This Ph.D. dissertation examined the effects of bacterial DNA on immune surveillance in ovine lymph nodes (LN). The first study identified long-term changes in lymph nodes following exposure to plasmid DNA. Treated lymph nodes were heavier and had larger medullary areas. Furthermore, medullary cord thickness and medullary sinus width as well as germinal center size and number were increased in plasmid treated lymph nodes.<p>To determine whether bacterial DNA altered cell trafficking through lymph nodes, the efferent lymphatic of the prescapular LN of sheep was cannulated and cells were collected. Intradermal injection of as little as 4 ìg of plasmid DNA expressing the green fluorescent protein of jellyfish (eGFP) caused a marked increase in the cell trafficking through the prescapular lymph node. A dose-dependent facet existed for this response, as the increase in cell trafficking response persisted longer with 40 ìg or 400 ìg of plasmid-eGFP than with 4 ìg. This increased cell trafficking was independent of green fluorescent protein expression as both pCAN1-eGFP and pCAN1 induced similar responses.<p>Increased cell traffic induced by bacterial DNA was further characterized by determining whether bacterial DNA form was critical for this response. Treatment with intact plasmid (circular) DNA induced the greatest increase in cell traffic. In contrast, when plasmid DNA was digested with restriction enzymes into linear fragments of DNA, then cell trafficking was not significantly increased. <p>Numerous studies have shown that immunostimulatory guanosine-cytosine (CpG) motifs activate cells in vitro and can improve protective immune responses in vivo . Therefore we tested the hypothesis that the presence of immunostimulatory CpG motifs within plasmids was responsible for altering cell trafficking. It was shown that plasmids with added immunostimulatory CpG sequences affected cell trafficking in a dose-dependent manner. The injection of 40 ìg of pBISIA-88 caused an increase in cell trafficking while injecting 400 ìg pBISIA-88 failed to increase cell flow above control levels.<p>Analysis of cell populations collected in efferent lymph gives insight into treatment effects on immune surveillance. This is well-studied following treatment with antigen and in general, antigen induces a selective movement of cells into lymph that occurs 24 hours post-treatment. In contrast, plasmid DNA induced a rapid, non-selective movement of lymphocytes through the lymph node, suggesting that bacterial DNA and antigen may affect cell trafficking by different mechanisms and thereby have distinct effects on immune surveillance.<p>Short-term effects of bacterial DNA on lymph node architecture and cellular composition were also investigated to determine whether an increase in cell trafficking was associated with structural changes within the lymph node. While it was shown that bacterial DNA induced changes within a lymph node, including and increased number of germinal centers and an increased frequency of CD72*CD21* B cells, these changes were not correlated to increased cell trafficking.<p>In summary, bacterial DNA altered immune surveillance in sheep lymph nodes by changing cell traffic and lymph node architecture and composition. Many of these responses differed from responses observed by others following antigen treatment. The present observations suggest that bacterial DNA can function as an important signal to modulate immune surveillance and host responses to infections by pathogens.

This Ph.D. dissertation examined the effects of bacterial DNA on immune surveillance in ovine lymph nodes (LN). The first study identified long-term changes in lymph nodes following exposure to plasmid DNA. Treated lymph nodes were heavier and had larger medullary areas. Furthermore, medullary cord thickness and medullary sinus width as well as germinal center size and number were increased in plasmid treated lymph nodes.<p>To determine whether bacterial DNA altered cell trafficking through lymph nodes, the efferent lymphatic of the prescapular LN of sheep was cannulated and cells were collected. Intradermal injection of as little as 4 ìg of plasmid DNA expressing the green fluorescent protein of jellyfish (eGFP) caused a marked increase in the cell trafficking through the prescapular lymph node. A dose-dependent facet existed for this response, as the increase in cell trafficking response persisted longer with 40 ìg or 400 ìg of plasmid-eGFP than with 4 ìg. This increased cell trafficking was independent of green fluorescent protein expression as both pCAN1-eGFP and pCAN1 induced similar responses.