TY - JOUR A1 - Peseschkian, Tara A1 - Cordts, Isabell A1 - Günther, René A1 - Stolte, Benjamin A1 - Zeller, Daniel A1 - Schröter, Carsten A1 - Weyen, Ute A1 - Regensburger, Martin A1 - Wolf, Joachim A1 - Schneider, Ilka A1 - Hermann, Andreas A1 - Metelmann, Moritz A1 - Kohl, Zacharias A1 - Linker, Ralf A. A1 - Koch, Jan Christoph A1 - Büchner, Boriana A1 - Weiland, Ulrike A1 - Schönfelder, Erik A1 - Heinrich, Felix A1 - Osmanovic, Alma A1 - Klopstock, Thomas A1 - Dorst, Johannes A1 - Ludolph, Albert C. A1 - Boentert, Matthias A1 - Hagenacker, Tim A1 - Deschauer, Marcus A1 - Lingor, Paul A1 - Petri, Susanne A1 - Schreiber-Katz, Olivia T1 - A nation-wide, multi-center study on the quality of life of ALS patients in Germany JF - Brain Sciences N2 - Improving quality of life (QoL) is central to amyotrophic lateral sclerosis (ALS) treatment. This Germany-wide, multicenter cross-sectional study analyses the impact of different symptom-specific treatments and ALS variants on QoL. Health-related QoL (HRQoL) in 325 ALS patients was assessed using the Amyotrophic Lateral Sclerosis Assessment Questionnaire 5 (ALSAQ-5) and EuroQol Five Dimension Five Level Scale (EQ-5D-5L), together with disease severity (captured by the revised ALS Functional Rating Scale (ALSFRS-R)) and the current care and therapies used by our cohort. At inclusion, the mean ALSAQ-5 total score was 56.93 (max. 100, best = 0) with a better QoL associated with a less severe disease status (β = −1.96 per increase of one point in the ALSFRS-R score, p < 0.001). “Limb-onset” ALS (lALS) was associated with a better QoL than “bulbar-onset” ALS (bALS) (mean ALSAQ-5 total score 55.46 versus 60.99, p = 0.040). Moreover, with the ALSFRS-R as a covariate, using a mobility aid (β = −7.60, p = 0.001), being tracheostomized (β = −14.80, p = 0.004) and using non-invasive ventilation (β = −5.71, p = 0.030) were associated with an improved QoL, compared to those at the same disease stage who did not use these aids. In contrast, antidepressant intake (β = 5.95, p = 0.007), and increasing age (β = 0.18, p = 0.023) were predictors of worse QoL. Our results showed that the ALSAQ-5 was better-suited for ALS patients than the EQ-5D-5L. Further, the early and symptom-specific clinical management and supply of assistive devices can significantly improve the individual HRQoL of ALS patients. Appropriate QoL questionnaires are needed to monitor the impact of treatment to provide the best possible and individualized care. KW - Amyotrophic Lateral Sclerosis (ALS) KW - Amyotrophic Lateral Sclerosis Assessment Questionnaire 5 (ALSAQ-5) KW - ALS treatment KW - “bulbar-onset” ALS (bALS) KW - “limb-onset” ALS (lALS) KW - EuroQol Five Dimension Five Level Scale (EQ-5D-5L) KW - health-related quality of life (HRQoL) KW - quality of life (QoL) KW - symptom-specific treatment KW - assistive devices Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234147 SN - 2076-3425 VL - 11 IS - 3 ER - TY - JOUR A1 - Detomas, Mario A1 - Altieri, Barbara A1 - Schlötelburg, Wiebke A1 - Appenzeller, Silke A1 - Schlaffer, Sven A1 - Coras, Roland A1 - Schirbel, Andreas A1 - Wild, Vanessa A1 - Kroiss, Matthias A1 - Sbiera, Silviu A1 - Fassnacht, Martin A1 - Deutschbein, Timo T1 - Case Report: Consecutive Adrenal Cushing’s Syndrome and Cushing’s Disease in a Patient With Somatic CTNNB1, USP8, and NR3C1 Mutations JF - Frontiers in Endocrinology N2 - The occurrence of different subtypes of endogenous Cushing’s syndrome (CS) in single individuals is extremely rare. We here present the case of a female patient who was successfully cured from adrenal CS 4 years before being diagnosed with Cushing’s disease (CD). The patient was diagnosed at the age of 50 with ACTH-independent CS and a left-sided adrenal adenoma, in January 2015. After adrenalectomy and histopathological confirmation of a cortisol-producing adrenocortical adenoma, biochemical hypercortisolism and clinical symptoms significantly improved. However, starting from 2018, the patient again developed signs and symptoms of recurrent CS. Subsequent biochemical and radiological workup suggested the presence of ACTH-dependent CS along with a pituitary microadenoma. The patient underwent successful transsphenoidal adenomectomy, and both postoperative adrenal insufficiency and histopathological workup confirmed the diagnosis of CD. Exome sequencing excluded a causative germline mutation but showed somatic mutations of the β-catenin protein gene (CTNNB1) in the adrenal adenoma, and of both the ubiquitin specific peptidase 8 (USP8) and the glucocorticoid receptor (NR3C1) genes in the pituitary adenoma. In conclusion, our case illustrates that both ACTH-independent and ACTH-dependent CS may develop in a single individual even without evidence for a common genetic background. KW - Cushing’s syndrome KW - Cushing’s disease KW - hypercortisolism KW - glucocorticoid excess KW - USP8 KW - CTNNB1 KW - NR3C1 Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244596 SN - 1664-2392 VL - 12 ER - TY - JOUR A1 - Kremer, Naomi I. A1 - Pauwels, Rik W. J. A1 - Pozzi, Nicolò G. A1 - Lange, Florian A1 - Roothans, Jonas A1 - Volkmann, Jens A1 - Reich, Martin M. T1 - Deep Brain Stimulation for Tremor: Update on Long-Term Outcomes, Target Considerations and Future Directions JF - Journal of Clinical Medicine N2 - Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus is one of the main advanced neurosurgical treatments for drug-resistant tremor. However, not every patient may be eligible for this procedure. Nowadays, various other functional neurosurgical procedures are available. In particular cases, radiofrequency thalamotomy, focused ultrasound and radiosurgery are proven alternatives to DBS. Besides, other DBS targets, such as the posterior subthalamic area (PSA) or the dentato-rubro-thalamic tract (DRT), may be appraised as well. In this review, the clinical characteristics and pathophysiology of tremor syndromes, as well as long-term outcomes of DBS in different targets, will be summarized. The effectiveness and safety of lesioning procedures will be discussed, and an evidence-based clinical treatment approach for patients with drug-resistant tremor will be presented. Lastly, the future directions in the treatment of severe tremor syndromes will be elaborated. KW - deep brain stimulation KW - tremor KW - essential tremor KW - Parkinson’s disease KW - outcomes KW - clinical approach KW - target considerations KW - future directions Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244982 SN - 2077-0383 VL - 10 IS - 16 ER - TY - JOUR A1 - Zhou, Yang A1 - Ding, Meiqi A1 - Duan, Xiaodong A1 - Konrad, Kai R. A1 - Nagel, Georg A1 - Gao, Shiqiang T1 - Extending the Anion Channelrhodopsin-Based Toolbox for Plant Optogenetics JF - Membranes N2 - Optogenetics was developed in the field of neuroscience and is most commonly using light-sensitive rhodopsins to control the neural activities. Lately, we have expanded this technique into plant science by co-expression of a chloroplast-targeted β-carotene dioxygenase and an improved anion channelrhodopsin GtACR1 from the green alga Guillardia theta. The growth of Nicotiana tabacum pollen tube can then be manipulated by localized green light illumination. To extend the application of analogous optogenetic tools in the pollen tube system, we engineered another two ACRs, GtACR2, and ZipACR, which have different action spectra, light sensitivity and kinetic features, and characterized them in Xenopus laevis oocytes, Nicotiana benthamiana leaves and N. tabacum pollen tubes. We found that the similar molecular engineering method used to improve GtACR1 also enhanced GtACR2 and ZipACR performance in Xenopus laevis oocytes. The ZipACR1 performed in N. benthamiana mesophyll cells and N. tabacum pollen tubes with faster kinetics and reduced light sensitivity, allowing for optogenetic control of anion fluxes with better temporal resolution. The reduced light sensitivity would potentially facilitate future application in plants, grown under low ambient white light, combined with an optogenetic manipulation triggered by stronger green light. KW - optogenetics KW - rhodopsin KW - light-sensitive anion channel KW - surface potential recording KW - pollen tube Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236617 SN - 2077-0375 VL - 11 IS - 4 ER - TY - JOUR A1 - Hensgen, Ronja A1 - England, Laura A1 - Homberg, Uwe A1 - Pfeiffer, Keram T1 - Neuroarchitecture of the central complex in the brain of the honeybee: Neuronal cell types JF - Journal of Comparative Neurology N2 - The central complex (CX) in the insect brain is a higher order integration center that controls a number of behaviors, most prominently goal directed locomotion. The CX comprises the protocerebral bridge (PB), the upper division of the central body (CBU), the lower division of the central body (CBL), and the paired noduli (NO). Although spatial orientation has been extensively studied in honeybees at the behavioral level, most electrophysiological and anatomical analyses have been carried out in other insect species, leaving the morphology and physiology of neurons that constitute the CX in the honeybee mostly enigmatic. The goal of this study was to morphologically identify neuronal cell types of the CX in the honeybee Apis mellifera. By performing iontophoretic dye injections into the CX, we traced 16 subtypes of neuron that connect a subdivision of the CX with other regions in the bee's central brain, and eight subtypes that mainly interconnect different subdivisions of the CX. They establish extensive connections between the CX and the lateral complex, the superior protocerebrum and the posterior protocerebrum. Characterized neuron classes and subtypes are morphologically similar to those described in other insects, suggesting considerable conservation in the neural network relevant for orientation. KW - RRID: AB_2337244 KW - RRID: AB_2315425 KW - central complex KW - insect brain KW - neuroanatomy KW - sky compass KW - Apis mellifera Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-215566 VL - 529 ER - TY - JOUR A1 - Augustin, Anne Marie A1 - Welsch, Stefan A1 - Bley, Thorsten Alexander A1 - Lopau, Kai A1 - Kickuth, Ralph T1 - Color-coded summation images in the evaluation of renal artery stenosis before and after percutaneous transluminal angioplasty JF - BMC Medical Imaging N2 - Background: Endovascular therapy is the gold standard in patients with hemodynamic relevant renal artery stenosis (RAS) resistant to medical therapy. The severity grading of the stenosis as well as the result assessment after endovascular approach is predominantly based on visible estimations of the anatomic appearance. We aim to investigate the application of color-coded DSA parameters to gain hemodynamic information during endovascular renal artery interventions and for the assessment of the procedures technical success. Methods: We retrospectively evaluated 32 patients who underwent endovascular renal artery revascularization and applied color-coded summation imaging on selected monochromatic DSA images. The differences in time to peak (dTTP) of contrast enhancement in predefined anatomical measuring points were analyzed. Furthermore, differences in systolic blood pressure values (SBP) and serum creatinine were obtained. The value of underlying diabetes mellitus as a predictor for clinical outcome was assessed. Correlation analysis between the patients gender as well as the presence of diabetes mellitus and dTTP was performed. Results: Endovascular revascularization resulted in statistically significant improvement in 4/7 regions of interest. Highly significant improvement of perfusion in terms of shortened TTP values could be found at the segmental artery level and in the intrastenotical segment (p<0.001), significant improvement prestenotical and in the apical renal parenchyma (p<0.05). In the other anatomic regions, differences revealed not to be significant. Differences between SBP and serum creatinine levels before and after the procedure were significant (p=0.004 and 0.0004). Patients ' gender as well as the presence of diabetes mellitus did not reveal to be predictors for the clinical success of the procedure. Furthermore, diabetes and gender did not show relevant correlation with dTTP in the parenchymal measuring points. Conclusions: The supplementary use of color-coding DSA and the data gained from parametric images may provide helpful information in the evaluation of the procedures ' technical success. The segmental artery might be a particularly suitable vascular territory for analyzing differences in blood flow characteristics. Further studies with larger cohorts are needed to further confirm the diagnostic value of this technique. KW - digital subtraction angiography KW - color-coded KW - endovascular KW - renal artery KW - PTA Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259086 VL - 21 IS - 1 ER - TY - JOUR A1 - Schwaab, Bernhard A1 - Bjarnason-Wehrens, Birna A1 - Meng, Karin A1 - Albus, Christian A1 - Salzwedel, Annett A1 - Schmid, Jean-Paul A1 - Benzer, Werner A1 - Metz, Matthes A1 - Jensen, Katrin A1 - Rauch, Bernhard A1 - Bönner, Gerd A1 - Brzoska, Patrick A1 - Buhr-Schinner, Heike A1 - Charrier, Albrecht A1 - Cordes, Carsten A1 - Dörr, Gesine A1 - Eichler, Sarah A1 - Exner, Anne-Kathrin A1 - Fromm, Bernd A1 - Gielen, Stephan A1 - Glatz, Johannes A1 - Gohlke, Helmut A1 - Grilli, Maurizio A1 - Gysan, Detlef A1 - Härtel, Ursula A1 - Hahmann, Harry A1 - Herrmann-Lingen, Christoph A1 - Karger, Gabriele A1 - Karoff, Marthin A1 - Kiwus, Ulrich A1 - Knoglinger, Ernst A1 - Krusch, Christian-Wolfgang A1 - Langheim, Eike A1 - Mann, Johannes A1 - Max, Regina A1 - Metzendorf, Maria-Inti A1 - Nebel, Roland A1 - Niebauer, Josef A1 - Predel, Hans-Georg A1 - Preßler, Axel A1 - Razum, Oliver A1 - Reiss, Nils A1 - Saure, Daniel A1 - von Schacky, Clemens A1 - Schütt, Morten A1 - Schultz, Konrad A1 - Skoda, Eva-Maria A1 - Steube, Diethard A1 - Streibelt, Marco A1 - Stüttgen, Martin A1 - Stüttgen, Michaela A1 - Teufel, Martin A1 - Tschanz, Hansueli A1 - Völler, Heinz A1 - Vogel, Heiner A1 - Westphal, Ronja T1 - Cardiac rehabilitation in German speaking countries of Europe — evidence-based guidelines from Germany, Austria and Switzerland LLKardReha-DACH — part 2 JF - Journal of Clinical Medicine N2 - Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients' groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for “distress management” and “lifestyle changes”. PE is able to increase patients’ knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients’ groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively. KW - cardiac rehabilitation KW - scientific guidelines KW - secondary prevention KW - physical activity KW - exercise training KW - psychological interventions KW - education KW - gender KW - frailty KW - migration KW - old patients KW - young patients KW - tele-medicine KW - home-based-rehabilitation Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242645 SN - 2077-0383 VL - 10 IS - 14 ER - TY - THES A1 - Klabouch [geb. Kleinbach], Stefanie T1 - Prädiktoren für die postinterventionelle Leberfunktion nach transarterieller Chemotherapie bei Patienten und Patientinnen mit hepatozellulärem Karzinom T1 - Predictors of postinterventional liver function after transarterial chemoembolization in patients with hepatocellular carcinoma N2 - Hintergrund: Die transarterielle Chemoembolisation (TACE) stellt eine Erstlinientherapie bei nicht resezierbarem HCC im intermediären Stadium (BCLC B) dar. TACE induziert einen zytotoxischen und ischämischen Gewebeeffekt, der möglicherweise zu einer Leberfunktionsstörung führt. Der 13C-Methacetin-Atemtest (MBT) ist ein nichtinvasiver CYP1A2-Funktionstest zur Beurteilung der funktionellen Leberzellmasse. Ziel dieser prospektiven Studie war es, die Auswirkung der konventionellen TACE auf die hepatozelluläre Reserve, gemessen mittels 13C-MBT, statischen Leberfunktionstests und entzündlichen Parametern bewerten zu können. Methoden & Ergebnisse: 27 Patient*innen mit nicht resezierbarem HCC (BCLC B, Child Pugh A) erhielten vor (d0), 24 Stunden (d1) und 72 Stunden (d3) nach 41 cTACE-Verfahren einen MBT. Das hepatische Lipiodol®-Verteilungsvolumen wurde aus CT-Daten berechnet. Statische Leberfunktionstests, entzündliche Parameter und klinische Ereignisse wurden an d0-3 analysiert. Es zeigte sich eine deutliche Verringerung der CYP1A2-Funktion nach cTACE an d1 und d3, was hauptsächlich durch die Entzündungsreaktion (CRP) und hepatozelluläre Schadensmarker (AST) und nur in geringem Maße durch das embolisierte Lebervolumen zu erklären ist. Schlussfolgerung: Der MBT kann die kurzfristige Verringerung der Leberfunktionsreserve sensitiv abbilden und korreliert mit klinischen Komplikationen nach cTACE. Der MBT kann Anwendung in der frühen Identifizierung einer hepatischen Dysfunktion finden. N2 - Background: Transarterial Chemoembolization (TACE) is a standard therapy for unresectable HCC and is suggested as first line-therapy for intermediate stages (BCLC B). TACE induces a cytotoxic and ischemic tissue effect potentially leading to hepatic dysfunction. 