Made available in DSpace on 2014-12-17T14:10:24Z (GMT). No. of bitstreams: 1 NormaHDM_DISSERT.pdf: 999595 bytes, checksum: c62cdc67318a196202b24c4678092ac5 (MD5) Previous issue date: 2011-03-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Toxoplasmosis, provoked by the intracellular parasite Toxoplasma gondii, is one of the most prevalent parasitoses in the world. In humans, transmission occurs by three evolutionary forms of the parasite: oocysts, tissue cysts and tachyzoites. Wild and domestic felines are definitive hosts. The ocular form of toxoplasmosis can be of congenital origin with early or late clinical manifestations, or acquired after birth. T. gondii is considered the main culprit for most cases of infectious uveitis. This study aimed at assessing ocular toxoplasmosis, relating it to factors associated to the patient s lifestyle and describing the epidemic-serological and clinical profile of affected individuals. A cross-sectional study was conducted with a population of 159 patients. Univariate analysis (odds ratio) was used to evaluate the data, with a confidence interval of 95% and p-value < 0.05. A prevalence of 4% of ocular toxoplasmosis was observed in the population of patients treated at an ophthalmological clinic. Of patients directly examined by immunoenzymatic assay (MEIA-AxSYM?- Microparticle Enzyme Immune Assay), considering only uveitis, a frequency of anti-T. gondii of 73%, most of whom exhibited titulation between 40-99 UI IgG/mL. With respect to location of ocular lesions, bilaterality was observed in 57% of patients assessed by the ophthalmoscopy technique. When compared with the results of an active search of medical records, a similarity in ocular toxoplasmosis (74%) and bilateral lesion location (55%) was observed. Type I lesion was the most frequent type observed, with intraocular disposition in the macula. An epidemiological survey revealed that direct contact with cats; consuming raw or poorly cooked meat and direct contact with the soil were significantly associated with greater likelihood of acquiring ocular toxoplasmosis. Sample characterization in relation to age range was significant for patients between 31 and 40 years [??, chi-square test (p = 0.04)], but population traits such as schooling, sanitary district, and monthly income were not significant. Results confirm that ocular toxoplasmosis is widely distributed in the metropolitan area of Natal, Brazil, with significant prevalence of ocular lesions provoked by T.gondii. It is suggested that sanitary authorities exert greater control in order to minimize the risk of toxoplasmic infection, mainly in pregnant women. / A toxoplasmose, provocada pelo parasito intracelular Toxoplasma gondii, ? uma das parasitoses mais prevalentes em todo o mundo. Nos humanos, a transmiss?o ocorre por meio das tr?s formas evolutivas do parasito: oocistos, cistos tissulares e taquizo?tos. Os fel?deos, silvestres ou dom?sticos, s?o os hospedeiros definitivos. A forma ocular da toxoplasmose pode ser de origem cong?nita com manifesta??es cl?nicas precoces ou tardias, ou ainda ser adquirida ap?s o nascimento. O T. gondii ? considerado o principal respons?vel pela maioria dos casos de uve?tes infecciosas. Este estudo avaliou a toxoplasmose ocular, relacionando-a com fatores associados ao modo de vida dos pacientes e descrever um perfil epid?mico-sorol?gico e cl?nico dos indiv?duos acometidos. Foi realizado um estudo seccional, com uma popula??o de 159 pacientes. Para avalia??o dos dados observados foi utilizada a an?lise univariada com c?lculo de Odds Ratio, tendo como ?ndice de confian?a de 95% e o valor de p < 0,05. Foi observada uma preval?ncia de 4% de toxoplasmose ocular na popula??o de pacientes atendidos na cl?nica oftalmol?gica. Dos pacientes examinados diretamente por ensaio imunoenzim?tico (MEIA-AxSYM?- Microparticle Enzyme Imune Assay), considerando apenas as uve?tes, foi verificada uma freq??ncia de anti- T. gondii de 73%, a maioria dos pacientes apresentaram titula??o entre 40-99 UI IgG/mL. Quanto ? localiza??o da les?o ocular foi observada a bilateralidade em 57% dos pacientes avaliados pela t?cnica de oftalmoscopia. Quando comparados com os resultados da busca ativa de prontu?rios se observou uma similaridade na freq??ncia de preval?ncia para toxoplasmose ocular (74%), e 55 % quanto a localiza??o bilateral da les?o. Quanto ao tipo de les?o observada, a mais freq?ente foi a les?o do tipo I, com disposi??o intraocular na m?cula. O inqu?rito epidemiol?gico revelou que os fatores de riscos: o contato direto com gatos, o consumo de carne crua ou mal cozida e o contato direto com o solo foram significativamente associados com as maiores chances de adquirir toxoplasmose ocular. A caracteriza??o da amostra em rela??o ? faixa et?ria foi significativa para pacientes entre 31-40 anos [??, Teste do qui-quadrado (p = 0,04)], por?m caracter?sticas populacionais tais como escolaridade, distrito sanit?rio, renda mensal n?o tiveram signific?ncia segundo esse teste estat?stico. Os resultados confirmam que a toxoplasmose ocular est? amplamente distribu?da na cidade do Natal, com significativa preval?ncia de les?es oculares provocadas pelo T.gondii. ? recomend?vel um maior controle por parte das autoridades sanit?rias, visando minimizar o risco de infec??o toxopl?smica em toda popula??o.

