@phdthesis{Kasang2013, author = {Kasang, Christa}, title = {Untersuchung der Effekte von Prednisolon auf die HIV-Progression und Ermittlung der Medikamentenresistenz in antiretroviral-unbehandelten HIV-Patienten in Tansania}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-85638}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {Die Progression der HIV Infektion ist vermutlich bedingt von einer unspezifischen generalisierten Immunaktivierung des Patienten (Sousa, Carneiro et al. 2002; Hazenberg, Otto et al. 2003). Somit k{\"o}nnte ein immunsuppressives Medikament wie das Kortisonpr{\"a}parat Prednisolon die Progression der Erkrankung verlangsamen. Im Rahmen nicht-kontrollierter Studien konnte die Stabilisierung der CD4+ T-Lymphozyten in HIV-Patienten durch den Einsatz von Kortison beobachtet werden (Andrieu, Lu et al. 1995; Lu, Salerno-Goncalves et al. 1995). Dieser Effekt konnte auch mit niedrig dosiertem Prednisolon (5 mg/Tag) nachgewiesen werden (Ulmer, Muller et al. 2005). Jedoch zeigen neuere Ergebnisse, dass der CD4+ T-Lymphozytenwert bei Studien zu Immunmodulatoren kein verl{\"a}sslicher Surrogatmarker f{\"u}r die Progression ist (Abrams, Levy et al. 2009). In der vorliegenden Arbeit sollte untersucht werden, ob sich zum Einen der stabilisierende Effekt von niedrig dosiertem Prednisolon (5 mg pro Tag) auf CD4+ T-Lymphozyten in einer kontrollierten Studie best{\"a}tigt, ob zum Zweiten die CD4+ T-Lymphozytenstabilisierung auf eine Senkung der Immunaktivierung zur{\"u}ckgef{\"u}hrt werden kann und ob zum Dritten die CD4+ TLymphozytenstabilisierung die klinische Krankheitsprogression verlangsamt. Im Rahmen der ProCort-Studie sollte außerdem eine Bestimmung der Pr{\"a}valenz medikamentenresistenter HIV-Infektionen bei ART unbehandelten Patienten erfolgen. Hierbei wurden die WHO Kriterien {\"u}berpr{\"u}ft, die als Einschlusskriterien f{\"u}r Patienten in Resistenz-{\"U}berwachungsstudien ein H{\"o}chstalter von 25 Jahren festgelegt hat. In unserer Untersuchung wurden demgegen{\"u}ber Proben von Patienten mit h{\"o}herem Alter und bereits therapierten Partnern analysiert.Methoden: Im Rahmen einer doppelblinden randomisierten klinischen Studie (ProCort1) im Bugando Medical Center (BMC) in Mwanza, Tansania, wurden 326 HIV-Patienten eingeschlossen, die zuvor noch nie mit ART behandelt wurden und einen CD4+ TLymphozytenwert von mindestens 300/μl aufwiesen. In 14 Visiten wurden, w{\"a}hrend einer zweij{\"a}hrigen Behandlungsdauer entweder mit 5mg Prednisolon t{\"a}glich oder mit Placebo, die CD4+ T-Lymphozytenwerte und das Auftreten von Progression der HIV-Infektion bestimmt. Prim{\"a}rer Studienendpunkt war die Krankheitsprogression, definiert als ein Unterschreiten von 200 CD4-Zellen/μl oder dem Auftreten AIDS-definierender Erkrankungen. Um die immunologische Wirkungsweise von Prednisolon in HIV-infizierten Patienten zu untersuchen wurden sowohl in den tansanischen Studienpatienten als auch in einer mit 5 mg Prednisolon behandelten deutschen Kohorte die Lymphozytenaktivierungsmarker CD38/HLADR auf CD3/CD8-Zellen, der Monozytenaktivierungsmarker sCD14 und der Entz{\"u}ndungsmarker suPAR bestimmt. Um die Pr{\"a}valenz der HIV Medikamentenresistenz (HIVDR) in der ProCort Studienpopulation zu ermitteln wurden 88 Proben der ART unbehandelten Patienten sequenziert. Ergebnisse: Die Ergebnisse der ProCort Studie zeigten eine statistisch signifikante Stabilisierung der CD4+ T-Lymphozytenwerte im Vergleich zum Ausgangswert durch Einsatz einer niedrig dosierten Prednisolonbehandlung (5 mg t{\"a}glich). In der Intent to treat Analyse wurde ein Zugewinn von +20,1 Zellen/μl pro Jahr f{\"u}r den Prednisolonarm (p < 0.0001) im Vergleich zu -54,2 Zellen/μl pro Jahr f{\"u}r den Placeboarm (p < 0.0001) bestimmt. Die CD4+ T-Lymphozytenwerte zum Zeitpunkt der Startvisite waren im Prednisolonarm statistisch signifikant niedriger (Mean 512.14 Zellen/μl ± S.E.M. 13.39) als im Placeboarm (Mean 554.40 ± S.E.M 15.75; p = 0.042). Dies bedeutet eine schlechtere Ausgangslage f{\"u}r die mit Prednisolon behandelten Patienten. Trotzdem entwickelten nur vier Patienten mit Prednisolonbehandlung im Vergleich zu 11 Patienten mit Placebobehandlung AIDS, was eine statistisch signifikante Verringerung der Progressionsrate bedeutet (p=0.0196). In 16 Patienten versus 18 Patienten fielen die CD4+ T-Lymphozytenwerte unter die Werte von 200 Zellen/μl. Die Behandlung mit Prednisolon war nicht mit einer h{\"o}heren Rate von unerw{\"u}nschten Ereignissen oder h{\"o}herer Viruslast assoziiert.