TY - JOUR A1 - Adolph, Jonas E. A1 - Fleischhack, Gudrun A1 - Gaab, Christine A1 - Mikasch, Ruth A1 - Mynarek, Martin A1 - Rutkowski, Stefan A1 - Schüller, Ulrich A1 - Pfister, Stefan M. A1 - Pajtler, Kristian W. A1 - Milde, Till A1 - Witt, Olaf A1 - Bison, Brigitte A1 - Warmuth-Metz, Monika A1 - Kortmann, Rolf-Dieter A1 - Dietzsch, Stefan A1 - Pietsch, Torsten A1 - Timmermann, Beate A1 - Tippelt, Stephan T1 - Systemic chemotherapy of pediatric recurrent ependymomas: results from the German HIT-REZ studies JF - Journal of Neuro-Oncology N2 - Purpose Survival in recurrent ependymoma (EPN) depends mainly on the extent of resection achieved. When complete resection is not feasible, chemotherapy is often used to extend progression-free and overall survival. However, no consistent effect of chemotherapy on survival has been found in patients with recurrent EPN. Methods Systemic chemotherapeutic treatment of 138 patients enrolled in the German HIT-REZ-studies was analyzed. Survival depending on the use of chemotherapy, disease-stabilization rates (RR), duration of response (DOR) and time to progression (TTP) were estimated. Results Median age at first recurrence was 7.6 years (IQR: 4.0–13.6). At first recurrence, median PFS and OS were 15.3 (CI 13.3–20.0) and 36.9 months (CI 29.7–53.4), respectively. The Hazard Ratio for the use of chemotherapy in local recurrences in a time-dependent Cox-regression analysis was 0.99 (CI 0.74–1.33). Evaluable responses for 140 applied chemotherapies were analyzed, of which sirolimus showed the best RR (50%) and longest median TTP [11.51 (CI 3.98; 14.0) months] in nine patients, with the strongest impact found when sirolimus was used as a monotherapy. Seven patients with progression-free survival > 12 months after subtotal/no-resection facilitated by chemotherapy were found. No definitive survival advantage for any drug in a specific molecularly defined EPN type was found. Conclusion No survival advantage for the general use of chemotherapy in recurrent EPN was found. In cases with incomplete resection, chemotherapy was able to extend survival in individual cases. Sirolimus showed the best RR, DOR and TTP out of all drugs analyzed and may warrant further investigation. KW - ependymoma KW - chemotherapy KW - recurrence KW - children KW - sirolimus Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308302 SN - 0167-594X SN - 1573-7373 VL - 155 IS - 2 ER - TY - JOUR A1 - Bartmann, Catharina A1 - Janaki Raman, Sudha R. A1 - Flöter, Jessica A1 - Schulze, Almut A1 - Bahlke, Katrin A1 - Willingstorfer, Jana A1 - Strunz, Maria A1 - Wöckel, Achim A1 - Klement, Rainer J. A1 - Kapp, Michaela A1 - Djuzenova, Cholpon S. A1 - Otto, Christoph A1 - Kämmerer, Ulrike T1 - Beta-hydroxybutyrate (3-OHB) can influence the energetic phenotype of breast cancer cells, but does not impact their proliferation and the response to chemotherapy or radiation JF - Cancer & Metabolism N2 - Background: Ketogenic diets (KDs) or short-term fasting are popular trends amongst supportive approaches for cancer patients. Beta-hydroxybutyrate (3-OHB) is the main physiological ketone body, whose concentration can reach plasma levels of 2–6 mM during KDs or fasting. The impact of 3-OHB on the biology of tumor cells described so far is contradictory. Therefore, we investigated the effect of a physiological concentration of 3 mM 3-OHB on metabolism, proliferation, and viability of breast cancer (BC) cells in vitro. Methods: Seven different human BC cell lines (BT20, BT474, HBL100, MCF-7, MDA-MB 231, MDA-MB 468, and T47D) were cultured in medium with 5 mM glucose in the presence of 3 mM 3-OHB at mild hypoxia (5% oxygen) or normoxia (21% oxygen). Metabolic profiling was performed by quantification of the turnover of glucose, lactate, and 3-OHB and by Seahorse metabolic flux analysis. Expression of key enzymes of ketolysis as well as the main monocarboxylic acid transporter MCT2 and the glucose-transporter GLUT1 was analyzed by RT-qPCR and Western blotting. The effect of 3-OHB on short- and long-term cell proliferation as well as chemo- and radiosensitivity were