Adoptiver Transfer EBV-spezifischer, polyklonaler T-Zelllinien findet Anwendung bei Prophylaxe und Therapie EBV-assoziierter Erkrankungen. Der Ansatz hat den Nachteil der aufwändigen Herstellung der T-Zelllinien, welche aufgrund der Stimulation mit EBV transformierten B-Zelllinien oft nicht die gewünschten EBV Antigene, sondern immundominante EBV Antigene erkennen. Eine Alternative zum polyklonalen T Zelltransfer stellt die Übertragung EBV-spezifischer T-Zellrezeptoren (TCRs) dar. Dadurch können subdominante EBV Antigene angegangen werden, die von Tumorzellen tatsächlich exprimiert werden. In den hier beschriebenen Arbeiten, verwendeten wir peptidbeladene dendritische Zellen (DCs), um selektiv CD4+ T-Zellen gegen ein Epitop aus dem EBV Protein EBNA2 anzureichern. Es gibt Hinweise darauf, dass DCs sich besonders zur Stimulation von T-Zellen eignen, die subdominante EBV Antigene erkennen. Die TCR Gene eines solchen CD4+ T-Zellklons, sowie zweier CD8+ Klone, wurden in Vektoren kloniert, mit denen die EBV Spezifität der Klone auf andere T-Zellen übertragen werden sollte. Wie bereits zuvor in anderen Laboren beobachtet, waren auch unsere TCR modifizierten T-Zellen zunächst nicht in der Lage, EBV infizierte Zielzellen effektiv zu attackieren. Erst durch Modifikation der Vektorstrategie (2A Peptidlinker als Ersatz für das IRES Element (internal ribosomal entry site)) sowie der TCR Gene (Codon-Optimierung) konnte eine deutlich verbesserte Expression und Funktion der modifizierten T-Zellen erreicht werden. Außerdem hing die Effektivität der modifizierten T-Zellen essentiell von der als Zielzelle verwendeten LCL ab. Die hier beschriebenen Arbeiten zeigen die erfolgreiche Übertragung von TCRs gegen EBV Antigene auf T-Zellen. Die so modifizierten T-Zellen erlangten anti-EBV Aktivität und sprechen daher für die prinzipielle Anwendbarkeit TCR-modifizierter T-Zellen zur Behandlung EBV-assoziierter Erkrankungen. / Adoptive transfer of polyclonal Epstein-Barr-virus (EBV)-specific T cell lines has been used as prophylaxis and therapy in patients with EBV-associated malignancies. This approach, however, is limited by the difficult expansion of polyclonal T cells directed mainly against dominant EBV antigens presented on EBV-transformed B cell lines (LCLs). Isolating EBV-specific T cell receptors (TCRs) for transduction of T cells is an alternative strategy to confer T cell immunity against EBV antigens including subdominant EBV antigens. In this study, we have used peptide-pulsed DCs to selectively expand EBV-specific CD4+ T cell clones against an EBNA2-derived epitope. Data suggested that peptide-pulsed DCs are particularly effective in stimulating T cells specific for subdominant EBV antigens. TCR genes from one of these clones as well as from two CD8+ T cell clones were identified by RACE PCR. TCR alpha and beta chains where then cloned into retroviral vectors for transduction of T cells to equip them with anti-EBV specificity. The TCR-modified T cells where then tested for their function towards LCLs to assess the chances for the use of EBV-redirected T cells in adoptive immunotherapy of EBV-associated disease. Like in previous reports, our EBV-specific TCRs at first did not confer effective activity against LCLs. Instead, we had to apply modifications to the TCR vectors to improve expression and function of the introduced TCRs. Codon optimization as well as replacement of the IRES site by a 2A peptide linker was required to significantly increase expression and function of transduced TCRs. Also, we found that the effectiveness of TCR transduced T cells is dependent on the target cell chosen. Our data show successful transfer of functionally active EBV-specific TCRs into T cells to render them effective against LCLs, representing the basis for the development of TCR-transgenic T cells for adoptive T cell transfer in EBV-associated disease.

Die spezifische adoptive Immuntherapie ist ein hoffnungsvoller Ansatz zur Behandlung von Tumoren. Die aufwendige individuelle Bereitstellung primärer Effektorlymphozyten könnte durch den Einsatz etablierter tumorantigenspezifischer Effektorzellinien vermieden werden. In dieser Arbeit wurde untersucht, ob sich ein Tumortargeting der humanen Natürlichen Killer-(NK)-Zellinie YT durch den Gentransfer chimärer Immunglobulin-T-Zellrezeptoren (cIgTCRs) erreichen läßt. Die cIgTCR-Konstrukte wurden aus single-chain-Fv-Fragmenten (scFv), dem IgG1-Fc-Teil und der CD3-Zeta-Signalkette erzeugt. Die scFv-Fragmente wurden aus den humanisierten Antikörpern BW431/26 und HuM195, die spezifisch für das karzinoembryonale Antigen (CEA) bzw. CD33 sind, konstruiert und zeigten als scFv-hFc-Fusionsproteine eine spezifische Bindung an Tumorzellen. Die YT-Zellen wurden mit den cIgTCR-Genkonstrukten über Elektroporation transfiziert und über immunologische Verfahren angereichert. In-vitro-Studien ergaben eine spezifische Lyse von CEA+ Kolonkarzinomzellinien durch die scBW431/26-hFcZeta+ YT-Zellen. Die Zytotoxizität korrelierte mit der Expression des cIgTCR-Antigens auf den Tumorzellen und wurde durch zirkulierendes CEA nicht gehemmt. Die scHuM195-hFcZeta+ YT-Zellen zeigten eine spezifische Lyse der CD33+ myeloischen Leukämiezellinie KG1. Die Bestrahlung wurde zur Wachstumsbegrenzung der YT-Zellen eingesetzt. Die spezifische Zytotoxizität der scBW431/26-hFcZeta+ YT-Zellen gegenüber CEA+ Tumorzellen war einen Tag nach Bestrahlung unverändert. Die Koinjektion von CEA+ Tumorzellen mit bestrahlten scBW431/26-hFcZeta+ YT-Zellen führte zu einer signifikanten Hemmung des Tumorwachstums in NOD/SCID-Mäusen. Die cIgTCR+ YT-Zellen zeigten in vitro eine geringe Sensibilität gegenüber allogenen Blutlymphozyten. Die Ergebnisse zeigen, daß die Zytotoxizität der NK-Zellinie YT tumorantigenspezifisch durch cIgTCR-Gentransfer erweitert wird und ein Potential zur Behandlung minimaler Tumorerkrankungen besteht. / The specific adoptive immunotherapy is a promising strategy for cancer treatment. The utilization of established tumor antigen specific