La maladie d'Alzheimer (MA) est la forme de démence la plus commune. Cette maladie neurodegenerative reliée à l'âge est caractérisée par des pertes de mémoire ainsi qu'une diminution des facultés de planification et de pensée. À ce jour, aucun traitement efficace n'est disponible pour ralentir ou arrêter l'évolution de la maladie. Selon la théorie de la cascade amyloïde, cette maladie, d'apparition héréditaire ou spontanée, serait causée par une accumulation de protéines bêta-amyloïde (Aβ) dans le cerveau des patients. La présence d'oligomères Aβ solubles serait hautement associée à l'accumulation d'enchevêtrements neurofîbrillaires ainsi qu'à une réaction inflammatoire importante. Les microglies sont reconnues comme les cellules immunitaires du cerveau. Pendant la MA, ces cellules sont reconnues pour produire des cytokines pro-inflammatoires et des molécules nocives pour les neurones. Ces cellules seraient cependant très importantes pour l'élimination de l'Aβ par phagocytose et pourrait alors être bénéfiques en empêchant l'évolution de la MA. Une meilleure compréhension des molécules impliquées dans l'activation des cellules microgliales contre les protéines Ap pourrait permettre le développement de nouveaux traitements contre la MA. Nous avons donc démontré que les cellules microgliales exprimaient le Toll-like receptor 2 (TLR2) en réponse à l'Aβ. De plus, plusieurs évidences démontrent aussi que ces récepteurs seraient très importants pour l'élimination de l'Aβ. Nous avons ici utilisé un modèle murin de MA pour démontrer l'importance du récepteur TLR2 ainsi que de la voie de signalisation intracellulaire dépendante de la protéine adaptatrice MyD88 dans l'évolution de la MA. L'importance de l'expression de ces protéines dans les cellules microgliales infiltrant le cerveau chez l'adulte a aussi été démontrée par la production de souris chimériques et par les techniques de thérapie génique, c'est-à-dire par la transduction de cellules de la moelle osseuse par un vecteur lentiviral. Ces résultats ont été obtenus dans le but de connaître davantage l'activation microgliale et l'élimination de l'Aβ du cerveau. Dans un avenir rapproché, ces connaissances nous permettront de moduler le système immunitaire des patients atteints de cette maladie dans le but d'arrêter ou du moins de ralentir sa progression.

L’excitotoxicité est un processus pathologique responsable de la mort neuronale dans plusieurs désordres neurologiques. La mort des neurones par excitotoxicité libère dans le milieu extracellulaire des molécules capables d’activer les microglies adjacentes aux sites lésés. L’activation du système immunitaire suite à une blessure cérébrale est généralement vue comme nocive pour les neurones. Les récepteurs toll-like (TLR) font partie des principaux récepteurs responsables de la reconnaissance des dommages cérébraux après une lésion excitotoxique. Les résultats de ce mémoire démontrent qu’un préconditionnement induit par l’injection systémique d’un ligand TLR2 ou TLR4 permet d’augmenter la survie neuronale face à une lésion excitotoxique. La neuroprotection est dépendante de la signalisation MyD88 et est associée avec une activation microgliale bénéfique. Des souris chimériques pour les cellules de la moelle osseuse ont révélé que la signalisation MyD88 au niveau des cellules résidentes du système nerveux central joue un rôle favorable dans la survie neuronale contre l’excitotoxicité. / Excitotoxicity is a pathological process responsible for the death of neurons as observed in multiple neurological disorders. This process releases danger signals in the extracellular space that alert and activate surrounding microglial cells. Immune system activation following acute brain injury is often considered detrimental, contributing to further neuronal damage. Toll-like receptors (TLR) are among the main receptors that recognize cell damage and initiate an inflammatory response following cell damage. The study presented in this report shows that a systemic injection of a TLR2 or TLR4 agonist induces a state of preconditioning that increases neuron survival against acute excitotoxicity. The neuroprotective effects are associated with a beneficial activation of microglial cells and depend upon MyD88 signaling. Furthermore, bone marrow chimeric mice revealed that MyD88 signaling in cells of the central nervous system has a protective effect against excitotoxicity.

