Orientador: Sandra Cecilia Botelho Costa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T23:14:22Z (GMT). No. of bitstreams: 1 Oliveira_TelmaBarbosade_M.pdf: 1175004 bytes, checksum: 5912fb5d3dc25609414bb097190091e2 (MD5) Previous issue date: 2008 / Resumo: O He/icobacter pylori é uma bactéria gram-negativa que está relacionada ao desenvolvimento de doenças gástricas e extragástricas. Dentre as doenças gástricas incluem-se o câncer gástrico, a gastrite crônica, a úlcera péptica e linfoma tipo MALT. Com relação às doenças extragástricas essa bactéria recentemente foi relacionada com a anemia por deficiência de ferro e com algumas doenças autoimunes, como a artrite reumatóide e a púrpura trombocitopênica idiopática. A PCR tem sido uma importante ferramenta para a análise de pequenos fragmentos de DNA, os quais podem, inclusive, ser armazenados por um tempo maior em amostras emblocadas em parafina ou obtidas a fresco à temperatura de -80°C. Dessa maneira, foram estudados 33 pacientes com púrpura trombocitopênica idiopática (PTI) e H.pylori positivo. No que diz respeito à detecção da bactéria pela nested PCR, foi obtido um resultado de 100% de concordância em comparação aos resultados de histologia e teste da urease, usados rotineiramente. Além dos primers para detecção do He/icobacter pylori foram utilizados primers para as regiões do gene urease C e do gene cagA, sendo os fragmentos obtidos analisados em gel de 2% agarose observados sob luz ultravioleta. Foi obtida também uma concordância de 100% para a região do gene urease C. Em relação ao gene cagA, 30,3% desses pacientes apresentaram esse. Dos 33 pacientes positivos para H pylori, após tratamento específico, 27,7% tiveram remissão completa do quadro clínico, 33% remissão parcial e 40% não tiveram remissão. Para o gene cagA positivo, 9,0% dos pacientes com PTI tiveram remissão completa e em 21,2% não houve remissão. Em relação ao gene cagA negativo, 21,2% tiveram remissão completa e em 48,4% não houve remissão. Foram aplicados testes estatísticos para observar a relação do gene cagA com a PTI, (teste exato de Fisher, Box-plot média e desvio padrão da contagem das plaquetas e Mann-Withney). Os resultadoS' obtidos não foram estatisticamente significantes neste grupo estudado. Portanto o gene cagA não está relacionado com o desenvolvimento da PTI / Abstract: Helicobacter pylori is a gram-negative bacterium that is related to the development of gastric and extragastric diseases. Gastric diseases include gastric cancer, chronic gastritis, peptic ulcer and MALT lymphoma. Extragastric diseases include iron deficiency anemia and some auto-immune conditions such as reumathoid arthritis and idiopathic thrombocytopenic purpura. PCR has been an important tool for the analysis of small fragments of DNA that may be stored for a longer time inserted in paraffin blocks or fresh tissue at -80ºC. Here we studied 45 patients with ITP and 33 of these ones had positive tests, with agreement of 100% of histological and rapid urease test. Besides the primers for H. pylori detection, primers for urease C region and cagA gene were used and the fragments obtained were analysed in agarose gel by ultraviolet radiation. We obtained 100% of agreement for urease C region and for detection of H. pylori and 30% of agreement for cagA gene. In these 33 patients which were H. pylori positive, 27,7% had complete remission, 33,0% partial remission and 40,0% had no remission. In positive patients for cagA gene, 9,0% had complete remission and 21,2% had no remission. In negative patients for cagA gene, 21,2% had complete remission and 48,4% had no remission. We used statistical analysis (Exact Fishers test, Box-plot and Mann-Withney) to relation cagA gene and thrombocytopenic idiopathic purpura Our results don't suggest or correlate the presence of cagA gene with idiopathic thrombocytopenic purpura development / Mestrado / Mestre em Farmacologia

