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Background A dysregulated immune response is emerging as a key feature of critical illness in COVID-19. Neutrophils are key components of early innate immunity that, if not tightly regulated, contribute to uncontrolled systemic inflammation. We sought to decipher the role of neutrophil phenotypes, functions, and homeostasis in COVID-19 disease severity and outcome. Methods By using flow cytometry, this longitudinal study compares peripheral whole-blood neutrophils from 90 COVID-19 ICU patients with those of 22 SARS-CoV-2-negative patients hospitalized for severe community-acquired pneumonia (CAP) and 38 healthy controls. We also assessed correlations between these phenotypic and functional indicators and markers of endothelial damage as well as disease severity. Results At ICU admission, the circulating neutrophils of the COVID-19 patients showed continuous basal hyperactivation not seen in CAP patients, associated with higher circulating levels of soluble E- and P-selectin, which reflect platelet and endothelial activation. Furthermore, COVID-19 patients had expanded aged-angiogenic and reverse transmigrated neutrophil subsets—both involved in endothelial dysfunction and vascular inflammation. Simultaneously, COVID-19 patients had significantly lower levels of neutrophil oxidative burst in response to bacterial formyl peptide. Moreover patients dying of COVID-19 had significantly higher expansion of aged-angiogenic neutrophil subset and greater impairment of oxidative burst response than survivors. Conclusions These data suggest that neutrophil exhaustion may be involved in the pathogenesis of severe COVID-19 and identify angiogenic neutrophils as a potentially harmful subset involved in fatal outcome. Graphic Abstract

International audience; No abstract available

International audience; Background: Scleromyxedema (SME) is a rare mucinosis associated with monoclonal gammopathy. Several biochemical peculiarities of monoclonal immunoglobulins (Ig) in SME patients were reported in case reports or short series, such as IgGλ over-representation, cationic migration, and partial deletion. Methods: Monoclonal immunoglobulins (Ig) from the serum of 12 consecutive patients diagnosed with scleromyxedema (SME) were analyzed using electrophoretic and immunoblotting techniques. Results: All monoclonal Ig from 12 SME were of IgG1 subclass, with an overrepresentation of the lambda-type light chain and a cationic mobility on standard zone electrophoresis, as compared with 21 cases of monoclonal gammopathy of undetermined significance (MGUS) of IgG1 subclass. Reactivity with specific monoclonal antibodies demonstrated no evident deletion of the heavy chain constant domains, which was also confirmed by analysis of Ig heavy chain molecular weight on a purified monoclonal component from one case. Conclusions: Significant isotype restriction of both heavy and light chains, and peculiar biochemical properties suggest that monoclonal Ig might be involved in pathophysiological events of SME.

International audience; Systemic lupus erythematosus (SLE) patients are at risk for pneumococcal infection. Twenty-one consecutive SLE patients (40[25-75] years) received the sequential PCV13/PPSV23 vaccine and factors associated with long-term protection were analyzed. Immune protection, defined by an antigen-specific IgG concentration ≥1.3 µg/mL for at least 70% of 7 pneumococcal serotypes was assessed at baseline, 2, 6, 12 and 36 months defining long-term protection. Only 10 patients showed pneumococcal immune protection 36 months after vaccination. Eleven (52.4%) patients had no long-term protection with a seroconversion that never or only transiently occurred. SLE disease features, treatment received and immunological characteristics did not differ between protected and unprotected patients except for the pre-vaccination IgG2 serum levels. Serum IgG2 level >2.125 µg/ml showed a sensitivity of 100% and a specificity of 90.9% for long-term protection. Sequential pneumococcal vaccination conferred poor immune protection in SLE. Baseline IgG2 serum level identified patients able to benefit from pneumococcal vaccination.

Randall-type heavy chain deposition disease (HCDD) is a rare disorder characterized by tissue deposition of a truncated monoclonal immunoglobulin heavy chain lacking the first constant domain. Pathophysiological mechanisms are unclear and management remains to be defined. Here we retrospectively studied 15 patients with biopsy-proven HCDD of whom 14 presented with stage 3 or higher chronic kidney disease, with nephrotic syndrome in 9. Renal lesions were characterized by nodular glomerulosclerosis, with linear peritubular and glomerular deposits of γ-heavy chain in 12 patients or α-heavy chain in 3 patients, without concurrent light chain staining. Only 2 patients had symptomatic myeloma. By serum protein electrophoresis/immunofixation, 13 patients had detectable monoclonal gammopathy. However, none of these techniques allowed detection of the nephrotoxic truncated heavy chain, which was achieved by immunoblot and/or bone marrow heavy chain sequencing in 14 of 15 patients. Serum-free kappa to lambda light chain ratio was abnormal in 11 of 11 patients so examined. Immunofluorescence studies of bone marrow plasma cells showed coexpression of the pathogenic heavy chain with light chain matching the abnormal serum-free light chain in all 3 tested patients. Heavy chain sequencing showed first constant domain deletion in 11 of 11 patients, with high isoelectric point values of the variable domain in 10 of 11 patients. All patients received chemotherapy, including bortezomib in 10 cases. Renal parameters improved in 11 patients who achieved a hematological response, as assessed by normalization of the free light chain ratio in 8 cases. Tissue deposition in HCDD relates to physicochemical peculiarities of both variable and constant heavy chain domains. Early diagnosis and treatment with bortezomib-based combinations appear important to preserve renal prognosis. Thus, monitoring of serum-free light chain is an indirect but useful method to evaluate the hematological response.