13C-methacetin breath test (MBT) is a noninvasive CYP1A2 function test for the assessment of hepatic functional reserve. We aimed to assess by MBT the effect of conventional TACE on hepatic functional reserve, static functional and inflammatory parameters. Methods & Results: 27 patients with unresectable HCC (BCLC B, Child Pugh A) underwent MBT before (d0), 24h (d1) and 72h (d3) after 41 cTACE procedures. Hepatic Lipiodol® distribution volumes were calculated from CT data. Static liver function, inflammatory markers and clinical events were assessed at d0-3. A rapid and marked reduction of CYP1A2 function occurred on d1 and d3, mainly explained by the inflammatory response (CRP) and hepatocellular damage markers (AST) but to a minor extent by hepatic embolization volumes. Conclusion: MBT can sensitively monitor short-term reduction in hepatic functional reserve and correlates with clinical complications after cTACE. MBT might be useful in the early identification of patients with hepatic dysfunction. KW - Leberfunktion KW - Leberzellkrebs KW - Kohlenstoff-13-Exhalationstest KW - Leberzirrhose KW - Leberversagen KW - Transarterielle Chemoembolisation KW - 13C-Methacetin-Atemtest KW - Hepatozelluläres Karzinom KW - Mikrosomale Leberfunktion Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237070 ER - TY - THES A1 - Hafner, Julia Alexandra T1 - Prospektives Biomarker Screening zur Diagnose der Invasiven Aspergillose bei pädiatrischen Hochrisikopatienten T1 - Prospective Biomarker Screening for the diagnosis of Invasive Aspergillosis in high-risk pediatric patients N2 - Die Invasive Aspergillose (IA) stellt eine Hauptursache der infektassoziierten Morbidität und Mortalität bei pädiatrischen Patienten mit hämato-onkologischer Grunderkrankung und/oder allogener Stammzelltransplantation dar. Die sichere und frühzeitige Diagnose ist bei Kindern aufgrund spärlicher pädiatrischer Daten weiterhin eine klinische Herausforderung. Die Kombination der Biomarker Galactomannanantigen und Aspergillus DNA hat sich in Erwachsenenstudien als vorteilhaft in der Diagnose der IA erwiesen. Ziel der durchgeführten Studie war daher, die diagnostische Güte des kombinierten Biomarkerscreenings in einer pädiatrischen Hochrisikokohorte zu ermitteln. Hierfür wurden 39 pädiatrische Patienten, die während eines Zeitraumes von drei Jahren aufgrund einer hämato-onkologischen Grunderkrankung und Notwendigkeit einer Stammzelltransplantation in der Würzburger Kinderklinik behandelt wurden, einem hochstandardisierten, zweimal wöchentlichen Screening auf Galactomannanantigen und fungaler DNA zugeführt. Zusätzlich wurde für jeden Patienten ein breites Spektrum an klinischen Daten sowie mikrobiologischen und radiologischen Ergebnissen erfasst und die IA-Klassifikation nach den EORTC/MSG-Kriterien durchgeführt. Unsere Daten zeigten eine IA-Inzidenz (probable IA) von 10%, was per definitionem einer Hochrisikokohorte entspricht. Das kombinierte Monitoring der Biomarker Galactomannanantigen und Aspergillus-DNA wies eine hohe diagnostische Genauigkeit mit einer Sensitivität/Spezifität/PPV/NPV von 1.00 und gute Eignung als Screeningtest auf. Die antifungale Prophylaxe zeigte keinen negativen Einfluss auf die diagnostischen Gütekriterien der beiden Biomarker, wie in anderen Studien postuliert. Der Galactomannanindex erwies sich als vielversprechender Surrogatmarker für das Outcome und das Therapieansprechen. Weiterführende Studien sind notwendig, um festzulegen, ob die Biomarkerkombination eine Detektion asymptomatischer subklinischer Infektionen als eine Art „Frühwarnsystem“ ermöglicht und somit eine Reduktion der Mortalität bedingen kann. N2 - Invasive aspergillosis (IA) is a major cause of infection-associated morbidity and mortality in pediatric patients with underlying hemato-oncologic disease and/or allogeneic stem cell transplantation. Reliable and early diagnosis remains a clinical challenge in children due to sparse pediatric data. The combination of the biomarkers galactomannan antigen and Aspergillus DNA has been shown to be beneficial in the diagnosis of IA in adult studies. Therefore, the aim of the conducted study was to determine the diagnostic performance of the combined biomarker screening in a pediatric high-risk cohort. For this purpose, 39 pediatric patients who were treated at the Würzburg Children's Hospital during a period of three years due to an underlying hemato-oncological disease and the need for stem cell transplantation were subjected to a highly standardized, twice weekly screening for galactomannan antigen and fungal DNA. In addition, a wide range of clinical data as well as microbiological and radiological results were recorded for each patient and IA classification was performed according to the EORTC/MSG criteria. Our data showed an IA incidence (probable IA) of 10%, which by definition corresponds to a high-risk cohort. Combined monitoring of the biomarkers galactomannan antigen and Aspergillus DNA showed high diagnostic accuracy with a sensitivity/specificity/PPV/NPV of 1.00 and good suitability as a screening test. Antifungal prophylaxis showed no negative effect on the diagnostic accuracy criteria of either biomarker, as postulated in other studies. The galactomannan index proved to be a promising surrogate marker for outcome and treatment response. Further studies are necessary to determine whether the biomarker combination allows detection of asymptomatic subclinical infections as a kind of "early warning system" and thus may condition a reduction in mortality. KW - Aspergillose KW - Biomarker KW - Reverse Transkriptase-Polymerase-Kettenreaktion KW - Akute Leukämie KW - Invasive Aspergillose KW - Invasive Pilzinfektionen KW - Galactomannanantigen KW - Allogene Stammzelltransplantation KW - Pädiatrie Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237226 ER - TY - THES A1 - Mortimer, Niall Patrick T1 - ADHD Genetics in Mouse and Man T1 - ADHS Genetik bei Maus und Mensch T1 - Genética del TDAH en ratón y hombre N2 - Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with an estimated heritability of around 70%. In order to fully understand ADHD biology it is necessary to incorporate multiple different types of research. In this thesis, both human and animal model research is described as both lines of research are required to elucidate the aetiology of ADHD and development new treatments. The role of a single gene, Adhesion G protein-coupled receptor L3 (ADGRL3) was investigated using a knockout mouse model. ADGRL3 has putative roles in neuronal migration and synapse function. Various polymorphisms in ADGRL3 have been linked with an increased risk of attention deficit/hyperactivity disorder (ADHD) in human studies. Adgrl3-deficient mice were examined across multiple behavioural domains related to ADHD: locomotive activity, visuospatial and recognition memory, gait impulsivity, aggression, sociability and anxiety-like behaviour. The transcriptomic alterations caused by Adgrl3-depletion were analysed by RNA-sequencing of three ADHD-relevant brain regions: prefrontal cortex (PFC), hippocampus and striatum. Increased locomotive activity in Adgrl3-/- mice was observed across all tests with the specific gait analysis revealing subtle gait abnormalities. Spatial memory and learning domains were also impaired in these mice. Increased levels of impulsivity and sociability accompanying decreased aggression were also detected. None of these alterations were observed in Adgrl3+/- mice. The numbers of genes found to exhibit differential expression was relatively small in all brain regions sequenced. The absence of large scale gene expression dysregulation indicates a specific pathway of action, rather than a broad neurobiological perturbation. The PFC had the greatest number of differentially expressed genes and gene-set analysis of differential expression in this brain region detected a number of ADHD-relevant pathways including dopaminergic synapses as well as cocaine and amphetamine addiction. The most dysregulated gene in the PFC was Slc6a3 which codes for the dopamine transporter, a molecule vital to current pharmacological treatment of ADHD. The behavioural and transcriptomic results described in this thesis further validate Adgrl3 constitutive knockout mice as an experimental model of ADHD and provide neuroanatomical targets for future studies involving ADGRL3 modified animal models. The study of ADHD risk genes such as ADGRL3 requires the gene to be first identified using human studies. These studies may be genome based such as genome wide association studies (GWAS) or transcriptome based using microarray or RNA sequencing technology. To explore ADHD biology in humans the research described in this thesis includes both GWAS and trancriptomic data. A two-step transcriptome profiling was performed in peripheral blood mononuclear cells (PBMCs) of 143 ADHD subjects and 169 healthy controls. We combined GWAS and expression data in an expression-based Polygenic Risk Score (PRS) analysis in a total sample of 879 ADHD cases and 1919 controls from three different datasets. Through this exploratory study we found eight differentially expressed genes in ADHD and no support for the genetic background of the disorder playing a role in the aberrant expression levels identified. These results highlight promising candidate genes and gene pathways for ADHD and support the use of peripheral tissues to assess gene expression signatures for ADHD. This thesis illustrates how both human and animal model research is required to increase our understanding of ADHD. The animal models provide biological insight into the targets identified in human studies and may themselves provide further relevant gene targets. Only by combining research from disparate sources can we develop the thorough understanding on ADHD biology required for treatment development, which is the ultimate goal of translational science research. N2 - Die Aufmerksamkeitsdefizit- / Hyperaktivitätsstörung (ADHS) ist eine neurologische Entwicklungsstörung mit einer geschätzten Erblichkeit von etwa 70%. Um die ADHS-Biologie vollständig verstehen zu können, müssen verschiedene Forschungsansätze verfolgt werden. In dieser Dissertation werden sowohl Forschungsansätze am Menschen als auch im Tiermodell beschrieben, da beide Forschungsansätze erforderlich sind, um die Ätiologie von ADHS aufzuklären und neue Therapien zu entwickeln. Die Rolle eines einzelnen Gens, des Adhesion G-Protein-gekoppelten Rezeptors L3 (ADGRL3), wurde unter Verwendung eines Knockout-Mausmodells untersucht. ADGRL3 spielt eine mutmaßliche Rolle bei der neuronalen Migration und der Synapsenfunktion. Verschiedene Polymorphismen in ADGRL3 wurden in Studien an Menschen mit einem erhöhten Risiko für Aufmerksamkeitsdefizit- / Hyperaktivitätsstörung (ADHS) in Verbindung gebracht. Adgrl3-defiziente Mäuse wurden in mehreren Verhaltensbereichen im Zusammenhang mit ADHS untersucht: Bewegungsaktivität, visuelles und Erkennungsgedächtnis, Gangimpulsivität, Aggression, Umgänglichkeit und angstartiges Verhalten. Die durch Adgrl3-Depletion verursachten transkriptomischen Veränderungen wurden durch RNA-Sequenzierung von drei ADHS-relevanten Hirnregionen analysiert: präfrontaler Cortex (PFC), Hippocampus und Striatum. Bei allen Tests wurde eine erhöhte Aktivität der Lokomotive bei Adgrl3 - / - Mäusen beobachtet, wobei die spezifische Ganganalyse subtile Gangstörungen aufdeckte. Das räumliche Gedächtnis und die Lerndomänen waren bei diesen Mäusen ebenfalls beeinträchtigt. Es wurde auch ein erhöhtes Maß an Impulsivität und Umgänglichkeit festgestellt, begleitet von verminderter Aggression. Keine dieser Veränderungen wurde bei Adgrl3 +/- Mäusen beobachtet. Die Anzahl der Gene, bei denen eine unterschiedliche Expression festgestellt wurde, war in allen sequenzierten Hirnregionen relativ gering. Das Fehlen einer Dysregulation der Genexpression in großem Maßstab weist eher auf einen spezifischen Wirkmechanismus als auf eine breite neurobiologische Störung hin. Die PFC hatte die größte Anzahl differentiell exprimierter Gene, und eine Gen-Set-Analyse der differentiellen Expression in dieser Hirnregion ergab eine Reihe von ADHS-relevanten Signalwegen, einschließlich dopaminerger Synapsen sowie Kokain- und Amphetaminsucht. Das am stärksten dysregulierte Gen in der PFC war Slc6a3, das für den Dopamintransporter kodiert.Dieses Gen ist bei der derzeitigen pharmakologischen Behandlung von ADHS von entscheidender Bedeutung. Die in dieser Arbeit beschriebenen Verhaltens- und Transkriptomergebnisse bestätigen die konstitutiven Adgrl3-Knockout-Mäuse als experimentelles Modell für ADHS und liefern neuroanatomische Zielstrukturen für zukünftige Studien mit ADGRL3-modifizierten Tiermodellen. Die Untersuchung von ADHS-Risikogenen wie ADGRL3 erfordert zunächst, dass das Gen in Studien im Menschen identifiziert wird. Diese Studien können genombasiert sein, z.B. wie genomweite Assoziationsstudie (GWAS), oder transkriptombasiert unter Verwendung von Microarray- oder RNA-Sequenzierungstechnologie. Um die ADHS-Biologie beim Menschen zu erforschen, umfassen die in dieser Arbeit beschriebenen Forschungsansätze sowohl GWAS- als auch trankriptomische Daten. Ein zweistufiges Transkriptom-Profiling wurde in mononukleären Zellen des peripheren Blutes (PBMCs) von 143 ADHS-Patienten und 169 gesunden Kontrollpersonen durchgeführt. Wir kombinierten GWAS- und Expressionsdaten in einer Expressions-basierten PRS-Analyse (Polygenic Risk Score) in einer Gesamtstichprobe von 879 ADHS-Fällen und 1919 Kontrollen aus drei verschiedenen Datensätzen. Durch diese Untersuchungen fanden wir acht differentiell exprimierte Gene bei ADHS und keinen Hinweis darauf, dass der genetische Hintergrund der Störung eine Rolle bei den identifizierten aberranten Expressionsniveaus spielt. Diese Ergebnisse weisen auf vielversprechende Kandidatengene und Genwege für ADHS hin und unterstützen die Verwendung peripherer Gewebe zur Beurteilung der Genexpressionssignaturen für ADHS. Diese Arbeit zeigt, dass sowohl Forschungsansätze am Menschen als auch Tiermodelle erforderlich sind, um unser Verständnis von ADHS zu verbessern. Die Tiermodelle bieten biologische Einblicke in die in Studien an Menschen identifizierten Ziele und können selbst weitere relevante Genziele liefern. Nur durch die Kombination von Forschungsansätzen aus unterschiedlichen Quellen können wir ein tiefes Verständnis der ADHS-Biologie entwickeln, das für die Entwicklung von Behandlungsstrategien erforderlich ist. Dies ist das ultimative Ziel der translationalen wissenschaftlichen Forschung. N2 - El trastorno por déficit de atención con hiperactividad (TDAH) es un trastorno del desarrollo neural con una heredabilidad estimada de alrededor de un 70%. Para poder comprender plenamente la biología del TDAH, es necesario incorporar diversos tipos de investigación. En esta tesis, se describe la investigación en modelos tanto humanos como animales, ya que se requieren ambas líneas de investigación para aclarar la etiología del TDAH y poder desarrollar nuevos tratamientos. El papel de un solo gen, el receptor L3 acoplado a la proteína de adhesión G (ADGRL3) se ha investigado utilizando un modelo de ratón knock-out. El ADGRL3 tiene efectos putativos en la migración neuronal y en la función de la sinapsis. Varios polimorfismos en ADGRL3 se han relacionado con un mayor riesgo de trastorno por déficit de atención/ hiperactividad (TDAH) en estudios en humanos. Adicionalmente se han examinado ratones deficientes en ADGRL3 en varios ámbitos conductuales relacionados con el TDAH tales como la actividad locomotriz, la memoria visoespacial y de reconocimiento, la impulsividad de la marcha, la agresividad, la sociabilidad y los comportamientos similares a la ansiedad. Las modificaciones trabscriptómicas causadas por el agotamiento de ADGRL3 se han analizado por secuenciación del ARN de tres regiones del cerebro relevantes al TDAH: la corteza prefrontal (CPF), el hipocampo, y el estriado. Se ha observado una mayor actividad locomotriz en ratones ADGRL3 -/- en todas las pruebas con el análisis específico de la marcha que revela anomalías sutiles de la marcha. La memoria espacial y los dominios de aprendizaje también se han visto afectados en estos mismos ratones. También se detectaron niveles aumentados de impulsividad y sociabilidad que acompañan a la disminución de la agresividad. Ninguno de estos cambios se han observado en ratones ADGRL3 +/-. El número de genes encontrados que exhibieron una expresión diferencial ha sido relativamente bajo en todas las regiones del cerebro secuenciadas. La ausencia de desregulación de expresión génica a gran escala indica una vía de acción específica, en vez de una perturbación neurobiológica amplia. La corteza prefrontal tenía el mayor número de genes expresados diferencialmente y el análisis de conjuntos de genes de expresión diferencial en esta región del cerebro ha mostrado una serie de vías relevantes para el TDAH, incluyendo las sinapsis dopaminérgicas así como la adicción a la cocaína y a las anfetaminas. El gen más desregulado en la corteza prefrontal fue el Slc6a3, que codifica para el transportador de dopamina, una molécula esencial para el tratamiento farmacológico actual del TDAH. Los resultados conductuales y transcriptómicos descritos en esta tesis dan aún más validez a los ratones knock-out constitutivos de Adgrl3 como modelo experimental de TDAH y ofrecen objetivos neuroanatómicos para estudios futuros con modelos animales modificados con ADGRL3. El estudio de genes de riesgo de TDAH como el ADGRL3 requiere que el gen se identifique primero mediante estudios en humanos. Estos estudios pueden basarse en el genoma, como GWAS (estudio extenso de asociación en todo el genoma) o en transcriptoma, usando microarrays o tecnología de secuenciación de ARN. Para explorar la biología del TDAH en humanos, la investigación descrita en esta tesis incluye datos GWAS y trancriptómicos. Se ha realizado un perfil de transcriptoma de dos fases en células mononucleares de sangre periférica (CMSP) de 143 sujetos con TDAH y 169 controles sanos. Hemos combinado GWAS y datos de expresión en un análisis de puntuación de riesgo poligénico con sede en expression genica en una muestra total de 879 casos de TDAH y 1919 controles de tres conjuntos de datos distintos. A través de este estudio exploratorio, hemos encontrado ocho genes expresados diferencialmente en el TDAH y además que no existe indicio de que el fondo genético del trastorno tiene un papel en los niveles de expresión aberrantes identificados. Estos resultados subrayan genes candidatos prometedores y vías genéticas para el TDAH y además apoyan el uso de tejidos periféricos para evaluar las firmas de expresión génica para el TDAH Esta tesis muestra cómo se requiere la investigación en modelos humanos y animales para aumentar nuestra comprensión del TDAH. Los modelos animales proporcionan información biológica sobre los objetivos identificados en estudios en humanos y pueden proporcionar objetivos genéticos relevantes adicionales. Solo mediante la combinación de las investigaciones de fuentes dispares podemos desarrollar la comprensión exhaustiva de la biología del TDAH necesaria para el desarrollo del tratamiento, lo que es el objetivo principal de la investigación científica traslacional. KW - ADGRL3 KW - Neuroscience KW - Genetics KW - ADHD KW - Mouse Model KW - Human Transcriptome Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236265 ER - TY - THES A1 - Wagenbrenner, Mike Helmut T1 - In vitro-Charakterisierung mesenchymaler Stromazellen aus dem menschlichen Hüftgelenk T1 - In vitro characterization of mesenchymal stromal cells from the human hip joint N2 - In dieser Arbeit konnte erstmals gezeigt werden, dass plastik-adhärent wachsende, multipotente Vorläuferzellen, die eine für MSCs charakteristische Kombination von Oberflächenantigenen tragen, aus allen vier untersuchten Geweben des arthrotischen Hüftgelenks isoliert werden konnten. MSC-ähnliche Zellen können somit nicht nur in der Spongiosa und im Gelenkknorpel, sondern auch in der anterioren Gelenkkapsel und dem Ligamentum capitis femoris (LCF) des arthrotisch veränderten menschlichen Hüftgelenks nachgewiesen werden. Die FACS Analyse der Oberflächenantigene auf Zellen, die aus den vier unterschiedlichen Geweben eines beispielhaft gewählten Spenders isoliert wurden, zeigte eine deutliche Expression der Antigene CD44, CD73, CD90 und CD105. Unabhängig vom Nativgewebe zeigten somit alle untersuchten Zellen ein für MSCs charakteristisches, aber nicht spezifisches Profil an Antigenen auf ihrer Oberfläche. Eine Übereinstimmung mit den ISCT Kriterien für MSCs war aufgrund der fehlenden Kontrolle hämatopoetischer Marker nicht möglich. Die multipotente Differenzierung der isolierten Zellen erfolgte mithilfe spezifischer Differenzierungsmedien in Monolayer-Kulturen oder für die chondrogene Differenzierung in dreidimensionalen Pellet-Kulturen. Nach 21 Tagen konnten in allen differenzierten Kulturen histologisch und immunhistochemisch klare Zeichen der Osteo- und Adipogenese detektiert werden, während die Auswertung spezifischer Markergene eine klare Steigerung der Expression dieser im Vergleich zu den Negativkontrollen zeigte. Histologische und immunhistochemische Auswertungen bestätigten auch eine erfolgreiche chondrogene Differenzierung der Zell-Pellets aus Spongiosa, Knorpel und Kapsel. Lediglich in den chondrogen differenzierten Zell-Pellets aus dem LCF konnte immunhistochemisch keine Bildung des knorpelspezifischen Matrixproteins Col II nachgewiesen werden. Mikroskopisch zeigten vor allem die differenzierten MSC-Pellets aus Spongiosa und Knorpel morphologisch eine starke Ähnlichkeit zu hyalinem Knorpelgewebe. Trotz dieser Abstufungen zeigten sich für die relative Expression der chondrogenen Markergene AGG, Col II und Sox-9 keine signifikanten Unterschiede zwischen den differenzierten MSC-Kulturen der vier unterschiedlichen Nativgewebe. Ein positiver Nachweis des Markers Col X wies nach 27 Tagen sowohl in differenzierten als auch in undifferenzierten Pellet-Kulturen auf eine leichte chondrogene Hypertrophie hin. Zusammenfassend zeigten sich keine signifikanten Unterschiede im Hinblick auf das osteogene und adipogene Differenzierungspotential aller untersuchten Zellen. Während das chondrogene Differenzierungspotential der Zellen aus Spongiosa, Knorpel und Kapsel sich aus histologischer und immunhistochemischer Sicht ähnelte, zeigten Pellets aus dem LCF