L’interaction entre les cellules souches neuronales et les cellules du système immunitaire lors d’une condition pathologique n’est pas bien caractérisée. D’ailleurs, la communauté scientifique s’interroge sur l’implication des cellules du système immunitaire inné sur la régénérescence du système nerveux central à la suite d’un accident aigu ou d’une maladie neurodégénérative. L’objectif de cette thèse est d’investiguer l’implication d’un récepteur de type Toll, plus précisément le récepteur TLR2, sur la modulation de la neurogenèse lors d’un accident aigu et dans le cadre d’une maladie neurodégénérative. Les récepteurs de type Toll font partie du groupe de récepteurs de reconnaissance de motifs moléculaires (PRR), activés à la suite d’une infection ou d’une blessure. D’ailleurs après une ischémie cérébrale, on peut observer par bioimagerie in-vivo une forte induction du récepteur TLR2. L’expression du récepteur de type TLR2 dans les neurones est principalement associée à deux régions : la région sous-ventriculaire du cerveau antérieur (SVZ) et la région sous-granulaire de l’hippocampe (SGZ). Nestin, une protéine impliquée dans la formation des filaments intermédiaires, est aussi fortement exprimée dans cette région par les cellules souches neuronales. C’est pourquoi nestin est utilisé comme marqueur de neurogenèse. Pour le premier chapitre de ma thèse, nous avons généré un nouveau modèle murin afin d’étudier la neurogenèse avec l’imagerie par bioluminescence. En effet, la souris Nestin-luc/GFP s’avère un excellent modèle qui permet de suivre l’expression de nestin dans les cellules progénitrices neuronales (NPCs) après une ischémie cérébrale en temps réelle. Une forte expression de nestin fut observée par imagerie à 1, 3 et 7 jours suivant l’ischémie cérébrale. Pour le deuxième chapitre de ma thèse, nous avons estimé la population des cellules progénitrices neuronales chez les souris TLR2 KO à la suite d’une ischémie cérébrale. Chez ces souris, nous avons pu observer par immunofluorescence une baisse significative du nombre de cellules progénitrices neuronales dans la région du SVZ et du SGZ. Ceci suggère que la présence du récepteur TLR2 est nécessaire afin de maintenir la survie des NPCs suite à une ischémie cérébrale. Pour le troisième chapitre de ma thèse, nous avons caractérisé un modèle murin de démence fronto-temporale (FTLD), la souris TDP-43A315T. Afin de mieux comprendre le rôle du récepteur TLR2 lors de la neurodégénérescence nous avons croisé la souris TLR2-luc/GFP à la souris TDP-43A315T. Dans ce modèle murin de FTLD, les symptômes cognitifs apparaissent vers l’âge de 7 à 8 mois et sont associés à une forte activation du récepteur TLR2. De plus, toujours grâce à l’imagerie in-vivo effectuée durant les 36 premiers mois de leur vie, on a pu observer des niveaux supérieurs d’activation du récepteur TLR2 durant la phase pré-symptomatique de la maladie comparée à la phase post-symptomatique. Par la suite, à l’aide de marqueurs de neurogenèse (Nestin, DCX et Ki-67) un nombre de NPCs plus élevé fut observé par immunofluorescence chez les souris plus jeunes ce qui suggère une corrélation entre le niveau d’activation du récepteur TLR2 et la neurogenèse. En se basant sur ces évidences, je peux conclure que ma thèse a démontré l’importance de la voie signalétique du récepteur TLR2 après un accident cérébrale aigu et lors de troubles neurodégénératifs. / Interaction between neural progenitors and immune cells under pathological conditions is not well understood. Still now researchers debate role of innate immune cells in the regeneration of central nervous system following acute injury and neurodegeneration. Our aim is to investigate the role of Toll-like receptors in the modulation of neurogenesis followed by acute and chronic neurodegeneration. Nestin, an intermediate filament protein, is expressed by neural stem and progenitor