effector cell lines could bypass the expendable individual preparation and often limited specificity of primary effector lymphocytes. This study investigated the tumor targeting of the human Natural Killer (NK) cell line YT by gene transfer of chimeric immunoglobulin T cell receptors (cIgTCRs). The cIgTCR constructs were generated of single chain antibody fragments (scFv), the IgG1 Fc part and the CD3 Zeta chain. The scFv fragments were constructed of the humanized antibodies BW431/26 and HuM195 with specificity for the carcinoembryonic antigen (CEA) and CD33, respectively, and showed as scFv-Fc fusion proteins a specific binding to tumor cells. YT cells were transfected with the cIgTCR gene constructs by electroporation and enriched by immunological cell separation. In vitro studies revealed a specific lysis of CEA+ colon carcinoma cell lines by scBW431/26-hFcZeta+ YT cells. The cytotoxicity correlated with the expression of the cIgTCR antigen on the tumor cells and was not inhibited in the presence of soluble CEA. The scHuM195-hFcZeta+ YT cells mediated a specific lysis of the CD33+ myeloic leukemia cell line KG1. The irradiation was used to limit the growth of the YT cell line. The specific cytotoxicity of the scBW431/26-hFcZeta+ YT cells against CEA+ tumor cells was unaltered one day after irradiation. The coinjection of CEA+ tumor cells and irradiated scBW431/26-hFcZeta+ YT cells led to a significant growth inhibition in NOD/SCID mice. The cIgTCR+ YT cells showed a low susceptibility to the cytotoxicity of allogeneic blood lymphocytes in vitro. The results demonstrated that the cytotoxicity of the human NK cell line YT can be specifically extended to tumor antigens by cIgTCR gene transfer. The employment of receptor gene modified YT cells could be a useful tool for the adoptive immunotherapy of minimal tumor diseases.

Les immunoglobulines intraveineuses (IVIg) constituent une préparation polyclonale d’IgG isolée et regroupée à partir du plasma sanguin de multiples donneurs. Initialement utilisé comme traitement de remplacement chez les patients souffrant d’immunodéficience primaire ou secondaire, les IVIg sont maintenant largement utilisées dans le traitement de plusieurs conditions auto-immunes, allergiques ou inflammatoires à une dose élevée, dite immunomodulatrice. Différents mécanismes d’action ont été postulés au fil des années pour expliquer l’effet thérapeutique des IVIg dans les maladies auto-immunes et inflammatoires. Entre autre, un nombre grandissant de données issues de modèles expérimentaux chez l’animal et l’humain suggère que les IVIg induisent l’expansion et augmentent l’action suppressive des cellules T régulatrices (Tregs), par un mécanisme qui demeure encore inconnu. Également, les patients atteints de maladies auto-immunes ou inflammatoires présentent souvent un nombre abaissé de Tregs par rapport aux individus sains. Ainsi, une meilleure compréhension des mécanismes par lesquels les IVIg modulent les cellules T régulatrices est requise afin de permettre un usage plus rationnel de ce produit sanguin en tant qu’alternative thérapeutique dans le traitement des maladies auto-immunes et inflammatoires. Par le biais d’un modèle expérimental d’allergie respiratoire induite par un allergène, nous avons démontré que les IVIg diminuaient significativement l’inflammation au niveau des voies aériennes ce, en association avec une différenciation des Tregs à partir des cellules T non régulatrices du tissu pulmonaire. Nous avons également démontré qu’au sein de notre modèle expérimental, l’effet anti-inflammatoire des IVIg était dépendant des cellules dendritiques CD11c+ (CDs) pulmonaires, puisque cet effet pouvait être complètement reproduit par le transfert adoptif de CDs provenant de souris préalablement traitées par les IVIg. À cet effet, il est déjà établi que les IVIg peuvent moduler l’activation et les propriétés des CDs pour favoriser la tolérance immunitaire et que ces cellules seraient cruciales pour l’induction périphérique des Tregs. C’est pourquoi, nous avons cherché à mieux comprendre comment les IVIg exercent leur effet sur ces cellules. Pour la première fois, nous avons démontré que la fraction d’IgG riche en acide sialique (SA-IVIg) (constituant 2-5% de l’ensemble des IgG des donneurs) interagit avec un récepteur dendritique inhibiteur de type lectine C (DCIR) et active une cascade de signalement intracellulaire initiée par la phosphorylation du motif ITIM qui est responsable des changements observés en faveur de la tolérance immunitaire auprès des cellules dendritiques et des Tregs. L’activité anti-inflammatoire de la composante SA-IVIg a déjà été décrite dans des études antérieures, mais encore une fois le mécanisme par lequel ce traitement modifie la fonction des CDs n’a pas été établi. Nous avons finalement démontré que le récepteur DCIR facilite l’internalisation des molécules d’IgG liées au récepteur et que cette étape est cruciale pour permettre l’induction périphérique des Tregs. En tant que produit sanguin, les IVIg constitue un traitement précieux qui existe en quantité limitée. La caractérisation des mécanismes d’action des IVIg permettra une meilleure utilisation de ce traitement dans un vaste éventail de pathologies auto-immunes et inflammatoires. / Intravenous immunoglobulin (IVIg) is a therapeutic preparation of normal human polyclonal IgG derived from pooled plasma from a large number of healthy donors. Initially used as replacement therapy for patients with primary and secondary immune deficiencies, IVIg is now also widely used for the treatment of a variety of autoimmune, allergic and systemic inflammatory disorders, at high immunomodulatory doses. The beneficial effect of IVIg in autoimmune and inflammatory diseases has been attributed to different mechanisms. Increasing evidence shows that IVIg induces expansion and enhances the suppressive function of regulatory T cells (Tregs) in different experimental animal models and human subjects, through an unknown mechanism. Human