@phdthesis{Schubert2011,
  author    = {Schubert, Sabrina},
  title     = {Funktionelle Analyse des „Multidrug-Resistance"-Regulators MRR1 im humanpathogenen Hefepilz Candida albicans},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-70916},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2011},
  abstract  = {Der Hefepilz Candida albicans geh{\"o}rt zu den fakultativ pathogenen Infektionserregern und ist Teil der nat{\"u}rlichen Mikroflora der Schleimh{\"a}ute des Verdauungs- und Urogenitaltraktes der meisten gesunden Menschen. Ist das Gleichgewicht der Flora gest{\"o}rt, kann es zu oberfl{\"a}chlichen Mykosen kommen, wie z.B. der oropharyngealen Candidiasis (Mundsoor), die in der Regel durch die Gabe eines Antimykotikums in wenigen Tagen zu behandeln sind. In seltenen F{\"a}llen kann es auch zu schwerwiegenden Infektionsverl{\"a}ufen bis hin zu lebensbedrohlichen systemischen Mykosen kommen. Haupts{\"a}chlich immunsupprimierte Patienten, wie z.B. AIDS-Patienten oder Personen, die k{\"u}rzlich einer Organ- oder Knochenmarkstransplantation unterzogen wurden, leiden h{\"a}ufig an oberfl{\"a}chlichen C. albicans-Infektionen. Insbesondere bei wiederkehrenden Infektionen ist der Pilz in der Lage, gegen das h{\"a}ufig verabreichte Medikament Fluconazol eine Resistenz zu entwickeln. Ein wichtiger Mechanismus dieser Resistenzentwicklung ist die {\"U}berexpression von Effluxpumpen, die das Medikament aus der Zelle heraustransportieren. Zwei Arten von Effluxpumpen, die eine Rolle in der Resistenzentwicklung in C. albicans spielen, konnten bisher identifiziert werden, die ABC (ATP binding cassette)-Transporter Cdr1 und Cdr2 sowie der MFS (major facilitator superfamily)-Transporter Mdr1. Der Zinc-Cluster Transkriptionsfaktor Mrr1 spielt eine wichtige Rolle in der Regulation der MDR1-E¬ffluxpumpe. Er kontrolliert die MDR1-Expression in Anwesenheit induzierender Substanzen und sogenannte "gain-of-function" Mutationen in MRR1 konnten als die Ursache der konstitutiven MDR1-Hochregulierung und der "Multidrug-Resistance" in C. albicans identifiziert werden. In dieser Arbeit konnte ein Ortholog zu MRR1 aus C. albicans in Candida dubliniensis, einer zu C. albicans nahe verwandten Hefe, identifiziert werden. Es wurde gezeigt, dass in den untersuchten klinischen und in vitro generierten Fluconazol-resistenten C. dubliniensis-St{\"a}mmen ebenfalls gain-of-funcion Mutationen in MRR1 die MDR1-{\"U}berexpression und eine Resistenz bewirken. Die Ergebnisse demonstrieren, dass der Transkriptionsfaktor Mrr1 eine wichtige Rolle in der Entwicklung der Resistenz in diesen humanpathogenen Pilzen spielt. Bisher ist nicht bekannt, wie der Zinc-Cluster Transkriptionsfaktor MRR1 durch induzierende Substanzen oder gain-of-function Mutationen aktiviert wird. Um zu verstehen, wie die Mrr1- Aktivit{\"a}t reguliert wird, wurden in dieser Arbeit durch Deletionsstudien funktionelle Dom{\"a}nen des Transkriptionsfaktors identifiziert. Um einen besseren Einblick in die Regulation der MDR1-vermittelten Resistenz in C. albicans zu bekommen, wurde in dieser Arbeit die gegenseitige Abh{\"a}ngigkeit von Mrr1 und Cap1 bzw. Upc2 in Bezug auf die MDR1-Expression untersucht. Es wurden ChIP-on-chip Analysen und Transkriptionsprofile mit aktiviertem Mrr1 durchgef{\"u}hrt, um direkte Targets von Mrr1 zu identifizieren. Mit der vorliegenden Arbeit wurde ein wichtiger Beitrag zum Verst{\"a}ndnis der Entwicklung der Multidrug-Resistenz in C. albicans geleistet. E¬ffluxpumpen und deren Regulatoren stellen in der Bek{\"a}mpfung von C. albicans-Infektionen ein interessantes Angriffsziel f{\"u}r die Entwicklung neuer Medikamente und die Weiterentwicklung bereits vorhandender Antimykotika dar.},
  subject      = {Candida albicans},
  language  = {de}
}
@article{SchubertUnkmeirKonradSlaninaetal.2010,
  author    = {Schubert-Unkmeir, Alexandra and Konrad, Christian and Slanina, Heiko and Czapek, Florian and Hebling, Sabrina and Frosch, Matthias},
  title     = {Neisseria meningitidis Induces Brain Microvascular Endothelial Cell Detachment from the Matrix and Cleavage of Occludin: A Role for MMP-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-68589},
  year      = {2010},