cells. Nestin is considered as a potential marker for neurogenesis. The two neurogenic niches of the brain, sub ventricular zone (SVZ) and sub granular zone (SGZ) produce neural stem cells throught the life. We have characterized transgenic mice to study neurogenesis by in vivo bioluminescence imaging. Our mouse model Nestin-luc/GFP mouse is an excellent tool to track the neural progenitors expression after stroke. In vivo bioluminescence imaging revealed that robust expression of nestin signal at 1 day, 3 days and 7 days following stroke. Toll like receptors are the member of pattern recognition receptors, they activated upon infection and injury. In recent years, expression of toll like receptors in neuronal cells is well established in the two neurogenic regions of the brain. Activation of TLR-2 signal has been observed previously by in vivo imaging followed by stroke. Stroke induced neurogenesis is well characterised in these two neurogenic regions. Secondly, we have studied the role of TLRs in the modulation of neurogenesis followed by ischemia. In the TLR2KO transgenic mice, following cerebral ischemia, neural progenitors population were declined in both neurogenic regions compared to the wild type mice indicating TLR2 is necessary for the survival of neural progenitors in the ischemic brain. TDP-43A315T is a transgenic mouse is valid mouse model of Fronto temporal dementia. The onset of symptom will start at the age of 7-8 months. In this mouse, we have seen the higher expression of TLR2 in comparison to the wild type mice. Regarding the pivotal role of TLR2 signalling in neurodegeneration, we have studied their impact on neurogenesis in the FTLD mouse model. In TLR-2 GFP/luc X TDP- 43A315T mice mouse model, TLR-2 expression was studied by in vivo imaging from 3months to 36 months. Longitudinal in vivo imaging showed an elevation of TLR2 signal in the pre-symptomatic phase of disease when compared to the post symptomatic transgenic mice. Next we have done an immunofluorescence analysis to estimate the NPGs population in the young and old mice. Up regulation of neurogenesis markers such as nestin, DCX and Ki-67 were observed in the young transgenic mice compared to the old mice which suggesting that TLR2 mediates the modulation of neurogenesis. In this thesis work first, we have developed a mouse model to study neurogenesis by in vivo imaging. Secondly we have showed the importance of TLR2 in the regulation of neurogenesis after ischemia induction. Finally, mediation of TLR2 in the neurodegeneration and neurogenesis was observed. Our results showed the importance of TLR2 signalling in the brain following acute and chronic neurodegenerative conditions.

Les neutrophiles jouent un rôle important dans les défenses immunitaires contre l'invasion des bactéries et des virus. Cette fonction est facilitée par l'expression de divers récepteurs à la surface des neutrophiles dont les récepteurs Toll-like (TLR). Les TLR reconnaissent des motifs moléculaires associés à des pathogènes (PAMP) qui sont exprimés sur les agents infectieux, et leur activation induit la médiation de la production de cytokines nécessaires pour le réponse immunitaire efficace. Les neutrophiles expriment divers TLR comme par exemple le TLR1/2 qui est activé par les composants de bactéries Gram-positives comme les peptidoglycane et les lipopeptides, . En plus des TLRs, les neutrophiles expriment des récepteurs P2, qui sont activés par des nucléotides extracellulaires. Plusieurs évidences montrent que les récepteurs P2 régulent des réponses pro-inflammatoires importantes chez le neutrophile. De plus, l'adhérence des neutrophiles à l'endothélium est médiée par une classe de protéines membranaires appelé intégrines dont l’antigène Macrophage-1 (ou αMβ2 intégrine) qui est un récepteur du complément (« CR3 ») composé de CD11b (intégrine αM) et CD18 (intégrine