Survival of patients with poor prognosis or relapsed haematopoietic malignancies can be markedly improved by allogeneic haematopoietic stem cell transplantation (HSCT). HSCT reconstitutes the immune and haematopoietic systems after myeloablative conditioning and inhibits the recurrence of the malignancy by a graft-versus-leukaemia (GVL) response mediated by donor T cells. However, significant post-transplant complications such as graft-versus-host disease (GVHD) continue to plague the event-free survival of this curative procedure. GVHD is facilitated by donor T cells that recognise histocompatibility antigens on host antigen presenting cells (APC), such as dendritic cells (DC). Current treatment options for GVHD are focused on these T cells. However, these treatments result in an increased incidence of infection, graft rejection and relapse. A novel means of immunosuppression in GVHD is the use of multi-potent, mesenchymal stromal cells (MSC). MSC are non-immunogenic cells that actively suppress T cell function in vitro, and can resolve steroid-refractory GVHD in the clinic. Despite their use in the clinic, there is a paucity of pre-clinical data. Our aim was to investigate the in vivo efficacy of MSC to control GVHD while maintaining the beneficial GVL effect, and to begin to understand the mechanism by which MSC exert their immunosuppressive effects. We isolated and characterised MSC from murine bone/bone marrow and demonstrated that they suppressed T cell proliferation in vitro, even at low ratios of 1 MSC per 100 T cells. This was true of both donor-derived MSC, and MSC derived from unrelated donors (third party). Importantly, we observed that MSC significantly reduced T cell production of the pro-inflammatory cytokines TNFα and IFNγ in culture supernatants and that IFNγ plays a key role in the ability of MSC to suppress T cell proliferation. In vivo, we examined the effects of donor-derived MSC on GVHD severity and onset in two myeloablative murine models of HSCT. A major histocompatibility complex (MHC)-mismatched donor-recipient pair combination was used as a proof–of-principle model [UBI-GFP/BL6 (H-2b)àBALB/c (H-2d)], and an MHC-matched, minor histocompatibility antigen (miHA) mismatched donor-recipient pair combination was used to mimic MHC-matched sibling transplantation [UBI-GFP/BL6 (H-2b)àBALB.B (H-2b)]. We examined a number of variables related to MSC infusion including timing, dose and route of injection. We found that early post transplant infusion of MSC by the intraperitoneal injection was most effective at delaying death from GVHD, compared to pre-transplant infusion or intravenous injection. Furthermore, we found that the dose of MSC was critical, as infusion of too few MSC was ineffective and infusion of too many MSC exacerbated the development of GVHD. Taken together, these results suggest that timing, dose and route of injection are all important factors to be considered to ensure successful therapeutic outcome. To investigate the in vivo mechanism of action, we conducted timed sacrifice experiments in the MHC-mismatched model to determine if MSC altered cytokine secretion and cellular effectors, such as DC, known to play a key role in GVHD. Despite the fact that MSC given post-HSCT enter an environment full of activated DC and IFNγ levels, by day 3 and 6 post infusion, these activated DC and IFNγ levels are decreased compared to controls or mice infused with MSC pre-transplant (p<0.05). This confirmed our in vitro data that IFNγ played an important role in MSC-mediated immunosuppression. In addition, when we removed a major source of IFNγ production in vivo by administering the T cell depleting antibody KT3 to mice with or without MSC, we found that although T cell depletion prolonged survival, MSC were unable to further enhance this effect. This was also true when MSC were used in combination with the conventional immunosuppressant cyclosporine. Finally, we examined whether the infusion of MSC would compromise the GVL effect. We found that whilst MSC could delay the onset of GVHD, in our model they did not alter the anti-tumour effects of the donor T cells. Overall, we have shown that MSC can delay but not prevent death from GVHD when administered at an appropriate time and dose and that IFNγ is required for MSC-mediated immunosuppression in our model. These data suggest that patients undergoing HSCT should be monitored for IFNγ, and administered MSC when high levels are reached. Whilst MSC may be a promising therapy for patients with severe GVHD, we highlight that further investigation is warranted before MSC are accepted for widespread use in the clinic. The risks and benefits for transplant recipients should be carefully considered before utilising MSC to treat or prevent GVHD.

Survival of patients with poor prognosis or relapsed haematopoietic malignancies can be markedly improved by allogeneic haematopoietic stem cell transplantation (HSCT). HSCT reconstitutes the immune and haematopoietic systems after myeloablative conditioning and inhibits the recurrence of the malignancy by a graft-versus-leukaemia (GVL) response mediated by donor T cells. However, significant post-transplant complications such as graft-versus-host disease (GVHD) continue to plague the event-free survival of this curative procedure. GVHD is facilitated by donor T cells that recognise histocompatibility antigens on host antigen presenting cells (APC), such as dendritic cells (DC). Current treatment options for GVHD are focused on these T cells. However, these treatments result in an increased incidence of infection, graft rejection and relapse. A novel means of immunosuppression in GVHD is the use of multi-potent, mesenchymal stromal cells (MSC). MSC are non-immunogenic cells that actively suppress T cell function in vitro, and can resolve steroid-refractory GVHD in the clinic. Despite their use in the clinic, there is a paucity of pre-clinical data. Our aim was to investigate the in vivo efficacy of MSC to control GVHD while maintaining the beneficial GVL effect, and to begin to understand the mechanism by which MSC exert their immunosuppressive effects. We isolated and characterised MSC from murine bone/bone marrow and demonstrated that they suppressed T cell proliferation in vitro, even at low ratios of 1 MSC per 100 T cells. This was true of both donor-derived MSC, and MSC derived from unrelated donors (third party). Importantly, we observed that MSC significantly reduced T cell production of the pro-inflammatory cytokines TNFα and IFNγ in culture supernatants and that IFNγ plays a key role in the ability of MSC to suppress T cell proliferation. In vivo, we examined the effects of donor-derived MSC on GVHD severity and onset in two myeloablative murine models of HSCT. A major histocompatibility complex (MHC)-mismatched donor-recipient pair combination was used as a proof–of-principle model [UBI-GFP/BL6 (H-2b)àBALB/c (H-2d)], and an MHC-matched, minor histocompatibility antigen (miHA) mismatched donor-recipient pair combination was used to mimic MHC-matched sibling transplantation [UBI-GFP/BL6 (H-2b)àBALB.B (H-2b)]. We examined a number of variables related to MSC infusion including timing, dose and route of injection. We found that early post transplant infusion of MSC by the intraperitoneal injection was most effective at delaying death from GVHD, compared to pre-transplant infusion or intravenous injection. Furthermore, we found that the dose of MSC was critical, as infusion of too few MSC was ineffective and infusion of too many MSC exacerbated the development of GVHD. Taken together, these results suggest that timing, dose and route of injection are all important factors to be considered to ensure successful therapeutic outcome. To investigate the in vivo mechanism of action, we conducted timed sacrifice experiments in the MHC-mismatched model to determine if MSC altered cytokine secretion and cellular effectors, such as DC, known to play a key role in GVHD. Despite the fact that MSC given post-HSCT enter an environment full of activated DC and IFNγ levels, by day 3 and 6 post infusion, these activated DC and IFNγ levels are decreased compared to controls or mice infused with MSC pre-transplant (p<0.05). This confirmed our in vitro data that IFNγ played an important role in MSC-mediated immunosuppression. In addition, when we removed a major source of IFNγ production in vivo by administering the T cell depleting antibody KT3 to mice with or without MSC, we found that although T cell depletion prolonged survival, MSC were unable to further enhance this effect. This was also true when MSC were used in combination with the conventional immunosuppressant cyclosporine. Finally, we examined whether the infusion of MSC would compromise the GVL effect. We found that whilst MSC could delay the onset of GVHD, in our model they did not alter the anti-tumour effects of the donor T cells. Overall, we have shown that MSC can delay but not prevent death from GVHD when administered at an appropriate time and dose and that IFNγ is required for MSC-mediated immunosuppression in our model. These data suggest that patients undergoing HSCT should be monitored for IFNγ, and administered MSC when high levels are reached. Whilst MSC may be a promising therapy for patients with severe GVHD, we highlight that further investigation is warranted before MSC are accepted for widespread use in the clinic. The risks and benefits for transplant recipients should be carefully considered before utilising MSC to treat or prevent GVHD.

