@phdthesis{Gulve2019,
  author    = {Gulve, Nitish},
  title     = {Subversion of Host Genome Integrity by Human Herpesvirus 6 and \(Chlamydia\) \(trachomatis\)},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-162026},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2019},
  abstract  = {Ovarian cancer is one of the most common gynecological malignancies in the world. The prevalence of a microbial signature in ovarian cancer has been reported by several studies till date. In these microorganisms, Human herpesvirus 6 (HHV-6) and Chlamydia trachomatis (C.tr) are especially important as they have significantly high prevalence rate. Moreover, these pathogens are directly involved in causing DNA damage and thereby disrupting the integrity of host genome which is the underlying cause of any cancer. This study focuses on how the two pathogens, HHV-6 and C. trachomatis can affect the genome integrity in their individual capacities and thereby may drive ovarian epithelial cells towards transformation. HHV-6 has unique tendency to integrate its genome into the host genome at subtelomeric regions and achieve a state of latency. This latent virus may get reactivated during the course of life by stress, drugs such as steroids, during transplantation, pregnancy etc. The study presented here began with an interesting observation wherein the direct repeat (DR) sequences flanking the ends of double stranded viral genome were found in unusually high numbers in human blood samples as opposed to normal ratio of two DR copies per viral genome. This study was corroborated with in vitro data where cell lines were generated to mimic the HHV-6 status in human samples. The same observation of unusually high DR copies was found in these cell lines as well. Interestingly, fluorescence in situ hybridization (FISH) and inverse polymerase chain reaction followed by southern blotting showed that DR sequences were found to be integrated in nontelomeric regions as opposed to the usual sub-telomeric integration sites in both human samples and in cell lines. Sanger sequencing confirmed the non-telomeric integration of viral DR sequences in the host genome. Several studies have shown that C. trachomatis causes DNA damage and inhibits the signaling cascade of DNA damage response. However, the effect of C. trachomatis infection on process of DNA repair itself was not addressed. In this study, the effect of C. trachomatis infection on host base excision repair (BER) has been addressed. Base excision repair is a pathway which is responsible for replacing the oxidized bases with new undamaged ones. Interestingly, it was found that C. trachomatis infection downregulated polymerase β expression and attenuated polymerase β- mediated BER in vitro. The mechanism of the polymerase β downregulation was found to be associated with the changes in the host microRNAs and downregulation of tumor suppressor, p53. MicroRNA-499 which has a binding site in the polymerase β 3'UTR was shown to be upregulated during C. trachomatis infection. Inhibition of miR-499 using synthetic miR-499 inhibitor indeed improved the repair efficiency during C. trachomatis infection in the in vitro repair assay. Moreover, p53 transcriptionally regulates polymerase β and stabilizing p53 during C. trachomatis infection enhanced the repair efficiency. Previous studies have shown that C. trachomatis can reactivate latent HHV-6. Therefore, genomic instability due to insertions of unstable 'transposon-like' HHV-6 DR followed by compromised BER during C. trachomatis infection cumulatively support the hypothesis of pathogenic infections as a probable cause of ovarian cancer},
  subject      = {Chlamydia trachomatis},
  language  = {en}
}
@phdthesis{MontalbandelBarrio2015,
  author    = {Montalb{\´a}n del Barrio, Itsaso},
