Made available in DSpace on 2016-12-12T17:32:57Z (GMT). No. of bitstreams: 1 RESUMO Samanta Rattis.pdf: 133512 bytes, checksum: 4f32bb1bce627b4748ef2be8e61db742 (MD5) Previous issue date: 2014-08-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The PROFILE PD scale was developed specifically to evaluate patients with Parkinson‟s disease (PD) within the contexts surrounding the International Classification of Functioning, Disability and Health, being directly applied to physical therapy practice. The aim of this study was to perform the translation and cross-cultural adaptation of PROFILE PD scale to Portuguese-Brazil, and to analyze its reliability, validity and other psychometric properties. Thirty three individuals with PD participated in the study. We assessed the clarity of the Brazilian version of the scale assessed by physiotherapists, presence of floor and ceiling effects, inter-rater and test-retest reliabilities, in addition to discriminant validity, concurrent validity (UPDRS), internal consistency, and minimal detectable change (MDC). The understanding level of physical therapists showed high clarity of the scale. Considering total score, the inter-rater and test-retest reliability showed an intra-class correlation coefficient (ICC) of 0.74 and 0.99 respectively. The analysis of concurrent validity showed the Spearman correlation between PROFILE PD Brazilian version and UPDRS with ρ=0.87. ANOVA oneway showed that PROFILE PD Brazilian version is able to discriminate the subject with PD in mild and moderate stages, and in mild and severe stages. A high internal consistency was found (α=0.90). MDC was 2.41 points and there were no floor and ceiling effects. So, the Brazillian version of PROFILE PD is a reliable and valid instrument that can be used to quantify impairments in body structure and function and limitations of activity and participation in early and mild-stages of PD and can provide an overall summary of the impact of disease being useful for physiotherapeutic practice. / A escala PROFILE PD foi desenvolvida especificamente para avaliar pacientes com Doença de Parkinson (DP) dentro dos contextos da Classificação Internacional de Funcionalidade (CIF), sendo diretamente aplicada à prática fisioterapêutica. O objetivo do presente estudo foi realizar a tradução e adaptação transcultural da escala PROFILE PD para a Língua Portuguesa-Brasil, e analisar sua confiabilidade, validade e outras propriedades psicométricas. Trinta e três indivíduos com DP participaram do estudo. Foram avaliadas: a clareza da versão brasileira da escala por fisioterapeutas, a presença de efeito piso e teto, as confiabilidades inter-avaliador e teste-reteste, além da validade discriminante, validade concorrente, consistência interna, e a mínima mudança detectável (MDC). O nível de entendimento de profissionais fisioterapeutas demonstrou alta clareza da escala. Considerando o escore total, as confiabilidades inter-avaliador e teste-reteste apresentaram um coeficiente de correlação intra-classe (CCI) igual a 0,74 e 0,99 respectivamente. A análise da validade concorrente demonstrou a correlação de Spearman entre a versão brasileira da PROFILE PD e a UPDRS ρ=0,87. A ANOVA oneway mostrou que a versão brasileira da PROFILE PD pode discriminar o indivíduo com DP entre os estágios leve e moderado, e leve e grave. Uma alta consistência interna foi encontrada (α=0,90). A MDC foi de 2,41 pontos, e não foi encontrado efeito piso e teto. A versão brasileira da PROFILE PD é um instrumento válido e confiável capaz de quantificar alterações na estrutura e função corporal e limitações de atividade e participação nos estágios leve e moderado da DP, fornecendo um perfil do impacto da doença nestes contextos, sendo diretamente aplicável à prática fisioterapêutica.

Made available in DSpace on 2015-05-14T13:21:08Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2470601 bytes, checksum: bbe63c6c08f3ff229939be1fa3d736d8 (MD5) Previous issue date: 2011-11-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The aim of this study is the preparation and characterization of the Pd/C catalyst for the stearic acid decarboxylation in order to obtain paraffinic biodiesel. The precursors used in the coal preparation were the coconut endocarp and the Manila palm sheath. These coals were chemically activated and by microwave hydrothermal treatment with HNO3 solution. Its characterization showed that the microwave activation induced a decrease in catalysts microporous structure. The porous structure of each coal was determined by N2 adsorption at 77 K. The isotherm data were by BET, Langmuir, t-plot and BJH methods. The ZCP values and the ash content were determined. The identification and quantification of chemical groups on the activated coals surface used the Boehm method and infrared spectroscopy, which showed formation of carboxylic groups for all samples. The coals originated from the coconut endocarp (CAE AC and CAE MW), activated by both methods, had higher SMIC than the coals from the palm sheath (CAB and CAB AC MW). The CAB coals are more mesoporous, while the CAE coals have a more relevant microporous structure. The Pd/C catalysts were prepared by dry impregnation and by alcohol reduction. The catalysts characterization was performed using the SEM-FE, H2 chemisorption, N2 adsorption/desorption of at 77 K and FTIR. The metallic phase deposition favored a decrease in total surface area. The catalysts synthesized by dry impregnation showed larger micropore areas. The SEM-FE showed that in the catalysts prepared by alcohol reduction the metal deposition occurred preferentially at the surface, where as it in the catalysts prepared by dry impregnation, probably occurred within the pores. The Pd/C catalysts used in the catalytic decarboxylation reaction of stearic acid, at 350°C in H2 atmosphere showed conversions and high selectivity for heptadecane. The catalysts derived from coal CAE showed higher selectivity in relation to the formation of the desired product, the heptadecane. We observed a trend of higher conversions for the catalysts synthesized by dry impregnation. Some catalysts showed deactivation after three hours of reaction. / A proposta deste trabalho é estudar a preparação e caracterização do catalisador Pd/C para a descarboxilação do ácido esteárico, a fim de obter biodiesel parafínico. Os precursores utilizados na preparação dos carvões foram o endocarpo do coco da baía e a bainha da palmeira de manila. Estes carvões foram ativados quimicamente e por microondas com solução de HNO3. A estrutura porosa de cada carvão foi determinada por adsorção de N2 a 77 K. Os dados das isotermas foram tratados pelas metodologias de BET, Langmuir, t-plot e BJH. Sua caracterização permitiu concluir que a ativação por microondas induziu uma diminuição da estrutura microporosa dos catalisadores. Foram determinados os valores de PCZ e teor de cinzas. Na identificação e quantificação dos grupos químicos da superfície dos carvões utilizou-se o método de Boehm e espectroscopia de infravermelho, que evidenciaram a formação de grupos carboxílicos para todas as amostras ativadas. Os carvões originados do endocarpo do coco ativados quimicamente e por microondas (CAE AC e CAE MW) apresentaram SMIC mais elevadas do que os carvões provenientes da bainha da palmeira (CAB AC e CAB MW). Os carvões CAB são mais mesoporosos, enquanto os CAE possuem estrutura microporosa mais relevante. Todos os carvões ativados apresentaram PCZ ácido. A ativação do CAE por microondas favoreceu o aumento da estrutura mesoporosa, com significativa diminuição da microporosa. Os catalisadores Pd/C foram preparados por impregnação seca e por redução por álcool. A caracterização destes catalisadores foi feita através do FE-SEM, quimissorção de H2, adsorção/dessorção de N2 a 77 K e FTIR. A deposição da fase metálica favoreceu uma diminuição da área superficial total. Os catalisadores sintetizados por impregnação seca apresentaram maiores áreas de microporos. O FE-SEM mostrou que nos catalisadores preparados por redução por álcool a deposição do metal ocorreu preferencialmente na superfície, enquanto nos preparados por impregnação seca, possivelmente ocorreu dentro dos poros. Os catalisadores Pd/C utilizados na reação de descarboxilação catalítica do ácido esteárico a 350 ºC, em atmosfera de H2 apresentaram elevada atividade catalítica e seletividade para o heptadecano. Os catalisadores derivados do carvão CAE mostraram seletividade superior em relação à formação do produto desejado, o heptadecano. Foi observada uma tendência de conversões maiores para os catalisadores sintetizados por impregnação seca. Alguns catalisadores apresentaram desativação após três horas de reação.

