Francisella tularensis, the causative agent of tularemia, is a potent pathogen in humans and other mammals. The ulceroglandular form of the disease is the most common expression in humans with a clinical picture characterized by a skin ulcer, enlarged regional lymph nodes and fever. Despite being a preferred route of infection, the skin also affords an effective defense barrier against F. tularensis. Doses required to induce infection by intradermal inoculation are several logs higher than those needed for infection by other routes. In the present thesis, the requirements for the local and systemic host defense to intradermal infection with F. tularensis was studied in experimental mouse models. Naïve mice and mice immunized by previous infection were challenged, mostly with the live vaccine strain F. tularensis LVS but also with a clinical isolate of F. tularensis. In naïve mice, intradermal inoculation of F. tularensis LVS resulted in a rapid increase of bacterial numbers during the first few days in the skin, lymph nodes, spleen and liver, followed by a decrease and eradication of the bacteria within two weeks of inoculation. Immune mice controlled the infection at the site of infection and very few bacteria spread to internal organs. When immunohistochemical staining of skin specimens was performed during the first 3 days, naïve mice showed a weak or barely discernible local expression of TNF-α, IL-12 and IFN-γ. In immune mice, the expression of all three cytokines was strongly enhanced, TNF-α and IL-12 within 24 h and IFN-γ within 72 h of inoculation. To investigate the role of T cells in the defense against intradermal infection with F. tularensis LVS, naïve and immune T-cell knockout mice (e.g., αβ TCR-/-, γδ TCR-/-, αβγδ TCR-/-) were used. Naïve mice lacking the αβ TCR had persistently high bacterial numbers in all organs and died at 4 weeks. Mice lacking the γδ TCR, on the other hand, controlled the infection as effectively as did wild-type mice. To enable αβ TCR-/- and αβγδ TCR-/- mice to survive, antibiotic treatment was given from day 10 to 20 of infection. When intradermally challenged 2 weeks later, these animals were found to control a secondary infection, resulting in decreasing viable counts in skin and lymph nodes and prevention of spread to liver and spleen. The results indicated the presence of a T-cell independent mechanism of resistance and analyses of serum showed high levels of F. tularensis-specific IgM, findings suggesting a role for antibodies in the protection against cutaneous tularemia. To study the effect of F. tularensis-specific antibodies on host resistance, we adoptively transferred immune serum to B-cell-deficient mice. After receiving immune serum, both naïve and immunized mice became capable of surviving an otherwise lethal dose of F. tularensis LVS. Moreover, transfer of immune serum to wild type mice, afforded significant protection to a lethal dose of a wild-type strain of F. tularensis subsp. holarctica, as disclosed by reduced bacterial counts in spleen and liver. Finally, we studied the effect of immune serum on the local expression of proinflammatory cytokines and neutrophils in response to an intradermal injection of F. tularensis LVS. As compared to normal serum, transfer of immune serum resulted in increased expression of TNF-α, IL-12 and neutrophils. These findings afford a possible explanation for the effect of specific antibodies in the local host protection in the skin against tularemia.

Made available in DSpace on 2014-06-11T19:30:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-12-08Bitstream added on 2014-06-13T20:00:43Z : No. of bitstreams: 1 cangiani_ee_dr_arafcf.pdf: 879107 bytes, checksum: bd2b88a537298b5f3ad944c986ece870 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Universidade Estadual Paulista (UNESP) / Yersinia enterocolitica é um enteropatógeno que pode levar ao desenvolvimento de artrite reativa. Um dos mecanismos imunomoduladores usados pelos patógenos artritogênicos é a ativação policlonal de linfócitos. O objetivo deste estudo foi verificar se ocorre ativação policlonal de linfócitos B e comparar o padrão isotípico de imunoglobulinas produzidas durante a infecção com Y. enterocolitica O:8 em linhagens de camundongos suscetíveis (BALB/c) e resistentes (C57BL/6), bem como analisar o padrão de secreção de citocinas pró-inflamatórias e regulatórias pelas populações de células T CD4+ e CD8+. / Yersinia enterocolitica is an enteropathogen that can lead to the development of reactive arthritis. One of the immunomodulating mechanisms used by arthritogenic pathogens is the polyclonal activation of lymphocytes. The objective of this study was to verify if the polyclonal activation of B-lymphocytes occur and to compare the different immunoglobulin (Ig) isotypes produced during the infection with Y. enterocolitica O:8 in susceptible (BALB/c) and resistant (C57BL/6) mice strains. We also analyzed the production of pro-inflammatory and regulatory cytokines in T CD4+ and T CD8+ lymphocytes populations.

