Sir Peter MacCallum Department of Oncology - Theses

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    A cell-based functional assay that accurately links genotype to phenotype in Familial HLH
    Noori, Tahereh ( 2023-04)
    Cytotoxic lymphocytes protect humans against viral pathogens and cancer by killing infected and transformed cells, through perforin-mediated mechanism. Mutations in perforin (PRF1) itself or in the secretory machinery responsible for its release (UNC13D, STX11, and STXBP2) are catastrophic, and lead to fatal immune dysregulation, an autosomal recessive disease called familial haemophagocytic lymphohistiocytosis (FHL). Traditionally, FHL has been associated with infant patients. However, it is now apparent that many patients remain disease-free for years, and then present with highly variable and often unexpected symptoms. They remain undiagnosed for a long time and, instead of receiving curative stem cell transplantation, they are treated symptomatically leading to high risk of severe neurological impairment, organ failure and/or death. While the pathogenicity of frame-shift/nonsense mutations is rarely in doubt, the effect of missense mutations on protein function can vary enormously. Yet, over the last two decades, the pathogenicity of missense mutations was almost invariably assumed, and invasive stem cell transplantation was considered without confirmed pathogenicity of mutations. Sadly, transplantation without genetically proven FHL results in a 20% increased mortality compared to patients with proven FHL. Therefore, early and accurate diagnosis of the disease is essential to determine the most appropriate treatment option. Due to the diversity of genetic causes of FHL, there was no test available to directly assess the effect of mutations on cytotoxic lymphocyte function, leading to delayed/erroneous diagnoses. To overcome this diagnostic problem, we have developed a simple, rapid, and robust method that takes advantage of the functional equivalence of the human and mouse orthologues of PRF1, UNC13D, STX11 and STXBP2 proteins. By knocking out endogenous mouse genes in CD8+ T cells and simultaneously expressing their mutated human orthologues, we can accurately assess the effect of mutations on cell function. The wide dynamic range of this novel system allowed us to understand the basis of otherwise cryptic cases of FHL/HLH and, in some instances, to demonstrate that previously reported mutations are unlikely to cause FHL. In addition to diagnosing patients, this unique approach will be paramount for assessing the prognosis of asymptomatic siblings and to guide genetic counselling advice for prospective parents.
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    Serglycin glycosylation role in the effector mechanism of cytotoxic lymphocytes
    Torres Riquelme, Alejandro Antonio ( 2022-04)
    The function of cytotoxic T lymphocytes and Natural Killer cells is important for the clearance of intracellular pathogens and malignantly transformed cells. Recognition of infected/transformed cells and their elimination depends strongly on the capacity of cytotoxic lymphocytes to release cytotoxic effector proteins Perforin and granzyme B. This process is known as the Granular death pathway, which has an essential role in Cytotoxic lymphocyte function and immune homeostasis since its deficiency is known to lead to pathologies related to immune misbalance, which are usually deadly to the host. Along with the cytotoxic effector proteins, a heavily glycosylated proteoglycan is found in the secreted granule content of Cytotoxic lymphocytes, which upon analysis, led to the discovery of a small protein serglycin, named after the serine-glycine repetitions found in the centre of it protein sequence. The presence of serglycin in cells has been associated with the storage and retention of multiple proteases and hormones in cells of endothelial and hematopoietic origin, suggesting its importance in secretory functions across various tissues and cells. In the case of cytotoxic T lymphocytes and NK cells, the presence of serglycin is central for the retention of cytotoxic effector proteins and the formation of dense-core secretory granules. However, how the interaction mechanism with Prf and GzmB, as the mechanism of cytotoxic secretory vesicle biogenesis remains unknown. This project will focus on the study of the serglycin gene, the produced protein, and its modification in the hopes to better understand the motifs and interaction allows the retention and function of cytotoxic effector proteins in cytotoxic T cells.
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    Investigating the mechanism of cytotoxic lymphocyte resistance to perforin
    Rudd-Schmidt, Jesse Alexander ( 2020)
    Cytotoxic lymphocytes are highly efficient killer cells of the immune system. They destroy cognate target cells by secreting highly toxic effector molecules, the pore-forming protein perforin and pro-apoptotic serine proteases granzymes, into the confines of the immune synapse. Despite both the lymphocyte and target cell plasma membrane being equally exposed to the perforin and granzymes, the lymphocytes invariably survive that encounter as they remain resistant to perforin pores. This project investigates the mechanisms behind this unique phenomenon.