TY - JOUR A1 - Tauscher, Sabine A1 - Nakagawa, Hitoshi A1 - Völker, Katharina A1 - Werner, Franziska A1 - Krebes, Lisa A1 - Potapenko, Tamara A1 - Doose, Sören A1 - Birkenfeld, Andreas L. A1 - Baba, Hideo A. A1 - Kuhn, Michaela T1 - β Cell-specific deletion of guanylyl cyclase A, the receptor for atrial natriuretic peptide, accelerates obesity-induced glucose intolerance in mice JF - Cardiovascular Diabetology N2 - Background: The cardiac hormones atrial (ANP) and B-type natriuretic peptides (BNP) moderate arterial blood pressure and improve energy metabolism as well as insulin sensitivity via their shared cGMP-producing guanylyl cyclase-A (GC-A) receptor. Obesity is associated with impaired NP/GC-A/cGMP signaling, which possibly contributes to the development of type 2 diabetes and its cardiometabolic complications. In vitro, synthetic ANP, via GC-A, stimulates glucose-dependent insulin release from cultured pancreatic islets and β-cell proliferation. However, the relevance for systemic glucose homeostasis in vivo is not known. To dissect whether the endogenous cardiac hormones modulate the secretory function and/or proliferation of β-cells under (patho)physiological conditions in vivo, here we generated a novel genetic mouse model with selective disruption of the GC-A receptor in β-cells. Methods: Mice with a floxed GC-A gene were bred to Rip-CreTG mice, thereby deleting GC-A selectively in β-cells (β GC-A KO). Weight gain, glucose tolerance, insulin sensitivity, and glucose-stimulated insulin secretion were monitored in normal diet (ND)- and high-fat diet (HFD)-fed mice. β-cell size and number were measured by immunofluorescence-based islet morphometry. Results: In vitro, the insulinotropic and proliferative actions of ANP were abolished in islets isolated from β GC-A KO mice. Concordantly, in vivo, infusion of BNP mildly enhanced baseline plasma insulin levels and glucose-induced insulin secretion in control mice. This effect of exogenous BNP was abolished in β GC-A KO mice, corroborating the efficient inactivation of the GC-A receptor in β-cells. Despite this under physiological, ND conditions, fasted and fed insulin levels, glucose-induced insulin secretion, glucose tolerance and β-cell morphology were similar in β GC-A KO mice and control littermates. However, HFD-fed β GC-A KO animals had accelerated glucose intolerance and diminished adaptative β-cell proliferation. Conclusions: Our studies of β GC-A KO mice demonstrate that the cardiac hormones ANP and BNP do not modulate β-cell's growth and secretory functions under physiological, normal dietary conditions. However, endogenous NP/GC-A signaling improves the initial adaptative response of β-cells to HFD-induced obesity. Impaired β-cell NP/GC-A signaling in obese individuals might contribute to the development of type 2 diabetes. KW - cylic GMP KW - guanylyl cyclase-A KW - insulin KW - natriuretic peptides KW - obesity KW - β-cells Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-176322 VL - 17 IS - 103 ER - TY - JOUR A1 - Werner, Katharina A1 - Schwede, Frank A1 - Genieser, Hans-Gottfried A1 - Geiger, Jörg A1 - Butt, Elke T1 - Quantification of cAMP and cGMP analogs in intact cells: pitfalls in enzyme immunoassays for cyclic nucleotides JF - Naunyn-Schmiedeberg's Archives of Pharmacology N2 - Immunoassays are routinely used as research tools to measure intracellular cAMP and cGMP concentrations. Ideally, this application requires antibodies with high sensitivity and specificity. The present work evaluates the cross-reactivity of commercially available cyclic nucleotide analogs with two non-radioactive and one radioactive cAMP and cGMP immunoassay. Most of the tested cyclic nucleotide analogs showed low degree competition with the antibodies; however, with Rp-cAMPS, 8-Br-cGMP and 8-pCPT-cGMP, a strong cross-reactivity with the corresponding cAMP and cGMP, respectively, immunoassays was observed. The determined EIA-binding constants enabled the measurement of the intracellular cyclic nucleotide concentrations and revealed a time- and lipophilicity-dependent cell membrane permeability of the compounds in the range of 10–30% of the extracellular applied concentration, thus allowing a more accurate prediction of the intracellular analog levels in a given experiment. KW - Cyclic nucleotides KW - Enzyme immunoassay KW - Lipophilicity KW - Cell permeability Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-141828 VL - 384 IS - 2 ER - TY - JOUR A1 - Werner, Rudolf A. A1 - Beykan, Seval A1 - Higuchi, Takahiro A1 - Lückerath, Katharina A1 - Weich, Alexander A1 - Scheurlen, Michael A1 - Bluemel, Christina A1 - Herrmann, Ken A1 - Buck, Andreas K. A1 - Lassmann, Michael A1 - Lapa, Constantin A1 - Hänscheid, Heribert T1 - The impact of \(^{177}\)Lu-octreotide therapy on \(^{99m}\)Tc-MAG3 clearance is not predictive for late nephropathy JF - Oncotarget N2 - Peptide Receptor Radionuclide Therapy (PRRT) for the treatment of neuroendocrine tumors may lead to kidney deterioration. This study aimed to evaluate the suitability of \(^{99m}\)Tc-mercaptoacetyltriglycine (\(^{99m}\)Tc-MAG3) clearance for the early detection of PRRT-induced changes on tubular extraction (TE). TE rate (TER) was measured prior to 128 PRRT cycles (7.6±0.4 GBq \(^{177}\)Lu-octreotate/octreotide each) in 32 patients. TER reduction during PRRT was corrected for age-related decrease and analyzed for the potential to predict loss of glomerular filtration (GF). The GF rate (GFR) as measure for renal function was derived from serum creatinine. The mean TER was 234 ± 53 ml/min/1.73 m² before PRRT (baseline) and 221 ± 45 ml/min/1.73 m² after a median follow-up of 370 days. The age-corrected decrease (mean: -3%, range: -27% to +19%) did not reach significance (p=0.09) but significantly correlated with the baseline TER (Spearman p=-0.62, p<0.001). Patients with low baseline TER showed an improved TER after PRRT, high decreases were only observed in individuals with high baseline TER. Pre-therapeutic TER data were inferior to plasma creatinine-derived GFR estimates in predicting late nephropathy. TER assessed by \(^{99m}\)Tc-MAG3­clearance prior to and during PRRT is not suitable as early predictor of renal injury and an increased risk for late nephropathy. KW - renal scintigraphy KW - neuroendocrine tumor KW - 177Lu KW - MAG3 KW - PRRT Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-177318 VL - 7 IS - 27 ER - TY - JOUR A1 - Heisig, Martin A1 - Frentzen, Alexa A1 - Bergmann, Birgit A1 - Gentschev, Katharina Ivaylo A1 - Hotz, Christian A1 - Schoen, Christoph A1 - Stritzker, Jochen A1 - Fensterle, Joachim A1 - Rapp, Ulf R. A1 - Goebel, Werner T1 - Specific antibody-receptor interactions trigger InlAB-independent uptake of Listeria monocytogenes into tumor cell lines N2 - Background: Specific cell targeting is an important, yet unsolved problem in bacteria-based therapeutic applications, like tumor or gene therapy. Here, we describe the construction of a novel, internalin A and B (InlAB)-deficient Listeria monocytogenes strain (Lm-spa+), which expresses protein A of Staphylococcus aureus (SPA) and anchors SPA in the correct orientation on the bacterial cell surface. Results: This listerial strain efficiently binds antibodies allowing specific interaction of the bacterium with the target recognized by the antibody. Binding of Trastuzumab (Herceptin®) or Cetuximab (Erbitux®) to Lm-spa+, two clinically approved monoclonal antibodies directed against HER2/neu and EGFR/HER1, respectively, triggers InlABindependent internalization into non-phagocytic cancer cell lines overexpressing the respective receptors. Internalization, subsequent escape into the host cell cytosol and intracellular replication of these bacteria are as efficient as of the corresponding InlAB-positive, SPA-negative parental strain. This specific antibody/receptormediated internalization of Lm-spa+ is shown in the murine 4T1 tumor cell line, the isogenic 4T1-HER2 cell line as well as the human cancer cell lines SK-BR-3 and SK-OV-3. Importantly, this targeting approach is applicable in a xenograft mouse tumor model after crosslinking the antibody to SPA on the listerial cell surface. Conclusions: Binding of receptor-specific antibodies to SPA-expressing L. monocytogenes may represent a promising approach to target L. monocytogenes to host cells expressing specific receptors triggering internalization. KW - Listeria monocytogenes Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68705 ER - TY - JOUR A1 - Lapa, Constantin A1 - Werner, Rudolf A. A1 - Bluemel, Christina A1 - Lueckerath, Katharina A1 - Muegge, Dirk O. A1 - Strate, Alexander A1 - Haenscheid, Heribert A1 - Schirbel, Andreas A1 - Allen-Auerbach, Martin S. A1 - Bundschuh, Ralph A. A1 - Buck, Andreas K. A1 - Herrmann, Ken T1 - Prediction of clinically relevant hyperkalemia in patients treated with peptide receptor radionuclide therapy JF - EJNMMI Research N2 - Background Peptide receptor