Thesis (doctoral)--University of Göteborg, 1997. / Added t.p. with thesis statement inserted.

Please read the abstract in the section 00front of this document / Thesis (DPhil (Medical Immunology))--University of Pretoria, 2007. / Immunology / unrestricted

This study was designed to follow up a chance observation in patients with an admission white blood cell (WBC) count showing an absolute lymphocytosis and relative neutropenia that changed to a lymphopenia and neutrophilia within 24 hours. As 15 of the 20 patients were admitted following trauma, we examined this association further by reviewing charts of 69 patients who had sustained stab wounds to the chest and abdomen. A prospective study involving 40 patients in the Intensive Care Unit was also undertaken because of the related hypothesis that the Adult Respiratory Distress Syndrome (ARDS) is associated with sequestration of complement activated polymorphonuclear leukocytes (PMN) by the lung. These studies show that trauma is frequently associated with a lymphocytosis and relative neutropenia. In cases where ARDS did develop, the onset of respiratory failure was associated with a profound fall in the circulating PMN count. To test the hypothesis that these leukocyte changes were due to catecholamine release and sequestration of PMN within the pulmonary micro-vasculature, we studied the effects of epinephrine infusion, lowered cardiac output and complement activation on WBC uptake and release from the dog lung. The data show that pulmonary blood flow has a marked effect on the uptake and release of WBC by the lung but has no effect on differential counts. Epinephrine infusion increases circulating WBC counts but also does not alter differential counts. In contrast, activation of the complement cascade alters differential values by causing preferential sequestration of PMN. We conclude that trauma is frequently associated with a lymphocytosis and relative neutropenia and speculate that this phenomenon is due to a combination of catecholamine release and sequestration of PMN within pulmonary and systemic microvasculatures. The findings that a profound fall in PMN counts occurs prior to the onset of ARDS and after activation of the complement pathway with cobra venom factor support the hypothesis that complement activated PMN play a role in the pathogenesis of ARDS. These data also suggest that prospective leukocyte counts may be a useful predictor with respect to determining which patients will develop this syndrome. / Medicine, Faculty of / Pathology and Laboratory Medicine, Department of / Graduate

In alcoholic hepatitis (AH), high neutrophil counts correlate with inflammation and poor clinical outcomes. Here, we sought to elucidate the neutrophil-mediated pathogenesis of AH. We revealed that in vivo neutrophil extracellular trap (NET) formation was significantly increased in AH patients and that alcohol alone is sufficient to induce NET formation in neutrophils; thereby, neutrophils increase liver damage through increased NET formation. Moreover, we identify that alcohol-induced NET formation is vital to NETosis and that high-density neutrophils (HDNs) become low-density neutrophils (LDNs) after NET formation in response to alcohol. Through transcriptome profile analysis, we found that genes related to neutrophil activation and immune responses are significantly upregulated in AH HDNs but significantly downregulated in AH LDNs compared to HDNs from healthy subjects. These data suggest that AH HDNs and LDNs have opposing phenotypes: HDNs are activated and more prone to release NETs, while LDNs are functionally incompetent. Consequently, the increase in activated HDNs and defective LDNs are likely associated with an increase in liver damage through NET formation and enhanced susceptibility to infection in AH patients, respectively. Therefore, we evaluated the therapeutic benefits of preventing NET formation in HDNs using peptidyl arginine deiminase 4 (PAD4) inhibition and granulocyte colony-stimulating factor (G-CSF) treatment as well as neutrophil depletion in mice. We observed that in vivo neutrophil depletion and G-CSF treatment prevent NET formation in the liver, thereby significantly reducing liver damage in alcohol-fed mice. Our work identifies the neutrophil/NET-mediated mechanisms of AH pathogenesis and provides insights into therapeutic interventions for AH.

