Identification de nouveaux facteurs de régulation physiopathologique de la NADPH oxydase du neutrophile : Importance de mTOR, de la dégradation de NOX2 via l’élastase et perspectives de traitement des déficits induits au cours de la cirrhose alcoolique

Superoxide anion (O2-) production by NADPH oxidase 2 (NOX2) complex of polymorphonuclear neutrophil (i.e respiratory burst, RB) contributes to efficient elimination of pathogens. This defense function is stimulated by various pro-inflammatory agents, especially by bacterial peptides (fMLP) which trigger a signaling cascade involving many protein kinases (PKC, AKT, MAP-Kinases) resulting in activation of NOX2, also called gp91phox, the catalytic core of the complex. In this thesis, I identified the protein kinase mTOR as a novel major RB effector of healthy neutrophils and I compared its transductional activity in neutrophils from patients suffering from alcoholic decompensated liver cirrhosis, aiming at understanding their high susceptibility to bacterial infections.A major contribution of mTOR to fMLP-induced neutrophil superoxide production was demonstrated using its specific drug antagonist Rapamycin, and by an antisens strategy. mTOR is activated upstream of p38-MAPK which phosphorylates p47phox, a major component of the NADPH oxidase complex. In neutrophils from cirrhotic patients, the RB is dramatically impaired and this was associated with a deficient activation of the p38-MAPK/p47phox(S345) signaling pathway. This RB deficiency was aggravated by Rapamycin. Neutrophils from cirrhotic patients also exhibited a deficient expression of gp91phox (NOX2), p22phox, p47phox and mTOR. A deficient NOX2 expression can be reproduced by treating healthy neutrophils with fMLP or plasma from cirrhotic patients. Furthermore, this phenomenon involved an unexpected proteolytic degradation of gp91phox mediated by elastase. Finally, this deficient superoxide production by neutrophil from cirrhotic patients can be corrected ex vivo in isolated neutrophils and in patients’ whole blood, using a Toll-like receptor agonist that acts by promoting the transcription and traduction of gp91phox .In conclusion, mTOR emerges as a novel and major signaling effector of neutrophil RB, promoting the activation of p47phox/gp91phox through MAPKs. This novel signaling pathway is strongly impaired during alcoholic liver cirrhosis, which increases patients’ susceptibility to bacterial infections. Although our study raises concerns about the use of mTOR inhibitors in immunocompromised patients, it also provides therapeutic propects for correcting neutrophil functional deficiencies using agents capable of stimulating intracellular TLR .La production d’anion superoxyde (O2-) par le complexe NADPH oxydase 2 (NOX2) du polynucléaire neutrophile (explosion oxydative, EO) contribue à l’élimination d’agents pathogènes. Cette fonction de défense est stimulée par divers agents pro-inflammatoires, notamment par des peptides bactériens (fMLP), qui déclenchent une cascade de signalisation impliquant différentes protéines kinases (PKC, AKT, MAP-Kinases) et aboutissant à l’activation de la NOX2 (également nommée gp91phox), le coeur catalytique du complexe. Dans cette thèse, j’ai identifié la protéine kinase mTOR comme un nouvel effecteur majeur de l’EO dans les neutrophiles sains et j’ai comparé son mode d’action transductionnel dans les neutrophiles de patients ayant une cirrhose alcoolique décompensée en vue de comprendre leur grande susceptibilité aux infections bactériennes.Une contribution majeure de mTOR dans la production d’O2- induite par le fMLP a pu être démontrée à l’aide de son antagoniste spécifique, le médicament Rapamycine et par une approche antisense. mTOR agit en amont de la p38-MAPK qui phosphoryle la p47phox, un composant majeur du complexe NADPH oxydase. Dans les neutrophiles de patients cirrhotiques, l’EO est fortement défaillante, associée à un défaut d’activation de la voie p38-MAPK/p47phox(S345). Ce déficit d’EO est aggravé par la Rapamycine. Les neutrophiles de patients cirrhotiques présentent également un déficit d’expression de la gp91phox (NOX2), p22phox, p47phox et mTOR. Un déficit d’expression de la NOX2 a pu être reproduit en traitant les neutrophiles sains par le fMLP ou du plasma des patients. De plus, ce phénomène met en jeu une dégradation protéolytique insoupçonnée de la gp91phox impliquant l’élastase. Enfin, la déficience fonctionnelle des neutrophiles de patients a pu être corrigée dans des neutrophiles isolés et dans du sang total des patients cirrhotiques à l’aide d’un agoniste de récepteurs « Toll-like receptor (TLR) » qui agit en favorisant la transcription du gène de la gp91phox et sa synthèse protéique.En conclusion, mTOR émerge comme un nouvel effecteur transductionnel majeur de l’EO des neutrophiles, favorisant l’activation de la voie p47phox/gp91phox via les MAPK. Cette nouvelle voie de signalisation est fortement impactée au cours de la cirrhose alcoolique, ce qui favorise la susceptibilité des patients aux infections bactériennes. Bien que notre étude soulève ainsi des inquiétudes quant à l’utilisation d’inhibiteurs de mTOR chez les patients immunodéprimés, elle suscite par ailleurs la perspective de pouvoir corriger les déficits fonctionnels des neutrophiles à l’aide d’agents capables de stimuler des TLR intracellulaires

