Le rôle de l'interleukine 2 (IL-2) dans les cellules dendritiques (DC) humaines n’est pas bien défini. Dans ce travail, nous avons exploré les effets de l'IL-2 sur des DC dérivées de monocytes. Nous démontrons une expression constitutive des chaines des β et γ du récepteur de l’IL-2 sur les DC ainsi qu’une une expression inductible de la chaîne α en réponse à des agents ‘maturants’ tels le LPS et le TNFα. L’IL-2 induit la phosphorylation du facteur de transcription STAT5 provoquant l’augmentation de la synthèse d'IFN-γ par les DC sans modifier leur phénotype ou leur survie. En revanche, nous n'avons pas mis en évidence d’activation des autres voies de signalisation du récepteur de l’IL-2. Nous avons également démontré que l'IL-2 augmente les capacités des DC à activer les lymphocytes T CD4+ allogéniques et les lymphocytes T CD8+ indépendamment des lymphocytes T auxilliaires. Nous n’avons pas pu mettre en évidence la sécrétion endogène d'IL-2 par les DC cependant les anticorps anti-CD25 diminuent les capacités allostimulatrices de DC en absence d’IL-2 exogène. Ainsi nos travaux indiquent que l’expression de CD25 par les DC matures est un événement clé menant la DC à un nouvel état d’activation. / Human dendritic cells (DC) express interleukin 2 (IL-2) receptor α-chain (CD25), but the role of IL-2 in DC is poorly understood. In this work, we explored the effects of IL-2 on monocyte-derived DC. First, we demonstrated the constitutional expression of β and γ chain of IL-2R on DC, while the α-chain was inducible by LPS and TNFα. Then we found that IL-2 does not affect DC phenotype and apoptosis but increases IFN-γ synthesis in DC through activation of transcription factor STAT5. Moreover we reported that IL-2 increases the ability of DC to activate allogeneic CD4+ T cells and helpless CD8+ T lymphocytes, most likely because of IL-2–triggered IFN-γ synthesis. We have not been able to demonstrate the endogenous secretion of IL-2 by DC, however anti-CD25 decreased allostimulatory capacity of DC in the absence of exogenous IL-2.In summary, we disclose that IL-2 induces DC functional maturation and activation. Interestingly, our study suggests a direct effect of anti-CD25 monoclonal antibodies on DC and that CD25 expression regulation on human DC could be used to control immune response in vivo.

Interleukin 2 (IL-2) ist ein Zytokin, welches in menschlichen Gedächtnis-T-Helfer-Zellen (Teff Zellen) exprimiert und sekretiert wird und damit die Immunantwort formt. Im Gegensatz dazu wird IL-2 normalerweise nicht in regulatorischen T-Zellen (Treg Zellen) exprimiert, sondern von diesen nur aufgenommen. Durch die Aktivierung des T-Zellrezeptors werden Signalkaskaden induziert, welche zur Aktivierung der Transkriptionsfaktoren AP-1, NFAT, und NF-kB führen. Diese sind entscheidend für die Genexpression von IL-2. Im Rahmen meiner Dissertation habe ich die Regulation der IL-2 Genexpression untersucht. Dabei vergleiche ich die transkriptionelle Regulation in Teff Zellen mit der Regulation in Treg Zellen. Insbesondere konnte ich zeigen, dass die endogene Konzentration der Transkriptionsfaktoren sich auf die Anzahl der IL-2 Produzenten auswirkt, aber nicht auf die Konzentration von IL-2 innerhalb einer Zelle. Deshalb untersuche ich wie sich die Konzentration der Transkriptionsfaktoren auf die Häufigkeit von IL-2 Produzenten auswirkt. Ich nutze die vorhandenen endogenen Konzentrationen und kann damit vorhersagen, dass die Zahl der IL-2 Produzenten entscheidend von der c-fos Konzentration in Teff Zellen abhängt. Mit Hilfe des entwickelten Modells kann ich voraussagen, wie der spezifische Inhibitor U0126 die Häufigkeit von IL-2 Produzenten verringert. Diese Vorhersage wurde durch Experimente belegt. Meine Modelle zeigen weiterhin, dass c-fos und NFATc2 die Häufigkeit der IL-2 Produzenten in Teff Zellen kooperativ regulieren. In Treg-Zellen zeigt meine Analyse, dass alle Transkriptionsfaktoren eine ähnliche sigmoidale Wirkung auf die Häufigkeit der IL-2-Produzenten ausüben. Im Gegensatz zu den Teff Zellen haben alle Transkriptionsfaktor eine ähnliche maximale Wirkung auf Genexpression von IL-2. Mittels eines Inhibitionsmodelles konnte ich zeigen, dass der Treg zellspezifische Transkriptionsfaktor FoxP3 allen aktivierenden Transkriptionsfaktoren entgegenwirkt. / Interleukin 2 (IL-2) is a cytokine expressed in human memory T helper cells (Teff cells) and the secretion of IL-2 shapes the immune response. In contrast, human regulatory T-cells (Treg cells) commonly do not express IL-2. The gene expression of IL-2 is induced by the activation of the T-cell receptor signaling network activating the transcription factors AP-1, NFAT, and NF-kB. These transcription factors are crucial for initiating IL-2 gene expression. Within my thesis I compare the regulation of IL-2 gene expression in Teff cells and Treg cells using experiments and modeling. I demonstrate that the transcription factor concentrations correlate with number of IL-2 producers but do not affect IL-2 concentration per cell. Thus, I investigate how the transcription factor concentration of c-fos, NFATc2, p65, and p-c-jun affects the frequency of IL-2 producing cells as a proxy for the probability of a cell to produce IL-2. Using the endogenous heterogeneity of transcription factor concentrations, I predict that the number of IL-2 producers is critically dependent on the amount of c-fos in Teff cells. I use my model to predict how perturbations of c-fos by the specific inhibitor U0126 decrease the frequency of IL-2 producers in Teff cells. This prediction was than validated by experiments. My models furthermore indicate the cooperative behavior of c-fos and NFATc2 on the level of frequency of IL-2 producers in Teff cells. In Treg cells, I show that all transcription factors exert a similar sigmoidal effect on the frequency of IL-2 producers. In contrast to the effects seen in Teff cells, all transcription factor have a similar maximal effect on the IL-2 gene expression. With an inhibitory model I explore the relation between the Treg cell-specific transcription factor FoxP3 the transcription factors c-fos, NFATc2, p65, and p-c-jun on the frequency of IL-2 producers. This model indicates that FoxP3 counteracts the activating function of NFATc2, AP-1, and also NF-kB.

