@phdthesis{Werner2014,
  author    = {Werner, Katharina Julia},
  title     = {Adipose Tissue Engineering - In vitro Development of a subcutaneous fat layer and a vascularized adipose tissue construct utilizing extracellular matrix structures},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-104676},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2014},
  abstract  = {Each year millions of plastic and reconstructive procedures are performed to regenerate soft tissue defects after, for example, traumata, deep burns or tumor resections. Tissue engineered adipose tissue grafts are a promising alternative to autologous fat transfer or synthetic implants to meet this demand for adipose tissue. Strategies of tissue engineering, especially the use of cell carriers, provide an environment for better cell survival, an easier positioning and supplemented with the appropriate conditions a faster vascularization in vivo. To successfully engineer an adipose tissue substitute for clinical use, it is crucial to know the actual intended application. In some areas, like the upper and lower extremities, only a thin subcutaneous fat layer is needed and in others, large volumes of vascularized fat grafts are more desirable. The use and interplay of stem cells and selected scaffolds were investigated and provide now a basis for the generation of fitted and suitable substitutes in two different application areas. Complex injuries of the upper and lower extremities, in many cases, lead to excessive scarring. Due to severe damage to the subcutaneous fat layer, a common sequela is adhesion formation to mobile structures like tendons, nerves, and blood vessels resulting in restricted motion and disabling pain [Moor 1996, McHugh 1997]. In order to generate a subcutaneous fat layer to cushion scarred tissue after substantial burns or injuries, different collagen matrices were tested for clinical handling and the ability to support adipogenesis. When testing five different collagen matrices, PermacolTM and StratticeTM showed promising characteristics; additionally both possess the clinical approval. Under culture conditions, only PermacolTM, a cross-linked collagen matrix, exhibited an excellent long-term stability. Ranking nearly on the same level was StratticeTM, a non-cross-linked dermal scaffold; it only exhibited a slight shrinkage. All other scaffolds tested were severely compromised in stability under culture conditions. Engineering a subcutaneous fat layer, a construct would be desirable with a thin layer of emerging fat for cushioning on one side, and a non-seeded other side for cell migration and host integration. With PermacolTM and StratticeTM, it was possible to produce constructs with ASC (adipose derived stem cells) seeded on one side, which could be adipogenically differentiated. Additionally, the thickness of the cell layer could be varied. Thereby, it becomes possible to adjust the thickness of the construct to the surrounding tissue. In order to reduce the pre-implantation time ex vivo and the costs, the culture time was varied by testing different induction protocols. An adipogenic induction period of only four days was demonstrated to be sufficient to obtain a substantial adipogenic differentiation of the applied ASC. Thus, seeded with ASC, PermacolTM and StratticeTM are suitable scaffolds to engineer subcutaneous fat layers for reconstruction of the upper and lower extremities, as they support adipogenesis and are appropriately thin, and therefore would not compromise the cosmesis. For the engineering of large-volume adipose tissue, adequate vascularization still represents a major challenge. With the objective to engineer vascularized fat pads, it is important to consider the slow kinetics of revascularization in vivo. Therefore, a decellularized porcine jejunum with pre-existing vascular structures and pedicles to connect to the host vasculature or the circulation of a bioreactor system was used. In a first step, the ability of a small decellularized jejunal section was tested for cell adhesion and for supporting adipogenic differentiation of hASC mono-cultures. Cell adhesion and adipogenic maturation of ASC seeded on the jejunal material was verified through histological and molecular analysis. After the successful mono-culture, the goal was to establish a MVEC (microvascular endothelial cells) and ASC co-culture; suitable culture conditions had to be found, which support the viability of both cell types and do not interfere with the adipogenic differentiation. After the elimination of EGF (epidermal growth factor) from the co-culture medium, substantial adipogenic maturation was observed. In the next step, a large jejunal segment (length 8 cm), with its pre-existing vascular structures and arterial/venous pedicles, was connected to the supply system of a custom-made bioreactor. After successful