  title     = {Immunosuppressive role of adenosine produced by ectonucleotidases CD39 and CD73 in ovarian cancer, tumor associated macrophages and the host immune system},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-133268},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Eierstockkrebs ist der Tumor mit der schlechtesten Heilungsprognose unter allen gyn{\"a}kologischen Malignomen. Allein in Deutschland verursacht er {\"u}ber 6000 Tote pro Jahr. Patienten mit Ovarialkarzinom zeigen erst in einem sehr fortgeschrittenen Stadium charakteristische Symptome. Die einzig m{\"o}glichen Behandlungsmethoden sind dann die operative Tumorentfernung und die Verabreichung von platinbasierter Chemotherapien sowie von Anthrazyklinen. Da die aktuelle 5-Jahres-{\"U}berlebensrate lediglich 20-40\% betr{\"a}gt, besteht ein dringender Bedarf an neuen therapeutischen Optionen. Seit herausgefunden wurde, dass immunologische Parameter das {\"U}berleben der Patienten beeinflussen, ist Immuntherapie zu einer der vielversprechendsten Behandlungsarten des Eierstockkrebs geworden. Das Ziel unserer Forschung ist die {\"U}berwindung der Immunevasion des Tumors durch ein Verhindern der immun-unterdr{\"u}ckenden Mechanismen des Tumors. Im Speziellen befasst sich diese Arbeit mit dem Einfluss von Adenosin, das durch die Ectonukleotidasen CD39 und CD73 in der Mikroumgebung des Tumors gebildet wird. Die CD39- und CD73-Expression der Zellen f{\"u}hrt zu Immunosuppression da diese Ectonukleotidasen immun-stimulierendes, extrazellul{\"a}res ATP in immunsuppressives Adenosin umwandeln. Dies wurde zuerst als Effektormechanismus f{\"u}r regulatorische T-Zellen beschrieben, kann aber auch im Tumormikromilieu von Bedeutung sein. Mit dem Wissen, dass Tumorzellen von Eierstockkrebs-Patientinnen große Mengen der ATP-unterdr{\"u}ckenden Ectonukleotidasen CD39 und CD73 bilden, analysierten wir die adenosinvermittelte Unterdr{\"u}ckendung von Immunantwortenin der Mikroumgebung der Tumorzellen. Im Vergleich zu regulatorischen T Zellen konnten wir bei Eierstockkrebs-Zelllinien und bei aus Aszites gewonnenen Krebszellen eine 30- bis 60-fache Adenosinproduktion messen. Um diesen mutmaßlichen Immunevasions-Mechanismus zu best{\"a}tigen, untersuchten wir seine Auswirkungen auf mehrere Immunzellenpopulationen. CSFE-basierte Experimente zeigten zum Beispiel eine Hemmung der CD4+ T-Zell-Proliferation durch Adenosin, welches von Eierstockkrebs-Zellen produziert wurde. In diesem Zusammenhang haben wir auch eine in-vitro Methode entwickelt, mit der wir die Beeinflussung von Makrophagen durch Eierstockkrebszellen analysieren und modulieren konnten. Neben seiner suppressiven Wirkung {\"u}bt Adenosin auch chemotaktische Effekte auf menschliche Monozyten aus und lockt wahrscheinlich myeloide Vorl{\"a}uferzellen zum Tumorgewebe. Anschließend differenzieren sich menschliche Monozyten in einer von Eierstockkrebszellen geformten Mikroumgebung zu M2 Makrophagen oder tumor-assoziierten Makrophagen (TAMs), die ihrerseits erhebliche Mengen der Adenosin-produzierenden Ectonukleotidasen CD39 und CD73 bilden. W{\"a}hrend wir die Regulierung der Ectonukleotidasen-Expression untersuchten, entdeckten wir auch, dass klinisch genutzte Techniken zur Behandlung von Eierstockkrebs (zum Beispiel die Anwendung von Doxorubicin oder Bestrahlung) in vitro das CD73- und CD39-Level von Eierstockkrebs- und Immunzellen beeinflussen. In dieser Studie zeigen wir, wie dieser behandlungsbedingte Wechsel des ATP/Adenosine-Verh{\"a}ltnisses die Effektorfunktion verschiedener Immunzellen moduliert. Dar{\"u}ber hinaus untersuchen wir den potentiellen Vorteil von klinisch verf{\"u}gbaren, niedermolekularen Inhibitoren f{\"u}r CD39 und CD73, die die Immunsuppression in der Mikroumgebung des Tumors partiell aufheben k{\"o}nnten, und die vor allem in Kombination mit g{\"a}ngigen Behandlungsschemata von großem Interesse sein k{\"o}nnten.},
  subject      = {Eierstockkrebs},
  language  = {en}
}
@phdthesis{Seida2012,
  author    = {Seida, Ahmed Adel},
  title     = {The Immunomodulatory Role of Endogenous Glucocorticoids in Ovarian Cancer},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-73901},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2012},