ein schwächeres chondrogenes Differenzierungspotential in vitro. Obwohl somit erstmals MSC-ähnliche Zellen aus dem LCF und Gewebsproben, die neben dem Stratum synoviale auch das Stratum fibrosum der Hüftgelenkskapsel beinhalteten, charakterisiert wurden, sind weitere wissenschaftliche Arbeiten notwendig, um das multipotente Differenzierungspotential dieser Zellen zu optimieren. N2 - This study showed for the first time that plastic-adherent growing multipotent progenitor cells carrying a combination of surface antigens characteristic of MSCs could be isolated from four tissues of the arthritic hip joint.MSC-like cells can thus be detected not only in cancellous bone and articular cartilage, but also in the anterior joint capsule and ligamentum capitis femoris (LCF) of the osteoarthritic human hip joint. FACS analysis of surface antigens on cells isolated from the four different tissues of an exemplarily selected donor showed a clear expression of the antigens CD44, CD73, CD90 and CD105. Thus, irrespective of the native tissue, all cells examined showed a profile of antigens on their surface that is characteristic but not specific for MSCs. However, cells did not meet the ISCT criteria since hematopoietic markers were not analyzed. Multipotent differentiation of the isolated cells was performed using specific differentiation media in monolayer cultures or three-dimensional pellet cultures for chondrogenic differentiation. After 21 days, clear signs of osteo- and adipogenesis could be detected histologically and immunohistochemically in all differentiated cultures, while evaluation of specific marker genes showed a clear increase in the expression of these compared with negative controls. Histological and immunohistochemical evaluations also confirmed successful chondrogenic differentiation of cell pellets from cancellous bone, cartilage, and capsule. Chondrogenically differentiated cell pellets from the LCF showed no formation of cartilage-specific matrix protein Col II. Microscopically the differentiated MSC pellets from cancellous bone and cartilage showed strong morphological similarity to hyaline cartilage tissue. Despite these gradations, there were no significant differences between the differentiated MSC cultures of the four different native tissues for the relative expression of the chondrogenic marker genes AGG, Col II, and Sox-9. Positive detection of the marker Col X indicated mild chondrogenic hypertrophy after 27 days in both differentiated and undifferentiated pellet cultures. In conclusion, there were no significant differences in osteogenic and adipogenic differentiation potential of all cells examined. While chondrogenic differentiation potential of progenitor cells isolated from cancellous bone, cartilage, and capsule was similar from a histological and immunohistochemical point of view, pellets from LCF showed a weaker chondrogenic differentiation potential in vitro. Although our current research proved the presence of MSC-like cells in the LCF and full-thickness tissue samples of the hip joint capsule further scientific work is required to evaluate the differentiation of the chondrogenic cells in the LCF. Histological and immunohistochemical evaluations also confirmed successful chondrogenic differentiation of cell pellets from cancellous bone, cartilage, and capsule. Only in the chondrogenically differentiated cell pellets from the LCF could no formation of the cartilage-specific matrix protein Col II be detected by immunohistochemistry. Microscopically, especially the differentiated MSC pellets from cancellous bone and cartilage showed strong morphological similarity to hyaline cartilage tissue. Despite these gradations, there were no significant differences between the differentiated MSC cultures of the four different native tissues for the relative expression of the chondrogenic marker genes AGG, Col II, and Sox-9. Positive detection of the marker Col X indicated mild chondrogenic hypertrophy after 27 days in both differentiated and undifferentiated pellet cultures. In conclusion, there were no significant differences in osteogenic and adipogenic differentiation potential of all cells examined. While the chondrogenic differentiation potential of cells from cancellous bone, cartilage, and capsule were similar from a histological and immunohistochemical point of view, pellets from LCF showed a weaker chondrogenic differentiation potential in vitro. Although our current research proved the presence of MSC-like cells in the LCF and full-thickness tissue samples of the human hip joint capsule further scientific work is required to optimize the multipotent differentiation potential of these cells. KW - Hüftgelenk KW - Arthrose KW - Mesenchymzelle KW - Knorpel KW - MSCs KW - tissue engineering KW - Hüfte KW - Arthrose KW - Regenerative Medizin KW - hip KW - Osteoarthritis Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237110 ER - TY - THES A1 - Breyer, Charles Pierre Paul T1 - Putative Eisenregulation von Fractalkin (CX3CL1), pathophysiologische Rolle von CX3CL1 in Plättchenmodellen und Eisenhaushalt in der Megakaryopoese T1 - Putative iron regulation of fractalkine (CX3CL1), pathophysiological role of CX3CL1 in platelet models and iron homeostasis in megakaryopoesis N2 - In dieser Arbeit wird gezeigt, dass Fractalkin (CX3L1) keine Eisenregulation im Sinne des klassischen IRE/IRP-Systems aufweist. Zusätzlich wird die pathophysiologische Rolle der CX3CL1/CX3CR1-Achse in Megakaryozyten untersucht. Ferner wird die Eisenhomöostase während der megakaryopetischen Differenzierung erforscht. N2 - In this thesis we showed that fractalkine (CX3CL1) is not an iron regulated gene following the classical IRE/IRP-system. Furthermore, we analysed the pathophysiological role of the CX3CL1/CX3CR1-axis in megakaryocytes. Finally, iron homeostasis during megakaryopoetic differentiation is analysed. KW - Fractalkin KW - iron responisve element KW - Megakaryopoese KW - Eisenhomöostase Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237929 ER - TY - THES A1 - Haack, Stephanie T1 - A novel mouse model for systemic cytokine release upon treatment with a superagonistic anti-CD28 antibody T1 - Ein neues Mausmodell zur Untersuchung der Zytokinfreisetzung nach Behandlung mit einem superagonistischen anti-CD28 Antikörper N2 - The adaptive immune system is known to provide highly specific and effective immunity against a broad variety of pathogens due to different effector cells. The most prominent are CD4+ T-cells which differentiate after activation into distinct subsets of effector and memory cells, amongst others T helper 1 (Th1) cells. We have recently shown that mouse as well as human Th1 cells depend on T cell receptor (TCR) signals concomitant with CD28 costimulation in order to secrete interferon  (IFN) which is considered as their main effector function. Moreover, there is a class of anti-CD28 monoclonal antibodies that is able to induce T cell (re-)activation without concomitant TCR ligation. These so-called CD28-superagonists (CD28-SA) have been shown to preferentially activate and expand CD4+ Foxp3+ regulatory T (Treg) cells and thereby efficaciously conferring protection e.g. against autoimmune responses in rodents and non-human primates. Considering this beneficial effect, CD28-SA were thought to be of great impact for immunotherapeutic approaches and a humanized CD28-SA was subjected to clinical testing starting with a first-in-man trial in London in 2006. Unexpectedly, the volunteers experienced life-threatening side effects due to a cytokine release syndrome (CRS) that was unpredicted by the preclinical studies prior to the trial. Retrospectively, CD4+ memory T cells within the tissues were identified as source of pro-inflammatory cytokines released upon CD28-SA administration. This was not predicted by the preclinical testing indicating a need for more reliable and predictive animal models. Whether mouse CD4+ T cells are generally irresponsive to CD28-SA stimulation or rather the lack of a bona fide memory T cell compartment in cleanly housed specific-pathogen-free (SPF) mice is the reason why the rodent models failed to predict the risk for a CRS remained unclear. To provide SPF mice with a true pool of memory/effector T cells, we transferred in vitro differentiated TCR-transgenic OT-II Th1 cells into untreated recipient mice. Given that Treg cells suppress T cell activation after CD28- SA injection in vivo, recipients were either Treg-competent or Treg-deficient, wild type or DEREG mice, respectively. Subsequent CD28-SA administration resulted in induction of systemic pro-inflammatory cytokine release, dominated by IFN, that was observed to be much more pronounced and robust in Treg-deficient recipients. Employing a newly established in vitro system mirroring the in vivo responses to CD28-SA stimulation of Th1 cells revealed that antigen-presenting cells (APCs) amplify CD28-SAinduced IFN release by Th1 cells due to CD40/CD40L-interactions. Thus, these data are the first to show that mouse Th1 cells are indeed sensitive to CD28-SA stimulation in vivo and in vitro responding with strong IFN release accompanied by secretion of further pro-inflammatory cytokines, which is compatible with a CRS. In conclusion, this study will facilitate preclinical testing of immunomodulatory agents providing a mouse model constituting more “human-like” conditions allowing a higher degree of reliability and translationability. N2 - Das adaptive Immunsystem ermöglicht mittels hocheffektiver, antigen-spezifischer Mechanismen und unterschiedlicher Effektorzellen den Schutz vor einer nahezu unbegrenzten Vielfalt von Pathogenen. Die Hauptakteure stellen hierbei CD4+ T-Zellen dar, welche nach Aktivierung distinkte Effektorpopulationen, unter anderem Th1 Zellen, bilden. Wir zeigten kürzlich, dass sowohl für Maus- als auch humane Th1-Zellen CD28-Kostimulation mit zeitgleicher T-Zellrezeptor (TZR)-Aktivierung essentiell für die Sekretion von Interferon  (IFN), deren Haupteffektorfunktion, ist. Allerdings sind monoklonale anti-CD28 Anti-körper bekannt, die auch ohne TZR-Signal T-Zellen aktivieren können. Diese sogenannten CD28 Supera-gonisten (CD28-SA) aktivieren und expandieren vorrangig CD4+ Foxp3+ regulatorische T-Zellen (Treg) und vermitteln wirksamen Schutz vor z.B. Autoimmunreaktionen in Nagern und Primaten. Um diesen erfolgversprechenden Effekt für immuntherapeutische Ansätze nutzen zu können, wurde 2006 in Lon-don eine erste klinische Erprobung eines humanisierten CD28-SA begonnen. Unerwarteterweise zeigten sich bei den Probanden lebensbedrohliche Nebenwirkungen, die Ausdruck eines Zytokin-Ausschüttungs-Syndroms (Cytokine Release Syndrome, CRS) waren, welches durch die vorangegangenen präklinischen Studien nicht vorhersagbar war. Rückblickend konnte die Sekretion pro-inflammatorischer Zytokine auf CD4+ Gedächtnis-T-Zellen im Gewebe zurückgeführt werden, die so auf die Gabe des CD28-SA reagier-ten. Die unvorhersehbare Reaktion im Menschen zeigt deutlich, dass verlässlichere und prädiktivere Tiermodelle unverzichtbar sind. Ob Maus CD4+-T-Zellen möglicherweise nicht durch CD28-SA stimulier-bar sind oder dieser fehlgeleiteten Einschätzung über das mögliche Risiko eines CRS eher das Fehlen eines echten CD4+ Gedächtnis-T-Zellen-Kompartiments in sauber gehaltenen spezifischen-Pathogen-freien (SPF) Mäusen zugrunde liegt, ist bisher ungeklärt. Um in SPF-Mäusen ein Gedächtnis-T-Zell-Kompartiment zu etablieren, wurden in vitro-differenzierte Th1 Zellen, die TZR-transgenen OT-II-Mäusen entstammen, in unbehandelte Empfängermäuse transferiert. Da bekannt ist, dass Treg-Zellen die Aktivierung von T-Zellen nach Anwendung von CD28-SA in vivo supprimieren, wurden Treg-kompetente (wildtypische) oder -defiziente (DEREG) Empfänger verwendet. Die anschließend erfolgte Injektion von CD28-SA löste die systemische Sekretion pro-inflammatorischer Zytokine aus, wobei eine stark erhöhter IFN-Konzentration im Serum zu beobachten war, welche deutlich ausgeprägter und robuster bei den Treg-defizienten Empfängern ausfiel. Ein neu etabliertes in vitro-System, welches die in vivo Antwort der Th1-Zellen auf CD28-SA-Stimulation widerspiegelt, identifizierte Antigen-präsentierende Zellen (APZs) als essentiellen Faktor für die erhöhte IFN-Sekretion der Th1-Zellen nach CD28-SA-Stimulation in Abhängigkeit von CD40/CD40L-Interaktionen. Zusammenfassend zeigt diese Thesis zum ersten Mal, dass Maus Th1 Zellen sowohl in vivo als auch in vitro durch CD28 SA stimulierbar sind, wodurch eine starke IFN-Sekretion induziert wird, die von der gesteigerten Ausschüttung anderer pro-inflammatorischer Zytokine begleitet wird und in Abwesenheit von Treg einem CRS gleicht. Folglich kann diese Erkenntnis die präklinische Forschung bei der Erprobung neuer immuntherapeutischer Ansät-ze durch ein neues Mausmodell voranbringen, das dem menschlichen erfahreneren Immunsystem mehr als bisherige Modelle entspricht und somit verlässlichere Vorhersagen erlaubt und eine verbesserte Übertragbarkeit von Maus zu Mensch ermöglicht. KW - CD28 KW - CD28-SA KW - cytokine release syndrome Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237757 ER - TY - THES A1 - Behr, Greta T1 - Die „Malen nach Zahlen“ Methode zur Lehre der Präparation einer einflügeligen Adhäsivbrücke aus Zirkoniumdioxidkeramik T1 - The “Painting by Numbers Method” for Education of Students in Adhesive Bridge Preparation N2 - Einleitung: Das Erlernen neuer Präparationsarten ist nicht einfach, insbesondere bei Präparationen, die hohe technische Anforderungen stellen und deren Form sich von konventionellen Vollkronen unterscheidet, wie z. B. die Präparation einer Klebebrücke. Um das spätere Therapiespektrum angehender Zahnärzte zu erweitern, sollten diese eine große Anzahl verschiedener Präparationen im Studium erlernen. Im Studentenalltag bleibt oft keine Zeit für lange Erklärungen und exemplarische Präparationen. Deshalb wurde die "Malen-nach-Zahlen-Methode" entwickelt, um den Studenten das Erlernen neuer Präparationen zu erleichtern. Materialien und Methoden: Nach der Erstellung der Druckdatei für den Übungszahn wurden diese mit einem Stereolithographie-Drucker hergestellt. Der Übungszahn bestand aus zwei unterschiedlich farbigen Schichten mit einer integrierten Präparation. Die Schicht, die zum Erreichen der Zielpräparation entfernt werden musste, war schwarz und sollte den Studenten das Ausmaß und die Dicke der Präparation zeigen. 42 Zahnmedizinstudenten ab dem vierten Studienjahr nahmen an einem freiwilligen Praktikum teil. Die Studenten wurden nach dem Zufallsprinzip in zwei gleich große Gruppen eingeteilt. Eine Gruppe übte mit den "Malen nach Zahlen" Zähnen, die andere mit Standardmodellzähnen. Trotzdem hatte jeder Student die Möglichkeit, die neuen gedruckten Zähne zu testen. Die Studenten hatten bereits Erfahrung mit anderen Standardmodell- und echten Zähnen. Die gedruckten Zähne wurden mit einem Fragebogen mit Schulnoten von 1 bis 6 bewertet. In einem zweiten Teil wurden die präparierten Zähne der Schüler eingescannt und mit Hilfe einer 3D-Auswertungssoftware mit dem idealen präparierten Zahn verglichen. So konnte die "Malen-nach-Zahlen-Methode" mit herkömmlichen Unterrichtsmethoden verglichen werden. Ergebnisse: Die Herstellung der Zähne zum Erlernen der Präparation einer Klebebrücke war einfach und kostengünstig. Insgesamt bewerteten die Studenten die Zähne mit 1,9 und die Lehrmethode als positiv. Das Zahnmodell wurde insgesamt mit 1,9 bewertet. Es unterstützte die Studierenden dabei, die Zielpräparation zu visualisieren und durch die Kontrolle mit der eigenen Arbeit eine Selbsteinschätzung zu entwickeln. Auch wenn die Studierenden ihren Lernerfolg und Lernprozess mit den 3D-gedruckten Zähnen als besser einschätzten, konnte kein signifikanter Unterschied bei der späteren Auswertung der Zähne festgestellt werden. Die Studenten wünschten sich eine stärkere Integration der gedruckten Zähne in den Präparationsunterricht und äußerten in den Freitextfragen, dass sie Vorteile in Bezug auf Unabhängigkeit, Kosten und Individualisierung der zahnmedizinischen Ausbildung sehen. Schlussfolgerungen: Es hat sich gezeigt, dass die Methode "Malen nach Zahlen" geeignet ist, neue Präparationen wie eine Klebebrücke zu lehren. Die farbkodierte integrierte Präparation in den gedruckten Zähnen und das gedruckte Zahnmodell ermöglichten es den Studenten, die Präparation einer Adhäsivbrücke selbstständig und mit geringem Aufwand zu erlernen. N2 - Introduction: Learning new types of preparation is not easy, especially preparations that have high technical requirements and the shape of which differs from conventional full crowns, such as the preparation of an adhesive bridge. In order to expand the later therapy spectrum of prospective dentists, a large number of different preparations should be learned in universitiy. In everyday student life, there is often no time for long explanations and exemplary preparations. Therefore, the “Painting by Numbers Method” was designed to help students to facilitate the learning of new preparations. Materials and methods: After the design of the print file for the practice tooth, these were produced with a stereolithographic printer. The training tooth consisted of two differently colored layers with an integrated adhesive bridge preparation. The layer to be removed to achieve the target preparation was black and should show the students the extent and thickness of the preparation. 