Survival of patients with poor prognosis or relapsed haematopoietic malignancies can be markedly improved by allogeneic haematopoietic stem cell transplantation (HSCT). HSCT reconstitutes the immune and haematopoietic systems after myeloablative conditioning and inhibits the recurrence of the malignancy by a graft-versus-leukaemia (GVL) response mediated by donor T cells. However, significant post-transplant complications such as graft-versus-host disease (GVHD) continue to plague the event-free survival of this curative procedure. GVHD is facilitated by donor T cells that recognise histocompatibility antigens on host antigen presenting cells (APC), such as dendritic cells (DC). Current treatment options for GVHD are focused on these T cells. However, these treatments result in an increased incidence of infection, graft rejection and relapse. A novel means of immunosuppression in GVHD is the use of multi-potent, mesenchymal stromal cells (MSC). MSC are non-immunogenic cells that actively suppress T cell function in vitro, and can resolve steroid-refractory GVHD in the clinic. Despite their use in the clinic, there is a paucity of pre-clinical data. Our aim was to investigate the in vivo efficacy of MSC to control GVHD while maintaining the beneficial GVL effect, and to begin to understand the mechanism by which MSC exert their immunosuppressive effects. We isolated and characterised MSC from murine bone/bone marrow and demonstrated that they suppressed T cell proliferation in vitro, even at low ratios of 1 MSC per 100 T cells. This was true of both donor-derived MSC, and MSC derived from unrelated donors (third party). Importantly, we observed that MSC significantly reduced T cell production of the pro-inflammatory cytokines TNFα and IFNγ in culture supernatants and that IFNγ plays a key role in the ability of MSC to suppress T cell proliferation. In vivo, we examined the effects of donor-derived MSC on GVHD severity and onset in two myeloablative murine models of HSCT. A major histocompatibility complex (MHC)-mismatched donor-recipient pair combination was used as a proof–of-principle model [UBI-GFP/BL6 (H-2b)àBALB/c (H-2d)], and an MHC-matched, minor histocompatibility antigen (miHA) mismatched donor-recipient pair combination was used to mimic MHC-matched sibling transplantation [UBI-GFP/BL6 (H-2b)àBALB.B (H-2b)]. We examined a number of variables related to MSC infusion including timing, dose and route of injection. We found that early post transplant infusion of MSC by the intraperitoneal injection was most effective at delaying death from GVHD, compared to pre-transplant infusion or intravenous injection. Furthermore, we found that the dose of MSC was critical, as infusion of too few MSC was ineffective and infusion of too many MSC exacerbated the development of GVHD. Taken together, these results suggest that timing, dose and route of injection are all important factors to be considered to ensure successful therapeutic outcome. To investigate the in vivo mechanism of action, we conducted timed sacrifice experiments in the MHC-mismatched model to determine if MSC altered cytokine secretion and cellular effectors, such as DC, known to play a key role in GVHD. Despite the fact that MSC given post-HSCT enter an environment full of activated DC and IFNγ levels, by day 3 and 6 post infusion, these activated DC and IFNγ levels are decreased compared to controls or mice infused with MSC pre-transplant (p<0.05). This confirmed our in vitro data that IFNγ played an important role in MSC-mediated immunosuppression. In addition, when we removed a major source of IFNγ production in vivo by administering the T cell depleting antibody KT3 to mice with or without MSC, we found that although T cell depletion prolonged survival, MSC were unable to further enhance this effect. This was also true when MSC were used in combination with the conventional immunosuppressant cyclosporine. Finally, we examined whether the infusion of MSC would compromise the GVL effect. We found that whilst MSC could delay the onset of GVHD, in our model they did not alter the anti-tumour effects of the donor T cells. Overall, we have shown that MSC can delay but not prevent death from GVHD when administered at an appropriate time and dose and that IFNγ is required for MSC-mediated immunosuppression in our model. These data suggest that patients undergoing HSCT should be monitored for IFNγ, and administered MSC when high levels are reached. Whilst MSC may be a promising therapy for patients with severe GVHD, we highlight that further investigation is warranted before MSC are accepted for widespread use in the clinic. The risks and benefits for transplant recipients should be carefully considered before utilising MSC to treat or prevent GVHD.