O objetivo deste trabalho foi analisar o comportamento das interleucinas 12 (IL- 12) e 18 (IL-18) em pacientes com endometriose pélvica comparando-as a pacientes de um grupo controle com sintomas sugestivos de endometriose e ausência comprovada da doença. Avaliamos, também, as dosagens das referidas interleucinas em relação à fase do ciclo menstrual, quadro clínico, local da doença, estadiamento e classificação histológica. PACIENTES E MÉTODOS: Foram avaliadas 105 pacientes entre 18 e 40 anos submetidas à videolaparoscopia, ; divididas em 2 grupos: 72 pacientes com endometriose e 33 controles. Colheu-se sangue periférico e fluido peritoneal no intra-operatório e procedeu-se a avaliação das interleucinas, relacionando-se as dosagens entre o grupo controle e o grupo com endometriose e também entre os parâmetros já mencionados. Dividimos as pacientes segundo a fase do ciclo menstrual, o quadro clínico, o local de maior gravidade da doença (peritoneal, ovariana ou profunda), o estadiamento e a classificação histológica. As dosagens das interleucinas foram feitas através do método de ELISA e a análise estatística pela aplicação dos testes Kruskal-Wallis e Dunn. RESULTADOS: A média das dosagens da IL-12 no fluido peritoneal foi significativamente maior nas pacientes com endometriose (82,37 +/- 16,61 pg/mL) que no grupo controle (29,20 +/- 10,21pg/mL), p < 0,001. Não houve diferenças significativas na comparação das dosagens séricas de IL-12 entre pacientes e grupo controle. As médias das dosagens da IL-12 no sangue de pacientes com endometriose avançada foi significativamente mais elevada (196,74 +/- 33,71 pg/mL) que aquela de pacientes com doença inicial (82,04 +/- 16,63 pg/mL), p = 0,007. Não houve diferenças significativas entre as dosagens de IL-18 no sangue e no fluido peritoneal de pacientes e grupo controle, nem em relação à comparação entre doença inicial e doença avançada. As médias das dosagens de IL-12 no fluido peritoneal foram mais elevadas em pacientes com endometriose com dismenorréia severa/incapacitante (82,21 +/- 20,54 pg/mL; p = 0,02), dispareunia de profundidade (101,62 +/- 29,25 pg/mL; p = 0,02) e dor acíclica (101,93 +/- 26,14 pg/mL; p = 0,02). As médias das dosagens de IL-18 no sangue foram mais elevadas em pacientes com endometriose com dismenorréia severa/incapacitante (77,59 +/- 16,50 pg/mL; p = 0,01) e dispareunia de profundidade (61,34 +/- 14,05 pg/mL; p = 0,03). Não houve diferenças significativas entre as dosagens de IL-12 e IL-18, no sangue ou no fluido peritoneal, de acordo com a localização da doença (peritônio, ovário ou doença profunda). Não houve diferenças significativas entre as dosagens de IL-12 e IL- 18, no sangue ou no fluido peritoneal, de acordo com a classificação histológica da doença (estromal, bem-diferenciada, padrão misto de diferenciação e indiferenciada). CONCLUSÕES: A interleucina 12 esteve aumentada no fluido peritoneal de pacientes com endometriose, e no sangue nos estádios avançados da doença. Não houve diferenças nas dosagens da interleucina 18 no sangue ou fluido peritoneal na endometriose em relação a mulheres sem a doença. / The aim of this work was to evaluate the behavior of interleukines 12 (IL-12) and 18 (IL-18) in patients with pelvic endometriosis comparing them with a control group that presented suggestive symptoms of endometriosis and proven absence of the disease, evaluating, also, the levels of the interleukines in relation to the phase of menstrual cycle, clinical symptoms, primary location, disease stage and histological classification. PATIENTS AND METHODS: 105 patients aging from 18 to 40 years have been submitted to the laparoscopic surgery and classified in 2 groups: 72 patients with endometriosis and 33 controls. Peripheral blood and peritoneal fluid were extracted and interleukins were evaluated, correlating the levels between the control group and the group with endometriosis, and also between the parameters previously mentioned. Patients were grouped according to the phase of the menstrual cycle, clinical symptoms, primary location, disease stage and histological classification. Interleukin levels have been measured by ELISA . Statistical analysis was performed by the application of Kruskal-Wallis and Dunn tests. RESULTS: Average levels of IL-12 in the peritoneal fluid was significantly higher in patients with endometriosis (82,37 +/- 16.61 pg/mL) when compared to the control group (29,20 +/- 10,21pg/mL), p < 0,001. No significant differences were found in the comparison of the serum levels of IL-12 between patients and control group.) Average levels of IL-12 in blood of patients with advanced endometriosis were significantly increased (196,74 +/- 33.71 pg/mL) when compared to patients with initial disease (82,04 +/- 16,63 pg/mL), p = 0,007. There were no significant differences between the levels of IL-18 in blood and in peritoneal fluid of patients and control group, nor between patients with initial disease and advanced disease. Average levels of IL-12 in peritoneal fluid were higher in patients with endometriosis with complaints of severe / incapacitating dysmenorrhea (82.21 +/- 20,54 pg/mL; p = 0,02), deep dyspareunia (101,62 +/- 29,25 pg/mL; p = 0,02) and acyclic pain (101,93 +/- 26,14 pg/mL; p = 0,02). Average levels of IL-18 in the blood were higher in patients with endometriosis and severe /incapacitating dysmenorrhea (77,59 +/- 16,50 pg/mL; p = 0,01) and deep dyspareunia (61,34 +/- 14,05 pg/mL; p = 0,03). There were no significant differences between the levels of IL-12 and IL-18, in blood or in peritoneal fluid, according to the primary location of the disease (peritoneal, ovarian or deep infiltrative disease). No significant differences were found between the levels of IL-12 and IL-18, in blood or peritoneal fluid, in accordance to the histological classification of the disease (estromal, well-differentiated, combined standard of differentiation and undifferentiated). CONCLUSIONS: Interleukin 12 wss increased in peritoneal fluid of patients with endometriosis, and in blood in advanced stages of the disease. There were no differences in the levels of interleukin 18 in blood or peritoneal fluid in endometriosis compared to women without the disease.

<p>Uvod: Interleukin 33 (IL-33) ima značajnu ulogu u inflamatornim i autoimunskim oboljenjima, ali se sve vi&scaron;e proučava njegov značaj u imunopatogenezi različitih alergijskih oboljenja, uključujući i alergijsku astmu (AA). Cilj: Ispitivanje vrednosti IL-33 u serumu pacijenata sa AA pre i posle &scaron;estomesečne inhalatorne kortikosteroidne terapije (ICS Th) i povezanosti dobijenih vrednosti IL-33 sa određenim kliničkim i laboratorijskim karakteristikama ovih pacijenata. Metode: Vrednost IL-33 u serumu određena je kod 61 pacijenta sa AA pre započinjanja i posle sprovedne &scaron;estomesečne ICS Th i kod 30 zdrave dece. U obradi podataka primenjene su standardne metode deskriptivne i analitičke statistike. Rezultati: Kod pacijenata sa nelečenom AA, serumske vrednosti IL-33 su signifikantno veće u odnosu na pacijente kod kojih je sprovedena &scaron;estomesečna ICS Th (p&lt;0,05), kao i u odnosu na zdravu decu (p&lt;0,01). Pacijenti sa AA koji su tokom 6 meseci lečeni sa ICS Th i zdrava deca imaju slične vrednosti IL-33 u serumu (p&gt;0,05). Kod pacijenata sa AA pre započinjanja i 6 meseci posle primene ICS Th ne postoji signifikantna korelacija između vrednosti IL-33 u serumu i eozinofilnih granulocita periferne krvi (p&gt;0,05), eozinofilnih granulocita u nazalnom sekretu (p&gt;0,05) i ukupnog IgE u serumu (p&gt;0,05). Kod pacijenata sa nelečenom AA postoji signifikantna negativna korelacija između vrednosti serumskog nivoa IL-33 i sledećih parametara plućne fukcije: FEV1 (p&lt;0,05), FEV1/FVC (p&lt;0,05), PEF(p&lt;0,05) i MEF 25/75 (p&lt;0,05). Posle &scaron;estomesečne ICS Th pobolj&scaron;ava se plućna funkcija, odnosno dolazi do porasta brzine protoka vazduha u disajnim putevima kao i promena u plućnim volumenima u zavisnosti od stepena opstrukcije u odnosu na vrednosti pre uključenja antiinflamatorne terapije (FEV1, FVC, FEV1/FVC, PEF, MEF 25/75, za sve vrednosti p&lt;0,01). Dok je signifikantna negativna korelacija dokazana između IL-33 i vrednosti FEV1 (p&lt;0,01), FVC (p&lt;0,01) i PEF (p&lt;0,05). Zaključak: Serumski nivo IL-33 je značajno povi&scaron;en kod dece sa nelečenom, odnosno nekontrolisanom AA. &Scaron;estomesečna primena ICS dovodi do značajne redukcije IL-33 u serumu čije su vrednosti u negativnoj korelaciji sa vrednostima FEV1, FVC i PEF, odnosno pozitivnoj korelaciji sa težinom i kontrolom AA. Rezultati na&scaron;e studije ističu da IL-33 ima značajnu ulogu u imunopatogenezi AA. Određivanje serumske vrednosti IL-33 može biti koristan indikator težine AA.