also analyzed. Results: 3-OHB significantly changed the oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) in BT20 cells resulting in a more oxidative energetic phenotype. MCF-7 and MDA-MB 468 cells had increased ECAR only in response to 3-OHB, while the other three cell types remained uninfluenced. All cells expressed MCT2 and GLUT1, thus being able to uptake the metabolites. The consumption of 3-OHB was not strongly linked to mRNA overexpression of key enzymes of ketolysis and did not correlate with lactate production and glucose consumption. Neither 3-OHB nor acetoacetate did interfere with proliferation. Further, 3-OHB incubation did not modify the response of the tested BC cell lines to chemotherapy or radiation. Conclusions: We found that a physiological level of 3-OHB can change the energetic profile of some BC cell lines. However, 3-OHB failed to influence different biologic processes in these cells, e.g., cell proliferation and the response to common breast cancer chemotherapy and radiotherapy. Thus, we have no evidence that 3-OHB generally influences the biology of breast cancer cells in vitro. KW - ketogenic diet KW - β-Hydroxybutyrate KW - ketone bodies KW - breast cancer KW - seahorse KW - metabolic profile KW - chemotherapy KW - ionizing radiation Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-175607 VL - 6 IS - 8 ER - TY - JOUR A1 - Brehm, Klaus A1 - Koziol, Uriel T1 - On the importance of targeting parasite stem cells in anti-echinococcosis drug development T1 - De l’importance de cibler les cellules souches du parasite dans la recherche de nouveaux médicaments contre les échinococcoses JF - Parasite N2 - The life-threatening diseases alveolar and cystic echinococcoses are caused by larvae of the tapeworms Echinococcus multilocularis and E. granulosus, respectively. In both cases, intermediate hosts, such as humans, are infected by oral uptake of oncosphere larvae, followed by asexual multiplication and almost unrestricted growth of the metacestode within host organs. Besides surgery, echinococcosis treatment relies on benzimidazole-based chemotherapy, directed against parasite beta-tubulin. However, since beta-tubulins are highly similar between cestodes and humans, benzimidazoles can only be applied at parasitostatic doses and are associated with adverse side effects. Mostly aiming at identifying alternative drug targets, the nuclear genome sequences of E. multilocularis and E. granulosus have recently been characterized, revealing a large number of druggable targets that are expressed by the metacestode. Furthermore, recent cell biological investigations have demonstrated that E. multilocularis employs pluripotent stem cells, called germinative cells, which are the only parasite cells capable of proliferation and which give rise to all differentiated cells. Hence, the germinative cells are the crucial cell type mediating proliferation of E. multilocularis, and most likely also E. granulosus, within host organs and should also be responsible for parasite recurrence upon discontinuation of chemotherapy. Interestingly, recent investigations have also indicated that germinative cells might be less sensitive to chemotherapy because they express a beta-tubulin isoform with limited affinity to benzimidazoles. In this article, we briefly review the recent findings concerning Echinococcus genomics and stem cell research and propose that future research into anti-echinococcosis drugs should also focus on the parasite’s stem cell population. N2 - Les échinococcoses alvéolaire et kystique, deux maladies potentiellement mortelles, sont respectivement causées par les larves des vers plats Echinococcus multilocularis et E. granulosus. Dans les deux cas, les hôtes intermédiaires, comme l’homme, s’infectent par l’ingestion des oncosphères, suivie de la multiplication asexuée et la croissance presque illimitée du métacestode dans les organes de l’hôte. À côté de la chirurgie, le traitement des échinococcoses repose sur une chimiothérapie par les benzimidazoles, dont l’action est dirigée contre la bêta-tubuline du