Introdução. A paracoccidioidomicose (PCM) é uma micose sistêmica crônica, endêmica na América Latina, principalmente Brasil, sendo a oitava causa de morte entre as doenças infecciosas crônicas recorrentes. A PCM infecção é caracterizada por uma resposta Th1, a forma aguda por um perfil misto da resposta Th2/Th9, enquanto na forma crônica caracteriza-se pelo perfil Th17/Th22. A ocorrência e gravidade da PCM humana podem também estar associadas a fatores genéticos como os polimorfismos dos genes de citocinas. Objetivos. 1. Descrever a frequência dos polimorfismos de (SNPs) IFNG +874 T/A, IL12B 3\' UTR +1188 A/C e IL12RB1 11014 A/G no éxon 7 em pacientes e controles; 2. Investigar a associação entre esses polimorfismos e as diferentes formas clínicas da micose; 3. Verificar se há associação entre esses polimorfismos e a secreção das citocinas IFN-y, IL-12p40 e IL-12p70. Materiais e Métodos. 143 pacientes com PCM foram incluídos (40 com a forma aguda, 100 com a forma crônica multifocal e 17 unifocal). Critérios de inclusão: ter doença ativa (DA) comprovada por exame micológico ou histopatológico positivo ou presença de anticorpos anti-Paracoccidioides brasiliensis (>= 1/32 por contraimunoeletroforese) ou ter doença curada/tratada (CT) quando comprovada anteriormente pelos critérios de DA e atualmente com títulos de anticorpos estáveis e <= 4 em dois períodos com intervalo >= 6 meses. Analisaram-se os SNPs IFNG pela técnica de PCR-ARMS (\"Polymerase Chain Reaction - Amplification Refractory Mutational System\"), IL12B e IL12RB1 por RFLP (\"PCR-Restriction Fragment Lenght Polymorphism\"). Para a dosagem de citocinas foram utilizadas as técnicas de ELISA (n=29) e CBA (\"Cytometric Bead Array\"; n= 18), sendo considerados estatisticamente significantes, os valores de p < 0,05 para os testes de x2 e o teste de Kruskal-Wallis, com pós-teste de Dunn. Resultados. O genótipo AA do SNP IL12RB1 foi mais frequente na forma crônica multifocal e o genótipo AG, na forma unifocal masculina (p= 0,048). À análise desta forma clínica entre ambos os sexos, o genótipo AG foi também mais frequente no sexo masculino (p= 0,009). Segundo a etnia, foi demonstrada diferença estatisticamente significante nas frequências dos genótipos e alelos dos SNPs IFNG e IL12RB1 (p < 0,05). Em relação às formas clínicas da PCM, houve similaridade nas frequências dos genótipos e alelos dos SNPs estudados. Quanto aos níveis das citocinas, para os SNPs IFNG, IL12B e IL12RB1, maiores níveis de secreção de citocinas, frente a PHA, foram registrados nos grupos CT e CO em relação ao DA, sugerindo relação com a evolução da doença e com a imunossupressão já descrita na doença ativa. Conclusão. Não houve associação entre os SNPs IFNG, IL12B e IL12RB1 e as diferentes formas da doença quando todos os pacientes foram analisados; no sexo masculino, sugere-se que o genótipo AA esteja associado à doença crônica mais disseminada (IL12RB1). Houve diferença significante entre as etnias nos SNPs IFNG e IL12RB1, sugerindo-se a ampliação do número de pacientes em determinadas etnias e na forma clínica unifocal para melhor compreensão dessas associações / Introduction. Paracoccidioidomycosis (PCM) is a systemic chronic mycosis, endemic in Latin America, mainly in Brazil where it is the eighth cause of death among chronic recurrent infectious diseases. PCM infection is characterized by the Th1 immune response, the acute form, by a mixed Th2/Th9 profile, while the chronic form is characterized by Th17/Th22 profile. The occurrence and severity of human PCM can also be associated with genetic factors such as polymorphisms on genes of cytokines. Objectives. 1. To describe the frequencies of the single nucleotide polymorphisms (SNPs) IFNG +874 T/A, IL12B 3\'UTR +1188 A/C and IL12RB1 11014 A/G on exon 7, on patients with PCM and non-PCM controls; 2. To investigate the association between those SNPs and the different clinical forms of PCM. 3. To verify the possible association between those SNPs and the secretion of the cytokines IFN-?, IL-12p40 and IL12p70. Materials and Methods. 143 patients with PCM were included (40 with acute form, 100 with multifocal chronic form and 17 unifocal). Inclusion criteria: active disease (DA) proved by fungal identification on direct microscopy/histopathology or culture, or presence of antibodies antiParacoccidioides brasiliensis ( >= 1/32 by counterimmunoelectrophoresis) or cured/treated disease (CT) when previously proved by criteria of DA and present stable antibodies titles =6 months in between. The SNP IFNG was analyzed by PCR-ARMS (Polymerase Chain Reaction - Amplification Refractory Mutational System) and the SNPs IL12B and IL12RB1 by PCR-RFLP (PCR-Restriction Fragment Length Polymorphism). The levels of cytokines were detected by ELISA (n= 29) and CBA (Cytometric Bead Array; n= 18) and values of p < 0.05 for ?2 test and Kruskal-Wallis\' test, with Dunn\'s post-test were considered statistically significant. Results. The AA genotype of SNP IL12RB1 was the most frequent in the multifocal chronic form while the AG was more frequent in men with the unifocal chronic form of PCM (p = 0.048). On this clinical form in the comparison between genres, the AG genotype was also more frequent in men (p= 0.009). On ethnicity, it was demonstrated statistical difference between the frequencies of genotypes and alleles of SNPs IFNG and IL12RB1 (p < 0.05). In the comparison between the clinical forms of PCM, the frequencies of genotypes and alleles of the evaluated SNPs were similar. On the levels of cytokines, for SNPs IFNG, IL12B and IL12RB1, increased levels of cytokines were observed with PHA on the CT and CO groups compared with DA, suggesting a connection with the evolution of the disease and the previously described immunosuppression during active disease. Conclusion. There was no association between the SNPs IFNG, IL12B and IL12RB1 and the different forms of PCM when all patients were analyzed; among men, it is suggested that the AA genotype of IL12RB1 is associated with a more disseminated chronic disease. There was a significant difference between the ethnicities on SNPs IFNG and IL12RB1, being the latter also associated with the chronic form in men. The increase in the number of patients in certain ethnic groups and in the unifocal clinical form of PCM might help the better understanding of these associations