}, subject = {Retroviren}, language = {de} } @article{BodemSchromMoschalletal.2013, author = {Bodem, Jochen and Schrom, Eva-Maria and Moschall, Rebecca and Hartl, Maximilian J. and Weitner, Helena and Fecher, David and Langemeier, J{\"o}rg and W{\"o}hrl, Brigitta M.}, title = {U1snRNP-mediated suppression of polyadenylation in conjunction with the RNA structure controls poly (A) site selection in foamy viruses}, series = {Retrovirology}, journal = {Retrovirology}, doi = {10.1186/1742-4690-10-55}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96085}, year = {2013}, abstract = {Background During reverse transcription, retroviruses duplicate the long terminal repeats (LTRs). These identical LTRs carry both promoter regions and functional polyadenylation sites. To express full-length transcripts, retroviruses have to suppress polyadenylation in the 5′LTR and activate polyadenylation in the 3′LTR. Foamy viruses have a unique LTR structure with respect to the location of the major splice donor (MSD), which is located upstream of the polyadenylation signal. Results Here, we describe the mechanisms of foamy viruses regulating polyadenylation. We show that binding of the U1 small nuclear ribonucleoprotein (U1snRNP) to the MSD suppresses polyadenylation at the 5′LTR. In contrast, polyadenylation at the 3′LTR is achieved by adoption of a different RNA structure at the MSD region, which blocks U1snRNP binding and furthers RNA cleavage and subsequent polyadenylation. Conclusion Recently, it was shown that U1snRNP is able to suppress the usage of intronic cryptic polyadenylation sites in the cellular genome. Foamy viruses take advantage of this surveillance mechanism to suppress premature polyadenylation at the 5'end of their RNA. At the 3'end, Foamy viruses use a secondary structure to presumably block access of U1snRNP and thereby activate polyadenylation at the end of the genome. Our data reveal a contribution of U1snRNP to cellular polyadenylation site selection and to the regulation of gene expression.}, subject = {Polyadenylierung}, language = {en} } @article{LutzHeuerBehlichetal.2013, author = {Lutz, Manfred B. and Heuer, Marion and Behlich, Anna-Sophie and Lee, Ji-Sook and Ribechini, Eliana and Jo, Eun-Kyeong}, title = {The 30-kDa and 38-kDa antigens from Mycobacterium tuberculosis induce partial maturation of human dendritic cells shifting CD4+ T cell responses towards IL-4 production}, series = {BMC Immunology}, journal = {BMC Immunology}, doi = {10.1186/1471-2172-14-48}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96871}, year = {2013}, abstract = {Background Mycobacterium tuberculosis (Mtb) infections are still a major cause of death among all infectious diseases. Although 99\% of individuals infected with Mtb develop a CD4+ Th1 and CD8+ T cell mediated immunity as measured by tuberculin skin test, this results only in partial protection and Mtb vaccines are not effective. Deviation of immune responses by pathogens towards a Th2 profile is a common mechanism of immune evasion, typically leading to the persistence of the microbes. Results Here we tested the stimulatory capacity of selective Mtb antigens on human monocyte-derived dendritic cell (DC) maturation and cytokine production. DC maturation markers CD80, CD86 and CD83 were readily upregulated by H37Ra- and H37Rv-associated antigens, the 30-kDa (from Ag85 B complex) and 38-KDa Mtb antigens only partially induced these markers. All Mtb antigens induced variable levels of IL-6 and low levels of IL-10, there was no release of IL-12p70 detectable. Substantial IL-12p40 production was restricted to LPS or H37Ra and H37Rv preparations. Although the proliferation levels of primary T cell responses were comparable using all the differentially stimulated DC, the 30-kDa and 38-kDa antigens showed a bias towards IL-4 secretion of polarized CD4+ T cells after secondary stimulation as compared to H37Ra and H37Rv preparations. Conclusion Together our data indicate that 30-kDa and 38-kDa Mtb antigens induced only partial DC maturation shifting immune responses towards a Th2 profile.