O desenvolvimento industrial e urbano tem causado aumento mundial das emissões de poluentes atmosféricos. Nas áreas metropolitanas o problema da deterioração da qualidade do ar tem se constituído numa das mais graves ameaças à qualidade de vida dos seus habitantes e os veículos automotores contribuem diretamente com o aumento do material particulado (MP). Neste trabalho foram descritas as etapas metodológicas para validar a Tibouchina granulosa como biomonitor ambiental. Assim, foram abordados a caracterização das folhas, categorização do MP, protocolo de remoção de MP e determinação dos EGPs (Pd, Pt e Rh) na deposição seca das folhas. Para tanto foram realizadas quatro coletas anuais (2011-2014) de folhas, entre os meses de agosto e setembro, em pontos específicos. Os resultados da caracterização mostraram que as folhas permanecem residentes nos ramos por até 6 meses e ocorre o desenvolvimento duas novas folhas por nó a cada mês, indicando que o biomonitoramento pode ser realizado com distribuição temporal e espacial. Os caracteres anatômicos foliares mais relevantes são os tricomas, sendo caracterizados quatro tipos (glandular, adpresso-escabro, base ramificada e estrigoso) que adsorvem o MP. No protocolo de remoção da deposição seca, o número de MP variou de acordo com os diferentes reagentes analíticos utilizados, sendo os mais significativos o ALCONOX&reg e a água régia, que apresentaram valores de remoção na faixa de 99-98% e de 94-99%. As estimativas das incertezas analíticas dos EGPs apresentam valores de uCPt=5% (Pt), uCPd=12% (Pd) e uCRh=5% (Rh) e as incertezas de amostragem, os valores de 57% para o Pd, 24% para a Pt e 27% para o Rh. Portanto, a incerteza expandida foi da Pt U=48%, Pd U=86% e Rh U=9%, a incerteza do Rh apresentou valor mais baixo por ser o elemento minoritário. A elevada sensibilidade do método para determinação dos EGPs apresentou limite de detecção de 0,1 pg g-1 para o Pd, 1,3 pg g-1 para Pt e 0,3 pg g-1 para o Rh e acompanhada boa reprodutibilidade. As concentrações dos EGPs encontradas na deposição seca nos vários pontos de coletas indicaram a clara diferença de acúmulo destes elementos entre o ponto de referência e os locais impactados, sugerindo que a liberação dos EGPS pelos catalisadores veiculares pode ser considerada alta. A evidência da presença dos EGPs na deposição seca foi confirmada por meio da análise da distribuição, que mostrou claramente a similaridade com o material de referência certificado Used Auto Catalystc-2557. As distribuições espaciais dos EGPs foram semelhantes para a Coleta 2, indicando os hot points da RMSP. As concentrações do EGPs foram ordenadas em Pt>Pd>Rh e foram mais baixas no ponto de coleta para controle das amostragens em comparação com os outros locais amostrados. Pode ser concluído que as folhas de T. granulosa foram validadas como biomonitor passivo dos EGPs constituintes de catalisadores veiculares. / Industrial and urban development has caused worldwide increase in emissions air pollutants. In metropolitan areas, the problem of deterioration air quality has been one the most serious threats to quality life its inhabitants, motor vehicles contribute directly increase pollutants. This work describes the methodological steps to validate Tibouchina granulosa as environmental biomonitor, which involved the characterization the leaves, PM categorization, PM removal protocol and determination PGEs in dry deposition, for which four annual collections (2011-2014) were performed between August and September of each year. The of results leaf characters showed that leaves in the branches remain for up to 6 months and the development two new leaf occurs every month. The most relevant foliar characters anatomical are trichomes, being characterized five types. The highest particle concentrations adsorbed to stray trichomes and star-based trichomes. In dry deposition removal protocol, MP number varied according to different analytical reagents used, the most significant being ALCONOX&reg and aqua regia, which presented range removal values of 99-98% and 94-99%, respectively. The estimates analytical uncertainties PGEs show de uCPt=5% (Pt), uCPd=12% (Pd) e uCRh=5% (Rh) and sampling uncertainties values were 57% (Pd), 24% (Pt) and 27% (Rh). Therefore, the expanded uncertainty was Pt u=48%, Pd u=86% e Rh u=9%, in case Rh the uncertainties should be reevaluated by presenting minority values. The high sensitivity of the method for determination of PGEs showed a detection limit of 0.1 pg g-1 for Pd, 1.3 pg g-1 for Pt and 0.3 pg g-1 for Rh and good reproducibility of the results. The concentrations PGEs found in dry deposition in various collection points indicated the clear difference accumulation these elements between reference point and impacted sites, suggesting that release PGEs by the vehicle catalysts can be considered high. Confirming this evidence, through the ternary graphs, which clearly showed similar distributions in the environmental samples and equality with MRC (Used Auto Catalysts). The spatial distributions of Pt, Pd and Rh are similar for Collection 2. Concentrations of the PGEs were ordered in Pt>Pd>Rh and were lower at the collection points for control samplings compared to other sites sampled. In view of the above, it can be concluded that the leaves of T. granulosa can be used as environmental biomonitor of vehicular emissions of PGEs constituent of vehicular catalysts.