reseeding the vascular structure with endothelial cells, the lumen was seeded with ASC which were then adipogenically induced. Histological and molecular examinations confirmed adipogenic maturation and the existence of seeded vessels within the engineered construct. Noteworthily, a co-localization of adipogenically differentiating ASC and endothelial cells in vascular networks could be observed. So, for the first time a vascularized fat construct was developed in vitro, based on the use of a decellularized porcine jejunum. As this engineered construct can be connected to a supply system or even to a patient vasculature, it is versatile in use, for example, as transplant in plastic and reconstruction surgery, as model in basic research or as an in vitro drug testing system. To summarize, in this work a promising substitute for subcutaneous fat layer reconstruction, in the upper and lower extremities, was developed, and the first, as far as reported, in vitro generated adipose tissue construct with integrated vascular networks was successfully engineered.},
  subject      = {Tissue Engineering},
  language  = {en}
}
@article{HartrampfKrebsPeteretal.2022,
  author    = {Hartrampf, Philipp E. and Krebs, Markus and Peter, Lea and Heinrich, Marieke and Ruffing, Julia and Kalogirou, Charis and Weinke, Maximilian and Brumberg, Joachim and K{\"u}bler, Hubert and Buck, Andreas K. and Werner, Rudolf A. and Seitz, Anna Katharina},
  title     = {Reduced segmentation of lesions is comparable to whole-body segmentation for response assessment by PSMA PET/CT: initial experience with the keyhole approach},
  series = {Biology},
  volume    = {11},
  journal   = {Biology},
  number    = {5},
  issn      = {2079-7737},
  doi       = {10.3390/biology11050660},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-271191},
  year      = {2022},
  abstract  = {Simple Summary The calculation of PSMA-positive tumor volume (PSMA-TV) of the whole body from PSMA PET scans for response evaluation remains a time-consuming procedure. We hypothesized that it may be possible to quantify changes in PSMA-TV by considering only a limited number of representative tumor lesions. Changes in the whole-body PSMA-TV of 65 patients were comparable to the changes in PSMA-TV after including only the ten largest lesions. Moreover, changes in PSMA-TV correlated well with changes in PSA levels, as did the changes in PSMA-TV with the reduced number of lesions. We conclude that a response assessment using PSMA-TV with a reduced number of lesions is feasible and could lead to a simplified process for evaluating PSMA PET/CT. Abstract (1) Background: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)-derived parameters, such as the commonly used standardized uptake value (SUV) and PSMA-positive tumor volume (PSMA-TV), have been proposed for response assessment in metastatic prostate cancer (PCa) patients. However, the calculation of whole-body PSMA-TV remains a time-consuming procedure. We hypothesized that it may be possible to quantify changes in PSMA-TV by considering only a limited number of representative lesions. (2) Methods: Sixty-five patients classified into different disease stages were assessed by PSMA PET/CT for staging and restaging after therapy. Whole-body PSMA-TV and whole-body SUV\(_{max}\) were calculated. We then repeated this calculation only including the five or ten hottest or largest lesions. The corresponding serum levels of prostate-specific antigen (PSA) were also determined. The derived delta between baseline and follow-up values provided the following parameters: ΔSUV\(_{maxall}\), ΔSUV\(_{max10}\), ΔSUV\(_{max5}\), ΔPSMA-TV\(_{all}\), ΔPSMA-TV\(_{10}\), ΔPSMA-TV\(_{5}\), ΔPSA. Finally, we compared the findings from our whole-body segmentation with the results from our keyhole approach (focusing on a limited number of lesions) and correlated all values with the biochemical response (ΔPSA). (3) Results: Among patients with metastatic hormone-sensitive PCa (mHSPC), none showed a relevant deviation for ΔSUV\(_{max10}\)/ΔSUV\(_{max5}\) or ΔPSMA-TV\(_{10}\)/ΔPSMA-TV\(_{5}\) compared to ΔSUV\(_{maxall}\) and ΔPSMA-TV\(_{all}\). For patients treated with taxanes, up to 6/21 (28.6\%) showed clinically relevant deviations between ΔSUV\(_{maxall}\) and ΔSUV\(_{max10}\) or ΔSUV\(_{max5}\), but only up to 2/21 (9.5\%) patients showed clinically relevant deviations between ΔPSMA-TV\(_{all}\) and ΔPSMA-TV\(_{10}\) or ΔPSMA-TV\(_{5}\). For patients treated with radioligand therapy (RLT), up to 5/28 (17.9\%) showed clinically relevant deviations between ΔSUV\(_{maxall}\) and ΔSUV\(_{max10}\) or ΔSUV\(_{max5}\), but only 1/28 (3.6\%) patients showed clinically relevant deviations between ΔPSMA-TV\(_{all}\) and ΔPSMA-TV\(_{10}\) or ΔPSMA-TV\(_{5}\). The highest correlations with ΔPSA were found for ΔPSMA-TV\(_{all}\) (r ≥ 0.59, p ≤ 0.01), followed by ΔPSMA-TV\(_{10}\) (r ≥ 0.57, p ≤ 0.01) and ΔPSMA-TV\(_{5}\) (r ≥ 0.53, p ≤ 0.02) in all cohorts. ΔPSA only correlated with ΔSUV\(_{maxall}\) (r = 0.60, p = 0.02) and with ΔSUV\(_{max10}\) (r = 0.53, p = 0.03) in the mHSPC cohort, as well as with ΔSUV\(_{maxall}\) (r = 0.51, p = 0.01) in the RLT cohort. (4) Conclusion: Response assessment using PSMA-TV with a reduced number of lesions is feasible, and may allow for a simplified evaluation process for PSMA PET/CT.},