Toll-like receptors (TLRs), named after toll proteins identified in Drosophila melanogaster, are the pattern recognition receptors in the innate immune system that detect microbes. TLRs are mono, membrane-spanning, as well as non-catalytic receptors, which are mainly expressed in sentinel cells, such as the dendritic cells, neutrophils and macrophages. While humans have ten TLRs (TLR 1 to 10), the mouse has another three (TLRs 11, 12, 13). TLRs are made up of glycoproteins, which have luminal ligand-binding sites consisting of leucine-rich repeat (LRR) for detection of pathogens leading to activation of immune cells. TLR1, 2, 4, and 6 are responsible for recognition of lipids (such as triacetylated lipopeptide), peptidoglycan, and lipopolysaccharide (LPS). However, the TLR3, 7, 8, and 9 mainly recognize nucleic acids, such as double-stranded RNA (dsRNA) and CpG DNA, while the TLR13 detects ribosomal RNA sequences. So far, there are no data on the localization and immunological functions of TLR10. I studied the expression, localization and role of TLR10 in S. pneumoniae infection. First, I examined the expression of TLR10 in lungs of pig, cattle, dog, rat, and chickens. The light and electron microscopic data show TLR10 expression in vascular endothelium and smooth muscles in lungs of control and inflamed animals. Further, we found altered basal level of expression and localization of TLR10 in bovine neutrophils treated with E. coli lipopolysaccharide. These data show the expression of TLR10 in the lungs of tested animal species, and its alteration by LPS in bovine neutrophils. The next study was designed to investigate the regulation of TLR10 expression and to address its role in neutrophil chemotaxis. E. coli LPS activated human neutrophils showed temporal and spatial change in TLR10 expression. Confocal microscopy showed cytosolic and nuclear distribution of TLR10 in normal and activated neutrophils. TLR10 in E. coli LPS-activated neutrophils colocalized with flotallin-1, a lipid raft marker, and EEA-1, an early endosomal marker, suggested its endocytosis. Live cell imaging of LPS activated neutrophils showed TLR10 translocation to the leading edge. Neutrophils upon TLR10 knockdown were unable for fMLP-induced migration. TLR10 knockdown reduced the number of membrane pseudopods in activated neutrophils without altering the expression of key proteins of actin nucleation process, ARP-3 and Diap1. These data show TLR4-mediated pathway for regulation of TLR10 expression, and that TLR10 may have a role in neutrophil chemotaxis. Next, I examined the role of TLR10 in innate immune response to S. pneumoniae infection in U937 human macrophage cell line. S. pneumoniae are major causative agents of pneumonia, meningitis and bacteremia. A significant increase in TLR10 mRNA expression was found in S. pneumoniae (107 cfu for 6hr) challenged macrophages. TLR10 knockdown significantly reduced production of IL-1β, IL-8, IL-17 and TNF-α and no significant change in IL-10 expression, and also significantly diminished nuclear translocation of NF-κB but without affecting the phagocytosis of S. pneumoniae. Altogether, I report the that TLR10 is expressed in the normal and inflamed lungs in cattle, pigs, dogs, rats, chickens and humans. The expression of TLR10 is altered in activated neutrophils, and it plays a role in neutrophils chemotaxis and production of pro-inflammatory cytokines in macrophages infected with S. pneumoniae.