42 dental students from the fourth year of study onwards took part in a voluntary practical course. The students were randomly divided into two groups of equal size. One group practiced with the “Painting by Numbers” teeth, the other one with standard model teeth. Nevertheless each student had the opportunity to test the new printed teeth. The students already had experience with other standard model and real teeth. The printed teeth were evaluated with a questionnaire using German school grades from 1 to 6. In a second part, the prepared teeth of the students were scanned and compared with the ideal prepared tooth using a 3D evaluation software. The “Painting by Numbers Method” could thus be compared with conventional teaching methods. Results: The production of teeth for learning the preparation of an adhesive bridge was simple and inexpensive. Overall, the students rated the teeth with 1.9 and evaluated the teaching method positively. The tooth model was rated overall with 1.9. It supported the students to visualize the target preparation and to develop a self-assessment through the control with their own work. Even though the students considered their learning success and learning process to be better with the 3D-printed teeth, no significant difference could be found when comparing the evaluation of the teeth. The students wished to integrate printed teeth more into the teaching of preparations and expressed in the free text questions to see advantages in terms of independence, cost and individualization of dental education. Conclusions: It has been shown that the "painting by numbers" method is suitable for teaching new preparations such as an adhesive bridge. The colour-coded integrated preparation in the printed teeth and the printed tooth model enabled the students to learn how to prepare an adhesive bridge independently and at low cost. KW - 3D-Druck KW - Präparation KW - Zirkoniumdioxid KW - Brücke KW - Stereolithographie KW - Adhäsivbrücke KW - Präparationslehre KW - 3D-Druckzähne Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237186 ER - TY - THES A1 - Auth, Charlotte Sophie T1 - Die Auswirkungen von Tph2-Defizienz und negativen frühen Umwelterfahrungen auf Angstverhalten in weiblichen Mäusen T1 - Differential anxiety-related behaviour and brain activation in Tph2-deficient female mice exposed to adverse early environment N2 - Angsterkrankungen gehören zu den am weitesten verbreiteten psychischen Erkrankungen und stellen eine beträchtliche soziale und wirtschaftliche Herausforderung für unsere Gesellschaft dar. Aversive frühe Erfahrungen sind ein bekannter Risikofaktor für die Entwicklung verschiedener psychischer Erkrankungen, insbesondere Angststörungen. Während der frühen Entwicklung findet die Programmierung der Hypothalamus-Hypophysen-Nebennierenrinden- (HHN)-Achse, die die Ausschüttung des Stresshormons Cortisol in Menschen bzw. Corticosteron in Mäusen steuert, statt. Wenn Individuen in dieser kritischen Phase Stress ausgesetzt sind, wird die regelrechte Ausbildung der HHN-Achse gestört, was zu dysregulierten Verhaltensantworten auf Stressreize im späteren Leben führen kann. Das Serotonin (5-HT)-System als eines der ausgedehntesten Neurotransmittersysteme ist an der Vermittlung der Effekte von früher Stressexposition auf angstähnliche Verhaltensweisen beteiligt. Das Ziel dieser Studie ist es, die Interaktion zwischen genetischer Prädisposition und negativen Einflüssen in frühen Entwicklungsstadien auf die Ausbildung von Angstverhalten im Erwachsenenalter näher zu beleuchten. In dieser Studie wurden Tryptophanhydroxylase 2 (Tph2)-defiziente weibliche Mäuse als Modell für ein lebenslanges konstitutives 5-HT Synthesedefizit im zentralen Nervensystem verwendet. Nachkommen dieser Mauslinie wurden im frühen Lebensalter Maternaler Separation (MS), d.h. einem mütterlichen Trennungsparadigma, unterzogen und im Erwachsenenalter im „Open field“ (OF) oder in der „Dark-light box“ (DLB) getestet. Im Anschluss an die Verhaltensexperimente wurde die neuronale Aktivierung immunhistochemisch durch Darstellung des frühzeitig auftretenden Genprodukts c-Fos bestimmt. In der DLB zeigten homozygot Tph2-defiziente Mäuse eine verringerte motorische Aktivität im hellen Kompartiment, und dieser Effekt konnte durch MS normalisiert werden. Zusätzlich verstärkte MS bei diesem Genotyp das Auftreten von fluchtartigen Sprüngen. Im OF hat MS fluchtartige Verhaltensweisen in homo- und heterozygoten Tph2-defizienten Mäusen befördert. Beide Verhaltenstests führten zu spezifischen neuronalen Aktivierungsmustern, die mithilfe von c-Fos- Immunhistochemie ausgewertet wurden. Die Durchführung des DLB-Tests führte in Abhängigkeit vom Vorhandensein von Tph2 zur Aktivierung des paraventrikulären Kerns des Hypothalamus (PVN) und der basolateralen Amygdala (BL), wohingegen die Exposition gegenüber dem OF-Test zu einer Aktivierung der lateralen Amygdala (La) in Tieren, die einem mütterlichen Trennungsparadigma unterzogen wurden, sowie einer Aktivierung des ventrolateralen (VLPAG) und dorsolateralen (DLPAG) periaquäduktalen Höhlengraus in Abhängigkeit von Tph2 und MS führte. Zusammenfassend weisen die Ergebnisse dieser Studie darauf hin, dass MS aktive Verhaltensantworten auf aversive Reize in Abhängigkeit vom Vorhandensein von 5-HT im Gehirn fördert. Diese Effekte könnten durch die spezifische Aktivierung von mit Angstverhalten in Zusammenhang stehenden Gehirnregionen während der Verhaltensexperimente vermittelt werden. N2 - In a previous phase 1 study, it was observed that CBF can be increased by intermittent controlled hypercapnia in the days after aneurysm rupture in patients with poor to very poor SAB. After resetting mechanical ventilation to baseline parameters, CBF showed a slow and asymptotic return to baseline values without a negative rebound effect. This observation suggests that a longer duration of hypercapnia may prolong the CBF-increasing effect. This study was designed as a dose-optimization study to identify the time point at which CBF reaches a maximum and under the assumption that after this maximum, buffering mechanisms in blood and CSF could lead to adaptation mechanisms that result in a negative rebound effect after cessation of the hypercapnic challenge. An optimal duration of hypercapnia of 45 minutes was noted. KW - Angst KW - Maus KW - Serotonin KW - Stress KW - Entwicklung KW - Angstverhalten KW - Early-Life Stress KW - Mausmodell KW - Serotonindefizienz Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239488 ER - TY - THES A1 - Grabenbauer, Felix T1 - Radiosensibilisierung humaner Tumorzelllinien unterschiedlicher Entitäten durch den MEK-Inhibitor PD184352 allein oder in Kombination mit dem HSP90-Inhibitor NVP-AUY922: Einfluss der Behandlungsschemas T1 - Radiosensitization of human tumor cell lines of different entities by the MEK inhibitor PD184352 alone or in combination with the HSP90 inhibitor NVP-AUY922: Influence of the treatment regimen N2 - Das Targeting des MEK-Proteins in Krebszellen führt in der Regel zu einer erworbenen Resistenz gegen MEK-Inhibitoren und zur Aktivierung des überlebenswichtigen Proteins Akt. Da sowohl MEK als auch Akt Clienten des Hsp90-Chaperonsystems sind, untersucht die vorliegende Arbeit die Reaktionen von bestrahlten Lungenkarzinom- (A549) und Glioblastom- (SNB19) Zelllinien auf eine kombinierte MEK- und Hsp90-Hemmung. Unerwarteterweise verbesserte der 24 h vor der Bestrahlung verabreichte MEK-Inhibitor PD184352 das Zellüberleben durch Hochregulation von MEK und Erk1/2, aber auch von Akt. Im Gegensatz dazu reduzierte PD184352, das 1 h vor der Bestrahlung zugegeben wurde, die Expression von Erk stark und regulierte Akt in beiden Zelllinien nicht hoch. Als Ergebnis verstärkte der MEK-Inhibitor die radiosensibilisierende Wirkung des Hsp90-Inhibitors NVP-AUY922 in Glioblastomzellen (SNB19). N2 - Targeting MEK protein in cancer cells usually leads to acquired resistance to MEK inhibitors and activation of the prosurvival protein Akt. Since both MEK and Akt are clients of the Hsp90 chaperone system, the present study explores the responses of irradiated lung carcinoma A549 and glioblastoma SNB19 cell lines to combined MEK and Hsp90 inhibition. Unexpectedly, the MEK inhibitor PD184352 administered 24 h prior to irradiation, enhanced cell survival through upregulation of not only MEK and Erk1/2 but also of Akt. In contrast, PD184352 added 1 h before irradiation strongly reduced the expression of Erk and did not upregulate Akt in both cell lines. As a result, the MEK inhibitor increased the radiosensitizing effect of the Hsp90 inhibitor NVP-AUY922 in glioblastoma SNB19 cells. KW - Strahlenbiologie KW - A549 KW - Zellforschung KW - Radiosensibilisierung KW - Humane Tumorzelllinien KW - SNB19 KW - MEK-Inhibition KW - PD184352 KW - CI-1040 KW - HSP90-Inhibition KW - NVP-AUY922 KW - AUY-922 KW - Luminespib Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239790 ER - TY - THES A1 - Molina Galindo, Lara Sophia T1 - Glaukomtherapie: Intraindividueller Vergleich zwischen der konventionellen Trabekulektomie und der filtrierenden Trabekulotomie T1 - Glaucoma therapy: Intraindividual comparison of the conventional trabeculectomy and the filtering trabeculotomy N2 - Hintergrund: Die konventionelle Trabekulektomie (TET) stellt trotz einem eher ungünstigen Komplikationsprofil weiterhin den Goldstandard der operativen Glaukomtherapie dar, da sie eine effektivere langfristige Drucksenkung als neuere Operationsverfahren aufweist. Fragestellung: Vergleich der Erfolgsquote und des Risikoprofils der TET mit einer durch Schaffen einer zweiten Filtrationsebene sowie Vermeiden einer peripheren Iridektomie modifizierten Trabekulektomie („Filtrierende Trabekulotomie“ (FTO)). Material und Methode: Retrospektiv durchgeführter intraindividueller Vergleich über 36 Monate an 20 Patienten mit Offenwinkelglaukom nach TET an einem Auge und FTO am anderen Auge an der Augenklinik der Universität Würzburg. Primärer Endpunkt war das Erreichen des absoluten/Teilerfolgs (IOD ≤18 mmHg und ≥ 20 % Druckreduktion ohne/mit Medikation). Als sekundäre Endpunkte wurden das Auftreten von Komplikationen sowie der Verlauf von Augeninnendruck, Visus und lokaler Pharmakotherapie analysiert. Ergebnisse: Beide Operationsverfahren führten zu einer signifikanten Reduktion des Augeninnendrucks zu jedem postoperativen Zeitpunkt. Nach 36 Monaten zeigte sich ein absoluter Erfolg bei 50 % der Augen in der TET-Gruppe und 20 % der FTO-Gruppe sowie ein Teilerfolg bei 71,4 % gegenüber 33,3 %. Zu Komplikationen kam es mit Ausnahme des häufigeren Auftretens eines Hyphämas in der FTO-Gruppe in vergleichbarem Ausmaß in beiden Gruppen. Der Visus und postoperative Medikamentenscore unterschieden sich nicht signifikant voneinander. Schlussfolgerung: Die TET war der FTO in Hinblick auf Erfolg und Komplikationsrisiko überlegen. Die möglichen Vorteile der Operation durch die genannten Modifikationen konnten nicht bestätigt werden. N2 - Background: Despite its numerous short- and long-term complications Trabeculectomy (TET) remains the gold standard of surgical management of glaucoma. It offers more effective IOP control than minimal invasive glaucoma surgery. Objectives: Comparison of the outcome of the TET and a modified trabeculectomy with a second outflow-resistance level of the aqueous humor and without iridectomy (“Filtering Trabeculotomy” (FTO)). Methods: Intraindividual comparison of 20 patients with open-angle glaucoma after TET on the first eye and FTO of the other eye in a retrospective design over a follow-up period of 36 month. Primary outcome measure was the rate of complete and qualified success (IOP ≤18 mmHg and ≥ 20 % reduction without/with medication). Secondary outcome measures were the development of IOP, visual acuity, anti-glaucoma medication and complications. Results: Both surgical procedures reduced the IOP significantly. After 36 month of follow-up 50 % of the patients in the TET-group and 20 % in the FTO-group had a complete success. For qualified success there were lower rates with 71,4 % and 33,3 %, respectively. Complications were comparable in both groups with the exception of hyphema, which was seen more frequently in the FTO-group. Visual acuity and anti-glaucoma medication did not differ significantly. Conclusions: TET was superior to the FTO regarding success rates and complications. Potential benefits of the modifications of the surgical procedure could not be proved. KW - Offenwinkelglaukom KW - Trabekulotomie KW - Iridektomie Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-246412 ER - TY - THES A1 - Soda, Hassan T1 - Interdisziplinäres Schlaganfallmanagement anhand des Stroke Manager Programms – Studiendaten und Perspektiven für die Schlaganfallversorgung T1 - Interdisciplinary stroke management using the Stroke Manager program – study data and perspectives for stroke care N2 - Die Schlaganfallnachsorge in Deutschland wird von verschiedenen Leistungserbringern geprägt, die teilweise komplementäre und komplexe Dienstleistungen erbringen und sektorenübergreifend arbeiten. In Bad Neustadt wurde in Kooperation mit der Universität Würzburg und dem Zentrum für Telemedizin Bad Kissingen das Stroke Manager Programm entwickelt und evaluiert. Das strukturierte Nachsorgeprogramm Stroke Manager basiert auf einer standardisierten Informations- und Software Unterstützung von der Akutversorgung bis drei Monate nach Entlassung aus der stationären Versorgung. Anhand der Ergebnisse des Stroke Manager Programms konnte eine vergleichsweise hohe Persistenz bzgl. der stationär verordneten medikamentösen Sekundärprävention über einen Zeitraum von drei Monaten festgestellt werden, ebenso konnten wir nachweisen, dass sich das Programm positiv auf die Versorgungsqualität sowie die Patientenzufriedenheit nach Schlaganfall auswirken kann. Die im Stroke Manager-Programm betreuten Schlaganfallpatienten wiesen im Vergleich signifikante Unterschiede bei den Faktoren Rauchverhalten, Schlaganfallschweregrad und subjektive, globale Lebensqualität auf. N2 - Stroke aftercare in Germany is shaped by different service providers, some of whom provide complementary and complex services and work across sectors. In Bad Neustadt, the Stroke Manager Program was developed and evaluated in cooperation with the University of Würzburg and the Centre for Telemedicine Bad Kissingen. The structured aftercare program Stroke Manager is based on standardized information and software support from acute care up to three months after discharge from inpatient care. Based on the results of the Stroke Manager program, a comparatively high persistence of inpatient secondary drug prevention was observed over a period of three months, and we were able to demonstrate that the program can have a positive impact on the quality of care and patient satisfaction after stroke. The stroke patients treated in the Stroke Manager program showed significant differences in smoking behaviour, stroke severity and subjective, global quality of life. KW - Stroke Manager KW - medikamentöse Sekundärprävention bei stroke KW - Lebensqualität nach stroke Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242061 ER - TY - THES A1 - Seidensticker, Katharina T1 - Aufbau eines humanen 3D-Atemwegsmodells zur Modellierung der Atemwegsinfektion mit Bordetella pertussis T1 - Investigations of pertussis toxins in a 3D in vitro model of the human respiratory mucosa N2 - Mittels Tissue Engineering hergestellte humane 3D in vitro-Testsysteme sind ein neuer Ansatz, um u.a. Erkrankungen der Atemwege zu simulieren und zu untersuchen. Obwohl gegen B. pertussis, den Erreger des Keuchhustens, Impfstoffe zur Verfügung stehen, nimmt die Erkrankungs-Inzidenz in den letzten Jahren deutlich zu. Da B. pertussis zu den obligat humanpathogenen Erregern zählt, sind die aus Tierversuchen stammenden Daten nur unzureichend auf den Menschen übertragbar. Die genauen Pathomechanismen der Infektion sind bisher nicht geklärt. Auf einer biologischen Kollagenmatrix wurde eine Ko-Kultur aus humanen tracheobronchialen Fibroblasten und humanen tracheobronchialen Epithelzellen (hTEC) angesiedelt und 3 Wochen unter apikaler Belüftung kultiviert. Die ausdifferenzierten 3D Testsysteme wurden mit Überständen von Bordetella pertussis-Kulturen inkubiert und auf licht- und elektronenmikroskopischer Ebene analysiert. Weiterhin wurden 2D Kulturen der hTEC mit Hilfe der Ramanspektroskopie nicht-invasiv auf intrazelluläre Veränderungen nach der Inkubation mit den bakteriellen Überständen untersucht. Das 3D Testsystem der humanen Atemwegschleimhaut zeigte auf lichtmikroskopischer und ultrastruktureller Ebene eine hohe in vitro – in vivo-Korrelation. Die elektronenmikroskopische Analyse zeigte morphologische Veränderungen nach der Inkubation mit den B. pertussis Überständen, die mit vorbeschrieben Effekten einer B. pertussis Infektion korrelieren. Mittels der Ramanspektroskopie ließen sich Gruppen von unbehandelten Zellen von Gruppen, die zuvor mit Bakterienüberständen inkubiert wurden, trennen. Somit zeigte sich die Ramanspektroskopie sensitiv für intrazelluläre Infektionsfolgen. Zusammenfassend wurde belegt, dass das 3D-Modell der humanen Atemwegschleimhaut zur Untersuchung obligat humanpathogener Infektionserreger geeignet ist und dass die Ramanspektroskopie eine nicht-invasive Methode ist, um durch Infektionen hervorgerufene intrazellulären Pathologien zu analysieren. N2 - Three dimensional (3D) tissue-engineered human tissue models are of high relevance, e.g. to investigate virulence mechanisms of human obligate pathogens in vitro. One major obligate agent causing acute respiratory diseases is Bordetella pertussis (Bp), the agent of whooping cough. The progress towards elimination Bp has stalled which is mainly caused due to an absence of suitable models to gain more knowledge about its pathomechanism. On a biological collagen matrix (SISser) a co-culture of human fibroblasts and human airway epithelial cells (hTEC) was seeded and cultured under airlift conditions. The completely differentiated test systems were treated with sterile-filtrated supernatants of Bp and afterwards analyzed with light and transmission electron microscopy. 2D cultures of hTEC were also infected and analyzed with Raman spectroscopy. The 3D test system of the human airway mucosa shows high in vitro - in vivo - correlation on both structural and ultrastructural level. Preliminary morphological analysis after infection with Bp supernatant reveals considerable ultrastructural changes which were not observed in control samples and correlate to effects knows from Bp infections in vivo. In 2D cultivation conditions the Raman spectra of infected hTEC clearly differ from spectra of the control. It is shown that the 3D airway mucosa model represents pathological effects of Bp toxins and offers an opportunity to further examine their pathomechanisms. Raman spectroscopy appears to be a practical method to show intracellular changes on living cells non-invasively. KW - Bordetella pertussis KW - Tissue Engineering KW - Raman-Spektroskopie KW - 3D-Gewebemodell KW - Keuchhusten KW - Konfokale Ramanspektroskopie KW - Airlift-Kultur Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242092 ER - TY - THES A1 - Kodandaraman, Geema T1 - Influence of insulin-induced oxidative stress in genotoxicity and disease T1 - Einfluss von insulininduziertem oxidativem Stress auf Genotoxitität und Krankheit N2 - Hormones are essential components in the body and their imbalance leads to pathological consequences. T2DM, insulin resistance and obesity are the most commonly occurring lifestyle diseases in the past decade. Also, an increased cancer incidence has been strongly associated with obese and T2DM patients. Therefore, our aim was to study the influence of high insulin levels in accumulating DNA damage in in vitro models and patients, through the induction of oxidative stress. The primary goal of this study was to analyze the genotoxicity induced by the combined action of two endogenous hormones (insulin and adrenaline) with in vitro models, through the induction of micronuclei and to see if they cause an additive increase in genomic damage. This is important for multifactorial diseases having high levels of more than one hormone, such as metabolic syndrome and conditions with multiple pathologies (e.g., T2DM along with high stress levels). Furthermore, the combination of insulin and the pharmacological inhibition of the tumor suppressor gene: PTEN, was to be tested in in vitro models for their genotoxic effect and oxidative stress inducing potential. As the tumor suppressor gene: PTEN is downregulated in PTEN associated syndromes and when presented along with T2DM and insulin resistance, this may increase the potential to accumulate genomic damage. The consequences of insulin action were to be further elucidated by following GFP-expressing cells in live cell-imaging to observe the ability of insulin, to induce micronuclei and replicative stress. Finally, the detrimental potential of high insulin levels in obese patients with hyperinsulinemia and pre-diabetes was to be studied by analyzing markers of oxidative stress and genomic damage. In summary, the intention of this work was to understand the effects of high insulin levels in in vitro and in patients to understand its relevance for the development of genomic instability and thus an elevated cancer risk. N2 - In-vitro-Genotoxizitätsstudien mit hohen Konzentrationen von Insulin und die Kombination mit Adrenalin zeigten keinen additiven Anstieg der Mikrokernzahl. Der Insulinrezeptor und der AKT-Signalweg waren in den insulinvermittelten Genomschaden involviert. Die endogenen ROS-Quellen, Mitochondrien und NOX, waren an dem insulinvermittelten DNA-Schaden beteiligt. Hohe Konzentrationen von mitochondrialen ROS alleine, verursacht durch einen Komplex III Mitochondrien-Inhibitor, führten zu Zytotoxizität, aber nicht zu einer Zunahme des Genomschadens. Daher ist die durch das NOX-Enzym vermittelte ROS-Produktion wahrscheinlich der gemeinsame Faktor des genotoxischen Signalweges von Insulin und Adrenalin. Die Überstimulation des NOX-Enzyms führte zu einer Sättigung der zellulären biologischen