Isoprenylcysteine Carboxylmethyltransferase-Based Therapy for Hutchinson-Gilford Progeria Syndrome.

Hutchinson-Gilford progeria syndrome (HGPS, progeria) is a rare genetic disease characterized by premature aging and death in childhood for which there were no approved drugs for its treatment until last November, when lonafarnib obtained long-sought FDA approval. However, the benefits of lonafarnib in patients are limited, highlighting the need for new therapeutic strategies. Here, we validate the enzyme isoprenylcysteine carboxylmethyltransferase (ICMT) as a new therapeutic target for progeria with the development of a new series of potent inhibitors of this enzyme that exhibit an excellent antiprogeroid profile. Among them, compound UCM-13207 significantly improved the main hallmarks of progeria. Specifically, treatment of fibroblasts from progeroid mice with UCM-13207 delocalized progerin from the nuclear membrane, diminished its total protein levels, resulting in decreased DNA damage, and increased cellular viability. Importantly, these effects were also observed in patient-derived cells. Using the Lmna G609G/G609G progeroid mouse model, UCM-13207 showed an excellent in vivo efficacy by increasing body weight, enhancing grip strength, extending lifespan by 20%, and decreasing tissue senescence in multiple organs. Furthermore, UCM-13207 treatment led to an improvement of key cardiovascular hallmarks such as reduced progerin levels in aortic and endocardial tissue and increased number of vascular smooth muscle cells (VSMCs). The beneficial effects go well beyond the effects induced by other therapeutic strategies previously reported in the field, thus supporting the use of UCM-13207 as a new treatment for progeria.This work was supported by grants from The Progeria Research Foundation (PRF 2016-65) and the Spanish MINECO (PID2019-106279RB-I00, PID2019-108489RBI00). The authors thank Fundación La Caixa (A.G.), CEI Moncloa (N.I.M.-R.), MINECO (F.J.O.-N. and M.B.) and Ministerio de Ciencia, Innovación y Universidades (N.K.-F.) for predoctoral fellowships. The authors thank C. López-Otín for kindly donating LmnaG609G/G609G progeroid and their corresponding wild-type fibroblasts and UCM’s CAIs Cytometry and Fluorescence Microscopy, Genomics, NMR, and Mass Spectrometry, for their assistance. The CNIC is supported by the Ministerio de Ciencia e Innovación, the Instituto de Salud Carlos III, and the pro-CNIC Foundation, and is a Severo Ochoa Center of Excellence (grant SEV-2015- 0505). The generation of the antiprogerin antibody was funded by the Wellcome Trust (098291/Z/12/Z to S.N.).S

Distinct Compartmentalization of the Chemokines CXCL1 and CXCL2 and the Atypical Receptor ACKR1 Determine Discrete Stages of Neutrophil Diapedesis.