Os neutrófilos ou leucócitos polimorfonucleares (PMNs) são células fagocíticas com funções bactericida e fungicida altamente potentes. A destruição dos microrganismos invasores é realizada através da liberação de substâncias tóxicas presentes em seus grânulos e das espécies reativas de oxigênio (EROs) produzidas durante o metabolismo oxidativo dessas células. Apesar dos benefícios da atividade antimicrobiana, em situações de intensa ativação celular, a grande produção e liberação de compostos citotóxicos podem causar efeitos deletérios sobre os tecidos do hospedeiro, como parece ocorrer em doenças por imunocomplexos. O grande potencial dos antioxidantes para o tratamento e prevenção dessas doenças tem levado à pesquisa de novos compostos que atuam no processo inflamatório em que estão envolvidos os neutrófilos ativados. Dentre estes, destacam-se os naturais, em que se encontra a planta Baccharis dracunculifolia (Asteraceae), principal fonte botânica da própolis verde, sendo que a própolis possui diversas atividades biológicas conhecidas. Entretanto, a produção de metabólitos secundários pelas plantas pode ser modificada de acordo com fatores sazonais o que dificulta os estudos e pode acarretar em alterações de atividade biológica. Desta forma, este trabalho avaliou o efeito da sazonalidade no perfil químico de B. dracunculifolia e na atividade desta planta sobre o metabolismo oxidativo de PMNs. Para isso, extratos etanólicos brutos das folhas de B. dracunculifolia (EEBBd), colhidas mensalmente durante 14 meses foram submetidos à ensaios de cromatografia líquida de alta eficiência (CLAE), e avaliados quanto à capacidade de inibir a quimioluminescência dependente de luminol (QLlum) e de lucigenina (QLluc) produzida por PMNs estimulados. Além disso, para desvendar o(s) possível(is) mecanismo(s) de ação responsável(is) pela atividade antioxidante, foram realizados, com a amostra mais ativa em inibir a QL, ensaios para avaliar a citotoxicidade, a atividade scavenger de radicais livres (DPPH) e a ação sobre a atividade da enzima NADPH oxidase. Os resultados mostraram que todos os EEBBd inibiram tanto a QLlum quanto a QLluc de forma dependente da concentração e que para ambos os ensaios houve variação na eficiência deste efeito biológico ao longo do período de tempo estudado, demonstrando que a sazonalidade desempenhou um papel importante na intensidade da atividade antioxidante dos extratos. O ensaio de CLAE permitiu análise dos seguintes compostos: ácido caféico, ácido p-cumárico, aromadendrina-4-metil éter, isosakuranetina e artepilin C, e revelaram que apesar de não haver notória variação qualitativa entre os componentes, foi observada grande diferença quantitativa. As análises com a amostra do mês de maior atividade antioxidante (Maio/07) revelou que esta foi colhida durante um período de baixo índice pluviométrico, temperaturas amenas e apresentou a menor concentração da maioria dos compostos fenólicos estudados, evidenciando que tais compostos não foram os maiores responsáveis pela atividade biológica da amostra e que alguns desses compostos podem ter atuado como pró-oxidantes. Além disso, foi verificado que esta amostra atuou de forma não tóxica sobre as células, através da captação de parte das EROs geradas no meio reacional e de inibição parcial da atividade da NADPH oxidase. / Neutrophils or polymorphonuclear (PMN) are phagocytic cells with potent bactericidal and fungicidal functions. The destruction of invading microorganisms is made by the release of toxic substances contained within their granules and by the reactive oxygen species (ROS) produced during the oxidative metabolism of these cells. Despite the benefits of antimicrobial activity, in situations of intense cellular activation, large production and release of toxic compounds may cause deleterious effects on host tissue, as it seems to occur in immune complex diseases. The great potential of the antioxidants for the treatment and prevention of these diseases has led to the search of new compounds that act in the inflammatory process where are involved the activated neutrophils. Within this context, natural products are highlighted, mainly plants, among which is the Baccharis dracunculifolia (Asteraceae), the main botanical source of green propolis, which has several activities already known. However, secondary metabolites of plants can be modified according to seasonal factors, what can difficult the studies and alter the biological activity results. Thus, this study evaluated the effect of seasonality in the chemical profile of B. dracunculifolia and in the activity of this plant on the oxidative metabolism of PMNs. For this, crude ethanolic extracts of B. dracunculifolia leaves (CEEBd), harvested monthly for 14 months were analyzed in high performance liquid chromatography (HPLC) and evaluated for their ability to inhibit the luminol- and lucigenin-dependent chemiluminescence (CLlum and CLluc, respectively) produced by stimulated PMNs. In addiction, to understand the possible mechanisms of action responsible for antioxidant effect, the most active sample in the CL test was evaluated for the following proprieties: cytotoxic, scavenger of free radicals (DPPH) and action on the NADPH oxidase activity. The results showed that all CEEBd inhibited both CLlum and CLluc in a concentration-dependent manner and that in both trials it was found variation in the biological effect over the study period, indicating that the seasonality played an important role on the intensity of the antioxidant activity of the extracts. The HPLC assay allowed the analysis of the following compounds: caffeic acid, p-coumaric acid, aromadendrin-4\'-methyl ether, isosakuranetin and artepillin C, and showed that although there was no evident variation in qualitative profile, it was observed large quantitative differences. The analysis of the sample of greatest antioxidant activity (May/07) revealed that it was harvested during a period of low rainfall, mild temperatures and had lower concentrations of most compounds studied, indicating that these compounds were not the most responsible for the biological activity of the sample and that some of these substances may have acted as pro-oxidants molecules. Furthermore, it was found that this sample works in a non-toxic manner on cells, by capturing some of the ROS generated in the reaction medium and by partial inhibition of NADPH oxidase activity.

