Ativação de neutrófilos de indivíduos saudáveis e imunocomprometidos por promastigotas de Leishmania spp.

Os neutrófilos são as primeiras células polimorfonucleares do sistema imunitário inato a chegar ao local de infeção, constituindo a primeira linha de defesa contra agentes invasores, como no caso do parasita Leishmania. Este parasita é causador da leishmaniose que tem sido reportada em mais de 98 países e que pode afetar animais e seres humanos. As diferentes espécies do parasita podem causar leishmaniose com diferentes apresentações clinicas, das quais salientamos a leishmaniose visceral e a leishmaniose cutânea. O presente trabalho teve como objetivo analisar a resposta imunitária de células polimórficas nucleares (PMN) de indivíduos com diferentes competências imunitárias quando expostas a parasitas de espécies viscerais (L. infantum) e cutâneas (L. amazonensis, L. shawi e L. guyanensis). A internalização parasitária foi confirmada por microscopia optica. A ativação celular foi avaliada através de técnicas laboratoriais que permitaram analisar os mecanismos oxidativos, nomeadamente a produção de ião superóxido, a exocitose de grânulos ricos em enzimas proteolíticas, como é o caso específico da elastase neutrofilica (NE) e da catepsina G (CatG) e a libertação de armadilhas extracelulares (NET). Verificou-se que as espécies de Leishmania induzem a exocitose de CatG e a libertação de NET, independentemente da competência imunitária dos indivíduos estudados. Contudo, idêntica situação não se verifica no caso do stress oxidativo ou da libertação de NE. Leishmania spp. estimulou o stress oxidativo, com produção do ião superóxido, nos PMN de indivíduos saudáveis enquanto os PMN de indivíduos imunocomprometidos apenas parece ficar ativado na presença de L. infantum e de L. amazonensis apontando para mecanismos de ativação diversos decorrentes quer da espécie do parasita quer do nível imunitário do hospedeiro. Situação similar ocorreu na exocitose de grânulos ricos em NE. L. infantum e L. shawi estimularam a libertação de NE por PMN de indivíduos saudáveis e imunocomprometidos. Porém, os PMN de indivíduos com comprometimento da imunidade também responderam aos parasitas da espécie L. amazonensis enquanto que L. guyanensis unicamente induziu a exocitose de NE nos PMN de indivíduos saudáveis. Estes resultados apontam para a existência de especificidades próprias na ativação destes mecanismos relativamente às espécies de Leishmania e ao estado imunitário do hospedeiro. Estudos complementares são necessários para esclarecer o processo de ativação, bem como identificar os eventuais antigénios parasitários (ou até ilhas CpG) que conduzem a ativação de PMN humanos.Neutrophils are the first polymorphonuclear cells of the innate immune system to reach the infection site, providing the first line of defense against invading pathogens, such as the Leishmania parasite. This parasite causes leishmaniasis that has been reported over 98 countries, affecting both animals and human beings. Different species of the parasite can cause leishmaniasis with diverse clinical presentations, as is the case of visceral leishmaniasis and cutaneous leishmaniasis. The present study aimed to evaluate the immune response of polymorphic nuclear cells (PMN) of individuals with different immune competence when exposed to visceral (L. infantum) and cutaneous parasitic species (L. amazonensis, L. guyanensis and L. shawi). Uptake of parasites by PMN was confirmed by optical microscopy. Laboratory techniques were used to evaluate the PMN activation by assessing oxidative mechanisms, namely the production of ion superoxide exocytosis, exocytosis of granules rich in proteolytic enzymes, as is the specific case of neutrophil elastase (NE) and cathepsin G (CatG) and the release of extracellular traps (NET). It was found that the species of Leishmania induce CatG exocytosis and NET release, regardless of the immune competence of the studied subjects. On the contrary, in the case of oxidative stress or the release of NE some differences were observed between PMN from healthy and immuncompromised individuals. All species of Leishmania induced oxidative stress, with production of superoxide ion in PMN of healthy individuals. However, PMN of immunocompromised individuals just seems to be activated in the presence of L. infantum and L. amazonensis parasites, pointing to the possible existence of more than one activation mechanism in association with the immune competence of the host that can be specifically primed by a particular parasite species. A similar situation was observed in the exocytosis of granules rich in NE. L. infantum and L. shawi stimulated the release of NE by PMN isolated from healthy and immunocompromised individuals. However, PMN from individuals with impaired immunity also appeared to respond to L. amazonensis parasites while L. guyanensis only induced PMN from healthy individuals to exocytosis NE. These findings suggest that the presence of specific features in the activation of these particular mechanisms might be related to the species of Leishmania and also to the immune status of the host. Additional studies are needed to clarify the activation process and identify parasitic antigens (or even CpG islands) that direct cell activation