Made available in DSpace on 2014-12-17T15:32:21Z (GMT). No. of bitstreams: 1 PedroCRN_DISSERT.pdf: 3117630 bytes, checksum: 2544a3022fe67731388c2238d7dc5289 (MD5) Previous issue date: 2012-02-29 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Odontogenic cysts are pathologic cavities covered by odontogenic epithelium and filled by liquid, desquamated cells or other materials. The intraosseous lesions, such as radicular cyst and dentigerous cyst, present a potential of expansion capable of promoting the destruction of the surrounding osseous tissue. The mechanisms related to this process of expansion are the proliferation of cystic epithelium, the increase of the osmolarity of the cystic fluid and the synthesis of reabsorption factors such as IFN-? and TGF-?1. The aim of this study was to evaluate and compare the immunohistochemical expression of IFN-? and TGF-?1 between radicular cysts and dentigerous cysts in order to understand the role and behavior of these proteins in the expansion of these cysts. We selected 20 cases of radicular cyst and 20 cases of dentigerous cyst chosen from the files of UFRN s Laboratory of Oral Pathology. After analyzing the clinical data, the cases underwent the routine staining technique (HE) and immunohistochemistry for the appearance of IFN-? and TGF-?1 in the epithelium and capsule of these cysts. The statistical analysis using the Mann-Whitney test revealed no statistically significant difference in immunoexpression of IFN-? between the epithelium (p = 0.565) and capsules (p = 0.414) of radicular cysts and dentigerous cysts. Moreover, there was no statistically significant difference of immunoexpression of TGF-?1 between the epithelium (p = 0.620) and capsules (p = 0.056) of radicular cysts and dentigerous cysts. The Wilcoxon test revealed no statistically significant difference between IFN-? and TGF-?1 imunoexpressions in the epithelium (p = 0.225) and capsules (p = 0.370) of radicular cysts. There was no statistically significant difference between IFN-? and TGF-?1 imunoexpressions in the epithelium (p = 0.361) of dentigerous cysts. However, there was a statistically significant difference between IFN-? and TGF-?1 immunoexpressions in the capsule (p = 0.001) of dentigerous cysts, being TGF-?1 the factor which presented the most significant immunoexpression. Given these results, we conclude that there was no difference in immunohistochemical expression of IFN-? and TGF-?1 between radicular and dentigerous cysts and that TGF-?1 was more significant than the IFN-? in the capsule of dentigerous cysts / Os cistos odontog?nicos s?o cavidades patol?gicas revestidas por epit?lio odontog?nico e preenchidas por l?quido, c?lulas descamadas, ou outros materiais. As les?es intra-?sseas, como o cisto radicular e o cisto dent?gero, apresentam um potencial de expans?o capaz de promover a destrui??o do tecido ?sseo circunjacente. Os mecanismos relacionados a esse processo de expans?o s?o a prolifera??o do epit?lio c?stico, o aumento da osmolaridade do fluido c?stico e a s?ntese de fatores de reabsor??o ?ssea como IFN-? e TGF-?1. O objetivo deste estudo foi avaliar e comparar a express?o imuno-histoqu?mica do IFN-? e do TGF-?1 entre cistos radiculares e cistos dent?geros com a finalidade de compreender o papel e o comportamento dessas prote?nas no processo de expans?o destes cistos. Selecionamos 20 casos de cisto radicular e 20 casos de cisto dent?gero retirados dos arquivos do Laborat?rio de Patologia Oral da UFRN. Ap?s an?lise dos dados cl?nicos, os casos foram submetidos a t?cnica de colora??o de rotina (HE) e ao m?todo imuno-histoqu?mico para evidencia??o da express?o do IFN-? e do TGF-?1 no epit?lio e na c?psula dos referidos cistos. A an?lise estat?stica dos dados utilizando o teste de Mann-Whitney revelou que n?o houve diferen?a estatisticamente significativa da imunoexpress?o do IFN- entre os epit?lios (p=0,565) e c?psulas (p=0,414) dos cistos radiculares e cistos dent?geros. Al?m disso, n?o houve diferen?a estatisticamente significativa da imunoexpress?o do TGF-?1 entre os epit?lios (p=0,620) e c?psulas (p=0,056) dos cistos radiculares e cistos dent?geros. O teste de Wilcoxon revelou que n?o houve diferen?a estatisticamente significativa entre as imunoexpress?es do IFN- e do TGF-?1 no epit?lio (p=0,225) e na c?psula (p=0,370) dos cistos radiculares. N?o houve diferen?a estatisticamente significativa entre as imunoexpress?es do IFN- e do TGF-?1 no epit?lio (p=0,361) dos cistos dent?geros. No entanto, houve diferen?a estatisticamente significativa entre as imunoexpress?es do IFN- e do TGF-?1 na c?psula (p=0,001) dos cistos dent?geros, sendo o TGF-?1 o que apresentou a imunoexpress?o mais significativa. Diante destes resultados, conclu?mos que n?o houve diferen?a de express?o imuno-histoqu?mica do IFN-? e do TGF-?1 entre os cistos radiculares e dent?geros e que o TGF-?1 foi mais expressivo do que o IFN-? na c?psula dos cistos dent?geros

Orientador: Alexandre Leite Rodrigues de Oliveira / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-17T18:11:52Z (GMT). No. of bitstreams: 1 Victorio_SheilaCristinadaSilva_D.pdf: 20891355 bytes, checksum: a0e7d9b08b387848f356367e4f3c8d86 (MD5) Previous issue date: 2011 / Resumo: Na medula espinal, o estabelecimento das sinapses é, provavelmente, coordenado pelos próprios neurônios. Contudo, as células da glia circunjacentes e o microambiente formado entre neurônios/glia, desempenham papel importante na modulação da excitabilidade neural, influenciando na transmissão e plasticidade sináptica. Em situações de injúria ou inflamação, há um aumento da reatividade glial e mudança do estado funcional dos neurônios, levando a uma consequente cascata de eventos visando a homeostase do tecido. Neste sentido, o IFN? está envolvido na regulação da expressão do MHC I, o qual tem recentemente mostrado exercer um papel importante nos processos de plasticidade sináptica após axotomia. Além disso, existem evidências de que o IFN? pode interferir na diferenciação e sobrevivência das células neurais. No entanto, pouco se sabe sobre os efeitos da ausência do IFN? nos neurônios espinais após lesão. Portanto, o objetivo deste trabalho foi investigar os fenômenos de plasticidade sináptica e da reatividade glial em camundongos mutantes para IFN?, a fim de analisar a dinâmica das sinapses na medula após a lesão do nervo isquiático em animais incapazes de regular a expressão de MHC I pela produção de IFN?. Para isso, camundongos mutantes para IFN? e do tipo selvagem C57BL/6J foram submetidos à transecção ou esmagamento unilateral do nervo isquiático (5animais/grupo/experimento) e o material foi processado para imunohistoquímica, Western blotting, microscopia de luz e de transmissão (MET). Além disso, a avaliação motora dos animais também foi investigada por meio do índice funcional do nervo isquiático. Secções da medula espinal de camundongos sem lesão foram também utilizados para análise de sobrevivência neuronal e presença de apoptose por TUNEL e imunomarcação para caspase 3. Camundongos neonatos foram utilizados para os experimentos com cultura primária de astrócitos. A ausência do IFN? nos animais mutantes levou à redução da expressão de MHC I após uma semana de lesão. Os motoneurônios encontrados no corno ventral destes animais exibiram menor tamanho do soma e maior número de células degeneradas comparado aos animais selvagens. A perda neuronal não foi agravada pela axotomia do nervo isquiático nos animais mutantes. A morte por apoptose foi sugerida baseado nos resultados positivos para TUNEL e caspase 3. A análise ultraestrutural mostrou menor retração de terminais sinápticos nos animais mutantes uma semana após lesão periférica. Além disso, a ausência do IFN? não prejudicou a recuperação motora dos animais