Tropheryma whipplei a longtemps été uniquement considérée comme l’agent responsable de la maladie de Whipple, une affection rare caractérisée notamment par une perte de poids, des diarrhées chroniques et des douleurs abdominales. Toutefois, au cours de ces dernières années, il est apparu que les infections à T. whipplei peuvent présenter des manifestations cliniques communes telles que des pneumonies, des bactériémies fébriles ou des gastroentérites, ce qui montre que la maladie de Whipple ne constitue pas la seule manifestation de l’infection à T. whipplei. Ma thèse a eu deux objectifs. Le premier a été de caractériser l’interaction entre T. whipplei et la cellule dans laquelle elle se réplique, le macrophage. J’ai montré en utilisant diverses techniques (biologie moléculaire à haut débit, biologie cellulaire et biochimie) que T. whipplei induit une réponse macrophagique inédite caractérisée par une polarisation M2 associée à une réponse interféron de type I. J’ai également montré que ces événements sont associés à l’apoptose des macrophages dont l’induction se fait par voie extrinsèque et que l’IL-16, pour laquelle un rôle au cours de l’infection à T. whipplei était avéré, intervient d’une part dans le blocage de la maturation phagosomale et d’autre part interfère avec l’activation des macrophages. Mon second objectif a été de montrer à travers un modèle animal que la primo-infection par T. whipplei se manifeste par une gastroentérite auto-résolutive. Cet objectif découlait directement de travaux récents qui associent T. whipplei à diverses manifestations cliniques et notamment à des épisodes diarrhéiques chez l’enfant. Mes résultats confortent clairement cette hypothèse et montrent également que des dommages préexistants de la muqueuse intestinale permet l’établissement de l’infection à T. whipplei. / Tropheryma whipplei has only been considered as the agent of Whipple‘s disease, a rare disease characterized by weight loss, chronic diarrheas and abdominal pains. It is now believed that infections with T. whipplei result in common clinical manifestations, such as pneumonia, fever, bacteriema or gastroenteritis and, as a consequence, it is likely that the Whipple’s disease is not the only manifestation of T. whipplei infection. During my PhD, I had 2 objectives. The first was to characterize the interaction between T. whipplei and the cell type in which T. whipplei replicates, namely macrophages. I showed using diverse techniques (high throughput molecular biology, cell biology and biochemistry) that T. whipplei induced an unusual macrophage response, characterized by M2 polarization with type I interferon response. I also showed that these events were associated with apoptosis of macrophages induced by the extrinsic pathway and that IL-16, which was already described during T. whipplei infection, was involved in the blockade of the phagosomal maturation and interfered with macrophage activation. The second objective was to show using a murine model that primary infection with T. whipplei results in self-limiting gastroenteritis. This objective directly arose from recent work that associated T. whipplei with various clinical manifestations and, in particular, with diarrheal episodes in children. My results clearly verified this hypothesis and also revealed that pre-existing mucosal damage allowed the establishment of the infection.

La transplantation pulmonaire est depuis une vingtaine d’années une option thérapeutique valide pour une grande variété de pathologies pulmonaires au stade terminal. Malgré les progrès réalisés ces dernières années en matière de traitement immunosuppresseur, les rejets restent une cause majeure de la perte du greffon. Plusieurs études ont souligné l'importance du rejet aigu comme un facteur contributif important à l’évolution de la dysfonction chronique du greffon (ou CLAD) et, in fine, à la perte du greffon. Par conséquent, des outils diagnostiques fiables de rejet aigu s’imposent pour mieux prévenir le CLAD. Dans notre première étude, nous avons évalué les marqueurs tissulaires de rejet aigu humoral (RAH) pulmonaire. Nous avons montré ainsi que les lésions histologiques dont l’inflammation microvasculaire ne sont pas spécifiques et le marquage C4d est un marqueur utile pour confirmer le diagnostic de RAH. Dans un second temps, nous avons étudié en cytométrie de flux la polarisation des macrophages obtenus par lavage bronchiolo-alvéolaire (LBA) chez des patients transplantés avec et sans rejet. Nos résultats montrent les limites des marqueurs membranaires (HLA-DR et CD206) dans l’évaluation de l’état de polarisation des macrophages au cours des rejets. Ce travail montre l’intérêt des marqueurs tissulaires, en particulier le marquage C4d, dans le suivi des patients transplantés pulmonaires et souligne la nécessité d’identifier des marqueurs appropriés et utilisables en cytométrie de flux pour avancer sur l’état de polarisation des macrophages alvéolaires. / Lung transplantation is considered as a valid therapeutic option for patients with end-stage lung disease. Despite considerable progress in immunosuppressive therapy, allograft rejection remains a major cause of graft loss. Multiple studies have highlighted the importance of acute rejection as an important risk factor for the development of chronic lung allograft dysfunction (CLAD) leading to graft failure. Therefore, the improvement in the diagnosis of acute rejection represents a major challenge to prevent CLAD. In this study, we evaluated the tissue markers of acute antibody-mediated rejection (AMR) in lung transplantation. In our experience, the histopathologic findings including the microvascular inflammation in pulmonary AMR are not specific and C4d staining is a useful marker to confirm the diagnosis of AMR. Secondly, we investigated by flow cytometry the polarization of alveolar macrophage obtained by bronchoalveolar lavage (BAL) from lung transplant patients with and without acute rejection. Our results show the limits of surface markers (CD206 and HLA-DR) in the evaluation of alveolar macrophage polarization. This study shows the interest of tissue markers, especially the C4d staining, in monitoring of lung transplant patients and highlights the need to identify appropriate and available markers for future studies of alveolar macrophage polarization by flow cytometry.