</p> / <p>Introduction: Interleukin 33 (IL-33) plays a significant role in inflammatory and autoimmune diseases, but its significance in the immunopathogenesis of various allergic diseases including allergic asthma (AA) has gained increasing attention in research over recent years. Objective: Testing serum levels of IL-33 in patients with AA before and after a six-month inhaled corticosteroid therapy (ICS Th) and correlation of IL-33 values with specific clinical and laboratory characteristics of these patients. Methods: Serum levels of IL-33 were determined in 61 patients with AA prior to the initiation of ICS Th and following the six-month ICS Th as well as in 30 healthy children. Data processing was performed applying standard methods of descriptive and analytical statistics. Results: In patients with untreated AA, serum levels of IL-33 were significantly higher as compared to the patients who have received a six month ICS Th (p &lt;0.05) as well as to healthy children (p &lt;0.01). Patients with AA, who were treated with ICS Th for six months, and healthy children have similar serum IL-33 (p&gt; 0.05). In patients with AA, significant correlation between serum IL-33 levels and eosinophilic peripheral blood granulocytes (p&gt;0.05), eosinophilic granulocytes in nasal secretion (p&gt;0.05) and the total IgE in serum has not been observed for the period prior to initiation and 6 months after the administration of ICS Th. In patients with untreated AA, there is significant negative correlation between serum IL-33 and the following pulmonary functions test results: FEV1 (p&lt;0.05), FEV1/FVC (p&lt;0.05), PEF (p&lt;0.05) and MEF 25/75 (p&lt;0.05). After a six-month ICS Th, significant improvement of pulmonary functions was evident, that is, increase in airflow speed and lung volume change as compared to the values determined before the initiation of the anti-inflammatory therapy (FEV1, FVC, FEV1/FVC, PEF, MEF 25/75, for all values p&lt;0.01). Significant negative correlation between IL-33 and the values of FEV1 (p&lt;0.01), FVC (p&lt;0.01)and PEF (p&lt;0.05) has been established. Conclusion: Serum level of IL-33 is significantly elevated in children with untreated, i.e., uncontrolled AA. A six-month ICS Th asthma treatment results in significant reduction of serum levels of IL-33. This level is negatively correlated with FEV1, FVC and PEF values while positively correlated with the severity of the disease and control of AA. The results of our study point out that IL-33 plays an important role in the immunopathogenesis of AA. Quantification of serum IL-33 levels can be a useful indicator of the severity of AA.</p>

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

O objetivo deste trabalho foi analisar o comportamento das interleucinas 12 (IL- 12) e 18 (IL-18) em pacientes com endometriose pélvica comparando-as a pacientes de um grupo controle com sintomas sugestivos de endometriose e ausência comprovada da doença. Avaliamos, também, as dosagens das referidas interleucinas em relação à fase do ciclo menstrual, quadro clínico, local da doença, estadiamento e classificação histológica. PACIENTES E MÉTODOS: Foram avaliadas 105 pacientes entre 18 e 40 anos submetidas à videolaparoscopia, ; divididas em 2 grupos: 72 pacientes com endometriose e 33 controles. Colheu-se sangue periférico e fluido peritoneal no intra-operatório e procedeu-se a avaliação das interleucinas, relacionando-se as dosagens entre o grupo controle e o grupo com endometriose e também entre os parâmetros já mencionados. Dividimos as pacientes segundo a fase do ciclo menstrual, o quadro clínico, o local de maior gravidade da doença (peritoneal, ovariana ou profunda), o estadiamento e a classificação histológica. As dosagens das interleucinas foram feitas através do método de ELISA e a análise estatística pela aplicação dos testes Kruskal-Wallis e Dunn. RESULTADOS: A média das dosagens da IL-12 no fluido peritoneal foi significativamente maior nas pacientes com endometriose (82,37 +/- 16,61 pg/mL) que no grupo controle (29,20 +/- 10,21pg/mL), p < 0,001. Não houve diferenças significativas na comparação das dosagens séricas de IL-12 entre pacientes e grupo controle. As médias das dosagens da IL-12 no sangue de pacientes com endometriose avançada foi significativamente mais elevada (196,74 +/- 33,71 pg/mL) que aquela de pacientes com doença inicial (82,04 +/- 16,63 pg/mL), p = 0,007. Não houve diferenças significativas entre as dosagens de IL-18 no sangue e no fluido peritoneal de