TY - JOUR A1 - Heinze, Britta A1 - Schirbel, Andreas A1 - Nannen, Lukas A1 - Michelmann, David A1 - Hartrampf, Philipp E. A1 - Bluemel, Christina A1 - Schneider, Magdalena A1 - Herrmann, Ken A1 - Haenscheid, Heribert A1 - Fassnacht, Martin A1 - Buck, Andreas K. A1 - Hahner, Stefanie T1 - Novel CYP11B-ligand [\(^{123/131}\)I]IMAZA as promising theranostic tool for adrenocortical tumors: comprehensive preclinical characterization and first clinical experience JF - European Journal of Nuclear Medicine and Molecular Imaging N2 - Purpose Adrenal tumors represent a diagnostic and therapeutic challenge. Promising results have been obtained through targeting the cytochrome P450 enzymes CYP11B1 and CYP11B2 for molecular imaging, and [\(^{123/131}\)I]iodometomidate ([\(^{123/131}\)I]IMTO) has even been successfully introduced as a theranostic agent. As this radiopharmaceutical shows rapid metabolic inactivation, we aimed at developing new improved tracers. Methods Several IMTO derivatives were newly designed by replacing the unstable methyl ester by different carboxylic esters or amides. The inhibition of aldosterone and cortisol synthesis was tested in different adrenocortical cell lines. The corresponding radiolabeled compounds were assessed regarding their stability, in vitro cell uptake, in vivo biodistribution in mice, and their binding specificity to cryosections of human adrenocortical and non-adrenocortical tissue. Furthermore, a first investigation was performed in patients with known metastatic adrenal cancer using both [\(^{123}\)I]IMTO and the most promising compound (R)-1-[1-(4-[\(^{123/}\)I]iodophenyl)ethyl]-1H-imidazole-5-carboxylic acid azetidinylamide ([\(^{123}\)I]IMAZA) for scintigraphy. Subsequently, a first endoradiotherapy with [\(^{131}\)I]IMAZA in one of these patients was performed. Results We identified three analogues to IMTO with high-affinity binding to the target enzymes and comparable or higher metabolic stability and very high and specific accumulation in adrenocortical cells in vitro and in vivo. Labeled IMAZA exhibited superior pharmacokinetic and imaging properties compared to IMTO in mice and 3 patients, too. An endoradiotherapy with [\(^{131}\)I]IMAZA induced a 21-month progression-free interval in a patient with rapidly progressing ACC prior this therapy. Conclusion We developed the new radiopharmaceutical [\(^{123/131}\)I]IMAZA with superior properties compared to the reference compound IMTO and promising first experiences in humans. KW - CYP11B enzymes KW - adrenal incidentaloma KW - adrenocortical carcinoma Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-265606 SN - 1619-7089 VL - 49 IS - 1 ER - TY - JOUR A1 - Chifu, Irina A1 - Heinze, Britta A1 - Fuss, Carmina T. A1 - Lang, Katharina A1 - Kroiss, Matthias A1 - Kircher, Stefan A1 - Ronchi, Cristina L. A1 - Altieri, Barbara A1 - Schirbel, Andreas A1 - Fassnacht, Martin A1 - Hahner, Stefanie T1 - Impact of the Chemokine Receptors CXCR4 and CXCR7 on Clinical Outcome in Adrenocortical Carcinoma JF - Frontiers in Endocrinology N2 - Chemokine receptors have a negative impact on tumor progression in several human cancers and have therefore been of interest for molecular imaging and targeted therapy. However, their clinical and prognostic significance in adrenocortical carcinoma (ACC) is unknown. The aim of this study was to evaluate the chemokine receptor profile in ACC and to analyse its association with clinicopathological characteristics and clinical outcome. A chemokine receptor profile was initially evaluated by quantitative PCR in 4 normal adrenals, 18 ACC samples and human ACC cell line NCI-H295. High expression of CXCR4 and CXCR7 in both healthy and malignant adrenal tissue and ACC cells was confirmed. In the next step, we analyzed the expression and cellular localization of CXCR4 and CXCR7 in ACC by immunohistochemistry in 187 and 84 samples, respectively. These results were correlated with clinicopathological parameters and survival outcome. We detected strong membrane expression of CXCR4 and CXCR7 in 50% of ACC samples. Strong cytoplasmic CXCR4 staining was more frequent among samples derived from metastases compared to primaries (p=0.01) and local recurrences (p=0.04). CXCR4 membrane staining positively correlated with proliferation index Ki67 (r=0.17, p=0.028). CXCR7 membrane staining negatively correlated with Ki67 (r=−0.254, p=0.03) but positively with tumor size (r=0.3, p=0.02). No differences in progression-free or overall survival were observed between patients with strong and weak