mutantes. Em cultura, os astrócitos dos animais mutantes mostraram um atraso na taxa de proliferação provavelmente em razão da ausência do IFN?. Com base nestes resultados, sugerimos que o IFN? pode exercer um papel neuroprotetor e que sua ausência resulta na morte neuronal, a qual não é agravada pela lesão periférica. / Abstract: In the spinal cord, the establishment of synapses is probably coordinated by the neurons. However, the glial cells and surrounding microenvironment formed between neurons/glia play an important role in modulating neural excitability, influencing the transmission and synaptic plasticity. In situations of injury or inflammation, there is an increase in glial reactivity and changes in functional status of neurons, with a consequent cascade of events aimed at restoration of homeostasis. In this regard, IFN? is involved in regulating the expression of MHC I, which has recently been shown to play an important role in the synaptic plasticity processes following axotomy. Also, there is evidence that IFN? absence on spinal cord neurons after injury. The aim of this study was to investigate the phenomena of synaptic plasticity and glial reactivity in mice mutant for IFN? in order to analyze the dynamics of spinal synapses after injury of the sciatic nerve in animals unable to regulate the expression of MHC I due the absence of IFN?. In this sense, mutant mice for IFN? and wild type C57BL/6J were subjected to unilateral transection or crushing of the sciatic nerve (5animals/group/experiment), and the specimens were processed for immunohistochemistry, Western blotting, light and transmission electron microscopy (TEM). In addition, the motor evaluation of the mice was investigated by the sciatic functional index. Spinal cord sections from non-lesioned animals were also used to investigate neuronal survival and the presence of apoptosis with TUNEL and caspase 3 immunostaining. Astrocytes from mutant and wild type newborn mice were also investigated in primary cell culture. The absence of IFN? in the mutant animals produced reduced expression of MHC I after one week from injury. Motoneurons in the lower lumbar ventral horn exhibited a smaller soma size and increased number of degenerated cells?when compared to wild type mice. Sciatic nerve axotomy did not further aggravate the neuronal loss in the mutant mice. Apoptotic death is suggested on TUNEL and caspase 3 positive immunostaining. The electron microscopy showed a smaller retraction of pre-synaptic terminals apposing to motoneurons in mutant mice one week after lesion. The absence of IFN? did not impair motor recovery of the mutant animals. In culture, astrocytes from mutant animals showed a delay in the rate of proliferation probably due to the absence of IFN?. Altogether, these results suggest that IFN? may be neuroprotective and its absence results in neuronal death, which is not further increased by peripheral axotomy. / Doutorado / Biologia Celular / Doutor em Biologia Celular e Estrutural

Orientador: Liana Maria Cardoso Verinaud / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-04T22:32:56Z (GMT). No. of bitstreams: 1 Brito_VaniaNieto_D.pdf: 17655224 bytes, checksum: 75de87a92111468f9002287b57e1c7fe (MD5) Previous issue date: 2005 / Resumo: O timo e o local de maturacao dos linfocitos T que coordenam a resposta imune apos o reconhecimento de antigenos; apesar disso, torna-se alvo em diversas infeccoes. O P. brasiliensis, causador da paracoccidioidomicose, e capaz de invadir o timo e induzir atrofia deste orgao em animais experimentais. Neste estudo, foi analisada a influencia da virulencia fungica (cepas Pb18 e Pb265), da linhagem murina (A/J e B10.A) e de citocinas pro-inflamatorias (TNF e IFN-g) nesse fenomeno. As leveduras da cepa virulenta Pb18 persistiram no timo por um periodo maior e induziram alteracoes histopatologicas mais intensas, embora o isolado Pb265, de baixa virulencia, tambem tenha causado atrofia. O padrao de atrofia, caracterizado por perda de peso do orgao, aumento na taxa de apoptose e perda de delimitacao corticomedular foi semelhante nas duas linhagens, contudo os camundongos B10.A apresentaram tambem alteracoes quantitativas nas subpopulacoes de timocitos e linfocitos T esplenicos. A infeccao fungica também provocou a depressao da resposta proliferativa frente a ConA de timocitos e esplenocitos de camundongos B10.A por um periodo mais prolongado do que de animais da linhagem A/J. Em ambas as linhagens, a infeccao provocou aumento na porcentagem de linfocitos T esplenicos de fenotipo CD4+CD8+. Houve reducao no numero de celulas timicas positivas para TNF e IFN-g apos infeccao com o P. brasiliensis. Utilizando-se camundongos deficientes para o receptor p55 de TNF ou para a producao de IFN-g, verificou-se que o TNF medeia o aumento na apoptose de timocitos pos-infeccao enquanto a perda de peso e da delimitação corticomedular sao desencadeadas pelo IFN-g. Nossos resultados indicam que a atrofia timica observada na paracoccidioidomicose experimental envolve a interacao de fatores relacionados ao fungo e ao hospedeiro, que podem influenciar o curso da doenca / Abstract: Thymus is the site of T cells maturation that orchestrates specific immune response following antigen recognition. In spite of this, it can be a target during many infectious diseases. Paracoccidioides brasiliensis, the etiological agent of paracoccidioidomycosis, is able to invade the thymus inducing atrophy in experimental models. In this study, it was analyzed the influence of fungal virulence (Pb18 and Pb265 isolates), murine strain (A/J e B10.A) and proinflammatory cytokines (TNF e IFN-g) in this phenomenon. Yeasts from virulent strain Pb18 persisted for a larger period in the thymus and induced stronger histopathological alterations, although poorly virulent Pb265 also has induced thymic atrophy. The pattern of atrophy that embodied organ weight decreases, increases in the apoptotic levels and the loss of corticomedullary delimitation was similar in both strains. However, B10. A strain also presented quantitative changes in the thymic and splenic T cell subpopulations. This strain showed a decreased proliferative response of thymocytes and splenocytes to Concanavalin A for a larger period than A/J strain, as well. Both strains had augmentation in the percentage of splenic CD4+CD8+ T cells. There was reduction in the amount of cells positive to TNF and IFN-g in the thymus after infection with P. brasiliensis. By using mice deficient to production of IFN-g or to p55 receptor of TNF it was seen that the TNF mediates the increase of apoptosis that takes place in the thymus after the infection, whereas organ weight decreases and loss of corticomedullary delimitation are performed by IFN-g. Our results suggest that thymic atrophy observed during experimental paracoccidioidomycosis involves interaction of fungal and host related factors and, most probably, influences the course of disease / Doutorado / Imunologia / Doutor em Genetica e Biologia Molecular