Um grupo especial de indivíduos transplantados renais mantém a função do enxerto estável após a total retirada da terapia imunossupressora, alcançando um estado imunológico chamado de Tolerância operacional. Ainda não há marcadores moleculares e celulares que discriminem a tolerância no transplante humano, e os seus mecanismos estão sendo investigados. O perfil de peptídeos presentes na urina pode trazer informações importantes sobre o estado fisiopatológico renal. Nós investigamos se a tolerância operacional apresenta um perfil diferencial de peptídeos urinários, potencialmente, relevante para diagnóstico deste estado imunológico, assim como para a compreensão de seus mecanismos. Realizamos análises qualitativas do extrato de peptídeos da urina de indivíduos dos diferentes grupos do estudo: saudáveis (SA, n=6), tolerantes operacionais (TO, n=5), rejeição crônica (RC, n=8) e estável sob terapia imunossupressora convencional (EST, n=5), utilizando a abordagem proteômica de Shotgun. Identificamos um total de 15283 diferentes peptídeos em todos os grupos, correspondentes a 646 proteínas distintas, distribuídas nos diferentes grupos: TO = 189, RC = 296, EST = 205 e no grupo SA 219 proteínas. Observamos proteínas exclusivas dos diferentes grupos: TO teve 87 proteínas exclusivas, RC 168, EST 106 e SA 108 proteínas. Apesar das proteínas exclusivas não terem sido compartilhadas por todos os indivíduos do mesmo grupo, a totalidade dos indivíduos de cada grupo apresentou várias dessas proteínas (cada indivíduo apresentou em média 15% das proteínas exclusivas de seu grupo). Das 646 proteínas identificadas, apenas 2,3% foram classificadas pelo Gene ontology como relacionadas ao sistema imune e os compartimentos celulares mais frequentes foram: núcleo 36% e citoplasma 23%. Destacamos algumas proteínas relacionadas à resposta imune, exclusivas de alguns grupos, como no grupo TO, a C-C motif chemokine 24 (CCL24) e Endothelin-1 e no grupo RC, a beta 2 microglobulina. Essas moléculas podem ter relevância nos mecanismos imunológicos desses estados clínicos. A abordagem proteômica aplicada neste trabalho permitiu a identificação de um perfil diferencial de peptídeos na urina de cada grupo diferente de estudo. Os peptídeos urinários diferenciais e suas respectivas proteínas podem ter relevância funcional ou como biomarcadores - em relação ao estado fisiológico e às diferentes evoluções clínicas no transplante renal / A special group of renal transplant recipients maintain stable graft function after the complete withdrawal of immunosuppression, achieving a state called operational tolerance. To date, there are no cellular or molecular biomarkers to discriminate human transplantation tolerance and the underlying mechanisms are being investigated. The profile of urinary peptides may provide important information about different renal physiopathological statuses. We investigated whether operational tolerance displays a differential urinary peptide profile, potentially relevant as biomarkers or for the understanding of mechanisms involved in tolerance. We performed qualitative analysis of peptide urinary extracts in individuals from different study groups: healthy (HI, n=6), operational tolerance (OT, n=5), chronic rejection (CR, n=8) e stable under conventional immunosuppression (Sta, n=5), using Shotgun proteomics. Altogether, we identified 15283 different peptides, corresponding to 646 distinct proteins, distributed in all groups: OT = 189, CR = 296, Sta = 205, and 219 proteins in HI. Several proteins were exclusively detected in specific groups: OT showed 87 exclusive proteins, CR 168, Sta 106 and HI 108 proteins. Although the exclusive proteins were not shared by all individuals from that specific group, all individuals from each group presented several of the group-exclusive proteins (each individual presented an average of 15% of the proteins exclusive to his group). Of the 646 proteins identified, only 2.3% were classified in Gene Ontology as related to the immune system and the most frequent cellular compartments were: 36% from nucleus and 23% cytoplasmic. Of notice, some proteins related to the immune response were also group-exclusive, such as, in OT, a C-C motif chemokine 24 (CCL24) and Endothelin-1, and beta 2 microglobulin in CR. These proteins may display relevant roles in the mechanisms involved in these clinical statuses. In conclusion, the proteomic approach used in this study allowed the identification of a differential urinary peptide profile in each different study groups. The differential urinary peptides and their corresponding proteins may display a relevant role functional or as biomarkers - in the state of homeostasis and in different clinical outcomes in renal transplantation