Introdução: A sepse é a maior causa de morbidade e mortalidade em pacientes queimados, uma vez que profundas alterações ocorrem na farmacocinética de agentes antimicrobianos prescritos para o controle das infecções. Além disso, pacientes queimados podem apresentar quadro de infecção por germes da comunidade, numa fase precoce de internação na UTI, e devem receber antimicrobianos que diferem daqueles indicados na sepse. Na vigência de infecção fúngica, o quadro se torna ainda mais grave para os pacientes queimados de prolongada internação e imunocomprometidos. Objetivo: Realizar o monitoramento plasmático de oito antimicrobianos largamente prescritos na UTI, a investigação da farmacocinética e a modelagem PK-PD para o ajuste do regime de dose e controle das infecções em pacientes queimados. Casuística: Investigaram-se 32 pacientes queimados internados na UTI/Unidade de Queimados - Divisão de Cirurgia Plástica do HC FMUSP, portadores de infecção recebendo pela via sistêmica sete antimicrobianos e um antifúngico. Métodos- Etapa Clinica: Os pacientes receberam os antimicrobianos geralmente em associação para o controle das infecções seguindo as recomendações da CCIH do hospital relativas ao regime de dose empírica inicial do controle de infecção na UTI de Queimados, na fase precoce e tardia da internação. Realizou-se o monitoramento plasmático do fluconazol, para a infecção fúngica, e dos sete antimicrobianos mais prescritos na UTI para os germes da comunidade e hospitalares (cefepime, ciprofloxacino, imipenem, oxacilina, piperacilina, sulfametoxazol e vancomicina) através das coletas de amostras sanguíneas de pico (termino da infusão) e vale (imediatamente antes da dose subseqüente). Complementarmente, a critério Clínico, foram colhidas amostras seriadas de sangue (pico, 1ª, 2ª, 4ª, 6ª e vale), totalizando seis coletas, para investigação da farmacocinética do agente que requereu ajuste de dose e individualização de terapia no paciente queimado. As coletas de sangue foram realizadas através de cateter venoso (2mL/coleta em tubos contendo EDTA sódico) pelo médico intensivista de plantão na UTI; o plasma foi obtido pela centrifugação para análise do fármaco de interesse ou então armazenado no congelador (-80o C) até o ensaio. Métodos - Etapa Analítica: Previamente à realização da Etapa Clínica, foi realizado no Laboratório o desenvolvimento, validação e otimização de método bioanalítico para quantificação dos oito antimicrobianos no plasma. Preferencialmente, as análises foram realizadas no dia da coleta de sangue do paciente, e o \"Laudo de Exame\" contendo os resultados foi expedido no mesmo dia ou na manhã do dia subseqüente possibilitando a intervenção precoce da Equipe Clínica e se necessária a substituição do regime empírico pela terapia individualizada dose ajustada. Métodos- Etapa estatística: A estatística propriamente dita foi realizada pelo tratamento estatístico com utilização do software GraphPad Instat 4.0., GraphPad Prism 4.0, pela utilização de testes paramétricos e não paramétricos. A modelagem farmacocinética foi realizada através da aplicação do software NonCompartmental Analysis, PK Solutions 2.0, aos pares de dados (C vs T) para cada antimicrobiano. Adicionalmente, aplicou-se o software GraphPad Prism 4.0 para a modelagem PK-PD, ferramenta importante na tomada de decisão relativa à alteração do regime empírico dos antimicrobianos. Resultados: Os pacientes queimados incluídos no protocolo eram adultos de ambos os sexos 23F/9M, 39,6 anos, 69,5 kg, 33,9% SCQ, e os agentes da queimadura foram para 27 pacientes/ térmico-fogo e para três pacientes/trauma elétrico; a lesão inalatória foi registrada em 11/32 pacientes. Foram realizados 303 seguimentos farmacoterapêuticos com a emissão de laudos de exame para os antimicrobianos prescritos aos pacientes nas fases precoce e tardia da internação. O ajuste de dose foi requerido para a vancomicina em 88% das solicitações de exame, cefepime (65%), sulfametozaxol (52%), fluconazol (74%) e imipenem (19%). Registrou-se alta variabilidade na farmacocinética para todos os antimicrobianos investigados. Adicionalmente, registrou-se alteração significativa dos parâmetros farmacocinéticos do imipenem, fluconazol, sulfametoxazol e vancomicina nos seguimentos de pacientes queimados com disfunção renal dialítica relativamente aqueles em que se registrou função renal preservada. A modelagem PK-PD para os diversos antimicrobianos se baseou nos parâmetros de predição de eficácia recomendados tais como o intervalo de tempo em que a concentração plasmática permaneceu acima da concentração inibitória mínima (%Δ T> CIM) para o cefepime, imipenem, oxacilina e piperacilina, ASCss0-24/CIM + Cssmax/CIM para o ciprofloxacino, ASCss0-24/CIM para o fluconazol e para a vancomicina e ASCss0-24/CIM +%Δ T> CIM para a sulfametoxazol. Conclusões: Registrou-se alta variabilidade na farmacocinética dos agentes investigados e a modelagem PK-PD justificou plenamente a substituição da terapia empírica inicial pela dose ajustada para a cobertura dos germes sensíveis, daqueles apresentando sensibilidade dose dependente ao antimicrobiano, além daqueles com alto CIM, pouco sensíveis as doses usuais. Finalmente, a modelagem PK-PD mostrou-se definitiva e ferramenta indispensável na manutenção desses agentes no arsenal terapêutico, garantindo terapia eficaz ao paciente queimado, evitando a emergência bacteriana e o desenvolvimento de resistência. / Introduction: Sepsis is a main cause of morbidity and mortality in burn patients, once pharmacokinetics of antimicrobials prescribed for the control of infections are significantly altered in those patients. In addition, burn patients in the ICU, initially can present infections by community microbial and must receive different antimicrobials than those prescribed for sepsis. On the other hand, burn immunocompromized patients with prolonged staying in the ICU, re-incidence of sepsis and fungal infection requires an effective antifungal agent that must be associated to the antimicrobials prescription. Objective: Therapeutic plasma monitoring of eight antimicrobials largely prescribed to burn patients from the ICU, Pharmacokinetic and PK-PD modeling