<p>Increased cell traffic induced by bacterial DNA was further characterized by determining whether bacterial DNA form was critical for this response. Treatment with intact plasmid (circular) DNA induced the greatest increase in cell traffic. In contrast, when plasmid DNA was digested with restriction enzymes into linear fragments of DNA, then cell trafficking was not significantly increased. <p>Numerous studies have shown that immunostimulatory guanosine-cytosine (CpG) motifs activate cells in vitro and can improve protective immune responses in vivo . Therefore we tested the hypothesis that the presence of immunostimulatory CpG motifs within plasmids was responsible for altering cell trafficking. It was shown that plasmids with added immunostimulatory CpG sequences affected cell trafficking in a dose-dependent manner. The injection of 40 ìg of pBISIA-88 caused an increase in cell trafficking while injecting 400 ìg pBISIA-88 failed to increase cell flow above control levels.<p>Analysis of cell populations collected in efferent lymph gives insight into treatment effects on immune surveillance. This is well-studied following treatment with antigen and in general, antigen induces a selective movement of cells into lymph that occurs 24 hours post-treatment. In contrast, plasmid DNA induced a rapid, non-selective movement of lymphocytes through the lymph node, suggesting that bacterial DNA and antigen may affect cell trafficking by different mechanisms and thereby have distinct effects on immune surveillance.<p>Short-term effects of bacterial DNA on lymph node architecture and cellular composition were also investigated to determine whether an increase in cell trafficking was associated with structural changes within the lymph node. While it was shown that bacterial DNA induced changes within a lymph node, including and increased number of germinal centers and an increased frequency of CD72*CD21* B cells, these changes were not correlated to increased cell trafficking.<p>In summary, bacterial DNA altered immune surveillance in sheep lymph nodes by changing cell traffic and lymph node architecture and composition. Many of these responses differed from responses observed by others following antigen treatment. The present observations suggest that bacterial DNA can function as an important signal to modulate immune surveillance and host responses to infections by pathogens.

Patients can develop malignancies due to various reasons including genetic factors, chemical carcinogens, radiation, and defects in their immune system. The immune system is postulated to carry out routine surveillance for malignancy. Patients who have defective immune responses may be susceptible to malignancies due to complicated underlying mechanisms. These include defective immune response to cancer-causing bacteria, transforming viruses, and concomitant molecular, cellular and immunoregulatory defects. Common variable immune deficiency (CVID) is characterized by hypogammaglobulinemia, impaired antibody responses and an increased susceptibility to infections. A disorderly immune response, or immune dysregulation, may also lead to autoimmune complications and possibly to malignancy. The treatment of CVID involves infusion of replacement doses of immunoglobulin, either intravenously (IGIV) or subcutaneously (SCIG). However, it is unclear whether adequate replacement of immunoglobulins is sufficient to prevent the increased risk of malignancy seen in this disease. We present two cases of unusual solid tumors complicating CVID treated with adequate doses of intravenous immunoglobulins. In this study we review the occurrence of malignancy in patients with CVID and postulate mechanisms that may be involved indigent to this disease. We will also review the role of replacement immunoglobulin and discuss cancer screening in these high risk individuals.

Le lymphome angioimmunoblastique à cellules T (AITL) est un lymphome périphérique à cellules T agressif dont les symptômes sont la lymphadénopathie et l'hypergammaglobulinémie. Actuellement, les patients atteints du AITL ont des options de thérapeutiques limitées et des résultats cliniques défavorables, avec un taux de survie sur 5 ans d'environ 30%. Les cellules tumorales du AITL proviennent de cellules T CD4+ appelées cellules T auxiliaires folliculaires (Tfh). Les cellules Tfh sont essentielles dans le centre germinatif (GC), où elles facilitent l'expansion et la différentiation des cellules B en plasmocytes. Cette fonction d'aide est soutenue par de nombreuses protéines dérivées des cellules Tfh et des programmes de transcription qui pourraient aussi fonctionner dans les cellules tumorales du AITL. Par conséquent, la perturbation des principaux mécanismes de signalisation soutenant l'identité des cellules Tfh et leurs interactions avec les cellules B pourrait inhiber la croissance du AITL. Des études ont démontré que les cellules hyperactives de type Tfh provoquent une accumulation de cellules immunitaires telles que les cellules B, les plasmocytes et les macrophages dans les tumeurs. Cependant, le