Em países tropicais como o Brasil, as micoses superficiais (dermatofitoses) são comumente encontradas. O Dermatófito mais comum é o Trichophyton rubrum (Tr). Mananas e galactomananas na parede do Tr podem suprimir a resposta celular ao fungo. Quanto à resposta imune antifúngica, sabe-se a importância da via Th17. Algumas lectinas do tipo C (CLRs) como o receptor de manose e/ou receptores similares a Toll (TLRs) regulam o equilíbrio entre as vias Th1 e Th17. Nossos objetivos foram obter um extrato antigênico de Tr que induza resposta imune celular; quantificar e qualificar a resposta imune de indivíduos controles com lesão branda e de pacientes com dermatofitose extensa e/ou persistente causadas pelo Tr e por fim, avaliar a expressão de CLRs em monócitos do sangue periférico nos mesmos grupos. Para tanto, produzimos 11 extratos antigênicos de Tr. Pudemos observar na eletroforese em gel de poliacrilamida proteínas com pesos moleculares de aproximadamente 70 kDa e 38 kDa para os extratos fúngicos: Extrato TCA - Meta 1, Extrato tindalizado G1 e Extrato Coca 1. Avaliamos a resposta linfoproliferativa de células mononucleares por incorporação de timidina triciada em controles e pacientes ao peptídeo YIIDTGIDID do fungo Tr (Tri R2) e aos extratos antigênicos produzidos em nosso laboratório. Utilizamos como estímulos: PWM, CMA, Tri R2, PMA/Ionomicina. Para os ensaios funcionais avaliamos quatro pacientes e 6 indivíduos controles. Para a fenotipagem das células Th17, Th17MEM, Tc17 e Tc17MEM por citometria de fluxo, utilizamos a análise Booleana no software FlowJo X. A avaliação da expressão dos CLRs: CD206 (Receptor de Manose), Dectin 1 e Dectin 2 em monócitos do sangue periférico de controles e pacientes foi efetuada por citometria de fluxo. Dos 11 extratos produzidos de Tr, 7 se mostraram bons estimuladores para pelo menos um dos controles analisados, expressos como ponto máximo de índice de estimulação (p.m.I.E.). Dentre eles destacamos: Extrato TCA - Meta 1 (p.m. I.E. = 14,49 em 5 ug/mL), Extrato Tindalizado G1 (p.m.I.E. = 23,00 em 2,5 ug/mL) e Extrato Coca 1 (p.m.I.E. = 173,36 em 0,31 ug/mL). Na avaliação da expressão dos receptores das células Th17 e Tc17 (Th17R e Tc17R, respectivamente) após seis dias de estímulo por: Tri R2, extrato Coca 1 e o extrato TCA - Meta 1, o extrato Coca se mostrou o melhor estimulador para as populações Th17, com a frequência de 8,40% (controle) e 12,30% (paciente 1). Na avaliação da expressão de Th17R e Tc17R por 6 horas ao estímulo por PMA/Iono, todos os controles (n=3) se mostraram responsivos e no grupo de pacientes (n=3) pudemos observar maior frequência para o paciente 1 nas populações Th17 (1,64%) e Th17MEM (3,27%), e para as células Tc17 (10,70%) e Tc17MEM (3,58%). Observamos redução da expressão de CLRs nos pacientes: CD206: média 60,24% (controles) e 21,27% (pacientes), Dectin 1: 22,42% (controles) e 12,06% (pacientes) e Dectin 2: 20,26% (controles) e 4,99% (pacientes). Controles (n=6) e pacientes (n=3). A inovação na produção de extrato antigênico Extrato TCA - Meta 1 encoraja o estudo dos extratos fúngicos, para se obter melhores condições de avaliações imunológicas em pacientes com dermatofitose. Caracterizamos e qualificamos a resposta imune celular frente ao peptídeo TriR2 e aos extratos antigênicos, além de avaliarmos a expressão dos CLRs nesse grupo especial de pacientes / In tropical countries like Brazil, superficial fungal infections (dermatophytosis) are commonly found. The most common dermatophyte is Trichophyton rubrum (Tr). Mannans and galactomannans of Tr cell wall can suppress cellular responses to the fungus. Regarding