International audience; BACKGROUND: Fibrillary glomerulonephritis (GN) is a rare disorder with poor renal prognosis. Therapeutic strategies, particularly the use of immunosuppressive drugs, are debated. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: 27 adults with fibrillary GN referred to 15 nephrology departments in France between 1990 and 2011 were included. All patients were given renin-angiotensin system blockers and 13 received immunosuppressive therapy, including rituximab (7 patients) and cyclophosphamide (3 patients). OUTCOMES & MEASUREMENTS: Clinical and histologic features of patients and kidney disease outcome. Renal response was defined as a >50% decrease in 24-hour proteinuria with

International audience; OBJECTIVE: To compare serum antiamyloid-β (Aβ) antibodies in typical and atypical Alzheimer disease (AD). DESIGN: Preliminary observations. SUBJECTS: Thirteen patients with AD, 8 patients with posterior cortical atrophy with evidence of AD (PCA-AD) pathophysiological process by both cerebrospinal fluid (CSF) biomarkers and amyloid imaging, and 12 age-matched control individuals. INTERVENTIONS: The class and subclass levels of serum anti-Aβ antibodies were measured using an oligomer-based enzyme-linked immunosorbent assay. This method allowed measuring both free antibodies and, after acidic treatment, the total fraction that includes all antibodies complexed with circulating Aβ40/42 and any cross-reacting antigen. RESULTS: Anti-Aβ IgG were restricted to the IgG1 and IgG3 subclasses. Their total levels were strikingly lower and more homogeneous in patients with PCA compared with both typical AD and controls, while biomarkers of amyloid deposition (CSF Aβ42 and positron emission tomography amyloid imaging) were similar in patients with AD and patients with PCA. CONCLUSIONS: Serum anti-Aβ IgG1 and IgG3 antibodies differ between distinct forms of AD. Its significance is discussed for possible implications as immune effectors in the specific pathophysiology of AD variants.

Accumulation of amyloid-β peptide (Aβ) is considered the triggering factor of pathogenic lesions in Alzheimer’s disease (AD), and vaccines targeting Aβ are promising therapeutic options. However, the occurrence of meningoencephalitides attributed to T cell responses in 6% of Aβ-immunized patients underscores the need for a better understanding of T cell responses to Aβ. We characterized the parameters controlling the magnitude of Aβ-specific CD4+ T cell responses in mice. T cell responsiveness to Aβ1-42 was highly heterogeneous between mouse strains of different H-2 haplotypes, with SJL/J (H-2s) mice displaying a strong response, mainly specific for Aβ10-24, and C57BL/6 (H-2b) mice displaying a weak response to Aβ16-30. Surprisingly, C57BL/6 mice congenic for the H-2s haplotype (B6.H-2S), which display a “permissive” MHC class II allele for presentation of the immunodominant Aβ10-24 epitope, showed a very weak CD4+ T cell response to Aβ, suggesting that MHC-independent genes downmodulate Aβ-specific CD4+ T cell responses in C57BL/6 background. Vaccine-induced CD4+ T cell responses to Aβ were significantly enhanced in both C57BL/6 and B6.H-2S mice upon depletion of regulatory T cells (Tregs), whereas Treg-depleted SJL/J mice displayed unaltered Aβ-specific T cell responses. Finally, Treg depletion in C57BL/6 transgenic APPPS1 mice, a mouse model of AD, results in enhanced vaccine-induced CD4+ T cell responses in AD compared with wild-type animals. We concluded that the magnitude of Aβ-specific CD4+ T cell responses is critically controlled in both physiological and pathological settings by MHC-independent genetic factors that determine the overall potency of Aβ-specific Treg responses.

International audience; Kidney involvement with immunoglobulin crystals usually relates to a light chain of the kappa type, in MGUS or smoldering myeloma, frequently causing Fanconi's syndrome with progressive renal insufficiency. We report on a case with severe myeloma featuring lambda light chain-derived crystals and acute kidney injury. Histology showed acute tubular necrosis and tubule obstruction with crystals, which were also abundant inside tubule epithelial cells, macrophages and bone marrow plasma cells. The light chain variable domain had a normal overall primary structure but included 11 somatic mutations, 3 of which likely increased the surface hydrophobicity, as observed in previously reported kappa-type crystals.