  abstract  = {Disruption of the blood-brain barrier (BBB) is a hallmark event in the pathophysiology of bacterial meningitis. Several inflammatory mediators, such as tumor necrosis factor alpha (TNF-a), nitric oxide and matrix metalloproteinases (MMPs), contribute to this disruption. Here we show that infection of human brain microvascular endothelial cells (HBMEC) with Neisseria meningitidis induced an increase of permeability at prolonged time of infection. This was paralleled by an increase in MMP-8 activity in supernatants collected from infected cells. A detailed analysis revealed that MMP-8 was involved in the proteolytic cleavage of the tight junction protein occludin, resulting in its disappearance from the cell periphery and cleavage to a lower-sized 50-kDa protein in infected HBMEC. Abrogation of MMP-8 activity by specific inhibitors as well as transfection with MMP-8 siRNA abolished production of the cleavage fragment and occludin remained attached to the cell periphery. In addition, MMP-8 affected cell adherence to the underlying matrix. A similar temporal relationship was observed for MMP activity and cell detachment. Injury of the HBMEC monolayer suggested the requirement of direct cell contact because no detachment was observed when bacteria were placed above a transwell membrane or when bacterial supernatant was directly added to cells. Inhibition of MMP-8 partially prevented detachment of infected HBMEC and restored BBB permeability. Together, we established that MMP-8 activity plays a crucial role in disassembly of cell junction components and cell adhesion during meningococcal infection.},
  subject      = {Neisseria meningitidis},
  language  = {en}
}
@article{SchubertUnkmeirSchneiderSchauliesGulbinsetal.2014,
  author    = {Schubert-Unkmeir, Alexandra and Schneider-Schaulies, Sibylle and Gulbins, Erich and Hebling, Sabrina and Simonis, Alexander},
  title     = {Differential Activation of Acid Sphingomyelinase and Ceramide Release Determines Invasiveness of Neisseria meningitidis into Brain Endothelial Cells},
  doi       = {10.1371/journal.ppat.1004160},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-113031},
  year      = {2014},
  abstract  = {The interaction with brain endothelial cells is central to the pathogenicity of Neisseria meningitidis infections. Here, we show that N. meningitidis causes transient activation of acid sphingomyelinase (ASM) followed by ceramide release in brain endothelial cells. In response to N. meningitidis infection, ASM and ceramide are displayed at the outer leaflet of the cell membrane and condense into large membrane platforms which also concentrate the ErbB2 receptor. The outer membrane protein Opc and phosphatidylcholine-specific phospholipase C that is activated upon binding of the pathogen to heparan sulfate proteoglycans, are required for N. meningitidis-mediated ASM activation. Pharmacologic or genetic ablation of ASM abrogated meningococcal internalization without affecting bacterial adherence. In accordance, the restricted invasiveness of a defined set of pathogenic isolates of the ST-11/ST-8 clonal complex into brain endothelial cells directly correlated with their restricted ability to induce ASM and ceramide release. In conclusion, ASM activation and ceramide release are essential for internalization of Opc-expressing meningococci into brain endothelial cells, and this segregates with invasiveness of N. meningitidis strains. Author Summary Neisseria meningitidis, an obligate human pathogen, is a causative agent of septicemia and meningitis worldwide. Meningococcal infection manifests in a variety of forms, including meningitis, meningococcemia with meningitis or meningococcemia without obvious meningitis. The interaction of N. meningitidis with human cells lining the blood vessels of the blood-cerebrospinal fluid barrier is a prerequisite for the development of meningitis. As a major pathogenicity factor, the meningococcal outer membrane protein Opc enhances bacterial entry into brain endothelial cells, however, mechanisms underlying trapping of receptors and signaling molecules following this interaction remained elusive. We now show that Opc-expressing meningococci activate acid sphingomyelinase (ASM) in brain endothelial cells, which hydrolyses sphingomyelin to cause ceramide release and formation of extended ceramide-enriched membrane platforms wherein ErbB2, an important receptor involved in bacterial uptake, clusters. Mechanistically, ASM activation relied on binding of N. meningitidis to its attachment receptor, HSPG, followed by activation of PC-PLC. Meningococcal isolates of the ST-11 clonal complex, which are reported to be more likely to cause severe sepsis, but rarely meningitis, barely invaded brain endothelial cells and revealed a highly restricted ability to induce ASM and ceramide release. Thus, our results unravel a differential activation of the ASM/ceramide system by the species N. meningitidis determining its invasiveness into brain endothelial cells.},