the antifungal immune response, the importance of Th17 pathway is warranted. Some C-type lectins (CLRs) as the mannose receptor and / or Toll-like receptors (TLRs) regulate the balance between Th1 and Th17 pathways. Our objectives were to obtain an antigenic extract of Tr to induce cellular immune response; to quantify and classify the immune response of control subjects with mild injury and patients with extensive and / or persistent dermatophytosis caused by Tr, and finally evaluating the expression of CLRs in peripheral blood monocytes in the same groups. Therefore, we produced 11 antigenic extracts of Tr. Proteins with molecular weights of approximately 70 kDa and 38 kDa were evidenced in polyacrylamide gel electrophoresis for the following fungal extracts: extract TCA - Target 1, Tindalized extract G1 and extract Coca 1. We assessed the lymphoproliferative response of mononuclear cells by tritiated thymidine incorporation in the controls and patients, stimulated by YIIDTGIDID peptide fungus Tr (Tri R2) and the antigenic extracts produced in our laboratory. We used as stimuli: PWM, CMA, Tri R2, and PMA/Iono. For functional assays we evaluated four patients and 6 control individuals. For the phenotyping of Th17 cells, Th17MEM, Tc17 and Tc17MEM by flow cytometry, we used a Boolean analysis performed by FlowJo X software. Evaluation of the expression of CLRs: CD206 (mannose receptor), Dectin 1 and Dectin 2 in peripheral blood monocytes from patients and controls was performed by flow cytometry. Of the 11 extracts produced from Tr, seven proved to be able to stimulate proliferation of peripheral blood mononuclear cells of at least one of the analyzed controls, expressed as peak stimulation index (p.m.I.E.). Among them, were included: extract TCA - Target 1 (pmIE = 14.49 at 5 ug /mL), Tindalized G1 Extract (pmIE = 23,00 at 2.5 ug /mL) and extract Coca 1 (pmIE = 173.36 at 0.31 ug /mL). In the evaluation of the expression of receptors of Th17 cells and Tc17 (Th17R and Tc17R, respectively) after six days of stimulation by: Tri R2, Coca extract and the extract TCA 1 - Meta 1, Coca extract showed to be the best stimulator for Th17 populations, with the frequency of 8.40% (control) and 12.30% (patient 1). In the evaluation of the expression of Th17R and Tc17R after 6 hours of stimulation by PMA / Iono, all controls (n = 3) responded and in the group of patients (n = 3) we observed response more frequently for the patient #1, in Th17 populations (1.64%), Th17MEM (3.27%), Tc17 cells (10.70%) and Tc17MEM (3.58%). We observed a reduction of expression of CLRs in patients: CD206: average 60.24% (controls) and 21.27% (patients), Dectin 1: 22.42% (controls) and 12.06% (patients) and Dectin2: 26% (controls) and 4.99% (patients). Controls (n = 6) and patients (n = 3). Innovation in the production of antigenic extract extract TCA - Target 1 encourages the study of fungal extracts to obtain better conditions of evaluation of the immune response in patients with dermatophytosis. We characterized and qualified the cellular immune response to the TriR2 peptide, to antigen extracts, and evaluated the expression of CLRs in this special group of patients

Orientador: Marcelo Lancellotti / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-23T11:46:02Z (GMT). No. of bitstreams: 1 Mattos_IvesBernardellide_M.pdf: 15060536 bytes, checksum: 32a633419d15c105fec735cb5753d5b2 (MD5) Previous issue date: 2012 / Resumo: O resumo poderá ser visualizado no texto completo da tese digital quando liberada / Abstract: The abstract is available with the full electronic document when available / Mestrado / Bioquimica / Mestre em Biologia Funcional e Molecular

