Diabete Melito tipo 1A (DM1A) é uma doença autoimune resultante da interação de fatores ambientais, alterações imunológicas e predisposição genética. Decorre da perda da tolerância aos antígenos das células beta pancreáticas e ativação do sistema imunológico, notadamente dos linfócitos T e B. A via linfocitária T helper 17 está fortemente associada ao processo inflamatório denominado insulite, que resulta na destruição das células beta pancreáticas, levando à perda gradativa da produção de insulina e à instalação do DM1A. A via T helper 17 é regulada pelas interleucinas IL-17, IL-21, IL-23 e IL-27, que também atuam na agressão autoimune. Neste estudo nós avaliamos a importância dos receptores da IL-21 (IL-21RA) e da IL-17 (IL-17RA) na susceptibilidade ao DM1A e nas suas manifestações autoimunes (autoanticorpos) em 631 pacientes portadores de DM1A (24.6 ± 13.0 anos) comparados com 652 controles saudáveis (28.5 ± 11.4 anos). Não há dados prévios na literatura. As variantes selecionadas dos genes do IL-17RA (n=4), do IL-21R (n=5) e da cadeia gama comum (n=1) foram genotipadas através da metodologia Vera Code, Golden Gate (Illumina, EUA). Os autoanticorpos circulantes anti-descarboxilase do ácido glutâmico (anti-GAD65), anti-tirosina fosfatase (anti-IA2), anti-peroxidase (anti-TPO) e anti-tireoglobulina (anti-TG) foram dosados por radioimunoensaio, o antitransportador de zinco 8 (anti-ZnT8) por ELISA, o anti-célula parietal por imunofluorescência direta e o anti-receptor de TSH (TRAb) por ensaio radiorreceptor, marcado com iodo radioativo. As frequências dos genótipos das variantes foram testadas para o Equilíbrio de Hardy-Weinberg e as associações genotípicas, pelos testes do qui-quadrado e exato de Fisher. Estes foram ajustados para as covariáveis (idade, sexo, cor autorreferida e duração do diabete) na análise de regressão logística binária. Obtivemos os seguintes resultados para o gene IL17RA: a variante rs2241049 (genótipos AG/GG) foi associada à susceptibilidade para o DM1A (OR=1,42; IC95%=1,11-1,81; p=0,005), enquanto a variante rs879577 à proteção ao DM1A (genótipo AA: OR=0,61; IC95%= 0,4 - 0,93; p=0.021) e à menor frequência do anticorpo anti-IA2 (AA/AG; OR=0,67, IC95%= 0,45-0,99; p=0.043). O genótipo GG de rs5748863 foi relacionado à menor frequência dos autoanticorpos anti-IA2 (OR=0,52, IC95%= 0,32- 0,86; p=0.010). Em relação ao gene IL21R, os genótipos GC/CC de rs7199138 foram relacionados à susceptibilidade ao DM1A (OR= 1,33; IC95%= 1,05-1,68; p= 0,018). As variantes rs2214537(CG/GG) e rs2285452 (AG/AA) foram associadas à menor frequência dos autoanticorpos anti-célula parietal (OR=0,24; IC95%= 0,09-0,59; p < 0.001) e antiendomísio (OR=0,17; IC95%= 0,04-0,8; p=0.025), respectivamente. As variantes rs3093315 (TG/TT) e rs2285452 (AA) condicionaram maior frequência de TRAb (OR=5,89; IC95%=1,26-27,61; p=0.024) e anti-TPO (OR=2,38; IC95%= 1,1-5,13; p=0.028), respectivamente. Nossos resultados sugerem que variantes dos genes IL17RA e IL21R estão associadas à fisiopatologia do DM1A e à expressão de autoanticorpos pancreáticos e extrapancreáticos / Type 1 diabetes mellitus (T1D) is an autoimmune disease resulting from the interaction of environmental factors, immunological changes and genetic predisposition. It results from the loss of tolerance to pancreatic beta cell antigens and to the activation of the immune system, notably T and B lymphocytes. The T helper-17 pathway is strongly associated with the inflammatory process called insulitis, which results in pancreatic beta cells destruction, leading to the gradual loss of insulin production and to the manifestation of T1D. The T helper 17 pathway is regulated by the interleukins IL-17, IL-21, IL-23 and IL-27, which also act in the autoimmune aggression. In this study we evaluated the importance of the receptors of IL-21 (IL-21RA) and IL-17 (IL-17RA) genes in the susceptibility to T1D and its autoimmune manifestations (autoantibodies) in 