@phdthesis{Li2014,
  author    = {Li, Xiang},
  title     = {Molecular imaging of inflammation in atherosclerosis: Preclinical study in Apolipoprotein E-Deficient mice and preliminary evaluation in human using positron emission tomography},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-104622},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2014},
  abstract  = {Motivation and Aim: Cardiovascular disease has been the leading cause of mortality and morbidity throughout the world. In developed countries, cardiovascular diseases are already responsible for a majority of deaths and will become the pre-eminent health problem worldwide (1,2). Rupture of atherosclerotic plaque accounts for approximately 70\% of fatal acute myocardial infarction and sudden heart deaths. Conventional criterias for the diagnosis of "vulnerable plaques" are calcified nodules, yellow appearance of plaque, a thin cap, a large lipid core, severe luminal stenosis, intraplaque hemorrhage, inflammation, thrombogenicity, and plaque injury (3-5). Noninvasive diagnosis of vulnerable plaque still remains a great challenge and a huge research prospect, which triggered us to investigate the feasibility of PET imaging on the evaluation of atherosclerosis. Nuclear imaging of atherosclerosis， especially co-registered imaging modalities, could provide a promising diagnostic tool including both anatomy and activities to identify vulnerable atherosclerotic plaque or early detection of inflammatory endothelium at risk. Furthermore, the development of specific imaging tracers for clinical applications is also a challenging task. The aim of this work was to assess the potential of novel PET imaging probes associated with intra-plaque inflammation on animal models and in human respectively. Methods In this work, several molecular imaging modalities were employed for evaluation of atherosclerosis. They included Positron emission tomography / Computed tomography (PET/CT) for human studies, and micro-PET, autoradiography and high-resolution magnetic resonance imaging (MRI) for animal studies. Radiotracers for PET imaging included the glucose analogue 18F-Fluorodeoxyglucose (18F-FDG), the somatostatin receptor avide tracer 68Ga-DOTATATE, and the Gallium-68 labeled fucoidan (68Ga-Fucoidan), which was developed as a PET tracer to detect endothelial P-selectin, which overexpressed at early stage of atherosclerosis and endothelial overlying activated plaque. Tracer's capabilities were firstly assessed on cellular level in vitro. Subsequently, Animal studies were conducted in two animal models: 1, Apolipoprotein E (ApoE-/-) mice having severe atherosclerotic plaque; 2, Lipopolysaccharide (LPS) -induced mice for receiving acute vascular inflammation. Corresponding analyses on protein and histological level were conducted as well to confirm our results. In human study, 16 patients with neuroendocrine tumors (NETs) were investigated on imaging vascular inflammation. These patients had undergone both 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT for staging or restaging within 6 weeks. 16 patients were randomized into two groups: high-risk group and low-risk group. Uptake ratio of both tracers from two groups were compared and correlated with common cardiovascular risk factors. Results and Conclusion In murine study, the expression of somatostatin receptor 2, which is the main bio-target of 68Ga-DOTATATE on macrophage/monocyte was confirmed by flow cytometry and immunohistochemistry. Prospectively, high specific accumulation of 68Ga-DOTATATE to the macrophage within the plaques was observed in aorta lesions by autoradiography and by micro-PET. In study with 68Ga-fucoidan, a strong expression of P-selectin on active endothelium overlying on inflamed plaque but weaker on inactive plaques was confirmed. Specific focal uptake of 68Ga-fucoidan were detected at aorta segments by micro-PET, and correlated with high-resolution magnetic resonance imaging (MRI), which was used to characterize the morphology of plaques. 