D.Litt.et Phil. (Psychology) / According to Cunningham (1978) there is a fair amount of controversy that surrounds the possible causes of auto-immune diseases. According to him there are two conflicting categories of causes of which psycho-social causes is one and abnormalities of the immune system is the other. Although a substantial amount of studies concerning the relationship between psychological factors and immune functioning have been done, the results have been inconclusive. The reason for this seems to be that there is a vast amount of mediating factors. A further aspect that needs to be taken into account is that psychoneuroimmunological research has focused mainly on adults. Schleifer, Scott, Stein and Keller (1986) is of the opinion that extensive research is required to study the effects of the central nervous system and behaviour during the early development of a person. The study attempted to identify possible psycho-social factors that could contribute to pediatric diseases such as rheumatoid arthritis. In order to identify factors that are unique to auto-immune diseases four groups were compared i.e, emotional disorders, behavioral disorders, auto-immune diseases and a "normal" group.

Activation and proliferation of antigen-specific T cells is the hallmark of an anti-viral immune response. Effector T cells generated during an immune response are heterogeneous in regards to their ability to populate the memory pool once the immune response has resolved. Initial T cell activation takes place in the lymphoid organs, after which T cells migrate into the non-lymphoid tissues. The presence of memory T cells at non-lymphoid tissue sites has been shown to be critical for protection against secondary virus challenge. Our lab has previously demonstrated that during and after the resolution of the immune response to Lymphocytic choriomeningitis virus (LCMV) CD8+T cells in the nonlymphoid tissues are more resistant to apoptosis than those in the lymphoid organs. This stability of T cells in the non-lymphoid tissues may be critical in ensuring protection against a secondary virus challenge. Mechanisms regulating tissue-dependent differences in CD8+T cell apoptosis were studied in an acute LCMV infection model. Virus-specific CD8+T cells from lymphoid (spleen, mesenteric lymph nodes (MLN), inguinal lymph nodes (ILN)) and non-lymphoid tissues (peritoneal exudate cells (PEC), fat-pads) were compared for expression of surface antigenic markers known to correlate with a memory phenotype. Non-lymphoid tissues were enriched in IL-7Rhi, KLRG-1lo, CD27hi and CXCR3hi virus-specific CD8+ T cells, and the presence of these antigenic markers correlated with increased memory potential and survival. Transcription factors in addition to cell surface antigens were assessed as correlates of resistance to apoptosis. Virus-specific CD8+T cells in the nonlymphoid tissues were enriched in cells expressing T cell factor-1 (TCF-1), which correlated with increased memory potential and survival. CD8+T cells in the peritoneum of TCF-1-deficient mice had decreased survival during resolution of the immune response to LCMV, suggesting a role for TCF-1 in promoting survival in the non-lymphoid tissues. As an additional mechanism, I investigated whether apoptosis-resistant CD8+T cells migrate to non-lymphoid tissues and contribute to tissue-dependent apoptotic differences. CXCR3+ CD8+T cells resisted apoptosis and accumulated in the lymph nodes of mice treated with FTY720, which blocks the export of lymph node cells into the peripheral tissues. The PECs expressed increased amounts of CXCR3 ligands, CXCL9 and CXCL10, which may have recruited the non-apoptotic cells from the lymph nodes. By adoptively transferring splenic T cells into the spleen or PEC environment I showed that the peritoneal environment through a yet undefined factor promoted survival of CD8+T cells. In this study I have elucidated the mechanisms by which CD8+T cells preferentially survive in the non-lymphoid tissues. I found that non-lymphoid tissues were enriched in memory-phenotype CD8+T cells which were intrinsically resistant to apoptosis irrespective of the tissue environment. Furthermore, apoptosisresistant CD8+T cells may preferentially migrate into the non-lymphoid tissues where the availability of tissue-specific factors may enhance memory cell survival. Few transcription factors have been identified that regulate CD8+T cell effector-memory differentiation during an immune response. In this