Effekte und fehlender Additivität bei der Induktion von Genomschaden. Dies könnte jedoch unter physiologischen Bedingungen anders sein, da die Hormonspiegel niedriger sind und die ROS-Quellen nicht durch jedes einzelne der Hormone bereits maximal genutzt und daher erschöpft werden. Damit könnte die Möglichkeit eines additiven Genomschadens in vivo bestehen. Die Rolle des AKT-Signalwegs bei der Insulin-vermittelten genomischen Schädigung ist bereits etabliert und hier wurde nun die Funktion des negativen Regulatorproteins PTEN untersucht. Die Ergebnisse zeigten, dass die PTEN Inhibierung nicht nur zu einer erhöhten Genotoxizität durch MN-Induktion führte, sondern auch zur Beeinträchtigung der mitochondrialen Funktion. Obwohl kein Anstieg von ROS nach PTEN-Inhibierung beobachtet wurde, könnte die mitochondriale Dysfunktion zur metabolischen Imbalance sowie zur Zunahme des Genomschadens führen. Dies könnte insbesondere bei Patienten mit bestimmten PTEN-assoziierten Syndromen und Krebserkrankungen, die eine defekte PTEN-vermittelte Tumorsuppressorfunktion, DNA-Reparaturdefekte und kompromittierte antioxidative Abwehrmechanismen aufweisen, eine wichtige Rolle spielen. Wenn diese Patienten zusätzlich von Hyperinsulinämie betroffen sind, könnte eine Akkumulation von Genomschaden erfolgen und das Risiko zur Krebsentstehung wäre erhöht. Der Mechanismus der Genomschadensinduktion durch Insulin wurde bisher mit einer ROS-vermittelten DNA-Oxidation in Verbindung gebracht, aber noch nicht mit der mitogenen Signalgebung. Bei dieser beschleunigte das mitogene Potential des Insulins die Zellteilung und verursachte einen leichten replikativen Stress. Der milde replikative Stress könnte der Kontrolle durch die mitotischen Checkpoint-Proteine entgehen und zu Chromosomen-Fehlverteilungen und Chromosomenbrüchen führen. Dieser Effekt wurde in der Krebszelllinie Hela in Form von multipolaren Spindeln und Mikronuklei beobachtet und es ist nicht klar ob normale Zellen mit effizienterer Kontrolle dies verhindern könnten. Insgesamt könnte ein durch hohe Insulinspiegel vermittelter Schaden im Kontext anderer Komorbiditäten wie etwa PTEN Syndromen, metabolischem Syndrom oder Adipositas zu einer Akkumulation von DNA-Schäden führen. Schließlich zeigte die Analyse von Proben adipöser Patienten eine Zunahme von DNA-Schaden und oxidativem Stress im Vergleich zu den gesunden Kontrollen. Der Anstieg des DNA-Schadens war am höchsten in der Untergruppe der Patienten mit Insulinresistenz. Hoher Insulinspiegel bedeutet somit ein Risiko vom erhöhten oxidativen Stress und Genomschaden, insbesondere in Kombination mit Komorbiditäten. Erschwert wird das Verständnis dieser multifaktoriellen Zusammenhänge durch das komplexe Zusammenspiel von oxidativem Stress und seiner zellulären Regulation in vielen physiologischen sowie pathophysiologischen Prozessen. Daneben ist es eine Herausforderung, Genomschäden bei den geringen Wirkspiegeln hormoneller Effekte zu detektieren. Weitere Untersuchungen der komplexen Insulin-vermittelten Genomschadenswege werden notwendig sein, um mögliche Risiken der Hyperinsulinämie bei Erkrankungen wie Stoffwechselkrankheiten, Diabetes Typ 2 und Adipositas besser zu charakterisieren. KW - Insulin KW - Genotoxicity KW - Micronucleus Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242005 ER - TY - THES A1 - Liang, Raimunde T1 - Identification of new drug targets in adrenocortical carcinoma through targeted mRNA analysis T1 - Identifikation neuer Drug Targets im Nebennierenrindenkarzinom durch gezielte mRNA-Analyse N2 - Adrenocortical carcinomas (ACC) are aggressive tumors associated with a heterogeneous but generally poor prognosis and limited treatment options for advanced stages. Despite promising molecular insights and improved understanding of ACC biology, efficient targeted therapies have not been identified yet. Thus, this study aims to identify potential new drug targets for a future personalized therapeutic approach. RNA was isolated from 104 formalin-fixed paraffin-embedded tumor samples from ACC patients, 40 of those 104 cases proved to be suitable for further mRNA analyses according to the quality check of the extracted RNA. Gene expression of 84 known cancer drug targets was evaluated by quantitative real-time PCR using 5 normal adrenal glands as reference. Protein expression was investigated for selected candidate drug targets by immunohistochemistry in 104 ACC samples, 11 adenomas and 6 normal adrenal glands. Efficacy of an available inhibitor of the most promising candidate was tested by functional in vitro experiments in two ACC cell lines (NCI-H295R and MUC1) alone or in combination with other drugs. Most frequently overexpressed genes were TOP2A, IGF2, CDK1, CDK4, PLK4 and PLK1. Nuclear immunostaining of CDK1, CDK4 and PLK1 significantly correlated with the respective mRNA expression. CDK4 was chosen as the most promising candidate for functional validation as it is actionable by FDA-approved CDK4/6 inhibitors. ACC samples with copy number gains at CDK4 locus presented significantly higher CDK4 expression levels. The CDK4/6 inhibitor palbociclib showed a concentration- and time- dependent reduction of cell viability in vitro, which was more pronounced in NCI-H295R than in MUC1 cells. This was in line with higher CDK4 expression at western blot analysis in NCI-H295R cells. Furthermore, palbociclib was applied in combination with dual IGFR/IR inhibitor linsitinib showing a synergistic effect on reducing cell viability. In conclusion, this proof-of-principle study confirmed RNA profiling to be useful to discover potential drug targets. Detected drug targets are suitable to be investigated by immunohistochemistry in the clinical setting. Moreover, CDK4/6 inhibitors are promising candidates for treatment of a subset of patients with tumors presenting CDK4 copy number gains and/or overexpression, while linsitinib might be an interesting combination partner in patients with both IGF2 and IGF1R overexpression. These results are intended as a basis for a validation study in a prospective cohort, further evaluation in vivo in suitable mouse models or testing in patients with ACC in clinical trials are needed and might improve the future management of patients with ACC in terms of precision medicine. N2 - Nebennierenrindenkarzinome (ACC) sind aggressive Tumore, die mit einer heterogenen, aber insgesamt ungünstigen Prognose sowie limitierten therapeutischen Optionen für fortgeschrittene Stadien assoziiert sind. Trotz hoffnungsvoll stimmenden molekularen Einblicken und verbessertem Verständnis für die Biologie des ACC wurden bisher keine effektiven Targeted Therapies (zielgerichtete Therapien) identifiziert. Daher strebt diese Studie die Identifikation potentieller neuer Drug Targets (Arzneimittelzielpunkte) im Rahmen einer zukünftigen personalisierten Therapie an. RNA wurde von 104 formalinfixierten und paraffineingebetteten Tumorproben von ACC Patienten isoliert, 40 der 104 Fälle zeigten sich nach der Qualitätsprüfung der extrahierten RNA geeignet für weiterführende mRNA-Analysen. Genexpression von 84 bekannten Karzinom-Drug Targets wurden durch quantitative Real-Time PCR unter Nutzung von 5 normalen Nebennieren als Referenz evaluiert. Proteinexpression wurde in selektierten Kandidaten-Drug Targets durch Immunhistochemie in 104 ACC-Proben, 11 Adenomen und 6 normalen Nebennieren untersucht. Das Potential eines verfügbaren Inhibitors gegen das vielversprechendste Kandidatengen wurde in funktionalen in vitro Experimenten mit zwei ACC-Zelllinien (NCI-H295R und MUC1) allein und in Kombination mit einem anderen Medikament getestet. Die am häufigsten überexprimierten Gene stellten TOP2A, IGF2, CDK1, CDK4, PLK4 und PLK1 dar. Die immunhistologische Kernfärbung für CDK1, CDK4 und PLK1 korrelierten signifikant mit der jeweiligen mRNA-Expression. CDK4 wurde als erfolgversprechendster Kandidat für weitere funktionale Validierung ausgewählt, da es durch FDA-genehmigte CDK4/6-Inhibitoren angreifbar ist. ACC-Proben mit Copy Number Gains des CDK4 Genlocus zeigten signifikant höhere CDK4 Expressionslevel. Der CDK4/6-Inhibitor Palbociclib wies eine zeit- und konzentrationsabhängige Reduktion der Zellviabilität in vitro auf, welche ausgeprägter in NCI-H295R- als in MUC1-Zellen war. Dies war in Einklang mit stärkerer CDK4 Expression in den NCI-H295R-Zellen in der Western Blot Analyse. Weiterhin wurde Palbociclib in Kombination mit dem dualen IGFR/IR-Inhibitor Linsitinib eingesetzt, dies zeigte einen synergistischen Effekt auf die Reduktion der Zellviabilität. Zusammenfassend bestätigte diese Proof-of-Principle den Nutzen von RNA Profiling zur Erfassung potentieller Drug Targets. Die ermittelten Drug Targets sind geeignet für immunhistochemische Untersuchungen im klinischen Setting. Darüber hinaus sind CDK4/6-Inhibitoren vielversprechende Kandidaten für die Behandlung einer Teilgruppe von Patienten mit Tumoren, die CDK4-Copy Number Gains und/oder -Überexpression aufweisen, während Linsitinib ein interessanter Kombinationspartner in Patienten mit sowohl IGF2- wie auch IGF1R-Überexpression darstellen könnte. Diese Resultate sollen als Basis für eine Validationsstudie in einer prospektiven Kohorte dienen, weitere Evaluation in vivo in geeigneten Mausmodellen oder Untersuchung in ACC-Patienten in klinischen Studien sind erforderlich und könnten das zukünftige Management von ACC-Patienten verbessern im Rahmen der Präzisionsmedizin. KW - Adrenokortikales Karzinom KW - CDK4 Inhibitor KW - Präzisionsmedizin KW - gezielte Therapie KW - Palbociclib KW - adrenocortical carcinoma KW - precision medicine KW - CDK4 inhibitor KW - ACC KW - targeted therapy Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235545 ER - TY - THES A1 - Qureischi, Musga T1 - Selective modulation of alloreactive T cells in preclinical models of acute Graft-versus-Host Disease T1 - Selektive Modulation von alloreaktiven T-Zellen in präklinischen Modellen der akuten Graft-versus-Host Erkrankung N2 - Hematopoietic cell transplantation (HCT) is a curative therapy for the treatment of malignant and non-malignant bone marrow diseases. The major complication of this treatment is a highly inflammatory reaction called Graft-versus-Host Disease (GvHD). Here, transplanted donor T cells cause massive tissue destruction and inflammation in the main target organs liver, skin and the intestine. Currently, this inflammatory reaction can be treated successfully using strong immunosuppressive agents. One efficient group of immunosuppressants are calcineurin inhibitors such as Cyclosporin A (CsA) and Tacrolimus (FK506). These treatment strategies target all T lymphocytes subsets equally and do not separate GvH from the desirable Graft-versus-Leukemia (GvL) effect. Therefore, we aimed to find immunological targets on alloreactive T cells in order to develop novel treatment strategies, which selectively modulates alloreactive T cells without impairing the GvL effect or hematopoietic immune reconstitution. The aim of this thesis was to develop a predictive marker panel to track alloreactive T cells in the peripheral blood (PB) of murine allo-HCT recipients. In clinically relevant model of aGvHD we demonstrated that alloreactive T cells have a distinct surface marker expression profile and can be detected in the PB before aGvHD manifestation. Based on our data, we propose a combinatory panel consisting of 4 surface markers (a4b7 integrin, CD162E, CD162P und CD62L) on circulating CD8+ T cells to identify the risk of aGvHD after allo-HCT. Since tumor necrosis factor receptor superfamily (TNFR SF) members are involved in several immunological processes, we did extensive surface marker expression analysis of several TNFR superfamily members and other immunomodulatory molecules on conventional and regulatory T cells (Tcons vs. Tregs) on different time points during aGvHD progression. The aim of this study was to find subset-specific immunomodulatory molecules on recently activated Tcons and Tregs. We found that GITR, 4-1BB and CD27 were highly expressed on alloreactive and naïve Tregs. In contrast, PD1 expression was highly upregulated on recently activated alloreactive Tcons. The data of this study serves as basis for future approaches, which aim to develop T cell subset specific therapeutic antibody fusion proteins. a4b7 integrin and CD162P (P-Selectin ligand) are highly upregulated on alloreactive T cells and mediate the infiltration of these cells into GvHD target organs. We developed recombinant (antibody) fusion proteins to target these two homing molecules and could show that antibody-based fusion proteins are superior to ligand-based fusion proteins regarding production efficiency and binding affinity. Therefore, we propose for future studies to focus on the described antibody-based fusion proteins for the selective targeting of T cells. Since the widely used calcineurin inhibitors are impairing the desirable GvL effect, we investigated if selective NFATc1 inhibition might be a novel strategy to prevent or reduce alloreactivity, while hopefully maintaining the GvL effect. In particular, we addressed the role of the isoform NFATc1 and inhibited its posttranslational modification by SUMO (Small Ubiquitin-related Modifier). Indeed, inhibition of NFATc1 SUMOylation resulted in reduced inflammation and increased Treg frequencies in a murine MHC major mismatch aGvHD model. Conclusively, we showed that alloreactive T cells can be identified by their surface profile in the PB of allo-HCT recipients before aGvHD symptoms appeared. Furthermore, we introduced a approach to selectively target alloreactive T cells by antibody fusion proteins, which might serve as a novel strategy to separate GvH from GvL. Additionally, we demonstrated that averted posttranslational modification of NFATc1 by SUMOylation serves as potential target to reduce alloreactivity of T cells. N2 - Die hämatopoetische Stammzelltransplantation ist eine weltweite Therapiemaßnahme für die Behandlung von malignen und nicht-malignen Knochenmarkserkrankungen(z. B. Leukämien). Eine schwerwiegende Komplikation dieser Therapieform ist die Transplantat-gegen-Wirt Erkrankung (engl. Graft-versus-Host Disease, GvHD). Hierbei greifen Spender-T-Lymphozyten den Körper des Empfängers an und verursachen massive Entzündungsreaktionenin den GvHD Zielorganen Leber, Haut und Darm. Diese überschießende Immunreaktion kann klinisch behandelt werden, indem starkimmunsuppressive Medikamente wie Cyclosporin A (CsA) und Tacrolimus (FK506) eingesetzt werden. Jedoch greifen diese Medikamente alle T-Zellen gleichermaßen an und vermindern ebenfalls die gewünschte anti-Tumorantwort der Spender-T-Lymphozyten(engl. Graft-versus-Leukemiaeffect, GvL effect). Ein Ziel dieser Arbeit war die Entwicklung eines prädiktiven FACS Tests, um T-Zellen im peripheren Blut (PB) von Stammzellenempfängern anhand ihrer Oberflächenmoleküle zu identifizieren. Dazu haben wir ein klinisch relevantes Mausmodell für aGvHD herangezogen und konnten zeigen, dass eine Kombination von Migrations- und Aktivierungsmolekülen (a4b7-Integrin, CD162E, CD162P und CD62L) alloreaktive T-Zellen im Blut eindeutig identifizieren konnten,bevor aGvHD Symptome entstanden. Einige Proteine der TNFR Superfamilie sind auf Immunzellen exprimiert und regulieren diverseimmunologische Prozesse. Wir haben konventionelle T-Zellen (Tcons) und regulatorische T-Zellen (Treg) an unterschiedlichen Zeitpunkten aus transplantierten Mäusenisoliert und die Expression von Proteinen der TNFR Superfamilie untersucht, um potenzielletherapeutische Zielstrukturen auf Spender-Lymphozytenzu identifizieren. Wir konnten zeigen, dass GITR,4-1BB und CD27 auf aktivierten, alloreaktiven wie auch auf naiven Tregs exprimiert wurde. Wohingegen, die PD1 Expression vor allem auf aktivierten Tcons induziert wurde. Die Daten dieser Studie dienen als Grundlage für künftige Strategien um T-Zellen mit Hilfe von Antikörper Fusionsproteinen selektiv zu modulieren. Unsere Daten zeigten, dass die Expression von 4 7-Integrin und CD162P auf alloreaktiven T Zellen im Zuge der aGvHD-Pathogenese induziert wird. Weiterhin erstellten wir rekombinante therapeutische Antikörper Fusionsproteinegegen dieoben genannten Migrationsmoleküle. Wir zeigten hier, dass Produktionseffizienz und Bindungsaffinität von Antikörperformaten besser waren als von Liganden-basierten Fusionsproteinen. Demnachempfehlen wir für künftige Studien Antikörperformate heranzuziehen und die hier aufgeführten Antikörper Konstrukteweiter zu entwickeln.Calcineurin Inhibitoren sind potente Immunsupressiva, die zur Behandlung von aGvHD eingesetzt werden. Diese Immunsuppressiva beeinträchtigen jedoch den GvL Effektsignifikant. Da Calcineurin Inhibitoren indirekt den NFAT Signalweg hemmen, haben wir hier dieselektive Inhibition von NFATin alloreaktiven T-Zellen untersucht. Wir zeigten, dass eine fehlende posttranslationale Modifikation von NFATc1 über SUMOylierung (Small Ubiquitin-related MOdifier) zu einer verminderten Alloreaktivität von T-Zellen führte. Diese Spender-T-Zellen zeigten eine verringerte Effektorfunktion, wobei die protektiven Tregs durch die fehlende SUMOylierung nicht beeinflusst wurden. Zusammenfassend konnte gezeigt werden, dass alloreaktive T-Zellen über ihr spezifisches Oberflächenmarkerprofil im Blut identifiziertwerden konnten bevor aGvHD Symptome entstanden. Weiterhin beschreiben wir eine neue Strategie, um alloreaktive T-Zellen mittels Antikörper-basierten Fusionsproteinen spezifisch zu modulieren. Darüber hinaus zeigten wir, dass eine Verhinderung der NFATc1 SUMOylierung die Alloreaktivität von T-Zellen deutlich reduzierte, ohne den protektiven Effekt von Tregs zu vermindern. KW - GvHD Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236031 ER - TY - THES A1 - Paul, Rebecca Theodora T1 - Subjektive Krankheitswahrnehmung, Therapieadhärenz und Zufriedenheit mit erhaltenen Informationen bei Patienten mit chronischer Nebenniereninsuffizienz – Zusammenhang mit der Teilnahme an einer standardisierten Patientenschulung T1 - Beliefs about glucocorticoid replacement therapy, medication adherence and satisfaction with information in patients with adrenal insufficiency – relation with a participation in the standardised education programme N2 - Rezente Studien mit kleineren Fallzahlen offenbaren bei Patienten mit chronischer Nebenniereninsuffizienz eine sehr negative Krankheitswahrnehmung, große Ängste und Sorgen hinsichtlich der Substitutionstherapie mit Glucocorticoiden sowie eine geringe Therapieadhärenz. Ziel der vorliegenden Beobachtungsstudie war es daher im Rahmen einer monozentrischen Querschnittstudie nebenniereninsuffiziente Patienten zu Therapieadhärenz, subjektiver Krankheits- und Glucocorticoidwahrnehmung und Zufriedenheit mit erhaltenen Informationen zu befragen. Zudem wurden erstmalig die Zusammenhänge zwischen der Teilnahme an einer standardisierten NNI-Schulung und oben genannten Aspekten im Rahmen einer multizentrischen Längschnittstudie untersucht. Die Ergebnisse der Querschnittstudie zeichnen insgesamt ein deutlich positiveres Bild von der subjektiven Krankheits- und Therapiewahrnehmung als bisher in der Literatur beschrieben. Die subjektive Therapieadhärenz war hoch. Zudem waren Sorgen und Ängste hinsichtlich der Glucocorticoid-Substitution geringer ausgeprägt als erwartet. Nichtsdestotrotz ließ sich konkordant zu früheren Publikationen eine zum Teil sehr große Unzufriedenheit mit erhaltenen Informationen zu möglichen Problemen der Glucocorticoid-Substitution feststellen. Die Ergebnisse der Längschnittstudie deuten darauf hin, dass die standardisierte Patientenschulung ein geeignetes Instrument sein könnte, um die Zufriedenheit von Patienten mit NNI zu steigern, das Selbstmanagement zu stärken und gleichzeitig positiven Einfluss auf die Wahrnehmung der Substitutionstherapie nehmen