  language  = {en}
}
@article{SlaninaHeblingHaucketal.2012,
  author    = {Slanina, Heiko and Hebling, Sabrina and Hauck, Christoph R. and Schubert-Unkmeir, Alexandra},
  title     = {Cell Invasion by Neisseria meningitidis Requires a Functional Interplay between the Focal Adhesion Kinase, Src and Cortactin},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75354},
  year      = {2012},
  abstract  = {Entry of Neisseria meningitidis (the meningococcus) into human brain microvascular endothelial cells (HBMEC) is mediated by fibronectin or vitronectin bound to the surface protein Opc forming a bridge to the respective integrins. This interaction leads to cytoskeletal rearrangement and uptake of meningococci. In this study, we determined that the focal adhesion kinase (FAK), which directly associates with integrins, is involved in integrin-mediated internalization of N. meningitidis in HBMEC. Inhibition of FAK activity by the specific FAK inhibitor PF 573882 reduced Opc-mediated invasion of HBMEC more than 90\%. Moreover, overexpression of FAK mutants that were either impaired in the kinase activity or were not capable of autophosphorylation or overexpression of the dominant-negative version of FAK (FRNK) blocked integrin-mediated internalization of N. meningitidis. Importantly, FAK-deficient fibroblasts were significantly less invaded by N. meningitidis. Furthermore, N. meningitidis induced tyrosine phosphorylation of several host proteins including the FAK/Src complex substrate cortactin. Inhibition of cortactin expression by siRNA silencing and mutation of critical amino acid residues within cortactin, that encompass Arp2/3 association and dynamin binding, significantly reduced meningococcal invasion into eukaryotic cells suggesting that both domains are critical for efficient uptake of N. meningitidis into eukaryotic cells. Together, these results indicate that N. meningitidis exploits the integrin signal pathway for its entry and that FAK mediates the transfer of signals from activated integrins to the cytoskeleton. A cooperative interplay between FAK, Src and cortactin then enables endocytosis of N. meningitidis into host cells.},
  subject      = {Medizin},
  language  = {en}
}
@article{SteinhardtCejkaChenetal.2024,
  author    = {Steinhardt, Maximilian J. and Cejka, Vladimir and Chen, Mengmeng and B{\"a}uerlein, Sabrina and Sch{\"a}fer, Julia and Adrah, Ali and Ihne-Schubert, Sandra M. and Papagianni, Aikaterini and Kort{\"u}m, K. Martin and Morbach, Caroline and St{\"o}rk, Stefan},
  title     = {Safety and tolerability of SGLT2 inhibitors in cardiac amyloidosis — a clinical feasibility study},
  series = {Journal of Clinical Medicine},
  volume    = {13},
  journal   = {Journal of Clinical Medicine},
  number    = {1},
  issn      = {2077-0383},
  doi       = {10.3390/jcm13010283},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-356024},
  year      = {2024},
  abstract  = {Sodium-glucose transport protein 2 inhibitors (SGLT2i) slow the progression of renal dysfunction and improve the prognosis of patients with heart failure. Amyloidosis constitutes an important subgroup for which evidence is lacking. Amyloidotic fibrils originating from misfolded transthyretin and light chains are the causal agents in ATTR and AL amyloidosis. In these most frequent subtypes, cardiac involvement is the most common organ manifestation. Because cardiac and renal function frequently deteriorate over time, even under best available treatment, SGLT2i emerge as a promising treatment option due to their reno- and cardioprotective properties. We retrospectively analyzed patients with cardiac amyloidosis, who received either dapagliflozin or empagliflozin. Out of 79 patients, 5.1\% had urinary tract infections; 2 stopped SGLT2i therapy; and 2.5\% died unrelated to the intake of SGLT2i. No genital mycotic infections were observed. As expected, a slight drop in the glomerular filtration rate was noted, while the NYHA functional status, cardiac and hepatic function, as well as the 6 min walk distance remained stable over time. These data provide a rationale for the use of SGLT2i in patients with amyloidosis and concomitant cardiac or renal dysfunction. Prospective randomized data are desired to confirm safety and to prove efficacy in this increasingly important group of patients.},
  language  = {en}
}