thesis, I have also studied the mechanism by which the transcription factor Blimp-1 regulates the generation of effector and memory CD8+T cells. Blimp-1 is known to repress a large number of target genes, and ChIP (chromatin immunoprecipitation) sequencing analysis done by Dr. HyunMu Shin in the lab of Dr. Leslie J. Berg identified CD25 (IL-2Rα) and CD27 as potential targets of Blimp-1. I found that Blimp-1-deficient CD8+T cells had sustained expression of CD25 (IL-2Rα) and CD27 during peak and resolution of the immune response to LCMV. By performing adoptive transfers of CD25hi and CD27hi CD8+T cells I showed that CD25 and CD27 expression on CD8+T cells during resolution of the immune response correlates with enhanced survival. Silencing Il2rα and Cd27 expression reduced the Blimp-1-deficient CD8+T cell response, suggesting that sustained expression of CD25 and CD27 was in part responsible for the enhanced CD8+T cell response seen in the Blimp-1-deficient mice. Furthermore, our collaborator Dr. HyunMu Shin showed that CD25 and CD27 are direct targets of Blimp-1, and that Blimp-1 recruits histone modifying enzymes to Il2rα and Cd27 loci to suppress their expression during the peak of the anti-viral immune response. This study identifies one of the mechanisms by which Blimp-1 regulates the balance between generation of effector and memory CD8+T cells. In this thesis work I also studied the function of the transcription factor ROG (Repressor of GATA-3) in regulating in vivo T cell responses during both acute and chronic LCMV infection. ROG-deficient mice had increased CD8+T cell responses during an acute LCMV infection. ROG deficiency also led to the generation of memory T cells with an enhanced recall response compared to WT controls. By using LCMV-specific P14+ TCR transgenic ROG-deficient CD8+T cells these defects were shown to be T cell intrinsic. ROG-deficient mice had enhanced CD8+T cell responses and viral clearance during a persistent high dose LCMV Clone 13 infection. During chronic LCMV infection ROG-deficient mice also had increased lung pathology and mortality. The results indicate that ROG negatively regulates T cell responses and memory generation during both acute and chronic LCMV infection. The studies highlighted in this thesis elucidate the mechanisms promoting CD8+T cell survival in non-lymphoid tissues as well as transcription factormediated regulation of memory CD8+T cell differentiation. Knowledge of this will help us better understand T cell immunity after infections and may eventually help develop better vaccines.

The dysregulation of immune system function has been centrally implicated in numerous age-related and neurodegenerative disorders, including Alzheimer’s disease (AD). Genetic susceptibility studies have positioned microglia, brain-resident immune cells, as critical actors in the development and the progression of the disease. Microglia are highly plastic cells with diverse functions across many modalities, and the appropriate regulation of their activities are a prerequisite for central nervous system homeostasis and cognitive health. Aging and pathogenic contexts are posited to modify microglial behavior, inhibiting their neuroprotective function and promoting a dysfunctional state that drives disease. However, the mechanisms underlying these pathogenic alterations in microglial state and function are complex and poorly understood. This thesis identifies three elements that are altered in the AD brain and investigates how these mechanisms may serve as triggers producing microglial dysregulation in AD. Chapter 3 examines the role of expression of the transposable element LINE-1 in AD-related microglial dysfunction. Chapter 4 explores the regulation of PLCG2, which encodes a critical AD-associated signaling enzyme. Chapter 5 investigates the role of the AD-linked sorting receptor SORL1 in microglia. Together, these data expand our understanding of mechanisms driving altered microglial pathophysiology in AD and illuminate pathways of interest with potential therapeutic applications meriting deeper exploration.