68Ga-fucoidan also showed a greater affinity to active inflamed plaque in comparison of inactive fibrous plaque, which was assessed by autoradiography. Specificity of 68Ga-DOTATATE and 68Ga-fucoidan were confirmed by ex-vivo blocking autoradiography and in vivo blocking PET imaging respectively. In human study, focal uptake of both 18F-FDG and 68Ga-DOTATATE was detected. Analyzing concordance of two tracers' uptake ratio, Out of the 37 sites with highest focal 68Ga-DOTATATE uptake, 16 (43.2\%) also had focal 18F-FDG uptake. Of 39 sites with highest 18F-FDG uptake, only 11 (28.2\%) had a colocalized 68Ga-DOTATATE accumulation. Correlated tracers' uptake and calcium burden and risk factors, Mean target-to-background ratio (TBR) of 68Ga-DOTATATE correlated significantly with the presence of calcified plaques (r=0.52), hypertension (r=0.60), age (r=0.56) and uptake of 18F-FDG (r=0.64). TBRmean of 18F-FDG correlated significantly only with hypertension (r=0.58; p<0.05). Additionally, TBRmean of 68Ga-DOTATATE is significant higher in the high risk group while TBRmean of 18F-FDG is not. In conclusion, we evaluated vascular inflammation of atherosclerosis non-invasively using the two PET tracers: 68Ga-DOTATATE and 68Ga-Fucoidan. 68Ga-DOTATATE show specific affinity to infiltrated macrophage within the plaques. 68Ga-Fucoidan may hold the potential to discriminate between active and inactive atherosclerotic plaques in terms of variant accumulation on different-types of plaques. PET as leading molecular imaging technique provides superiority in assessing cellular activity, which is pivotal for understanding internal activity of atherosclerotic plaques. Since diagnosis of atherosclerosis is a complex and multi-dimensional task. More integrated imaging technology such as PET/MRI, faster imaging algorithm, more efficient radiotracer are required for further development of atherosclerosis imaging,},
  subject      = {Arteriosklerose},
  language  = {en}
}
@phdthesis{Fischer2008,
  author    = {Fischer, Stefan Martin},
  title     = {Regulation and functional consequences of MCP-1 expression in a model of Charcot-Marie-Tooth 1B disease},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-29189},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2008},
  abstract  = {Charcot-Marie-Tooth 1B (CMT1B) is a progressive inherited demyelinating disease of human peripheral nervous system leading to sensory and/or motor function disability and is caused by mutations in the P0 gene. Mice heterozygously deficient for P0 (P0+/-) are an adequate model of this human disorder showing myelin degeneration, formation of onion bulbs, remyelination and a reduced motor conduction velocity of around 30m/s similar to patients. Previously, it had been shown that T-lymphocytes and macrophages play a crucial role during pathogenesis in peripheral nerves of P0+/- mice. Both, T-lymphocytes and macrophages increase in number in the endoneurium and deletion of T-lymphocytes or deletion of a macrophage-directed cytokine ameliorates the disease. In this study the monocyte chemoattractant protein-1 (MCP-1) was identified as an early regulated cytokine before onset of disease is visible at the age of six months. MCP-1 mRNA and protein expression could be detected in femoral quadriceps and sciatic nerves of P0+/- mice already at the age of one month but not in cutaneous saphenous nerves which are never affected by the disease. MCP-1 was shown to be expressed by Schwann cells and to mediate the immigration of immune cells into peripheral nerves. Deletion of MCP-1 in P0+/- mice accomplished by crossbreeding P0 and MCP-1 deficient mice revealed a substantial reduction of immune cells in peripheral nerves of P0+/-/MCP-1+/- and P0+/-/MCP-1-/- mice at the age of six months. In twelve months old mice reduction of immune cells in peripheral nerves is accompanied by amelioration of demyelinating disease in P0+/-/MCP-1+/- and aggravation of demyelinating disease in lumbar ventral roots of P0+/ /MCP-1-/- mice in comparison to P0+/ /MCP 1+/+ mice. Furthermore, activation of the MEK1/2-ERK1/2 signalling cascade could be demonstrated to take place in Schwann cells of affected peripheral nerves of P0+/- mice overlapping temporarily and spatially with MCP-1 expression. An animal experiment using a MEK1/2-inhibitor in vivo, CI-1040, revealed that upon reduction of ERK1/2 phosphorylation MCP-1 mRNA expression is diminished suggesting that the activation of the MEK1/2-ERK1/2 signalling cascade is necessary for MCP-1 expression. Additionally, peripheral nerves of P0+/- mice showing reduced ERK1/2 phosphorylation and MCP-1 mRNA expression also show reduced numbers of macrophages in the endoneurium. This study shows a molecular link between a Schwann cell based mutation and immune cell function. Inhibition of the identified signalling cascade might be a putative target for therapeutic approaches.},
  subject      = {Schwann-Zelle},
  language  = {en}
}
@phdthesis{Lim2007,
  author    = {Lim, Hee-Young},
  title     = {Functional studies of GR and MR function by RNA interference},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-23646},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2007},