parasite. Cependant, comme les bêta-tubulines sont extrêmement similaires chez les cestodes et les humains, les benzimidazoles ne peuvent être utilisés qu’à des posologies parasitostatiques et sont associés à des effets secondaires indésirables. Avec l’objectif principal d’identifier des cibles pour des médicaments alternatifs, le génome nucléaire d’E. multilocularis et d’E. granulosus a été récemment séquencé, et de nombreuses cibles potentielles pour des médicaments sont exprimées par le métacestode. De plus, des études récentes de biologie cellulaire ont montré qu’E. multilocularis dispose de cellules souches multipotentes, appelées cellules germinales, qui sont les seules cellules parasitaires capables de prolifération et à l’origine de toutes les cellules différenciées. Ces cellules germinales représentent donc un type cellulaire crucial pour la prolifération d’E. multilocularis, et très vraisemblablement aussi d’E. granulosus, dans les organes de l’hôte, et vraisemblablement responsables des récurrences parasitaires à l’arrêt de la chimiothérapie. Des études récentes ont aussi indiqué que les cellules germinales pourraient être moins sensibles à la chimiothérapie car elles expriment un isoforme de la bêta-tubuline à affinité limitée vis-à-vis des benzimidazoles. Dans cet article, nous faisons une courte revue des découvertes récentes concernant la génomique d’Echinococcus et la recherche sur les cellules souches. Nous proposons que les recherches futures sur de nouveaux médicaments contre les échinococcoses se focalisent sur la population des cellules souches du parasite. KW - genome KW - chemotherapy KW - benzimidazole KW - stem cells KW - germinative cells KW - beta-tubulin Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-118030 SN - 1252-607X VL - 21 ER - TY - JOUR A1 - Cardani, Diego A1 - Sardi, Claudia A1 - La Ferla, Barbara A1 - D'Orazio, Guiseppe A1 - Sommariva, Michele A1 - Marcucci, Fabrizio A1 - Olivero, Daniela A1 - Tagliabue, Elda A1 - Koepsell, Hermann A1 - Nicotra, Francesco A1 - Balsari, Andrea A1 - Rumio, Christiano T1 - Sodium glucose cotransporter 1 ligand BLF501 as a novel tool for management of gastrointestinal mucositis JF - Molecular Cancer N2 - Background: Recent studies demonstrated that engagement of sodium glucose transporter 1 (SGLT-1) by orally administered D-glucose protects the intestinal mucosa from lipopolysaccharide (LPS)-induced injury. We tested whether SGLT-1 engagement might protect the intestinal mucosa from doxorubicin (DXR)- and 5-fluorouracil (5-FU)-induced injury in animal models mimicking acute or chronic mucositis. Methods: Mice were treated intraperitoneally with DXR, alone or in combination with 5-FU, and orally with BLF501, a glucose-derived synthetic compound with high affinity for SGLT-1. Intestinal mucosal epithelium integrity was assessed by histological analysis, cellular proliferation assays, real-time PCR gene expression assays and Western blot assays. Student's t-test (paired two-tailed) and X-2 analyses were used for comparisons between groups. Differences were considered significant at p < 0.05. Results: BLF501 administration in mice treated with DXR and/or 5-FU decreased the injuries to the mucosa in terms of epithelial integrity and cellular proliferative ability. Co-treatment with BLF501 led to a normal expression and distribution of both zonula occludens-1 (ZO-1) and beta-catenin, which were underexpressed after treatment with either chemotherapeutic agent alone. BLF501 administration also restored normal expression of caspase-3 and ezrin/radixin/moesin (ERM), which were overexpressed after treatment with DXR and 5-FU. In SGLT1-/- mice, BLF501 had no detectable effects. BLF501 administration in wild-type mice with growing A431 tumors did not modify antitumor activity of DXR. Conclusions: BLF501-induced protection of the intestinal mucosa is a promising novel therapeutic approach to reducing the severity of chemotherapy-induced mucositis. KW - apoptosis KW - prevention KW - doxorubicin KW - cancer KW - gastrointestinal mucositis KW - SGLT-1 KW - synthetic D-glucose analogy KW - chemotherapy