β2). Mac-1 (CD11b/CD18) est l'une des molécules d'adhésion importantes qui régule l'adhérence des neutrophiles à l'endothélium. Des études antérieures ont montré que les récepteurs P2 sont impliqués dans la migration des neutrophiles via la stimulation de la libération de chimiokines. Dans cette maîtrise nous avons cherché à savoir si ces récepteurs sont impliqués dans ces réponses induites par l’activation du TLR1/2. En accord avec un rôle des récepteurs P2, l'induction de l’adhérence des neutrophiles stimulées par un agoniste du TLR1/2 était inhibées par les antagonistes des récepteurs de P2, la suramine et le réactif bleu 2 (RB-2). La participation des récepteurs P2Y4 P2Y1, P2Y6 et P2Y11 ont été exclus avec des antagonistes sélectifs. Comme il n'y a pas d'antagoniste spécifique du récepteur P2Y2, un agoniste spécifique non hydrolysable pour P2Y2 à savoir PSB1114 a été utilisé. PSB1114 a régulé à la hausse l'expression de Mac-1 à la surface des neutrophiles, indiquant que P2Y2 est impliqué dans cette régulation. En outre, UTP et l'ATP, les ligands naturels du P2Y2 ont potentialisés fortement cette réponse induite par un agoniste du TLR1/2 (Pam3CSK4) à faible concentration. Cependant l'ATP et UTP seul ont induit une réponse modéré sur l'adhésion des neutrophiles sur une plaque coaté avec du fibrinogène. Nos résultats suggèrent que le récepteur P2Y2 contrôlent l’induction de l’expression de Mac-1 induite par le TLR1/2 in vitro et nous avons aussi confirmé que tel que nous nous attendions le P2Y2 contrôlait aussi l’adhesion des neutrophiles. / Neutrophils play an important role in immune defences against invading bacteria and viruses. This function is facilitated by the expression of Toll-like receptor (TLR) family members by neutrophils. TLRs recognize pathogen-associated molecular patterns (PAMPs) that are expressed on infectious agents, and mediate the production of cytokines necessary for the development of effective immunity. Neutrophils express various TLRs. For example TLR1/2 is activated by peptidoglycan and lipopeptide, components of Gram-positive bacteria. In addition to TLR, neutrophil express P2 receptors, those are activated by extracellular nucleotides. There is growing evidence indicating that P2 receptors mediate some important pro-inflammatory responses. Moreover, neutrophil adhesion to endothelium is mediated by a class of membrane proteins called integrins. Macrophage-1 antigen (or integrin αMβ2) is a complement receptor ("CR3") consisting of CD11b (integrin αM) and CD18 (integrin β2) Mac-1(CD11b/CD18 is one of the important adhesion molecules that mediate neutrophil adhesion to the endothelium. Previous studies showed that P2 receptors are involved in neutrophil migration via stimulation of chemokine release and by facilitating chemoattractant gradient sensing. Here, we have investigated whether these receptors are involved in TLR1/2-induced neutrophil activation and adhesion. In line with a role of P2 receptors, neutrophil activation and adhesion induced by a TLR1/2 agonist were inhibited by the P2 receptor antagonists, suramin and reactive blue 2 (RB-2). The involvement of P2Y4 was unlikely as this receptor is insensitive to suramin while P2Y1, P2Y6 and P2Y11 were excluded with selective antagonists. As there is no specific antagonist for P2Y2 receptor, a non-hydrolysable specific agonist for P2Y2 namely PSB1114 was used. PSB1114 up-regulates surface expression of Mac-1 a result that suggests that P2Y2 involved in the regulation of Mac-1. Moreover, UTP and ATP, the natural P2Y2 ligands, markedly potentiated TLR1/2 agonist-induced neutrophil adhesion. Interestingly, ATP and UTP without Pam3CSK4 stimulation have shown a moderate effect on neutrophil adhesion in fibrinogen adhesion assay. Our data suggest that P2Y2 receptors control the TLR1/2 agonist-induced neutrophil adhesion in vitro via up regulation of Mac-1.