The spectrum of renal diseases associated with proliferations of the B cell lineage is continuously expanding. Most of them are caused by deposition of a monoclonal Ig or a fragment thereof, whereas others include neoplastic cell infiltration, nephrocalcinosis, and infection-related complications. Solomon et al. (1) first demonstrated that human renal lesions associated with deposition of monoclonal lights chains (LC) could be reproduced in mice by intraperitoneal injection. Subsequent studies have shown that the pattern of renal lesions associated with the deposition of monoclonal Ig mostly depends on biochemical and structural abnormalities of Ig (2). Most renal complications occur in patients who produce free LC with or without complete IgG molecules. Renal complications of malignant IgM-secreting proliferations are rare. Their incidence seems to have decreased, mostly because of improved therapy of Waldenstrom macroglobulinemia (WM), the major cause of those nephropathies. First reviewed by Morel-Maroger et al. (3), WM-related nephropathies include characteristic intracapillary deposits of IgM with or without cryoglobulinemia, AL-amyloidosis, and infiltration of the interstitium by neoplastic lymphoplasmacytic cells. Subsequent case reports included immunotactoid and nonamyloid fibrillary glomerulopathy (4,5), cryoglobulinemia-related glomerulonephritis (6), and crescentic glomerulonephritis (7,8). Cases of cast nephropathy (9), Fanconi syndrome (10), and LC deposition disease (11) as a result of free LC toxicity have also been reported in patients who presented with a circulating monoclonal IgM. In this study, we retrospectively analyzed 14 patients with renal lesions associated with an IgM-secreting proliferation with the aims of reappraising the relative prevalence of the various renal lesions and underlying hematologic disorders, the characteristics of the nephropathies, and the patients’ outcome. We included both renal lesions that were caused by cell infiltration and those that were caused by the deposition of the monoclonal component (complete IgM and/or isolated LC) to cover the full disease spectrum.

Peripherally acquired transmissible spongiform encephalopathies display strikingly long incubation periods, during which increasing amounts of prions can be detected in lymphoid tissues. While precise sites of peripheral accumulation have been described, the mechanisms of prion transport from mucosa and skin to lymphoid and nervous tissues remain unknown. Because of unique functional abilities, dendritic cells (DCs) have been suspected to participate in prion pathogenesis. In mice inoculated subcutaneously with scrapie-infected DCs, the incubation was shorter when cells were alive as compared with killed cells, suggesting that DC functions may facilitate prion neuroinvasion. However, early propagation in lymphoid tissues seemed not importantly affected by DC vitality. Mutant (plt) mice that have deficient CCL19/CCL21 expression and DC migration displayed similar infection of secondary lymphoid organs as normal mice, regardless of the route of inoculation and scrapie strain. Under certain conditions of transcutaneous inoculation, the incubation and duration of disease were moderately prolonged inpltmice. This was not related to a milder neuropathogenesis, sincepltand normal mice were equally susceptible to intracerebral prion challenge. We conclude that peripheral spreading of prions appears poorly dependent on cell migration through the chemokine/receptor system CCL19/CCL21/CCR7, although DCs might be able to help prions reach sites of neuroinvasion.

International audience; Marked polyclonal immunoglobulin (Ig)G4 hypergammaglobulinemia has exceptionally been reported. Here we report on two Algerian patients who presented a syndrome characterized by anemia, plasmacytic lymphadenopathy, renal manifestations, and a marked polyclonal IgG4 hypergammaglobulinemia leading to a hyperviscosity syndrome in one case. The IgG4-expressing cell percentage was significantly increased in the peripheral blood lymphocytes collected from the two patients upon diagnosis. Moreover, in contrast with normal sera, both patients' sera significantly increased the percentage of IgG4-expressing cells when incubated with CD40-stimulated normal B lymphocytes. Similar effects were obtained with the culture supernatants of the patients' activated T cells. Anti-interleukin (IL) 4 and/or anti-IL-13 antibodies were unable to antagonize the IgG4 production. IL-4 and IL-13 serum concentrations were found to be normal in the two patients. The increased IgG4 production was found to be mediated by soluble factor(s), most probably secreted by activated T cells, which did not require the signal transducer and activator of transcription 6 signaling pathway.

Recent reports suggest that immunity against the prion protein (PrP) retards transmissible spongiform encephalopathies progression in infected mice. A major obstacle to the development of vaccines comes from the fact that PrP is poorly immunogenic, as it is seen as self by the host immune system. Additional questions concern the immune mechanisms involved in protection and the risk of eliciting adverse reactions in the central nervous system of treated patients. Peptide-based vaccines offer an attractive strategy to overcome these difficulties. We have undertaken the identification of the immunogenic regions of PrP, which trigger helper T cells (Th) associated with antibody production. Our results identify two main regions, one between the structured and flexible portion of PrP (98–127) and a second between α 1 and α 2 helix (143–187). Peptides (30-mer) corresponding to these regions elicit class II-restricted Th cells and antibody production against native PrP and could therefore be of potential interest for a peptide-based vaccination.

International audience; Transmissible spongiform encephalopathies display long incubation periods at the beginning of which the titer of infectious agents (prions) increases in peripheral lymphoid organs. This "replication" leads to a progressive invasion of the CNS. Follicular dendritic cells appear to support prion replication in lymphoid follicles. However, the subsequent steps of neuroinvasion remain obscure. CD11c(+) dendritic cells, an unrelated cell type, are candidate vectors for prion propagation. We found a high infectivity titer in splenic dendritic cells from prion-infected mice, suggesting that dendritic cells carry infection. To test this hypothesis, we injected RAG-1(0/0) mice intravenously with live spleen cell subsets from scrapie-infected donors. Injection of infected dendritic cells induced scrapie without accumulation of prions in the spleen. These results suggest that CD11c(+) dendritic cells can propagate prions from the periphery to the CNS in the absence of any additional lymphoid element.

