Maintaining energy homeostasis at reduced temperatures is essential for the survival of the organisms. In this diploma thesis, we determined the impact of cold stress and cold adaptation on the rat immune system. A number of different factors participate at the process of thermoregulation, but the adrenergic signalling plays a crucial role. The binding of norepinephrine to β-adrenergic receptors leads to the formation of brown adipose tissue, which is necessary for non-shivering thermogenesis, as well as for energy balance. Bioactive products of adipocytes subsequently modulate the immune system, this process is significantly influenced by signalling of nerve cells. In order to understand neuro-immune interaction during the cold adaptation, we monitored changes in immune cell populations and the production of soluble products in rats treated with specific inhibitors of β-adrenergic receptors. Relationship between the immune and nervous system seems to be very important in many biological processes. Deciphering basic mechanisms of the influence of cold adaptation on immune cells can therefore explain other clinically relevant topics, such as treatment of obesity. Key words: immune system, cold adaptation, norepinephrine, adrenergic receptor, cytokines, brown adipose tissue, non-shivering thermogenesis

Orientador: Andreia Bufalino / Resumo: O carcinoma espinocelular (CEC) representa mais de 95% de todas as neoplasias malignas que acometem a cavidade oral e muitas vezes estes tumores são precedidos por alterações clínicas que apresentam um evidente potencial de transformação maligna, as quais são chamadas de desordens potencialmente malignas orais (DPMOs). Dentre estas, a leucoplasia oral (LO) possui taxa de transformação maligna que varia de 0,2% até 17,5%; contudo, uma outra DPMO conhecida como leucoplasia verrucosa proliferativa (LVP) apresenta um comportamento persistente e progressivo para malignidade, com taxa de transformação maligna maior que 70%. Diferente da LO, fator de risco como tabaco, álcool e noz de areca não parecem estar associados com o desenvolvimento da LVP. Adicionalmente, a LVP frequentemente apresenta resposta inadequada a todas as modalidades de tratamento, sofre rápida disseminação pelos sítios orais e muitas vezes demonstra recorrência. Estudos recentes sugerem que o infiltrado inflamatório associado às lesões leucoplásicas de paciente com LVP pode estar relacionado a etiologia e/ou comportamento clínico agressivo desta DPMO. Assim, foi realizada uma análise comparativa entre amostras de LO e LVP que consistiu em: (1) avaliar a porcentagem e identificar os subtipos de linfócitos T auxiliares e estado de ativação de linfócitos T citotóxicos, (2) avaliar a densidade e estado de ativação das células dendríticas, e (3) determinar o efeito de produtos solúveis de células displásicas na modul... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

Chronic inflammation is a triggering mechanism for many metabolic diseases including atherosclerosis and diabetes. A critical step in the development of chronic inflammation is the accumulation of classically activated pro-inflammatory macrophages in the extracellular matrix (ECM) of peripheral tissues. Recently, we demonstrated that adhesion receptor integrin αDβ2 is upregulated on macrophages in atherosclerotic lesions and inflamed adipose tissue, and promotes the development of atherosclerosis and insulin resistance. This pathophysiological mechanism is mediated by αDβ2-dependent strong adhesion of macrophages to the inflamed ECM, which promotes macrophage retention at the site of inflammation. Typical healthy ECM has a limited ligand capacity for integrin αDβ2. However, we recently found that the end-product of DHA oxidation, 2-(ω-carboxyethyl)pyrrole (CEP) serves as ligand for αDβ2. CEP is preferentially generated during inflammation-mediated oxidation and forms adduct with ECM proteins. CEP-modified proteins are detected in inflamed tissue during atherosclerosis, insulin resistance and pathological angiogenesis. In this project, we propose a new strategy for the treatment of chronic inflammation by targeting macrophage retention in the inflamed tissue by focusing on the development of the inhibitor, which is exclusively specific for αDβ2-CEP interaction. The advantage of CEP as a new therapeutic target resides in its unique formation in inflamed tissue. Using specially designed peptide library, protein-protein interaction measured by Biacore and adhesion assay with integrin-transfected HEK293 cells, we identified a sequence (called P5-peptide), which significantly inhibited αD-CEP binding. In vitro three-dimensional migration assay demonstrated that P5 peptide regulates macrophage migration within ECM but not the transendothelial migration of monocytes. The injection of cyclic P5 peptide in the model of thioglycollate-induced peritoneal inflammation led to 3-fold reduction in the number of macrophages accumulated in the peritoneal cavity after 72 hours. Interestingly, P5 peptide injection had no effect on the accumulation of macrophages in αD-deficient mice, that confirmed the specificity of inhibition. This inhibition only affects the recruitment of macrophages, while it has no effect on the efflux of macrophage from the peritoneal cavity in our in vivo studies. The tracking of adoptively transferred fluorescently-labeled WT and αD-/- monocytes in mice on a high fat diet revealed that αD-deficiency reduced 3 folds the accumulation of macrophages in the adipose tissue. The injection of P5 peptide in this model demonstrated the marked reduction of adoptively transferred WT macrophages in adipose tissue. Taken together, these results demonstrate the importance of αDβ2-CEP interaction for the accumulation of infiltrating macrophages during inflammation and propose P5 peptide as a potential inhibitor of atherogenesis and diabetes. Further studies are required to develop these results.