inflammatory and autoimmune diseases are known to be associated with Treg deficiency. Therefore, a more precise understanding of the mechanisms by which IVIg modulate Treg populations seems to be needed for more rational use of this compound as an alternative therapy in context of various inflammatory and autoimmune disorders. Using a robust antigen-driven model of allergic airway disease, we have demonstrated that IVIg markedly attenuates airway inflammation and this effect is associated with the induction of Tregs from non-regulatory T cells in pulmonary tissues. We have also demonstrated that the antiinflammatory actions of IVIg, in our model are dependent on a population of pulmonary CD11c+ dendritic cells (DCs), as the action of IVIg could be completely replicated by adoptive transfer of CD11c+ DCs from IVIg-treated mice. we have shown that tolerogenic DCs involve in the peripheral induction of Tregs. Given the requirement of DCs in the induction of Tregs, we explored the mechanism by which IVIg interacts and modulate these cells and for the first time demonstrated that the purified sialylated fraction of human IgG (SA-IVIg) (that consists 2-5% of whole IgG) interacts with an inhibitory C-type lectin receptor on dendritic (DCIR) and this interaction triggers an ITIM intracellular signaling cascade. This subsequently results in rendering tolerogenic activities to DCs and peripheral induction of Tregs. The anti-inflammatory activity of SA-IVIg has been shown in previous studies, but the mechanism by which it modulates DCs functions is not well understood. We also demonstrated that DCIR facilitates the internalization of IgG molecules into DC and this internalization appears to be a crucial step for induction of Tregs. IVIg is a costly therapeutic compound. Characterization of the mechanism of action of IVIg can lead to a better application of this plasma based therapy in a wide range of autoimmune and inflammatory diseases.

La vaccination muqueuse est un moyen efficace de lutter contre les pathogènes qui utilisent les muqueuses comme porte d’entrée. Cependant, la vaccination muqueuse avec des antigènes non réplicatifs nécessite l’utilisation d’adjuvants. Les molécules de la famille de la toxine du choléra, l’entérotoxine thermolabile d’E.coli (LT), la toxine du choléra (CT) ainsi que le mutant LT-R192G et les sous-unités B non toxiques de ces toxines (LTB et CTB) ont été montrées augmenter les réponses immunitaires contre des antigènes coadministrés par voie muqueuse. Cependant leur mécanisme d’action est complexe et reste encore mal connu et des différences entre molécules entières et sous-unités B ont été rapportées ainsi que, pour une même molécule, des différences selon le modèle utilisé. Dans ce travail, nous avons étudié les effets de ces cinq molécules sur les réponses anticorps ainsi que sur les lymphocytes T CD4 dans un modèle murin d’immunisation intrarectale avec des pseudoparticules virales de rotavirus (VLP-2/6). Chez les souris non immunisées, nous avons montré que ces molécules, à l’exception de la CTB, diminuent in vitro les lymphocytes T régulateurs naturels CD4+CD25+Foxp3+, probablement par un mécanisme d’apoptose. Chez les souris immunisées, toutes les molécules étudiées induisent une même réponse anticorps sérique et fécale spécifique des VLP-2/6, qu’il s’agisse des molécules entières connues pour leur fort pouvoir adjuvant ou des sous-unités B qui, elles, ont été rapportées avoir un plus faible effet adjuvant voire un effet tolérogène dans certaines études. Concernant la réponse T CD4, les réponses spécifiques de l’antigène et de l’adjuvant ont été analysées. Des différences importantes ont été mises en évidence entre ces molécules. Notamment, seules les molécules entières (LT, LT-R192G et CT) induisent la production d’IL-2 et l’activation de lymphocytes T CD4+CD25+Foxp3- mémoires spécifiques de l’antigène tout en permettant la mise en place d’une régulation médiée par des lymphocytes T régulateurs CD4+CD25+Foxp3+ (boucle d’autorégulation), qui pourraient jouer un rôle majeur lors d’une réponse secondaire, afin d’éviter les réactions inflammatoires délétères. Malgré ces différences, toutes les molécules étudiées induisent la production d’IL-17, suggérant le rôle majeur de cette cytokine dans l’effet adjuvant.L’influence de la voie d’administration sur ces effets est en cours d’étude grâce à la comparaison avec la voie intranasale / Mucosal immunization is an important goal of vaccine development to protect against pathogens that use mucosa as portals of entry. However, the use of non-replicating antigens requires the addition of adjuvants.Cholera-like enterotoxins, cholera toxin (CT) from Vibrio cholerae and the heat-labile enterotoxin (LT) from toxinogenic strains of E. coli, as well as the mutant LR-192G and their B subunits (CTB and LTB) have been shown to increase immune responses against unrelated co-administered antigens by mucosal routes. However, their mechanism of action is very complex and not completely understood and differences exist between holotoxins and B subunits and within molecules, differences exist between the models used.In this work, we have studied the effects of these five molecules on antibody responses and on CD4+ T cell responses in a murine model of intrarectal immunization using rotavirus-like particles (2/6-VLP). In non-immunized mice, we have shown that all molecules, except CTB, decreased CD4+CD25+Foxp3+ natural regulatory T cells, probably by induction of apoptosis.In immunized mice, all molecules induced similar VLP-2/6 specific systemic and fecal antibody responses, teither he holotoxins, which are well known for their strong adjuvanticity or their B subunits with a less strong adjuvanticity but with also a tolerogenic effect in some studies.Regarding the CD4+ T cell response, antigen- and adjuvant- specific responses have been analysed. Important differences have been highlighted between the molecules. Among others things, only whole toxins (LT, LT-R192G and CT) trigger IL-2 production and activation of antigen specific memory CD4+CD25+Foxp3- T cells and at the same time antigen specific CD4+CD25+Foxp3+ regulatory T cells are activated which may control the effector response (Feedback loop regulation) and avoid deleterious inflammation. In spite of these differences, all studied molecules triggered IL-17 production, suggesting the major role of this cytokine in adjuvanticity. We are currently comparing the intrarectal and intranasl routes in order to evaluate the role played by the route of immunisation in different effects of these molecules