microenvironnement du AITL n'a pas été bien étudié et il n'a pas été vérifié si certaines cellules immunitaires pourraient être utilisées pour arrêter la croissance de la tumeur. Bien que l’on trouve des cellules Tfh circulantes dans l’AITL humain, le taux de propagation peut varier d’un patient à l’autre. Ainsi, une possibilité est la présence de mécanismes de surveillance immunitaire s'opposant à la progression de la tumeur. En accord avec cette hypothèse, un signal positif pour la phagocytose nommé SLAMF7 (contrebalancé par la voie inhibitrice CD47-SIRPα) est exprimé dans un sous-ensemble de patients atteints du AITL. Toutefois, la corrélation entre les différents niveaux d'expression du SLAMF7 et l'amélioration des résultats pour les patients n'a pas été étudiée. En utilisant des souris Roquinsan/+, qui développent spontanément l’AITL, nous avons étudié le rôle des mécanismes de signalisation immunitaire dans les cellules tumorales de type Tfh et du microenvironnement tumoral. Nous avons cherché à inhiber les protéines et les voies de signalisation typiques des cellules Tfh dans les tumeurs afin d'évaluer la valeur thérapeutique potentielle. Nous avons aussi étudié le rôle de la phagocytose dépendante des macrophages dans le contexte SLAMF7 et comment la modulation de la signalisation de CD47-SIRPα peut améliorer l'efficacité de la phagocytose des cellules tumorales. Notre hypothèse centrale est qu'en supprimant les programmes fondamentaux des cellules Tfh ou en favorisant l'élimination phagocytaire des cellules tumorales de type Tfh, nous pouvons favoriser la régression de la tumeur. Nous avons démontré que les tumeurs AITL nécessitent des protéines d’identité des cellules Tfh essentielles telles que le facteur de transcription Bcl6 et la protéine adaptatrice SAP, ainsi que la communication entre les cellules T et B (T-B). Même en l'absence de GC classiques, les cellules tumorales de type Tfh ont apporté un soutien aux cellules B. Cela est démontré par des titres élevés d'IgG et l'accumulation de cellules précurseurs des plasmocytes dans les tumeurs. Nous avons trouvé des preuves de l'opposition entre la surveillance immunitaire et l'évasion au sein des tumeurs de type AITL, car les cellules Tfh augmentent l’expression de la molécule inhibitrice CD47 tandis que les macrophages stimulent le niveau de SLAMF7. Les cellules de type AITL ont été phagocytées plus efficacement in vitro quand la signalisation du CD47 était bloquée. En résumé, nous démontrons que les voies de signalisation importantes pour l'identité des cellules Tfh et la communication entre les cellules T et B sont essentielles pour la progression de l’AITL et suggèrent qu’une surveillance immunitaire continue par les macrophages peut influencer l’évolution de la maladie. Des études futures pourraient explorer la possibilité de combiner des inhibiteurs de l'activité des cellules Tfh ou T-B avec des médicaments qui stimulent l'activité phagocytaire antitumorale pour améliorer l'efficacité thérapeutique du traitement. / Angioimmunoblastic T cell lymphoma (AITL) is an aggressive peripheral T cell lymphoma manifesting with symptoms such as generalized lymphadenopathy and hypergammaglobulinemia. Currently, AITL patients have limited treatment options and poor clinical outcomes with a 5-year survival rate around 30%. AITL tumor cells derive from a subset of CD4+ T cell, the T follicular helper (Tfh) cell. Tfh cells are essential in germinal centers (GC), where they facilitate B cell expansion and differentiation into plasma cells. This helper function is supported by numerous Tfh cell-derived proteins and transcriptional programs which may still be operational in AITL tumor cells. Therefore, disrupting key signaling mechanisms sustaining Tfh cell identity and their ability to interact with B cells could inhibit AITL tumor growth. Studies have demonstrated that these hyperactive Tfh-like cells lead to the accumulation of immune cell subsets such as B cells, plasma cells, and macrophages within tumor lymph nodes. Nevertheless, the AITL tumor microenvironment itself has not been well-studied and whether some immune cells could be harnessed to impede tumor growth has not been tested. In human AITL, although circulating Tfh cells have been reported, the rate of tumor spreading can vary between patients. As such, one possibility is the presence of immune surveillance mechanisms opposing tumor progression. In line with this idea, SLAMF7, a positive signal for macrophage-mediated phagocytosis (counterbalanced by the inhibitory CD47-SIRPα pathway), is expressed in a subset of AITL patients. Despite this, whether differing levels of SLAMF7 expression correlates with improved patient outcomes has not been investigated. Using Roquinsan/+ mice, a spontaneous AITL-like mouse model, we addressed the role of immune signaling mechanisms within Tfh-like