In situ follicular neoplasia (ISFN) is defined as a monoclonal proliferation of B cells with immunophenotypic and genetic features of follicular lymphoma (FL) but confined to germinal centers of lymph nodes or other organs. It may not be associated with underlying overt lymphoma. It can be associated with lymphoproliferative disorders other than FL. A fifty-seven-year-old caucasian male initially presented with atypical chest pain, which led to cardiology evaluation. Patient underwent a coronary CT angiogram, which revealed a calcium score of 0, however also incidentally revealed mediastinal lymphadenopathy. Patient had a bronchoscopy which revealed no endobronchial lesions bilaterally. Using endo-bronchial ultrasound, right carinal lymph node was visualized, and trans-bronchial fine needle aspiration was performed. Cytology was positive for necrotic lesion with atypical cells. Patient had a dedicated CT scan of chest which showed enlarged sub-carinal lymph node measuring 3.3 x 3.0 cm. PET/CT scan showed increased uptake in the sub-carinal lymph nodes, also increased uptake of mid para-esophageal lymph nodes. It also showed some low-grade lymphadenopathy in right lower paratracheal region as well as mesenteric lymphadenopathy with misty appearance. Small pulmonary nodules were also noted in right middle and lower lobes with no associated uptake. Patient was scheduled for a mediastinoscopy and lymph node dissection. Patient proceeded with mediastinoscopy and a total of 4 lymph node specimens were removed from level 4R and level 7. Pathology from one of the lymph nodes revealed necrotizing granulomatous inflammation with staining consistent with histoplasmosis. Interestingly, two other lymph nodes showed in situ follicular neoplasia. Immunohistochemical stains demonstrated rare secondary lymphoid follicles with unremarkable morphology, showing strong germinal center staining with BCL2. FISH analysis was normal indicating absence of t(14;18). Pathology showed morphologically unremarkable B-cell nodules, concentrated in the cortical area which were CD20 positive and BCL2-positive. Patient underwent subsequent treatment with anti-fungal agents for the Histoplasmosis and is currently under surveillance for in-situ follicular lymphoma. In-situ follicular neoplasia is considered a premalignant lesion and a precursor of follicular lymphoma. Incidence of ISFN is difficult to ascertain, as it is usually a subclinical diagnosis. Incidence of FL is 3.18 per 100,000 population in the United States and findings suggest that ISFN is likely more frequent than that. Also, similar to FL, ISFN is seen in middle-aged and older individuals, mean age being around the fifth decade of life.Incidentally found ISFN without prior or simultaneous lymphoma is associated with a very low rate of clinical progression. Because some cases of ISFN are associated with prior or concurrent lymphoma, screening studies including computed tomography (CT) scan and bone marrow biopsy should be conducted after the diagnosis of ISFN is made. In the absence of overt lymphoma, it has been recommended that patients with ISFN be observed without chemotherapy, based on the very low incidence of progression into overt FL. The clinical significance of ISFN is not fully understood, however studies have demonstrated that incidentally found ISFN without prior or simultaneous lymphoma is associated with a very low rate of clinical progression. (

