A associação da obesidade e asma atópica está bem descrita. Embora reconhecidamente uma patologia mediada por eosinófilos, à asma apresenta fenótipos distintos onde os neutrófilos exercem relevante papel na inflamação pulmonar e manutenção da inflamação. Existem dados de que mulheres obesas asmáticas são mais propensas a desenvolver a asma mediada por neutrófilos, cuja característica é ser de difícil controle, e ainda refrataria a corticoterapia. Ainda não existem modelos experimentais de asma neutrofílica, que visem a ligar os mecanismos associados à resistência aos corticoides em mulheres com asma neutrofílica. Neste estudo caracterizamos um modelo experimental de asma neutrofilica em camundongos fêmeas e apresentamos dados do papel da obesidade na inflamação pulmonar. Nossos dados permitem sugerir que o modelo de asma neutrofílica está, sob ponto de vista inflamatório caracterizado, e que o recrutamento de neutrófilos independe da obesidade. Nosso estudo pode contribuir para a compreensão dos mecanismos que regulam a asma de neutrofilica em mulheres obesas. / The association of obesity and atopic asthma is well described. Although admittedly an eosinophil-mediated pathology, asthma presents distinct phenotypes where neutrophils exert a relevant role in lung inflammation and maintenance of inflammation. There are data that obese asthmatic women are more likely to develop neutrophil-mediated asthma, which is difficult to control and still refractory to corticosteroids. There are as yet no experimental models of neutrophilic asthma to link mechanisms associated with resistance to corticosteroids in women with neutrophilic asthma. In this study we characterized an experimental model of neutrophilic asthma in female mice and presented data on the role of obesity in pulmonary inflammation. Our data allow us to suggest that the neutrophilic asthma model is, under a characterized inflammatory point of view, and that neutrophil recruitment is independent of obesity. Our study may contribute to understanding the mechanisms that regulate neutrophilic asthma in obese women.

Neutrophils, known primarily as key players in defense against invading pathogens, represent an essential component of both the innate and adaptive immunity. Continuous production of large quantities of neutrophils is ensured by a complex process termed granulopoiesis. In order to maintain a stable neutrophilic population, granulopoiesis requires to be tightly regulated. Moreover, impaired granulopoiesis may lead to aberrant bone marrow function and, ultimately, give rise to acute myeloid leukemia (AML). Despite decades of research, the mechanisms regulating granulopoiesis are still unclear. In particular, the CCAAT/enhancer binding protein (C/EBP) family of transcription factors plays a critical role in this process. C/EBPα acts as a master regulator of granulopoiesis mainly by orchestrating expression of its target genes, which will mediate granulocytic differentiation. Thus, characterization of novel C/EBPα target genes is critical for a better understanding of the molecular mechanisms that regulate granulopoiesis. Previously, we showed that another C/EBP member, CEBPG, is a direct target of C/EBPα. In the first part of the present work, we addressed the unknown role of C/EBPγ in granulopoiesis. We observed that Cebpg conditional knockout (KO) mice, which have the Cebpg gene ablated specifically...

<p>Clinical islet transplantation is an emerging procedure to cure type 1 diabetes. The graft is implanted by infusion into the liver through the portal vein. A major obstacle that still needs to be overcome is the requirement for islets from multiple donors to achieve insulin independence. </p><p>An innate inflammatory reaction, the IBMIR, is elicited when islets are exposed to blood. The IBMIR has been described as a clotting reaction culminating in disruption of islet morphology and is a plausible cause for loss of tissue during the early post-transplant period. </p><p>In this thesis, the underlying mechanisms of the IBMIR were characterized. The IBMIR was for the first time demonstrated in patients undergoing an islet transplant, and a number of clinically applicable strategies to limit this reaction were identified.</p><p>The thrombin inhibitor melagatran completely blocked the IBMIR in an <i>in vitro</i> tubing blood loop system, indicating that thrombin is the driving force in the reaction. Interestingly, islets were shown to produce and secrete tissue factor (TF), the physiological trigger of coagulation. Inactivated FVIIa, a specific inhibitor of TF, successfully blocked initiation of the IBMIR. An alternative approach to limit the IBMIR was to pre-treat islets in culture prior to transplantation. Nicotinamide added to the culture medium effectively decreased the level of TF in human islets. Infiltration of immune cells, also a part of the IBMIR, was characterized in detail. The predominant cell types infiltrating the islets were neutrophilic granulocytes and, to a lesser degree, monocytes. Both cell types may exert direct cytotoxic effects, and the antigen-presenting monocytes may also be important for directing the specific immune system to the site of inflammation. </p><p>These findings have provided new insight into the nature of the IBMIR and offer several new strategies to improve the outcome of clinical islet transplantation.</p>

