A proliferation inducing ligand (APRIL), une molécule, deux fonctions opposées dans l'autoimmunité

Abstract : Autoimmune diseases result from a dysfunction of the immune system. The disease etiology is often unknown, complicating the design of appropriate treatments. This thesis project focused on the molecule “a proliferation inducing ligand” (APRIL), a survival factor for antibody-producing plasma cells (PC), in autoimmune hepatitis (AIH) and multiple sclerosis (MS). In AIH, one main histological feature is the presence of a lymphoplasmacytic infiltration forming a damaging interface hepatitis. In this disease, we first noticed a positive correlation between APRIL expression and PC infiltration in portal spaces. In vitro, we further observed an extended survival of liver PC in the presence of APRIL. The corticosteroid therapy commonly applied to AIH patients does not directly target PC. However, we noticed a concomitant reduction in portal PC density and APRIL expression. Hence, this study is extending the survival role of APRIL to liver PC in AIH. Relapses are frequent after treatment withdrawal, telling us that pathogenic cells are spared by the therapy. Our results indicate that APRIL targeting might also be valuable in AIH. Own to its role on PC, APRIL has been successfully targeted in several autoimmune diseases. Besides successes, a clinical trial aiming at APRIL blockade in MS has unfortunately led to an unexpected disease exacerbation. We have been able to show that APRIL targets a new cell type in the central nervous system, the astrocyte. The APRIL binding to astrocyte surface depends on a new binding partner, expressed by the latter, the chondroitin sulfate proteoglycans. This binding induces the production of the anti-inflammatory cytokine IL-10, leading to the inhibition of, self-reactive T-cell proliferation and pro-inflammatory cytokine secretion. Use of APRIL-deficient mice in the standard model of MS allowed us to confirm the neuroprotective role of APRIL. Finally, after recombinant APRIL injection in this model, a lowered disease severity was observed. Overall, we identified APRIL as a dual role molecule in autoimmune diseases.
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Laurie Baert. A proliferation inducing ligand (APRIL), une molécule, deux fonctions opposées dans l'autoimmunité. Immunothérapie. Université Grenoble Alpes, 2019. Français. ⟨NNT : 2019GREAV008⟩. ⟨tel-02191630⟩

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