KW - inflammation KW - clinical practice guidelines KW - intestinal mucositis KW - epithelial cells KW - oral mucositis KW - gene-expression Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-117352 SN - 1476-4598 VL - 13 IS - 23 ER - TY - JOUR A1 - Chiorean, E. G. A1 - Von Hoff, D. D. A1 - Reni, M. A1 - Arena, F. P. A1 - Infante, J. R. A1 - Bathini, V. G. A1 - Wood, T. E. A1 - Mainwaring, P. N. A1 - Muldoon, R. T. A1 - Clingan, P. R. A1 - Kunzmann, V. A1 - Ramanathan, R. K. A1 - Tabernero, J. A1 - Goldstein, D. A1 - McGovern, D. A1 - Lu, B. A1 - Ko, A. T1 - CA19-9 decrease at 8 weeks as a predictor of overall survival in a randomized phase III trial (MPACT) of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone in patients with metastatic pancreatic cancer JF - Annals of Oncology N2 - Background A phase I/II study and subsequent phase III study (MPACT) reported significant correlations between CA19-9 decreases and prolonged overall survival (OS) with nab-paclitaxel plus gemcitabine (nab-P + Gem) treatment for metastatic pancreatic cancer (MPC). CA19-9 changes at week 8 and potential associations with efficacy were investigated as part of an exploratory analysis in the MPACT trial. Patients and methods Untreated patients with MPC (N = 861) received nab-P + Gem or Gem alone. CA19-9 was evaluated at baseline and every 8 weeks. Results Patients with baseline and week-8 CA19-9 measurements were analyzed (nab-P + Gem: 252; Gem: 202). In an analysis pooling the treatments, patients with any CA19-9 decline (80%) versus those without (20%) had improved OS (median 11.1 versus 8.0 months; P = 0.005). In the nab-P + Gem arm, patients with (n = 206) versus without (n = 46) any CA19-9 decrease at week 8 had a confirmed overall response rate (ORR) of 40% versus 13%, and a median OS of 13.2 versus 8.3 months (P = 0.001), respectively. In the Gem-alone arm, patients with (n = 159) versus without (n = 43) CA19-9 decrease at week 8 had a confirmed ORR of 15% versus 5%, and a median OS of 9.4 versus 7.1 months (P = 0.404), respectively. In the nab-P + Gem and Gem-alone arms, by week 8, 16% (40/252) and 6% (13/202) of patients, respectively, had an unconfirmed radiologic response (median OS 13.7 and 14.7 months, respectively), and 79% and 84% of patients, respectively, had stable disease (SD) (median OS 11.1 and 9 months, respectively). Patients with SD and any CA19-9 decrease (158/199 and 133/170) had a median OS of 13.2 and 9.4 months, respectively. Conclusion This analysis demonstrated that, in patients with MPC, any CA19-9 decrease at week 8 can be an early marker for chemotherapy efficacy, including in those patients with SD. CA19-9 decrease identified more patients with survival benefit than radiologic response by week 8. KW - CA19-9 KW - pancreatic cancer KW - chemotherapy KW - nab-paclitaxel KW - MPACT Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-189659 VL - 27 IS - 4 ER - TY - JOUR A1 - Dufner, Vera A1 - Kessler, Almuth Friederike A1 - Just, Larissa A1 - Hau, Peter A1 - Bumes, Elisabeth A1 - Pels, Hendrik Johannes A1 - Grauer, Oliver Martin A1 - Wiese, Bettina A1 - Löhr, Mario A1 - Jordan, Karin A1 - Strik, Herwig T1 - The emesis trial: depressive glioma patients are more affected by chemotherapy-induced nausea and vomiting JF - Frontiers in Neurology N2 - Purpose Glioma patients face a limited life expectancy and at the same time, they suffer from afflicting symptoms and undesired effects of tumor treatment. Apart from bone marrow suppression, standard chemotherapy with temozolomide causes nausea, emesis and loss of appetite. In this pilot study, we investigated how chemotherapy-induced nausea and vomiting (CINV) affects the patients' levels of depression and their quality of life. Methods In this prospective observational multicentre study (n = 87), nausea, emesis and loss of appetite were evaluated with an expanded MASCC questionnaire, covering 10 days during the first and the second cycle of chemotherapy. Quality of life was assessed with the EORTC QLQ-C30 and BN 20 questionnaire and levels of depression with the PHQ-9 inventory