Les pDCs répondent aux infections virales par la production d'IFN-α. L'élimination du virus de l'hépatite C (VHC) chez plus de 50% des patients infectés par le traitement à l'IFN-alpha suggère que les pDCs jouent un rôle majeur dans le contrôle de l'infection VHC. Les pDCs exposées aux hépatocytes infectés par VHC, produisent beaucoup d'IFN-α. Néanmoins, en dépit de cette production par TLR7 par les pDCs, VHC continue à se répliquer dans le foie infecté. J'ai approfondi les connaissances des mécanismes moléculaires d'exploration des particules de VHC et des cellules infectées par le VHC par les pDCs. J'ai ciblé ma recherche sur le contact des particules de VHC avec la surface des pDCs, sur la voie de signalisation de déclenchée, sur leur effet sur la production des IFNs et des cytokines proinflammatoires et sur la différenciation cellulaire. Nos résultats suggèrent que le virus associé aux cellules signalise dans les pDCs via un mécanisme dépendant de l'endocytose et d'IRF7 mais pas de la voie NF-κB. En dépit de l'induction d'IFN-α, le VHC associé aux hépatocytes n'induit une réponse pleinement fonctionnelle des pDCs. Les particules virales de VHC inhibent, via la fixation de la glycoprotéine E2 aux CLRs, la production d'IFN-α et d'IFN-λ dans les pDCs exposées aux hépatocytes infectés par VHC et induisent dans les pDCs, une phosphorylation rapide d'Akt et Erk1/2, d'une manière similaire au crosslinking de BDCA-2 ou DCIR. Ainsi, le blocage de BDCA-2 et de DCIR avec des fragments Fab des anticorps monoclonaux préserve la capacité des pDCs à produire des IFNs de type I et III en présence des particules virales. / Plasmacytoid dendritic cells (pDCs) respond to viral infection by production of alpha interferon (IFN-alpha), proinflammatory cytokines, and cell differentiation. The elimination of hepatitis C virus (HCV) in more than 50% of infected patients by treatment with IFN-alpha suggests that pDCs play an important role in the control of HCV infection. pDCs exposed to HCV infected hepatoma cells produce large amounts of IFN-alpha. However, despite large amounts of Toll-like receptor 7-mediated IFN-α, produced by pDCs, HCV still replicates in infected liver. During my PhD training, I went into in depth to understand the molecular mecanisms used by HCV particles and HCV infected hepatocytes to explore pDCs. I focused my research on the binding of HCV particles with the pDC surface, on the triggered downstream signaling pathway, on the cellular differentiation. Our results suggest that cell-associated HCV signals in pDCs via an endocytosis-dependent mechanism and IRF7 but not via the NF-kappaB pathway. In spite of IFN-alpha induction, cell-associated HCV does not induce a full functional response of pDCs. HCV particles inhibit, via binding of E2 glycoprotein to CLRs, production of IFN-α and IFN-λ in pDCs exposed to HCV-infected hepatocytes, and induce in pDCs a rapid phosphorylation of Akt and Erk1/2, in a manner similar to the crosslinking of BDCA-2 or DCIR. Blocking of BDCA-2 and DCIR with Fab fragments of monoclonal antibodies preserves the capacity of pDCs to produce type I and III IFNs in the presence of HCV particles.

As oncoproteínas E6 e E7 do Papilomavírus Humano (HPV) estão envolvidas na desregulação do sistema imune inato, provocando alterações na expressão dos receptores do tipo Toll (TLR). Considerando-se a função da via de sinalização iniciada por TLR, haveria uma vantagem para o vírus capaz de manipular a resposta desta via de modo que possa persistir nas células sem ser detectado pelo sistema imune ou ainda modulando essa resposta e criando um ambiente mais propício à manutenção da infecção. No entanto, muitos dos mecanismos que levam à eliminação da infecção ou persistência do HPV ainda são pouco conhecidos. O objetivo principal desse trabalho é investigar o papel das vias de TLR no processo de carcinogênese mediado por HPV. Inicialmente, foi analisada a expressão de genes da via de TLR em linhagens de tumores cervicais e em células expressando as oncoproteínas virais. Foram identificados vários genes diferencialmente expressos entre linhagens de células tumorais e queratinócitos normais, incluindo moléculas adaptadoras da via de TLR e genes associados à via da MAP quinase, ativação de NFkappaB e resposta imune antiviral. Cerca de 90% destes genes foram regulados negativamente. Entre eles, destacamos HMGB1, que apesar de possuir menos