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-12-15T13:04:14Z No. of bitstreams: 1 marinamarquespardini.pdf: 1130678 bytes, checksum: 6b0cced1c7d41de2488ba773203968cd (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-12-15T14:16:47Z (GMT) No. of bitstreams: 1 marinamarquespardini.pdf: 1130678 bytes, checksum: 6b0cced1c7d41de2488ba773203968cd (MD5) / Made available in DSpace on 2016-12-15T14:16:47Z (GMT). No. of bitstreams: 1 marinamarquespardini.pdf: 1130678 bytes, checksum: 6b0cced1c7d41de2488ba773203968cd (MD5) Previous issue date: 2008-06-05 / As infestações por carrapatos em bovinos reduzem a produtividade do gado de corte e leiteiro causando grandes perdas econômicas à pecuária. Os prejuízos acarretam desde debilidade física e transmissão de doenças ao rebanho, como anaplasmose e babesiose, até a morte dos indivíduos mais vulneráveis. Os carrapatos permanecem por longos períodos fixados em seus hospedeiros sendo expostos ao sistema de defesa do bovino, o que provoca inflamação e ativa elementos da resposta imune humoral e celular do hospedeiro. Em contrapartida, componentes imunogênicos da glândula salivar do carrapato modulam a resposta bovina para perfis de citocinas favoráveis à hematofagia. Existem poucos estudos sobre mecanismos imunes que guiam a interação parasito-hospedeiro e determinam o sucesso ou não do parasitismo. Trabalhos recentes apontam para importância de fatores genéticos relacionados à resistência ao carrapato em determinadas raças bovinas, além de estudos que mostram o papel crítico das citocinas na prevenção e progressão de quadros patológicos. O objetivo desse trabalho foi avaliar a resposta imunológica de bovinos infestados artificialmente pelo carrapato Boophilus microplus através de ensaios de proliferação celular e detecção de óxido nítrico (NO) e interferon-gama (IFN-) em células mononucleares do sangue periférico a fim de verificar diferentes níveis de resistência bovina. Seis bovinos mais resistentes e seis mais susceptíveis de uma população F2 de 332 animais, originária do cruzamento de F1 (½ Holandês : ½ Gir), foram selecionados com base na contagem de carrapatos e valor genético. Amostras de sangue foram coletadas nos pontos 0, 5º e 12º dias pós-infestação para cultura de células e estimulação in vitro com antígenos do B. microplus. A proliferação celular e os níveis de NO e IFN- foram avaliados respectivamente pelos métodos de MTT, Griess e ELISA. As células dos animais resistentes (R) tenderam ao aumento de proliferação no 5º dia quando estimuladas com antígenos do carrapato retornando aos níveis iniciais no 12° dia. Já nos animais susceptíveis (S), a estimulação pareceu inibir a proliferação das células no dia 0 e não alterou os índices do 5° e 12° dia. Apesar disso, não houve diferença significativa na proliferação celular entre os grupos R e S. Quando as células obtidas no dia 0 foram cultivadas na ausência de estímulo, os níveis de NO dos animais R tenderam a ser mais altos que dos animais S. A estimulação com antígenos de carrapato pareceu inibir a produção de NO no 5º dia por células de animais R. Também não houve diferença significativa nas produções de NO e de IFN- entre os grupos R e S. Os resultados sugerem que o NO possa ter um papel no início da resposta imune que delineia o mecanismo de resistência ao carrapato, uma vez que as alterações mais importantes foram detectadas até o 5º dia após a infestação. É possível que o mecanismo de resistência esteja associado à regulação negativa da resposta imune a fim de não incitar a modulação desta pelo carrapato, porém sendo eficaz o suficiente para eliminá-lo. A avaliação da resposta imunológica nos primeiros momentos após a fixação do carrapato no couro bovino, bem como um acompanhamento mais detalhado dos pontos temporais da infestação poderia fornecer dados mais conclusivos. / Tick infestations in cattle reduce its beef and dairy productivity causing great economic losses to livestock. The potential damages are physical weakness, transmission of diseases to the herd, as anaplasmosis and babesiosis, and even vulnerable animals deaths. Thus, the tick control has been considered priority in tropical regions worldwide. The ticks remain fixed to their hosts for long periods being exposed to the cattle defense system; it causes inflammation and activates the host’s humoral and cellular immune response. Nevertheless, immunogenic components of the salivary gland of cattle tick modulate the response to profiles of cytokines that promote the blood-feeding. There are few studies approaching immune mechanisms that lead to host-parasite interaction and determine the success or unsuccessful of parasitism. Recent works suggest the importance of genetic factors related to the resistance to ticks in Bos taurus and Bos indicus breeds. In addition, studies show the critical role of cytokines in the prevention and progression of diseases. The aimed of this work was to evaluate the immune response in cattle artificially infested by Boophilus microplus through cell proliferation assays and detection of nitric oxide (NO) and interferon-gamma (IFN-) in peripheral blood mononuclear cells, in order to establish different resistance levels in Girolando breed. Six tick-resistant and six tick-susceptible animals from a F2 population of 332 animals originated from crossing cattle F1 (½ Holstein : ½ Gir) were selected based on the ticks counting and breeding value. Blood samples were collected for cell culture and stimulation in vitro with antigens of B. microplus in the points 0, 5 and 12 days after infestation. The cell proliferation and the NO and IFN- levels were evaluated by MTT, Griess and ELISA, respectively. There was a tendency of increasing proliferation of resistant animals (R) cells in the 5th day when they were stimulated with the tick antigens, returning to initial levels at 12th day. In the other hand, for the susceptible animals (S) the stimulation seemed to inhibit proliferation of cells in day 0, and did not altered the rates of 5th and 12th day. There was no significant difference between the cell proliferation of the groups R and S. When the cells obtained in the day 0 were cultured in the absence of stimulation, the levels of NO of animals R tended to be higher than that of the animals S. The stimulation with tick antigens inhibited the NO production by cells of animals R in the 5th day. In addition, there was no significant difference in NO and IFN- production between the groups R and S. The results suggest that NO may play a role in the early immune response that outlines the mechanism of resistance to ticks, since the most important changes were detected until the 5th day after the infestation. It is possible that the resistance mechanism is associated to the downregulation of immune response in order not to encourage the modulation by the ticks, although being effective enough to eliminate it. An evaluation of the immune response in the first moments after the tick fixation to cattle leather, as well as a more detailed monitoring of the temporal points of the infestation, could provide more conclusive data.