for dose adjustment and for the control of infections. Study design: Thirty two burn inpatients with infections from the ICU Burns- Division of Plastic Surgery of Clinics Hospital Medical School University of Sao Paulo received systemically antimicrobials/ antifungal agents. Methods - Clinical Procedures: In general burn patients received several antimicrobial agents as recommended by the Control of Hospital Infection Committee as empirical dose at the beginning of therapy and also afterwards in the ICU. The control of infections by community microbials or yet by hospital microbials, and also for fungal infection, was performed by drug plasma monitoring of cefepime, ciprofloxacin, imipenem, oxacillin, piperacillin, sulphamethoxazole, vancomycin and fluconazole after blood sample collection at the peak and at the trough. Complementary, usually by clinical criteria, six blood sample collections were performed at time dose interval (end of drug infusion, 1st, 2nd, 4th, 6th and at the trough) for pharmacokinetic purposes, dose adjustment and individualization of drug therapy for burn patients. Blood sample collection was done by the physician from the ICU by venous catheter (2mL/each into blood collection tubes sodium EDTA); plasma obtained by centrifugation of blood tubes were analyzed in the same day or in a deep freezer to storage (-80o C) until assay. Methods - Analytical Procedures: Previously to the clinical study, in the Laboratory School of Pharmaceutical Sciences was performed the development, validation and optimization of bioanalytical methods for drug plasma monitoring of eight antimicrobial/antifungal agents by HPLC-UV. Drug measurements were performed on the day of blood collection and data were preferentially informed to the physician at the same day or at the early morning of the following day to facilitate the therapeutic intervention and changes on the morning prescription to guarantee drug efficacy. Methods Statistics Procedures: Descriptive statistics was performed by applying the software GraphPad Instat v 4.0., GraphPad Prism v.4.0 by parametric and non parametric tests. Pharmacokinetics was estimated by applying the software NonCompartmental Analysis, PK Solutions 2.0, to data (C vs T) for each antimicrobial agent. Additionally, the software GraphPad Prism v 4.0 was applied to PK-PD modeling, an important tool related to dilemma decision about changes on empirical dose of an antimicrobial agent and obviously helps the physician in the rationalization of drug therapy in severe burns. Results: Burn patients included in the protocol were of both genders 23F/9M, 39.6 yrs, 69.5 kg, 33.9% TBSA; agents of the accident were fire/ alcohol for 27 patients and electrical trauma for three patients; inhalation injury were described for 11/32 patients. Approximately 1500 drug plasma measurements for all antimicrobials prescribed to burn patients for the control of infection in the ICU were performed totalizing 303 follow up for pharmacokinetic purposes during the period in the ICU for 32 burn patients. Dose adjustment was required in 88% of vancomycin prescription, 65% for cefepime, 52% for sulphamethoxazole, 74% for fluconazole e 19% for imipenem. High pharmacokinetic variability was registered for all agents investigated. In addition, significant changes on pharmacokinetic parameters were described for imipenem, fluconazole, sulphamethoxazole and vancomycin for burn patients with dialytic renal dysfunction compared to those with renal function preserved. PK-PD modeling applied to antimicrobials investigated in the present study was based on predictive parameters recommended like time interval to maintain drug plasma concentration higher than the minimum effective concentration (%Δ T> MIC) for cefepime and also for imipenem, oxacillin and piperacillin; AUCss0-24/MIC plus Cssmax/MIC for ciprofloxacin, AUCss0-24/MIC for fluconazole and vancomycin, and finally, AUCss0-24/MIC plus %Δ T> MIC for sulphamethoxazole. Conclusions: High pharmacokinetic variability was obtained for all investigated agents. PK-PD modeling applied could justify definitively the antimicrobial therapy dose adjustment instead the empirical dose regimen. Then, drug efficacy was guaranteed against susceptible microbial, spreading to susceptible to antimicrobial dose dependent and also those presenting high value for MIC related to microbial resistance to empiric dose regimen. In conclusion, it was demonstrated that PK-PD modeling of antimicrobials with basis on predictive drug efficacy parameter is definitively an important tool to preserve and safeguard these agents for the control of severe infection in burn patients, to avoid the bacterial emergency and microbial resistance.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-06-22T18:06:10Z No. of bitstreams: 1 alansantospimentel.pdf: 908522 bytes, checksum: 481a497653c77923c89d08522bba1820 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-07T19:24:28Z (GMT) No. of bitstreams: 1 alansantospimentel.pdf: 908522 bytes, checksum: 481a497653c77923c89d08522bba1820 (MD5) / Made available in DSpace on 2017-08-07T19:24:28Z (GMT). No. of bitstreams: 1 alansantospimentel.pdf: 908522 bytes, checksum: 481a497653c77923c89d08522bba1820 (MD5) Previous issue date: 2014-03-07 / 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 / Objetivo: avaliar o efeito do bloqueio central do receptor AT2 para angiotensina II nas respostas termorregulatórias em ratos durante o exercício físico. Material e métodos: foram utilizados ratos Wistar, não treinados, pesando entre 240-350 g. Os animais portavam cânula no ventrículo cerebral lateral direito para administração de 2 μL de PD (10 μg, n = 7) ou de 0,15 M NaCl (SAL, n = 7). A temperatura corporal interna (Tc), determinada por telemetria através de sensor de temperatura implantado na cavidade intraperitoneal do rato, e a temperatura da cauda (Tcauda) foram medidas durante o repouso e enquanto os animais realizavam exercício submáximo a uma velocidade de 18 m/min, 5 % de inclinação, até a fadiga. A partir dos dados obtidos foram determinados: a taxa de aquecimento corporal (BHR), a taxa de calor acumulado (HSR), o limiar térmico de vasodilatação