Nous avons sélectionné des patients atteints d’une TO biologiquement confirmée et avons exploré les différences cliniques et biologiques de deux groupes de patients, l’un en France, l’autre en Colombie. Dans notre hypothèse de départ, les souches sud-américaines, seraient plus virulentes et elles pourraient jouer un rôle crucial dans la sévérité et l’évolution de la TO. Nous avons constaté, chez les patients colombiens, de plus grandes lésions de la rétine et une plus grande proportion de lésions maculaires, dans un contexte inflammatoire vitréen plus sévère. Le cytoquinome oculaire confirme une forte réponse inflammatoire chez les patients européens centrée sur l’IL-17, mais cette réponse Th17 est absente chez les sujets colombiens. L’IL-6 et l’IL-13 sont au contraire fortement augmentées chez ces derniers. Nous avons également démontré que certaines cytokines étaient associées à certaines caractéristiques cliniques comme la sévérité de l’inflammation ou la récurrence. Des travaux préliminaires nous ont permis de débuter une modélisation de ces affactions oculaires en employant une souche de type II et une souche atypique de T. gondii. Nous avons aussi évalué la possibilité d’effectuer des traitements ciblés en intraoculaires par transfection in vivo. Conclusion: Nous avons constaté des différences cliniques et biologiques entre les patients colombien et français. Il semble y avoir une régulation souche dépendante de la production d’IFN-y et d’IL-17. Ces différences pourraient contribuer à expliquer la plus grande sévérité des toxoplasmoses oculaires en Colombie. En se basant sur nos résultats nous pouvons envisager d’explorer des traitements immunomodulateurs plus ciblés. / Ocular involvement, mainly retinochoroiditis, is one of the most severe sequelae of Toxoplasma gondii infection. However, the pathophysiological mechanisms of retinal destruction are poorly understood. Several studies suggested a more frequent and more severe ocular involvement in South American infections compared with European infections, probably due to different T. gondii strains (Type I/III, and atypical vs. Type II). To compare the clinical characteristics and biological and immunological responses in a single study and using the same parameters, in Colombian and French patients with active ocular toxoplasmosis (OT), as well as to study the local cytokinome in aqueous humor of these patients and correlate it with the clinical features. We prospectively collected and compared the clinical features of patients with active OT, evaluated at the Department of Ophthalmology of Strasbourg University Hospital and of Quindio University Health-Center. Results of biological tests in the collected aqueous humor samples were compared between Colombian and French patients: the pattern of protein recognition by immunoblotting (IB); the relative diagnostic sensitivities of IB and Polymerase Chain Reaction (PCR); and the cytokine and chemokine profiles. We found that Colombian and French OT patients presented not only different clinical characteristics but also biological characteristics, and that more virulent South American strains might be responsible for these differences, due to a disruption of the protective effects of interferon gamma (IFN-γ). Retinal lesions were 50% greater in Colombian patients. Macular localization leading to visual impairment was observed in 56% of Colombian cases, compared with 13% of French patients. Moreover, more vitreous inflammation and vasculitis were observed in Colombian patients. However, cytokine assays of the aqueous humor showed upregulation of inflammatory responses in European patients, notably IL-17, which we did not observe in Colombian patients. In a mouse model, intraocular tachyzoite injection of type II and atypical T. gondii strains resulted in differences in parasite multiplication and pathology similar to those observed in human infections. Production of IL-17 and other inflammatory markers, like IL-6, MCP-1, and the Th17 transcription factor ROR-γt was observed upon infection with the type II PRU strain, but was much less with the atypical LEF strain. In a previous work, the cytokine and mRNA