@phdthesis{Eman2013,
  author    = {Eman, Maher Othman Sholkamy},
  title     = {In Vitro and In Vivo Analysis of Insulin-Induced Oxidative Stress and DNA Damage},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-69274},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2013},
  abstract  = {Hyperinsulinemia, a condition with excessively high insulin blood levels, is related to an increased cancer incidence. Diabetes mellitus, metabolic syndrome, obesity and polycystic ovarian syndrome are the most common of several diseases accompanied by hyperinsulinemia. Since an elevated cancer risk especially for colon and kidney cancers, was reported for those patients, we investigated for the first time the induction of genomic damage by insulin mainly in HT29 (human colon cells), LLC-PK1 (pig kidney cells), HK2 (human kidney cells) and peripheral lymphocytes, and to confirm the genotoxicity of insulin in other cells from different tissues. To ascertain that the insulin effects were not only limited to permanent cell lines, rat primary colon, kidney, liver and fatty tissue cells were also studied. To connect the study and the findings to in vivo conditions, two in vivo models for hyperinsulinemia were used; Zucker diabetic fatty rats in a lean and diabetic state infused with different insulin concentrations and peripheral lymphocytes from type 2 diabetes mellitus patients. First, the human colon adenocarcinoma cells (HT29) showed significant elevation of DNA damage using comet assay and micronucleus frequency analysis upon treatment with 5 nM insulin in standard protocols. Extension of the treatment to 6 days lowered the concentration needed to reach significance to 0.5-1 nM. Insulin enhanced the cellular ROS production as examined by the oxidation of the dyes 2´,7´-dichlorodihydrofluorescein diacetate (H2DCF-DA) and dihydroethidium (DHE). The FPG modified comet assay and the reduction of damage by the radical scavenger tempol connected the insulin-mediatedDNA damage to ROS production. To investigate the sources of ROS upon insulin stimulation, apocynin and VAS2870 as NADPH oxidase inhibitors and rotenone as mitochondrial inhibitor were applied in combination with insulin and all of them led to a reduction of the genomic damage. Investigation of the signaling pathway started by evaluation of the binding of insulin to its receptor and to the IGF-1 receptor. The results showed the involvement of both receptors in the signaling mechanism. Following the activation of both receptors, PI3K activation occurs leading to phosphorylation of AKT which in turn activates two pathways for ROS production, the first related to mitochondria and the second through activation of Rac1 , resulting in the activation of Nox1. Both pathways could be activated through AKT or through the mitochondrial ROS which in turn could activates Nox1. Studying another human colon cancer cell line, Caco-2 and rat primary colon cells in vitro confirmed the effect of insulin on cellular chromatin. We conclude that pathophysiological levels of insulin can cause DNA damage in colon cells, which may contribute to the induction or progression of colon cancer. Second, in kidney cells, insulin at a concentration of 5 nM caused a significant increase in DNA damage in vitro. This was associated with the formation of reactive oxygen species (ROS). In the presence of antioxidants, blockers of the insulin and IGF-1 receptors, and a phosphatidylinositol 3-kinases (PI3K) inhibitor, the insulin mediated DNA damage was reduced. Phosphorylation of AKT was increased and p53 accumulated. Inhibition of the mitochondrial and NADPH oxidase related ROS production reduced the insulin mediated damage. In primary rat cells insulin also induced genomic damage. HK2 cells were used to investigate the mechanistic pathway in the kidney The signaling is identical to the one in the colon cells untill the activation of the mitochondrial ROS production, because after the activation of PI3K activation of Nox4 occurs at the same time across talk between mitochondria and Nox4 activation has been suggested and might play a role in the observed effects. In the in vivo model, kidneys from healthy, lean ZDF rats, which were infused with insulin to yield normal or high blood insulin levels, while keeping blood glucose levels constant, the amounts of ROS and p53 were elevated in the high insulin group compared to the control level group. ROS and p53 were also elevated in diabetic obese ZDF rats. The treatment of the diabetic rats with metformin reduced the DNA oxidation measured as 8-oxodG as well as the ROS production in that group. HL60 the human premyelocytic cells and cultured lymphocytes as models for the hemopoietic system cells showed a significant induction for DNA damage upon treatment with insulin. The diabetic patients also exhibited an increase in the micronucleus formation over the healthy individuals. In the present study, we showed for the first time that insulin induced oxidative stress resulting in genomic damage in different tissues, and that the source of the produced ROS differs between the tissues. If the same mechanisms are active in patients, hyperinsulinemia might cause genomic damage through the induction of ROS contributing to the increased cancer risk, against which the use of antioxidants as well as mitochondrial and NADPH oxidase inhibitors might exert protective effects with cancer preventive potential