  language  = {en}
}
@article{KressJessenHufnageletal.2023,
  author    = {Kreß, Julia Katharina Charlotte and Jessen, Christina and Hufnagel, Anita and Schmitz, Werner and Da Xavier Silva, Thamara Nishida and Ferreira Dos Santos, Anc{\´e}ly and Mosteo, Laura and Goding, Colin R. and Friedmann Angeli, Jos{\´e} Pedro and Meierjohann, Svenja},
  title     = {The integrated stress response effector ATF4 is an obligatory metabolic activator of NRF2},
  series = {Cell Reports},
  volume    = {42},
  journal   = {Cell Reports},
  number    = {7},
  doi       = {10.1016/j.celrep.2023.112724},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-350312},
  year      = {2023},
  abstract  = {Highlights • The integrated stress response leads to a general ATF4-dependent activation of NRF2 • ATF4 causes a CHAC1-dependent GSH depletion, resulting in NRF2 stabilization • An elevation of NRF2 transcript levels fosters this effect • NRF2 supports the ISR/ATF4 pathway by improving cystine and antioxidant supply Summary The redox regulator NRF2 becomes activated upon oxidative and electrophilic stress and orchestrates a response program associated with redox regulation, metabolism, tumor therapy resistance, and immune suppression. Here, we describe an unrecognized link between the integrated stress response (ISR) and NRF2 mediated by the ISR effector ATF4. The ISR is commonly activated after starvation or ER stress and plays a central role in tissue homeostasis and cancer plasticity. ATF4 increases NRF2 transcription and induces the glutathione-degrading enzyme CHAC1, which we now show to be critically important for maintaining NRF2 activation. In-depth analyses reveal that NRF2 supports ATF4-induced cells by increasing cystine uptake via the glutamate-cystine antiporter xCT. In addition, NRF2 upregulates genes mediating thioredoxin usage and regeneration, thus balancing the glutathione decrease. In conclusion, we demonstrate that the NRF2 response serves as second layer of the ISR, an observation highly relevant for the understanding of cellular resilience in health and disease.},
  language  = {en}
}
@article{MeinertJessenHufnageletal.2024,
  author    = {Meinert, Madlen and Jessen, Christina and Hufnagel, Anita and Kreß, Julia Katharina Charlotte and Burnworth, Mychal and D{\"a}ubler, Theo and Gallasch, Till and Da Xavier Silva, Thamara Nishida and Dos Santos, Anc{\´e}ly Ferreira and Ade, Carsten Patrick and Schmitz, Werner and Kneitz, Susanne and Friedmann Angeli, Jos{\´e} Pedro and Meierjohann, Svenja},
  title     = {Thiol starvation triggers melanoma state switching in an ATF4 and NRF2-dependent manner},
  series = {Redox Biology},
  volume    = {70},
  journal   = {Redox Biology},
  doi       = {10.1016/j.redox.2023.103011},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-350328},
  year      = {2024},
  abstract  = {The cystine/glutamate antiporter xCT is an important source of cysteine for cancer cells. Once taken up, cystine is reduced to cysteine and serves as a building block for the synthesis of glutathione, which efficiently protects cells from oxidative damage and prevents ferroptosis. As melanomas are particularly exposed to several sources of oxidative stress, we investigated the biological role of cysteine and glutathione supply by xCT in melanoma. xCT activity was abolished by genetic depletion in the Tyr::CreER; Braf\(^{CA}\); Pten\(^{lox/+}\) melanoma model and by acute cystine withdrawal in melanoma cell lines. Both interventions profoundly impacted melanoma glutathione levels, but they were surprisingly well tolerated by murine melanomas in vivo and by most human melanoma cell lines in vitro. RNA sequencing of human melanoma cells revealed a strong adaptive upregulation of NRF2 and ATF4 pathways, which orchestrated the compensatory upregulation of genes involved in antioxidant defence and de novo cysteine biosynthesis. In addition, the joint activation of ATF4 and NRF2 triggered a phenotypic switch characterized by a reduction of differentiation genes and induction of pro-invasive features, which was also observed after erastin treatment or the inhibition of glutathione synthesis. NRF2 alone was capable of inducing the phenotypic switch in a transient manner. Together, our data show that cystine or glutathione levels regulate the phenotypic plasticity of melanoma cells by elevating ATF4 and NRF2.},
  language  = {en}
}