RNAm nas células tumorais possui um nível proteico muito maior, além de ter-se mostrado de grande importância para a viabilidade e proliferação das células tumorais, conforme demonstrado através de experimentos de supressão gênica. Em conjunto, os nossos dados indicam que E6 e E7 de HPVs de alto risco inibem proteínas da via de sinalização de TLR / Previous studies have shown that E6 and E7 HPV oncoproteins are involved in innate immune system dysregulation, causing alterations on Toll-like receptors (TLR) expression. Considering TLR pathway function, it would be advantageous for a virus to manipulate the response of this pathway so it can persist in cells without being detected by the immune system or to modulate this response to create a better environment for persistence of infection. However, many of the mechanisms leading to HPV infection clearance or persistence are still unknown and matter of active investigation. We analyzed in cervical cancer cell lines expression of genes from TLR pathway; several were differentially expressed between tumor cells lines and normal keratinocytes, including TLR adaptors molecules and genes associated with MAP kinase pathway, NFkappaB activation and antiviral immune response. About 90% of these genes were down regulated. Among them, we selected HMGB1 for further characterization due to its interference with tumor cell viability and proliferation. Altogether, our data indicate that high risk HPV E6 and E7 can inhibit TLR signaling pathway

Seres humanos dependem incessantemente de um sistema de reconhecimento efetivo contra infecções para sobreviver. Dentre as diversas proteínas que compõem a resposta imune inata estão os receptores do tipo Toll (TLR Toll-like Receptors), que possuem a função de reconhecer padrões moleculares associados a patógenos e dar início a uma resposta imune adequada. O carcinoma do colo uterino é uma das principais causas de morte de mulheres por câncer mundialmente, sendo o terceiro tipo de câncer mais comum entre mulheres. Este tipo de neoplasia é vinculada etiologicamente à infecção pelo Papilomavírus humano (HPV). Dentre as principais proteínas virais, E6 e E7 são responsáveis pela manipulação dos processos celulares para promover ciclo viral, sendo essenciais no processo de transformação celular. Nesse contexto, o objetivo deste trabalho foi investigar a importância da via de sinalização de TLRs sobre a infecção por HPV. O polimorfismo rs5743836, na região promotora de TLR9, capaz de alterar a expressão deste receptor, foi estudado quanto à influência sobre a história natural da infecção por HPV em uma coorte de mulheres brasileiras; nenhuma associação relevante foi encontrada, indicando que este polimorfismo não interfere significativamente na resposta à infecção e risco de desenvolvimento de lesões no colo do útero causadas por HPV. Proteínas componentes da via de TLRs demonstraram serem alvos de interação com E6 de HPV16; dentre elas, o notável adaptador MyD88 e IKKε, enzima ativadora de importantes transfatores do sistema imune. Estas interações foram aqui estudadas. A interação de E6 com MyD88 resultou em estabilização da proteína viral, o que parece não depender do sítio LxxLL presente em MyD88, como ocorre com outros parceiros moleculares de E6. O sítio de interação de E6 com IKKε coincide com a região onde se localiza o sítio catalítico desta enzima, sugerindo a ação de E6 na ativação de proteínas alvo de IKKε. Esta interação foi observada em queratinócitos, células alvo das infecções por HPV. A produção de citocinas foi afetada por E6 de HPV16, resultando num aumento da quantidade de IL-8 e IL-6; a indução desta citocina poderia ser explicada pela ativação de IKKε. Estes resultados apontam para a capacidade do HPV16 de interferir com o sistema imune, contribuindo para o processo de carcinogênese. / Humans constantly rely on an effective recognition system against infections in order to survive. Among various proteins that compose the innate immune response, Toll-like Receptors (TLRs) have the role to recognize pathogen associated molecular patterns and initiate a proper immune response. The cervical cancer is one of the main causes of women death worldwide, being the third most common cancer type among women. This type of neoplasia is etiologically associated with the Human papillomavirus (HPV) infection. E6 and E7, two main viral proteins, are responsible for manipulating