}, language = {en} } @article{GundaKasangKidenyaetal.2013, author = {Gunda, Daniel W. and Kasang, Christa and Kidenya, Benson R. and Kabangila, Rodrick and Mshana, Stephen E. and Kidola, Jeremiah and Kalluvya, Samuel E. and Kongola, Gilbert W. and Klinker, Hartwig}, title = {Plasma Concentrations of Efavirenz and Nevirapine among HIV-Infected Patients with Immunological Failure Attending a Tertiary Hospital in North-Western Tanzania}, series = {PLOS ONE}, volume = {8}, journal = {PLOS ONE}, number = {9}, issn = {1932-6203}, doi = {10.1371/journal.pone.0075118}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-128456}, pages = {e75118}, year = {2013}, abstract = {Background: Sub-therapeutic and supra-therapeutic plasma concentrations of antriretrovirals are the significant causes of treatment failure and toxicity respectively among HIV-infected patients. We conducted this study to determine the pattern of efavirenz and nevirapine plasma drug concentrations among adult HIV-infected patients with immunological failure attending at a tertiary hospital in North-western Tanzania. Materials and Methods: A cross-sectional study was conducted among adult HIV-infected patients with immunological failure who have been on either efavirenz or nevirapine based antiretroviral regimen for more than 6 months. Patients were serially enrolled through routine Care and Treatment Clinic (CTC) activities. Plasma drug concentrations for efavirenz and nevirapine were determined by high performance liquid chromatography (HPLC) and Gas Chromatography (GC) respectively. Demographic, clinical and laboratory data such as viral load and CD4 counts were collected. Data analysis was done using STATA 12. Results: Of the 152 patients with immunological failure enrolled, the sub-therapeutic, therapeutic and supra-therapeutic plasma antiretroviral drug concentrations were found in 43/152 (28.3\%), 76/152 (50.0\%) and 33/152 (21.7\%) respectively. Half of the patients were outside therapeutic window with either sub-therapeutic or supra-therapeutic plasma ARV drug concentrations. There was a significant difference in distribution of ARV adherence (p-value<0.001), NRTI backbone (p-value = 0.039), HIV stage (p-value = 0.026) and viral load (p-value = 0.007) within sub-therapeutic, therapeutic and supratherapeutic ARV plasma drug concentrations. Conclusion: There is a wide inter-individual variability of plasma ARV concentrations among HIV patients with immunological failure, with a large proportion of patients being outside therapeutic window. This variability is significant based on ARV adherence, NRTI backbone, viral load and HIV stage. Routine therapeutic drug monitoring (TDM) could assist identifying these patients early and making timely correction to avoid virological failure, poor immunological outcome and prevent associated drug toxicities. Nonetheless, ARV adherence should be strictly emphasized on HIV patients with immunological failure.}, language = {en} } @article{PrifertStrengKrempletal.2013, author = {Prifert, Christiane and Streng, Andrea and Krempl, Christine D. and Liese, Johannes and Weissbrich, Benedikt}, title = {Novel Respiratory Syncytial Virus A Genotype, Germany, 2011-2012}, series = {Emerging Infectious Diseases}, volume = {19}, journal = {Emerging Infectious Diseases}, number = {6}, doi = {10.3201/eid1906.121582}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-129041}, pages = {1029-1030}, year = {2013}, abstract = {No abstract available.}, language = {en} } @article{HornSchellerduPlessisetal.2013, author = {Horn, Anne and Scheller, Carsten and du Plessis, Stefan and Arendt, Gabriele and Nolting, Thorsten and Joska, John and Sopper, Sieghart and Maschke, Matthias and Obermann, Mark and Husstedt, Ingo W. and Hain, Johannes and Maponga, Tongai and Riederer, Peter and Koutsilieri, Eleni}, title = {Increases in CSF dopamine in HIV patients are due to the dopamine transporter 10/10-repeat allele which is more frequent in HIV-infected individuals}, series = {Journal of Neural Transmission}, volume = {120}, journal = {Journal of Neural Transmission}, doi = {10.1007/s00702-013-1086-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132385}, pages = {1411-1419}, year = {2013}, abstract = {Dysfunction of dopaminergic neurotransmission has been implicated in HIV infection. We showed previously increased dopamine (DA) levels in CSF of therapy-na{\"i}ve HIV patients and an inverse correlation between CSF DA and CD4 counts in the periphery, suggesting adverse effects of high levels of DA on HIV infection. In the current study including a total of 167 HIV-positive and negative donors from Germany and South Africa (SA), we investigated the mechanistic background for the increase of CSF DA in HIV individuals. Interestingly, we found that the DAT 10/10-repeat allele is present more frequently within HIV individuals than in uninfected subjects. Logistic regression analysis adjusted for gender and ethnicity showed an odds ratio for HIV infection in DAT 10/10 allele carriers of 3.93 (95 \% CI 1.72-8.96; p = 0.001, Fishers exact test). 