Os tecidos periodontais estão em confronto contínuo com microrganismos capazes de disparar mecanismos da resposta imune inata, dando origem ao infiltrado inflamatório neutrofílico. A participação dos receptores tipo Toll (TLRs) na resposta de neutrófilos frente à periodontopatógenos associados à doença periodontal precisam ser determinados. Nesse estudo procuramos caracterizar o infiltrado inflamatório presente no peritônio de animais deficientes de TLR2-/-, avaliar a atividade fagocítica, bem como a produção de óxido nítrico (NO) e a atividade de mieloperoxidase (MPO) no curso da infecção por Aggregatibacter actinomycetemcomitans (Aa). Os resultados revelaram um menor recrutamento de leucócitos para o peritônio de animais deficientes de TLR2 (TLR2-/-), com predomínio de macrófagos no exsudato peritoneal tanto de animais selvagens (WTTLR2-/-) como nos animais nocautes. A análise da atividade fagocítica revelou uma menor taxa de fagocitose pelas células do exsudato de animais TLR2-/- e, ainda, a deficiência do receptor TLR2 inibiu a produção de NO (óxido nítrico) e aatividade de MPO (mieloperoxidase). Adicionalmente, são apresentados os resultados referentes ao protocolo de doença periodontal experimentalmente induzida (DPEI) com Aggregatibacter actinomycetemcomitans (Aa) em camundongos deficientes de TLR2. Os resultados mostraram que 100% dos animais deficientes de TLR2 sobreviveram à infecção durante o período de observação. Em relação à análise de perda óssea os dados revelaram uma maior perda progressiva de osso alveolar na região dos molares de animais deficientes de TLR2. A ausência do receptor interferiu com a disseminação da bactéria, uma vez que se observou um grande número de bacilos no linfonodo e baço dos animais que não expressaram TLR2, diferente do observado para os animais selvagens (WTTLR2-/-). Os resultados indicam a importância da sinalização via TLR2 durante a resposta imune contra Aggregatibacter actinomycetemcomitans. / Polymorphonuclear leukocytes (PMNs) are the first line of defense against bacterial infections. PMNs express a numerous pattern-recognition receptors (PRR) that facilitate identification of invading microorganisms. Toll-like receptors (TLRs) represent the main class of PRR involved to a recognize pathogenic microorganism. However, the role played by TLR-2 in the recognition and killing of Aggregatibacter actinomycentemcomitans by PMNs is unknown. Thus, we investigated the ability of TLR-2 to mediate neutrophil phagocytosis and bactericidal activity. To determine the role of A. actinomycentemcomitans in triggering neutrophil infiltration, TLR2-/- mice were infected intraperitoneally (2x109 bacteria) and sacrificed after 24 hours. Peritoneal inflammatory cells were isolated and analyzed by optical microscopy. Examination of local inflammatory infiltrates revealed that neutrophil influx into peritoneal cavity of TLR2-/- mice was similar than that observed into their littermate controls wild type C57BL/6 mice (WT). A. actinomycentemcomitans was detected in the spleen of the TLR2-/- mice but not in WT. In the phagocytic assays, TLR2-/- presented minor number of ingested inflammatory cells than WT. Peritoneal cells were stimulated with A. actinomycetemcomitans antigens, and NO and myeloperoxidase was measured after 48 hours; results showed that TLR2-/- cells produce less NO and MPO than WT. In addition, TLR2-/- deficient mice presented higher bone loss following oral infection with A. actinomycetemcomitans when compared with WT and higher tissue destruction.