Clinical islet transplantation is an emerging procedure to cure type 1 diabetes. The graft is implanted by infusion into the liver through the portal vein. A major obstacle that still needs to be overcome is the requirement for islets from multiple donors to achieve insulin independence. An innate inflammatory reaction, the IBMIR, is elicited when islets are exposed to blood. The IBMIR has been described as a clotting reaction culminating in disruption of islet morphology and is a plausible cause for loss of tissue during the early post-transplant period. In this thesis, the underlying mechanisms of the IBMIR were characterized. The IBMIR was for the first time demonstrated in patients undergoing an islet transplant, and a number of clinically applicable strategies to limit this reaction were identified. The thrombin inhibitor melagatran completely blocked the IBMIR in an in vitro tubing blood loop system, indicating that thrombin is the driving force in the reaction. Interestingly, islets were shown to produce and secrete tissue factor (TF), the physiological trigger of coagulation. Inactivated FVIIa, a specific inhibitor of TF, successfully blocked initiation of the IBMIR. An alternative approach to limit the IBMIR was to pre-treat islets in culture prior to transplantation. Nicotinamide added to the culture medium effectively decreased the level of TF in human islets. Infiltration of immune cells, also a part of the IBMIR, was characterized in detail. The predominant cell types infiltrating the islets were neutrophilic granulocytes and, to a lesser degree, monocytes. Both cell types may exert direct cytotoxic effects, and the antigen-presenting monocytes may also be important for directing the specific immune system to the site of inflammation. These findings have provided new insight into the nature of the IBMIR and offer several new strategies to improve the outcome of clinical islet transplantation.

The objective of the study is to investigate the total antioxidative capacity of plasma and the level of survival of non-activated neutrophilic leucocytes in peripheral venous blood, their oxidative function and its changes when activated by non-opsonised E.coli and S.aureus, exposed to glucose and investigate the effect of glycosylated haemoglobin (HbA1c%) of different concentrations, using the methods of luminol- and liucigenin-dependent chemiluminescence, with respect to the patients suffering from type 1 diabetes mellitus (DM) and a severe form of periodontitis, as well as those who suffer from type 1 diabetes mellitus, but have healthy periodontal tissues, and also persons without systemic diseases and inflammatory periodontal diseases. An integrated investigation of the level of oxidative capacity of neutrophilic leucocytes in peripheral venous blood, using the methods of luminol- and liucigenin-dependent chemiluminescence, of the patients who suffer from type 1 diabetes mellitus and a severe form of periodontitis as well as persons suffering from type 1 diabetes mellitus, but with no inflammatory periodontal disease, and also healthy persons, has been performed for the first time. A new presumption has been presented on the basis of the collected material, which states that the development of inflammatory diseases of periodontal tissues is determined by the decreased level of survival of bactericidal myeloperoxidase system of neutrophilic leucocytes.