before and after the first and second cycle of chemotherapy. Results CINV affected a minor part of patients. If present, it reached its maximum at day 3 and decreased to baseline level not before day 8. Levels of depression increased significantly after the first cycle of chemotherapy, but decreased during the further course of treatment. Patients with higher levels of depression were more severely affected by CINV and showed a lower quality of life through all time-points. Conclusion We conclude that symptoms of depression should be perceived in advance and treated in order to avoid more severe side effects of tumor treatment. Additionally, in affected patients, delayed nausea was most prominent, pointing toward an activation of the NK1 receptor. We conclude that long acting antiemetics are necessary totreat temozolomide-induced nausea. KW - glioblastoma KW - chemotherapy KW - depression KW - nausea and emesis KW - quality of life Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-262859 SN - 1664-2295 VL - 13 ER - TY - JOUR A1 - Gaab, Christine A1 - Adolph, Jonas E. A1 - Tippelt, Stephan A1 - Mikasch, Ruth A1 - Obrecht, Denise A1 - Mynarek, Martin A1 - Rutkowski, Stefan A1 - Pfister, Stefan M. A1 - Milde, Till A1 - Witt, Olaf A1 - Bison, Brigitte A1 - Warmuth-Metz, Monika A1 - Kortmann, Rolf-Dieter A1 - Dietzsch, Stefan A1 - Pietsch, Torsten A1 - Timmermann, Beate A1 - Sträter, Ronald A1 - Bode, Udo A1 - Faldum, Andreas A1 - Kwiecien, Robert A1 - Fleischhack, Gudrun T1 - Local and systemic therapy of recurrent medulloblastomas in children and adolescents: results of the P-HIT-REZ 2005 Study JF - Cancers N2 - Recurrent medulloblastomas are associated with survival rates <10%. Adequate multimodal therapy is being discussed as having a major impact on survival. In this study, 93 patients with recurrent medulloblastoma treated in the German P-HIT-REZ 2005 Study were analyzed for survival (PFS, OS) dependent on patient, disease, and treatment characteristics. The median age at the first recurrence was 10.1 years (IQR: 6.9–16.1). Median PFS and OS, at first recurrence, were 7.9 months (CI: 5.7–10.0) and 18.5 months (CI: 13.6–23.5), respectively. Early relapses/progressions (<18 months, n = 30/93) found mainly in molecular subgroup 3 were associated with markedly worse median PFS (HR: 2.34) and OS (HR: 3.26) in regression analyses. A significant survival advantage was found for the use of volume-reducing surgery as well as radiotherapy. Intravenous chemotherapy with carboplatin and etoposide (ivCHT, n = 28/93) showed improved PFS and OS data and the best objective response rate (ORR) was 66.7% compared to oral temozolomide (oCHT, n = 47/93) which was 34.8%. Intraventricular (n = 43) as well as high-dose chemotherapy (n = 17) at first relapse was not related to a significant survival benefit. Although the results are limited due to a non-randomized study design, they may serve as a basis for future treatment decisions in order to improve the patients' survival. KW - medulloblastoma KW - refractory KW - recurrent KW - children KW - chemotherapy KW - surgery KW - radiotherapy KW - re-irradiation KW - intraventricular therapy Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-254809 SN - 2072-6694 VL - 14 IS - 3 ER - TY - THES A1 - Gelmedin, Verena Magdalena T1 - Targeting flatworm signaling cascades for the development of novel anthelminthic drugs T1 - Signalkaskaden von Plattwürmern als Angriffspunkte zur Entwicklung neuer Antihelminthika N2 - Echinococcus multilocularis verursacht die Alveoläre Echinokokkose (AE), eine lebendsbedrohliche Krankheit mit limitierten chemotherapeutischen Möglichkeiten. Die jetzige Anti-AE Chemotherapie basiert auf einer einzigen Wirkstoffklasse, den Benzimidazolen. Obwohl Benzimidazole in vitro parasitozid wirken, wirken sie in vivo bei AE-Behandlung lediglich parasitostatisch und rufen schwere Nebenwirkungen hervor. In Fällen operabler Läsionen erfordert die Resektion des Parasitengewebes über einen längeren Zeitraum eine chemotherapeutische Unterstützung. Damit sind die jetzigen Behandlungsmöglichkeiten