2373 vaccination was overall good and comparable to the one reported for the general population. After the second NVX-CoV2373 vaccination, 59% of S1PR-modulated patients developed antispike IgG antibodies above the predefined cutoff of 200 binding antibody units (BAU)/ml (mean, 1,204.37 [95% CI, 693.15, 2,092.65] BAU/ml), whereas no clinically significant T-cell response was found. In the subgroup of the patients on ocrelizumab treatment, 23.5% developed antispike IgG > 200 BAU/ml (mean, 116.3 [95% CI, 47.04, 287.51] BAU/ml) and 53% showed positive spike-specific T-cellular responses (IFN-gamma release to antigen 1: mean, 0.2 [95% CI, 0.11, 0.31] IU/ml; antigen 2: mean, 0.24 [95% CI, 0.14, 0.37]) after the second vaccination. Conclusions: Vaccination with two doses of NVX-CoV2373 was able to elicit a SARS-CoV-2-specific immune response in pwMS lacking adequate immune responses to previous mRNA/viral vector vaccination. For patients receiving S1PR modulators, an increase in anti-SARS-CoV-2 IgG antibodies was detected after NVX-CoV2373 vaccination, whereas in ocrelizumab-treated patients, the increase of antiviral T-cell responses was more pronounced. Our data may impact clinical decision-making by influencing the preference for NVX-CoV2373 vaccination in pwMS receiving treatment with S1PR modulation or anti-CD20 treatment.

Hintergrund: Die chronisch obstruktive Lungenerkrankung (COPD) ist eine der Haupttodesursachen weltweit. Eine gesteigerte Aktivität des sympathischen Nervensystems wird als wesentlicher pathophysiologischer Aspekt vermutet. Grundsätze: Die vorliegende Arbeit untersuchte die muskelsympathische Nervenaktivität (MSNA) und die Baroreflex-Sensitivität bei COPD-Patienten und gesunden Probanden in Ruhe sowie unter moderater körperlicher Belastung. Ergebnisse: COPD-Patienten zeigten in Ruhe eine signifikant gesteigerte MSNA sowie eine signifikant verminderte Baroreflex-Sensitivität. Diese Ergebnisse bestätigen die Resultate vorausgegangener Publikationen der Arbeitsgruppe. In der vorliegenden Arbeit konnte erstmals ein signifikanter Anstieg der MSNA unter moderater statischer Belastung bei COPD-Patienten nachgewiesen werden. Fazit: In der vorliegenden Arbeit konnte erstmals eine Korrelation zwischen sympatho-vagaler Imbalance und verminderter körperlicher Leistungsfähigkeit bei COPD-Patienten nachgewiesen werden. Eine Modifikation der neuro-humoralen Aktivität bei COPD-Patienten könnte in Zukunft eine Rolle in der Behandlung der COPD spielen und sollte in größeren, randomisierten Studien untersucht werden.

Malaria, caused by the apicomplexan parasite Plasmodium, is a major cause of morbidity and mortality throughout the world. This study has focused on the role of the spleen in the control of the blood stage of infection. Three aspects have been examined specifically: the effect of infection on the architecture of the spleen, the role of the spleen in parasite clearance and the formation of B cell memory. Firstly, the effect of infection on the splenic microarchitecture was examined. An essential component of the splenic architecture is the marginal zone (MZ), an area of the spleen that separates the reticuloendothelial red pulp of the spleen from the lymphoid white pulp compartment. Two unique populations of macrophages are found in the marginal zone: marginal zone macrophages (MZM) and marginal metallophilic macrophages (MMM). In the current study, parasitised red blood cells (pRBC) as well as normal RBC located to the MZ thirty minutes after intravenous injection and formed close associations with both MMM and MZM. Eight days after infection, at the time of peak parasitemia, a complete loss of both MMM and MZM was observed. Assays to detect cell death revealed that the loss of both MMM and MZM appeared to occur as a result of apoptosis. The apoptosis was not induced by up regulation of the inflammatory cytokines tumour necrosis factor or interferon-γ and could not be blocked by over expression of the apoptosis inhibitor Bcl2. Significantly, MMM were retained in the absence of CD8+ T cells implicating CD8+ T cells in the loss of MMM. Finally, infection of CD95-/- mice demonstrated that CD95/CD95-ligand (Fas/Fas-ligand) interactions were responsible for some of the CD8+ T cell-mediated loss of MMM. These data provide evidence for a novel interaction between MMM and CD8+ T cellsfollowing infection with Plasmodium. Secondly, the role of the spleen in the control of parasitemia and disease was monitored with an emphasis on determining the role of splenic macrophage populations (MMM, MZM and red pulp macrophages [RPM]) in parasite clearance. A clodronate liposome-mediated macrophage depletion technique was used, and caused a complete loss of all three macrophage sub-populations, as well as 50% of splenic dendritic cells, within 24 hours of administration. Each of the macrophage populations, as well as splenic DC, demonstrated different repopulation kinetics following their depletion from the spleen and these kinetics were utilised to examine each cell population in isolation. RPM depleted mice had significantly higher peak parasitemias than the controls. This peak returned to the level observed in undepleted control animals only after the repopulation of RPM was complete, suggesting that RPM play a role in the control of peak parasitemia following infection. Neither MMM nor MZM played a role in the control of parasitemia. The role of non-splenic macrophages and splenic dendritic cells also was investigated and shown to be insignificant in the absence of splenic macrophages. Finally, the role of RPM in mice immune to infection was investigated and their role shown to be dispensable, with immune mice clearing parasitemia efficiently in the absence of RPM. RPM therefore are important for the innate control of infection with P. chabaudi but are dispensible once adaptive immunity is established. Finally, the role of the spleen in the development of parasite-specific B cell memory was examined. Initial studies demonstrated that germinal centre (GC) development was compromised following infection with P. chabaudi, with an involution of B cell follicles noted early in infection. Adoptive transfer of memory B cells from immunised to naïve mice demonstrated that some protection was conferred on recipient mice by parasite-specific memory B cells. But, the memory B cells could not protect the host from developing parasitemia and did not produce significant amounts of parasite-specific immunoglobulin within seven days of challenge infection. Memory B cells could not be detected ten weeks after infection, indicating that the development, or survival, of parasite-specific memory B cells was compromised. The development of bystander memory B cells was not affected by infection. Finally, long-lived plasma cells were shown to develop in response to infection, although re-exposure of the cells to parasites in the form of recrudescent parasitemia resulted in their loss. This study therefore has identified a defect in the development of long-term, B cell-mediated, protection against infection with P. chabaudi. Each of these factors has significant implications for the understanding of how the spleen contributes to the control of infection with Plasmodium and potential applications for the further development of malaria vaccines and treatment regimens.