da cauda (TTcV), o tempo total de exercício (TTE) e o trabalho (W). Resultados: Durante o repouso, a Tc dos animais de ambos os grupos permaneceu estável e diferenças não foram encontradas entre os tratamentos. Observou-se que a administração icv de PD promoveu aumento de 17 % no TTE (18 ± 1,8 min, PD vs. 15 ± 2,1 min, SAL, p < 0,01) e de 20 % no W quando comparado com os controles (4,62 ± 0,34 kgm, PD vs. 3,74 ± 0,4 kgm, SAL, p < 0,01). Apesar dos ratos injetados com PD apresentarem aumento semelhante da Tc durante o exercício físico, no ponto de fadiga verificou-se maior variação da Tc (2,37 ± 0,24 °C, PD; 1,73 ± 0,21 °C, SAL, p< 0,05). Entretanto, durante o exercício físico, diferenças não foram encontradas entre a BHR (0,14 ± 0,01 °C.min-1, PD vs. 0,13 ± 0,02 °C.min-1, SAL), a HSR (33,75 ± 1,37 cal. min-1, PD vs. 30,9 ± 2,82 cal. min-1, SAL) e o TTcV (37,75 ± 0,12 °C, PD vs. 37,61 ± 0,15 °C, SAL) entre os grupos. Adicionalmente, a partir do 13° minuto até a fadiga, a variação da Tcauda foi maior nos animais PD (4,87± 0,44 °C, PD; 3,10 ± 0,57 °C, SAL, p<0,05), que se mostrou intimamente relacionado com o TTE aumentado (r= 0,871, p <0,01). Conclusões: Os dados mostram que o bloqueio do receptor AT2 melhora o balanço térmico durante o exercício físico devido a maior habilidade de dissipar calor, consequentemente contribuindo para aprimoramento do desempenho físico. / Aim: The aim of the study was to verify the effect of central angiotensin ll AT2 receptor blockade in thermoregulatory responses during exercise in rats. Material and methods: Wistar rats weighing between 250 and 350g. Were implanted with a guide cannula in the right lateral cerebral ventricle for administration of 2µL PD (10 μg, n = 7) or 0,15 M NaCl (SAL, n = 7). The internal body temperature (Tb) was determined by telemetry via a temperature sensor implanted in the animal's intraperitoneal cavity. The tail temperature (Ttail) was measured using a temperature sensor attached to the animal's tail. Both temperatures were measured continuously, during resting and while the animals performed submaximal exercise at a speed of 18m/min and 5% inclination, until failure. From the data obtained, body heating rate (BHR), heat storage rate (HSR), body temperature threshold for tail vasodilation (TTbV), time to fatigue (TTF) and workload (W) were determined. Results: Tb remained stable in both group, and no difference was seen between treatments during a resting period. It was observed that icv administration of PD promoted an increase of 17% in the TTF (18 ± 1,8 min, PD vs. 15 ± 2,1 min, SAL, p < 0,01), and of 20% in the W, when compared with controls (4,62 ± 0,34 kgm, PD vs. 3,74 ± 0,4 kgm, SAL, p < 0,01). Despite that the rats injected with PD exhibited similar increase in Tb during exercise, at fatigue point it was found greater variation of Tb (2,37 ± 0,24 °C, PD; 1,73 ± 0,21 °C, SAL, p< 0,05). However, no difference was seen between BHR (0,14 ± 0,01 °C.min-1, PD vs. 0,13 ± 0,02 °C.min-1, SAL), HSR (33,75 ± 1,37 cal. min-1, PD vs. 30,9 ± 2,82 cal. min-1, SAL) and TTbV (37,75 ± 0,12 °C, PD vs. 37,61 ± 0,15 °C, SAL) in both group. Additionally, from the 13° minute of exercise until fatigue, Ttail variation was higher in PD animals (4,87 ± 0,44 °C, PD; 3,10 ± 0,57 °C, SAL, p<0,05), and closely related with the increased TTF (r= 0,871, p <0,01). Conclusion: The data shows that AT2 receptor blockade improves heat balance during exercise due to better ability to dissipate heat, which contributed to superior exercise performance.

L'objet de cette étude était le développement de nanocatalyseurs pour une application dans unepile glucose/oxygène en milieu alcalin. Avec la demande de plus en plus croissante d'énergiepropre et moins chère, il paraît judicieux de s'orienter vers des dispositifs moins toxiques de pile àcombustible qui peuvent utiliser le glucose comme combustible. Ce travail de thèse s’est doncattaché à synthétiser et caractériser de nouveaux matériaux catalytiques à base de palladium(Pd/C, PdAg/C et PdNi/C) et à analyser leur activité vis-à-vis des réactions de réduction del'oxygène et de l'électrooxydation du glucose. Les nanocatalyseurs utilisés lors de ces travaux ontété synthétisés par microémulsion «water-in-oil» et sont supportés sur du carbone Vulcan XC-72R.Les caractérisations physiques montrent des nanoparticules assez uniformes et la taille moyennedes particules reste inférieure à 5 nm. La réaction de réduction de l'oxygène commence tôt à lasurface de ces catalyseurs (environ 0,92 V vs. ERH) et le nombre d'électrons échangés est prochede 4. Le couplage voltammétrie / spectroscopie IR a permis de montrer que le glucose s’oxyde àbas potentiel à la surface de ces électrodes. Le produit primaire de cette déshydrogénation est lagluconolactone qui s’hydrolyse en solution en gluconate. Le dioxyde de carbone est aussi unproduit d’oxydation. Sa présence à des potentiels élevés montre que le squelette de la moléculeinitiale du glucose subit une adsorption dissociative notamment sur Pd70Ag30. / This work concerns the development of nanocatalysts for a glucose/oxygen fuel in alkalinemedium. Therefore, carbon supported based palladium nanomaterials (Pd/C, PdAg/C and PdNi/C)were synthesized and characterized. Their electrocatalytic activity towards both the glucoseoxidation and oxygen reduction reaction (ORR) was studied. The electrode materials have beensynthesized by “water-in-oil microemulsion” and the physic-chemical characterizations providedinformation on their shape, morphology. Their average particle size remained less than 5 nm. Theoxygen reduction reaction performed with Rotation Ring Disk Electrode (RRDE) on these catalystsled to a four electrons process i.e. without hydrogen peroxide as intermediate (at ca. 0.85 V vs.RHE). Cycling voltammetry combined with Single Potential Alteration Infrared ReflectanceSpectroscopy (SPAIRS) was helpful to show that the primary product of the glucosedehydrogenation is the d-gluconolactone. The latter oxidation product undergoes hydrolysis togluconate in electrolytic solution. At high potential, the dissociative adsorption of glucose onPd70Ag30 gave carbon dioxide as another oxidation product.