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Atherosclerosis is a major underlying cause of cardiovascular disease; however, the molecular mechanisms by which cardiovascular risk factors promote the development of atherosclerosis are poorly understood. Recent evidence from our laboratory suggests that endoplasmic reticulum (ER) stress signaling through glycogen synthase kinase (GSK)-3α/β is involved in the activation of pro-atherosclerotic processes. Previous studies from our lab show that myeloid-specific deletion of GSK3α attenuates the progression of atherosclerosis. However, the precise role(s) of GSK3α/β in atherosclerotic regression is not known. The primary goal of this thesis is to investigate the role(s) of GSK3α/β in lesional macrophages and atherosclerotic regression. Initially, we have targeted the ER stress- GSK3α/β pathway by supplementing the drinking water of low-density lipoprotein receptor (Ldlr)-/- mice with the small molecules 4-phenylbutyric acid or valproate. The results suggest that ER stress or GSK3α/β inhibition can attenuate the growth of existing atherosclerotic lesions and appear to increase lesion stability. From this study it remains unclear whether these interventions can promote atherosclerotic regression. Next, to investigate the role(s) of GSK3α/β in pro-atherogenic processes, bone marrow derived macrophages were isolated from myeloid-specific GSK3α- and/or GSK3β-deficient mice. The effects of GSK3α/β-deficiency on signaling pathways regulating atherogenic functions in macrophage were analyzed. This study revealed that GSK3α and GSK3β play distinct, and often opposing roles in macrophage polarization, inflammatory response, lipid accumulation and migration. Furthermore, both GSK3α and GSK3β appear to play redundant roles macrophage viability, proliferation, and metabolism. Lastly, we investigated the effect of macrophage-specific deletion of GSK3α and/or GSK3β on atherosclerotic regression in Ldlr−/− mice. A novel inducible knock out mouse model has been created in which GSK3α and/or GSK3β expression can be ablated by treating the mice with tamoxifen. These mice were fed a high fat diet to promote the development of atherosclerosis, and then mice were treated with tamoxifen to induce GSK3α/β deletion and switched to a chow diet for 12 weeks. All mice were sacrificed at 33 weeks of age and atherosclerotic plaques were analysed. Female mice with induced macrophage-specific GSK3α deficiency, but not GSK3β deficiency, showed regression of existing atherosclerotic lesions. Together, these studies begin to delineate the specific roles of GSK3α and GSK3β in atherosclerotic regression. Furthermore, these data suggest that GSK3α inhibition could be an effective strategy for the treatment of atherosclerotic cardiovascular disease. / Thesis / Doctor of Philosophy (PhD) / Atherosclerosis is a disease involving the build-up of fatty plaques in the arteries, making them hard and narrow, which leads to damage in the heart, coronary or peripheral blood vessels. This can cause acute cardiovascular complications (heart attacks or stroke) and potentially death. We suspect that protein named glycogen synthase kinase (GSK)-3α/β is involved in the development of atherosclerosis. The purpose of this research is to see if we can treat atherosclerosis by blocking GSK3α/β’s functions. The findings of this study demonstrate that blocking GSK3α reduces inflammation, which is a primary cause of atherosclerosis. Furthermore, blocking GSK3α promotes the regression of atherosclerotic plaques and may lower the risk of cardiovascular disease. This knowledge could aid in the development of medications to treat atherosclerosis and reduce the number of individuals who die from heart attacks or strokes.