patterns showed an upregulation of Th1 responses, notably IFN-γ production, in French patients, and anti-IL-17A antibody markedly diminished clinical damage and retinal inflammation, and also diminished parasite proliferation. In contrast to these previous findings in French patients, the cytokinome of aqueous humor of OT Colombian patients showed a downregulation of Th1 and Th17 responses and an upregulation of the Th2 response. Correlation between the clinical characteristics of Colombian patients with active OT and the levels of cytokines in aqueous humor (AH) showed that local production of cytokines differed between patients with OT, and particular cytokine levels were related to more severe clinical characteristics. Some cytokines were related to a higher number of recurrences.There are clinical and biological differences between Colombian and French patients with OT. There seem to be strain-specific differences in IL-17 and IFN-γ induction, which play an important role in the pathogenesis of this disease. These differences should be considered when thinking in perspectives of any possible immune-modulatory treatment in OT.

Toxoplasma gondii est un parasite intracellulaire obligatoire qui infecte plus du tiers de la population mondiale. La toxoplasmose oculaire (TO), qu’elle soit d’origine acquise ou congénitale, est une infection fréquente et redoutable où le pronostic visuel est fortement engagé. La présence du parasite dans le tissu rétinien, ainsi que la réponse immunitaire de l’hôte, qu’il génère participent au développement des lésions. Cependant, les mécanismes physiopathologiques aboutissant à la destruction de la rétine et ceux conduisant à la latence et à la réactivation parasitaires ne sont toujours pas clairement identifiés. De plus, des améliorations des traitements actuels semblent nécessaires afin de traiter au mieux l’ensemble des patients et d’agir également sur la forme latente du parasite et les récidives qui en découlent. Nos travaux sur des modèles murins de la phase aiguë de la TO démontrent que le facteur de virulence parasitaire ROP16 est responsable de l’augmentation de la charge parasitaire et des réponses inflammatoires oculaires Th1 et Th17. De plus, lorsque cette protéine se trouve dans un génotype parasitaire différent de celui d’origine, la pathologie oculaire en est exacerbée. Nous avons également démontré que la cytokine IL-23 participe à la destruction de la rétine et à la multiplication parasitaire. Notre modèle murin de réactivation de la TO met en évidence le rôle protecteur de la voie Th1 à travers l’IFN-γ et celui fortement délétère de la cytokine IL-6. La neutralisation de cette cytokine dans notre modèle diminue la charge parasitaire oculaire ainsi que l’ensemble de la réponse inflammatoire et n’altère en rien la structure rétinienne. Il serait donc très intéressant d’utiliser une thérapie ciblant le récepteur de l’IL-6 afin de contrecarrer les effets des récurrences de la TO. / The obligate intracellular parasite Toxoplasma gondii infects more than one third of the world population. Ocular toxoplasmosis (OT), whether acquired or congenital, is a common and frightening infection which can strongly impair the visual function. OT is considered as a major cause of posterior uveitis and retinochoroiditis is its most common manifestation. The presence of the parasite in the retina as well as the immune response it generates in the host are two factors involved in the development of ocular lesions. However, up to now, the pathophysiological mechanisms leading to the destruction of the retina and those implied in the parasite latency and reactivation have not been clearly identified. Morever, improvements of current treatments are necessary in order to give all patients a better care but also to fight the parasite latent form and relapses they may cause. Our mouse models of OT acute phase have demonstrated that the parasite virulence factor ROP16 is responsible for the parasite load increase and the Th1 and Th17 ocular inflammatory responses. When this protein is in a different genotype than its original one – this has been made possible by recombining strains – the ocular pathology is more severe. We also showed that the IL-23 cytokine was involved in the destruction of the retina and in parasite multiplication. Our mouse model of OT reactivation highlighted the protective role of the Th1 pathway through IFN-γ as well as the highly deleterious IL-6 cytokine. By neutralizing this cytokine in our model, we reduced the ocular parasite load and the global inflammatory response without modifying the retinal structure. It would be very interesting to elaborate a therapy targeting the IL-6 receptor in order to counter the effects of OT recurrences.