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-05-22T11:28:08Z No. of bitstreams: 1 adrianaalvessilva.pdf: 479342 bytes, checksum: e8874dc2bfd843cc66a19f10a9099d36 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-22T17:19:25Z (GMT) No. of bitstreams: 1 adrianaalvessilva.pdf: 479342 bytes, checksum: e8874dc2bfd843cc66a19f10a9099d36 (MD5) / Made available in DSpace on 2017-05-22T17:19:25Z (GMT). No. of bitstreams: 1 adrianaalvessilva.pdf: 479342 bytes, checksum: e8874dc2bfd843cc66a19f10a9099d36 (MD5) Previous issue date: 2008-02-20 / Muitos estudos têm avaliado o comportamento das ligaduras elásticas em relação às suas propriedades físicas. No entanto, a biocompatibilidade destes materiais não se apresenta bem documentada na literatura. O presente estudo teve como objetivo avaliar, in vitro, a viabilidade celular de macrófagos murinos J774 na presença de ligaduras elásticas de diferentes marcas e cores e, analisar o efeito destas ligaduras na produção de óxido nítrico (NO) produzido por estas células, com e sem ativação de interferon-gama (IFN-γ), uma citocina pró-inflamatória. Para cada tempo estudado, foram utilizados 6 elos de ligaduras elásticas de 3 marcas diferentes (Morelli, GAC e TP) nas cores prata e transparente após esterilização com óxido de etileno. As placas de cultura de 96 poços, utilizadas no experimento, foram divididas em 2 metades. A primeira foi preenchida pelas células J774 resuspensas em meio RPMI suplementado juntamente com os elos de cada tipo de ligadura e células controle. A segunda metade foi completada com outros 6 elos dos mesmos tipos de ligaduras mantidos em culturas juntamente com 10μl de IFN—γ (5 ng/ml) e grupo controle. As placas foram incubadas em diferentes intervalos de tempo: 24, 48 e 72 horas. As células foram submetidas à avaliação da viabilidade celular através da técnica do MTT [3 – (4,5-dimethylthiazol-2-yl) – diphenyl tetrazolium bromide] e os sobrenadantes foram coletados para a análise da produção de NO, utilizando-se o método de Griess. Para análise dos resultados foram utilizados os testes de Kruskal-Wallis e Mann-Whitney. Na ausência do estímulo (IFN—γ), a viabilidade celular nos grupos de ligaduras foi maior no período final da avaliação em relação ao grupo controle. No entanto, 3 grupos de ligaduras (Morelli prata, Morelli transparente e GAC prata) exibiram proliferação significativa em 72 horas. As ligaduras da marca TP Orthodontics (prata e transparente) não influenciaram de forma significativa a viabilidade celular e a produção de NO. Embora a ligadura Morelli prata tenha estimulado as células J774 a realizarem uma maior produção de NO, os outros tipos de ligaduras nos diferentes tempos avaliados não apresentaram diferenças significativas na produção de óxido nítrico em relação às células controle. Na presença do IFN-γ, houve uma redução significativa da viabilidade celular no tempo 48 horas para o grupo das ligaduras Morelli e GAC. Entretanto, uma média de viabilidade superior ao apresentado pelas células controle foi observada em todos os grupos de ligaduras no tempo 72 horas, sendo significativa para o grupo das ligaduras GAC transparente. O grupo das ligaduras TP foi o que apresentou comportamento semelhante ao grupo controle, apesar das ligaduras TP prata terem apresentado menor viabilidade em 24 horas. O IFN-γ proporcionou aumento significativo na produção de NO em todos os grupos no período final em relação ao inicial. As ligaduras Morelli transparente e GAC (prata e transparente) demonstraram a menor produção desta molécula nos 3 tempos analisados. / Although the physical properties of elastic ligatures have been the subject of several studies, the biocompatibility of these materials has not been well documented in the literature. This study was an in vitro investigation of the cellular viability of the murine macrophage J774 cell line in the presence of elastomeric ligatures of different brands and colors, and of nitric oxide (NO) production of these cells both, under the presence of such ligatures, and under the influence of a proinflammatory cytokine: gamma-interferon. After sterilization with ethylene oxide, 6 chains of ligatures of 3 different brands (Morelli, GAC e TP) and colors (silver and transparent) were used at each study time. The 96-well culture plates used in the experiment were divided in 2 halves. The first was filled with J774 cells resuspended in supplemented RPMI medium, along with the chains of each kind of ligature and control cells. The second half was filled with another 6 chains of the same kinds of ligatures, kept in J774 cell cultures in supplemented RPMI medium, along with 10μl of IFN-γ (5 ng/ml) and control cells. The plates were incubated at 24, 48, and 72 hours. The MTT [3 – (4,5-dimethylthiazol-2-yl) – diphenyl tetrazolium bromide] technique was used for cellular viability assessment, and the supernatants were collected for NO production analysis with the Griess method. Kruskal-Wallis and Mann-Whitney tests were used to analyze the results. Cellular viability in the elastomeric groups was higher at the final time point in relation to the control group. However, 3 elastomeric groups (silver Morelli, transparent Morelli and silver GAC) showed significant proliferation after 72 hours. TP-ligature-exposed cells had the same behavior of controls, no significant changes in cellular viability and NO production being found. Although silver Morelli ligatures led to higher NO production, the other types of ligatures did not significantly affect NO production, as compared to control cells. In the presence of IFN-γ, Morelli and GAC ligatures led to a significant reduction of cellular viability after 48 hours. Yet a viability mean higher than that seen in control cells was observed for all ligatures after 72 hours, with transparent GAC showing significant proliferation. Cells exposed to TP ligatures had the same behavior of controls, although silver TP ligatures led to lower viability at 24 hours. Nitric oxide production was significantly greater in all groups at the final time point in relation to the initial time point. The transparent Morelli and silver and transparent GAC showed the smallest NO production at the 3 study time points.