Introdução: Os linfomas não-Hodgkin de células T periféricas (LCTP) são neoplasias raras caracterizadas pela proliferação monoclonal de linfócitos T maduros. Correspondem a 15% das malignidades linfoides e têm distribuição geográfica peculiar. Compreendem 22 entidades clínico-patológicas distintas, heterogêneas do ponto de vista clínico-epidemiológico, morfológico, fenotípico e molecular. O grupo de apresentação predominantemente nodal compreende as variantes histológicas LGCA/ALK+, LGCA/ALK-, LCTA e LCTP/SOE. Sua terapêutica se baseia em poliquimioterápicos à base de antraciclina e consolidação com transplante de células tronco hematopoiéticas autólogas (TCTH). Com exceção do LGCA/ALK+, apresentam sobrevida global em cinco anos de 30% a 40%. Devido aos desfechos desfavoráveis, estudos de perfil de expressão gênica e de metilação de genes supressores tumorais têm emergido nos últimos anos para refinar o diagnóstico destas neoplasias, melhorar o conhecimento fisiopatológico e o prognóstico e estabelecer possíveis alvos terapêuticos. Estudos preliminares com LCTP nodais indicam valor prognóstico favorável da hiperexpressão de genes de padrão inflamatório NFkB1 e IKBkB e desfavorável nos casos de supraregulação de genes de padrão proliferativo como CCNA2, TOP2A e CHEK1 e do fenótipo metilado de p15INK4b e p16INK4a. Objetivo:Avaliar o impacto da expressão relativa dos genes CCNA2, TOP2A, CHEK1, NFkB1, IKBkB e VEGF1 e da metilação dos genes p15 e p16 em população brasileira com LCTP nodais tratados com quimioterapia CHOP-símile para os desfechos de sobrevida global, sobrevida livre de progressão e sobrevida livre de doença. Métodos: A expressão gênica foi avaliada por qtPCR de amostras fixadas em formol e incluídas em parafina de 63 pacientes. A mediana de expressão dos genes foi comparada com variáveis clínicas e desfechos. PCR qualitativa metilação-específico foi usada avaliar a metilação de p15 e p16. Resultados: Com mediana de seguimento de vinte meses, as SG, SLP e SLD foram, respectivamente, 45,6%, 34,3% e 63,0% e a resposta completa de 46,0%. Em análise multivariada, ECOG >= 2 e a hiperexpressão do gene CCNA2 foram associadas à pior SG em cinco anos, nos LCTP nodais (p=0,008 e p=0,002). Em análise univariada os genes CCNA2, TOP2A e CHEK1 foram associados ao pior prognóstico nos LCTP/SOE e melhor nos LGCA/ALK-. A hiperexpressão do gene VEGF1 se associou ao pior prognóstico no LGCA/ALK- e LCTA. Metilação de p15INK4b não foi encontrada nos LGCA/ALK+ e em análise multivariada foi associada a pior SLP em 5 anos nos LCTP não-ALK+ (HR: 9,88; p=0,03). O painel gênico testado não apresentou poder para discriminar as diferentes variantes histopatólogicas de LCTP nodais, porém demonstrou-se associação direta entre a intensidade de mediana de expressão desses genes e agressividade biológica nesse grupo heterogêneo de neoplasias. O significado prognóstico de imunoexpressão da proteína ALK sofreu influência das variáveis constituintes do IPI nessa coorte. Conclusão: A hiperexpressao dos genes CCNA2, TOP2A e CHEK1 foram associadas a prognóstico desfavorável nos LCTP/SOE e favorável nos LGCA/ALK-. Fenótipo hipermetilado de p15INK4b não foi evento observado em LGCA/ALK+, porém foi associado a pior prognóstico nos LCTP nodais não-ALK+ / Background: Peripheral T-cell non-Hodgkin\'s lymphomas (PTCL) are rare tumors characterized by monoclonal proliferation of mature T lymphocytes; they correspond to 15% of lymphoid malignancies and have specific geographic distribution. PTCL comprise 22 distinct clinicopathologic entities, heterogeneous from the clinical and epidemiological perspective, as well as morphologic, phenotypic and molecular. The group of presentation predominantly nodal comprises the histological variants ALCL/ALK+, ALCL/ALK-, AITL and PTCL/NOS. Its treatment is based on polychemotherapy with anthracycline and consolidation with autologous hematopoietic stem cell transplantation (ASCT). With the exception of ALCL/ALK+, these tumors show overall survival at 5 years from 30% to 40%. Due to unfavorable outcomes, gene expression profile studies, as well as studies of methylation of tumor suppressor genes, have emerged in recent years in order to refine the pathological diagnosis of these cancers, improve the pathophysiological knowledge and prognosis, and establish possible therapeutic targets. Preliminary studies with nodal PTCLs indicate favorable prognostic value of overexpression of inflammatory pattern genes like NFkB1 e IKBkB, and unfavorable in the case of proliferative genes as CCNA2, TOP2A, CHEK1 and the methylated phenotype of suppressor genes p15INK4b e p16INK4a. Objectives: Assess the impact of relative expression of genes CCNA2, TOP2A, CHEK1, NFkB, IKBkB and VEGF1 and the methylation of the genes p15 and p16 in Brazilian population with nodal PTCLs treated with CHOP-like chemotherapy for the outcomes of overall survival, progression-free survival and disease-free survival. Methods: Gene expression was assessed by qtPCR of paraffin samples of 63 patients. The median gene expression was compared with clinical variables and outcomes. Qualitative methylation-specific PCR was used to assess the methylation of p15 and p16. Results: With a segment median of 20 months, the OS, PFS and DFS were, respectively, 45,6%, 34,3% and 63,0% and the complete response (CR) was 46,0%. In multivariate analysis, ECOG >= 2 and overexpression of the gene CCNA2 were