International audience; The variability subgroup of human monoclonal ϰ chains purified from urine in 3 consecutive patients with myeloma associated light chain deposition disease was determined from amino acid sequences of their first framework regions (FR1). N-glycosylation was searched for by N-glycosidase F treatment. These data together with our previously published results, indicate the pathogenic potential of the rare VϰIV subgroup and confirm the absence of detectable serum and urine free monoclonal light chains when they are N-glycosylated.

Light-chain amyloidosis and light-chain deposition disease are closely related processes characterized by tissue deposition of organized (fibrillar) or nonorganized material related to monoclonal immunoglobulin light chains. Both conditions can occur in patients with immunoproliferative disorders. The clinical manifestations of light-chain deposition disease result from multivisceral involvement and are heterogeneous. Rapidly progressive renal failure or the nephrotic syndrome is the most common manifestation, but heart failure, arrhythmia, liver involvement (peliosis), and neurologic disorders may also be present. These findings may be caused by structural abnormalities or unusual behavior of deposited light chains. In particular, pathogenic light chains are characterized by unusual . . .

Jacalin is a plant lectin known to specifically induce the proliferation of CD4+ T lymphocytes in human. We demonstrate here that jacalin completely blocks human immunodeficiency virus type 1 (HIV-1) in vitro infection of lymphoid cells. Jacalin does not bind the viral envelope glycoprotein gp120. Besides other T cell surface molecules, it interacts with CD4, the high-affinity receptor to HIV. Binding of jacalin to CD4 does not prevent gp120-CD4 interaction and does not inhibit virus binding and syncytia formation. The anti-HIV effect of the native lectin can be reproduced by its separated alpha-subunits. More importantly, we have defined in the alpha-chain of jacalin a 14-amino acid sequence which shows high similarities with a peptide of the second conserved domain of gp120. A synthetic peptide corresponding to this similar stretch also exerts a potent anti-HIV effect. This peptide is not mitogenic for peripheral blood mononuclear cells and does not inhibit anti-CD3-induced lymphocyte proliferation. These results make jacalin alpha chain-derived peptide a potentially valuable therapeutic agent for acquired immunodeficiency syndrome.

International audience; The primary structure of three amyloid precursor light chains was deduced from the sequence of complementary DNA (cDNA) from bone marrow cells from patients affected with classical lambda (patient Air) or kappa (patient Arn) amyloidosis and from a patient (Aub) in whom lambda amyloid deposits were unusual by their perimembranous location in the kidney glomerulus. All three RNAs were of normal size, as estimated by Northern blotting, and encoded normal-sized light chains. The deduced light-chain sequence from patient Arn was related to the V kappa 1 subgroup, and included ten residues that had not been previously reported at these positions, only one of which (Leu-21) was located in a beta-sheet (4-2). The unusual presence of Asn-70 determined a potential N-glycosylation site. The sequence of the light chain from patient Air belonged to the V lambda 1 subgroup, and included three unusually located amino acid residues, one of which had already been reported in an amyloidogenic lambda-chain. The sequence of the light chain from patient Aub was related to the V lambda 3 subgroup, and contained five amino acid residues that had not previously been described at the corresponding positions; two of them (His-36 and Ser-77) were located in beta-sheets (3-1 and 4-3 respectively). This sequence was also peculiar because of the presence of numerous acidic residues in the complementarity-determining regions. Such unusual primary structures might be responsible for the amyloidogenic properties of these light-chain precursors.

International audience; That structural abnormalities may be responsible for nonamyloid immunoglobulin (Ig) light chain deposition disease (LCDD) is suggested by previous results of Ig biosynthesis studies, but this hypothesis was not documented at the molecular level. We report on the first complete primary sequence deduced from cDNA analysis of a kappa light chain responsible for LCDD associated with an apparently nonsecretory myeloma. Bone marrow myeloma cells contained intracellular kappa chains and no heavy chains by immunofluorescence. Kidney biopsy showed typical nonamyloid PAS-positive kappa chain deposits. SDS-PAGE analysis of material extracted from a kidney biopsy specimen and of Ig produced by the myeloma cells revealed kappa chains of abnormally high apparent molecular mass (30,000). Comparison of the NH2-terminal aminoacid sequence of the kappa chain deposited in the kidney and of the complete sequence of several identical kappa cDNA clones from bone marrow cells showed the identity of the tissue deposited and plasma cell kappa chain. The kappa mRNA had an overall normal structure and corresponded to the V kappa IV gene rearranged to J kappa 1 and followed by a normal constant exon of the Km(3) allotype. The variable sequence differed from the V kappa IV germline gene by nine point mutations, including an Asp----Asn substitution at position +70 resulting in a potential N-glycosylation site. In vitro biosynthesis experiments and treatment with N-glycosidase provided evidence for the intracellular glycosylation of the monoclonal kappa chain. The peculiar sequence and the glycosylation of a kappa chain of the rare V kappa IV subgroup might be responsible for structural abnormalities leading to tissue deposition.