En Europe, l’utilisation en agriculture de grandes quantités d’engrais chimiques est la principale cause de contamination des eaux. Les concentrations en nitrate dans l’eau deviennent nuisibles pour les personnes lorsqu’elles dépassent certaines limites car elles sont la cause de méthémoglobinémie, de cancers et agissent comme perturbateurs endocriniens. L’hydrogénation catalytique hétérogène des nitrates est la méthode de dénitration la plus connue et la plus efficace due à la grande sélectivité pour les produits non toxiques, azote et eau. La photocatalyse hétérogène a émergé comme une voie très prometteuse de dénitration du fait de la possibilité d’utiliser la lumière solaire ce qui la rend commercialement compétitive et compatible avec la protection de l’environnement. Les procédés catalytiques conduisent fréquemment à l’obtention des sous-produits toxiques nitrite et ion ammonium, ainsi qu’à des oxydes d’azote gazeux NOx. Dans ce travail ont été utilisés des catalyseurs monométalliques supportés (Ag/P25, Pt/P25), leur mélange physique, et des catalyseurs bimétalliques supportés (Ag-Pt/P25 et Pd-Sn/P25). Le support oxyde de titane (TiO2) P25 est choisi pour développer un catalyseur performant pour la dénitration à la fois catalytique et photocatalytique permettant d’atteindre les normes requises par l’UE dans l’eau potable (50 mg/L NO3-, 0.5 mg/L NO2-, 0.3 mg/L NH4+). L’influence des teneurs en métaux (Ag: 0.5 – 4 pds.%; Pt: 2 et 4 pds.%), du précurseur Pt (H2PtCl6 (H)/K2PtCl6 (K)), de l’ordre d’imprégnation de Ag et Pt et de la morphologie des particules bimétalliques Pd-Sn (nanoparticules et nanobâtonnets) ont été étudiés. Les conditions expérimentales (présence/absence de H2 ; λ = 254 ou 365 nm; 4W; 45.4 mW/cm2) ont été également variées et les réactions effectuées dans un réacteur batch en PTFE sous atmosphère inerte et dans des conditions standard (catalyseur : 0.7 mg/L ; 100 mg/L NO3- ; 500 r.p.m). Contrairement à la plupart des études précédentes aucun «piégeur de trous» (expl. acides formique ou oxalique) n’a été utilisé dans nos conditions de réaction, Les analyses ont été effectuées par chromatographie ionique ou photométrie. Les propriétés physico-chimiques des catalyseurs ont été déterminées par DRX, Physisorption de N2, MET, DRUV-Vis, XPS, TPR et chimisorption de H2. Le support TiO2 P25 est inactif dans les deux procèdés non photocatalytique et photocatalyique. Le mélange physique Ag/P25+Pt/P25 conduit à une conversion (~ 56%) et sélectivité en N2 (~ 76%) plus élevées dans les conditions non photocatalytiques que chacun des homologues monométalliques, cependant NO2- and NH4+ sont obtenus. Les catalyseurs bimétalliques Ag-Pt(Pt-Ag)/P25 se montrent polyvalents étant actifs dans les procédés non-photocatalytiques et photocatalytiques. Les meilleurs résultats photocatalytiques ont été obtenus sous irradiation ultraviolette de 365 nm et en présence de H2 dû à la synergie entre les électrons générés par irradiation et l’hydrogène dissocié sut Pt. Le Pt imprégné en premier conduit à une conversion plus élevée en raison de l'amélioration de l'accessibilité de NO3- aux sites actifs Ag0 recouvrant partiellement Pt. Toutefois la sélectivité en NO2- est élevée du fait de la faible accessibilité de Pt. Pt imprégné en second décore les ensembles Ag et diminue de ce fait le nombre de sites actifs et la conversion. Le catalyseur bimétallique Pt(4)-Ag(2)/P25(K) conduit au meilleur compromis entre conversion (ca. 45%) et sélectivité en N2 (ca. 80%) dans les conditions photocatalytiques. Ceci est attribué au transfert électronique élevé entre Ag et Pt en forte interaction mis en évidence par XPS. Néanmoins, NO2- et NH4+ sont aussi obtenus. Des travaux sont encore nécessaires pour améliorer le rendement en N2. / In Europe, the agricultural use of nitrates in chemical fertilizers has been a main source of water contamination. High level of soluble nitrate in water becomes harmful pollutant for people when it exceeds the limit causing methemoglobinemia (blue baby syndrome), cancer or act as endocrine disruptor. Conventional catalytic nitrate reduction processes into N2 and H2O lead to some toxic products (NO2-, NH4+, and NOx gases). Alternatively, photocatalytic nitrate removal using solar irradiation and heterogeneous catalysts is a very promising and ecofriendly route, which has been scarcely performed. In this work monometallic supported catalysts (Ag/P25, Pt/P25), their physical mixture, and bimetallic supported catalysts (Ag-Pt(Pt-Ag)/P25 and Pd-Sn/P25) have been used. The support TiO2 P25 was chosen to develop both efficient non-photocatalytic and photocatalytic processes able to reach the EU legislation in drinking water (50 mg/L NO3-, 0.5 mg/L NO2-, 0.3 mg/L NH4+). Different compositions of catalyst including, various metal loadings (Ag: 0.5 – 4 wt%; Pt: 2 and 4 wt%), Pt precursor (H2PtCl6 (H)/K2PtCl6 (K)), Ag and Pt impregnation order, and morphology of Pd-Sn nanoparticles (spherical and nanorods) have been studied. Different experimental conditions (presence/absence of H2; λ = 254 or 365 nm; 4W; 45.4 mW/cm2) have been also evaluated and the experiments performed in a PTFE batch reactor under inert standard operational conditions (0.7 mg/L catalyst ; 100 mg/L NO3- ; 500 r.p.m). Contrary to most previous studies, any hole scavenger (e.g. formic or oxalic acid) was used in the reaction . Analyses were performed by ionic chromatography or photometry. Physico-chemical characterizations of the catalysts were done by XRD, N2-physisorption, TEM, DRUV-Vis, XPS, TPR and H2-Chemisorption in order to explain both the catalytic and photocatalytic performances.The support TiO2 P25 was inactive in both processes. The physical mixture Ag(2)/P25+Pt(4)/P25(H) showed better conversion (ca. 56 %) and N2 selectivity (ca. 76%) under non-photocatalytic conditions than each monometallic catalyst, however NO2- and NH4+ were obtained. Bimetallic Ag-Pt(Pt-Ag)/P25 catalysts exhibit a versatile behavior being active both in the non-photocatalytic and photocatalytic processes. The best photocatalytic conditions were interestingly obtained under the ultraviolet irradiation of 365 nm and in presence of hydrogen. Photocatalytic activity was enhanced in presence of H2 due to synergetic effect induced by light between photogenerated electrons and dissociation of hydrogen on Pt. Therefore, all bimetallic catalysts based on Ag and Pt were tested under these conditions. Pt impregnated first leads to higher conversion due to improved accessibility of NO3- to active Ag0 sites partially covering Pt than the opposite impregnation order where the Pt decorates Ag and reduces the number of active sites. However, high NO2- selectivity at the expense of N2 is obtained in the former case due to low Pt accessibility. The bimetallic catalyst Pt(4)-Ag(2)/P25(K) led to the most interesting conversion (ca. 45%) with the highest selectivity to N2 (ca. 80%) under photocatalytic conditions. This was assigned to the highest electronic transfer between Ag et Pt particles in close contact revealed by XPS. Nevertheless, NO2- and NH4+ are obtained too. Further studies must be done to enhance the catalytic and photocatalytic activity towards desired N2.