radionuclide therapy (PRRT) is applied in patients with advanced neuroendocrine tumors. Co-infused amino acids (AA) should prevent nephrotoxicity. The aims of this study were to correlate the incidence of AA-induced hyperkalemia (HK) (≥5.0 mmol/l) and to identify predictors of AA-induced severe HK (>6.0). Methods In 38 patients, standard activity of \(^{177}Lu\)-labelled somatostatin analogs was administered. Pre-therapeutic kidney function was assessed by renal scintigraphy and laboratory tests. For kidney protection, AA was co-infused. Biochemical parameters (potassium, glomerular filtration rate, creatinine, blood urea nitrogen (BUN), sodium, phosphate, chloride, and lactate dehydrogenase (LDH)) were obtained prior to 4 and 24 h after the AA infusion. Incidence of HK (≥5.0) was correlated with pre-therapeutic kidney function and serum parameters. Formulas for the prediction of severe hyperkalemia (>6.0) were computed and prospectively validated. Results At 4 h, HK (≥5.0) was present in 94.7% with severe HK (>6.0) in 36.1%. Values normalized after 24 h in 84.2%. Pre-therapeutic kidney function did not correlate with the incidence of severe HK. Increases in K+ were significantly correlated with decreases in phosphate (r = −0.444, p < 0.005) and increases in BUN (r = 0.313, p = 0.056). A baseline BUN of >28 mg/dl had a sensitivity of 84.6% and a specificity of 60.0% (AUC = 0.75) in predicting severe HK of >6.0 (phosphate, AUC = 0.37). Computing of five standard serum parameters (potassium, BUN, sodium, phosphate, LDH) resulted in a sensitivity of 88.9% and a specificity of 79.3% for the prediction of severe HK >6.0 (accuracy = 81.6%). Conclusions A combination of serum parameters predicted prospectively the occurrence of relevant HK with an accuracy of 81.6% underlining its potential utility for identifying ‘high-risk’ patients prone to PRRT. KW - amino acids KW - kidney function KW - hyperkalemia KW - PRRT KW - NET KW - MAG3 Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-124963 VL - 4 IS - 74 ER - TY - JOUR A1 - Schwarz, Tobias A1 - Remer, Katharina A. A1 - Nahrendorf, Wiebke A1 - Masic, Anita A1 - Siewe, Lisa A1 - Müller, Werner A1 - Roers, Axel A1 - Moll, Heidrun T1 - T Cell-Derived IL-10 Determines Leishmaniasis Disease Outcome and Is Suppressed by a Dendritic Cell Based Vaccine JF - PLoS Pathogens N2 - Abstract In the murine model of Leishmania major infection, resistance or susceptibility to the parasite has been associated with the development of a Th1 or Th2 type of immune response. Recently, however, the immunosuppressive effects of IL-10 have been ascribed a crucial role in the development of the different clinical correlates of Leishmania infection in humans. Since T cells and professional APC are important cellular sources of IL-10, we compared leishmaniasis disease progression in T cell-specific, macrophage/neutrophil-specific and complete IL-10-deficient C57BL/6 as well as T cell-specific and complete IL-10-deficient BALB/c mice. As early as two weeks after infection of these mice with L. major, T cell-specific and complete IL-10-deficient animals showed significantly increased lesion development accompanied by a markedly elevated secretion of IFN-γ or IFN-γ and IL-4 in the lymph nodes draining the lesions of the C57BL/6 or BALB/c mutants, respectively. In contrast, macrophage/neutrophil-specific IL-10-deficient C57BL/6 mice did not show any altered phenotype. During the further course of disease, the T cell-specific as well as the complete IL-10-deficient BALB/c mice were able to control the infection. Furthermore, a dendritic cell-based vaccination against leishmaniasis efficiently suppresses the early secretion of IL-10, thus contributing to the control of parasite spread. Taken together, IL-10 secretion by T cells has an influence on immune activation early after infection and is sufficient to render BALB/c mice susceptible to an uncontrolled Leishmania major infection. Author Summary The clinical symptoms caused by infections with Leishmania parasites range from self-healing cutaneous to uncontrolled visceral disease and depend not only on the parasite species but also on the type of the host's immune response. It is estimated that 350 million people worldwide are at risk, with a global incidence of 1–1.5 million cases of cutaneous and 500,000 cases of visceral leishmaniasis. Murine leishmaniasis is the best-characterized model to elucidate the mechanisms underlying resistance or