Multiple myeloma is characterized by the malignant proliferation of clonal plasma cells producing monoclonal paraproteins, leading to multi-organ damage. On the other hand monoclonal B-cell lymphocytosis (MBCL) is characterized by the malignant proliferation of clonal B-lymphocytes, with potential to develop into chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). CLL/SLL can result in visceromegaly, anemia, thrombocytopenia, fevers, night sweats and unintentional weight loss. Literature review demonstrates these two malignant clonal bone marrow disorders are most frequently seen independently in patients; however, we report one rare diagnostic challenge where both clonal disorders were identified in a single patient concurrently. A 64-year-old man initially presented with worsening back pain. Thoracic spine x-ray revealed a T11 compression fracture, confirmed by magnetic resonance imaging. Complete blood count revealed a white blood cell count of 7.3 K/uL with 54% lymphocyte predominance and peripheral smear demonstrated a population of small lymphocytes with round nuclei and an atypical chromatin pattern suggestive of CLL/MBCL. Flow cytometry revealed a monoclonal B-cell CD5 positive, CD23 positive, CD10 negative population with an absolute count of 1.6 K/uL. Due to the instability and pain associated with the spinal fracture, patient had kyphoplasty performed and intraoperative bone biopsies were taken from both T11 and T12 vertebrae. Interestingly each bone biopsy revealed involvement by both a kappa-light chain restricted plasma cell neoplasm, ranging from 15% to 30% cellularity, as well as a CD5-positive B-cell lymphocyte population. It suggested two concurrent but pathologically distinct pathologies including plasma cell myeloma and a separate B-cell lymphoproliferative disorder with immunophenotypic features suggestive of CLL/MBCL. Bone marrow biopsy was performed for definitive evaluation and confirmed multiple myeloma with 15-20% kappa-restricted plasma cells identified, and also confirmed concurrent MBCL with CD5 and CD23-positive, kappa-restricted B-cells identified on bone marrow flow cytometry. Adding an additional layer of complexity, bone marrow molecular genetics revealed presence of a MYD88 mutation, raising concern for possible lymphoplasmacytic lymphoma (LPL). However, secondary pathologic review ruled out LPL, as the immunophenotypic pattern of the clonal B-cells was not consistent with that of LPL, and although the MYD88 mutation is predominantly seen in LPL, it has also been seen in a small percentage of CLL/SLL cases and exceedingly rarely described in MM as well. Serum protein electrophoresis with immunofixation, serum quantitative immunoglobulins and serum quantitative free light chain assay revealed findings consistent with IgG kappa multiple myeloma and systemic CT imaging was negative for any lymphadenopathy, confirming MBCL. Patient was started on first-line multiple myeloma systemic therapy for transplant eligible patients and has demonstrated an excellent response to treatment thus far. This patient case serves to demonstrate the importance of maintaining a broad differential when approaching hematological problems; It also underlines the necessity for a complete diagnostic evaluation to identify rare clinical conundrums such as with our patient, allowing for proper and timely treatment. While we use “Occam’s razor” to explain multiple problems with a single unifying diagnosis the rare possibility of divergent diagnosis is to be always entertained.

Alexithymia represents a deficit in identifying and expressing emotions, paucity of fantasies, and an externally oriented cognitive style. Currently, numerous studies document that alexithymia and several mental and somatic disorders are significantly related. Several findings also indicate that this association might be caused by alexithymia related dysregulation of neuroendocrine and immune functions. Together these findings indicate that stressors related to alexithymia could underlie the process of neuroendocrine and immune dysregulation that likely may present a significant risk, sustaining and mediating pathogenesis of several disorders and particulary psychosomatic illnesses. In this context, it is also known that several proinflammatory cytokines may play a role in pain generation and that alexithymia is significantly associated with pain symptoms in several pain disorders. Following these findings this study includes several new data developing current state of the art and showing some alexithymia specific changes in patients with neurological disorders. Main finding of this study shows that alexithymia and anxiety in their specific interactions are linked to increased levels of interleukine-8 (IL-8) in cerebrospinal fluid (CSF) in the group of patients with non-inflammatory neurological...