International audience; Aquous extracts from seeds of Artocarpus altilis (breadfruit) and Artocarpus heterophyllus (jackfruit) were compared by polyacrylamide gel electrophoresis. Two bands of the same size (12 and 15 kD) as the jacalin subunits were the major components in breadfruit seed extract. They strongly reacted with anti-jacalin antibodies by western blotting. The breadfruit lectin displayed the same IgAl and IgD precipitation specificity as jacalin in gel double diffusion experiments. It also stimulated in vitro proliferation of human peripheral blood mononuclear cells. These results suggest that lectins from both species of Artocarpus are very similar.

International audience; The distribution of human IgG subclasses among mesangial glomerular deposits of 11 patients with IgA nephropathy (IgA-N) was examined by indirect immunofluorescence with subclass-specific mouse monoclonal antibodies (mAb). A subclass restriction was observed with mesangial deposits containing almost exclusively IgG1 (81% of the studied biopsies) and IgG3 (64%). IgG2 was present in only 1 out of the 11 cases studied and IgG4 was never found to be present, although seven different anti-IgG4 mAb were used. In addition, serum levels of total IgA and IgG, as well as serum IgG subclass levels, were measured in 27 patients with IgA nephropathy by an indirect competitive immunoenzymatic assay using mAb. It was noted in IgA-N patients, but not in normal individuals, that there was significant positive correlation between total IgA and IgG serum levels which was entirely due to a positive correlation between total serum IgA and IgG2 levels. This study provides no explanation for the subclass restrictions observed but suggests that (i) the presence of IgA-IgG1-IgG3 in mesangial deposits may be secondary to an antigenic stimulation, possibly viral, and (ii) the positive correlation between IgA and IgG2 serum levels may result from an increased T helper function.

International audience; Subclasses of 176 IgG and 62 IgA myeloma proteins were determined by indirect ELISA with monoclonal antibodies, as well as by an immunoblotting technique (for monoclonal IgG) and by immunoelectrophoresis against the lectin jacalin (for IgA). The subclass distribution of monoclonal IgG did not reflect mean normal serum levels of the correspondent isotypes, with an over-representation of IgG1 and IgG4 and an under-representation of IgG2 and IgG3 in myeloma. Similarly, IgA2 myeloma were clearly under-represented.

International audience; The lectin jacalin from the jackfruit Artocarpus heterophyllus reacts by precipitation and western blotting with human IgA1 and IgD but not with IgA2 (nor IgG and IgM). However, it weakly binds IgA2 as shown by affinity chromatography and competitive ELISA. Predominantly reactive carbohydrates are D-galactose and N-acetyl D-galactosamine. Jacalin has an apparent Mr of about 54,000 and is probably made up of three non-glycosylated and one glycosylated non-covalently linked subunits. Its electrophoretic properties and amino acid and carbohydrate composition are indicated.

The β-amyloïd peptide (Aβ) accumulates in the brain parenchyma in Alzheimer’s Disease, and in brain blood vessels during cerebral amyloid angiopathy (CAA), which manifests itself by hemorrhages (CAA-he) or vascular inflammation (CAA-ri). In CAA, experimental and clinical arguments suggest the presence of anti-Aβ antibodies in the CSF of patients during acute phase of CAA-ri. However, their presence and relevance in the serum of healthy subjects and CAA patients in poorly described.We designed an ELISA-based method to analyze several anti-Aβ antibodies features (reactivity toward different antigens, isotypes, concentrations, avidity), and studied these antibodies in animal and human. Our results suggest that these antibodies are present spontaneously in mice and humans, as part of natural antibodies, and their elevation with ageing. We showed the existence of specific though complex serological profiles in a cohort of 105 participants, either healthy or with CAA-he or CAA-ri. The administration of high avidity anti-Aβ IgG in APP23 mouse apparently leads to astrocytosis, however without elevation of CAA severity or microbleeding. This contribution to the study of anti-Aβ antibodies allows to better understand physiological and pathological variations of these antibodies, and suggests that their analysis can lead to biomarkers for CAA and its manifestations.; Le peptide β-amyloïde (ou Aβ) s’accumule dans le parenchyme cérébral au cours de la maladie d’Alzheimer (MA), et dans les vaisseaux cérébraux dans l’angiopathie amyloïde cérébrale (AAC), qui se manifeste notamment par des présentations hémorragiques (AAC-he), ou inflammatoires (AAC-ri). Dans l’AAC, des arguments expérimentaux et cliniques suggèrent la présence d’anticorps anti-Aβ dans le liquide céphalo-rachidien en phase aiguë d’AAC-ri, mais leur présence et leur importance dans le sérum des sujets sains ou atteints d’AAC demeure mal connue. Nous avons mis au point d’une technique dérivée de l’ELISA pour l’analyse de différentes caractéristiques des anticorps anti-Aβ sériques (réactivité vis-à-vis de différentes antigènes, isotypes, concentrations, avidité), et étudié les anticorps anti-Aβ sériques chez l’animal et chez l’homme. Nos résultats suggèrent la présence spontanée de ces anticorps chez la souris et chez l’homme en tant que part des anticorps naturels, ainsi que leur augmentation avec l’âge. Nous avons montré l’existence de profils sérologiques spécifiques complexes sur une cohorte de 105 participants sains ou présentant une AAC-he ou une AAC-ri. Enfin, l’administration d’IgG anti-Aβ de forte affinité chez la souris APP23 semble provoquer une forte réaction astrocytaire, cependant sans augmentation de l’Aβ vasculaire, ni augmentation des microsaignements. Cette contribution à l’étude des anticorps anti-Aβ permet de mieux comprendre les variations physiologiques et pathologiques de ces anticorps, et suggère que leur analyse comme potentiel biomarqueur de l’AAC, et de ses manifestations hémorragiques ou inflammatoires.