susceptibility to Leishmania major parasites in vivo. Using T cell-specific and macrophage-specific mutant mice, we demonstrate that abrogating the secretion of the immunosuppressive cytokine IL-10 by T cells is sufficient to render otherwise susceptible mice resistant to an infection with the pathogen. The healing phenotype is accompanied by an elevated specific inflammatory immune response very early after infection. We further show that dendritic cell-based vaccination against leishmaniasis suppresses the early secretion of IL-10 following challenge infection. Thus, our study unravels a molecular mechanism critical for host immune defense, aiding in the development of an effective vaccine against leishmaniasis. KW - cytokines KW - mouse models KW - T cells KW - lymph nodes KW - leishmania major KW - secretion KW - parasitic diseases KW - immune response Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-130385 VL - 9 IS - 6 ER - TY - JOUR A1 - Werner, Rudolf A. A1 - Lapa, Constantin A1 - Bluemel, Christina A1 - Lückerath, Katharina A1 - Schirbel, Andreas A1 - Strate, Alexander A1 - Buck, Andreas K. A1 - Herrmann, Ken T1 - Influence of the amount of co-infused amino acids on post-therapeutic potassium levels in peptide receptor radionuclide therapy N2 - Background Peptide receptor radionuclide therapy (PRRT) is routinely used for advanced or metastasized neuroendocrine tumours (NET). To prevent nephrotoxicity, positively charged amino acids (AA) are co-infused. The aim of this study was to correlate the risk for therapy-related hyperkalaemia with the total amount of AA infused. Methods Twenty-two patients undergoing PRRT with standard activities of 177Lu-DOTATATE/-TOC were monitored during two following treatment cycles with co-infusion of 75 and 50 g of AA (L-arginine and L-lysine), respectively. Mean serum levels of potassium and other parameters (glomerular filtration rate [GFR], creatinine, blood urea nitrogen [BUN], phosphate, chloride, lactate dehydrogenase) prior to, 4 h and 24 h after AA infusion were compared. Results Self-limiting hyperkalaemia (>5.0 mmol/l) resolving after 24 h occurred in 91% (20/22) of patients in both protocols. Potassium levels, BUN, creatinine, GFR, phosphate, chloride and LDH showed a similar range at 4 h after co-infusion of 75 or 50 g of AA, respectively (p > 0.05). Only GFR and creatinine levels at 24 h varied significantly between the two co-infusion protocols (p < 0.05). Conclusions Hyperkalaemia is a frequent side effect of AA infusion in PRRT. Varying the dose of co-infused amino acids did not impact on the incidence and severity of hyperkalaemia. KW - NET KW - PRRT KW - Hyperkalaemia KW - Arginine KW - Lysine Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-110617 ER - TY - THES A1 - Werner, Katharina Julia T1 - Adipose Tissue Engineering - In vitro Development of a subcutaneous fat layer and a vascularized adipose tissue construct utilizing extracellular matrix structures T1 - Fettgewebe Engineering - In vitro Entwicklung einer subkutanen Fettschicht und eines vaskularisierten Fettgewebskonstruktes unter Verwendung extrazellulärer Matrixstrukturen N2 - Each year millions of plastic and reconstructive procedures are performed to regenerate soft tissue defects after, for example, traumata, deep burns or tumor resections. Tissue engineered adipose tissue grafts are a promising alternative to autologous fat transfer or synthetic implants to meet this demand for adipose tissue. Strategies of tissue engineering, especially the use of cell carriers, provide an environment for better cell survival, an easier positioning and supplemented with the appropriate conditions a faster vascularization in vivo. To successfully engineer an adipose tissue substitute for clinical use, it is crucial to know the actual intended application. In some areas, like the upper and lower extremities, only a thin subcutaneous fat layer is needed and in others, large volumes of vascularized fat grafts are more desirable. The use and interplay of stem cells and selected scaffolds were investigated and provide now a basis for the generation of fitted and suitable substitutes in two different application areas. Complex injuries of the upper and lower extremities, in many cases, lead to excessive scarring. Due to severe damage to the subcutaneous fat layer, a common sequela is adhesion formation to mobile structures like tendons, nerves, and blood vessels resulting in restricted motion and disabling