631 patients with DM1A (24.6 ± 13.0 years) , compared with 652 health controls (28.5 ± 11.4 years).There is no previous data in the literature. The selected variants of the IL-17RA (n = 4), IL-21R (n = 5) and of the common gamma chain (n = 1) genes were genotyped using the Vera Code methodology, Golden Gate (Illumina, USA). The autoantibodies anti-decarboxylase of glutamic acid (anti-GAD65), anti-tyrosine phosphatase (anti-IA2), anti-peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) were measured by radioimmunoassay, anti zinc transporter 8 (Anti-ZnT8) by ELISA, anti-parietal cell by direct immunofluorescence and anti-TSH receptor (TRAb) by radiolabeled radioiodine receptor assay. The frequencies of the genotypes of the variants were tested by Hardy-Weinberg Equilibrium and the genotypic associations were performed by the chi-square and Fisher\'s exact tests. These were adjusted for the covariates (age, gender, self-reported color and diabetes duration) in binary logistic regression analysis.We obtained the following results for IL-17RA : the rs2241049 variant (AG/GG genotypes) was associated with susceptibility to T1D (OR = 1,42; CI65%= 1,11-1,81; p = 0,005), while the rs879577 variant to T1D protection (genotype AA: OR = 0,61; CI95%= 0,4 - 0,93; p = 0,021) and to lower anti-IA2 frequency (AA/AG; OR = 0,067; CI95%=0,45-0,99; p=0,043). Further, the GG genotype of rs5748863 variant was related to lower frequency of the autoantibody anti-IA2 (OR= 0,52; CI95%= 0,32- 0,86; p= 0,010). Regarding IL21R, the GC / CC genotypes of rs7199138 were related to susceptibility to T1D (OR = 1,33; CI95%= 1,05-1,68; p = 0,018). The variants rs2214537 (CG/GG) and rs2285452 (AG/AA) were associated with lower frequency of parietal cell (OR=0,24; CI95%= 0,09-0,59; p < 0,001) and antiendomysial autoantibodies (OR=0,17; CI95%= 0,04-0,8; p=0,025), respectively. The rs3093315 (TG/TT) and rs2285452 (AA) variants were related to higher frequency of TRAb (OR=5,89; CI95%= 1,26-27,61; p=0,024) and anti-TPO (OR=2,38; CI95%= 1,1-5,13; p=0,028), respectively. Our results suggest that variants of the IL17RA and IL21R genes are associated with the pathophysiology of T1D and the expression of pancreatic and extra-pancreatic autoantibodies

O Diabetes Mellitus tipo 1 (DM1A) é uma doença autoimune caracterizada pela infiltração pancreática de linfócitos T e B, macrófagos e células dendríticas, levando à perda progressiva da capacidade de secreção de insulina pelas células beta pancreáticas. A homeostase das células T, ou seja, o desenvolvimento e manutenção apropriados dos números e funções das células T são essenciais para a integridade do sistema imune. Classicamente acreditava-se que as células T CD4+ poderiam se subdividir em duas populações efetoras distintas, T helper 1 e T helper 2. Recentemente, foram descritas duas novas vias de ativação de linfócitos T CD4+: a via Th17, que tem papel fundamental na autoimunidade; a via T regulatória, onde células T CD4+CD25+ high são essenciais na tolerância periférica e proteção contra autoimunidade. As Interleucinas (IL) de cadeia gama comum agem em várias etapas desta diferenciação linfocítica. A IL-21 é o membro mais recente desta família de citocinas, que inclui também: IL-2, IL-4, IL-7 , IL-9 e IL-15. A IL-21 atua através da interação com seu receptor, o IL-21R, apresentando ações pleiotrópicas e, como regra, pró-inflamatórias. Em estudos com modelos animais de diabetes autoimune verificou-se que a IL-21 e seu receptor são essenciais para o desenvolvimento da doença, porém ainda não há estudos sobre a ação desta interleucina no DM1 em humanos. O objetivo de nosso estudo foi avaliar o papel dos receptores das interleucinas de cadeia gama comum na patogênese do DM1A através da determinação da expressão da proteína de superfície e do RNA mensageiro destes receptores em pacientes com DM1A de início recente, em comparação com indivíduos controles normais, e da correlação