The β-amyloïd peptide (Aβ) accumulates in the brain parenchyma in Alzheimer’s Disease, and in brain blood vessels during cerebral amyloid angiopathy (CAA), which manifests itself by hemorrhages (CAA-he) or vascular inflammation (CAA-ri). In CAA, experimental and clinical arguments suggest the presence of anti-Aβ antibodies in the CSF of patients during acute phase of CAA-ri. However, their presence and relevance in the serum of healthy subjects and CAA patients in poorly described.We designed an ELISA-based method to analyze several anti-Aβ antibodies features (reactivity toward different antigens, isotypes, concentrations, avidity), and studied these antibodies in animal and human. Our results suggest that these antibodies are present spontaneously in mice and humans, as part of natural antibodies, and their elevation with ageing. We showed the existence of specific though complex serological profiles in a cohort of 105 participants, either healthy or with CAA-he or CAA-ri. The administration of high avidity anti-Aβ IgG in APP23 mouse apparently leads to astrocytosis, however without elevation of CAA severity or microbleeding. This contribution to the study of anti-Aβ antibodies allows to better understand physiological and pathological variations of these antibodies, and suggests that their analysis can lead to biomarkers for CAA and its manifestations., Le peptide β-amyloïde (ou Aβ) s’accumule dans le parenchyme cérébral au cours de la maladie d’Alzheimer (MA), et dans les vaisseaux cérébraux dans l’angiopathie amyloïde cérébrale (AAC), qui se manifeste notamment par des présentations hémorragiques (AAC-he), ou inflammatoires (AAC-ri). Dans l’AAC, des arguments expérimentaux et cliniques suggèrent la présence d’anticorps anti-Aβ dans le liquide céphalo-rachidien en phase aiguë d’AAC-ri, mais leur présence et leur importance dans le sérum des sujets sains ou atteints d’AAC demeure mal connue. Nous avons mis au point d’une technique dérivée de l’ELISA pour l’analyse de différentes caractéristiques des anticorps anti-Aβ sériques (réactivité vis-à-vis de différentes antigènes, isotypes, concentrations, avidité), et étudié les anticorps anti-Aβ sériques chez l’animal et chez l’homme. Nos résultats suggèrent la présence spontanée de ces anticorps chez la souris et chez l’homme en tant que part des anticorps naturels, ainsi que leur augmentation avec l’âge. Nous avons montré l’existence de profils sérologiques spécifiques complexes sur une cohorte de 105 participants sains ou présentant une AAC-he ou une AAC-ri. Enfin, l’administration d’IgG anti-Aβ de forte affinité chez la souris APP23 semble provoquer une forte réaction astrocytaire, cependant sans augmentation de l’Aβ vasculaire, ni augmentation des microsaignements. Cette contribution à l’étude des anticorps anti-Aβ permet de mieux comprendre les variations physiologiques et pathologiques de ces anticorps, et suggère que leur analyse comme potentiel biomarqueur de l’AAC, et de ses manifestations hémorragiques ou inflammatoires.

OBJECTIVE The non-neuronal cholinergic system represents non-neuronal cells that have the biochemical machinery to synthetize de novo and/or respond to acetylcholine (ACh). We undertook this study to investigate this biochemical machinery in chondrocytes and its involvement in osteoarthritis (OA). METHODS Expression of the biochemical machinery for ACh metabolism and nicotinic ACh receptors (nAChR), particularly α7-nAChR, in human OA and murine chondrocytes was determined by polymerase chain reaction and ligand-binding. We investigated the messenger RNA expression of the human duplicate α7-nACh subunit, called CHRFAM7A, which is responsible for truncated α7-nAChR. We assessed the effect of nAChR on chondrocytes activated by interleukin-1β (IL-1β) and the involvement of α7-nAChR using chondrocytes from wild-type (WT) and α7-deficient Chrna7-/- mice. The role of α7-nAChR in OA was explored after medial meniscectomy in WT and Chrna7-/- mice. RESULTS Human and murine chondrocytes express the biochemical partners of the non-neuronal cholinergic system and a functional α7-nAChR at their cell surface (n = 5 experiments with 5 samples each). The expression of CHRFAM7A in human OA chondrocytes (n = 23 samples) correlated positively with matrix metalloproteinase 3 (MMP-3) (r = 0.38, P < 0.05) and MMP-13 (r = 0.48, P < 0.05) expression. Nicotine decreased the IL-1β-induced IL-6 and MMP expression, in a dose-dependent manner, in WT chondrocytes but not in Chrna7-/- chondrocytes. Chrna7-/- mice that underwent meniscectomy (n = 7) displayed more severe OA cartilage damage (mean ± SD Osteoarthritis Research Society International [OARSI] score 4.46 ± 1.09) compared to WT mice that underwent meniscectomy (n = 9) (mean ± SD OARSI score 3.05 ± 0.9; P < 0.05). CONCLUSION The non-neuronal cholinergic system is functionally expressed in chondrocytes. Stimulation of nAChR induces antiinflammatory and anticatabolic activity through α7-nAChR, but the anticatabolic activity may be mitigated by truncated α7-nAChR in human chondrocytes. In vivo experiments strongly suggest that α7-nAChR has a protective role in OA.