pain [Moor 1996, McHugh 1997]. In order to generate a subcutaneous fat layer to cushion scarred tissue after substantial burns or injuries, different collagen matrices were tested for clinical handling and the ability to support adipogenesis. When testing five different collagen matrices, PermacolTM and StratticeTM showed promising characteristics; additionally both possess the clinical approval. Under culture conditions, only PermacolTM, a cross-linked collagen matrix, exhibited an excellent long-term stability. Ranking nearly on the same level was StratticeTM, a non-cross-linked dermal scaffold; it only exhibited a slight shrinkage. All other scaffolds tested were severely compromised in stability under culture conditions. Engineering a subcutaneous fat layer, a construct would be desirable with a thin layer of emerging fat for cushioning on one side, and a non-seeded other side for cell migration and host integration. With PermacolTM and StratticeTM, it was possible to produce constructs with ASC (adipose derived stem cells) seeded on one side, which could be adipogenically differentiated. Additionally, the thickness of the cell layer could be varied. Thereby, it becomes possible to adjust the thickness of the construct to the surrounding tissue. In order to reduce the pre-implantation time ex vivo and the costs, the culture time was varied by testing different induction protocols. An adipogenic induction period of only four days was demonstrated to be sufficient to obtain a substantial adipogenic differentiation of the applied ASC. Thus, seeded with ASC, PermacolTM and StratticeTM are suitable scaffolds to engineer subcutaneous fat layers for reconstruction of the upper and lower extremities, as they support adipogenesis and are appropriately thin, and therefore would not compromise the cosmesis. For the engineering of large-volume adipose tissue, adequate vascularization still represents a major challenge. With the objective to engineer vascularized fat pads, it is important to consider the slow kinetics of revascularization in vivo. Therefore, a decellularized porcine jejunum with pre-existing vascular structures and pedicles to connect to the host vasculature or the circulation of a bioreactor system was used. In a first step, the ability of a small decellularized jejunal section was tested for cell adhesion and for supporting adipogenic differentiation of hASC mono-cultures. Cell adhesion and adipogenic maturation of ASC seeded on the jejunal material was verified through histological and molecular analysis. After the successful mono-culture, the goal was to establish a MVEC (microvascular endothelial cells) and ASC co-culture; suitable culture conditions had to be found, which support the viability of both cell types and do not interfere with the adipogenic differentiation. After the elimination of EGF (epidermal growth factor) from the co-culture medium, substantial adipogenic maturation was observed. In the next step, a large jejunal segment (length 8 cm), with its pre-existing vascular structures and arterial/venous pedicles, was connected to the supply system of a custom-made bioreactor. After successful reseeding the vascular structure with endothelial cells, the lumen was seeded with ASC which were then adipogenically induced. Histological and molecular examinations confirmed adipogenic maturation and the existence of seeded vessels within the engineered construct. Noteworthily, a co-localization of adipogenically differentiating ASC and endothelial cells in vascular networks could be observed. So, for the first time a vascularized fat construct was developed in vitro, based on the use of a decellularized porcine jejunum. As this engineered construct can be connected to a supply system or even to a patient vasculature, it is versatile in use, for example, as transplant in plastic and reconstruction surgery, as model in basic research or as an in vitro drug testing system. To summarize, in this work a promising substitute for subcutaneous fat layer reconstruction, in the upper and lower extremities, was developed, and the first, as far as reported, in vitro generated adipose tissue construct with integrated vascular networks was successfully engineered. N2 - Jedes Jahr werden Millionen von plastischen und wiederherstellenden Eingriffe durchgeführt, um zum Beispiel nach Traumata, hochgradigen Verbrennungen oder Tumorekonstruktionen, die natürliche Erscheinung und Funktion im Bereich von Weichgewebsdefekt