associated with worse OS at 5 years in nodal PTCLs (p = 0,008 and p = 0,002). In univariate analysis, the genes CCNA2, TOP2A and CHEK1 were associated with worse prognosis in PTCL/NOS and better in ALCL/ALK negative. The overexpression of the gene VEGF1 was associated with worse prognosis in the variants AITL and ALCL/ALK negative. Methylation of the gene p15INK4b was not found in ALCL/ALK+ group, and in multivariate analysis was associated with worse 5-years PFS in the group of PTCL non-ALK+ (HR: 9,88 and p = 0,03). The gene panel tested showed no power to discriminate the different histopathology of nodal PTCL, but it showed a direct association between the median intensity of expression of these genes and biological aggressiveness in this heterogeneous group of neoplasms. The prognostic significance of immunostaining of ALK protein was influenced by IPI constituents variables in this cohort. Conclusion: The overexpression of genes CCNA2, TOP2A e CHEK1 were associated with poor prognosis in PTCL/NOS and favorable in ALCL/ALK negative. Hypermethylated phenotype of gene p15INK4b was not an observed event in ALCL/ALK+, but it was associated with poor prognosis in nodal PTCL non-ALK+

Introdução: A Síndrome de Down (SD) é uma doença genética de alta prevalência, com várias alterações imunológicas decorrentes da disfunção tímica associada à doença. Neste estudo, avaliou-se a associação entre presença de autoimunidade e disfunção do timo em pacientes com SD. Métodos: Foram avaliados 22 pacientes com SD (11 com autoimunidade e 11 sem), que preenchiam os critérios de inclusão: diagnóstico clinico e genético, idade > a 10 anos e sem uso de drogas imunossupressoras. Estes pacientes foram comparados a um grupo controle formado por adolescentes saudáveis (n=11) e outro de pacientes com doenças autoimunes, caracterizados por manifestações clínicas e presença de autoanticorpos (n=11). Todos os grupos foram pareados por idade e sexo. Os parâmetros laboratoriais avaliados foram: número de leucócitos, linfócitos CD3+, CD4+, CD8+, CD19+, CD21+, CD4+CD28null , células T reguladoras (CD4+CD25+Foxp3+), linfócitos T naive (CD4+CD45RA+CD62L+) e linfócitos T de memória (CD4+CD45RO+CD62L- ) e célula NK (CD3-CD16+, CD56+) por citometria de fluxo, Foi também avaliada a concentração de sjTREC (T receptor excision circles) em sangue total por qRT-PCR .Resultados: Nos pacientes com SD, observou-se redução das concentrações séricas de sjTREC, do número de linfócitos B e aumento do número de células CD4+CD28null. Na análise concomitante entre os grupos formados (SD com e sem autoimunidade, controle e autoimunidade sem SD), após correção de Bonferroni, observou-se que o grupo SD com autoimunidade apresentou redução de linfócitos T CD4, linfócitos naive e linfócitos B. Quando comparados os grupos SD com e sem autoimunidade observou-se redução significativa das concentrações de TREC no primeiro grupo. Não houve alterações das Células NK. Em valores percentuais, os pacientes com SD e autoimunidade apresentaram elevação da subpopulação de células T reguladoras. Conclusões: Este estudo mostra que pacientes com SD apresentam disfunção tímica quando avaliados pela quantificação de concentrações de TREC, sendo esta última mais expressiva nos pacientes com SD e autoimunidade. A redução dos linfócitos T naive associada a número normal de linfócitos T de memória sugere disfunção tímica primária, não compatível com processo de senescência. A observação do aumento do número de linfócitos CD4+CD28null poderia ser consequência de múltiplos estímulos celulares provavelmente em consequência da linfopenia observada. A elevação de células Treg em pacientes com SD e autoimunidade poderia ser decorrente de alterações funcionais destas células bem como de alterações nos processos de homeostase / Introduction: Down syndrome (DS) is a genetic disease of high prevalence, with many immunological alterations as a consequence of thymic disfunction associated to this disease. In this study, it was evaluated the association between the presence of thymic disfunction and autoimmunity in patients with DS. Methods: It was evaluated 22 patients with DS (11 with and 11 without autoimmunity) who fulfilled the inclusion criteria: clinical and genetic diagnosis, and age >10 years and no use of immunosuppressive drugs. These patients were compared to a control group composed by health adolescents (n=11) and patients with autoimmune diseases, characterized by clinical manifestations and autoantibodies (n=11). All groups were matched for age and sex. The laboratory parameters evaluated were: number of leukocytes, CD3+, CD4+, CD8+, CD19+, CD4+CD28null lymphocytes, regulatory T cells (CD4+CD25+Foxp3+), naive T lymphocytes (CD4+CD45RA+CD62L+), memory T lymphocytes (CD4+CD45RO+CD62L-) and NK cells (CD3-CD16+CD56+). The subpopulations of lymphocytes were determined by flow cytometry. It was also evaluated whole blood sjTREC (T receptor excision circles) concentrations by PCR. Results: In DS patients, there was reduction of sjTREC concentration, B lymphocytes number and increase of CD4+CD28null cells number. When compared all the groups formed (SD with and without autoimmunity, autoimmunity without SD and control group), after Bonferroni correction, the SD group with autoimmunity showed a reduction of T CD4+lymphocytes, naïve cells and B lymphocytes. When SD with and without autoimmunity groups were compared it was observed significant reduction in the TREC concentrations in the first group. There were no changes in NK cells. Patients with DS and autoimmune diseases had huge percentages of T reg cells comparing different groups. Conclusions: This study showed that DS patients presented thymic disfunction by reduced levels of whole blood sjTREC, and this condition is more expressive to patients with DS and autoimmune disease associated. The reduction of TCD4+ naïve cells with normal TCD4+ memory cells is suggestive of primary thymic disfunction against a senescent process. The elevated number of CD4+CD28null in DS patients probably was a consequence of reduced T cell numbers. The elevation of Treg cells remains unclear, and coud be a result of ineffective cells or deregulation of Thymus dependent immunity