Neutrophils require directional cues to navigate through the complex structure of venular walls and into inflamed tissues. Here we applied confocal intravital microscopy to analyze neutrophil emigration in cytokine-stimulated mouse cremaster muscles. We identified differential and non-redundant roles for the chemokines CXCL1 and CXCL2, governed by their distinct cellular sources. CXCL1 was produced mainly by TNF-stimulated endothelial cells (ECs) and pericytes and supported luminal and sub-EC neutrophil crawling. Conversely, neutrophils were the main producers of CXCL2, and this chemokine was critical for correct breaching of endothelial junctions. This pro-migratory activity of CXCL2 depended on the atypical chemokine receptor 1 (ACKR1), which is enriched within endothelial junctions. Transmigrating neutrophils promoted a self-guided migration response through EC junctions, creating a junctional chemokine "depot" in the form of ACKR1-presented CXCL2 that enabled efficient unidirectional luminal-to-abluminal migration. Thus, CXCL1 and CXCL2 act in a sequential manner to guide neutrophils through venular walls as governed by their distinct cellular sources.This work was supported by funds from the British Heart Foundation (FS/14/3/30518 to T.G. and S.N.), the People Programme (Marie Curie Actions) of the EU’s 7th Framework Programme (FP7/2007-2013) under REA grant agreement 608765 (to T.G. and S.N.), and by the Wellcome Trust (098291/Z/12/Z to S.N.). D.S. is supported by the CNIC, SAF2016-79040-R from the Spanish Ministerio de Ciencia, and ERC-2016-CoG 725091 from the European Research Council. M.T. and A.R. are supported by the Sinergia grant CRSII3_160719 of the Swiss National Science Foundation. G.G. is supported by the Wellcome Trust and the MRC. U.H.v.A. and A.T. are supported by the Ragon Institute of MGH, MIT and Harvard and the HMS Center for Immune Imaging

Identification of novel physiopathological factors regulating the neutrophil NADPH oxidase : Importance of mTOR, elastase-mediated NOX2 degradation and prospects for treatment of liver cirrhosis-induced deficiencies