T. gondii é um protozoário amplamente disseminado pelo mundo que pode causar doença em animais e humanos. A evolução e a gravidade da doença dependem de características genéticas do parasita e do hospedeiro. A prevalência varia geograficamente, em Erechim, RS, 88% da população é soropositiva e 18% destes apresentam toxoplasmose ocular (TO). A resposta imune humoral contra T. gondii é persistente em todas as fases da infecção. O objetivo deste retrospectivo estudo foi correlacionar a imunidade humoral e a resposta contra peptídeos cepa-específicos com a gravidade da TO em pacientes de Erechim. 327 amostras de soro foram testadas (ELISA) para a pesquisa dos isótipos específicos e contra peptídeos cepa-específicos de regiões polimórficas (GRA6 e GRA7) do parasita. Nossos resultados sugerem que IgG2 e IgG3 estão associados à infecção adquirida recente, porém não há associação entre os isótipos e a evolução clínica da TO. Entretanto, embora seis diferentes sorotipos infectem estes pacientes, a gravidade da TO está associada a um novo padrão sorotípico (Atípico D). / T. gondii is a widespread protozoan parasite that is associated with a large spectrum of diseases in both humans and animals. The progression and severity of disease is quite variable and presumably due to some combination of host and parasite genetics. Prevalence varies with geography. In Erechim, Brazil, it is 88% prevalent and is related with a high incidence (18%) of ocular toxoplasmosis (OT). Humoral immune response against the parasite is effective. The aim of this retrospective study was to correlate the humoral immunity and response against the strain-specific peptides with the severity of the TO in Erechim`s patients. 327 sera were evaluated by ELISA to isotypes, IgG avidity and serotyped using strain-specific polymorphic peptides (GRA6 and GRA7). Our results suggest that IgG2 and IgG3 were associated with recent acquired infection. However, there is no association between isotypes and clinical evolution of OT, and also 6 different serotype-strains were detected in this population, but only one of these (Atypical D) was strongly associated with severe OT.

Made available in DSpace on 2016-01-26T12:51:36Z (GMT). No. of bitstreams: 1 cinaradecassiabrandaodemattos_tese.pdf: 2369764 bytes, checksum: d694ab0e38db337b769ea1ace729b6e3 (MD5) Previous issue date: 2012-04-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / T. gondii is an obligate intracellular parasite and cosmopolitan, whose infection congenital or acquired, results in different forms of toxoplasmosis. The clinical manifestations of this disease are nonspecific and variable. Its diagnosis essentially laboratory is aimed at pregnant women, neonates, patients with immunodeficiencies, patients with eye injury and even normal individuals. Serological methods are often used in the characterization of IgM and IgG anti-T.gondii, but those of nature of molecular favoring genetic characterization of the strains isolated from biological samples. Objectives: The overall objective of this thesis was to investigate the infection by T.gondii in the northwestern region of São Paulo state. Its specific objectives were: 1. to characterize infection in pregnant women, newborns and people with eye diseases 2. to evaluate the applicability of the method of PCR inperipheral blood sample in patients with eye diseases 3. to identify the strains from peripheral blood samples. Casuisitc and Methods: epidemiological data and samples of peripheral blood from patients treated in Outpatient Clinic of High Risk Pregnancy and Retinopathy were collected and analyzed for infection by T. gondii using serological methods (ELISA) and molecular (cnPCR and qPCR). Results: among 574 women with mean age equal to 27.2 ± 6.5, 62% (345/556) showed positive for IgG and 3.4% (n = 19/556) for IgM. In 87 mother-newborn pairs, 64.4% (n = 58) were reactive for anti-T. gondii and 2.3% (n = 2), IgM, 92.9% (52/56) had IgG avidity greater than or equal to 30%. Among 184 patients with different eye diseases, 26% (n = 49) had ocular toxoplasmosis, all reagents for IgG. The PCR (qPCR and cnPCR) applied to the analysis of peripheral blood showed sensitivity and specificity equal to 40.8% and 100%, respectively. Five patients with ocular toxoplasmosis were shown to be infected by the strain toxoDB # 65. Conclusion: The results show that the prevalence of infection with T. gondii in pregnant women, neonates and patients with eye diseases is high in the northwertern region of São Paulo state, and to estimate the rates of congenital infection in the region. In addition to describing the first time the ocular toxoplasmosis in the region, this study reinforces the importance of cnPCR and qPCR methods for the characterization of infection and laboratory strains toxoDB # 65 from peripheral blood samples of patients with chronic infection. / T. gondii é um parasito intracelular obrigatório e cosmopolita, cuja infecção de natureza congênita ou adquirida, resulta nas diferentes formas de toxoplasmose. A manifestação clínica desta doença é inespecífica e variável. Seu diagnóstico, essencialmente laboratorial, é direcionado a gestantes, neonatos, portadores de imunodeficiências, portadores de lesão ocular e mesmo indivíduos normais. Métodos sorológicos são frequentemente utilizados na caracterização de anticorpos IgM e IgG anti-T. gondii, porém aqueles de natureza molecular favorecem a caracterização gênica das cepas em isolados de amostras biológicas. Objetivos: O objetivo geral desta tese foi investigar a infecção por T. gondii na região Noroeste Paulista. Seus objetivos específicos foram: 1. caracterizar a infecção em gestantes, neonatos e indivíduos com doenças oculares; 2. avaliar a aplicabilidade do método de PCR em amostra de sangue periférico em pacientes com doenças oculares; 3. identificar as cepas a partir de amostras de sangue periférico. Casuísitca e Métodos: dados epidemiológicos e amostras de sangue periférico de pacientes atendidos em Ambulatório de Gestação de Alto Risco e Retinopatia foram coletadas e analisadas quanto à infecção por T. gondii por métodos sorológicos (ELISA) e moleculares (cnPCR e qPCR). Resultados: entre 574 gestantes com média de idade igual a 27,2±6,5, 62% (345/556) mostraram-se reagentes para IgG e 3,4% (n=19/556), para IgM. Em 87 pares mãe-bebê, 64,4% (n=58) foram reagentes para anti-T. gondii e 2,3% (n=2), para IgM; 92,9% (52/56) apresentaram IgG com avidez maior ou igual a 30%. Dentre 184 pacientes com diferentes doenças oculares, 26% (n=49) apresentaram toxoplasmose ocular, todos reagentes para IgG. O método PCR (cnPCR e qPCR) aplicado à análise do sangue periférico apresentou sensibilidade e especificidade iguais a 40,8% e 100%, respectivamente. Cinco pacientes com toxoplasmose ocular mostraram-se infectados pela cepa toxoDB#65. Conclusão: Os resultados demonstram que a prevalência de infecção por T. gondii em gestantes, neonatos e pacientes com doenças oculares é elevada na região Noroeste paulista, e permitem estimar os índices de infecção congênita na região. Além de descrever pela primeira vez a toxoplasmose ocular na região, este estudo reforça a importância dos métodos cnPCR e qPCR na caracterização laboratorial da infecção e da cepas toxoDB #65 a partir de amostras de sangue periférico de pacientes com infecção crônica.