Introdução: A Síndrome de Down (SD) é uma doença genética de alta prevalência, com várias alterações imunológicas decorrentes da disfunção tímica associada à doença. Neste estudo, avaliou-se a associação entre presença de autoimunidade e disfunção do timo em pacientes com SD. Métodos: Foram avaliados 22 pacientes com SD (11 com autoimunidade e 11 sem), que preenchiam os critérios de inclusão: diagnóstico clinico e genético, idade > a 10 anos e sem uso de drogas imunossupressoras. Estes pacientes foram comparados a um grupo controle formado por adolescentes saudáveis (n=11) e outro de pacientes com doenças autoimunes, caracterizados por manifestações clínicas e presença de autoanticorpos (n=11). Todos os grupos foram pareados por idade e sexo. Os parâmetros laboratoriais avaliados foram: número de leucócitos, linfócitos CD3+, CD4+, CD8+, CD19+, CD21+, CD4+CD28null , células T reguladoras (CD4+CD25+Foxp3+), linfócitos T naive (CD4+CD45RA+CD62L+) e linfócitos T de memória (CD4+CD45RO+CD62L- ) e célula NK (CD3-CD16+, CD56+) por citometria de fluxo, Foi também avaliada a concentração de sjTREC (T receptor excision circles) em sangue total por qRT-PCR .Resultados: Nos pacientes com SD, observou-se redução das concentrações séricas de sjTREC, do número de linfócitos B e aumento do número de células CD4+CD28null. Na análise concomitante entre os grupos formados (SD com e sem autoimunidade, controle e autoimunidade sem SD), após correção de Bonferroni, observou-se que o grupo SD com autoimunidade apresentou redução de linfócitos T CD4, linfócitos naive e linfócitos B. Quando comparados os grupos SD com e sem autoimunidade observou-se redução significativa das concentrações de TREC no primeiro grupo. Não houve alterações das Células NK. Em valores percentuais, os pacientes com SD e autoimunidade apresentaram elevação da subpopulação de células T reguladoras. Conclusões: Este estudo mostra que pacientes com SD apresentam disfunção tímica quando avaliados pela quantificação de concentrações de TREC, sendo esta última mais expressiva nos pacientes com SD e autoimunidade. A redução dos linfócitos T naive associada a número normal de linfócitos T de memória sugere disfunção tímica primária, não compatível com processo de senescência. A observação do aumento do número de linfócitos CD4+CD28null poderia ser consequência de múltiplos estímulos celulares provavelmente em consequência da linfopenia observada. A elevação de células Treg em pacientes com SD e autoimunidade poderia ser decorrente de alterações funcionais destas células bem como de alterações nos processos de homeostase / Introduction: Down syndrome (DS) is a genetic disease of high prevalence, with many immunological alterations as a consequence of thymic disfunction associated to this disease. In this study, it was evaluated the association between the presence of thymic disfunction and autoimmunity in patients with DS. Methods: It was evaluated 22 patients with DS (11 with and 11 without autoimmunity) who fulfilled the inclusion criteria: clinical and genetic diagnosis, and age >10 years and no use of immunosuppressive drugs. These patients were compared to a control group composed by health adolescents (n=11) and patients with autoimmune diseases, characterized by clinical manifestations and autoantibodies (n=11). All groups were matched for age and sex. The laboratory parameters evaluated were: number of leukocytes, CD3+, CD4+, CD8+, CD19+, CD4+CD28null lymphocytes, regulatory T cells (CD4+CD25+Foxp3+), naive T lymphocytes (CD4+CD45RA+CD62L+), memory T lymphocytes (CD4+CD45RO+CD62L-) and NK cells (CD3-CD16+CD56+). The subpopulations of lymphocytes were determined by flow cytometry. It was also evaluated whole blood sjTREC (T receptor excision circles) concentrations by PCR. Results: In DS patients, there was reduction of sjTREC concentration, B lymphocytes number and increase of CD4+CD28null cells number. When compared all the groups formed (SD with and without autoimmunity, autoimmunity without SD and control group), after Bonferroni correction, the SD group with autoimmunity showed a reduction of T CD4+lymphocytes, naïve cells and B lymphocytes. When SD with and without autoimmunity groups were compared it was observed significant reduction in the TREC concentrations in the first group. There were no changes in NK cells. Patients with DS and autoimmune diseases had huge percentages of T reg cells comparing different groups. Conclusions: This study showed that DS patients presented thymic disfunction by reduced levels of whole blood sjTREC, and this condition is more expressive to patients with DS and autoimmune disease associated. The reduction of TCD4+ naïve cells with normal TCD4+ memory cells is suggestive of primary thymic disfunction against a senescent process. The elevated number of CD4+CD28null in DS patients probably was a consequence of reduced T cell numbers. The elevation of Treg cells remains unclear, and coud be a result of ineffective cells or deregulation of Thymus dependent immunity