destes valores com títulos de autoanticorpos pancreáticos. Estudamos a expressão da proteína de superfície do IL-21R, IL-2R (CD25), IL-2R (CD122), IL-4R (CD124) e IL-7R (CD127) em linfócitos T periféricos de 35 pacientes com DM1 e 25 controles sadios utilizando citometria de fluxo. O tempo médio de diagnóstico do DM1 foi de 3 meses, e todos os pacientes estavam em uso de insulina no momento da coleta de sangue. Auto-anticorpos pancreáticos (anti-GAD65 e anti-IA2) foram dosados através de radioimunoensaio. A expressão do RNAm de IL-21R, IL-2R e IL-2R foi quantificada por PCR em tempo real em 23 dos pacientes portadores de DM1A. Detectamos, pela primeira vez, diminuição significativa na expressão proporcional de IL-21R, CD25 e CD122 em linfócitos TCD3+ e TCD4+, além de diminuição na expressão de CD124 em linfócitos T CD4+ e CD127 em linfócitos T CD3+. Verificamos também redução significativa na quantidade de células TCD4+CD25+high (T regulatórias) nos pacientes DM1A. Não houve correlação entre expressão dos receptores de superfície das interleucinas de cadeia gama comum e títulos de autoanticorpos pancreáticos. Realizamos o PCR em tempo real para quantificar a expressão do RNA mensageiro (RNAm) dos receptores de interleucinas de cadeia gama comum, e avaliar se esta correspondia à expressão das proteínas de superfície obtida através de citometria de fluxo. Comparamos a expressão do RNAm de IL-21R, IL-2R e IL-2R nos pacientes DM1A dividindo-os em tercis de acordo com os valores de expressão de proteína de superfície obtidos por citometria de fluxo em linfócitos T CD3+, e verificamos que não houve diferença entre os 3 grupos na expressão relativa dos genes estudados. Portanto, em nossa casuística a redução da expressão da proteína de superfície dos receptores de interleucinas de cadeia gama comum possivelmente decorreu de alterações posteriores à transcrição do RNA mensageiro / Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by pancreatic infiltration of T and B lymphocytes, macrophages and dendritic cells, leading to a progressive destruction of the insulin-producing -cells. Homeostasis of T cells can be defined as the ability of the immune system to maintain normal T-cell counts and to restore T-cell numbers following T-cell depletion or expansion. It was classically believed that the CD4+ T cells could be activated into two distinct effector populations, T helper1 and T helper2. It was recently described two new pathways of CD4+ T lymphocytes activation: the Th17 pathway, that plays a fundamental role in autoimmunity and the regulatory pathway (Treg), where CD4+CD25+high T cells are essential to maintain peripheral tolerance and therefore protect against autoimmunity. The common gamma chain cytokines interfere with several steps of the CD4+ T lymphocytes differentiation. Interleukin-21 (IL-21) is the most recent member of this family, that also includes IL-2, IL-4, IL-7, IL-9 and IL-15, and has pleiotropic effects on the immune system. Interleukin-21 acts through interaction with its receptor, the IL-21R, which is expressed in a great variety of immune cells. Various studies with animal models of autoimmune diabetes demonstrated that IL-21 and its receptor are essential for the development of the disease, but there are no studies evaluating the role of this interleukin and its receptor in T1DM in humans. The aim of our study was to assess the role of common gamma chain-dependent cytokine receptors in the pathogenesis of T1D, by determining the expression of the surface protein and mRNA of these receptors in recent-onset T1D patients and correlating these values with titles of pancreatic autoantibodies. We studied the surface protein expression of IL-21R, IL-2R (CD25), IL-2R (CD122), IL-4R (CD124) and IL-7R (CD127) in peripheral T lymphocytes of 35 patients with T1D and 25 healthy controls using flow cytometry. Mean T1D duration was 3 months and all patients were using insulin at