La production d’anion superoxyde (O2-) par le complexe NADPH oxydase 2 (NOX2) du polynucléaire neutrophile (explosion oxydative, EO) contribue à l’élimination d’agents pathogènes. Cette fonction de défense est stimulée par divers agents pro-inflammatoires, notamment par des peptides bactériens (fMLP), qui déclenchent une cascade de signalisation impliquant différentes protéines kinases (PKC, AKT, MAP-Kinases) et aboutissant à l’activation de la NOX2 (également nommée gp91phox), le coeur catalytique du complexe. Dans cette thèse, j’ai identifié la protéine kinase mTOR comme un nouvel effecteur majeur de l’EO dans les neutrophiles sains et j’ai comparé son mode d’action transductionnel dans les neutrophiles de patients ayant une cirrhose alcoolique décompensée en vue de comprendre leur grande susceptibilité aux infections bactériennes.Une contribution majeure de mTOR dans la production d’O2- induite par le fMLP a pu être démontrée à l’aide de son antagoniste spécifique, le médicament Rapamycine et par une approche antisense. mTOR agit en amont de la p38-MAPK qui phosphoryle la p47phox, un composant majeur du complexe NADPH oxydase. Dans les neutrophiles de patients cirrhotiques, l’EO est fortement défaillante, associée à un défaut d’activation de la voie p38-MAPK/p47phox(S345). Ce déficit d’EO est aggravé par la Rapamycine. Les neutrophiles de patients cirrhotiques présentent également un déficit d’expression de la gp91phox (NOX2), p22phox, p47phox et mTOR. Un déficit d’expression de la NOX2 a pu être reproduit en traitant les neutrophiles sains par le fMLP ou du plasma des patients. De plus, ce phénomène met en jeu une dégradation protéolytique insoupçonnée de la gp91phox impliquant l’élastase. Enfin, la déficience fonctionnelle des neutrophiles de patients a pu être corrigée dans des neutrophiles isolés et dans du sang total des patients cirrhotiques à l’aide d’un agoniste de récepteurs « Toll-like receptor (TLR) » qui agit en favorisant la transcription du gène de la gp91phox et sa synthèse protéique.En conclusion, mTOR émerge comme un nouvel effecteur transductionnel majeur de l’EO des neutrophiles, favorisant l’activation de la voie p47phox/gp91phox via les MAPK. Cette nouvelle voie de signalisation est fortement impactée au cours de la cirrhose alcoolique, ce qui favorise la susceptibilité des patients aux infections bactériennes. Bien que notre étude soulève ainsi des inquiétudes quant à l’utilisation d’inhibiteurs de mTOR chez les patients immunodéprimés, elle suscite par ailleurs la perspective de pouvoir corriger les déficits fonctionnels des neutrophiles à l’aide d’agents capables de stimuler des TLR intracellulaires.Superoxide anion (O2-) production by NADPH oxidase 2 (NOX2) complex of polymorphonuclear neutrophil (i.e respiratory burst, RB) contributes to efficient elimination of pathogens. This defense function is stimulated by various pro-inflammatory agents, especially by bacterial peptides (fMLP) which trigger a signaling cascade involving many protein kinases (PKC, AKT, MAP-Kinases) resulting in activation of NOX2, also called gp91phox, the catalytic core of the complex. In this thesis, I identified the protein kinase mTOR as a novel major RB effector of healthy neutrophils and I compared its transductional activity in neutrophils from patients suffering from alcoholic decompensated liver cirrhosis, aiming at understanding their high susceptibility to bacterial infections.A major contribution of mTOR to fMLP-induced neutrophil superoxide production was demonstrated using its specific drug antagonist Rapamycin, and by an antisens strategy. mTOR is activated upstream of p38-MAPK which phosphorylates p47phox, a major component of the NADPH oxidase complex. In neutrophils from cirrhotic patients, the RB is dramatically impaired and this was associated with a deficient activation of the p38-MAPK/p47phox(S345) signaling pathway. This RB deficiency was aggravated by Rapamycin. Neutrophils from cirrhotic patients also exhibited a deficient expression of gp91phox (NOX2), p22phox, p47phox and mTOR. A deficient NOX2 expression can be reproduced by treating healthy neutrophils with fMLP or plasma from cirrhotic patients. Furthermore, this phenomenon involved an unexpected proteolytic degradation of gp91phox mediated by elastase. Finally, this deficient superoxide production by neutrophil from cirrhotic patients can be corrected ex vivo in isolated neutrophils and in patients’ whole blood, using a Toll-like receptor agonist that acts by promoting the transcription and traduction of gp91phox .In conclusion, mTOR emerges as a novel and major signaling effector of neutrophil RB, promoting the activation of p47phox/gp91phox through MAPKs. This novel signaling pathway is strongly impaired during alcoholic liver cirrhosis, which increases patients’ susceptibility to bacterial infections. Although our study raises concerns about the use of mTOR inhibitors in immunocompromised patients, it also provides therapeutic propects for correcting neutrophil functional deficiencies using agents capable of stimulating intracellular TLR

NADPH oxidase activation in neutrophils: Role of the phosphorylation of its subunits

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NADPH oxidase depletion in neutrophils from patients with cirrhosis and restoration via toll-like receptor 7/8 activation

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The Kinesin Light Chain–Related Protein PAT1 Promotes Superoxide Anion Production in Human Phagocytes

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