Alzheimer’s Disease (AD) is a neurodegenerative disorder characterized by progressive loss of memory and cognitive functions. Accumulation of Aβ peptide is considered the initiating cause of pathogenic lesions, and immunotherapy strategies targeting Aβ represent promising therapeutic approaches. Vaccination against Aβ provided encouraging results in experimental mouse models and, to a lesser extent, in a subsequent clinical trial (AN1792). Although the AN1792 trial had to be interrupted due to meningoencephalitis attributed to pro-inflammatory T cell responses in 6% of the patients, preclinical murine models did not show evidence of T cell-related side effects. In addition, several reports suggest that Aβ-specific CD4+ T cells may be implicated in the natural course of AD and could have a strong therapeutic potential as well, pointing out the need for better understanding the role and regulation of T cell responses to Aβ. We previously showed that regulatory T cells (Tregs) control Aβ-specific CD4+ T cell responses in physiological and pathological settings upon vaccination. The aim of this work was to analyze the impact of Tregs on the natural course of the disease progression in a mouse model of AD. Early transient depletion of Tregs accelerated the onset of cognitive deficits in APPPS1 mice. This result was correlated with less recruitment of microglia towards amyloid deposits and altered disease-related gene expression profile. Conversely, Tregs selectively amplifying resulted in higher numbers of plaque-associated microglia and improved cognitive functions in APPPS1 mice. These data suggest a beneficial role of Tregs in the pathophysiology of AD by modulating microglial response. Our study highlithts the therapeutic potential of Treg-based immunotherapies in AD.; La MA est caractérisée par une altération progressive des fonctions cognitives, et définie par les "dégénérescences neurofibrillaires", les "plaques séniles" et une neuroinflammation impliquant les cellules microgliales. L’immunothérapie constitue une approche thérapeutique prometteuse dans la MA. Un premier essai clinique de vaccination anti-Aβ a été arrêté après la survenue de 6% de cas de méningoencéphalites imputés à l’activation de réponses T anti-Aβ pro-inflammatoires. Cependant, des études récentes suggèrent un effet bénéfique de certaines populations de cellules T CD4+ anti-Aβ. L'ensemble de ces données suggère des rôles complexes de différentes réponses lymphocytaires T au cours de la MA, et soulignent la nécessité de mieux comprendre leur implication dans la maladie et les mécanismes de leur régulation. L’objectif de ce travail a été d’étudier l’impact des Tregs sur la progression de la maladie dans un modèle murin APPPS1. Les résultats montrent que la déplétion transitoire des Tregs accélère l’apparition des troubles cognitifs, sans altérer la pathologie amyloïde. Ces observations sont corrélées avec une réduction du recrutement des cellules microgliales autour des plaques Aβ et une altération du profil d’expression, dans le cerveau des souris, de certains gènes impliqués dans la maladie. A l’inverse, l’amplification sélective des réponses Tregs entraine une augmentation du recrutement des cellules microgliales autour des plaques et une amélioration des fonctions cognitives. L’ensemble de ces résultats suggère un rôle bénéfique des Tregs au cours de la maladie d’Alzheimer et encourage le développement d’approches d’immunothérapie basées sur leur modulation.