the time of blood withdraw. Pancreatic autoantibodies (anti-GAD65 and anti-IA2) were assessed by radioimmunoassay. The mRNA expression of IL-21R, IL-2R and IL-2R was quantified by real time PCR in 23 of the T1D patients. We detected for the first time a statistically significant decrease in the proportional expression of IL-21R, CD25 and CD122 on CD3+ and CD4+ T lymphocytes, a decrease in the expression of CD124 on CD4+ T cells and CD127 on CD3+ T lymphocytes. We also observed a significant reduction in the amount of CD4+ CD25+high (T regulatory cells) in T1D patients. There was no correlation between the expression of the surface receptors of common gamma chain cytokines and titles of pancreatic autoantibodies. We performed real-time PCR to quantify RNA expression of common gamma-chain interleukin receptors, and evaluate if these values corresponded to those of surface proteins obtained using flow cytometry. We compared the mRNA expression of IL-21R, IL-2R and IL-2R in T1D patients by dividing them into tertiles according to the expression values of surface protein obtained by flow cytometry in CD3+T lymphocytes. We observed that there was no difference in the relative expression of mRNA among the 3 groups of patients. Therefore, in our study, the reduction of surface protein expression of common gamma chain cytokines receptors was possibly due to alterations that occurred after the transcription of mRNA

La vaccination est largement utilisée pour la génération de lymphocytes T spécifiques contre les tumeurs. Malheureusement, cette stratégie n'est pas adaptée aux personnes âgées car leur thymus régresse avec l'âge conduisant ainsi à une baisse dans la production de cellules T et à l'accumulation de cellules immunitaires âgées ayant des défauts liés à leurs stimulations. Comme il a été démontré auparavant que L’IL-21 est capable d’induire des fonctions thymiques, nous avons émis l’hypothèse que l’injection d’IL-21 à des souris âgées stimulera la thymopoïèse. Nos résultats montrent que l’administration de l’IL-21 augmente le nombre absolu de thymocytes chez les souris âgées et augmente la migration de ces cellules vers la périphérie ou ils contribuent à la diversité du TCR. De plus les cellules T en périphérie expriment un niveau plus élevé de miR181-a, et par conséquent moins de phosphatase comme SHP2, DUSP5/6 qui inhibent le TCR. En vaccinant des souris âgées avec le peptide Trp2, les souris traitées avec l’IL-21 montrent un retard dans la croissance des cellules B16 tumorales. Cette étude montre que l’IL-21 pourrait être utilisé comme stratégie pour le rétablissement du systeme immunitaire chez les personnes âgées. / Vaccines have been largely sought for the generation of protective tumor-specific T cells. Unfortunately however, this strategy is not suitable for the elderly as their thymus regresses with age leading to a decline in T-cell production and accumulation of aged lymphocytes endowed with stimulation-related defects. Interleukin (IL)-21 has been shown to display thymostimulatory properties. Therefore, we hypothesized that IL-21 administration to ageing host may boost T-cell production and restore a competent peripheral T-cell compartment. Our study shows that IL-21 injection to aged mice lead to an increase in the thymocytes absolute number and an increase in thymocytes egress to the periphery where they enhance the T-cell receptor (TCR) diversity. Furthermore T-cell in the periphery express higher level of miR-181a and thus less TCR-inhibiting phosphatases SHP-2 and DUSP5/6 enable them to be more responsive upon stimulation. Consequently, aged rIL-21-treated mice vaccinated using a tyrosinase-related protein 2 (Trp2)-derived peptide exhibited a substantial delay in B16 tumor growth and improved survival. The results of this study highlight the immunorestorative function of rIL-21 paving its use as a strategy for the re-establishment of effective immunity in the elderly.

