TY - THES A1 - Strehl, Marie-Annette T1 - Die Rolle der DNA-Methylierung in der Kontrolle des MHC-II-spezifischen Typ-IV-Promotors in Thymomen T1 - The Role Of DNA-Methylation In The Control Of The MHC II Specific Type IV Promotor In Thymoma N2 - Die Moleküle des „major histocompatibility complex“ (MHC) spielen in der thymischen T-Zell-Reifung eine zentrale Rolle. Durch Interaktion des T-Zell-Rezeptors auf der unreifen T-Zelle und den Co-Rezeptoren CD4 und CD8 mit dem MHC auf dem Thymusepithel werden die zwei wichtigsten Reifungs- und Selektionsprozesse, positive und negative Selektion, vermittelt. Störungen dieser Selektionsmechanismen können zu Immundefekten oder Autoimmunphänomenen führen. Die Regulierung der MHC IIExpression erfolgt hauptsächlich transkriptionell und wird vor allem durch den sogenannten Class II Transaktivator (CIITA) bestimmt. Die Transkription von CIITA wird über vier alternative, gewebsspezifische Promotoren durch alternatives splicing reguliert. Unter diesen Splicevarianten ist der CIITA Typ IV Promotor für die konstitutive MHC II-Expression in Thymusepithelzellen und für die IFN-g induzierte Expression in anderen Geweben verantwortlich. Thymome sind menschliche Tumoren des Thymusepithels, welche häufig mit einer paraneoplastischen Myasthenia gravis (MG) assoziiert sind. Die paraneoplastische MG zeigt eine starke positive Korrelation mit der Fähigkeit eines Thymoms, reife CD4+ T-Zellen zu produzieren und in das periphere Blut zu exportieren. Thymome weisen aus bislang ungeklärten Gründen häufig eine starke Reduktion der epithelialen MHC II- Expression auf. Ziel dieser Arbeit war die Beantwortung der Frage, ob eine DNA-Methylierung der Promotorregion des MHC-Klasse II Transaktivators (CIITA) Typ IV daran beteiligt ist. Hierzu wurden 27 Thymome mit sowohl hoher und als auch niedriger MHC II-Expression und 9 Normalthymi aus unterschiedlichen Altersgruppen untersucht. Die Ergebnisse zeigten, dass der CIITA Typ IV Promotor in kindlichen Kontrollthymi vollständig unmethyliert ist, während die Thymi erwachsener Kontrollpersonen eine vermehrte Methylierung aufweisen. Im Gegensatz dazu war der CIITA Typ IV in nahezu allen Thymomen stark hypermethyliert. Da aber kein signifikanter Unterschied in der Methylierung zwischen Thymomen mit hoher und solchen mit niedriger MHC II-Expression festgestellt werden konnte, lassen diese Ergebnisse vermuten, dass eine Hypermethylierung des CIITA Typ IV Promotors sehr wahrscheinlich nicht der alleinige Grund für die verminderte MHC II-Expression in Thymomen ist, sondern das auch andere Regulationsmechanismen wie zum Beispiel Histon-Acetylierung beteiligt sein könnten beteiligt sein könnten. N2 - The major histocompatibility complex (MHC) plays an important role in the development and maturation of T-cells in the human thymus. Interaction between the T-cell-receptor, the co-receptors CD4 and CD8 and the MHC-molecules on thymic epithelial cells account for the two most important selection mechanisms, positive and negative selection. Disturbances of these selection mechanisms can lead to immune defects or autoimmunity. The regulation of MHC-II expression is mainly transcriptional and is controlled by the class II transactivator (CIITA). The transcription of CIITA is regulated by four alternative and tissue specific promotors through alternative splicing. The CIITY type IV promotor is responsible for the the konstitutive MHC II expression in the thymic epithelium and for the IFN-gamma induced expression in other tissues. Thymomas are tumors of the human thymic epithelium and are often associated with paraneoplastic Myasthenia gravis (MG). Paraneoplastic MG shows a strong positive correlation with the ability of a thymoma to produce mature CD4+ T-cells and release them into the peripheral blood. Thymomas often show a strong reduction of the epithelial MHC II expression. The aim of this thesis was to analyze if DNA-methylation of the promotorregion of the MHC class II transactivator CIITA type IV is involved. 27 Thymomas with high and reduced MHC II expression were analyzed, as well as 9 normal thymi of different age groups. The results show that the CIITA type IV promotor is completely unmethylated in juvenile control thymi, while the thymi of adult controls show a low level of methylation. In contrast the CIITA typ IV in almost all thymomas was strongly hypermethylated. There was no significant difference between the level of methylation of thymomas with low MHC II expression and high expression, which leads to the conclusion that hypermethylation of CIITY type IV is not the only reason for the reduced MHC II expression in thymomas. Other regulating mechanisms like histone-acetylation could also play a role in the reduction of MHC II expression. KW - MHC KW - CIITA KW - Thymom KW - Myasthenia gravis KW - Methylierung KW - MHC KW - CIITA KW - Thymoma KW - Myasthenia gravis KW - Methylation Y1 - 2004 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-16183 ER - TY - JOUR A1 - Völker, Hans-Ullrich A1 - Weigel, Michael A1 - Strehl, Annette A1 - Frey, Lea T1 - Levels of uPA and PAI-1 in breast cancer and its correlation to Ki67-index and results of a 21-multigene-array JF - Diagnostic Pathology N2 - Background: Conventional parameters including Ki67, hormone receptor and Her2/neu status are used for risk stratification for breast cancer. The serine protease urokinase plasminogen activator (uPA) and the plasminogen activator inhibitor type-1 (PAI-1) play an important role in tumour invasion and metastasis. Increased concentrations in tumour tissue are associated with more aggressive potential of the disease. Multigene tests provide detailed insights into tumour biology by simultaneously testing several prognostically relevant genes. With OncotypeDX\(^{®}\), a panel of 21 genes is tested by means of quantitative real-time polymerase chain reaction. The purpose of this pilot study was to analyse whether a combination of Ki67 and uPA/PAI-1 supplies indications of the result of the multigene test. Methods: The results of Ki67, uPA/PAI-1 and OncotypeDX\(^{®}\) were analysed in 25 breast carcinomas (luminal type, pT1/2, max pN1a, G2). A statistical and descriptive analysis was performed. Results: With a proliferation index Ki67 of < 14%, the recurrence score (RS) from the multigene test was on average in the low risk range, with an intermediate RS usually resulting if Ki67 was > 14%. Not elevated values of uPA and PAI-1 showed a lower rate of proliferation (average 8.5%) than carcinomas with an increase of uPA and/or PAI-1 (average 13.9%); p = 0.054, Student’s t-test. When Ki67 was > 14% and uPA and/or PAI-1 was raised, an intermediate RS resulted. These differences were significant when compared to cases with Ki67 < 14% with non-raised uPA/PAI-1 (p < 0.03, Student’s t-test). Without taking into account the proliferative activity, an intermediate RS was also verifiable if both uPA and PAI-1 showed raised values. Conclusion: A combination of the values Ki67 and uPA/PAI-1 tended to depict the RS to be expected. From this it can be deduced that an appropriate analysis of this parameter combination may be undertaken before the multigene test in routine clinical practice. The increasing cost pressure makes it necessary to base the implementation of a multigene test on ancillary variables and to potentially leave it out if not required in the event of a certain constellation of results (Ki67 raised, uPA and PAI-1 raised). KW - breast cancer KW - OncotypeDX\(^{®}\) KW - uPA KW - multigene-array KW - PAI-1 Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-176960 VL - 13 IS - 67 ER -