tumor cells and the surrounding tumor microenvironment that would promote tumor regression. First, we aimed to inhibit signature Tfh cell proteins and downstream signaling pathways in developed AITL-like tumors to evaluate potential therapeutic value. Second, we investigated the role of macrophage-mediated phagocytosis in the context of SLAMF7 and how modulating CD47-SIRPα signaling may enhance the efficiency of AITL tumor cell engulfment. Our central hypothesis is that by removing fundamental Tfh cell supporting programs from tumor cells or by promoting the phagocytic removal of Tfh-like tumor cells we can favour tumor regression and impair future growth. Through this work, we demonstrated that AITL-like tumors continuously require critical Tfh cell identity proteins such as transcription factor Bcl6 and adaptor protein SAP, as well as T cell-B cell (T-B) crosstalk. Importantly, despite the absence of conventional GCs, Tfh-like tumor cells provided functional support to B cells as evidenced by elevated IgG titers and accumulation of plasma cell precursors in tumors. We also found evidence of opposition between immune surveillance and evasion within AITL-like tumors as Tfh-like cells upregulated inhibitory CD47 levels while macrophages increased expression of prophagocytic SLAMF7. Moreover, AITL-like tumor cells were more efficiently phagocytosed in vitro when CD47 signaling was blocked. Taken together, we demonstrate that pathways important for Tfh cell identity and T-B communication are critical for AITL-like disease progression and suggest that ongoing macrophage-mediated immune surveillance may influence disease outcomes. Future studies may explore combining inhibitors of Tfh cell activity or T-B crosstalk along with drugs which boost antitumor phagocytic activity to further improve the therapeutic efficacy of treatment.

L’élimination des cellules sénescentes met en jeu le SASP et les cellules immunitaires de l’immunité innée et adaptative tels que les macrophages (Mφ). Dans le cadre de ce projet, nous rapportons que le SASP a un effet pléiotropique sur l’activité des cellules immunitaires incluant leur recrutement, leur activation et leur différenciation. Nos données montrent que les Mφ humains mis en culture avec le SASP de fibroblastes humains développement un profil inflammatoire spécifique au SASP caractérisé par une sécrétion pro-inflammatoire (M1) (ex : IL- 1β, GM-CSF) et des marqueurs de surface anti-inflammatoires (M2) (cellules CD23+CD206+). Le SASP est aussi capable d’augmenter les capacités d’invasion des Mφ, tel que montré via des essais d’invasion, mais n’a pas d’effet sur la différentiation des monocytes. Nos modèles de co- culture montrent que, quoique les cellules NK sont probablement responsables de l’élimination directe et spécifique des cellules sénescentes, leur activité peut être modulée par d’autres cellules immunitaires tels que les Mφ qui réduisent l’élimination faite par les cellules NK, suggérant un profil M2. Les lymphocytes T CD8+ sont aussi essentiels pour l’élimination des cellules sénescentes puisque leur retrait retarde le processus. De plus, nous démontrons que les cellules T CD4+ mises en culture pendant 48h dans le SASP sécrètent de hauts niveaux d’IL-4, indiquant une polarisation Th2. Somme toute, ces données montrent que le SASP peut moduler l’activité des Mφ tout comme celle d’autres cellules immunitaires impliquées dans l’élimination des cellules sénescentes et peut promouvoir, étonnamment, une réponse immunosuppressive pouvant être importante pendant la réparation tissulaire. / Senescent cell clearance brings into play the senescence-associated secretory phenotype (SASP) and immune cells from the innate and adaptive immunity including macrophages (Mφ). In this study, we report that the SASP has a pleiotropic effect on immune cell activity including recruitment, activation and differentiation. We show that human Mφ exposed to the SASP of human fibroblasts develop a SASP-specific inflammatory profile characterized by pro- inflammatory (M1) secretion (e.g. IL-1β, GM-CSF) and anti-inflammatory (M2) surface markers (CD23 and CD206). The SASP also increases Mφ invasion but has no effect on monocyte differentiation. Co-culture models show that while NK cells are likely the direct effectors of senescent cell specific killing, their activity is modulated by other immune cells including Mφ, which reduced NK-mediated killing, suggesting a M2 profile. Alternatively, CD8+ T lymphocytes are essential for senescent cell killing by NK cells. Finally, CD4+ T cells cultured for 48h in the SASP secrete high-levels of IL-4, indicating a Th2 polarization. Overall, our data reveal that the SASP can modulate Mφ and other immune cells involved in senescent cell clearance and surprisingly promote an immunosuppressive response that could be important in tissue repair.