inadäquat und benötigen Alternativen. In der vorliegenden Arbeit wurden die Signalwege von Plattwürmern analysiert, um potentielle Targets für neue therapeutische Ansätze zu identifizieren. Dabei konzentrierte ich mich unter Anwendung von molekularbiologischer, biochemischer und zellbiologischer Methoden auf Faktoren, die an Entwicklung und Proliferation von E. multilocularis beteiligt sind. Darunter waren die drei MAP kinases des Parasiten EmMPK1, ein Erk1/2-Ortholog, EmMPK2, ein p38-Ortholog und EmMPK3, ein Erk7/8-Ortholog. Des Weiteren identifizierte und charakterisierte ich EmMKK2, ein MEK1/2-Ortholog des Parasiten, welches zusammen mit den bekannten Kinasen EmRaf und EmMPK1 ein Erk1/2-ähnliches MAPK Modul bildet. Ich konnte zudem verschiedene Einflüsse von Wirtswachstumsfaktoren wie EGF (epidermal growth factor) und Insulin auf die Signalmechanismen des Parasiten und das Larvenwachstum zeigen, darunter die Phosphorylierung von Elp, ein Ezrin-Radixin-Moesin ähnliches Protein, die Aktivierung von EmMPK1 und EmMPK3 und eine gesteigerte mitotische Aktivität der Echinokokkenzellen. Zusätzlich wurden verschiedene Substanzen auf ihre letale Wirkung auf den Parasiten untersucht, darunter befanden sich (1.) generelle Inhibitoren von Tyrosinkinasen (PP2, Leflunamid), (2.) gegen die Aktivität von Rezeptor-Tyrosin-Kinasen gerichtete Präparate, (3.) ursprünglich anti-neoplastische Wirkstoffe wie Miltefosin und Perifosin, (4.) Inhibitoren von Serin/ Threonin-Kinasen, die die Erk1/2 MAPK Kaskade blockieren und (5.) Inhibitoren der p38 MAPK. In diesen Untersuchungen hat sich EmMPK2 aus den folgenden Gründen als vielversprechendes Target erwiesen. Aminosäuresequenz-Analysen offenbarten einige Unterschiede zu menschlichen p38 MAP Kinasen, welche sehr wahrscheinlich die beobachtete gesteigerte basale Aktivität des rekombinanten EmMPK2 verursachen, verglichen mit der Aktivität humaner p38 MAPK-α. Zusätzlich suggerieren die prominente Autophosphorylierungsaktivität von rekombinantem EmMPK2 und das Ausbleiben einer Interaktion mit den Echinococcus MKKs einen unterschiedlichen Regulierungsmechanismus im Vergleich zu den humanen Proteinen. Die Aktivität von EmMPK2 konnte sowohl in vitro als auch in kultivierten Metazestodenvesikeln durch die Behandlung mit SB202190 und ML3403, zwei ATP kompetitiven Pyridinylimidazolinhibitoren der p38 MAPK, in Konzentrations-abhängiger Weise inhibiert werden. Zudem verursachten beide Substanzen, insbesondere ML3403 die Inaktivierung von Parasitenvesikeln bei Konzentrationen, die kultivierte Säugerzellen nicht beeinträchtigten. Ebenso verhinderte die Anwesenheit von ML3403 die Generation von neuen Vesikeln während der Kultivierung von Echinococcus Primärzellen. Das Targeting von Mitgliedern des EGF-Signalwegs, insbesondere der Erk1/2-ähnlichen MAPK Kaskade mit Raf- und MEK- Inhibitoren verhinderte die Phosphorylierung von EmMPK1 in in vitro kultivierten Metazestoden. Obwohl das Parasitenwachstum unter diesen Konditionen verhindert wurde, blieb die strukturelle Integrität der Metazestodenvesikeln während der Langzeitkultivierung in Anwesenheit der MAPK Kaskade-Inhibitoren erhalten. Ähnliche Effekte wurden beobachtet nach Behandlung mit den anderen zuvor aufgeführten Inhibitoren. Zusammenfassend lässt sich festhalten, dass verschiedene Targets identifiziert werden konnten, die hoch sensibel auf die Anwesenheit der inhibitorischen Substanzen reagierten, aber nicht zum Absterben des Parasiten führten, mit Ausnahme der Pyridinylimidazolen. Die vorliegenden Daten zeigen, dass EmMPK2 ein Überlebendsignal vermittelnden Faktor darstellt und dessen Inhibierung zur Behandlung der AE benutzt werden könnte. Dabei erwiesen sich p38 MAPK Inhibitoren der Pyridinylimidazolklasse als potentielle neue Substanzklasse gegen Echinokokken. N2 - Echinococcus multilocularis is the causative agent of alveolar echinococcosis (AE), a life-threatening disease with limited options of chemotherapeutic treatment. Anti-AE chemotherapy is currently based on a single class of drugs, the benzimidazoles. Although acting parasitocidic in vitro, benzimidazoles are merely