pacientes e grupo controle, nem em relação à comparação entre doença inicial e doença avançada. As médias das dosagens de IL-12 no fluido peritoneal foram mais elevadas em pacientes com endometriose com dismenorréia severa/incapacitante (82,21 +/- 20,54 pg/mL; p = 0,02), dispareunia de profundidade (101,62 +/- 29,25 pg/mL; p = 0,02) e dor acíclica (101,93 +/- 26,14 pg/mL; p = 0,02). As médias das dosagens de IL-18 no sangue foram mais elevadas em pacientes com endometriose com dismenorréia severa/incapacitante (77,59 +/- 16,50 pg/mL; p = 0,01) e dispareunia de profundidade (61,34 +/- 14,05 pg/mL; p = 0,03). Não houve diferenças significativas entre as dosagens de IL-12 e IL-18, no sangue ou no fluido peritoneal, de acordo com a localização da doença (peritônio, ovário ou doença profunda). Não houve diferenças significativas entre as dosagens de IL-12 e IL- 18, no sangue ou no fluido peritoneal, de acordo com a classificação histológica da doença (estromal, bem-diferenciada, padrão misto de diferenciação e indiferenciada). CONCLUSÕES: A interleucina 12 esteve aumentada no fluido peritoneal de pacientes com endometriose, e no sangue nos estádios avançados da doença. Não houve diferenças nas dosagens da interleucina 18 no sangue ou fluido peritoneal na endometriose em relação a mulheres sem a doença. / The aim of this work was to evaluate the behavior of interleukines 12 (IL-12) and 18 (IL-18) in patients with pelvic endometriosis comparing them with a control group that presented suggestive symptoms of endometriosis and proven absence of the disease, evaluating, also, the levels of the interleukines in relation to the phase of menstrual cycle, clinical symptoms, primary location, disease stage and histological classification. PATIENTS AND METHODS: 105 patients aging from 18 to 40 years have been submitted to the laparoscopic surgery and classified in 2 groups: 72 patients with endometriosis and 33 controls. Peripheral blood and peritoneal fluid were extracted and interleukins were evaluated, correlating the levels between the control group and the group with endometriosis, and also between the parameters previously mentioned. Patients were grouped according to the phase of the menstrual cycle, clinical symptoms, primary location, disease stage and histological classification. Interleukin levels have been measured by ELISA . Statistical analysis was performed by the application of Kruskal-Wallis and Dunn tests. RESULTS: Average levels of IL-12 in the peritoneal fluid was significantly higher in patients with endometriosis (82,37 +/- 16.61 pg/mL) when compared to the control group (29,20 +/- 10,21pg/mL), p < 0,001. No significant differences were found in the comparison of the serum levels of IL-12 between patients and control group.) Average levels of IL-12 in blood of patients with advanced endometriosis were significantly increased (196,74 +/- 33.71 pg/mL) when compared to patients with initial disease (82,04 +/- 16,63 pg/mL), p = 0,007. There were no significant differences between the levels of IL-18 in blood and in peritoneal fluid of patients and control group, nor between patients with initial disease and advanced disease. Average levels of IL-12 in peritoneal fluid were higher in patients with endometriosis with complaints of severe / incapacitating dysmenorrhea (82.21 +/- 20,54 pg/mL; p = 0,02), deep dyspareunia (101,62 +/- 29,25 pg/mL; p = 0,02) and acyclic pain (101,93 +/- 26,14 pg/mL; p = 0,02). Average levels of IL-18 in the blood were higher in patients with endometriosis and severe /incapacitating dysmenorrhea (77,59 +/- 16,50 pg/mL; p = 0,01) and deep dyspareunia (61,34 +/- 14,05 pg/mL; p = 0,03). There were no significant differences between the levels of IL-12 and IL-18, in blood or in peritoneal fluid, according to the primary location of the disease (peritoneal, ovarian or deep infiltrative disease). No significant differences were found between the levels of IL-12 and IL-18, in blood or peritoneal fluid, in accordance to the histological classification of the disease (estromal, well-differentiated, combined standard of differentiation and undifferentiated). CONCLUSIONS: Interleukin 12 wss increased in peritoneal fluid of patients with endometriosis, and in blood in advanced stages of the disease. There were no differences in the levels of interleukin 18 in blood or peritoneal fluid in endometriosis compared to women without the disease.