  abstract  = {Ovarian cancer currently causes ~6,000 deaths per year in Germany alone. Since only palliative treatment is available for ovarian carcinomas that have developed resistance against platinum-based chemotherapy and paclitaxel, there is a pressing medical need for the development of new therapeutic approaches. As survival is strongly influenced by immunological parameters, immunotherapeutic strategies appear promising. The research of our group thus aims at overcoming tumour immune escape by counteracting immunosuppressive mechanisms in the tumour microenvironment. In this context, we found that tumour-infiltrating myeloid-derived suppressor cells (MDSC) or tumour associated macrophages (TAM) which are abundant in ovarian cancer express high levels of the enzyme 11β-hydroxysteroid dehydrogenase1 (11-HSD1). This oxido-reductase enzyme is essential for the conversion of biologically inactive cortisone into active cortisol. In line with this observation, high endogenous cortisol levels could be detected in serum, ascitic fluid and tumour exudates from ovarian cancer patients. Considering that cortisol exerts strong anti-inflammatory and immunosuppressive effects on immune cells, it appears likely that high endogenous cortisol levels contribute to immune escape in ovarian cancer. We thus hypothesised that local activation of endogenous glucocorticoids could suppress beneficial immune responses in the tumour microenvironment and thereby prevent a successful immunotherapy. To investigate the in vivo relevance of this postulated immune escape mechanism, irradiated PTENloxP/loxP loxP-Stop-loxP-krasG12D mice were reconstituted with hematopoietic stem cells from either glucocorticoid receptor (GR) expressing mice (GRloxP/loxP) or from mice with a T cell-specific glucocorticoid receptor knock-out (lck-Cre GRloxP/loxP) mice. In the host mice, the combination of a conditional PTEN knock-out with a latent oncogenic kras leads to tumour development when a Cre-encoding adenovirus is injected into the ovarian bursa. Using this model, mice that had been reconstituted with GC-insensitive T cells showed better intratumoural T cell infiltration than control mice that had received functionally unaltered GRloxP/loxP cells via adoptive transfer. However, tumour-infiltrating T cells mostly assumed a Foxp3+ (regulatory) phenotype and survival was even shortened in mice with cortisol-insensitive T cells. Thus, endogenous cortisol seems to inhibit immune cell infiltration in ovarian cancer, but productive anti-tumour immune responses might still be prevented by further factors from the tumour microenvironment. Thus, our data did not provide a sufficiently strong rationale to further pursue the antagonisation of glucocorticoid signalling in ovarian cancer patients, Moreover, glucocorticoids are frequently administered to cancer patients to reduce inflammation and swelling and to prevent chemotherapy-related toxic side effects like nausea or hypersensitivity reactions associated with paclitaxel therapy. Thus, we decided to address the question whether specific signalling pathways in innate immune cells, preferentially in NK cells, could still be activated even in the presence of GC. A careful investigation of the various activating NK cell receptors (i.e. NKp30, NKp44, NKp46), DNAM-1 and NKG2D) was thus performed which revealed that NKp30, NKp44 and NKG2D are all down-regulated by cortisol whereas NKp46 is actually induced by cortisol. Interestingly, NKp46 is the only known receptor that is strictly confined to NK cells. Its activation via crosslinking leads to cytokine release and activation of cytotoxic activity. Stimulation of NK cells via NKp46 may contribute to immune-mediated tumour destruction by triggering the lysis of tumour cells and by altering the cytokine pattern in the tumour microenvironment, thereby generating more favourable conditions for the recruitment of antigen-specific immune cells. Accordingly, our observation that even cortisol-treated NK cells can still be activated via NKp46 and CD2 might become valuable for the design of immunotherapies that can still be applied in the presence of endogenous or therapeutically administered glucocorticoids.},
  subject      = {Cortison},
  language  = {en}
}