Étude de la réponse immunitaire cérébrale innée dans la pathogenèse de l'encéphalite herpétique et évaluation de stratégies immunomodulatrices

Authors: Canivet, Coraline
Advisor: Boivin, Guy
Abstract: Pathogenesis of herpes simplex encephalitis is not completely understood, but viral replication results in acute necrotizing encephalitis of the temporal/frontal lobes and cerebral inflammation leading to the infiltration of the peripheral immune cells to the central nervous system (CNS). Although most brain damage is caused by viral replication, a lot of data suggest that the immune response could also contribute to the pathogenesis of HSE. The innate immune response is the first line of host defense that limits viral spread. Numerous studies showed that the immune response is induced by the recognition of HSV-1, in particular by the toll-like receptors (TLRs). Likewise, type I interferon (IFN) is essential to the antiviral response. Indeed, studies showed that impairment of a component involved in signaling pathways inducing the type I IFN synthesis is deleterious in mice and humans during HSE. For several years, a series of studies have suggested that the immune response participated in this CNS pathology resulting in a fatal course and that hyperinflammatory responses initiated by early infiltrating innate cells play a key role in the development of this pathology. In addition, the complexity of the CNS inflammatory response constitutes a challenge for our understanding of the pathogenesis of herpetic encephalitis. The main objective of this thesis was to better understand the immune response as a contributor to the pathogenesis of HSE, and more specifically, the recruitment of peripheral immune cells in the CNS, the involvement of signaling pathway mediated by the interferon regulatory transcription factors (IRF) 3 and IRF7 and the evaluation of the effects of immunomodulators such as artesunate and rapamycin on the susceptibility of different murine strains during experimental HSE An effective innate cerebral immune response contributes to the natural resistance of C57BL/6 mice compared to naturally sensitive BALB/c mice. In fact, the viral load in the CNS of C57BL/6 mice infected with HSV-1 by the I.N. route is lower at the peak of infection (day 6 post-infection (p.i)) compared to BALB/c mice. This control of the viral load is associated with rapid and coordinated infiltration of cells in the CNS (infiltration of inflammatory monocytes, conventional dendritic cells (cDCs), plasmacytoid dendritic cells (pDCs), natural killer cells (NK), natural killer cells T (NKT) on day 4 p.i) followed by T lymphocyte infiltration on day 8 p.i. Moreover, the control of viral replication is orchestrated by the activation of transcription factors IRF3 and particularly IRF7. In this regard, mice deficient for IRF3 or IRF7 are more susceptible to intranasal infection by HSV-1 than wild type C57BL/6 mice. In mice deficient for IRF7 and to a lesser extent for IRF3, the loss of control of viral replication in the brain is associated with a defect in IFN-b production at an early time after infection followed by overproduction of type I IFNs. Increased susceptibility of BALB/c mice, IRF3- or IRF7-deficient mice is associated with higher levels of pro-inflammatory cytokines and chemokines levels in the CNS compared to C57BL/6 mice at later times post-infection. We therefore evaluated the effect of the addition of immunomodulators to antiviral treatment: artesunate (ART), acting on signaling pathways mediated by TLR2 and 9 and rapamycin (RAPA), acting on signaling pathways mediated by TLR3 and 9. We show that the administration of ART or RAPA to the antiviral therapy was beneficial and improve the outcome of HSE in mice, without a direct effect on the viral load. Instead they act by decreasing significantly pro-inflammatory cytokine and chemokine levels in the CNS. Using these different experimental models, we also demonstrated overexpression of pro-inflammatory cytokines (IL-1 b, IL-6, IFN -g) and chemokine (CC2) during experimental HSE. In this regard, adding of immunomodulatory compound to antiviral therapy allowed to decrease levels of these inflammatory proteins. In conclusion, these data provide new evidence for the contribution of the immune response in the pathogenesis of herpetic encephalitis, as well as the development of potential new therapeutic targets.
Document Type: Thèse de doctorat
Issue Date: 2020
Open Access Date: 13 February 2020
Permalink: http://hdl.handle.net/20.500.11794/38088
Grantor: Université Laval
Collection:Thèses et mémoires

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