The proprotein convertases (PC) are endoproteolytic enzymes essential for the generation of bioactive peptides.The production of KO mice for some of these PCs has allowed us to identify many different physiological phenotypes for these enzymes. PC1/3 is traditionally classified as a neuroendocrine enzyme. This has been supported by many studies performed in PC1/3 KO mice, as well as human subjects deficient in PC1/3, where this enzyme is responsible for the cleavage of neuroendocrine substrates, namely POMC and pro-insulin. However, very little research has been done on the potential role of PC1/3 in the immune system, despite evidence of its expression in immune cells, including macrophages. In the present study, we investigate the PC1/3 KO mouse through an immunological aspect. Our laboratory has previously reported an increase in the expression of PC1/3 in the spleen following LPS stimulation. By examining closely the spleen, we observed a splenomegaly of the organ as well as a marked disorganization of the regions of the spleen, such as an invasion of the red pulp with the marginal zone, which may affect the proper immunological response. Labeling of different immune cells demonstrated a decrease in the dendritic cells present in the PC1/3 KO mouse spleen. An interesting phenotype that was observed in the PC1/3 KO mice is their sensitivity to an LPS-induced septic shock, which was evident by an exaggerated secretion of pro-inflammatory cytokines (IL-6, IL-1[bêta] et TNF-[alpha]). Furthermore, the present study identifies the macrophages as major contributors to the unbalanced secretion observed in the PC1/3 KO mice since we report an increase in cytokine secretion in isolated peritoneal macrophages. We also demonstrate a link with the adaptive immune system. A massive secretion of IFN-[gamma] was measured in the PC1/3 KO mouse plasma, supporting the notion that the Th1 pro-inflammatory pathway is predominant in these mice following an LPS challenge. Taking into account these results, the study presented identifies a novel and unconventional role of PC1/3 in the regulation of the innate immune system.

Macrophages and neutrophils are vital cells of the immune system, performing crucial innate functions and bridging innate and adaptive immunity. However, inappropriate activation or poor resolution of responses results in chronic inflammatory and autoimmune conditions due to accumulation of myeloid cells and uncontrolled cytokine production, as is commonly seen in the aging immune system. It is not clear what is required to maintain healthy myeloid cells throughout life or what links inflammation and myeloid dysfunction during the aging process. We have shown that autophagy, a vital intracellular degradation mechanism, is required for normal macrophage innate and adaptive immune functions such as phagocytosis and antigen presentation, as well as being an important regulator of the inflammatory response. Loss of autophagy also results in reduced surface antigen expression and increased glycolysis. We found that autophagy-deficient macrophages have a similar phenotype to aged macrophages. Furthermore, aged macrophages exhibit reduced autophagy compared with young macrophages, suggesting a link between reduced autophagy and acquisition of the aging macrophage phenotype. Finally, we show that autophagy plays a vital role in normal neutrophil differentiation, with autophagy-deficient neutrophils exhibiting altered nuclear morphology and aberrant granule formation. These data show that autophagy plays a critical role in the maintenance of essential macrophage homeostasis and functions by regulating inflammation and metabolism, thereby preventing immunosenescence. We postulate that autophagy modulation in macrophages and neutrophils may be used to prevent excess inflammation, such as in inflammatory and autoimmune diseases. Moreover, inflammation due to aging may potentially be delayed by induction or preservation of autophagy, which could improve immune responses and reduce the morbidity and mortality associated with “inflamm-aging”.

Transcription factors regulate distinct macrophage functions by regulating gene expression in response to micro-environmental cues. This functional plasticity is critical for regulating innate and adaptive immune responses during infection and during chronic disease processes including inflammatory diseases and cancer. Microarray analysis of macrophages polarized to a pro-inflammatory (M1) phenotype with LPS and IFNγ revealed that basic leucine zipper transcription factor ATF-like 2 (Batf2), a member of the AP1 transcription factors, is selectively upregulated in M1 macrophages compared to anti-inflammatory IL-4-polarized (M2) macrophages. The initial hypothesis was that Batf2 is a master regulator of gene expression that orchestrates M1 polarization. To investigate a potential role of Batf2 during macrophage polarization, its expression in M1 polarized macrophages was examined. Batf2 mRNA appears within 60 minutes following LPS/ IFNγ treatment and is sustained for at least 48 hours. To address the hypothesis that Batf2 acts as a master transcriptional factor driving a functional M1 phenotype, we have established macrophage cell lines that constitutively express Batf2. Batf2 overexpression did not enhance key M1-associated genes, including iNOS and H2-Aa, but did enhance LPS/IFNγ-driven Cxcl10. Batf2 overexpression also failed to suppress key M2-associated genes including Fizz1 and Mrc1. Batf2 overexpression also failed to alter multiple non-immunity-related genes established or predicted to be downstream of Batf2 in macrophages or other cells. Overall, contrary to our initial hypothesis, constitutive Batf2 expression by itself does not appear to broadly induce M1 gene expression; rather, it appears to enhance only select genes. Since other Batf family members interact with members of the IRF family, I discuss the possibility that Batf2 works in conjunction with a limiting cofactor, possibly Irf family members and/or other regulatory proteins.