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<p>Inflammatory Bowel Disease (IBD) is a chronic intestinal inflammation that has caused many challenges for healthcare providers in treating the disease and also altered the quality of life of the patients. The cure for IBD is still symptomatic-based; the causes mechanism and pathogenesis of IBD are to be further investigated. Currently, IBD has been considered as an excessive immune response to commensal flora that in normal condition is tolerable to the host. Antigen presenting cells (APCs) play an important role in the pathogenesis of IBD. Macrophage is one of the professional APCs that present antigen information to T cells and induce the T cell subtype proliferation. Aside from this role, macrophages also phagocytose pathogens and clean cell debris in thebody.</p> <p>T cell immunoglobulin and mucin domain (TIM)-4 is a glycoprotein expressed on the surface of macrophage, which recognizes phosphatidylserine (PS) that is expressed mainly on the surface of the early apoptotic cell phospholipid membrane; the latter is a negatively charged molecule that can bind to the TIM-4 to enhance the phagocytosing activity. In IBD, the loss of intestinal epithelial cells (IECs) due to apoptosis is prominent in the site of inflammation especially in ulcerative colitis (UC).</p> <p>The aim of this study is to elucidate whether there is an increase of TIM-4 expression in colitis mice model after exposure to excessive number of apoptotic IECs and whether TIM-4 plays a role in the development of colitis in mice.</p> <p>The expression of TIM-4 is measured with several tests; including flow cytometry, immunohistochemistry, western blotting and real time RT-PCR. In the first step, we tried to see if there is a difference in the TIM-4 expression in colitis mice and ethanol control mice. After the association was established, we further observed the role of TIM-4 in the pathogenesis of IBD by injecting TIM-4+ macrophages into the mice prior to inducing a mild colitis in the mice and finally injected neutralizing anti TIM-4 antibodies to block the available TIM-4 receptors.</p> <p>We found that TIM-4 expression was higher in a colitis mouse model compared to the control. Also by injecting TIM-4+ macrophages into the mice, the frequency of intestinal T regulatory (Treg) cells was decreased significantly. Finally in the group treated with anti-TIM-4 neutralizing antibodies prior to colitis induction, the frequency of intestinal Treg cells increased significantly and the inflammation response was less severe than the colitis control group. This study revealed, for the first time in the world, that TIM-4 expression in the colon of colitis mice was significantly increased, which suppressed Tregs and promoted T effector cells.</p> / Master of Science in Medical Sciences (MSMS)

Clostridium perfringens is the most common cause of gas gangrene (clostridial myonecrosis), a disease that begins when ischemic tissues become contaminated with C. perfringens. C. perfringens quickly multiplies in ischemic tissues and spreads to healthy areas, leading to high levels of morbidity and mortality. As a species, the bacterium can synthesize thirteen different toxins. The alpha toxin (PLC) and perfringolysin O (PFO) are thought to be important virulence factors in gangrene. We wished to understand how C. perfringens is capable of avoiding killing by the host immune system, and determine if PLC and PFO play a role in this avoidance. We found C. perfringens was not killed by J774-33 cells or mouse peritoneal macrophages under aerobic or anaerobic conditions. Using electron microscopy, we showed that C. perfringens could escape the phagosome of J774-33 and mouse peritoneal macrophages. We believe the ability of C. perfringens to survive in the presence of macrophages is due to its ability to escape the phagosome. Using a variety of inhibitors of specific receptors, we identified those used by J774-33 cells to phagocytose C. perfringens. The scavenger receptor, mannose receptor(s), and complement receptor (CR3) were involved in the phagocytosis of C. perfringens. To determine if PFO or PLC were involved in the ability of C. perfringens to survive in the presence of macrophages, we constructed C. perfringens strains lacking these toxins. The ability of C. perfringens to survive in the presence of J774-33 cells is dependent on PFO, while survival in mouse peritoneal macrophages is dependent on PFO and PLC. The ability of C. perfringens to escape the phagosome of J774-33 cells and mouse peritoneal macrophages is mediated by either PFO or PLC. Using a mouse model, we found that PFO and PLC were necessary for C. perfringens to survive in vivo using infectious doses 1000 times lower than those required to initiate a gangrene infection. We propose that PFO and PLC play a critical role in the survival of C. perfringens during the early stages of gangrene infections, when phagocytic cells are present and bacterial numbers are low. / Ph. D.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.