Thesis (M. Tech. (Biomedical technology)) - Central University of technology, Free State, 2013 / INTRODUCTION: The renal effects of Tenofovir Disoproxil Fumarate (TDF) and antiretroviral treatment (ART) outcomes remain under-reported in African settings. The study sought to assess immunological outcomes and to compare renal function outcomes between patients exposed to TDF and unexposed patient group. METHODS: Phase 1 of the study was a retrospective case control analysis of serum creatinine data for 312 ART naïve adult patients exposed to TDF and 173 unexposed patients enrolled on ART between Dec 2006 and Jan 2011 at Roma Health Service Area in Lesotho. Sub-optimal renal function outcomes were serum creatinine clearance values <50 ml/min calculated using the Cockcroft-Gault equation. Phase 2 was based on re-sampling of the study population and analysis of CD4 counts of 516 adult naïve HIV-positive patients. Univariate logistic regression (p<0.1) and multivariate analyses (p<0.05) were performed using STATA® version 11 software. RESULTS: Overall, 153 (31.5%) patients had moderate baseline (30-60 ml/min) renal insufficiency. Renal function improved by +2 ml/min at 24 months. Almost 18% (n=312) of the patients on TDF were erroneously put on TDF. The use of TDF was a marginally significant factor (p=0.054) associated with CrCl<50 ml/min outcomes in univariate analysis but was insignificant (p=0.122) in multivariate analysis. Female gender (p=0.016), high blood pressure (p=0.009), ages over 60 (p=0.004), and underweight (p<0.001) were significantly associated with CrCl<50 ml/min outcomes. The proportion of patients who developed immunological failure in this study was low (6.8%, n=516). The mean CD4 count increased significantly after treatment (p<0.001). Baseline CD4 count below 50 cells/mm3 (p=0.049) and male gender (p=0.005) were significantly associated with sub-optimal immunological outcomes. CONCLUSIONS: TDF is a weak contributing factor associated with renal impairment outcomes compared to other variables such as hypertension, older age, underweight and female gender. More research on long term effects of TDF is recommended. Baseline renal function screening should be improved to minimise leakages of patients contraindicated of TDF. Although the patients’ immunological status generally improved, males and patients with low baseline CD4 counts should be monitored closely while on ART.

Objetivo: Verificar o remodelamento da pele e produção de anticorpos em modelo experimental de esclerodermia em coelhos, após indução de tolerância nasal com colágeno tipo V. Métodos: Coelhas Nova Zelândia (N=12) foram imunizadas com 1mg/ml de colágeno V (Col V) em adjuvante completo de Freund e dois reforços com adjuvante incompleto de Freund. Seis coelhas imunizadas receberam uma dose diária de 25ug de Col V, iniciado via nasal (grupo tolerado) 150 dias do começo das imunizações e seis animais foram somente imunizadas (grupo imunizado). Um grupo imunizado com adjuvante de Freund serviu como controle. Biopsias de pele foram coletadas em 0, 75, 120, 150 e 210 dias e coradas pelo H&E, tricrômico de Masson e Sírius red para analise morfológica e morfométrica. Os colágenos I, III e V, além de TGFbeta e PDGF foram imunomarcados por imunofluorescência. Os soros dos animais foram coletados em 0, 150 e 210 dias para determinar anticorpos anti-colágenos I, III, IV e V e anti-nucleares. Resultados: Os animais imunizados mostraram progressivo decréscimo da derme papilar, atrofia de anexos, aumento no depósito dos colágenos I, III e V e aumento da expressão de TGFbeta e PDGF. Os tolerados apresentaram aumento dos anexos cutâneos e significante diminuição no depósito dos colágenos I, III e V, TGFbeta e PDGF. O grupo de imunizados e de tolerados apresentaram anticorpos anti-colágenos III e IV e antinucleares. Conclusões: A indução de tolerância nasal com Col V diminuiu o remodelamento da pele observado no modelo experimental de esclerodermia e inibiu a síntese de citocinas fibrogênicas. Portanto, a tolerância nasal com Col V