Objetivo: determinar as concentrações séricas e peritoneais das interleucinas 1ß (IL-1ß) e 6 (IL-6) e da proteína amilóide A (SAA) em pacientes com endometriose pélvica. Métodos: foram avaliadas 97 pacientes submetidas à videolaparoscopia, 57 com endometriose (A), 27 com sintomas sugestivos porém sem endometriose (B) e 13 sem sintomas e doenças (C). Foram coletados no ato cirúrgico líquido peritoneal e sangue. As concentrações dos mediadores foram determinadas em pg/ml (IL-1 e 6) e ng/ml (SAA) por método imunoenzimático e leitura óptica. Resultados: (líquido peritoneal e sangue medianas) IL-1ß: A- 11,22 and 1,83; B- 15,62 and 1,16; C- 1,92 and 0,80; IL-6: A- 6,80 and 3,70; B- 8,60 and 3,90; C- 3,40 and 2,0; SAA- A- 310,30 and 14,01; B- 306,20 and 10,39; C- 53,4 e 9,5. Conclusão: as concentrações dos mediadores de inflamação avaliados estão elevadas no líquido peritoneal e no soro das mulheres com endometriose. Estas concentrações foram semelhantes às das pacientes com sintomas sugestivos porém sem a doença. A fase do ciclo menstrual, o tipo histológico envolvido e o local de acometimento da doença não influíram de forma significante nas concentrações séricas ou peritoneais de IL-1ß, IL-6 e SAA. / Objective: to assess peritoneal and seric interleukin-1ß (IL-1ß), 6 (IL-6), and protein amyloid A (SAA) concentrations in patients with pelvic endometriosis. Methods: 97 patients were submitted to video laparoscopic surgery, 57 with endometriosis (A), 27 with suggestive symptoms but no endometriosis (B), and 13 without symptoms and diseases (C). Peritoneal fluid and blood were collected during the procedure. Mediator s concentration was determined in pg/ml (IL-1ß and IL-6) and ng/ml (SAA) through immunoenzimatic test and optic measure. Results: (peritoneal fluid and blood -medians) IL-1ß: A- 11,22 and 1,83; B- 15,62 and 1,16; C- 1,92 and 0,80; IL-6: A- 6,80 and 3,70; B- 8,60 and 3,90; C- 3,40 and 2,0; SAA- A- 310,30 and 14,01; B- 306,20 and 10,39; C- 53,4 e 9,5. Conclusion: the inflammation mediators are increased in the peritoneal fluid and blood of women with pelvic endometriosis. The concentrations are similar to those found in patients with suggestive symptoms but no endometriosis. The place of the disease, the histological type and the day of the menstrual cycle didn t alter peritoneal or seric concentration of these cytokines.

A fibrose hepática é uma patologia que acompanha outras doenças crônicas do fígado como a cirrose e o hepatocarcinoma. As células estreladas hepáticas (HSC, do inglês hepatic stellate cells) compõem uma população celular heterogênea que se caracteriza por transitar entre dois fenótipos. As células com fenótipo quiescente possuem a capacidade de armazenar vitamina A em gotas lipídicas. Os insultos ao fígado desencadeiam uma resposta inflamatória que gera estímulos parácrinos e autócrinos mediados por citocinas e espécies reativas. Neste contexto, as HSC assumem um fenótipo ativado fibrogênico e tornam-se responsáveis pela cicatrização hepática. Danos crônicos ao fígado levam a uma deposição de matriz extracelular exagerada que configura o estado patológico da fibrose. O resveratrol (RSV – 3,4’,5-tri-hidroxi-trans-estilbeno) é uma fitoalexina produzida por algumas espécies de plantas. Inúmeros efeitos benéficos à saúde são atribuídos ao RSV por causa do seu potencial antioxidante, antiinflamatório e pró-apoptótico. Estudos anteriores mostraram que tratamento da GRX, uma linhagem murina de HSC ativadas, com concentrações de RSV próximas as biodisponíveis (0,1 a 1 μM) resultou em parada do ciclo na fase S com consequente inibição de proliferação celular, um efeito associado à citotoxicidade e que pode favorecer a resolução da fibrose hepática. Neste estudo, por técnicas espectrofotométricas, foi demonstrado que tratamento da GRX por 24 horas com concentrações entre 0,1 a 50 μM de RSV promoveu um efeito pró-oxidante que causa uma citotoxicidade dependente da dose, bastante aumentada no grupo tratado com a concentração mais alta. Os efeitos citotóxicos atenuados encontrados nas células tratadas por 120 horas sugerem que a GRX pode se tornar resistente a estes efeitos. O potencial pró-oxidante do RSV foi o ponto de partida para investigar a possibilidade de que esta fitoalexina provocasse uma alteração no metabolismo mitocondrial da GRX. Para isso, os efeitos do RSV (1 a 50 μM) na função mitocondrial, na indução de morte mediada por estas organelas e na autofagia/mitofagia foram investigados por técnicas de espectrofotometria, de imunocitoquímica, de citometria de fluxo, de microscopia confocal e de microscopia eletrônica de transmissão em GRX tratadas por 24 e 120 horas. Foi demonstrado que todas as concentrações de RSV promovem apoptose por meio da ativação de caspases, alteram a dinâmica/função mitocondrial e induzem o aumento de autofagia/mitofagia na GRX. No entanto, o RSV provocou biogênese de mitocôndrias nos grupos tratados com 1 e 10 μM, enquanto que o tratamento com 50 μM causou dano celular evidente na GRX, sem induzir biogênese de mitocôndrias. Desta forma, é possível que a citotoxicidade “dose-dependente” do RSV, que causa a morte celular e dano oxidativo em 24 horas de tratamento, esteja relacionada com o desequilíbrio