staining intensities for CXCR4 or CXCR7. Taken together, high expression of CXCR4 and CXCR7 in both local tumors and metastases suggests that some ACC patients might benefit from CXCR4/CXCR7-targeted therapy. KW - chemokine receptor KW - prognosis KW - adrenocortical carcinoma KW - CXCR4 KW - CXCR7 Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-216494 SN - 1664-2392 VL - 11 ER - TY - JOUR A1 - Fuss, Carmina Teresa A1 - Other, Katharina A1 - Heinze, Britta A1 - Landwehr, Laura-Sophie A1 - Wiegering, Armin A1 - Kalogirou, Charis A1 - Hahner, Stefanie A1 - Fassnacht, Martin T1 - Expression of the chemokine receptor CCR7 in the normal adrenal gland and adrenal tumors and its correlation with clinical outcome in adrenocortical carcinoma JF - Cancers N2 - Background: The chemokine receptor CCR7 is crucial for an intact immune function, but its expression is also associated with clinical outcome in several malignancies. No data exist on the expression of CCR7 in adrenocortical tumors. Methods: CCR7 expression was investigated by qRT-PCR and immunohistochemistry in 4 normal adrenal glands, 59 adrenocortical adenomas, and 181 adrenocortical carcinoma (ACC) samples. Results: CCR7 is highly expressed in the outer adrenocortical zones and medulla. Aldosterone-producing adenomas showed lower CCR7 protein levels (H-score 1.3 ± 1.0) compared to non-functioning (2.4 ± 0.5) and cortisol-producing adenomas (2.3 ± 0.6), whereas protein expression was variable in ACC (1.8 ± 0.8). In ACC, CCR7 protein expression was significantly higher in lymph node metastases (2.5 ± 0.5) compared to primary tumors (1.8±0.8) or distant metastases (2.0 ± 0.4; p < 0.01). mRNA levels of CCR7 were not significantly different between ACCs, normal adrenals, and adrenocortical adenomas. In contrast to other tumor entities, neither CCR7 protein nor mRNA expression significantly impacted patients' survival. Conclusion: We show that CCR7 is expressed on mRNA and protein level across normal adrenals, benign adrenocortical tumors, as well as ACCs. Given that CCR7 did not influence survival in ACC, it is probably not involved in tumor progression, but it could play a role in adrenocortical homeostasis. KW - CCR7 KW - chemokine receptor KW - adrenocortical carcinoma KW - adrenal tumors Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-250112 SN - 2072-6694 VL - 13 IS - 22 ER - TY - THES A1 - Heinze, Britta T1 - Charakterisierung der angeborenen Immunantwort gegen Pneumoviren in einem in vivo Modell T1 - Characterization of the innate immune response against pneumoviruses in an in vivo model N2 - In dieser Arbeit wurde das PVM-Mausmodell verwendet, um die Bedeutung der Typ I und Typ III Interferonantwort für die Pathogenese einer pneumoviralen Infektion zu analysieren. Hierzu wurden zunächst mit Hilfe der reversen Genetik rekombinante PVM-Mutanten hergestellt, bei denen die Gene für die NS-Proteine, welche vermutlich als Interferonantagonisten fungieren, deletiert sind. Die Charakterisierung der Replikationsfähigkeit der rPVM dNS-Mutanten erfolgte in vitro in Interferon-kompetenten und Interferon-inkompetenten Zelllinien. Ein zentraler Schritt innerhalb dieser Charakterisierung war die Untersuchung der Induktion von Interferonen in vivo und in vitro nach Infektion mit den rPVM dNSMutanten, wobei nachgewiesen wurde, dass die NS-Proteine von PVM als Interferonantagonisten fungieren. In allen Interferon-kompetenten Zellkulturen wurde eine Attenuierung von rPVM dNS1, rPVM dNS2 und rPVM dNS1dNS2 bezogen auf rPVM beobachtet. In allen Interferon-inkompetenten Zellkulturen konnte die Attenuierung der rPVM dNS-Mutanten nahezu vollständig revertiert werden. Nach Infektion mit den rPVM dNS-Mutanten wurde in verschiedenen Zelllinien eine Induktion von Typ I und Typ III Interferonen betrachtet, wobei Unterschiede in der Stärke der Interferon-Induktion nach Infektion mit den rPVM dNS-Mutanten vorhanden waren. Zusammenfassend war es möglich, die NS1- und NS2-Proteine von PVM in Analogie zu RSV eindeutig als Antagonisten der Interferonantwort zu identifizieren. Die Untersuchung der protektiven Rolle von Typ I und Typ III Interferonen für die Replikation und Pathogenität von PVM bildete den zweiten Teil dieser Arbeit. Hierzu wurde die Replikationsfähigkeit und Pathogenität der rPVM dNS-Mutanten in verschiedenen Interferon-defizienten Mausstämmen getestet. Die Untersuchungen ergaben eine protektive Rolle von Typ I und Typ III Interferonen bei einer Infektion mit PVM, wobei den Typ I Interferonen ein effektiverer Einfluss zugeordnet werden