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Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-05-03T11:38:10Z No. of bitstreams: 1 flaviamarciadecastroesilva.pdf: 2659537 bytes, checksum: 1c8331ace53624c1553f76ae25681622 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-06-03T15:37:23Z (GMT) No. of bitstreams: 1 flaviamarciadecastroesilva.pdf: 2659537 bytes, checksum: 1c8331ace53624c1553f76ae25681622 (MD5) / Made available in DSpace on 2016-06-03T15:37:23Z (GMT). No. of bitstreams: 1 flaviamarciadecastroesilva.pdf: 2659537 bytes, checksum: 1c8331ace53624c1553f76ae25681622 (MD5) Previous issue date: 2015-04-10 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / A asma e a obesidade são doenças inflamatórias crônicas de perfis imunológicos opostos. Contudo, estudos clínicos e epidemiológicos demonstram uma associação entre as duas patologias, através da observação de que indivíduos obesos asmáticos representam um fenótipo clínico distinto da asma alérgica clássica, apresentando aumento na gravidade dos sintomas e resistência a terapias convencionais. Entretanto, os mecanismos imunológicos envolvidos na associação obesidade e asma não estão esclarecidos, devido à escassez de estudos e a uma heterogeneidade nos dados encontrados em modelos experimentais. Portanto, o objetivo do presente estudo foi avaliar a influência da obesidade sobre a inflamação alérgica pulmonar. Para isso, a obesidade foi induzida por dieta com alto teor de gordura durante dez semanas nos animais dos grupos OB e OB/AP, enquanto os animais dos grupos CN e AP foram alimentados com a dieta padrão. Da sexta a décima semana do protocolo de indução da obesidade, os animais dos grupos AP e OB/AP foram submetidos a subsequentes sensibilizações e desafios com a ovalbumina. As análises foram realizadas em 24 e 48 horas após o último desafio com a OVA. Os resultados demonstraram que após os desafios com o alérgeno, os animais do grupo AP apresentaram características marcantes da resposta imune alérgica, com elevado número de eosinófilos no LBA, no tecido pulmonar e na medula óssea, correlacionando com os níveis elevados de CCL11 e peroxidase eosinofílica, além de citocinas de eperfil Th2 como IL-4, IL-5, IL-9, IL-13, IL-25, IL-33 e TSLP e de IgE sérica anti-OVA. Contudo, foi observado em 48 horas um declíneo na resposta de perfil Th2 nos animais deste grupo. Já os animais do grupo OB/AP apresentaram em 24 horas, um menor número de eosinófilos no lavado broncoalveolar, no tecido pulmonar e na medula óssea, associado a menores níveis de CCL11, EPO e de IL-4, IL-5, TSLP e IL-25 assim como de IgE sérica anti-OVA. Em 48 horas, as análises de citocinas no grupo OB/AP demonstraram um aumento nos níveis de IL-1β, IL-4, IL-6, IL-9, IL-12, IL-13, IL-17A, TNF-α e IFN- associado ao maior influxo de macrófagos M1. Surpreendentemente, em 48 horas após o último desafio com a OVA, houve um aumento significativo de neutrófilos na medula óssea e de mieloperoxidase no tecido pulmonar. Paralelamente, os animais do grupo OB/AP, apresentaram um número maior de mastócitos e células caliciformes em ambos os tempos analisados, quando comparado aos animais do grupo AP. Conclusão: Somados estes resultados sugerem que a obesidade desenvolvida em camundongos BALB/c, foi capaz de influenciar a resposta imune no pulmão dos animais após as sensibilizações e os desafios com alérgeno, interferindo no desenvolvimento da resposta imune Th2 clássica e acarretando um atraso no desenvolvimento da resposta imune inflamatória. Adicionalmente, os animais obesos asmáticos apresentaram exacerbada resposta imune Th2, Th9 e altos níveis de IL-17A associada a um maior influxo de neutrófilos para o pulmão e a uma intensa produção de muco, sugerindo que estes animais apresentaram um perfil inflamatório mais grave de alergia pulmonar. / Asthma and obesity are chronic inflammatory diseases with opposite immune profiles. Although, clinical and epidemiological studies reveal the association between them, as obese asthmatic individuals represent a distinct phenotype from the classic allergic asthma. However, the immune mechanisms involved in this association are not established yet, due to the lack of studies and the heterogeneity of the data obtained in experimental models. Therefore, the present study aimed to evaluate the influence of obesity over the immune response pulmonary allergic. Female Balb/c mice were fed with high fat diet during ten weeks so as to induce obesity. From the sixth to the tenth week of the protocol, PA and PA/OB groups were sensitized and challenged with ovalbumin. The following analyses were performed 24 and 48 hours after the last OVA challenge. Striking features of the allergic immune response were observed in the PA group, as elevated eosinophil count in BAL, lung tissue bone marrow, in association with high IL-4, IL-5, IL-9, IL-13, IL-25, IL-33, TSLP and anti-OVA IgE levels. There was also elevated production of CCL11 and EPO correlated with the eosinophilia. In contrast, IL-4, IL-5, TSLP and IL-25 levels were diminished in PA/OB group. In association with the reduced eosinophil count, low levels of CCL11, EPO and Anti-OVA IgE were detected. However, 48 hours after the last challenge, IL-1β, IL-4, IL-6, IL-9, IL-12, IL-13, IL-17A, TNF-α and IFN- level were higher in the PA/OB, the was also an increased M1 macrophage influx. There was also more neutrophils in the bone marrow and MPO in the lung tissue, indicating their increased influx to the lung of PA/OB animals. Mast cells and goblet cells count was increased in this group, 24 and 48 hours after the last challenge. Taken together these results suggest that obesity developed in BALB/c mice was able to influence the immune response in the lungs of animals after sensitization and challenge with allergen, interfering with the immune response classical Th2 and causing a delay in the development inflammatory immune response. Additionally, asthmatic obese animals showed exaggerated Th2 immune response, Th9 and high IL-17A levels associated with an increased influx of neutrophils into the lung and an intense mucus production, suggesting that these animals showed an allergy more severe inflammatory profile lung.