under certain conditions. Normal healthy human plasma insulin concentrations are in the order of 0.04 nM after overnight fasting and increase to less than about 0.2 nM after a meal. Pathophysiological levels can reach 1 nM and can stay above 0.2 nM for the majority of the daytime yielding condictions close to the insulin concentrations determined in the present study. Whether the observed effects also occur in vivo and whether they actually initiate or promote tumor formation remains to be determined. However, if proof of that can be obtained, our experiments with inhibitors indicate chances for pharmacological intervention applying antioxidants or enzyme inhibitors. It will not be the aim to reduce ROS in any case or as much as possible because ROS have now been recognized as important signaling molecules and participatants in immune defense, but a reduction to physiological levels instead of pathophysiological levels in the context of a disease associated with ROS overproduction might be beneficial.},
  subject      = {Insulin},
  language  = {en}
}
@phdthesis{Vukicevic2004,
  author    = {Vukicevic, Vladimir},
  title     = {Mechanisms of apoptosis modulation and their contribution to genomic instability in tumor cells},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-10605},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2004},
  abstract  = {The concept of programmed cell death has been increasingly considered from various aspects since early 1970's. Primarily, knowledge of apoptosis referred to morphological changes in which chromatin is condensed and increasingly fragmented, revealed as small structure in the nucleus. The membrane shrinks and the cell becomes dense as can be seen by flow cytometry. Interestingly, similar modes of cell deletion were observed in nematodes indicating that apoptosis is a highly conserved machinery. Three Caeonorhabditis elegans gene products are found to have high homology with mammalian apoptotic genes: CED-9 inhibits apoptosis and is related to bcl-2; CED-3 and CED-4 promote apoptosis and are related to caspase 9 and APAF-1. Apoptosis is not accidental death, but a highly controlled and medically important molecular process. More general terms such as 'physiological' or 'regulated' cell death cover different morphologies and sequences. Programmed suicide of cells that were subjected to toxic exogenous and endogenous stimuli plays a key role in understanding cancer development and its treatment. Apoptosis involves sequences of events that may overlap and play contradictory or antagonistic roles in cell death. Generally, the ability to trigger apoptotic processes in cancer cells would benefit an organism by keeping homeostasis intact. Programmed cell death is a regularly present mechanism, for instance, in lymphocyte recruitment in the thymus where immature lymphocytes may recognize host antigens. Therefore, such lymphocytes become apoptotic and are removed by macrophages. Removal prevents possible autoimmune diseases. Unlike apoptosis, necrosis is a passive process of cell death recognizable by membrane morphological changes and accompanied by leakage of intracellular material into intercellular space that may cause inflammation in the organism. Signals that may initiate apoptosis are generally classified into two groups: signals that launch extrinsic apoptotic pathways starting with aggregation of death receptors and intrinsic apoptotic pathways starting with disruption of intracellular homeostasis such as the release of mitochondrial factors or DNA degradation. Early in the process, apoptotic signals may lead to a broad range of signaling mechanisms such as DNA repair and assessment of DNA damage (check points). Thus, failure in any of these steps can cause a defective apoptotic response that plays a decisive role in both tumorigenesis and drug resistance in tumor treatment. More distinctly, the capability of cancer cells to go into apoptosis prevents further neoplastic changes. Generally, the purpose of this study is to investigate the balance between formation of genomic damage and induction of apoptosis under genotoxic stress. After genotoxic insult there are different possibilities for the fate of a cell (Figure 1). The genomic integrity is analyzed at cellular checkpoints, usually leading to a delay in cell cycle progression if DNA was damaged. Mutations in genes such as p53 and p21 change the cellular response to genotoxic stress and may alter the balance between apoptosis and genomic damage. However, p53 is usually mutated or not expressed in 70\% of human tumors. Alterations in p53 states that reflect distinct apoptotic response upon induction of DNA damage were examined. In this study, three cell lines with distinct p53 states were used: TK6 harboring wild-type p53, WTK1 with mutated p53 and NH32 with knocked out p53. In the present work we applied different approaches to investigate the correlation between DNA damage and apoptotic responsiveness in cancer cell lines with different p53 states or in hormone responsive cell lines with over expressed bcl-2 gene. We were focused on effects caused by temporary down regulation of the p53 and Bcl-2 activity in human lymphoblastoid cell lines. In addition, we investigated the impact of estradiol-induced proliferation on apoptosis and DNA damage in stably transfected cells with bcl-2gene.},
  subject      = {Apoptosis},
  language  = {en}
}