könnte. N2 - Recent studies in patients with chronic adrenal insufficiency revealed negative illness perceptions, strong concerns regarding glucocorticoid replacement and low medication adherence. In order to further evaluate subjective medication adherence, illness and glucocorticoids perception and satisfaction with information, we conducted a cross-sectional study comprising a larger German sample size. Furthermore, as part of a longitudinal study we aimed at evaluating the relation between the above-mentioned aspects and participation in a standardised education programme. The findings of the cross-sectional study show a more positive perception of adrenal insufficiency and glucocorticoid replacement as than previously described in literature. Self-reported medication adherence was high in this sample. Therapy-related concerns were considerably lower than previously described. Participants reported low satisfaction with the information they received about potential problems of glucocorticoid intake. The results of the longitudinal study indicate that the standardised education programme may be an adequate tool to enhance satisfaction with information, to strengthen the patients` self-management of adrenal insufficiency and to improve the patients` perception of glucocorticoid replacement KW - Nebennierenrindeninsuffizienz KW - Hypoadrenalismus KW - Patientenschulungen KW - Subjektive Krankheitswahrnehmung KW - Therapieadhärenz KW - Patientenzufriedenheit Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235522 ER - TY - JOUR A1 - Wagner, Nicole A1 - Mott, Kristina A1 - Upcin, Berin A1 - Stegner, David A1 - Schulze, Harald A1 - Ergün, Süleyman T1 - CXCL12-abundant reticular (CAR) cells direct megakaryocyte protrusions across the bone marrow sinusoid wall JF - Cells N2 - Megakaryocytes (MKs) release platelets into the lumen of bone marrow (BM) sinusoids while remaining to reside within the BM. The morphogenetic events of this complex process are still not fully understood. We combined confocal laser scanning microscopy with transmission and serial block-face scanning electron microscopy followed by 3D-reconstruction on mouse BM tissue sections. These analyses revealed that MKs in close vicinity to BM sinusoid (BMS) wall first induce the lateral retraction of CXCL12-abundant reticular (CAR) cells (CAR), followed by basal lamina (BL) degradation enabling direct MK-sinusoidal endothelial cells (SECs) interaction. Subsequently, an endothelial engulfment starts that contains a large MK protrusion. Then, MK protrusions penetrate the SEC, transmigrate into the BMS lumen and form proplatelets that are in direct contact to the SEC surface. Furthermore, such processes are induced on several sites, as observed by 3D reconstructions. Our data demonstrate that MKs in interaction with CAR-cells actively induce BMS wall alterations, including CAR-cell retraction, BL degradation, and SEC engulfment containing a large MK protrusion. This results in SEC penetration enabling the migration of MK protrusion into the BMS lumen where proplatelets that are adherent to the luminal SEC surface are formed and contribute to platelet release into the blood circulation. KW - megakaryocytes KW - microvasculature KW - CXCL12-abundant reticular (CAR)-cells Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234180 SN - 2073-4409 VL - 10 IS - 4 ER - TY - JOUR A1 - Krist, Lilian A1 - Dornquast, Christina A1 - Reinhold, Thomas A1 - Becher, Heiko A1 - Jöckel, Karl-Heinz A1 - Schmidt, Börge A1 - Schramm, Sara A1 - Icke, Katja A1 - Danquah, Ina A1 - Willich, Stefan N. A1 - Keil, Thomas A1 - Brand, Tilman T1 - Association of acculturation status with longitudinal changes in health-related quality of life — results from a cohort study of adults with Turkish origin in Germany JF - International Journal of Environmental Research and Public Health N2 - Health-related quality of life (HRQL) among migrant populations can be associated with acculturation (i.e., the process of adopting, acquiring and adjusting to a new cultural environment). Since there is a lack of longitudinal studies, we aimed to describe HRQL changes among adults of Turkish descent living in Berlin and Essen, Germany, and their association with acculturation. Participants of a population-based study were recruited in 2012–2013 and reinvited six years later to complete a questionnaire. Acculturation was assessed at baseline using the Frankfurt acculturation scale (integration, assimilation, separation and marginalization). HRQL was assessed at baseline (SF-8) and at follow-up (SF-12) resulting in a physical (PCS) and mental (MCS) sum score. Associations with acculturation and HRQL were analyzed with linear regression models using a time-by-acculturation status interaction term. In the study 330 persons were included (65% women, mean age ± standard deviation 43.3 ± 11.8 years). Over the 6 years, MCS decreased, while PCS remained stable. While cross-sectional analyses showed associations of acculturation status with both MCS and PCS, temporal changes including the time interaction term did not reveal associations of baseline acculturation status with HRQL. When investigating HRQL in acculturation, more longitudinal studies are needed to take changes in both HRQL and acculturation status into account. KW - health-related quality of life KW - HRQL KW - acculturation KW - Turkish KW - migrants Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234068 SN - 1660-4601 VL - 18 IS - 6 ER - TY - JOUR A1 - Kraft, Robin A1 - Reichert, Manfred A1 - Pryss, Rüdiger T1 - Towards the interpretation of sound measurements from smartphones collected with mobile crowdsensing in the healthcare domain: an experiment with Android devices JF - Sensors N2 - The ubiquity of mobile devices fosters the combined use of ecological momentary assessments (EMA) and mobile crowdsensing (MCS) in the field of healthcare. This combination not only allows researchers to collect ecologically valid data, but also to use smartphone sensors to capture the context in which these data are collected. The TrackYourTinnitus (TYT) platform uses EMA to track users' individual subjective tinnitus perception and MCS to capture an objective environmental sound level while the EMA questionnaire is filled in. However, the sound level data cannot be used directly among the different smartphones used by TYT users, since uncalibrated raw values are stored. This work describes an approach towards making these values comparable. In the described setting, the evaluation of sensor measurements from different smartphone users becomes increasingly prevalent. Therefore, the shown approach can be also considered as a more general solution as it not only shows how it helped to interpret TYT sound level data, but may also stimulate other researchers, especially those who need to interpret sensor data in a similar setting. Altogether, the approach will show that measuring sound levels with mobile devices is possible in healthcare scenarios, but there are many challenges to ensuring that the measured values are interpretable. KW - mHealth KW - crowdsensing KW - tinnitus KW - noise measurement KW - environmental sound Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-252246 SN - 1424-8220 VL - 22 IS - 1 ER - TY - JOUR A1 - Ankenbrand, Markus J. A1 - Shainberg, Liliia A1 - Hock, Michael A1 - Lohr, David A1 - Schreiber, Laura M. T1 - Sensitivity analysis for interpretation of machine learning based segmentation models in cardiac MRI JF - BMC Medical Imaging N2 - Background Image segmentation is a common task in medical imaging e.g., for volumetry analysis in cardiac MRI. Artificial neural networks are used to automate this task with performance similar to manual operators. However, this performance is only achieved in the narrow tasks networks are trained on. Performance drops dramatically when data characteristics differ from the training set properties. Moreover, neural networks are commonly considered black boxes, because it is hard to understand how they make decisions and why they fail. Therefore, it is also hard to predict whether they will generalize and work well with new data. Here we present a generic method for segmentation model interpretation. Sensitivity analysis is an approach where model input is modified in a controlled manner and the effect of these modifications on the model output is evaluated. This method yields insights into the sensitivity of the model to these alterations and therefore to the importance of certain features on segmentation performance. Results We present an open-source Python library (misas), that facilitates the use of sensitivity analysis with arbitrary data and models. We show that this method is a suitable approach to answer practical questions regarding use and functionality of segmentation models. We demonstrate this in two case studies on cardiac magnetic resonance imaging. The first case study explores the suitability of a published network for use on a public dataset the network has not been trained on. The second case study demonstrates how sensitivity analysis can be used to evaluate the robustness of a newly trained model. Conclusions Sensitivity analysis is a useful tool for deep learning developers as well as users such as clinicians. It extends their toolbox, enabling and improving interpretability of segmentation models. Enhancing our understanding of neural networks through sensitivity analysis also assists in decision making. Although demonstrated only on cardiac magnetic resonance images this approach and software are much more broadly applicable. KW - deep learning KW - neural networks KW - cardiac magnetic resonance KW - sensitivity analysis KW - transformations KW - augmentation KW - segmentation Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259169 VL - 21 IS - 1 ER - TY - JOUR A1 - Pauli, Martin A1 - Paul, Mila M. A1 - Proppert, Sven A1 - Mrestani, Achmed A1 - Sharifi, Marzieh A1 - Repp, Felix A1 - Kürzinger, Lydia A1 - Kollmannsberger, Philip A1 - Sauer, Markus A1 - Heckmann, Manfred A1 - Sirén, Anna-Leena T1 - Targeted volumetric single-molecule localization microscopy of defined presynaptic structures in brain sections JF - Communications Biology N2 - Revealing the molecular organization of anatomically precisely defined brain regions is necessary for refined understanding of synaptic plasticity. Although three-dimensional (3D) single-molecule localization microscopy can provide the required resolution, imaging more than a few micrometers deep into tissue remains challenging. To quantify presynaptic active zones (AZ) of entire, large, conditional detonator hippocampal mossy fiber (MF) boutons with diameters as large as 10 mu m, we developed a method for targeted volumetric direct stochastic optical reconstruction microscopy (dSTORM). An optimized protocol for fast repeated axial scanning and efficient sequential labeling of the AZ scaffold Bassoon and membrane bound GFP with Alexa Fluor 647 enabled 3D-dSTORM imaging of 25 mu m thick mouse brain sections and assignment of AZs to specific neuronal substructures. Quantitative data analysis revealed large differences in Bassoon cluster size and density for distinct hippocampal regions with largest clusters in MF boutons. Pauli et al. develop targeted volumetric dSTORM in order to image large hippocampal mossy fiber boutons (MFBs) in brain slices. They can identify synaptic targets of individual MFBs and measured size and density of Bassoon clusters within individual untruncated MFBs at nanoscopic resolution. KW - mossy fiber synapses KW - CA3 pyrimidal cells KW - CA2+ channels KW - active zone KW - hippocampal KW - release KW - plasticity KW - proteins KW - platform KW - reveals Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259830 VL - 4 ER - TY - JOUR A1 - Page, Lukas A1 - Wallstabe, Julia A1 - Lother, Jasmin A1 - Bauser, Maximilian A1 - Kniemeyer, Olaf A1 - Strobel, Lea A1 - Voltersen, Vera A1 - Teutschbein, Janka A1 - Hortschansky, Peter A1 - Morton, Charles Oliver A1 - Brakhage, Axel A. A1 - Topp, Max A1 - Einsele, Hermann A1 - Wurster, Sebastian A1 - Loeffler, Juergen T1 - CcpA- and Shm2-Pulsed Myeloid Dendritic Cells Induce T-Cell Activation and Enhance the Neutrophilic Oxidative Burst Response to Aspergillus fumigatus JF - Frontiers in Immunology N2 - Aspergillus fumigatus causes life-threatening opportunistic infections in immunocompromised patients. As therapeutic outcomes of invasive aspergillosis (IA) are often unsatisfactory, the development of targeted immunotherapy remains an important goal. Linking the innate and adaptive immune system, dendritic cells are pivotal in anti-Aspergillus defense and have generated interest as a potential immunotherapeutic approach in IA. While monocyte-derived dendritic cells (moDCs) require ex vivo differentiation, antigen-pulsed primary myeloid dendritic cells (mDCs) may present a more immediate platform for immunotherapy. To that end, we compared the response patterns and cellular interactions of human primary mDCs and moDCs pulsed with an A. fumigatus lysate and two A. fumigatus proteins (CcpA and Shm2) in a serum-free, GMP-compliant medium. CcpA and Shm2 triggered significant upregulation of maturation markers in mDCs and, to a lesser extent, moDCs. Furthermore, both A. fumigatus proteins elicited the release of an array of key pro-inflammatory cytokines including TNF-α, IL-1β, IL-6, IL-8, and CCL3 from both DC populations. Compared to moDCs, CcpA- and Shm2-pulsed mDCs exhibited greater expression of MHC class II antigens and stimulated stronger proliferation and IFN-γ secretion from autologous CD4\(^+\) and CD8\(^+\) T-cells. Moreover, supernatants of CcpA- and Shm2-pulsed mDCs significantly enhanced the oxidative burst in allogeneic neutrophils co-cultured with A. fumigatus germ tubes. Taken together, our in vitro data suggest that ex vivo CcpA- and Shm2-pulsed primary mDCs have the potential to be developed into an immunotherapeutic approach to tackle IA. KW - antigens KW - dendritic cells KW - cytokines KW - host defense KW - immunotherapy KW - Aspergillus Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239493 SN - 1664-3224 VL - 12 ER - TY - JOUR A1 - Kreß, Julia Katharina Charlotte A1 - Jessen, Christina A1 - Marquardt, André A1 - Hufnagel, Anita A1 - Meierjohann, Svenja T1 - NRF2 enables EGFR signaling in melanoma cells JF - International Journal of Molecular Sciences N2 - Receptor tyrosine kinases (RTK) are rarely mutated in cutaneous melanoma, but the expression and activation of several RTK family members are associated with a proinvasive phenotype and therapy resistance. Epidermal growth factor receptor (EGFR) is a member of the RTK family and is only expressed in a subgroup of melanomas with poor prognosis. The insight into regulators of EGFR expression and activation is important for the understanding of the development of this malignant melanoma phenotype. Here, we describe that the transcription factor NRF2, the master regulator of the oxidative and electrophilic stress response, mediates the expression and activation of EGFR in melanoma by elevating the levels of EGFR as well as its ligands EGF and TGFα. ChIP sequencing data show that NRF2 directly binds to the promoter of EGF, which contains a canonical antioxidant response element. Accordingly, EGF is induced by oxidative stress and is also increased in lung adenocarcinoma and head and neck carcinoma with mutationally activated NRF2. In contrast, regulation of EGFR and TGFA occurs by an indirect mechanism, which is enabled by the ability of NRF2 to block the activity of the melanocytic lineage factor MITF in melanoma. MITF effectively suppresses EGFR and TGFA expression and therefore serves as link between NRF2 and EGFR. As EGFR was previously described to stimulate NRF2 activity, the mutual activation of NRF2 and EGFR pathways was investigated. The presence of NRF2 was necessary for full EGFR pathway activation, as NRF2-knockout cells showed reduced AKT activation in response to EGF stimulation compared to controls. Conversely, EGF led to the nuclear localization and activation of NRF2, thereby demonstrating that NRF2 and EGFR are connected in a positive feedback loop in melanoma. In summary, our data show that the EGFR-positive melanoma phenotype is strongly supported by NRF2, thus revealing a novel maintenance mechanism for this clinically challenging melanoma subpopulation. KW - EGFR KW - NRF2 KW - NFE2L2 KW - KEAP1 KW - MITF-low KW - TGF-alpha KW - EGF KW - NSCLC KW - HNSC Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-260222 SN - 1422-0067 VL - 22 IS - 8 ER - TY - JOUR A1 - Gerova, Milan A1 - Wicke, Laura A1 - Chihara, Kotaro A1 - Schneider, Cornelius A1 - Lavigne, Rob A1 - Vogel, Jörg T1 - A grad-seq view of RNA and protein complexes in Pseudomonas aeruginosa under standard and bacteriophage predation conditions JF - mbio N2 - The Gram-negative rod-shaped bacterium Pseudomonas aeruginosa is not only a major cause of nosocomial infections but also serves as a model species of bacterial RNA biology. While its transcriptome architecture and posttranscriptional regulation through the RNA-binding proteins Hfq, RsmA, and RsmN have been studied in detail, global information about stable RNA-protein complexes in this human pathogen is currently lacking. Here, we implement gradient profiling by sequencing (Grad-seq) in exponentially growing P. aeruginosa cells to comprehensively predict RNA and protein complexes, based on glycerol gradient sedimentation profiles of >73% of all transcripts and ∼40% of all proteins. As to benchmarking, our global profiles readily reported complexes of stable RNAs of P. aeruginosa, including 6S RNA with RNA polymerase and associated product RNAs (pRNAs). We observe specific clusters of noncoding RNAs, which correlate with Hfq and RsmA/N, and provide a first hint that P. aeruginosa expresses a ProQ-like FinO domain-containing RNA-binding protein. To understand how biological stress may perturb cellular RNA/protein complexes, we performed Grad-seq after infection by the bacteriophage ΦKZ. This model phage, which has a well-defined transcription profile during host takeover, displayed efficient translational utilization of phage mRNAs and tRNAs, as evident from their increased cosedimentation with ribosomal subunits. Additionally, Grad-seq experimentally determines previously overlooked phage-encoded noncoding RNAs. Taken together, the Pseudomonas protein and RNA complex data provided here will pave the way to a better understanding of RNA-protein interactions during viral predation of the bacterial cell. IMPORTANCE Stable complexes by cellular proteins and RNA molecules lie at the heart of gene regulation and physiology in any bacterium of interest. It is therefore crucial to globally determine these complexes in order to identify and characterize new molecular players and regulation mechanisms. Pseudomonads harbor some of the largest genomes known in bacteria, encoding ∼5,500 different proteins. Here, we provide a first glimpse on which proteins and cellular transcripts form stable complexes in the human pathogen Pseudomonas aeruginosa. We additionally performed this analysis with bacteria subjected to the important and frequently encountered biological stress of a bacteriophage infection. We identified several molecules with established roles in a variety of cellular pathways, which were affected by the phage and can now be explored for their role during phage infection. Most importantly, we observed strong colocalization of phage transcripts and host ribosomes, indicating the existence of specialized translation mechanisms during phage infection. All data are publicly available in an interactive and easy to use browser. KW - Grad-seq KW - Pseudomonas KW - UKZ KW - bacteriophage KW - infection