Les lymphocytes B jouent un rôle central dans l’immunité humorale par leur capacité à présenter des antigènes aux lymphocytes T, à sécréter des cytokines et à se différencier en plasmocytes produisant des anticorps. Ces fonctions peuvent être induites par leur stimulation in vitro. Par leur aptitude à présenter des antigènes indépendamment de la spécificité du récepteur des lymphocytes B (BCR), les lymphocytes B peuvent être utilisés comme cellules présentatrices d’antigènes (antigen-presenting cells, APC) afin d’induire la réponse cellulaire des lymphocytes T CD8+ cytotoxiques spécifiques. L’immunité cellulaire est cruciale pour prévenir les infections contre certains virus et en immunothérapie du cancer. L’objectif général de ces travaux est d’étudier la biologie des lymphocytes B. Plus particulièrement, nous souhaitons comprendre et améliorer leur fonction de présentation d’antigène afin d’utiliser les lymphocytes B comme source alternative d’APC. Dans la première partie de ces travaux, notre attention s’est portée sur la compréhension du mécanisme de présentation croisée par le complexe majeur d’histocompatibilité de classe I (CMH-I) par lequel un épitope de la protéine gp100 du mélanome, inséré dans une nanoparticule pseudo-virale (VLP) composée de la protéine de surface du virus de la mosaïque de la papaye (PapMV), est présenté par les lymphocytes B. Cette VLP est une plateforme vaccinale capable de stimuler le système immunitaire sans l’aide d’adjuvant et facilite la présentation croisée de l’épitope inséré, de façon indépendante de l’activité du protéasome. Les résultats obtenus démontrent que l’apprêtement de l’épitope inséré dans la nanoparticule s’effectue selon une voie de présentation croisée vacuolaire qui dépend de l’activité de la cathepsine S, de l’acidification des lysosomes et requiert l’induction de l’autophagie. Ainsi, nous avons défini plus précisément le mécanisme de présentation croisée par lequel les lymphocytes B apprêtent et présentent un épitope inséré dans la VLP de PapMV. Par la suite, nous avons cherché à améliorer le protocole d’activation in vitro permettant d’amplifier et d’induire les fonctions de présentation d’antigènes des lymphocytes B, dans le but d’utiliser ces cellules pour activer les réponses cellulaires des lymphocytes T CD8+ cytotoxiques. Les stimulations in vitro des lymphocytes B par le CD40 ligand (CD40L) et l’interleukine (IL)-21 ou la combinaison de l’IL-4 et l’IL-21 au lieu de l’activation standard avec le CD40L et l’IL-4 ont été évaluées. Nos résultats ont approfondi nos connaissances de la biologie des lymphocytes B. Nous avons démontré que la stimulation des lymphocytes B avec le CD40L et l’IL-21 augmente leur prolifération, mais mène à leur différenciation en plasmocytes sécrétant des anticorps. Au contraire, la stimulation avec le CD40L et l’IL-4 induit efficacement leur fonction de présentation d’antigènes. La stimulation des lymphocytes B avec le CD40L et la combinaison de l’IL-4 et de l’IL-21 augmente leur prolifération, mène seulement faiblement à leur différenciation en cellules sécrétrices d’anticorps, mais induit efficacement leur fonction de présentation d’antigènes. Nous avons démontré pour la première fois que cette méthode permet de générer des APC puissantes capables d’induire la réponse des lymphocytes T CD8+ cytotoxiques in vitro. Nos résultats nous permettent de postuler que ces cellules pourraient être capables de mener à une réponse cellulaire in vivo. En tant qu’APC efficaces, les lymphocytes B pourraient être utilisés dans une stratégie vaccinale ou être employés comme APC afin d’améliorer les traitements d’immunothérapie du cancer par transfert adoptif de lymphocytes T. Ainsi, les travaux présentés dans cette thèse ont porté tant sur la compréhension des mécanismes de présentation croisée d’un épitope inséré dans la VLP de PapMV par les lymphocytes B, que sur l’amélioration de la méthode permettant d’induire leur fonction de présentation d’antigènes pour activer