42.6 \% HIV-infected patients harbored the DAT 10/10 allele compared to only 10.5 \% uninfected DAT 10/10 carriers in SA (odds ratio 6.31), whereas 68.1 versus 40.9 \%, respectively, in Germany (odds ratio 3.08). Subjects homozygous for the 10-repeat allele had higher amounts of CSF DA and reduced DAT mRNA expression but similar disease severity compared with those carrying other DAT genotypes. These intriguing and novel findings show the mutual interaction between DA and HIV, suggesting caution in the interpretation of CNS DA alterations in HIV infection solely as a secondary phenomenon to the virus and open the door for larger studies investigating consequences of the DAT functional polymorphism on HIV epidemiology and progression of disease.}, language = {en} } @phdthesis{Merkl2013, author = {Merkl, Martin}, title = {Immunologische Effekte der Therapie mit rezeptor-homologen Peptiden im Rattenmodell der antik{\"o}rper-induzierten dilatativen Immunkardiomyopathie}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-85161}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {Unsere Arbeitsgruppe verfolgt im Rattenmodell der Antik{\"o}rper-induzierten DiCM einen Antik{\"o}rper-spezifischen Therapieansatz durch die Gabe eines synthetischen β1-ECII homologen zyklischen „F{\"a}nger"-Peptids. Die Applikation dieses Peptids f{\"u}hrte zu einer deutlichen Verbesserung wichtiger Herzparameter wie z.B. des Durchmessers des linken Ventrikels (LV) sowie der LV-Verk{\"u}rzungsfraktion und des kardialen Indexes. Des Weiteren kam es unter der Peptid-Therapie zu einer signifikanten Reduktion des anti-β1-ECII Antik{\"o}rpertiters trotz kontinuierlich durchgef{\"u}hrter Immunisierungen mit dem die Erkrankung induzierenden Antigen. Es lag daher nahe, dass durch die Peptid-Therapie auch eine Art immunologischer Toleranz induziert wird, der eine Depletion bzw. funktionelle Beeintr{\"a}chtigung von Zellen des Immunsystems, die an der Produktion von anti-β1-ECII Antik{\"o}rpern beteiligt sind, zugrunde liegen k{\"o}nnte. Im Rahmen der vorliegenden Doktorarbeit war es daher Aufgabe, die verschiedenen Zellkomponenten der humoralen und zellul{\"a}ren Immunantwort zu untersuchen, um den immunologischen Effekt der Peptid-Applikation besser zu verstehen. So scheinen in unserem Modell die β1-ECII-spezifischen CD4+T-Zellen durch die Peptid-Therapie nicht beeinflusst zu werden; ebenso konnten unsere Experimente keinen Zyklopeptideffekt auf die langlebigen Plasmazellen nachweisen. Die erzielten Ergebnisse sprechen jedoch daf{\"u}r, dass die R{\"u}ckbildung des DiCM Ph{\"a}notyps und der Abfall des anti-β1-ECII Antik{\"o}rpertiters trotz kontinuierlicher Immunisierung zum einen auf der direkten Neutralisierung der anti-β1-ECII Antik{\"o}rper durch die Ring-Peptide (Scavenger-Effekt)und zum anderen auf einer Depletion bzw. funktionellen Beeintr{\"a}chtigung der β1-ECII-spezifischen Memory B-Zellen beruhen k{\"o}nnte. Der f{\"u}r die Reduktion der Memory B-Zellen letztlich verantwortliche molekulare Mechanismus muss jedoch noch in weiteren Experimenten untersucht werden. Die im Rahmen der vorliegenden Arbeit erzielten Ergebnisse tragen aber wesentlich zum besseren Verst{\"a}ndnis der Wirkungsweise dieses neuartigen Therapiekonzepts zur Behandlung der immuninduzierten Kardiomyopathie bei.