entre a indução concomitante de apoptose mediada por dano mitocondrial, autofagia/mitofagia e biogênese de mitocôndrias. Por fim, foi investigada a liberação de TNF-α, Interleucina-6 e Interleucina-10 pela GRX tratada por 24 e 120 horas com RSV (0,1 a 50 μM), considerando o papel antiinflamatório do RSV e o papel das HSC ativadas na sinalização autócrina que contribui para a modulação fenotípica destas células. Foi demonstrado que o tratamento da GRX com RSV por 24 e 120 horas induziu a redução da liberação de Interleucina-6; enquanto que a liberação de TNF-α e Interleucina-10 foi aumentada. Estes resultados confirmam um efeito antiinflamatório do RSV que deve contribuir na prevenção da ativação ou da perpetuação do estado ativado das HSC por meio de sinalização autócrina. Ainda que a concentração do RSV seja importante para efetivamente induzir a morte das HSC ativadas, o tratamento com esta fitoalexina pode ser promissor para a resolução da fibrose hepática por diminuir a população de células ativadas e, possivelmente, prevenir a perpetuação do estado fenotípico ativado. Estudos avaliando indicadores de quiescência em células tratadas são ainda necessários para desvendar completamente os efeitos do RSV quanto às possibilidades de inibição da perpetuação ou reversão fenotípica das HSC ativadas. / Liver fibrosis is a disease that accompanies other hepatic chronic diseases such as cirrhosis and hepatocellular carcinoma. Hepatic stellate cells (HSC) are a heterogeneous cell population characterized by transiting between two phenotypes. Cells with a quiescent phenotype are able to store vitamin A into lipid droplets. Damage to the liver trigger an inflammatory response that generates paracrine and autocrine stimulation mediated by cytokines and reactive species. In this context, HSC assume an activated and fibrogenic phenotype responsive for hepatic wound-healing. Chronic insults to the liver lead to an excessive deposition of extracellular matrix that configures the pathological state of fibrosis. Resveratrol (RSV – 3,4’,5-tri-hidroxi-trans-stilbeno) is a phytoalexin produced by some species of plants. Several beneficial effects are attributed to this molecule due to its antioxidant, antiproliferative and pro-apoptotic potential. Previous studies showed that treatment with bioavailable concentrations of RSV (0.1 to 1 μM) promoted an arrest cycle at the S phase in GRX, a murine activated HSC model, leading to cell proliferation inhibition, a cytotoxic effect that contributes to the liver fibrosis resolution. In this study, it was shown by spectrophotometric techniques that GRX treatment for 24 hours at concentrations between 0.1 to 50 μM of RSV promoted a fairly clear pro-oxidant effect that causes a dose-dependent cytotoxicity that was higher in the group treated with 50 μM. The attenuated cytotoxicity found after 120 hours of GRX treatment suggest that these cells became resistant to this effect. The pro-oxidant potential of RSV was the starting point for investigating the possibility that this phytoalexin would cause a change in the GRX mitochondrial metabolism. Thus, the effects of RSV (1 to 50 μM) on altering the mitochondrial function, on inducing mitochondrial-mediated cell death, and autophagy/mitofagia were investigated in GRX treated for 24 and 120 hours by spectrophotometric techniques, immunocytochemistry, flow cytometry, confocal microscopy, and transmission electron microscopy. All the RSV concentrations promote cell apoptosis through caspases activation, alter the mitochondrial dynamics and function, and induce an increase of autophagy/mitofagia. Curiously, only 1 and 10 μM of RSV induced mitochondrial biogenesis in GRX, while the highest concentration caused an evident cell damage without inducing mitochondrial biogenesis. Thus, it is possible that the "dose-dependent" cytotoxicity of RSV, which causes cell death and oxidative damage in 24 hours of treatment, is related to an imbalance between the concomitant induction of mitochondrial-mediated apoptosis, autophagy/mitofagia, and mitochondrial biogenesis. Finally, it was investigated the release of TNF-α, Interleukin-6 and Interleukin-10 by GRX treated for 24 and 120 hours with RSV (0.1 to 50 μM), considering the anti-inflammatory role of RSV and the autocrine signalling role of HSC that contributes to the perpetuation of its activated phenotype. It was demonstrated that GRX treatment with RSV for 24 and 120 hours reduced the release of Interleukin-6 in the culture medium; whereas the release of TNF-α and Interleukin-10 was increased. These results confirm the anti-inflammatory properties of RSV and may contribute to the prevention of HSC activation through autocrine signalling. Although RSV concentration is important to effectively induce activated HSC death, cells treatment with this phytoalexin may be promising for liver fibrosis resolution through decreasing the population of activated cells or through preventing the perpetuation of activated state of HSC. Future studies evaluating the quiescence indicators of GRX under RSV treatment are still needed to fully unravel the effects of this phytoalexin on inhibiting the perpetuation of activated HSC or reversing its activated phenotype.