The prognostic and predictive value of Tregs and tumor immune subtypes in postmenopausal, hormone receptor-positive breast cancer patients treated with adjuvant endocrine therapy: a Dutch TEAM study analysis

Evidence exists for an immunomodulatory effect of endocrine therapy in hormone receptor-positive (HR+ve) breast cancer (BC). Therefore, the aim of this study was to define the prognostic and predictive value of tumor immune markers and the tumor immune profile in HR+ve BC, treated with different endocrine treatment regimens. 2,596 Dutch TEAM patients were treated with 5 years of adjuvant hormonal treatment, randomly assigned to different regimens: 5 years of exemestane or sequential treatment (2.5 years of tamoxifen–2.5 years of exemestane). Immunohistochemistry was performed for HLA class I, HLA-E, HLA-G, and FoxP3. Tumor immune subtypes (IS) (low, intermediate & high immune susceptible) were determined by the effect size of mono-immune markers on relapse rate. Patients on sequential treatment with high level of tumor-infiltrating FoxP3+ cells had significant (p = 0.019, HR 0.729, 95 % CI 0.560–0.949) better OS. Significant interaction for endocrine treatment and FoxP3+ presence was seen (OS p < 0.001). Tumor IS were only of prognostic value for the sequentially endocrine-treated patients (RFP: p = 0.035, HR intermediate IS 1.420, 95 % CI 0.878–2.297; HR low IS 1.657, 95 % CI 1.131–2.428; BCSS: p = 0.002, HR intermediate IS 2.486, 95 % CI 1.375–4.495; HR low IS 2.422, 95 % CI 1.439–4.076; and OS: p = 0.005, HR intermediate IS 1.509, 95 % CI 0.950–2.395; HR low IS 1.848, 95 % CI 1.277–2.675). Tregs and the tumor IS presented in this study harbor prognostic value for sequentially endocrine-treated HR+ve postmenopausal BC patients, but not for solely exemestane-treated patients. Therefore, these markers could be used as a clinical risk stratification tool to guide adjuvant treatment in this BC population

THE ASSESSMENT OF BREAST TUMOR MARKERS IN AN OVARY ENVIRONMENT: A COMPREHENSIVE IMMUNOHISTOCHEMICAL ANALYSIS

Immunology and molecular genetics of gynecological cancersTI9 - Endometriumpathologi

COX-2 expression influences the prognostic effect of aspirin use after diagnosis in colon cancer patients

MTG2 - Moleculaire genetica van gastrointestinale tumore

HLA-G protein expression in colorectal cancer evaluated by immunohistochemistry and western blot analysis: Its expression characteristics remain enigmatic

Surgical oncolog

The prognostic and predictive value of Tregs and tumor immune subtypes in postmenopausal, hormone receptor-positive breast cancer patients treated with adjuvant endocrine therapy: a Dutch TEAM study analysis

Immunology and molecular genetics of gynecological cancer

Expression of HLA Class I Antigen, Aspirin Use, and Survival After a Diagnosis of Colon Cancer

Surgical oncolog

Longitudinal Serum Protein Analysis of Women with a High Risk of Developing Breast Cancer Reveals Large Interpatient Versus Small Intrapatient Variations: First Results from the TESTBREAST Study

The prospective, multicenter TESTBREAST study was initiated with the aim of identifying a novel panel of blood-based protein biomarkers to enable early breast cancer detection for moderate-to-high-risk women. Serum samples were collected every (half) year up until diagnosis. Protein levels were longitudinally measured to determine intrapatient and interpatient variabilities. To this end, protein cluster patterns were evaluated to form a conceptual basis for further clinical analyses. Using a mass spectrometry-based bottom-up proteomics strategy, the protein abundance of 30 samples was analyzed: five sequential serum samples from six high-risk women; three who developed a breast malignancy (cases) and three who did not (controls). Serum samples were chromatographically fractionated and an in-depth serum proteome was acquired. Cluster analyses were applied to indicate differences between and within protein levels in serum samples of individuals. Statistical analyses were performed using ANOVA to select proteins with a high level of clustering. Cluster analyses on 30 serum samples revealed unique patterns of protein clustering for each patient, indicating a greater interpatient than intrapatient variability in protein levels of the longitudinally acquired samples. Moreover, the most distinctive proteins in the cluster analysis were identified. Strong clustering patterns within longitudinal intrapatient samples have demonstrated the importance of identifying small changes in protein levels for individuals over time. This underlines the significance of longitudinal serum measurements, that patients can serve as their own controls, and the relevance of the current study set-up for early detection. The TESTBREAST study will continue its pursuit toward establishing a protein panel for early breast cancer detection