O objetivo deste estudo foi avaliar o efeito da competição de triathlon na função e morte de neutrófilos de atletas de elite e investigar o possível envolvimento dos ácidos graxos livres (AGs) neste processo. Os neutrófilos foram obtidos do sangue coletado de 11 sedentários e de 12 triatletas em repouso e após competição de triathlon (Half Ironman, 2 Km de natação, 80 Km de ciclismo e 20 Km de corrida). A competição de triathlon aumentou a capacidade dos neutrófilos de migrar e de realizar burst oxidativo, porém inibiu a fagociose realizada por estas células. Além disso, induziu aumento da fragmentação de DNA e externalização de fosfatidilserina. A competição de triathlon aumentou a concentração de AGs no plasma dos triatletas e esta foi correlacionada positivamente com a proporção de neutrófilos com DNA fragmentado e fosfatidilserina externalizada. A elevação da concentração plasmática dos ácidos oléico, linoléico e esteárico induzida pela competição parece estar envolvida nas alterações funcionais e na apoptose verificadas após a competição de triathlon. / The objective of this study was to evaluate the effect of triathlon competition on function and death of neutrophils from elite athletes and to investigate the involvement of fatty acids in this process. Neutrophils were obtained from blood collected from eleven sedentary volunteers and twelve triathletes under rest and after a Half Ironman triathlon competition (2 Km swimming, 80 Km cycling and 20 Km running). The triathlon competition increased the migration and reactive oxygen species production in neutrophils, however it reduced the phagocytosis activity. Moreover, it induced neutrophils death possibly by apoptosis as indicated by DNA fragmentation and phosphatidylserine externalization. The increase in plasma levels of oleic, linoleic and stearic acids induced by the competition may be involved in modulation on neutrophil function and death.

La déstabilisation de la plaque d’athérosclérose reste de nos jours un problème majeur, malgré les progrès récents dans sa compréhension. Les neutrophiles sont des acteurs puissants de l’immunité innée capables d’altérer les plaques. Un chimio-attractant majeur des neutrophiles, le leucotriène B4, pourrait être un des contributeurs potentiels de la déstabilisation des plaques en particulier dans l’endotoxémie, elle-même associée aux accidents cardiovasculaires. L’objectif de ce travail a été de définir le rôle du leucotriène B4 dans l’attraction des neutrophiles dans la plaque au cours de l’endotoxémie et de déterminer si les neutrophiles peuvent basculer l’équilibre qui maintient les plaques stables. Nous avons montré que le recrutement des neutrophiles médié par le leucotriène B4 a un impact délétère sur la stabilité des plaques au cours de l’endotoxémie en favorisant l’apoptose et la dégradation de fibres matricielles. En conclusion, cette étude ouvre la voie vers de nouvelles approches thérapeutiques visant à cibler l’axe leucotriène-neutrophiles dans la maladie athérosclérotique. / Atherosclerotic plaque destabilisation remains an important issue, in spite of the recent advances in its comprehension. Neutrophils are powerful innate immune actors capable of altering plaques. In this context, the leukotriene B4, one of the main chemoattractants of neutrophils, has been proposed as a potential contributor to plaque destabilisation. A particular context in which these two actors are closely linked is endotoxemia, itself associated with plaque destabilisation This work was aimed at determining whether leukotriene B4 plays a role in the chemoattraction of neutrophils in plaques during endotoxemia and at assessing whether neutrophils can tip the balance which maintains plaques stable. We have herein evidenced that the recruitment of neutrophils mediated by leukotriene B4 has a deleterious impact upon plaque stability during endotoxemia by promoting apoptosis and degrading matrix fibres. In conclusion, this study paves the way to novel therapeutic approaches aimed at targeting the axis leukotriene-neutrophil in atherosclerotic disease.