Inledning: Kronisk inflammation är ett gemensamt symptom för inflammatoriska systemsjukdomar så som reumatisk artrit, systemisk lupus erytematosus, Sjögrens syndrom och idiopatiska inflammatoriska myopatier. Behandlingsstrategin för inflammatoriska systemsjukdomar handlar om att begränsa den primärt hälsoskadliga faktorn, som i detta fall är inflammation. Fysisk aktivitet och träning har länge ingått i den kliniska rehabiliteringsplanen för inflammatoriska systemsjukdomar för att bibehålla funktion och fysisk kapacitet, men har under senare tid uppmärksammats för sina inflammationsdämpande egenskaper.  Syftet med denna systematiska litteraturstudie är att fastställa evidensen för aerob träning avseende inflammation jämfört med placebo, ingen behandling, farmaka eller annan typ av fysisk aktivitet vid inflammatoriska systemsjukdomar.  Metod: Litteraturstudien följerPreferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) riktlinjer för inklusionskriterier och använder Statens Beredning för Medicinsk och Social Utvärdering (SBU) mall för kvalitetsgranskning samt Grading of Recommendations Assessment, Development and Evaluation (GRADE) för evidensgradering. Resultat: Artikelsökningen genererade totalt 384 studier varav sju studier uppfyllde alla inklusionskriterier. Studier var fördelat på två olika sjukdomsdiagnoser med tre utfallsmått. Låg vetenskaplig evidens som pekar för att aerob träning ger liten till ingen effekt på CRP/CPK samt ett väldigt lågt vetenskapligt underlag för att aerob träning ger liten till ingen effekt på IL-8 i jämförelse med råd om fysisk aktivitet/ingen aktiv behandling Slutsats:Denna systematiska litteraturstudie fann en låg vetenskaplig evidens som pekar mot att aerob träning ger liten till ingen effekt på CRP/CPK i jämförelse med råd om fysisk aktivitet/ingen aktiv behandling. En väldigt låg grad av evidens indikerar att aerob träning ger liten till ingen effekt på IL-8 i jämförelse med råd om fysisk aktivitet/ingen aktiv behandling.

The cytokines GM-CSF, IL-3 and IL-5 are central regulators of haemopoietic cell functions and are pivotal in the regulation of haemopoiesis and inflammatory responses of myeloid cells. In particular, these cytokines have been shown to perform essential functions in host defence against foreign pathogens through their ability to regulate innate immune responses in myeloid cells. As key regulators of such important processes, these cytokines play an important role in human inflammatory pathologies such as rheumatoid arthritis, asthma, multiple sclerosis and psoriasis as well as a number of leukemias such as JML and CMML. GM-CSF, IL-3 and IL-5 signal through receptors containing α subunits specific to each cytokine and a common β subunit (βc). Cytokine stimulation leads to tyrosine phosphorylation of the βc and promotes specific responses such as proliferation, survival and activation of haemopoietic cells. Mouse knockout studies identified a key function of these cytokines in the activation of effector functions of myeloid cells, including production of reactive oxygen species (ROS) and phagocytosis. These earlier studies provide a link between cytokine signalling and inflammation, but the molecular mechanisms by which βc activation regulates effector cell functions, and the receptor motifs involved, are unknown. The aim of this thesis was to address two broad questions with regard to βc signalling: (1) Does βc regulate specific cellular responses by phosphotyrosine-independent mechanisms? (2) What are the molecular mechanisms by which βc initiates signalling to promote specific biological responses such as activation of effector cell functions? To address the first question, we have focussed on Serine 585, a potential 14-3-3 binding site which lies in the cytoplasmic potion of huβc. Out results show that the mutation huβc S585G disrupted the interaction of 14-3-3ζ with βc, whilst not affecting receptor tyrosine phosphorylation. Both mouse and human βc were shown to interact with 14-3-3 proteins, indicating that this interaction is conserved between these species. Significantly, a huβc S585G mutant was unable to promote haemopoietic cell survival in response to IL-3. These results identify a new mechanism by which cytokine receptors are able to couple to downstream signalling pathways that regulate cell survival. An approach was developed and optimised to analyse specific GM-CSF-mediated responses in monocytes/macrophages expressing wildtype or mutant huβc, (including huβc S585G that was defective in regulating survival). Bone marrow-derived muβc -/-;muβIL-3 -/- monocytes/macrophages were retrovirally transduced with constructs expressing wildtype or mutant huβc, along with huGMRα, then purified by FACS. Two assays were established to measure effector functions in the transduced monocyte/macrophages; (1) a flow cytometry assay for ROS production, and (2) an assay for phagocytosis. The capacity for GM-CSF to prime (i.e. enhance effector functions) ROS production and phagocytosis was investigated in huGMRα-transduced monocytes/macrophages. Our results have identified two key residues in the cytoplasmic domain of βc subunit: Tyrosine 577 (required for huβc interaction with the adaptor protein Shc) and serine 585 (required for 14-3-3 association), that are essential for the ability of GM-CSF to regulate key effector functions in monocytes/macrophages. These novel findings are significant in that they establish a molecular link between the GM-CSF/IL-3/IL-5 receptor and the regulation of both haemopoietic cell survival and inflammatory responses, and therefore have important implications in our understanding of inflammatory diseases such as rheumatoid arthritis and asthma. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317007 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2008