Resumo: Yersinia enterocolitica é um enteropatógeno que pode levar ao desenvolvimento de artrite reativa. Um dos mecanismos imunomoduladores usados pelos patógenos artritogênicos é a ativação policlonal de linfócitos. O objetivo deste estudo foi verificar se ocorre ativação policlonal de linfócitos B e comparar o padrão isotípico de imunoglobulinas produzidas durante a infecção com Y. enterocolitica O:8 em linhagens de camundongos suscetíveis (BALB/c) e resistentes (C57BL/6), bem como analisar o padrão de secreção de citocinas pró-inflamatórias e regulatórias pelas populações de células T CD4+ e CD8+. / Abstract: Yersinia enterocolitica is an enteropathogen that can lead to the development of reactive arthritis. One of the immunomodulating mechanisms used by arthritogenic pathogens is the polyclonal activation of lymphocytes. The objective of this study was to verify if the polyclonal activation of B-lymphocytes occur and to compare the different immunoglobulin (Ig) isotypes produced during the infection with Y. enterocolitica O:8 in susceptible (BALB/c) and resistant (C57BL/6) mice strains. We also analyzed the production of pro-inflammatory and regulatory cytokines in T CD4+ and T CD8+ lymphocytes populations. / Orientador: Beatriz Maria Machado de Medeiros / Coorientador: Iracilda Zeppone Carlos / Banca: Maria Regina D'Império Lima / Banca: Phileno Pinge / Banca: Ângela Maria Victoriano de Campos Soares / Banca: Deise Pasetto Falcão / Doutor

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<p>AMR as a cause of graft rejection has been long recognized and the presence of pre formed antibodies against donor HLA is a risk factor for increased graft rejection. FlowXM is the current clinical gold standard for detecting harmful DSA in the recipients and a positive FlowXM is considered a strong contraindication to transplantation. However, newer techniques such as SAB provide with a highly sensitive and specific method for DSA detection that is unattainable by FlowXM. But due to the intrinsic limitations associated with SAB assays, the clinical relevance of DSA detected on SAB has been highly disputable. Therefore, the overall aim of this study was to investigate the utility of SAB in predicting harmful DSA levels, by establishing a fluorescence range on SAB that correlated to positive FlowXM. This was done by retrospectively testing the highest serum dilutions on FlowPRA SAB that produced positive B or T cell FlowXM from 15 variably sensitized patients. Thus, a very narrow MFI range on SAB was established, for B and T cells separately, that correlated to positive FlowXM. On B cells this correlate ranged from 2780-7772 MFI (Mean MFI =5641), whereas T cell range was 1089-6731 (Mean MFI= 3226). In order to test these ranges for prediction of positive FlowXM, B and T cell FlowXM tests were carried out using various serum/cell combinations. DSA MFI of >3000 on SAB resulted in a significantly higher T cell positive FlowXM (p</p> / Master of Science (MSc)

Kidney transplantation is the treatment of choice for patients with end stage renal failure and is associated with prolonged survival of patients and better quality of life than long-term dialysis. Simultaneously, however, transplantation carries the risk of immunological complications leading to graft rejection. A serious problem in patients after organ transplantation is the development of humoral rejection, which is most often associated with the presence of antibodies specific to HLA antigens, particularly against mismatched HLA antigens of the organ donor. In certain cases antibodies may be specific to antigens expressed on endothelial cells, not on lymphocytes, like MICA, MICB, ICAM, and up till now unidentified tissue-specific antigens. Humoral rejection has significantly worse prognosis for the transplanted kidney than cellular rejection, and therefore its timely diagnosis is of great importance for the subsequent choice of appropriate therapy. The diagnosis of humoral rejection is based on the simultaneous detection of C4d deposits in the peritubular capillaries of the transplanted kidney and the finding of antibodies specific to the mismatched antigens of the donor (donor specific antibodies, DSA). The aim of our retrospective study was to contribute to improvement of the diagnosis of acute and...