Les cellules Natural Killer (NK) sont des effecteurs de l’immunité innée et constituent de véritables sentinelles dans l’immuno-surveillance contre les virus et les processus tumoraux. Pour échapper à la reconnaissance NK, les virus ainsi que les cellules tumorales utilisent de nombreux subterfuges. Au cours de ce travail, nous nous sommes intéressés à deux facteurs régulateurs de la fonction des cellules NK, la molécule PD-1 et la prostaglandine E2 (PGE2). Programmed death 1 (PD-1) est une molécule régulatrice exprimée sur les lymphocytes T et B activés. L’engagement de PD-1 par ses ligands inhibe leurs fonctions effectrices et prolifératives. Au cours de certaines infections virales chroniques ou de tumeurs, l’expression de PD-1 est associée à l'épuisement fonctionnel des lymphocytes T effecteurs. Le blocage de l’axe PD-1/PD-1 ligands restaure les fonctions effectrices des lymphocytes et représente ainsi une approche thérapeutique prometteuse. Nous avons mis en évidence de manière fortuite une expression inhabituelle du récepteur PD-1 sur les cellules NK au cours de certaines infections virales chroniques (HHV8, VIH ou VHC). L’expression de PD-1 sur les cellules NK caractérise une population récemment activée (CD69++, CD25 + et Nkp44 +), susceptible à l’apoptose (Annexin V+), exprimant une moindre quantité du récepteur de cytotoxicité naturelle NKp46. L’analyse fonctionnelle montre que les cellules NK PD-1+ ont des capacités de cytotoxicité (dégranulation CD107a) et de production de cytokines (IFNγ) réduites en comparaison avec leurs homologues PD-1-. De façon intéressante, l’IL-2 et l’IL-15 peuvent restaurer les fonctions effectrices des cellules NK PD-1+. Contrairement aux cellules T dont l’expression de PD-1 est induite par divers stimuli, seule la stimulation des récepteurs NKp46 et NKp30, en synergie avec l’action de l’IL-15 ou l’IL-2, induit in vitro de façon reproductible l’expression de PD-1 sur les cellules NK de témoins sains. Pour pouvoir disposer d’un modèle in vitro de cellules NK PD-1+, nous avons généré des cellules exprimant PD-1 de manière stable par transduction lentivirale de la lignée NKL. En comparaison avec les cellules transduites par le vecteur vide, les cellules NKL PD-1+ ont des capacités cytotoxiques réduites, confirmant nos résultats chez les patients. Nous avons aussi étudié les mécanismes par lesquels la PGE2, une autre molécule immuno-modularice, régule les fonctions des cellules NK. Nos résultats suggèrent que la PGE2 agit à travers ses récepteurs EP2 et EP4 pour inhiber l’expression de NKG2D et de l’IL-15Rγ induite par l’IL-15 sur les cellules NK. Ce travail doit nous permettre de mieux comprendre comment la PGE2 s’oppose aux effets activateurs de l’IL-15 sur les cellules NK, et représente un mécanisme de rétrocontrôle de l’inflammation. En conclusion, nos résultats montrent que l’expression de PD-1 sur les cellules NK représente un mécanisme supplémentaire d’échappement viral à la réponse immune. La suite de l’étude sur la PGE2 devrait nous permettre d’évaluer l’intérêt de l’utilisation d’antagonistes spécifiques dans l’immunothérapie anti-tumorale par l’IL-15. Le lien entre la PGE2 et l’expression de PD-1 sur les cellules NK est en cours d’investigation. / Natural Killer (NK) cells are effectors of the innate immune system, and play a crucial role in virus and cancer immunesurveillance. To escape NK-cell mediated elimination of infected or transformed cells, viruses and tumors have developed multiple strategies to interfere with NK-cell functions. In the present study, we investigated the role of two regulatory molecules, Programmed Death-1 (PD-1) and Prostaglandine E2 (PGE2), in controlling NK cell activation and effector functions. PD-1 is a key immune checkpoint receptor expressed by activated T and B lymphocytes. Upon interaction with its cognate ligands, PD-1 inhibits lymphocyte proliferation and functions. During cancer or chronic viral infections, PD-1 expression is associated with functional exhaustion of effector T cells. Blockade of PD-1 signaling restores T-cell functions, and represents a promising therapeutic tool. We fortuitously observed unusual expression of PD-1 on a subset of CD56dim NK cells in some patients with persistent viral infection (HHV8, HIV or HCV). We show that PD-1 expression on NK cells characterizes a subpopulation of recently activated cells (CD69+, CD25+, Nkp44+) that are sensitive to apoptosis (Annexin V+) and not senescent (CD57-). NKp46 expression was also markedly decreased on PD-1+ NK cells. In vitro functional experiments showed that PD-1+ NK cells had impaired cytotoxic capacity (CD107a degranulation) and reduced IFN-γ production compared to their PD-1- counterpart, suggesting that they might represent functionally exhausted NK cells. Interestingly, exogenous IL-2 and IL-15 could restore PD-1+ NK cell effector functions. While strong non-specific stimulation by PMA/ionomycin transiently induced PD-1 on control NK cells, only activation through NKp46 or NKp30 receptors in the presence of IL-15 could reproducibly induce stable PD-1 expression. To investigate the effect of PD-1 expression on NK cells in the absence of any confounding factor related to the underlying disease, we generated NK cells stably expressing PD-1 after lentiviral transduction. Compared to NK cells transduced with the control vector, PD-1+ cells showed a constitutively decreased CD107a degranulation, thus confirming our findings in NK cells from infected patients. In the second part of this study, we investigated the immunosuppressive role of PGE2 in the control of IL-15-mediated NK cell activation. Our results suggest that PGE2 acts through EP2 and EP4 receptors to inhibit IL-15 induced NKG2D and IL-15Rγ expression on NK cells. These findings allow a better comprehension of PGE2/IL-15 antagonism in the regulation of NK cell responses. In conclusion, our results indicate that PD-1 expression on NK cells could represent a supplementary mechanism of immune evasion strategy, and allow introducing the concept of exhausted NK cells, similar to exhausted PD-1+ T cells. Our results also demonstrate that PGE2 exerts a negative feedback on IL-15-mediated effects on NK cells. Blocking PGE2 or its receptors could be of interest in IL-15 tumor immunotherapy to potentiate IL-15-induced cytotoxic functions of NK cells.