konnte. Ein Vergleich von Replikation und Virulenz zwischen den verschiedenen Typ I oder Typ III oder Typ I/Typ III Interferonrezeptor-defizienten Mausstämmen belegte eine erhöhte Suszeptibilität der Typ I/Typ III Interferonrezeptor-defizienten Mäuse gegenüber einer Infektion mit den rPVM dNS-Mutanten. Eine vollständige Aufhebung der Attenuierung wurde auch in den Typ I/Typ III Interferonrezeptor-defizienten Mäusen nicht erlangt. Eine anti-apoptotische Funktion der NS-Proteine zusätzlich zu ihrer Wirkungsweise als Interferonantagonisten wurde aufgrund der unvollständigen Revertierung der Pathogenität der rPVM dNS-Mutanten in Typ I/Typ III Interferonrezeptor-defizienten Mäusen vermutet. Der abschließende Teil dieser Dissertation befasste sich mit der Frage, welche Zellen bei einer natürlichen pulmonalen Infektion Interferone in vivo produzieren. In vitro wurde beobachtet, dass überraschenderweise nur sehr wenige virusinfizierte oder uninfizierte Zellen Typ I Interferone bilden. Der Nachweis darüber, welche Zellen während einer pulmonalen Infektion hauptsächlich Interferone in vivo produzieren, war aufgrund der fehlenden Eignung der kommerziell erhältlichen Interferon-Antikörper für intrazelluläre Gewebefärbungen nicht möglich. Dennoch gelang es abschließend durch eine neue Nachweismethode erstmals Zellen mit rezeptorgebundenen Interferon zu identifizieren, wobei es sich um ziliierte Epithelzellen, Alveolarmakrophagen und vermutlich Clarazellen sowie Typ I und Typ II Pneumozyten handelte. N2 - In this thesis the PVM mouse model was used to unveil the role of type I and type III interferone response for the pathogenesis of pneumoviral infection. First, recombinant PVM dNS-mutants with single or combined deletions of the NS-genes were generated and replication efficiency characterization was analyzed in interferon-competent cells as well as in interferon-incompetent cells. A major point was to elucidate the NS-proteins of PVM as interferon antagonists. In interferon-competent cells the replication of rPVM dNS-mutants were significantly attenuated. These attenuation of all three rPVM dNS-mutants was almost completely reversed when interferon-incompetent cells were infected. Induction of type I and type III interferons was determined in different cell types after infection with rPVM dNS-mutants with differences in intensity of interferon induction. Thus, NS1- and NS2-proteins were clearly identified as interferon antagonists. To analyze the protective capacity of type I and type III interferons with respect to replication and pathology of PVM, mice lacking functional receptors for either or both interferons were infected with rPVM or the respective dNS-mutants. The results indicated that both type I and type III interferons which one restricted replication and pathology of PVM, with the former playing the greater role. Interestingly, the replication and virulence of wild-type PVM were completely unaffected by the presence or absence of functional receptors to type I and type III interferon, indicating that both systems are strongly suppressed during infection. However, pretreatment of mice with type I interferon were protective against lethal rPVM challenge, whereas pretreatment with type III interferon delayed but did not prevent death. Finally, the PVM-NS-proteins appeared to delay apoptosis independently of its IFN-antagonistic activity that may contribute to the limited pathogenicity of the viruses in type I/type III receptor deficient mice. In the last part type I interferon producing cells in a pneumoviral infection in vivo should be identified. It was documented that type I interferon producing cells are virusinfected cells as well as uninfected cells. Surprisingly, in vitro only few cells produced type I interferon during rPVM-GFP7 dNS1dNS2 infection. Because the commercially available interferon antibodies are not qualified for intracellular tissue staining it was not possible to identify in vivo the interferon producing cells, but by inventing a new method it was possible to verify the binding of type I interferon to the cell surface receptor of ciliated epithelial cells, alveolar macrophages and presumably Clara cells and type I and type II pneumocytes. KW - Interferon KW - RS-Virus KW - Immunreaktion KW - Lungenentzündung KW - Apoptosis KW - Tiermodell KW - Toll-like-Rezeptoren KW - PVM KW - Nichtstrukturproteine KW - IFNAR KW - Interferonrezeptor KW - PVM KW - interferon KW - IFNAR KW - receptor KW - apoptosis Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-56454 ER -