Há um amplo espectro de doenças causadas por estreptococos do grupo A (GAS), e são consideradas um problema de saúde pública em vários países, principalmente os em desenvolvimento, com aproximadamente 600 milhões de casos/ano. As infecções causadas por GAS podem ocasionar doenças invasivas como faringite e pioderma com seqüelas auto-imunes graves como a febre reumática (FR) e glomerulonefrite. A FR acomete principalmente crianças e jovens adultos. A FR apresenta diversas manifestações, sendo a doença reumática cardíaca (DRC) a seqüela mais grave, caracterizada por lesões cardíacas valvares progressivas e permanentes. O tratamento, frequentemente envolve cirurgia cardíaca para a correção de lesões valvulares, o que acarreta alto custo para o Sistema Único de Saúde no Brasil e em vários países. Em trabalhos anteriores sobre os mecanismos desencadeadores das lesões reumáticas no coração, foi possível identificar o papel do linfócito T como mediador principal da autoimunidade, através da análise do receptor de células T infiltrantes de lesão cardíaca de indivíduos com DRC. Várias expansões oligoclonais com diferentes tamanhos da região que reconhece o antígeno, CDR3 foram encontradas. No presente trabalho, analisou-se a atividade tímica através da quantificação de fragmentos circulares excisados pelo rearranjo do gene do receptor do linfócito T (TREC) em linfócitos T de sangue periférico de indivíduos com FR e DRC. Também foi avaliada a presença de células T naïve e de memória através de citometria de fluxo. Os resultados do presente trabalho mostraram que a quantidade de TREC em amostras de sangue periférico do grupo de pacientes com FR/DRC foi significantemente menor quando comparada a observada em indivíduos saudáveis. Interessantemente, em ambos os grupos a quantidade de TREC apresentou correlação negativa com a idade dos indivíduos estudados. Os resultados indicaram diferenças na atividade tímica em pacientes com FR/DRC, provavelmente decorrente do processo autoimune que envolve linfócitos T / There is a wide spectrum of diseases caused by group A streptococci (GAS), that still being considered a public health problem in developing countries, with about 600 million cases per year. Infections by GAS can cause invasive diseases such as pharyngitis and pyoderma leading to serious autoimmune complications such as rheumatic fever (RF) and glomerulonephritis. RF mainly affects children and young adults, and presents different manifestations. Rheumatic heart disease (RHD) is considered the most serious complication leading to valvular lesions that are characterized by progressive and permanent heart damage, which entails high cost to the Public Health System in Brazil and worldwide. In previous works that focused on the mechanisms leading to rheumatic heart lesions, we identified the role of T lymphocytes as principal mediator of autoimmune reactions. Through the in deep analysis of infiltrating T-cell receptor repertoire of patients with RHD, we identified oligoclonal expansions with different sizes of CDR3 that is the region of antigen recognition. In the present study we analyzed the thymic activity through T cell receptor excision circles (TREC) quantification in T cells from peripheral blood of RF/RHD patients. We also evaluated naïve and memory T cells from peripheral blood by flow cytometry. Our results showed that the amount of TREC in the peripheral blood of patients was significantly lower when compared to the healthy individuals. In addition, both groups showed that the amount of TREC is negatively correlated with age. These results indicated that the thymic activity in RF/RHD patients is altered probably due to the autoimmune process that involves T lymphocytes

L’atteinte de l’âge sur les populations lymphocytaires T conventionnelles CD4 et CD8 avec l’avancée en âge est relativement bien décrite en périphérie lymphoïde secondaire chez la souris, et dans le sang périphérique chez l’homme. Deux paramètres sont observés : réduction du nombre de ces cellules et altération du ratio naïve/mémoire. À l’inverse, l’évaluation des tissus lymphoïdes tertiaires et des tissus extra lymphoïdes dans les réponses immunes, reste à affiner. Notre étude au cours du vieillissement physiologique du compartiment T fut menée dans des tissus lymphoïdes et non lymphoïdes de souris C57BL/6 wild-type, âgées entre 2 et 6 mois, entre 10 et 14 mois et entre 22 et 26 mois. Nous avons démontré que la lymphopénie T classiquement décrite liée au vieillissement dans les organes lymphoïdes secondaires ne s’applique pas à tout l’organisme : les compartiments intestinaux étudiés présentent une accumulation de cellules TCRαβ+ CD4+ (TCD4) et CD8+ (TCD8). Nos résultats dévoilent un impact différentiel du vieillissement sur le nombre absolu des différents compartiments cellulaires TCRαβ+ dans les organes lymphoïdes et la muqueuse intestinale. Ces résultats suggèrent donc que la lymphopénie T décrite dans les organes lymphoïdes s’établissant au cours du vieillissement pourrait être essentiellement liée à une redistribution des lymphocytes. A l’inverse, la persistance des cellules T régulatrices dans les organes lymphoïdes secondaires pourrait être liée à une production locale dans la muqueuse intestinale. Il semble donc que l’équilibre TCD8/TCD4 peut être différemment affecté selon le site considéré et cette observation peut fournir une justification pour la plus grande susceptibilité aux infections observée avec l’âge. / Consequences of ageing on conventional CD4 and CD8 T lymphocytes populations is relatively well described in murine secondary lymphoid organs and in human peripheral blood: reduction the number of these cells and alteration of naïve/effector-memory ratio in favour of effector-memory cells. Conversely, evaluation in tertiary lymphoid tissues and non-lymphoid tissues remains to be refined. We conducted an exhaustive analysis of T cell compartments during physiological aging in lymphoid and non-lymphoid tissues isolated from wild-type C57BL/6 mice aged of 2 to 6 months, 10 to 14 months and 22 to 26 months. We demonstrated that T lymphopenia described classically associated with aging in the secondary lymphoid organs does not apply to the whole organism: intestinal compartments studied show an accumulation of TCRαβ+ CD4+ cells (TCD4) and CD8+ (TCD8). Our results reveal a differential impact of aging on the absolute number of different TCRαβ+ cellular compartments in lymphoid organs and intestinal mucosa. T cell lymphopenia in secondary lymphoid organs currently associated to ageing may essentially reflect T cell redistribution. TCD8/TCD4 balance may be affected differently depending on the site considered and this observation may provide a rationale for the greater susceptibility to infection observed with age.

