Régulation de la réaction asthmatique par des agents microbiens : quelle place pour les cellules natural killer ?

Abstract : Asthma is a chronic inflammatory disease of the airways affecting 334 million of people worldwide. Among asthma patients, 5% suffers from severe asthma. Severe asthma represents a major unmet need because, despite heavy treatments, patients still suffer from uncontrolled asthma symptoms, frequent exacerbations and a dramatic decrease in their respiratory capacity. The role of microorganisms in asthma is complex. On one hand, a group of epidemiologic and experimental studies have shown that chronic exposure with bacteria or microbial compounds, particularly during early childhood, would provide protection against allergic asthma. On the other hand, respiratory viruses are responsible for 80% of exacerbations and are associated with an increasing risk of developing asthma in children, whether allergic or not. Natural Killer cells (NK) are lymphocytes involved in innate antiviral immunity. They have cytotoxic functions by lysing different types of cells but also regulatory functions by producing cytokines and activating other immune cells. Their role in asthma and its exacerbations has yet to be identified, although phenotypic changes have been observed in asthmatic patients and it has recently been shown in a mouse model that they are not involved in the development of allergic asthma. The objective of the thesis was to better understand the role of NK cells in asthmatic pathology by focusing on two aspects : virus-induced exacerbation and inhibition by microbial compounds.The hypothesis for the first part was that NK cells from asthma patients may present a dysfunction in their response to microbial agents that could promote the exacerbation of the asthmatic reaction. To do this, we analysed NK cell activation, cytotoxicity and production of cytokines from severe asthmatic patients stimulated with molecules mimicking microbes or a human rhinovirus (HRV), compared to healthy donors. We showed that NK cells from severe asthma patients were less cytotoxic than NK cells from healthy donors in response to stimulation with a Toll-like Receptor 3 or TLR7/8 agonist and HRV. Moreover, when stimulated with IL-12 and IL-15, cytokines produced during viral infections, NK cells from severe asthma patient express less IFN-γ than NK cells from healthy donors. Our results suggest that the activation of NK cells in asthma patients may be insufficient during respiratory infections and may contribute to the worsening of asthma.The hypothesis for the second part was that NK cells may participate to the inhibition of a mouse model of allergic asthma. In C57BL/6 mice sensitized with ovalbumin, instillation of FSL1, agonist of TLR2/6, inhibits the features of experimental asthma. Since this inhibition is associated with changes in the population of NK cells, we analysed their role using mice deficient in NK cells. In the absence of NK cells, mice develop allergic asthma, and inhibition by FSL1 is maintained. Therefore, NK cells do not play a role in the development of experimental allergic asthma or in its inhibition induced by a microbial agent. However, they may be modified by the allergic environment, and thus have a role in viro-induced exacerbations. This crucial question is in line with the work done in the first part of the thesis.In conclusion, our results suggest that the functions of NK cells may be modified in asthmatic pathology, whether allergic or not. Our hypothesis is that the defect in NK cell activation may participate to virus-induced asthma exacerbations. Perspectives of this work are to further characterize NK cells in severe asthma patients and to evaluate the role of NK cells in a mouse model of asthma exacerbation.
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Justine Devulder. Régulation de la réaction asthmatique par des agents microbiens : quelle place pour les cellules natural killer ?. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2019. Français. ⟨NNT : 2019LIL2S005⟩. ⟨tel-02275027⟩

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