pode ser uma opção terapêutica promissora para o controle do remodelamento cutâneo em pacientes com esclerodermia. / Objective: Our aim was to verify the skin remodeling and antibody production in experimental model of scleroderma in rabbits, after induction of tolerance by daily nasal administration of human type V collagen (Col V). Methods: Female New Zealand rabbits (N=12) were immunized with 1mg/ml of Col V in complete Freund\'s adjuvant, followed by more two boosters in incomplete Freund\'s adjuvant. Six immunized rabbits received daily nasal administrating of 25ug of Col V (tolerated group), started 150 days after the first immunization, and the others animals (N=6) were only immunized (immunized group). Finally a group of rabbits immunized with Freund\'s adjuvant served as control. Skin biopsies were collected at 0, 75, 120, 150 and 210 days, and stained with H&E, Masson\'s trichrome and Sirius red for morphological and morphometric analysis. Types I, III and V collagen, TGFbeta and PDGF were immunostained by immunofluorescence. The sera of animals were colleted at 0, 150 and 210 days to determine anti types I, III, IV and V collagen and antinuclear antibodies. Results: The immunized animals showed progressive decrease of papillary dermis, appendages atrophy, increase of types I, III and V collagen deposition and increased expression of TGF-beta and PDGF. The tolerated rabbits presented increase of cutaneous appendages and significant decrease of types I, III and V and TGF-beta and PDGF. Both immunized and tolerated rabbits presented anti types III and IV antibodies and antinuclear antibodies. Conclusions: Col V nasal tolerance reduced skin remodeling in experimental model of scleroderma and inhibited synthesis of fibrotic cytokines. Therefore, the nasal tolerance with type V collagen can be a promising therapeutic option to control the skin remodeling in patients with scleroderma.

A proteína Cpn60 faz parte de um grupo de proteínas altamente conservadas que estão envolvidas em funções celulares essenciais. camundongos BALB\\c foram imunizados com 5 ou 10 µg da proteína recombinante (Cpn60r) sozinha ou adicionada à vacina DTP sem hidróxido de alumínio (NADTP). A vacina DTP do Instituto Butantan (DTP) foi usada como controle. Foi avaliada a produção de citocinas por células esplênicas após reestímulo in vitro com a Cpn60r. Os animais foram desafiados após o protocolo de imunização. A Cpn60r sozinha ou misturada à vacina NADTP foi capaz de induzir níveis de anticorpos contra pertussis mais altos do que os induzidos pela DTP. Os níveis de IgG1 e IgG2a foram similares para todos os grupos. Pôde-se observar a produção de de IL-6 e IFN-&#947 nos grupos imunizados com Cpn60r. Os grupos imunizados com Cpn60r+NADTP apresentaram um índice de proteção entre 60 e 80% contra o desafio pela bactéria virulenta, semelhante ao grupo imunizado com DTP. A proteína Cpn60r é bastante promissora não somente como imunógeno, mas também como adjuvante. / The Cpn60 protein is a member of a group of higly conserved proteins linked to essencial cell functions. The Cpn60 was cloned, expressed and its immune response has been evaluated. BALB\\c mice were immunized with 5 or 10 µg of the recombinant protein (Cpn60r) alone or mixed with DPT vaccine without aluminum hidroxyde (NADPT). The DPT vaccine from Instituto Butantan was used as control. We evaluated the cytokines production by spleen cells after they have been reestimulated in vitro with Cpn60r. The animals were challenged after the immunization protocol. The Cpn60r alone or mixed with NADPT vaccine was able to induce higher antibodies levels than DPT. IgG1 and IgG2a levels were similar in all groups. We could detect levels of IL-6 and IFN-&#947 on groups immunized with Cpn60r. The groups immunized with Cpn60r+NADTP showed a 60 and 80% protection rate against the challenge with the live bacteria, similar to the group immunized with DPT. These results show the immune response of the recombinant protein that could be included in immunization protocols for pertussis.