T. gondii é um protozoário amplamente disseminado pelo mundo que pode causar doença em animais e humanos. A evolução e a gravidade da doença dependem de características genéticas do parasita e do hospedeiro. A prevalência varia geograficamente, em Erechim, RS, 88% da população é soropositiva e 18% destes apresentam toxoplasmose ocular (TO). A resposta imune humoral contra T. gondii é persistente em todas as fases da infecção. O objetivo deste retrospectivo estudo foi correlacionar a imunidade humoral e a resposta contra peptídeos cepa-específicos com a gravidade da TO em pacientes de Erechim. 327 amostras de soro foram testadas (ELISA) para a pesquisa dos isótipos específicos e contra peptídeos cepa-específicos de regiões polimórficas (GRA6 e GRA7) do parasita. Nossos resultados sugerem que IgG2 e IgG3 estão associados à infecção adquirida recente, porém não há associação entre os isótipos e a evolução clínica da TO. Entretanto, embora seis diferentes sorotipos infectem estes pacientes, a gravidade da TO está associada a um novo padrão sorotípico (Atípico D). / T. gondii is a widespread protozoan parasite that is associated with a large spectrum of diseases in both humans and animals. The progression and severity of disease is quite variable and presumably due to some combination of host and parasite genetics. Prevalence varies with geography. In Erechim, Brazil, it is 88% prevalent and is related with a high incidence (18%) of ocular toxoplasmosis (OT). Humoral immune response against the parasite is effective. The aim of this retrospective study was to correlate the humoral immunity and response against the strain-specific peptides with the severity of the TO in Erechim`s patients. 327 sera were evaluated by ELISA to isotypes, IgG avidity and serotyped using strain-specific polymorphic peptides (GRA6 and GRA7). Our results suggest that IgG2 and IgG3 were associated with recent acquired infection. However, there is no association between isotypes and clinical evolution of OT, and also 6 different serotype-strains were detected in this population, but only one of these (Atypical D) was strongly associated with severe OT.

Ocular involvement, mainly retinochoroiditis, is one of the most severe sequelae of Toxoplasma gondii infection. However, the pathophysiological mechanisms of retinal destruction are poorly understood. Several studies suggested a more frequent and more severe ocular involvement in South American infections compared with European infections, probably due to different T. gondii strains (Type I/III, and atypical vs. Type II). To compare the clinical characteristics and biological and immunological responses in a single study and using the same parameters, in Colombian and French patients with active ocular toxoplasmosis (OT), as well as to study the local cytokinome in aqueous humor of these patients and correlate it with the clinical features. We prospectively collected and compared the clinical features of patients with active OT, evaluated at the Department of Ophthalmology of Strasbourg University Hospital and of Quindio University Health-Center. Results of biological tests in the collected aqueous humor samples were compared between Colombian and French patients: the pattern of protein recognition by immunoblotting (IB); the relative diagnostic sensitivities of IB and Polymerase Chain Reaction (PCR); and the cytokine and chemokine profiles. We found that Colombian and French OT patients presented not only different clinical characteristics but also biological characteristics, and that more virulent South American strains might be responsible for these differences, due to a disruption of the protective effects of interferon gamma (IFN-γ). Retinal lesions were 50% greater in Colombian patients. Macular localization leading to visual impairment was observed in 56% of Colombian cases, compared with 13% of French patients. Moreover, more vitreous inflammation and vasculitis were observed in Colombian patients. However, cytokine assays of the aqueous humor showed upregulation of inflammatory responses in European patients, notably IL-17, which we did not observe in Colombian patients. In a mouse model, intraocular tachyzoite injection of type II and atypical T. gondii strains resulted in differences in parasite multiplication and pathology similar to those observed in human infections. Production of IL-17 and other inflammatory markers, like IL-6, MCP-1, and the Th17 transcription factor ROR-γt was observed upon infection with the type II PRU strain, but was much less with the atypical LEF strain. In a previous work, the cytokine and mRNA patterns showed an upregulation of Th1 responses, notably IFN-γ production, in French patients, and anti-IL-17A antibody markedly diminished clinical damage and retinal inflammation, and also diminished parasite proliferation. In contrast to these previous findings in French patients, the cytokinome of aqueous humor of OT Colombian patients showed a downregulation of Th1 and Th17 responses and an upregulation of the Th2 response. Correlation between the clinical characteristics of Colombian patients with active OT and the levels of cytokines in aqueous humor (AH) showed that local production of cytokines differed between patients with OT, and particular cytokine levels were related to more severe clinical characteristics. Some cytokines were related to a higher number of recurrences.There are clinical and biological differences between Colombian and French patients with OT. There seem to be strain-specific differences in IL-17 and IFN-γ induction, which play an important role in the pathogenesis of this disease. These differences should be considered when thinking in perspectives of any possible immune-modulatory treatment in OT.