  abstract  = {Die Steroidhormone Corticosteron/Cortisol und Aldosteron werden in Folge von Stress oder eines ver{\"a}nderten Salz-Wasser-Haushalt durch die Nebenniere synthetisiert und sezerniert. Dies wird durch negative R{\"u}ckkopplungsmechanismen kontrolliert, die als HPA-Achse und RAAS bezeichnet werden. Die Aktivit{\"a}t dieser Steroidhormone wird durch den Glukokortikoid Rezeptor (GR) und den Mineralokortikoid-Rezeptor (MR) vermittelt, die im Zytosol als Komplex mit Hitze-Schock-Proteinen vorliegen. Sowohl der GR als auch der MR geh{\"o}ren zur Kern-Rezeptor Superfamilie und besitzen eine gemeinsame Proteinstruktur die aus drei verschiedenen Dom{\"a}nen besteht. Trotzdem haben sie verschiedene Affinit{\"a}ten f{\"u}r ihre Liganden, ihre Aktivit{\"a}t h{\"a}ngt von der Hormonkonzentration ab, sie werden durch Pr{\"a}-Rezeptor-Mechansimen wie der 11b-HSD2 reguliert und ihre Gewebeverteilung ist unterschiedlich. Aldosteron wirkt in epithelialen und nicht-epithelialen Zellen {\"u}ber den MR und reguliert den Salz-Wasser-Haushalt, die Herzfunktion, die neuronale Erregbarkeit und die Adipozyten-Differenzierung. Bislang war die Analyse der Geninaktivierung in vivo auf M{\"a}use beschr{\"a}nkt, obwohl Krankheitsmodelle in der Ratte die Verh{\"a}ltnisse im Menschen manchmal besser widerspiegeln. Da embryonale Stammzellen und damit die gezielte Genmanipulation in Ratten nicht verf{\"u}gbar sind, haben wir MR knock-down Ratten mittels lentiviral eingef{\"u}hrter shRNAs hergestellt. Die F1 Nachkommen der Gr{\"u}nder-Ratten zeigten unterschiedlich stark reduzierte MR mRNA und Protein Niveaus in Niere und Hippocampus, den Hauptexpressions-Regionen des MR. Im Gegensatz dazu war die Expression des GR unver{\"a}ndert, was die Spezifit{\"a}t der Geninaktivierung belegt. Die zwei MR Zielgene Sgk1 und ENaC waren hochreguliert w{\"a}hrend die mRNA Spiegel anderer Gene wie IK1 und SCD2 erniedrigt waren. {\"A}hnlich wie in den knock-out M{\"a}usen und Patienten zeigten die knock-down Ratten die typischen Merkmale des Pseudohypoaldosteronismus Typ I wie erh{\"o}hte Serumspiegel von Aldosteron und Renin sowie Wachstumsretardation. Weiterhin fanden wir einen linearen Zusammenhang zwischen der MR Expression in der Niere, den Serum Aldosteron-Werten und dem K{\"o}rpergewicht. Zusammengefasst sind unsere MR knock-down Ratten unter den ersten Beispielen f{\"u}r RNAi in vivo und belegen, dass diese Technik es erlaubt, abgestufte Auspr{\"a}gugen der Geninktivierung wie in humanen genetischen Erkrankungen zu erreichen. Weiterhin haben wir die Rolle des GR und des MR f{\"u}r die immunmodulatorische Aktivit{\"a}t der Glukokortikoide in peritonealen Makrophagen untersucht. GCs sind an der Kontrolle der Makrophagenfunktion beteiligt und regulieren so die Reaktion gegen{\"u}ber Pathogenen. Aus diesem Grund werden GCs weitverbreitet zur Behandlung von Enz{\"u}ndungen und Autoimmunerkrankungen eingesetzt. Allerdings ist bez{\"u}glich dieser GC Aktivit{\"a}ten weder bekannt welche Kontrolle die Hormonkonzentration spielt noch kennt man den differentiellen Beitrag des GR und des MR. Zuerst best{\"a}tigten wir die Expression beider Rezeptoren in peritonealen Makrophagen w{\"a}hrend die 11b-HSD2 nicht exprimiert war. Anschließend zeigten wir, dass niedrigte Corticosteron-Level die NO Produktion sowie die mRNA Expression von pro-inflammatorischen Zytokinen, Chemokinen und Enzymen die f{\"u}r die Mediator-Synthesee ben{\"o}tigt werden erh{\"o}hen. Im Gegensatz dazu war die Makrophagen Funktion bei hohen Corticosteron-Konzentrationen stark reprimiert. Eine wichtige Beobachtung war, dass die Inaktivierung des GR durch lentiviral eingef{\"u}hrte siRNAs sowohl die immunstimulatorischen als auch die immunsuppressiven GR Aktivit{\"a}ten aufhob w{\"a}hrend die Inaktivierung des MR keine Konsequenzen hatte. Weiterhin f{\"u}hrte der Verlust endogenener GCs nach Adrenalektomie in vivo zu einem pr{\"a}-aktivierten Zustand der Makrophagen, welcher durch Corticosteron moduliert werden konnte. Wir schließen hieraus, dass GCs in Abh{\"a}ngigkeit von ihrer Konzentration unterschiedliche Effekte auf die Makrophagen Funktion haben und dass diese durch den GR vermittelt werden, obwohl der MR ebenfalls exprimiert ist. Zusammengefasst best{\"a}tigen unsere Ergebnisse dass die lenivirale Transduktion von shRNAs eine effiziente Methode zur Geninaktivierung in prim{\"a}ren Zellen und transgenen Ratten darstellt und es so erlaubt, funktionelle Studien durchzuf{\"u}hren die zuvor auf M{\"a}use beschr{\"a}nkt waren.},
  language  = {en}
}