the cellular processes to promote the virus\' life-cycle, being essential to the cellular transformation process. In the context, the objective of this work was to investigate the relevance of the TLR signaling pathway on the HPV infection. The rs5743836 polymorphism, in the TLR9 promoter region, capable of altering this receptor\'s expression, was studied regarding its influence on the natural history of HPV infection in a Brazilian women cohort; no relevant association was found, indicating that this polymorphism does not interfere significantly in the infection response and risk of developing cervix lesions caused by HPV. Component proteins of TLR pathway were shown to be interaction targets of HPV16 E6; among them, the notable adaptor MyD88 and IKKε, enzyme that activates important immune system transfactors. These interactions were studied in this work. The interaction of E6 with MyD88 resulted in the stabilization of the viral protein, which seems independent of the LxxLL site present on MyD88, as in other E6 molecular partners. The interaction site on IKK with E6 matches with the region containing the enzyme\'s catalytic site, suggesting an influence of E6 in the activation of IKKε target proteins. This interaction was observed in keratinocytes, natural targets of HPV infections. The cytokines production was altered by HPV16 E6, resulting in an increase of IL-8 and IL-6 concentration; the induction of the latter could be explained by the activation of IKKε. These results point to the ability of HPV16 of interfering with the immune system, contributing to the carcinogenesis process.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / nÃo hà / Paclitaxel (PCX) foi o 1 antineoplÃsico efetivo no tratamento de cÃnceres refratÃrios a quimioterapia convencional. Clinicamente, induz artralgias e mialgias de carÃter incapacitante que comprometem a qualidade de vida e limitam o tempo de tratamento antitumoral, acometendo atà 57% dos doentes. Apesar destas repercussÃes clÃnicas nada foi descrito atà o momento, visando elucidar o envolvimento de citocinas prÃ-inflamatÃrias, na gÃnese da atividade hipernociceptiva do PCX, jà que a droga compartilha com o LPS uma via de sinalizaÃÃo desencadeada por receptores Toll (TLR-4 e TLR-2) para geraÃÃo de genes que codificam TNF-&#945;. Dados da literatura sugerem que ocorra um âcross-talkâ entre esses dois membros da famÃlia Toll e, que agonistas diferentes de TLR-2 e TLR-4 sÃo capazes de induzir a ativaÃÃo de NF-&#945;B, AP1 e MAP kinase e a geraÃÃo de TNF-&#945;, citocina chave na cascata de liberaÃÃo de mediadores inflamatÃrios finais que atuam diretamente no nociceptor. Dados do laboratÃrio registraram que o zymosan (ZY) intrarticular em joelhos de ratos produz uma periartrite caracterÃstica da hipernocicepÃÃo no teste de incapacitaÃÃo articular (IA), e que PCX (8mg/kg) amplificou essa resposta quando se injetou  da dose do ZY. Tal amplificaÃÃo foi inibida com o prÃ-tratamento com inibidores de citocina e de prostanÃides. Objetivo. Investigar a participaÃÃo do TLR-4 e TNF-&#945; na gÃnese do efeito potencializador do PCX na artralgia experimental induzida por ZY. Material e MÃtodos. Ratos foram prÃ-tratados Sc com talidomida (TLD), pentoxifilina, dexametasona, indometacina ou celecoxib e estimulados com subdose de ZY (250&#956;g/animal; i-art). ApÃs a 1 medida do tempo de suspensÃo de pata (TSP) no teste de IA, os animais receberam PCX (8mg/kg; ip). Numa segunda etapa os ratos receberam durante trÃs dias consecutivos o prÃ-tratamento com atorvastatina (3, 10, 30mg/kg/dia; VO). Os seguintes parÃmetros foram avaliados: modulaÃÃo da hipernocicepÃÃo no teste de incapacitaÃÃo articular, dosagem de citocinas em lavado de joelho de ratos (TNF-&#945;, IL-1&#945;, Il-6, KC e CINC) e imunohistoquÃmica para TNF-&#945;, IL-1&#945; e TLR-4 no tecido sinovial. Resultados. Ficou demonstrado que PCX (8mg/kg) potencializa a artralgia experimental induzida por ZY em ratos avaliada pelo aumento significativo do TSP (p<0,001) na 4Âh de artrite em relaÃÃo ao controle no teste de IA. Tal efeito foi inibido de maneira significativa pelo prÃ-tratamento com TLD (45mg/kg) e essa inibiÃÃo foi associada à reduÃÃo dos nÃveis de TNF-&#945; produzido pelas cÃlulas do tecido sinovial no lavado articular e da marcaÃÃo imunohistoquÃmica para TNF-&#61537;. Da mesma forma a inibiÃÃo dessa resposta amplificadora do PCX foi ratificado pelo