Introdução: O fragmento C4d e os anticorpos anti-HLA doador específicos (DSA) são marcadores de resposta humoral em enxertos renais com rejeição, mas o papel das células B nesse processo ainda não é claro. Neste estudo foi avaliada a correlação entre C4d, DSA e células B de enxertos com disfunção e sua associação com aspectos morfológicos, função e sobrevida do rim transplantado. Material e Métodos: A marcação para C4d, células B CD20+ e plasmócitos CD138+ foi realizada por imunoperoxidase em biópsias por indicação de 110 receptores de transplante renal. Positividade para CD20 e CD138 foi definida por curva ROC (≥5 céls./mm2). O soro coletado concomitante a biópsia foi testado para DSA classe I e classe II. Estes marcadores foram correlacionados com dados clínicos e do transplante, a histopatologia de Banff e a evolução do rim transplantado. Resultados: Depósitos de C4d e DSA circulantes foram detectados em 100% e 70% dos pacientes com rejeição mediada por anticorpos (RMA) respectivamente, e nos casos de rejeição aguda celular (RAC) em 42% (p<0,001, vs. RMA) e 28% (p=0,003, vs. RMA). Estes dois marcadores correlacionaram-se positivamente (r=0,31, p=0,016). Houve correlação significativa entre DSA e plasmócitos CD138+ (r=0.32 p=0,006), mas as células CD20 e CD138 não se correlacionaram entre si. As células CD138+ predominaram na RMA, associadas com maior painel pré-transplante e DSA, mas não a C4d, e as células CD20+ predominaram na RAC e nas biópsias com fibrose intersticial/atrofia tubular, associadas a maior incompatibilidade HLA e a retransplantes. Pacientes com C4d+ tiveram pior função e sobrevida do enxerto em três anos de transplante, e aqueles com DSA+ uma pior 7 sobrevida do enxerto. Positividade para CD20 ou CD138 não foi preditiva da função ou sobrevida do enxerto. Na análise multivariada, somente o C4d foi fator de risco para perda do enxerto. Conclusões: Esses resultados confirmam o valor prognóstico do C4d e dos DSA para uma pior evolução do enxerto renal, e sugerem uma associação das células B CD20+ com parâmetros de rejeição celular e dos plasmócitos CD138+ com marcadores de resposta humoral. Entretanto, nesse estudo o infiltrado de células B na biópsia do enxerto não foi preditivo de uma pior evolução do rim transplantado. / Introduction: The fragment C4d and the donor specific anti-HLA antibodies (DSA) are markers of the humoral response in rejecting kidney grafts, but the role of B cells in this process is still unclear. In this study we evaluated the correlation between C4d, DSA and B cells in dysfunctional grafts, and their association with morphological features, and graft function and survival. Material and Methods: The staining for C4d, CD20+ B cells and CD138+ plasmocytes were done by immunoperoxidase in 110 kidney graft biopsies for cause. Positivity for CD20 and CD138 were established by ROC curve (≥5 cells/mm2). Serum collected at biopsy were tested for anti-HLA class I and II antibodies. These markers were correlated with clinical and transplant characteristics, Banff histopathology and graft outcomes. Results: C4d deposits and circulating DSA were detected in 100% and 70% of the patients with antibody-mediated rejection (AMR) respectively, and in cases with acute cellular rejection (ACR) in 42% (p<0.001, vs. AMR) and 28% (p=0.003, vs. AMR), respectively. Both markers were positively correlated (r=0.31, p=0.016), and there was also a significant correlation between DSA and plasmocytes CD138+ (r=0.32 p=0.006). CD20 and C138 cells were not siginificantly correlated. Plasmocytes CD138+ predominated in AMR, and were associated with higher pre transplant PRA and DSA positivity, but not with C4d. CD20+ B cells were highly expressed in ACR and in biopsies with interstitial fibrosis and tubular atrophy, in association with more HLA mismatches and re-transplants. Patients with C4d had poorer graft function and survival, and those 9 with DSA + also had a worse graft survival in three years of transplant. CD20 or CD138 cells were not predictive of graft outcomes. In multivariated analysis, only C4d remained a risk factor for graft loss. Conclusion: These results confirm the prognostic value of C4d and circulating DSA for a worse kidney graft outcome, and suggest an association of CD20+ B cells with parameters of cellular rejection whereas CD138+ plasmocytes correlated with markers of the humoral response. However, in this study the B cell infiltrate in graft biopsy was not predictive of adverse outcomes to the transplanted kidney.

B cells have a central role in the pathogenesis of collagen-induced arthritis (CIA), an animal model of the autoimmune disease rheumatoid arthritis. In this report, a specific subset of an innate type of B cells, B-1 B cells, have been studied for the involvement in CIA. The B-1 B cells were shown to produce small amounts of collagen-specific antibodies upon stimulation in vitro, suggesting that they play a minor role in the development of CIA. This report also includes how marginal zone B cells, another innate type of B cells with natural collagen-reactivity, can be identified in the medullary sinuses of lymph nodes of collagen-immunized mice, implying involvement in auto antigen trapping.