}, subject = {Peptidtherapie}, language = {de} } @book{BockGauchGiernatetal.2013, author = {Bock, Stefanie and Gauch, Fabian and Giernat, Yannik and Hillebrand, Frank and Kozlova, Darja and Linck, Lisa and Moschall, Rebecca and Sauer, Markus and Schenk, Christian and Ulrich, Kristina and Bodem, Jochen}, title = {HIV-1 : Lehrbuch von Studenten f{\"u}r Studenten}, organization = {Bachelor- und Masterkurs Virologie 2013}, isbn = {978-3-923959-90-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-78980}, publisher = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {Dies ist ein Lehrbuch {\"u}ber die HIV-1 Replikation, Pathogenese und Therapie. Es richtet sich an Studenten der Biologie und der Medizin, die etwas mehr {\"u}ber HIV erfahren wollen und stellt neben virologischen Themen auch die zellul{\"a}ren Grundlagen dar. Es umfasst den Viruseintritt, die reverse Transkription, Genom-Integration, Transkriptionsregualtion, die Kotrolle des Spleißens, der Polyadenylierung und des RNA-Exportes. Die Darstellung wird abgerundet mit Kapiteln zum intrazellul{\"a}rem Transport, zu Nef und zum Virusassembly. In zwei weiteren Kapitel wird die HIV-1 Pathogenese und die Therapie besprochen. Zur Lernkontrolle sind den Kapiteln Fragen und auch Klausurfragen angef{\"u}gt.}, subject = {HIV}, language = {de} } @article{SchneiderSchauliesBieringerHanetal.2013, author = {Schneider-Schaulies, J{\"u}rgen and Bieringer, Maria and Han, Jung Woo and Kendl, Sabine and Khosravi, Mojtaba and Plattet, Philippe}, title = {Experimental Adaptation of Wild-Type Canine Distemper Virus (CDV) to the Human Entry Receptor CD150}, series = {PLoS ONE}, journal = {PLoS ONE}, doi = {10.1371/journal.pone.0057488}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96537}, year = {2013}, abstract = {Canine distemper virus (CDV), a close relative of measles virus (MV), is widespread and well known for its broad host range. When the goal of measles eradication may be achieved, and when measles vaccination will be stopped, CDV might eventually cross the species barrier to humans and emerge as a new human pathogen. In order to get an impression how fast such alterations may occur, we characterized required adaptive mutations to the human entry receptors CD150 (SLAM) and nectin-4 as first step to infect human target cells. Recombinant wild-type CDV-A75/17red adapted quickly to growth in human H358 epithelial cells expressing human nectin-4. Sequencing of the viral attachment proteins (hemagglutinin, H, and fusion protein, F) genes revealed that no adaptive alteration was required to utilize human nectin-4. In contrast, the virus replicated only to low titres (102 pfu/ml) in Vero cells expressing human CD150 (Vero-hSLAM). After three passages using these cells virus was adapted to human CD150 and replicated to high titres (105 pfu/ml). Sequence analyses revealed that only one amino acid exchange in the H-protein at position 540 Asp→Gly (D540G) was required for functional adaptation to human CD150. Structural modelling suggests that the adaptive mutation D540G in H reflects the sequence alteration from canine to human CD150 at position 70 and 71 from Pro to Leu (P70L) and Gly to Glu (G71E), and compensates for the gain of a negative charge in the human CD150 molecule. Using this model system our data indicate that only a minimal alteration, in this case one adaptive mutation, is required for adaptation of CDV to the human entry receptors, and help to understand the molecular basis why this adaptive mutation occurs.}, language = {en} } @article{BodemRethwilm2013, author = {Bodem, Jochen and Rethwilm, Axel}, title = {Evolution of Foamy Viruses: The Most Ancient of All Retroviruses}, series = {Viruses}, journal = {Viruses}, doi = {10.3390/v5102349}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97312}, year = {2013}, abstract = {Recent evidence indicates that foamy viruses (FVs) are the oldest retroviruses (RVs) that we know and coevolved with their hosts for several hundred million years. This coevolution may have contributed to the non-pathogenicity of FVs, an important factor in development of foamy viral vectors in gene therapy. However, various questions on the molecular evolution of FVs remain still unanswered. The analysis of the spectrum of animal species infected by exogenous FVs or harboring endogenous FV elements in their genome is pivotal. Furthermore, animal studies might reveal important issues, such as the identification of the FV in vivo target cells, which than require a detailed characterization, to resolve the molecular basis of the accuracy with which FVs copy their genome. The issues of the extent of FV viremia and of the nature of the virion genome (RNA vs. DNA) also need to be experimentally addressed.}, language = {en} }