Alzheimer’s Disease (AD) is a neurodegenerative disorder characterized by progressive loss of memory and cognitive functions. Accumulation of Aβ peptide is considered the initiating cause of pathogenic lesions, and immunotherapy strategies targeting Aβ represent promising therapeutic approaches. Vaccination against Aβ provided encouraging results in experimental mouse models and, to a lesser extent, in a subsequent clinical trial (AN1792). Although the AN1792 trial had to be interrupted due to meningoencephalitis attributed to pro-inflammatory T cell responses in 6% of the patients, preclinical murine models did not show evidence of T cell-related side effects. In addition, several reports suggest that Aβ-specific CD4+ T cells may be implicated in the natural course of AD and could have a strong therapeutic potential as well, pointing out the need for better understanding the role and regulation of T cell responses to Aβ. We previously showed that regulatory T cells (Tregs) control Aβ-specific CD4+ T cell responses in physiological and pathological settings upon vaccination. The aim of this work was to analyze the impact of Tregs on the natural course of the disease progression in a mouse model of AD. Early transient depletion of Tregs accelerated the onset of cognitive deficits in APPPS1 mice. This result was correlated with less recruitment of microglia towards amyloid deposits and altered disease-related gene expression profile. Conversely, Tregs selectively amplifying resulted in higher numbers of plaque-associated microglia and improved cognitive functions in APPPS1 mice. These data suggest a beneficial role of Tregs in the pathophysiology of AD by modulating microglial response. Our study highlithts the therapeutic potential of Treg-based immunotherapies in AD., La MA est caractérisée par une altération progressive des fonctions cognitives, et définie par les "dégénérescences neurofibrillaires", les "plaques séniles" et une neuroinflammation impliquant les cellules microgliales. L’immunothérapie constitue une approche thérapeutique prometteuse dans la MA. Un premier essai clinique de vaccination anti-Aβ a été arrêté après la survenue de 6% de cas de méningoencéphalites imputés à l’activation de réponses T anti-Aβ pro-inflammatoires. Cependant, des études récentes suggèrent un effet bénéfique de certaines populations de cellules T CD4+ anti-Aβ. L'ensemble de ces données suggère des rôles complexes de différentes réponses lymphocytaires T au cours de la MA, et soulignent la nécessité de mieux comprendre leur implication dans la maladie et les mécanismes de leur régulation. L’objectif de ce travail a été d’étudier l’impact des Tregs sur la progression de la maladie dans un modèle murin APPPS1. Les résultats montrent que la déplétion transitoire des Tregs accélère l’apparition des troubles cognitifs, sans altérer la pathologie amyloïde. Ces observations sont corrélées avec une réduction du recrutement des cellules microgliales autour des plaques Aβ et une altération du profil d’expression, dans le cerveau des souris, de certains gènes impliqués dans la maladie. A l’inverse, l’amplification sélective des réponses Tregs entraine une augmentation du recrutement des cellules microgliales autour des plaques et une amélioration des fonctions cognitives. L’ensemble de ces résultats suggère un rôle bénéfique des Tregs au cours de la maladie d’Alzheimer et encourage le développement d’approches d’immunothérapie basées sur leur modulation.

Cerebral accumulation of aggregated Aβ40-42 peptides is among the major pathological hallmarks of Alzheimer's disease (AD). In spite of encouraging results of Aβ vaccination in preclinical mouse models, the first human clinical trial had to be interrupted because of the occurence of meningoencephalitides in 6% of the cases, supposedly related to inappropriate T cell responses. Thus, a better understanding of vaccination-induced anti-Aβ CD4+ T cell responses seems essential for the optimisation of future immunotherapeutical approaches. We tried to identify the genetic factors that control the magnitude and the nature of vaccination-induced Aβ-specific CD4+ T cell responses in mice. Both MHC-dependent and MHC-independent genetic factors are critical parameters. Among MHC-independent genetic factors, those that determine the individual propensity of generating Aβ-specific regulatory T cell (Treg) responses are important. Moreover, the vaccination-induced CD4+ T cell responses analysis in an APPPS1 mouse model of AD suggest that Tregs may inhibit anti-Aβ CD4+ T cells responses that spontaneously arise in the course of AD. These observations led us to evaluate the impact of CD4+ effector and regulatory T cell responses in the pathophysiology of AD. Using Treg depletion experiments, we evidenced the anti-neuroinflammatory functions and beneficial effects of these cells on the amyloid pathology and cognition of APPPS1 mice. Altogether, our results suggest that Treg responses may both limit vaccination efficacy and have a neuroprotective role in the course of AD., L'accumulation des peptides Aβ40-42 au niveau cérébral est un élément physiopathologique majeur de la Maladie d'Alzheimer (MA) et une cible thérapeutique potentielle. A l'issue de résultats encourageants de vaccination par Aβ dans des modèles murins de la MA, un essai clinique a été entrepris chez l'Homme. Mais il a dû être interrompu en raison de la survenue de méningo-encéphalites chez 6% des patients, supposées liées à une activation inappropriée de lymphocytes T. Une meilleure compréhension des réponses T CD4+ induites par la vaccination semble donc primordiale pour l'optimisation des stratégies vaccinales. Nous avons cherché à identifier les facteurs génétiques qui pourraient avoir un rôle sur l'amplitude et la nature des réponses vaccinales T CD4+ anti-Aβ chez la souris. Nous avons mis en évidence que l'amplitude de la réponse variait en fonction des haplotypes H-2 mais aussi de facteurs génétiques indépendants du CMH et liés à la capacité de générer des réponses T régulatrices (Tregs) anti-Aβ. De plus, l'analyse des réponses vaccinales dans un modèle murin de MA (souris APPPS1) semble suggérer qu'une réponse Treg inhiberait des réponses T CD4 effectrices anti- Aβ spontanées. Ces observations nous ont conduits à rechercher l'impact de ces réponses effectrices et régulatrices dans la physiopathologie de la maladie. En inactivant les cellules Tregs, nous avons pu mettre en évidence les fonctions anti-neuroinflammatoires et les effets bénéfiques de ces cellules sur la pathologie amyloïde et la cognition. Ensemble, nos résultats suggèrent donc que les réponses Treg pourraient limiter l'efficacité vaccinale mais auraient une action neuroprotectrice dans la physiopathologie de la MA.