A sepse é uma resposta inflamatória sistêmica resultante da inabilidade do sistema imune em controlar uma infecção, onde a taxa de sobrevida está associada ao recrutamento de neutrófilos para o local da infecção. Tem sido demonstrado que a expressão de receptores quimiotáticos pode ser alterada durante a sepse. Neutrófilos de animais naives respondem às quimiocinas CXC, mas são irresponsivos às quimiocinas CC. Entretanto, dados do nosso laboratório mostram que a expressão de CXCR2 é reduzida na sepse, prejudicando a migração de neutrófilos para o foco da infecção. Além disso, ocorre o aparecimento do receptor CCR2 nos neutrófilos, levando à infiltração dessas células no pulmão e outros órgãos. Nesse contexto, o nosso objetivo foi investigar a possível expressão do receptor CCR5 em neutrófilos e seu papel na evolução da sepse. Demostramos que animais sham-operados expressam baixos níveis de CCR5 e altos níveis de CXCR2. Entretanto, sob a condição de sepse experimental induzida por ligação e perfuração do ceco (CLP), neutrófilos circulantes e que migraram para a cavidade peritoneal expressam altos níveis de CCR5 em paralelo com a internalização de CXCR2. Além disso, animais deficientes para CCR5 (CCR5-/-), submetidos à CLP, apresentam diminuição na taxa de sobrevida, redução na migração de neutrófilos para o foco da infecção, aumento da disseminação bacteriana, aumento no infiltrado de neutrófilos no pulmão e aumento nos níveis de marcadores de lesão do coração e rim, quando comparados com animais selvagens (WT). Adicionalmente, a incubação de neutrófilos isolados da medula óssea com LPS aumentou a expressão de CCR5 e os tornou responsivos à MIP-1? (ligante de CCR5), induzindo quimiotaxia. Também demonstramos que o receptor CCR5 possui importante papel durante a adesão de neutrófilos ao endotélio vascular para posterior migração. Em conjunto, esses resultados indicam que durante a CLP, o aumento da expressão de CCR5 em neutrófilos tem um papel protetor, visto que animais CCR5-/- sépticos apresentam reduzida migração de neutrófilos para o foco infeccioso, inflamação sistêmica acentuada e baixa taxa de sobrevivência. / Sepsis is a systemic inflammatory response resulted from the inability of the innate immune system to control infections, being the survival rate associated to the recruitment of neutrophils to the infection site. It has been demonstrated that chemokine receptors expression profile can be altered under sepsis conditions. Neutrophils from naïve mice respond to CXC chemokines, but are usually unresponsive to CC chemokines. However, data from our laboratory show that CXCR2 expression is down regulated, impairing the neutrophil migration to infection focus. In addition, CCR2 appears on the surface of neutrophils, mediating the accumulation of these cells in the lung and other organs. In this context, we aimed to investigate the possible expression of CCR5 receptor on neutrophils and its role on sepsis evolution. We showed that neutrophils from sham mice express high levels of CXCR2 and low levels of CCR5. However, during experimental sepsis, induced by cecal ligation and puncture (CLP), in parallel with CXCR2 internalization, neutrophils from the circulation or from the peritoneal cavity express higher levels of CCR5. Interestingly, deficient mice for the CCR5 receptor (CCR5-/-), undergone to CLP show decreased survival rate, reduction in the neutrophil migration to the site of infection, increase in the numbers of bacteria, increase in the neutrophil infiltration in lung and heart and increase in the levels of markers of injuries in heart and kidney, when compared to wild type mice (WT).In addition, the incubation of bone marrow derivedneutrophils with LPS enhances the expression of CCR5 and renders them responsive to CCL4 (a ligant of CCR5)-induced chemotaxis. Moreover, we demonstrated that CCR5 receptor has an important role during neutrophil adhesion to the vascular endothelium before transmigration. Together, these results indicate that during CLP-induced sepsis, the increase of the expression of CCR5 on neutrophils plays a host protective role, since CCR5-/- mice under sepsis present reduced neutrophil migration to infection focus, high systemic inflammation and low survival rate.