Marathon runners (N = 22) who had completed at least seven marathons (X ± SEM = 23.6 ± 5.7) and had been training for marathon race events for at least 4 yr (12.3 ± 1.3) were compared with sedentary controls (N = 18). Although the two groups were of similar age (38.7 ± 1.5 and 43.9 ± 2.2 yr, respectively) and height, the marathon runners were significantly leaner and possessed a VO2max 60% higher than that of the controls. Neutrophil counts tended to be lower in the group of marathoners, while other leukocyte and lymphocyte subsets were similar to controls. Mitogen-induced lymphocyte proliferation did not differ between groups. Natural killer cell cyto-toxic activity (NKCA) was significantly higher in the marathoners versus controls (373 ± 38 vs 237 ± 41 total lytic units, respectively, a 57% difference, P = 0.02). For all subjects combined (N = 40) and within the group of marathon runners (N — 22), percent body fat was negatively correlated with NKCA (r = -0.48, P = 0.002; r = -0.49, P = 0.019, respectively), and age was negatively correlated with Con A-induccd lymphocyte proliferation (r = -0.41, P = 0.009; r = -0.53, P = 0.011, respectively). These data indicate that NKCA but not mitogen-induced lymphocyte proliferation is higher in marathon runners relative to sedentary controls.

Exposure to Poaceae airborne pollen (PAP) has been shown to induce allergic reactions in individuals sensitive to PAP. Patient care for individuals sensitive to PAP can be aided by knowledge of PAP profiles. Air samples were collected using a Rotorod M40 rotation impact sampler from February 2005 to September 2017. Air samples were collected daily, excluding weekends and winter months, and are expressed in grains per cubic meter (g/m3). Light microscopy at 400x magnification was used to analyze samples. Pollen was classified according to the classifications provided by the American Academy of Allergy Asthma and Immunology and the National Allergy Bureau. Detection of PAP onset averaged on day 84 (March 25th); end day averaged on day 285 (October 12th); average duration was 202 days; average peak level onset was on day 146 (May 26th) and the average peak level was 135 g/m3. Average number of days during Poaceae season with 1 to 19 g/m^3 detected was 95; with 20 to 39 g/m^3 was 7; with 40 to 59 g/m^3 was 4; and with 60 g/m^3 or more was 2. Day of onset of PAP trended to be 1.6 days earlier in the year over the course of our data collection, with R2= 0.3476. Poaceae airborne pollen in Johnson City, Tennessee was noticeable for almost 7 months out of the year. We can assume the riskiest months of the year are from March to October with the highest risk period being the end of May.

Psychoneuroimmunology is an interdisciplinary area that examines the interaction between behavior, the central nervous system, and the immune system. Many investigations have utilized a taste aversion paradigm to examine the effects of classical conditioning on an immune response. The procedure generally consists of an animal ingesting a novel flavor, and then being made ill and immunosuppressed by injection of a pharmacological agent. The animal is provided access to that flavor at a later time. The rejection of the novel flavor on the test day is called taste aversion and the depressed antibody titer has been labeled conditioned immunosuppression. The present research was designed condition a secondary immune response and expand the evaluation of such conditioning to include both antibody titer and affinity. The Enzyme Linked Immunoassay was also introduced as the procedure of choice to quantify immune reactivity. A depression in antibody titer and affinity was found following exposure to three of four test trials. Taste aversion did not correlate with the immune response as increased consumption of the novel flavor was exhibited on the third and fourth test trial. In the second experiment, the dosage of cyclophosphamide was increased. A depression in antibody affinity was found after the third and fourth test trials, which was consistent with the results of the first experiment. Unlike the first experiment, a depression in antibody titer was not attained on test days. Although taste aversion was observed in the treatment group on three of the four test trials, it had extinguished by test four. The results support the concept of conditioned suppression of an antigen specific immune response by exposure to the taste aversion paradigm. An important contribution of the present research was the use and modification of a precise and sensitive assay for quantification of titer and affinity; the demonstration of conditioned suppression in both antibody titer and affinity; and the demonstration of conditioned immunosuppression with a single component CS.