KW - Pseudomonas aeruginosa KW - RNA-binding proteins KW - noncoding RNA KW - phage Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259054 VL - 12 IS - 1 ER - TY - JOUR A1 - Doryab, Ali A1 - Taskin, Mehmet Berat A1 - Stahlhut, Philipp A1 - Schröppel, Andreas A1 - Wagner, Darcy E. A1 - Groll, Jürgen A1 - Schmid, Otmar T1 - A Biomimetic, Copolymeric Membrane for Cell‐Stretch Experiments with Pulmonary Epithelial Cells at the Air‐Liquid Interface JF - Advanced Functional Materials N2 - Chronic respiratory diseases are among the leading causes of death worldwide, but only symptomatic therapies are available for terminal illness. This in part reflects a lack of biomimetic in vitro models that can imitate the complex environment and physiology of the lung. Here, a copolymeric membrane consisting of poly(ε‐)caprolactone and gelatin with tunable properties, resembling the main characteristics of the alveolar basement membrane is introduced. The thin bioinspired membrane (≤5 μm) is stretchable (up to 25% linear strain) with appropriate surface wettability and porosity for culturing lung epithelial cells under air–liquid interface conditions. The unique biphasic concept of this membrane provides optimum characteristics for initial cell growth (phase I) and then switch to biomimetic properties for cyclic cell‐stretch experiments (phase II). It is showed that physiologic cyclic mechanical stretch improves formation of F‐actin cytoskeleton filaments and tight junctions while non‐physiologic over‐stretch induces cell apoptosis, activates inflammatory response (IL‐8), and impairs epithelial barrier integrity. It is also demonstrated that cyclic physiologic stretch can enhance the cellular uptake of nanoparticles. Since this membrane offers considerable advantages over currently used membranes, it may lead the way to more biomimetic in vitro models of the lung for translation of in vitro response studies into clinical outcome. KW - alveolar‐capillary barrier KW - cyclic mechanical stretch KW - hybrid polymers KW - in vitro cell‐stretch model KW - tunable ultra‐thin biphasic membrane Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-225645 VL - 31 IS - 10 ER - TY - JOUR A1 - Ryma, Matthias A1 - Tylek, Tina A1 - Liebscher, Julia A1 - Blum, Carina A1 - Fernandez, Robin A1 - Böhm, Christoph A1 - Kastenmüller, Wolfgang A1 - Gasteiger, Georg A1 - Groll, Jürgen T1 - Translation of collagen ultrastructure to biomaterial fabrication for material-independent but highly efficient topographic immunomodulation JF - Advanced materials N2 - Supplement-free induction of cellular differentiation and polarization solely through the topography of materials is an auspicious strategy but has so far significantly lagged behind the efficiency and intensity of media-supplementation-based protocols. Consistent with the idea that 3D structural motifs in the extracellular matrix possess immunomodulatory capacity as part of the natural healing process, it is found in this study that human-monocyte-derived macrophages show a strong M2a-like prohealing polarization when cultured on type I rat-tail collagen fibers but not on collagen I films. Therefore, it is hypothesized that highly aligned nanofibrils also of synthetic polymers, if packed into larger bundles in 3D topographical biomimetic similarity to native collagen I, would induce a localized macrophage polarization. For the automated fabrication of such bundles in a 3D printing manner, the strategy of “melt electrofibrillation” is pioneered by the integration of flow-directed polymer phase separation into melt electrowriting and subsequent selective dissolution of the matrix polymer postprocessing. This process yields nanofiber bundles with a remarkable structural similarity to native collagen I fibers, particularly for medical-grade poly(ε-caprolactone). These biomimetic fibrillar structures indeed induce a pronounced elongation of human-monocyte-derived macrophages and unprecedentedly trigger their M2-like polarization similar in efficacy as interleukin-4 treatment. KW - biofabrication KW - extracellular matrix KW - immunomodulation KW - macrophages KW - melt electrofibrillation KW - melt electrowriting Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-256381 VL - 33 IS - 33 ER - TY - JOUR A1 - Herzberg, Moritz A1 - Scherling, Korbinian A1 - Stahl, Robert A1 - Tiedt, Steffen A1 - Wollenweber, Frank A. A1 - Küpper, Clemens A1 - Feil, Katharina A1 - Forbrig, Robert A1 - Patzig, Maximilian A1 - Kellert, Lars A1 - Kunz, Wolfgang G. A1 - Reidler, Paul A1 - Zimmermann, Hanna A1 - Liebig, Thomas A1 - Dieterich, Marianne A1 - Dorn, Franziska T1 - Late Thrombectomy in Clinical Practice: Retrospective Application of DAWN/DEFUSE3 Criteria within the German Stroke Registry JF - Clinical Neuroradiology N2 - Background and Purpose To provide real-world data on outcome and procedural factors of late thrombectomy patients. Methods We retrospectively analyzed patients from the multicenter German Stroke Registry. The primary endpoint was clinical outcome on the modified Rankin scale (mRS) at 3 months. Trial-eligible patients and the subgroups were compared to the ineligible group. Secondary analyses included multivariate logistic regression to identify predictors of good outcome (mRS ≤ 2). Results Of 1917 patients who underwent thrombectomy, 208 (11%) were treated within a time window ≥ 6–24 h and met the baseline trial criteria. Of these, 27 patients (13%) were eligible for DAWN and 39 (19%) for DEFUSE3 and 156 patients were not eligible for DAWN or DEFUSE3 (75%), mainly because there was no perfusion imaging (62%; n = 129). Good outcome was not significantly higher in trial-ineligible (27%) than in trial-eligible (20%) patients (p = 0.343). Patients with large trial-ineligible CT perfusion imaging (CTP) lesions had significantly more hemorrhagic complications (33%) as well as unfavorable outcomes. Conclusion In clinical practice, the high number of patients with a good clinical outcome after endovascular therapy ≥ 6–24 h as in DAWN/DEFUSE3 could not be achieved. Similar outcomes are seen in patients selected for EVT ≥ 6 h based on factors other than CTP. Patients triaged without CTP showed trends for shorter arrival to reperfusion times and higher rates of independence. KW - late thrombectomy KW - stroke KW - endovascular therapy KW - outcome Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-264765 VL - 31 IS - 3 ER - TY - JOUR A1 - Hein, Grit A1 - Gamer, Matthias A1 - Gall, Dominik A1 - Gründahl, Marthe A1 - Domschke, Katharina A1 - Andreatta, Marta A1 - Wieser, Matthias J. A1 - Pauli, Paul T1 - Social cognitive factors outweigh negative emotionality in predicting COVID-19 related safety behaviors JF - Preventive Medicine Reports N2 - Emotion-motivation models propose that behaviors, including health behaviors, should be predicted by the same variables that also predict negative affect since emotional reactions should induce a motivation to avoid threatening situations. In contrast, social cognitive models propose that safety behaviors are predicted by a different set of variables that mainly reflect cognitive and socio-structural aspects. Here, we directly tested these opposing hypotheses in young adults (N = 4134) in the context of COVID-19-related safety behaviors to prevent infections. In each participant, we collected measures of negative affect as well as cognitive and socio-structural variables during the lockdown in the first infection wave in Germany. We found a negative effect of the pandemic on emotional responses. However, this was not the main predictor for young adults’ willingness to comply with COVID-19-related safety measures. Instead, individual differences in compliance were mainly predicted by cognitive and socio-structural variables. These results were confirmed in an independent data set. This study shows that individuals scoring high on negative affect during the pandemic are not necessarily more likely to comply with safety regulations. Instead, political measures should focus on cognitive interventions and the societal relevance of the health issue. These findings provide important insights into the basis of health-related concerns and feelings as well as behavioral adaptations. KW - social cognitive KW - negative affect KW - safety behavior KW - survey KW - COVID-19 Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-265008 VL - 24 ER - TY - JOUR A1 - Andelovic, Kristina A1 - Winter, Patrick A1 - Kampf, Thomas A1 - Xu, Anton A1 - Jakob, Peter Michael A1 - Herold, Volker A1 - Bauer, Wolfgang Rudolf A1 - Zernecke, Alma T1 - 2D Projection Maps of WSS and OSI Reveal Distinct Spatiotemporal Changes in Hemodynamics in the Murine Aorta during Ageing and Atherosclerosis JF - Biomedicines N2 - Growth, ageing and atherosclerotic plaque development alter the biomechanical forces acting on the vessel wall. However, monitoring the detailed local changes in wall shear stress (WSS) at distinct sites of the murine aortic arch over time has been challenging. Here, we studied the temporal and spatial changes in flow, WSS, oscillatory shear index (OSI) and elastic properties of healthy wildtype (WT, n = 5) and atherosclerotic apolipoprotein E-deficient (Apoe\(^{−/−}\), n = 6) mice during ageing and atherosclerosis using high-resolution 4D flow magnetic resonance imaging (MRI). Spatially resolved 2D projection maps of WSS and OSI of the complete aortic arch were generated, allowing the pixel-wise statistical analysis of inter- and intragroup hemodynamic changes over time and local correlations between WSS, pulse wave velocity (PWV), plaque and vessel wall characteristics. The study revealed converse differences of local hemodynamic profiles in healthy WT and atherosclerotic Apoe\(^{−/−}\) mice, and we identified the circumferential WSS as potential marker of plaque size and composition in advanced atherosclerosis and the radial strain as a potential marker for vascular elasticity. Two-dimensional (2D) projection maps of WSS and OSI, including statistical analysis provide a powerful tool to monitor local aortic hemodynamics during ageing and atherosclerosis. The correlation of spatially resolved hemodynamics and plaque characteristics could significantly improve our understanding of the impact of hemodynamics on atherosclerosis, which may be key to understand plaque progression towards vulnerability. KW - atherosclerosis KW - mouse KW - 4D flow MRI KW - aortic arch KW - flow dynamics KW - WSS KW - mapping KW - PWV KW - plaque characteristics Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-252164 SN - 2227-9059 VL - 9 IS - 12 ER - TY - JOUR A1 - Dirks, Johannes A1 - Fischer, Jonas A1 - Haase, Gabriele A1 - Holl-Wieden, Annette A1 - Hofmann, Christine A1 - Girschick, Hermann A1 - Morbach, Henner T1 - CD21\(^{lo/−}\)CD27\(^−\)IgM\(^−\) Double-Negative B Cells Accumulate in the Joints of Patients With Antinuclear Antibody-Positive Juvenile Idiopathic Arthritis JF - Frontiers in Pediatrics N2 - Juvenile idiopathic arthritis (JIA) encompasses a heterogeneous group of diseases. The appearance of antinuclear antibodies (ANAs) in almost half of the patients suggests B cell dysregulation as a distinct pathomechanism in these patients. Additionally, ANAs were considered potential biomarkers encompassing a clinically homogenous subgroup of JIA patients. However, in ANA+ JIA patients, the site of dysregulated B cell activation as well as the B cell subsets involved in this process is still unknown. Hence, in this cross-sectional study, we aimed in an explorative approach at characterizing potential divergences in B cell differentiation in ANA+ JIA patients by assessing the distribution of peripheral blood (PB) and synovial fluid (SF) B cell subpopulations using flow cytometry. The frequency of transitional as well as switched-memory B cells was higher in PB of JIA patients than in healthy controls. There were no differences in the distribution of B cell subsets between ANA- and ANA+ patients in PB. However, the composition of SF B cells was different between ANA- and ANA+ patients with increased frequencies of CD21\(^{lo/−}\)CD27\(^−\)IgM\(^−\) “double negative” (DN) B cells in the latter. DN B cells might be a characteristic subset expanding in the joints of ANA+ JIA patients and are potentially involved in the antinuclear immune response in these patients. The results of our explorative study might foster further research dissecting the pathogenesis of ANA+ JIA patients. KW - juvenile idiopathic arthritis KW - B cells KW - antinuclear antibodies KW - synovial fluid KW - double negative B cells Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236286 SN - 2296-2360 VL - 9 ER - TY - JOUR A1 - Petri, Nils A1 - Lengenfelder, Björn A1 - Voelker, Wolfram A1 - Nordbeck, Peter T1 - Interventional closure of aortomitral perforation after TAVR: A case report JF - Catheterization and Cardiovascular Interventions N2 - Despite TAVR emerging as the gold standard for a broad spectrum of patients, it is associated with serious complications. In this report we present a case, where a TAVR procedure led to a perforation at the aortomitral continuity, discuss the risk factors for the occurrence of perforations and how we decided to treat the patient. KW - medicine KW - closure AV fistula/AVM (CLAV) KW - transcatheter valveimplantation (TVI) KW - percutaneous valve therapy (PVT) KW - aortic valve disease percutaneous intervention (AVDP) KW - imaging TTE/TEE (ITTE) Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-256625 VL - 98 IS - 3 ER - TY - JOUR A1 - Winter, Michael A1 - Pryss, Rüdiger A1 - Probst, Thomas A1 - Reichert, Manfred T1 - Applying Eye Movement Modeling Examples to guide novices' attention in the comprehension of process models JF - Brain Sciences N2 - Process models are crucial artifacts in many domains, and hence, their proper comprehension is of importance. Process models mediate a plethora of aspects that are needed to be comprehended correctly. Novices especially face difficulties in the comprehension of process models, since the correct comprehension of such models requires process modeling expertise and visual observation capabilities to interpret these models correctly. Research from other domains demonstrated that the visual observation capabilities of experts can be conveyed to novices. In order to evaluate the latter in the context of process model comprehension, this paper presents the results from ongoing research, in which gaze data from experts are used as Eye Movement Modeling Examples (EMMEs) to convey visual observation capabilities to novices. Compared to prior results, the application of EMMEs improves process model comprehension significantly for novices. Novices achieved in some cases similar performances in process model comprehension to experts. The study's insights highlight the positive effect of EMMEs on fostering the comprehension of process models. KW - Business Process Models KW - Process Model Comprehension KW - Eye Movement Modeling Examples KW - eye tracking KW - human-centered design KW - cognition Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-222966 SN - 2076-3425 VL - 11 IS - 1 ER - TY - JOUR A1 - Tran-Gia, Johannes A1 - Denis-Bacelar, Ana M. A1 - Ferreira, Kelley M. A1 - Robinson, Andrew P. A1 - Calvert, Nicholas A1 - Fenwick, Andrew J. A1 - Finocchiaro, Domenico A1 - Fioroni, Federica A1 - Grassi, Elisa A1 - Heetun, Warda A1 - Jewitt, Stephanie J. A1 - Kotzassarlidou, Maria A1 - Ljungberg, Michael A1 - McGowan, Daniel R. A1 - Scott, Nathaniel A1 - Scuffham, James A1 - Gleisner, Katarina Sjögreen A1 - Tipping, Jill A1 - Wevrett, Jill A1 - Lassmann, Michael T1 - A multicentre and multi-national evaluation of the accuracy of quantitative Lu-177 SPECT/CT imaging performed within the MRTDosimetry project JF - EJNMMI Physics N2 - Purpose Patient-specific dosimetry is required to ensure the safety of molecular radiotherapy and to predict response. Dosimetry involves several steps, the first of which is the determination of the activity of the radiopharmaceutical taken up by an organ/lesion over time. As uncertainties propagate along each of the subsequent steps (integration of the time–activity curve, absorbed dose calculation), establishing a reliable activity quantification is essential. The MRTDosimetry project was a European initiative to bring together expertise in metrology and nuclear medicine research, with one main goal of standardizing quantitative \(^{177}\)Lu SPECT/CT imaging based on a calibration protocol developed and tested in a multicentre inter-comparison. This study presents the setup and results of this comparison exercise. Methods The inter-comparison included nine SPECT/CT systems. Each site performed a set of three measurements with the same setup (system, acquisition and reconstruction): (1) Determination of an image calibration for conversion from counts to activity concentration (large cylinder phantom), (2) determination of recovery coefficients for partial volume correction (IEC NEMA PET body phantom with sphere inserts), (3) validation of the established quantitative imaging setup using a 3D printed two-organ phantom (ICRP110-based kidney and spleen). In contrast to previous efforts, traceability of the activity measurement was required for each participant, and all participants were asked to calculate uncertainties for their SPECT-based activities. Results Similar combinations of imaging system and reconstruction lead to similar image calibration factors. The activity ratio results of the anthropomorphic phantom validation demonstrate significant harmonization of quantitative imaging performance between the sites with all sites falling within one standard deviation of the mean values for all inserts. Activity recovery was underestimated for total kidney, spleen, and kidney cortex, while it was overestimated for the medulla. Conclusion This international comparison exercise demonstrates that harmonization of quantitative SPECT/CT is feasible when following very specific instructions of a dedicated calibration protocol, as developed within the MRTDosimetry project. While quantitative imaging performance demonstrates significant harmonization, an over- and underestimation of the activity recovery highlights the limitations of any partial volume correction in the presence of spill-in and spill-out between two adjacent volumes of interests. KW - quantitative SPECT/CT KW - 177Lu SPECT/CT imaging KW - standardization of SPECT/CT imaging KW - harmonization of SPECT/CT imaging KW - international multicenter comparison exercise KW - traceability of SPECT/CT imaging KW - molecular radiotherapy (MRT) KW - 3D printing KW - phantom Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-270380 VL - 8 ER - TY - JOUR A1 - Lange, Florian A1 - Steigerwald, Frank A1 - Malzacher, Tobias A1 - Brandt, Gregor Alexander A1 - Odorfer, Thorsten Michael A1 - Roothans, Jonas A1 - Reich, Martin M. A1 - Fricke, Patrick A1 - Volkmann, Jens A1 - Matthies, Cordula A1 - Capetian, Philipp D. T1 - Reduced Programming Time and Strong Symptom Control Even in Chronic Course Through Imaging-Based DBS Programming JF - Frontiers in Neurology N2 - Objectives: Deep brain stimulation (DBS) programming is based on clinical response testing. Our clinical pilot trial assessed the feasibility of image-guided programing using software depicting the lead location in a patient-specific anatomical model. Methods: Parkinson's disease patients with subthalamic nucleus-DBS were randomly assigned to standard clinical-based programming (CBP) or anatomical-based (imaging-guided) programming (ABP) in an 8-week crossover trial. Programming characteristics and clinical outcomes were evaluated. Results: In 10 patients, both programs led to similar motor symptom control (MDS-UPDRS III) after 4 weeks (medicationOFF/stimulationON; CPB: 18.27 ± 9.23; ABP: 18.37 ± 6.66). Stimulation settings were not significantly different, apart from higher frequency in the baseline program than CBP (p = 0.01) or ABP (p = 0.003). Time spent in a program was not significantly different (CBP: 86.1 ± 29.82%, ABP: 88.6 ± 29.0%). Programing time was significantly shorter (p = 0.039) with ABP (19.78 ± 5.86 min) than CBP (45.22 ± 18.32). Conclusion: Image-guided DBS programming in PD patients drastically reduces programming time without compromising symptom control and patient satisfaction in this small feasibility trial. KW - directional deep brain stimulation KW - image-guided programming KW - subthalamic nucleus KW - chronic stimulation KW - randomized controlled double-blind study KW - Parkinson's disease Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-249634 SN - 1664-2295 VL - 12 ER - TY - JOUR A1 - Nguemeni, Carine A1 - Stiehl, Annika A1 - Hiew, Shawn A1 - Zeller, Daniel T1 - No Impact of Cerebellar Anodal Transcranial Direct Current Stimulation at Three Different Timings on Motor Learning in a Sequential Finger-Tapping Task JF - Frontiers in Human Neuroscience N2 - Background: Recently, attention has grown toward cerebellar neuromodulation in motor learning using transcranial direct current stimulation (tDCS). An important point of discussion regarding this modulation is the optimal timing of tDCS, as this parameter could significantly influence the outcome. Hence, this study aimed to investigate the effects of the timing of cerebellar anodal tDCS (ca-tDCS) on motor learning using a sequential finger-tapping task (FTT). Methods: One hundred and twenty two healthy young, right-handed subjects (96 females) were randomized into four groups (During\(_{sham}\), Before, During\(_{real}\), After). They performed 2 days of FTT with their non-dominant hand on a custom keyboard. The task consisted of 40 s of typing followed by 20 s rest. Each participant received ca-tDCS (2 mA, sponge electrodes of 25 cm\(^{2}\), 20 min) at the appropriate timing and performed 20 trials on the first day (T1, 20 min). On the following day, only 10 trials of FTT were performed without tDCS (T2, 10 min). Motor skill performance and retention were assessed. Results: All participants showed a time-dependent increase in learning. Motor performance was not different between groups at the end of T1 (p = 0.59). ca-tDCS did not facilitate the retention of the motor skill in the FTT at T2 (p = 0.27). Thus, our findings indicate an absence of the effect of ca-tDCS on motor performance or retention of the FTT independently from the timing of stimulation. Conclusion: The present results suggest that the outcome of ca-tDCS is highly dependent on the task and stimulation parameters. Future studies need to establish a clear basis for the successful and reproducible clinical application of ca-tDCS. KW - cerebellar tDCS KW - finger-tapping task KW - timing KW - motor learning KW - task retention Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-225477 SN - 1662-5161 VL - 15 ER - TY - JOUR A1 - Boulos, Joelle C. A1 - Saeed, Mohamed E. M. A1 - Chatterjee, Manik A1 - Bülbül, Yagmur A1 - Crudo, Francesco A1 - Marko, Doris A1 - Munder, Markus A1 - Klauck, Sabine M. A1 - Efferth, Thomas T1 - Repurposing of the ALK inhibitor crizotinib for acute leukemia and multiple myeloma cells JF - Pharmaceuticals N2 - Crizotinib was a first generation of ALK tyrosine kinase inhibitor approved for the treatment of ALK-positive non-small-cell lung carcinoma (NSCLC) patients. COMPARE and cluster analyses of transcriptomic data of the NCI cell line panel indicated that genes with different cellular functions regulated the sensitivity or resistance of cancer cells to crizotinib. Transcription factor binding motif analyses in gene promoters divulged two transcription factors possibly regulating the expression of these genes, i.e., RXRA and GATA1, which are important for leukemia and erythroid development, respectively. COMPARE analyses also implied that cell lines of various cancer types displayed varying degrees of sensitivity to crizotinib. Unexpectedly, leukemia but not lung cancer cells were the most sensitive cells among the different types of NCI cancer cell lines. Re-examining this result in another panel of cell lines indeed revealed that crizotinib exhibited potent cytotoxicity towards acute myeloid leukemia and multiple myeloma cells. P-glycoprotein-overexpressing CEM/ADR5000 leukemia cells were cross-resistant to crizotinib. NCI-H929 multiple myeloma cells were the most sensitive cells. Hence, we evaluated the mode of action of crizotinib on these cells. Although crizotinib is a TKI, it showed highest correlation rates with DNA topoisomerase II inhibitors and tubulin inhibitors. The altered gene expression profiles after crizotinib treatment predicted several networks, where TOP2A and genes related to cell cycle were downregulated. Cell cycle analyses showed that cells incubated with crizotinib for 24 h accumulated in the G\(_2\)M phase. Crizotinib also increased the number of p-H3(Ser10)-positive NCI-H929 cells illustrating crizotinib's ability to prevent mitotic exit. However, cells accumulated in the sub-G\(_0\)G\(_1\) fraction with longer incubation periods, indicating apoptosis induction. Additionally, crizotinib disassembled the tubulin network of U2OS cells expressing an α-tubulin-GFP fusion protein, preventing migration of cancer cells. This result was verified by in vitro tubulin polymerization assays. In silico molecular docking also revealed a strong binding affinity of crizotinib to the colchicine and Vinca alkaloid binding sites. Taken together, these results demonstrate that crizotinib destabilized microtubules. Additionally, the decatenation assay showed that crizotinib partwise inhibited the catalytic activity of DNA topoisomerase II. In conclusion, crizotinib exerted kinase-independent cytotoxic effects through the dual inhibition of tubulin polymerization and topoisomerase II and might be used to treat not only NSCLC but also multiple myeloma. KW - acute myeloid leukemia KW - drug repurposing KW - multiple myeloma KW - network pharmacology KW - transcriptomics KW - tyrosine kinase inhibitors Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-250258 SN - 1424-8247 VL - 14 IS - 11 ER - TY - JOUR A1 - Holzmeister, Ib A1 - Weichhold, Jan A1 - Groll, Jürgen A1 - Zreiqat,, Hala A1 - Gbureck, Uwe T1 - Hydraulic reactivity and cement formation of baghdadite JF - Journal of the American Ceramic Society N2 - In this study, the hydraulic reactivity and cement formation of baghdadite (Ca\(_{3}\)ZrSi\(_{2}\)O\(_{9}\)) was investigated. The material was synthesized by sintering a mixture of CaCO\(_{3}\), SiO\(_{2}\), and ZrO\(_{2}\) and then mechanically activated using a planetary mill. This leads to a decrease in particle and crystallite size and a partial amorphization of baghdadite as shown by X-ray powder diffraction (XRD) and laser diffraction measurements. Baghdadite cements were formed by the addition of water at a powder to liquid ratio of 2.0 g/ml. Maximum compressive strengths were found to be ~2 MPa after 3-day setting for a 24-h ground material. Inductively coupled plasma mass spectrometry (ICP-MS) measurements showed an incongruent dissolution profile of set cements with a preferred dissolution of calcium and only marginal release of zirconium ions. Cement formation occurs under alkaline conditions, whereas the unground raw powder leads to a pH of 11.9 during setting, while prolonged grinding increased pH values to approximately 12.3. KW - baghdadite KW - bone cement KW - hydraulic reactivity KW - mechanical activation Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259457 VL - 104 IS - 7 ER - TY - JOUR A1 - Gentzsch, Christian A1 - Chen, Xinyu A1 - Spatz, Philipp A1 - Košak, Urban A1 - Knez, Damijan A1 - Nose, Naoko A1 - Gobec, Stanislav A1 - Higuchi, Takahiro A1 - Decker, Michael T1 - Synthesis and Initial Characterization of a Reversible, Selective \(^{18}\)F-Labeled Radiotracer for Human Butyrylcholinesterase JF - Molecular Imaging and Biology N2 - Purpose A neuropathological hallmark of Alzheimer's disease (AD) is the presence of amyloid-β (Aβ) plaques in the brain, which are observed in a significant number of cognitively normal, older adults as well. In AD, butyrylcholinesterase (BChE) becomes associated with A\(_{β}\) aggregates, making it a promising target for imaging probes to support diagnosis of AD. In this study, we present the synthesis, radiochemistry, in vitro and preliminary ex and in vivo investigations of a selective, reversible BChE inhibitor as PET-tracer for evaluation as an AD diagnostic. Procedures Radiolabeling of the inhibitor was achieved by fluorination of a respective tosylated precursor using K[\(^{18}\)F]. IC\(_{50}\) values of the fluorinated compound were obtained in a colorimetric assay using recombinant, human (h) BChE. Dissociation constants were determined by measuring hBChE activity in the presence of different concentrations of inhibitor. Results Radiofluorination of the tosylate precursor gave the desired radiotracer in an average radiochemical yield of 20 ± 3 %. Identity and > 95.5 % radiochemical purity were confirmed by HPLC and TLC autoradiography. The inhibitory potency determined in Ellman's assay gave an IC\(_{50}\) value of 118.3 ± 19.6 nM. Dissociation constants measured in kinetic experiments revealed lower affinity of the inhibitor for binding to the acylated enzyme (K2 = 68.0 nM) in comparison to the free enzyme (K\(_{1}\) = 32.9 nM). Conclusions The reversibly acting, selective radiotracer is synthetically easily accessible and retains promising activity and binding potential on hBChE. Radiosynthesis with \(^{18}\)F labeling of tosylates was feasible in a reasonable time frame and good radiochemical yield. KW - Alzheimer’s disease KW - amyloid-β (Aβ) KW - butyrylcholinesterase Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-269870 SN - 1860-2002 VL - 23 IS - 4 ER - TY - JOUR A1 - Chen, Chunguang A1 - Rawat, Divya A1 - Samikannu, Balaji A1 - Bender, Markus A1 - Preissner, Klaus T. A1 - Linn, Thomas T1 - Platelet glycoprotein VI‐dependent thrombus stabilization is essential for the intraportal engraftment of pancreatic islets JF - American Journal of Transplantation N2 - Platelet activation and thrombus formation have been implicated to be detrimental for intraportal pancreatic islet transplants. The platelet‐specific collagen receptor glycoprotein VI (GPVI) plays a key role in thrombosis through cellular activation and the subsequent release of secondary mediators. In aggregometry and in a microfluidic dynamic assay system modeling flow in the portal vein, pancreatic islets promoted platelet aggregation and triggered thrombus formation, respectively. While platelet GPVI deficiency did not affect the initiation of these events, it was found to destabilize platelet aggregates and thrombi in this process. Interestingly, while no major difference was detected in early thrombus formation after intraportal islet transplantation, genetic GPVI deficiency or acute anti‐GPVI treatment led to an inferior graft survival and function in both syngeneic mouse islet transplantation and xenogeneic human islet transplantation models. These results demonstrate that platelet GPVI signaling is indispensable in stable thrombus formation induced by pancreatic islets. GPVI deficiency resulted in thrombus destabilization and inferior islet engraftment indicating that thrombus formation is necessary for a successful intraportal islet transplantation in which platelets are active modulators. KW - basic (laboratory) research / science KW - coagulation and hemostasis KW - graft survival KW - islet transplantation KW - molecular biology Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-224471 VL - 21 SP - 2079 EP - 2089 ER - TY - JOUR A1 - Frings, Verena G. A1 - Roth, Sabine A1 - Rosenwald, Andreas A1 - Goebeler, Matthias A1 - Geissinger, Eva A1 - Wobser, Marion T1 - EBER in situ hybridization in subcutaneous aluminum granulomas/lymphoid hyperplasia: A diagnostic clue to differentiate injection-associated lymphoid hyperplasia from other forms of pseudolymphomas and cutaneous lymphomas JF - Journal of Cutaneous Pathology N2 - Background Subcutaneous vaccination or desensitization may induce persistent nodules at the injection sites. Without the knowledge of prior injection, histopathological work-up may be challenging. Objective Aim of this study was to contribute to the histopathological work-up of unclear subcutaneous nodules, especially their differentiation from cutaneous lymphoma. Methods We retrospectively reviewed clinical data and histopathological slides of four patients with subcutaneous nodules, which were suspected to suffer from cutaneous T- or B-cell lymphoma. Sections of these cases and 12 negative controls were stained with hematoxylin and eosin and a standardized immunohistochemical panel of B- and T-cell markers including EBER in situ hybridization as well as electron microscopy. Results In all cases, large histiocytes with granular cytoplasm compatible with intracellular aluminum hydroxide were present. EBER in situ hybridization revealed positive staining of these granular histiocytes while staining was absent in negative controls. Limitations Post hoc completion of medical history revealed that vaccination or specific immunotherapy had been applied before at the biopsy site in only three out of four patients; one patient was lost to follow-up. Conclusion EBER in situ hybridization is an adjunctive tool to differentiate aluminum-induced granuloma/lymphoid hyperplasia from other forms of pseudolymphoma and cutaneous B- or T-cell lymphomas. KW - RNA probe KW - aluminum granuloma KW - EBER in situ hybridization KW - lymphoid hyperplasia KW - pseudolymphoma Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-258405 VL - 48 IS - 5 ER - TY - JOUR A1 - Sbiera, Iuliu A1 - Kircher, Stefan A1 - Altieri, Barbara A1 - Lenz, Kerstin A1 - Hantel, Constanze A1 - Fassnacht, Martin A1 - Sbiera, Silviu A1 - Kroiss, Matthias T1 - Role of FGF Receptors and Their Pathways in Adrenocortical Tumors and Possible Therapeutic Implications JF - Frontiers in Endocrinology N2 - Adrenocortical carcinoma (ACC) is a rare endocrine malignancy and treatment of advanced disease is challenging. Clinical trials with multi-tyrosine kinase inhibitors in the past have yielded disappointing results. Here, we investigated fibroblast growth factor (FGF) receptors and their pathways in adrenocortical tumors as potential treatment targets. We performed real-time RT-PCR of 93 FGF pathway related genes in a cohort of 39 fresh frozen benign and malignant adrenocortical, 9 non-adrenal tissues and 4 cell lines. The expression of FGF receptors was validated in 166 formalin-fixed paraffin embedded (FFPE) tissues using RNA in situ hybridization (RNAscope) and correlated with clinical data. In malignant compared to benign adrenal tumors, we found significant differences in the expression of 16/94 FGF receptor pathway related genes. Genes involved in tissue differentiation and metastatic spread through epithelial to mesechymal transition were most strongly altered. The therapeutically targetable FGF receptors 1 and 4 were upregulated 4.6- and 6-fold, respectively, in malignant compared to benign adrenocortical tumors, which was confirmed by RNAscope in FFPE samples. High expression of FGFR1 and 4 was significantly associated with worse patient prognosis in univariate analysis. After multivariate adjustment for the known prognostic factors Ki-67 and ENSAT tumor stage, FGFR1 remained significantly associated with recurrence-free survival (HR=6.10, 95%CI: 1.78 – 20.86, p=0.004) and FGFR4 with overall survival (HR=3.23, 95%CI: 1.52 – 6.88, p=0.002). Collectively, our study supports a role of FGF pathways in malignant adrenocortical tumors. Quantification of FGF receptors may enable a stratification of ACC for the use of FGFR inhibitors in future clinical trials. KW - normal adrenal glands KW - adrenocortical tumors KW - FGF-pathway KW - FGFR KW - RNA Expression KW - RNAScope KW - unsupervised clustering KW - patient survival Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-251953 SN - 1664-2392 VL - 12 ER - TY - JOUR A1 - Prieto-Garcia, Cristian A1 - Tomašković, Ines A1 - Shah, Varun Jayeshkumar A1 - Dikic, Ivan A1 - Diefenbacher, Markus T1 - USP28: oncogene or tumor suppressor? a unifying paradigm for squamous cell carcinoma JF - Cells N2 - Squamous cell carcinomas are therapeutically challenging tumor entities. Low response rates to radiotherapy and chemotherapy are commonly observed in squamous patients and, accordingly, the mortality rate is relatively high compared to other tumor entities. Recently, targeting USP28 has been emerged as a potential alternative to improve the therapeutic response and clinical outcomes of squamous patients. USP28 is a catalytically active deubiquitinase that governs a plethora of biological processes, including cellular proliferation, DNA damage repair, apoptosis and oncogenesis. In squamous cell carcinoma, USP28 is strongly expressed and stabilizes the essential squamous transcription factor ΔNp63, together with important oncogenic factors, such as NOTCH1, c-MYC and c-JUN. It is presumed that USP28 is an oncoprotein; however, recent data suggest that the deubiquitinase also has an antineoplastic effect regulating important tumor suppressor proteins, such as p53 and CHK2. In this review, we discuss: (1) The emerging role of USP28 in cancer. (2) The complexity and mutational landscape of squamous tumors. (3) The genetic alterations and cellular pathways that determine the function of USP28 in squamous cancer. (4) The development and current state of novel USP28 inhibitors. KW - USP28 KW - SCC KW - USP25 KW - FBXW7 KW - Tp63 KW - c-MYC KW - ΔNp63 KW - p53 KW - cancer KW - DUB inhibitor KW - squamous Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-248409 SN - 2073-4409 VL - 10 IS - 10 ER - TY - JOUR A1 - Hrynevich, Andrei A1 - Achenbach, Pascal A1 - Jungst, Tomasz A1 - Brook, Gary A. A1 - Dalton, Paul D. T1 - Design of Suspended Melt Electrowritten Fiber Arrays for Schwann Cell Migration and Neurite Outgrowth JF - Macromolecular Bioscience N2 - In this study, well-defined, 3D arrays of air-suspended melt electrowritten fibers are made from medical grade poly(ɛ-caprolactone) (PCL). Low processing temperatures, lower voltages, lower ambient temperature, increased collector distance, and high collector speeds all aid to direct-write suspended fibers that can span gaps of several millimeters between support structures. Such processing parameters are quantitatively determined using a “wedge-design” melt electrowritten test frame to identify the conditions that increase the suspension probability of long-distance fibers. All the measured parameters impact the probability that a fiber is suspended over multimillimeter distances. The height of the suspended fibers can be controlled by a concurrently fabricated fiber wall and the 3D suspended PCL fiber arrays investigated with early post-natal mouse dorsal root ganglion explants. The resulting Schwann cell and neurite outgrowth extends substantial distances by 21 d, following the orientation of the suspended fibers and the supporting walls, often generating circular whorls of high density Schwann cells between the suspended fibers. This research provides a design perspective and the fundamental parametric basis for suspending individual melt electrowritten fibers into a form that facilitates cell culture. KW - cell migration KW - electrospinning KW - fibers KW - neurite growth KW - polycaprolactone KW - tissue engineering Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-257535 VL - 21 IS - 7 ER -