Introdução: O fragmento C4d e os anticorpos anti-HLA doador específicos (DSA) são marcadores de resposta humoral em enxertos renais com rejeição, mas o papel das células B nesse processo ainda não é claro. Neste estudo foi avaliada a correlação entre C4d, DSA e células B de enxertos com disfunção e sua associação com aspectos morfológicos, função e sobrevida do rim transplantado. Material e Métodos: A marcação para C4d, células B CD20+ e plasmócitos CD138+ foi realizada por imunoperoxidase em biópsias por indicação de 110 receptores de transplante renal. Positividade para CD20 e CD138 foi definida por curva ROC (≥5 céls./mm2). O soro coletado concomitante a biópsia foi testado para DSA classe I e classe II. Estes marcadores foram correlacionados com dados clínicos e do transplante, a histopatologia de Banff e a evolução do rim transplantado. Resultados: Depósitos de C4d e DSA circulantes foram detectados em 100% e 70% dos pacientes com rejeição mediada por anticorpos (RMA) respectivamente, e nos casos de rejeição aguda celular (RAC) em 42% (p<0,001, vs. RMA) e 28% (p=0,003, vs. RMA). Estes dois marcadores correlacionaram-se positivamente (r=0,31, p=0,016). Houve correlação significativa entre DSA e plasmócitos CD138+ (r=0.32 p=0,006), mas as células CD20 e CD138 não se correlacionaram entre si. As células CD138+ predominaram na RMA, associadas com maior painel pré-transplante e DSA, mas não a C4d, e as células CD20+ predominaram na RAC e nas biópsias com fibrose intersticial/atrofia tubular, associadas a maior incompatibilidade HLA e a retransplantes. Pacientes com C4d+ tiveram pior função e sobrevida do enxerto em três anos de transplante, e aqueles com DSA+ uma pior 7 sobrevida do enxerto. Positividade para CD20 ou CD138 não foi preditiva da função ou sobrevida do enxerto. Na análise multivariada, somente o C4d foi fator de risco para perda do enxerto. Conclusões: Esses resultados confirmam o valor prognóstico do C4d e dos DSA para uma pior evolução do enxerto renal, e sugerem uma associação das células B CD20+ com parâmetros de rejeição celular e dos plasmócitos CD138+ com marcadores de resposta humoral. Entretanto, nesse estudo o infiltrado de células B na biópsia do enxerto não foi preditivo de uma pior evolução do rim transplantado. / Introduction: The fragment C4d and the donor specific anti-HLA antibodies (DSA) are markers of the humoral response in rejecting kidney grafts, but the role of B cells in this process is still unclear. In this study we evaluated the correlation between C4d, DSA and B cells in dysfunctional grafts, and their association with morphological features, and graft function and survival. Material and Methods: The staining for C4d, CD20+ B cells and CD138+ plasmocytes were done by immunoperoxidase in 110 kidney graft biopsies for cause. Positivity for CD20 and CD138 were established by ROC curve (≥5 cells/mm2). Serum collected at biopsy were tested for anti-HLA class I and II antibodies. These markers were correlated with clinical and transplant characteristics, Banff histopathology and graft outcomes. Results: C4d deposits and circulating DSA were detected in 100% and 70% of the patients with antibody-mediated rejection (AMR) respectively, and in cases with acute cellular rejection (ACR) in 42% (p<0.001, vs. AMR) and 28% (p=0.003, vs. AMR), respectively. Both markers were positively correlated (r=0.31, p=0.016), and there was also a significant correlation between DSA and plasmocytes CD138+ (r=0.32 p=0.006). CD20 and C138 cells were not siginificantly correlated. Plasmocytes CD138+ predominated in AMR, and were associated with higher pre transplant PRA and DSA positivity, but not with C4d. CD20+ B cells were highly expressed in ACR and in biopsies with interstitial fibrosis and tubular atrophy, in association with more HLA mismatches and re-transplants. Patients with C4d had poorer graft function and survival, and those 9 with DSA + also had a worse graft survival in three years of transplant. CD20 or CD138 cells were not predictive of graft outcomes. In multivariated analysis, only C4d remained a risk factor for graft loss. Conclusion: These results confirm the prognostic value of C4d and circulating DSA for a worse kidney graft outcome, and suggest an association of CD20+ B cells with parameters of cellular rejection whereas CD138+ plasmocytes correlated with markers of the humoral response. However, in this study the B cell infiltrate in graft biopsy was not predictive of adverse outcomes to the transplanted kidney.