prÃ-tratamento com atorvastatina nas trÃs doses utilizadas no modelo, tambÃm sendo associado à diminuiÃÃo significativa dos nÃveis de TNF-&#61537; no lavado articular e visÃvel reduÃÃo na marcaÃÃo imunohistoquÃmica para TNF-&#61537;, IL-1&#61538; e TLR-4, nas trÃs doses utilizadas. ConclusÃes. PCX potencializa a hipernocicepÃÃo induzida por ZY por um mecanismo indireto sobre cÃlulas residentes da membrana sinovial que liberam TNF-&#61537; provavelmente pela ativaÃÃo da NF-&#61547;B via TLR-4/MD2, pois esse efeito potencializador foi inibido pela atorvastatina, um provÃvel antagonista de TLR-4. O TNF-&#61537; liberado age iniciando a cascata de mediadores envolvidos com a dor inflamatÃria, o que justifica em parte as artralgias dos pacientes em tratamento com PCX. / Paclitaxel (PCX) was the first effective antineoplastic medicine in the treatment of tumors that do not respond to conventional chemotherapy. Clinically, it induces incapacitating arthralgias and myalgias that interfere with the patient quality of life and limit the duration of the treatment. This is observed in up to 57% of the patients using the drug. Despite these clinical manifestations, nothing has been published that could explain the involvement of pro-inflammatory cytokines in the triggering of the hypernociceptive effect of PCX, even though it is known that the drug shares with LPS a signaling pathway started by Toll-like receptors (TLR-2 and TLR-4) that activates genes coding for TNF-&#945;. The literature suggests that there is a crosstalk between these two members of the Toll family and that different agonists of TLR-2 and TLR-4 are able to induce the activation of NF-kB, AP1 and MAP kinase in the generation of TNF-&#945;, a key cytokines in the cascade liberating the final inflammatory mediators that act directly on the nociceptor. Data obtained in laboratory show that the injection of zymozan into rat knee-joints produces a periarthritis characteristic of the hypernociception seen in the knee joint incapacitation test and that PCX (8mg/kg) amplified the response when  of the zymozan (ZY) doses was injected. The amplification was inhibited when animals were pre-treated with inhibitors of cytokines and prostanoids. Objective: To study the role of TNF-&#945; and TLR-4 on the initiation of the potentiating effect of PCX on the experimental arthralgia induced by ZY. Material and Methods: Rats were pre-treated Sc with thalidomide, pentoxifiline, dexametazone, indometacin and celecoxib and then stimulated with an intra-articular subdoses of ZY (250&#956;g/animal). After the first measurement of the paw elevation time in the knee joint incapacitation test, the animals were treated with PCX (8mg/kg ip). On a second trial, rats were treated for three consecutive days with atorvastatin (3, 10, 30mg/kg/day; VO). The following parameters were evaluated: modulation of the effect on the knee joint incapacitation test (JIT), amount of cytokines in the ratâs knee lavage (TNF-&#945;, IL-1 &#946;, IL-6, KC and CINC) and immunohistochemistry for TNF-&#945;, IL-1&#946; and TLR-4 on synovial tissue. Results: It was shown that PCX (8mg/kg) potentiates the experimental arthralgia induced by ZY in the rats as evaluated by the significant increase in paw elevation time (p<0.001) at the 4th h of arthritis in relations to controls. Such effect was significantly inhibited by pre-treatment with thalidomide (45mg/kg) and the inhibition was associated with a decrease in the amount of TNF-&#945; produced by synovial tissue cells and detected in the joint lavage and in the immunohistochemistry for TNF-&#945;. Likewise the inhibition of the amplifying response to PCX was seen with pre-treatment with atorvastatin at the three doses used in the experiment, which was also associated with a lower TNF-&#945; in the joint lavage and perceptible decrease in the immunohistochemistry for TNF-&#945;, IL-1&#946; and TLR-4. Conclusions: PCX potentiates the hypernociception induced by ZY through an indirect effect on synovial membrane resident cells that release TNF-&#945; probably through activation of the NF-kB pathway by TLR-4/MD2, since the potentiating effect was inhibited by atorvastatin, a TLR-4 antagonist. Released TNF-&#945; act starting the cascade of mediators involved in the inflammatory pain and this partially explains the arthralgia in patients treated with PCX.

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