Tuberculosis (TB) remains the main cause of death in people living with HIV (PLHIV). Indeed, PLHIV have a 20-30% greater risk of developing TB compared to HIV-uninfected subjects and have lower TB treatment success rates. In 2014, among the 9.6 million incident cases of TB reported worldwide, 12% occurred in PLHIV and 0.4 million deaths from HIV-associated TB were recorded.Mycobacterium tuberculosis is the main etiological agent for TB. For a majority of individuals, the immune response upon infection by M. tuberculosis is sufficient to prevent the development of disease, but insufficient to clear the bacteria. This leads to the persistence of viable M. tuberculosis in diverse cells with no resulting clinical manifestations, an entity known as latent tuberculosis infection (LTBI). The resulting reservoir of M. tuberculosis is vast, and an estimated one third of the world population is concerned. For subjects with LTBI, the life-time risk of reactivation and progression to TB lies between 5 and 10%. However, if co-infected with HIV, the risk is much greater and reaches 10% per year. According to a Cochrane review in 2010, the screening and treatment of LTBI in PLHIV reduces this risk by 30-60%. This prevention strategy is therefore widely recommended. However, the implementation of LTBI screening and treatment into standard HIV-care has been limited. In this work, three different approaches have been used to understand and address this issue, focusing on a low TB-incidence and high-income setting.The first approach was to assess the implementation of LTBI screening in HIV-care across Belgium and identify its barriers as perceived by the caregivers on the field. Raising awareness to this issue was an indirect objective of the study. A multi-choice questionnaire was sent to 55 physicians working in a Belgian AIDS reference center or satellite clinic. A response rate of 62% was obtained. Only 20% of participants performed LTBI screening on all their patients and notable variations in the screening methods used were observed. A large majority of participants were in favor of targeting LTBI screening to HIV-infected patients at highest risk of TB rather than a systematic screening of all PLHIV. These results have been communicated to the Belgian LTBI working group, currently updating the national LTBI screening guidelines. Indeed, targeting screening to those at highest risk of TB is an attractive strategy in low-TB incidence countries and is already recommended in the United Kingdom. However, to date, no score assessing the risk of TB in PLHIV has been validated. Among the barriers to LTBI screening identified by the participants of this first study, the most frequently reported were lack of sensitivity of screening tools, risk associated to polypharmacy and toxicity of treatment. Improving the sensitivity of LTBI screening was the cornerstone of the second approach. The available screening tools for LTBI are the tuberculin skin test (TST) and two Interferon-gamma release assays (IGRAs): the QuantiFERON-TB Gold-IT (QFT-GIT) and the T-SPOT.TB®. All three lack sensitivity in PLHIV. Various strategies to discover superior LTBI screening tools are therefore being explored, including the development of IGRAs in response to alternative M. tuberculosis antigens to those used in the QFT-GIT or T-SPOT.TB®. A potential candidate is the native Heparin-Binding Haemagglutin (nHBHA), a methylated M. tuberculosis protein regarded as a latency-associated antigen. An in-house IGRA based on nHBHA (nHBHA-IGRA) has been shown to be a promising LTBI screening tool both in immunocompetent adults and in hemodialysed patients. The contribution of this nHBHA-IGRA to the detection of M. tuberculosis in PLHIV was therefore investigated. Treatment-naïve HIV-infected subjects were recruited from 4 Brussels-based hospitals. Subjects underwent screening for latent TB using the nHBHA-IGRA in parallel to the classical method consisting of medical history, chest X-ray, TST and QFT-GIT. Prospective clinical and biological follow-up ensued, with repeated testing with nHBHA-IGRA. Among 48 candidates enrolled for screening, 9 were diagnosed with LTBI by combining the TST and QFT-GIT results (3 TST+/QFT-GIT+, 1 TST+/QFT-GIT- and 5 TST-/QFT-GIT+). All 3 TST+/QFT-GIT+ patients, the TST+/QFT-GIT- patient as well an additional 3 subjects screened positive with the nHBHA-IGRA. These 3 additional patients had known M. tuberculosis exposure risks compatible with LTBI. During follow-up (median 14 months) no case of TB was reported and nHBHA-IGRA results remained globally constant. Multiplex analysis confirmed IFN- as the best read-out for the assay. From this study, we concluded that the nHBHA-IGRA appears complementary to the QFT-GIT for the screening of LTBI in PLHIV and the combination of the two tests may increase the sensitivity of screening. A large-scale study is however necessary to determine whether combining nHBHA-IGRA and QFT-GIT offers sufficient sensitivity to dismiss TST, as suggested by our results. In the same study, a group of HIV-infected adults with clinical suspicion of active TB were also recruited and tested with nHBHA-IGRA. Contrary to results in HIV-uninfected subjects, the nHBHA-IGRA could not discriminate between LTBI and active TB in PLHIV. This is an important caveat as HIV-infected subjects may present subclinical TB.A different angle was used for the third approach to the problem of LTBI in PLHIV. Systemic immune activation (SIA) is one of the principal driving forces in the natural course of HIV-infection. Despite long-term viral suppression by combination antiretroviral treatment (cART), a low-level SIA persists and is associated with an early-onset of age-associated disorders such as cardiovascular disease, dementia and osteoporosis. Causes of SIA in PLHIV are multiple and certain chronic infections appear to be implicated. A recent study in South Africa found that LTBI in PLHIV was associated with an increase in circulating activated CD8+ T-cells. If LTBI should contribute to the persistence of SIA, its screening and treatment could have an additional benefit on the clinical outcome of PLHIV. To investigate this theory, the expression of T-cell activation markers (CD38 and HLADR) as well as the level of plasmatic markers of immune activation (IL-6, sCD14, D-Dimers) were compared between subjects presenting active TB, subjects with LTBI and M. tuberculosis-free persons, with and without HIV-infection. In accordance with previous studies, active TB was associated with higher levels of SIA biomarkers in both HIV-infected and -uninfected groups. Among the HIV-uninfected subjects, no significant difference in biomarker level was found between those presenting LTBI and those with no evidence of M. tuberculosis. The effect of LTBI on activation biomarkers in the HIV-infected groups remained inconclusive because of the small number of individuals in the HIV+/LTBI group. Further investigation is therefore warranted. Interestingly, it was found that plasmatic markers may have a greater sensitivity for the detection of M. tuberculosis-associated SIA than the T-cell activation markers, an important result for future studies.Overall, LTBI in PLHIV is a challenging topic, in particular because of the lack of a gold-standard for the diagnosis of LTBI. Despite suboptimal tools, the evident clinical impact of LTBI screening and treatment in PLHIV on TB incidence justifies its implementation in standard HIV-care. In low TB-incidence countries, who, when and how to screen for LTBI in PLHIV remains unclear. This work offers an overview on the subject with particular focus on possible measures for improvement in the field. / Doctorat en Sciences médicales (Médecine) / info:eu-repo/semantics/nonPublished