Programmed death-1 (PD-1) et ses ligands PD-L1 et PD-L2 appartiennent à la famille B7 : CD28 des molécules de cosignalisation immunitaire. Leur interaction délivre un signal inhibiteur à l’activation lymphocytaire. Ces molécules sont impliquées non seulement dans le contrôle de la tolérance, mais aussi dans un mécanisme d’échappement tumoral et viral au système immunitaire. Les deux ligands de PD-1 : PD-L1 et PD-L2 montrent une expression tissulaire assez large, témoignant de leur rôle étendu aux différents stades de la réponse immunitaire. L’expression de PD-L1 est plus large que celle de PD-L2. PD-L1 est exprimé sur les cellules hématopoïétiques et non hématopoïétiques, PDL2 présente une expression assez restreinte aux CPAs professionnelles. L’expression de PD-L1 et PD-L2 est fortement régulée dans plusieurs cas pathologiques et notamment dans les cancers. La régulation de l’expression de PD-L2 qui fait l’objet de notre étude, représente une cible importante dans le domaine de l’immunothérapie. Notre projet porte sur l’analyse de l’expression, la régulation et la fonction de PD-L2 dans les LT, dans différents contextes physiologiques et pathologiques. Nous avons pu démontrer que PD-L2 qui avait été décrit chez la souris pour son expression restreinte aux CDs et aux macrophages, était de façon surprenante exprimé avec son homologue PD-L1 sur les LT après costimulation CD3+CD28. Nous l’avons confirmé ex vivo par activation par Staphylococcal enterotoxin E. Ce résultat montre que PD-L2 est bien induit sur des LT dans des conditions d’activation physiologique ou pathologique. Nous avons pu démontrer aussi une régulation négative de l’expression transcriptionnelle et protéique de PD-L1 et de PDL2 sous l’effet de la CyclosporineA (CsA). Cet effet est indépendant de l’action de l’IL-2. Nos données d’analyses bioinformatiques nous ont permis d’identifier les sites putatifs de fixation de facteurs de transcription au niveau du promoteur du gène pd-l2, qui peuvent être régulés par la CsA. L’analyse de la fonction de PDL2 sur les LT nous a permis de démontrer que la stimulation de PDL2 par des anticorps monoclonaux fabriqués dans le laboratoire inhibait l’activation T. Nos résultats démontrent pour la première fois une fonction de PDL2 et une signalisation « reverse siglaling » dans les LT potentiels. La caractérisation fonctionnelle et l’étude des voies de signalisation de PD-L2 que nous avons déjà étudié dans notre projet, représentent une piste importante à explorer. Cela permettrait de proposer de nouvelles stratégies permettant de lutter contre les mécanismes d’échappement tumoral. / PD-1 (programmed death-1) is a new CD28 families member, that deliver inhibitory signals that regulate the balance between T cell activation, tolerance, and immunopathology. (1) (ref octa).PD-1, is inducibly expressed on T cells. The PD-1 ligands PD-L1 (B7-H1) and PD-L2 (B7-DC) exhibit distinct patterns of expression: PD-L1 is expressed more broadly than is PD-L2. PD-L1 is expressed on resting and up regulated on hematopoietic, nonhematopoietic cells and cancer cell. However, PD-L2 is expressed only on professional antigen-presenting cells. In addition, it has been demonstrated that PD-L1 and PD-L2 are differentially regulated by Th1 and Th2 cytokines.Suggesting that PD-L2 is regulated differently in the former versus the latter, and this proved to be the case, both in transcription and promotion (2) (ref octa) However, little is known about the regulation of PD-L2 expression and nine is known about the expression of PD-L2 on T cells. In the present study, we observed in the first time, by flow cytometer and real time PCR (RT PCR) that PD-L2 expression is induced on ex vivo on activated CD4+ and CD8+ T cells, on in vitro on activated JURKAT T cell line and this expression is inhibited by the immunosuppressive drogue Cyclosporin A (CsA). In the second time we showed that PD-L2 is up regulated in vivo on Non hodchkin lymphoma, other up regulation of PD-L2 expression is observed on Vb8+ T cells after PBMC treatment with the Staphylococcal enterotoxin E (SEE) super antigen. Finally, we attributed a function to PD-L2 to be a co-inhibitory molecule for CD4+ T cells activation.

Le mélanome métastatique reste un enjeu majeur de santé publique. Les avancées fulgurantes de ces dernières années ont permis d’améliorer la prise en charge thérapeutique, notamment avec l’arrivée des anticorps bloquant ou agonistiques ciblant les molécules de co-inhibition ou de co-stimulation. Cependant, certains patients sont réfractaires à tout traitement. Il est donc nécessaire de mettre en évidence l’importance de certains paramètres immunologiques permettant d’améliorer le suivi des patients de stade III à haut risque de récidive. De plus, il est primordial de découvrir des marqueurs prédictifs associés à la réponse à ces différents traitements immunomodulateurs. Nous avons identifié une association entre une fréquence élevée de CD45RA+CD4+ et de CD3-CD56- au sein des métastases ganglionnaires avec la survenue d’une récidive anticipée.Une forte expression de NKG2D à la surface des lymphocytes T CD8+, une faible proportion de Tregs ou une faible expression de PD-L1 à la surface des T circulants sont associées à une meilleure survie. Aussi, la mise en place d’un test in-vitro étudiant les réactivités fonctionnelles des lymphocytes infiltrant les tumeurs a permis de dégager l’importance de l’expression de CD95/Fas sur les T CD4+ circulants et de CD137/4-1BB sur les T CD8+ circulants dans la prédiction de la réponse à l’ipilimumab (anti-CTLA-4) et à la combinaison ipilimumab + nivolumab (anti-PD-1). Par ailleurs, le pattern d’expression des récepteurs de chimiokines à la surface des lymphocytes T périphériques permet de détecter les localisations métastatiques de mélanome. Cette étude a révélé également l’importance biologique de l’axe CCR9/CCL25 dans l’immunosurveillance naturelle anti-tumorale. / Metastatic melanoma (MM) is an unmet medical need. The development of immune checkpoint blockers (ICB) improved patient’s clinical outcomes. However, some patients still do not respond to these therapies. To adress these issues, we must find some immunological parameters which predict the relapse of high risk resected stage III melanoma patients. Moreover, it is an urgent need to identify some predicting parameters to these ICB. In our studies, high frequencies of CD45RA+CD4+ and CD3-CD56- in metastatic lymph nodes are associated with a short relapse-free survival. Higher expression of NKG2D on CD8 T cells, low Tregs and low PD-L1 expression on circulating T cells are associated with a prolonged overall survival.Furthermore, we designed an in-vitro test to assess intratumor lymphocytes reactivities to ICB and cytokines (IL-2 and IFNα2a). Low expression of CD95/Fas on CD4+ circulating T cells and high expression of CD137/4-1BB on circulating CD8+ T cells are associated with the response to ipilimumab (anti-CTLA-4) and to the combination ipilimumab + nivolumab (anti-PD-1), respectively. In addition, the chemokine receptor pattern expressed at the surface of circulating lymphocytes could predict the metastatic spreading of melanoma. In this last study, we demonstrated the critical role of CCR9/CCL25 pathway in the natural anti-cancer immune surveillance.