les lymphocytes T CD8+ cytotoxiques. Ces travaux de recherche fondamentale ont permis de contribuer à des avancées sur les connaissances de la biologie des lymphocytes B. Ils offrent de nouvelles pistes de réflexion quant aux utilisations biotechnologiques des lymphocytes B comme source alternative d’APC pour des applications de recherche fondamentale et clinique telles que la vaccination et les traitements d’immunothérapie du cancer. / B lymphocytes are central to humoral immunity due to their ability to present antigens to T cells, secrete cytokines and to differentiate into antibody-producing plasma cells. These functions can be induced by their in vitro stimulation. Being able to present antigens independently of the specificity of their B cell receptor (BCR), B cells can be used as antigen-presenting cells (APC) to induce specific cytotoxic CD8+ T cell cellular responses. Cellular immunity is crucial to prevent infections against viruses and in cancer immunotherapy. The main aim of this thesis is to study B cell biology. Specifically, we aim to deepen our understanding of their antigen presentation function and improve this function to use B cells as an alternative source of APC. First, we focused on deciphering the class I major histocompatibility complex (MHC-I) cross-presentation mechanism by which an epitope from gp100 melanoma protein, inserted in a virus-like particle (VLP) made of the coat protein of the papaya mosaic virus (PapMV), is presented by B cells. This VLP is a vaccine platform able to stimulate the immune system with no adjuvant and mediate a proteasome independent cross-presentation of the inserted epitope. Our results show that the inserted epitope is processed through a vacuolar pathway dependent on cathepsin S activity, lysosome acidification and requires the induction of autophagy. Thus, we provide a more detailed characterization of the mechanism used by B cells to process and cross-present an epitope inserted in PapMV VLP. Secondly, we aimed to improve the in vitro activation protocol used to expand B cells and induce their antigen presentation functions to use these cells to trigger cytotoxic CD8+ T cell cellular responses. We evaluated the in vitro stimulation of B cells with CD40 ligand (CD40L) and interleukin (IL)-21 or the combination of IL-4 and IL-21 instead of the standard activation method based on CD40L and IL-4. Our results deepen our knowledge of B cell biology. We showed that stimulating B cells with CD40L and IL-21 increases their proliferation but leads to their differentiation in antibody-producing plasma cells. In comparison, the stimulation with CD40L and IL-4 efficiently induces their antigen presentation function. The stimulation of B lymphocytes with CD40L and the combination of IL-4 and IL-21 increases their proliferation, weakly leads to their differentiation in antibody-secreting cells but is very efficient in inducing their antigen presentation function. We show for the first time that this method can generate potent APC able to induce cytotoxic CD8+ T cell responses in vitro. Our results allow us to hypothesize that these cells could be capable of triggering cellular immunity in vivo. As efficient APC, B cells could be used in a vaccination strategy or be employed as APC to improve cancer immunotherapy treatments such as adoptive cell transfer of T lymphocytes. Thus, the work presented in this thesis provides a deeper understanding of the antigen cross-presentation pathway by which B cells process and present an epitope inserted in PapMV VLP. It also reports an improved method to induce antigen presentation function of B cells to stimulate cytotoxic CD8+ T cells. This research work constitutes a leap forward in fundamental B cell research by increasing our knowledge of B cell biology. It also brings new opportunities regarding biotechnological uses of B cells as an alternative source of APC for fundamental and clinical applications such as vaccination and cancer immunotherapy treatments.