parasitostatic during in vivo treatment of AE and cause severe site effects. In the case of operable lesions, the resection of parasite tissue needs to be supported by a prolonged chemotherapy. Thus, the current treatment options for AE are inadequate and require alternatives. In the present work, the flatworm signaling pathways were analyzed to establish potential targets for novel therapeutic approaches. I focused on factors that are involved in development and proliferation of E. multilocularis using molecular, biochemical and cell biological methods. Among the analysed factors were three MAP kinases of the parasite, EmMPK1, an Erk-1/2 orthologue, EmMPK2, a p38 orthologue and EmMPK3, an Erk7/8 orthologue. Further, I identified and characterized EmMKK2, a MEK1/2 orthologue of the parasite, which, together with the known kinases EmRaf and EmMPK1, forms an Erk1/2-like MAPK module. Moreover, I was able to demonstrate several influences of host growth factors such as EGF (epidermal growth factor) and insulin on worm signaling mechanisms and larval growth, including the phosphorylation of Elp, an ezrin-radixin-moesin like protein, EmMPK1, EmMPK3 and increased mitotic activity of Echinococcus cells. In addition, several substances were examined for their efficacy against the parasite including (i) general tyrosine kinase inhibitors (PP2, leflunamide), (ii) compounds designed to inhibit the activity of receptor tyrosine kinases, (iii) anti-neoplastic agents (miltefosine, perifosine), (iv) serine/threonine kinase inhibitors that have been designed to block the Erk1/2 MAPK cascade and (v) inhibitors of p38 MAPKs. In these studies, EmMPK2 proved to be a promising drug target for the following reasons. Amino acid sequence analysis disclosed several differences to human p38 MAPKs, which is likely to be the reason for the observed enhanced basal activity of recombinant EmMPK2 towards myelin basic protein in comparison to human recombinant p38 MAPK-α. In addition, the prominent auto-phosphorylation activity of the recombinant EmMPK2 protein together with the absence of an interaction with the Echinococcus MKKs suggest a different mechanism of regulation compared to the human enzyme. EmMPK2 activity could be effectively inhibited in vitro and in cultivated metacestode vesicles by treatment with SB202190 and ML3403, two ATP-competitive pyridinyl imidazole inhibitors of p38 MAPKs, in a concentration-dependent manner. Moreover, both compounds, in particular ML3403, caused parasite vesicle inactivation at concentrations which did not affect cultured mammalian cells. Likewise, during the cultivation of Echinococcus primary cells, the presence of ML3403 prevented the generation of new vesicles. Targeting members of the EGF signaling pathway, particulary of the Erk1/2-like MAPK cascade, with Raf and MEK inhibitors prevented the phosphorylation of EmMPK1 in metacestodes cultivated in vitro. However, although parasite growth was prevented under these conditions, the structural integrity of the metacestode vesicles maintained during long-term cultivation in the presence of the MAPK cascade inhibitors. Similar results were obtained when studying the effects of other drugs mentioned above. Taken together, several targets could be identified that reacted with high sensitivity to the presence of inhibitory substances, but did not cause the parasite’s death with one exception, the pyridinyl imidazoles. Based on the presented data, I suggest pyridinyl imidazoles as a novel class of anti-Echinococcus drugs and imply EmMPK2 as survival signal mediating factor, the inhibition of which could be used for the treatment of AE. KW - Fuchsbandwurm KW - Signaltransduktion KW - MAP-Kinase KW - Eingeweidewürmer KW - Proliferation KW - Zelldifferenzierung KW - Inhibitor KW - Entwicklung KW - Heilmittel KW - Fox tapeworm KW - signaltransduction KW - MAP kinase KW - chemotherapy KW - development Y1 - 2008 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-33334 ER - TY - JOUR A1 - Kandels, Daniela A1 - Pietsch, Torsten A1 - Bison, Brigitte A1 - Warmuth‐Metz, Monika A1 - Thomale, Ulrich‐Wilhelm A1 - Kortmann, Rolf‐Dieter A1 - Timmermann, Beate A1 - Hernáiz Driever, Pablo A1 - Witt, Olaf A1 - Schmidt, René A1 - Gnekow, Astrid K. T1 - Loss of efficacy of subsequent nonsurgical therapy after primary treatment failure in pediatric low‐grade glioma patients—Report from the German SIOP‐LGG 2004 cohort JF - International Journal of Cancer N2 - First‐line treatment of pediatric low‐grade glioma using surgery, radio‐ or chemotherapy fails in a relevant proportion of patients. We analyzed efficacy of subsequent surgical and nonsurgical therapies of the German cohort of the SIOP‐LGG 2004 study (2004‐2012, 1558 registered patients; median age at diagnosis 7.6 years, median observation time 9.2 years, overall survival 98%/96% at 5/10 years, 15% neurofibromatosis type 1 [NF1]). During follow‐up, 1078/1558 patients remained observed without (n = 217), with 1 (n = 707), 2 (n = 124) or 3 to 6 (n = 30) tumor volume reductions; 480/1558 had 1 (n = 332), 2 (n = 80), 3 or more (n = 68) nonsurgical treatment‐lines, accompanied by up to 4 tumor‐reductive surgeries in 215/480; 265/480 patients never underwent any neurosurgical tumor volume reduction (163/265 optic pathway glioma). Patients with progressing tumors after first‐line adjuvant treatment were at increased risk of suffering further progressions. Risk factors were young age (<1 year) at start of treatment, tumor dissemination or progression within 18 months after start of chemotherapy. Progression‐free survival rates declined with subsequent treatment‐lines, yet remaining higher for patients with NF1. In non‐NF1‐associated tumors, vinblastine monotherapy vs platinum‐based chemotherapy was noticeably less effective when used as second‐line treatment. Yet, for the entire cohort, results did not favor a certain sequence of specific treatment options. Rather, all can be aligned as a portfolio of choices which need careful balancing of risks and benefits. Future molecular data may predict long‐term tumor biology. KW - chemotherapy KW - pediatric low‐grade glioma KW - progression KW - radiotherapy KW - surgery Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-216130 VL - 147 IS - 12 SP - 3471 EP - 3489 ER - TY - JOUR A1 - Koch, Oliver A1 - Cappel, Daniel A1 - Nocker, Monika A1 - Jäger, Timo A1 - Flohé, Leopold A1 - Sotriffer, Christoph A. A1 - Selzer, Paul M. T1 - Molecular Dynamics Reveal Binding Mode of Glutathionylspermidine by Trypanothione Synthetase JF - PLoS ONE N2 - The trypanothione synthetase (TryS) catalyses the two-step biosynthesis of trypanothione from spermidine and glutathione and is an attractive new drug target for the development of trypanocidal and antileishmanial drugs, especially since the structural information of TryS from Leishmania major has become available. Unfortunately, the TryS structure was solved without any of the substrates and lacks loop regions that are mechanistically important. This contribution describes docking and molecular dynamics simulations that led to further insights into trypanothione biosynthesis and, in particular, explains the binding modes of substrates for the second catalytic step. The structural model essentially confirm previously proposed binding sites for glutathione, ATP and two \(Mg^{2+}\) ions, which appear identical for both catalytic steps. The analysis of an unsolved loop region near the proposed spermidine binding site revealed a new pocket that was demonstrated to bind glutathionylspermidine in an inverted orientation. For the second step of trypanothione synthesis glutathionylspermidine is bound in a way that preferentially allows \(N^1\)-glutathionylation of \(N^8\)-glutathionylspermidine, classifying \(N^8\)-glutathionylspermidine as the favoured substrate. By inhibitor docking, the binding site for \(N^8\)-glutathionylspermidine was characterised as druggable. KW - purification KW - crithidia fasciulata KW - trypanosoma cruzi KW - RESP model KW - biosynthesis KW - chemotherapy KW - metabolism KW - brucei KW - system KW - leishmaniasis Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-131070 VL - 8 IS - 2 ER -