Die Effizienz einer Tumortherapie durch einen Transfer von ex vivo aktivierten Tumor-spezifischen zytotoxischen T-Lymphozyten wird durch zahlreiche Faktoren wie geringe Anzahl der isolierten spezifischen T-Zellen, schnelles Abklingen der Aktivität und kurzzeitige Persistenz der transferierten Effektorzellen im Empfängerorganismus stark limitiert. Eine Möglichkeit zur Überwindung dieser Einschränkungen bietet die Entwicklung einer neuen Strategie zur Armierung der zytotoxischen T-Lymphozyten mit Tumor-spezifischen chimären Rezeptoren. Ziel dieser Arbeit war es, die Grundlagen für eine solche immuntherapeutische Strategie zu erarbeiten. Da das Prostatakarzinom die am meisten diagnostizierte maligne Erkrankung und die dritt häufigste Todesursache des Mannes ist, wurde das auf der Oberfläche von Prostatakarzinomzellen exprimierte PSCA (prostataspezifisches Stammzellantigen) als Zielantigen gewählt. Neben der therapierefraktären Spätstadien des Prostatakarzinoms bedürfen die früh entstehenden Mikrometastasen (minimale Resterkrankung) einer neuen adjuvanten Behandlungsoption. Das PSCA ist ein membranständiges Tumor-assoziiertes Antigen, das in mehr als 80 % der primären Prostatakarzinome überexprimiert wird. PSCA wird als besonders aussichtsreiches Zielantigen einer Immuntherapie bei fortgeschrittenen Prostatakarzinomen angesehen, weil sein Expressionsniveau mit der Tumorprogression und der Entwicklung zum androgenunabhängigen Wachstum ansteigt. In der vorgelegten Arbeit wurde zunächst ein neuer monoklonaler PSCA-spezifischer Antikörper generiert, der als Grundlage für die Konstruktion eines Einzelkettenantikörpers (scFv) verwendet wurde. Aus einem Hybridomklon, der sich durch sehr hohe Bindungsstärke auszeichnete, wurden mittels degenerierter Primer die kodierenden Sequenzen für die variablen VH und VL Domänen des Antikörpers amplifiziert. Durch die Verbindung der beiden VH und VL Domänen mittels eines Linkers wurde der PSCA-spezifische Einzelkettenantikörper generiert. Die mit gereinigtem scFv durchgeführten Bindungsanalysen bestätigten die Funktionalität des rekombinanten Proteins und seine Anwendbarkeit zur Chimerisierung eines membranständigen Rezeptors. Nach dem ?Zwei-Signal-Modell? benötigen T-Zellen für eine effiziente Antigen-spezifische Aktivierung neben dem T-Zell-Rezeptorsignal ein zusätzliches kostimulatorisches Signal. Daher wurden chimäre Rezeptoren auf der Basis der Beta-Kette des T-Zell-Rezeptors und des CD28-Moleküls generiert. Bei der Konstruktion des chimären T-Zell-Rezeptors wurde die konstante Domäne der Beta-Kette mit der CD3 -Kette fusioniert. Neben einer starken Oberflächenexpression des Rezeptors wurde auch die effiziente Bindung von löslichem PSCA nachgewiesen. Die Bindung des Rezeptors an das PSCA führte zur Phosphorylierung der ITAM-Sequenzen der heterodimeren -Kette, was die Funktionalität des chimären Rezeptors bestätigte. Die Stimulation der Zellen über den anti-CD3 Antikörper resultierte ebenfalls in der Phosphorylierung der heterodimeren -Kette, was ein Hinweis auf eine mögliche Interaktion der chimären Kette mit dem endogenen CD3-Komplex lieferte. Um die kostimulatorische Wirkung über das selbe Antigen zu erzielen, wurde das CD28 Molekül N-terminal ebenfalls mit dem Einzelkettenantikörper modifiziert. Die durch Bindung des löslichen Proteins induzierte Phosphorylierung der Akt-Kinase bewies die Funktionalität der chimären CD28 Kette als PSCA-spezifischer Rezeptor. Diese Arbeit demonstriert die Generierung eines hochaffinen PSCA-spezifischen Einzelkettenantikörpers als eine Antigen-erkennende Struktur eines chimären Rezeptors. Die Armierung polyklonaler zytotoxischer T-Lymphozyten mit den funktionsfähigen chimären Rezeptoren stellt den ersten Schritt einer neuen Strategie zur Eliminierung hormon-refrektärer und metastasierender Prostatakarzinomzellen dar.