Introduction. La toxoplasmose oculaire (TO) est la première cause d’uvéite postérieure. L’évolution de cette pathologie dépend d’une balance entre la régulation de la réponse immunitaire et la limitation de la prolifération parasitaire.Méthodes. Le but de nos travaux est de déterminer le spectre des cytokines dans l’humeur aqueuse de patients une To ou une autre inflammation intraoculaire (uvéite d’étiologies virales ou secondaires à des maladies inflammatoires systémiques et endophtalmie bactérienne). Pour mieux appréhender les mécanismes immunitaires mis en jeu lors d’une TO, des dosages de transcrits par RT-PCR et de protéines inflammatoires par immunoessaimultiplexe sont réalisés à partir de modèles murins de TO. Enfin, l’effet de l’injection intraoculaire d’anticorps (AC) anti-IL-17A sur l’inflammation intraoculaire et la prolifération parasitaire est étudié.Résultats. Les spectres de cytokines observés dans l’humeur aqueuse diffèrent nettement en fonction de la cause de l’inflammation. Plus particulièrement, IL-17A semble jouer un rôle primordial dans la pathogénicité de la TO humaine et murine. Chez la souris infectée, l’inflammation intraoculaire et le nombre de parasites intraoculaires sont diminués parl’administration d’AC anti-IL-17A. Les niveaux d’ARNm de T-bet et Foxp3, ainsi que la concentration en IFN-γ (marqueurs de l’immunité cellulaire de type Th1 et Treg), sont augmentés après l’injection d’AC anti-IL-17A.Discussion. Les AC anti-IL-17A modèrent la réponse inflammatoire intraoculaire et limitent la prolifération parasitaire en antagonisant les cellules Th17, probablement via l’induction des cellules Th1 et Treg, secrétant IL-10 et IL-27. Ces résultats préliminaires suggèrent une nouvelle approche thérapeutique in vivo lors d’une toxoplasmose oculaire. / Purpose. Toxoplasmosis is the most common cause of posterior uveitis in immunocompetent subjects. Taking into account the opposing needs of limiting parasite multiplication and minimizing tissue destruction, the immune imbalance implies especially Th17 and T regulatory (Treg) cells.Methods. In a prospective clinical study of acute intraocular inflammation including ocular toxoplasmosis, viral uveitis, systemic inflammatory disease related uveitis and bacterial endophthalmitis we evaluated the cytokine pattern in aqueous humors of affected patients. To further study the immunological mechanisms involved during ocular toxoplasmosis, weevaluated the intraocular inflammation, the parasite load and the immunological response characterized on mRNA and protein level in a mouse model. To evaluate the role of IL-17A, anti IL-17A monoclonal antibodies (mAbs) were administered concomitantly with the parasite.Results. Cytokines networks are different, depending on the cause of intraocular inflammation. In OT, we observed severe ocular inflammation and cytokine patterns comparable to human cases, including IL-17A production. Neutralizing IL-17A decreased intraocular inflammation and parasite load in mice. Detailed studies revealed upregulation of Treg and Th1 pathways. When IFN-γ was neutralized concomitantly, the initial parasite multiplication rate was partially restored.Conclusions. Local IL-17A production plays a central role in pathology of OT. The balance of Th17 and Th1 responses (especially IFN-γ) is crucial for the outcome of infection. These data open new in vivo therapeutic approaches by repressing inflammatory pathways using intravitreal injection of IL-17A mAbs.