Les protéines IFITM (« InterFeron Inducible TransMembrane proteins »), et en particulier les membres 1, 2 et 3, sont des facteurs de restriction antiviraux dont l’expression est induite par le système immunitaire inné en réponse à une infection virale. Elles inhibent la réplication de nombreux virus pathogènes pour l’homme parmi lesquels figurent le virus de la grippe A, le VIH (Virus de l’Immunodéficience Humaine) de type 1 ou encore le virus de l’hépatite C. Ces virus entrent dans la cellule hôte, soit par fusion directe avec la membrane plasmique, soit par la voie de l’endocytose. Il est à présent communément admis que les protéines IFITM, localisées au sein des membranes plasmiques et endolysosomales, agissent en inhibant la fusion des membranes virales et cellulaires, empêchant par conséquent l’entrée du virus dans la cellule et donc sa réplication. D’autre part, dans le cas du VIH, leur incorporation dans les particules virales produites par la cellule hôte diminuerait la capacité de ces particules à infecter de nouvelles cellules cibles. Cependant, les mécanismes moléculaires par lesquels les protéines IFITM interfèrent avec le cycle viral ne sont pas encore clairement définis.Parmi les membres de la famille IFITM, IFITM3 est celui qui présente l’effet antiviral le plus systématique selon les différentes études. Il constitue donc un modèle de référence pour étudier la famille IFITM.Déterminer la structure ainsi que la topologie membranaire d’IFITM3 sous sa forme active rendrait alors possible la réalisation d’études fonctionnelles, dont les résultats contribueraient sans nul doute à élucider le(s) mécanisme(s) par le(s)quel(s) IFITM3 exerce son activité antivirale.C’est pourquoi, nous nous sommes tout d’abord attelés à reconstituer IFITM3 au sein de membranes artificielles (liposomes, nanodisques), car contrairement aux micelles de détergent, ces membranes artificielles peuvent mimer l’environnement natif des protéines membranaires et par conséquent, offrir de plus grandes chances de les y étudier sous leur forme active. Nous avons ensuite procédé à la caractérisation biochimique et biophysique d’IFITM3 et avons mis en évidence la formation de dimère de la protéine ainsi que de plus grandes espèces oligomériques. L’analyse structurale d’IFITM3 reconstituée en nanodisques par RMN nous a quant à elle permis d’identifier une courte région hélicoïdale dans la région N-terminale extramembranaire d’IFITM3 encore jamais décrite auparavant et pouvant correspondre à un motif d’internalisation. Nous avons en outre observé, par microscopie électronique à coloration négative, de potentiels effets d’IFITM3 sur la courbure de la membrane de liposomes qui pourraient être à l’origine de son action inhibitrice sur la fusion virale. Et enfin, nous avons montré au travers d’expériences TEVC que lorsqu’IFITM3 est présente dans l’environnement extracellulaire d’ovocytes de xénope, celle-ci est capable d’engendrer des fuites ioniques au travers de la membrane des ovocytes qui pourraient résulter soit, d’une déstabilisation de la membrane par IFITM3 soit, d’une formation de pores membranaires par la protéine. / The host cell first line of defence against viral infections induces the production of interferons. These interferons are then released in the surrounding medium where they bind to target cells and induce the expression of hundreds of genes so called interferon-stimulated genes (ISGs). The interferon inducible transmembrane proteins IFITM are part of the products of these ISGs. IFITM1, 2 and 3 are antiviral factors able to restrict the replication of a broad variety of enveloped viruses, such as influenza virus, HIV-1 (Human Immunodeficiency Virus) and Hepatitis C virus. These viruses enter in the host cell either by direct fusion with the cell membrane or by endocytosis. IFITM proteins contain two membrane regions for insertion or interaction with plasma and endolysosomal membranes where they block the fusion of virus particles with cellular membranes by a mechanism which is still undefined. In addition, their incorporation into new HIV virions, in virus producing cells, has been correlated with decreased infectivity.Among the IFITM protein family members, IFITM3 is the one showing the most recurrent antiviral effect in the different studies. Therefore it represents a good model to study the whole IFITM family.The determination of its structure and membrane topology is crucial to be able to clarify, through structure-based functional studies, the mechanism(s) by which IFITM3 interfere with the viral cycle.Here we characterized and we studied IFITM3 structure and membrane topology in a lipidic environment close to its native environment such as liposomes and nanodiscs. We demonstrated that IFITM3 can self-associate to form at least a dimer. Some higher order associations of IFITM3 have been observed after its reconstitution into liposomes and big size nanodiscs. We discovered by NMR in solution that the N-terminal region of IFITM3 contains a small helical region, never described until now, which could correspond to an internalization motif. We also observed by negative staining electron microscopy some liposomal membrane curvature changes that could be assigned to the presence of IFITM3 in these liposomes. And we discovered through TEVC experiments that IFITM3 addition in the extracellular environment of xenopus oocytes produces ion leaks through the oocyte membrane which could result either from membrane destabilization or from a pore formation.