wiederherzustellen. Gezüchtete Fettgewebskonstrukte sind eine vielversprechende Alternative zu autologen Fettgewebstransfers oder synthetischen Implantaten, um dem Bedarf an Fettgewebe gerecht zu werden. Die Strategien der Gewebezüchtung, besonders das Verwenden von Zellträgern, schaffen eine Umgebung für besseres Zellüberleben, eine einfachere Positionierung und - versehen mit den entsprechenden Eigenschaften - eine schnellere Vaskularisierung in vivo. Um erfolgreich einen Fettgewebe-Ersatz für die klinische Anwendung herzustellen, ist es notwendig das spätere Anwendungsgebiet zu kennen. In manchen Bereichen, wie in den oberen und unteren Extremitäten, braucht man nur eine dünne Unterhautfettschicht, und in anderen Bereichen wiederum ist ein großes Volumen an vaskularisiertem Fettgewebskonstrukt anzustreben. Die Nutzung und das Zusammenspiel von Stammzellen und ausgewählten Zellträgern wurden untersucht und legen nun eine Basis für die Herstellung von passendem und zweckmäßigem Ersatzgewebe zweier unterschiedlicher Anwendungsgebiete. Komplexe Verletzungen der oberen und unteren Extremitäten führen oftmals zu beträchtlicher Narbenbildung. Eine häufige Folgeerscheinung, hervorgerufen durch eine schwere Beschädigung des Unterhautfettgewebes, ist die Adhäsion zwischen mobilen Strukturen wie Sehnen, Nerven und Blutgefäßen. Dies resultiert dann in eingeschränkter Beweglichkeit und lähmenden Schmerzen [Moor 1996, McHugh 1997]. Um eine subkutane Fettschicht herzustellen, die das vernarbte Gewebe nach schwerer Verbrennung oder Verletzung polstert, wurden verschiedene Kollagenmaterialien auf die klinische Handhabung und die Unterstützung der Adipogenese untersucht. In der Untersuchung von fünf verschiedenen Kollagenmatrices zeigten PermacolTM und StratticeTM vielversprechende Eigenschaften. Beide besitzen außerdem die klinische Zulassung. PermacolTM, eine chemisch quervernetzte Kollagenmatrix, zeigte unter Kulturbedingungen hervorragende Langzeitstabilität. Fast ebenso gute Eigenschaften konnten bei StratticeTM, einem nicht vernetzten dermalen Gerüstmaterial, beobachtet werden; es zeigte lediglich leichte Schrumpfung. Alle sonst getesteten Kollagenmaterialien waren unter Kulturbedingungen stark in ihrer Stabilität beeinträchtigt. Zur Herstellung einer subkutanen Fettschicht wäre ein Konstrukt wünschenswert mit einer dünnen, gerade entstehenden Fettschicht für die Polsterung auf der einen Seite und einer nicht besiedelten anderen Seite für die Zelleinwanderung und die Integration in das umliegende Gewebe. Mit PermacolTM und StratticeTM war es möglich Konstrukte herzustellen, welche auf einer Seite mit ASC (aus dem Fettgewebe isolierte Stammzellen) besiedelt und anschließend adipogen differenziert werden konnten. Zusätzlich konnte die Dicke der Zellschicht hierbei variiert werden. Somit ist es möglich die Dicke des Konstruktes an das umliegende Gewebe anzupassen. Um die Preimplantationszeit ex vivo zu verkürzen und damit auch die Kosten zu senken, wurde die Kulturzeit variiert, indem verschiedene Induktionsprotokolle getestet wurden. Eine adipogene Induktionsperiode von nur vier Tagen erwies sich als ausreichend, um eine substantielle adipogene Differenzierung der eingesetzten ASC zu erreichen. Das heißt, die mit ASC besiedelten PermacolTM und StratticeTM Matrices sind zweckdienliche Zellträgermaterialien, um eine subkutane Fettschicht für die oberen und unteren Extremitäten herzustellen, da sie die Adipogenese unterstützen und durch die nur geringe und anpassbare Dicke die Kosmesis nicht beeinträchtigen. Für die Entwicklung von großvolumigem Fettgewebe stellt die adäquate Vaskularisierung noch immer eine große Herausforderung dar. Mit dem Ziel ein vaskularisiertes Fettkonstrukt herzustellen, ist es wichtig die langsame Kinetik der Revaskularisierung in vivo zu berücksichtigen. Daher wurde hier ein dezellularisiertes Schweinedarmsegment mit schon vorhandenen Gefäßstrukturen und Gefäßanschlüssen für die Verbindung zum Kreislaufsystem des Patienten oder eines Bioreaktor-Systems verwendet. Im ersten Schritt wurden auf einem kleinen dezellularisierten Schweinedarm-Stück die Zelladhäsion und die adipogene Differenzierung der ASC in Monokultur getestet. Die Zelladhäsion und die adipogene Reifung konnte mittels histologischer und molekularer Analysen auf dem jejunalen Material nachgewiesen werden. Nach der erfolgreichen Monokultur musste die Co-Kultur von MVEC (micro vaskuläre Endothelzellen) und ASC etabliert werden. Um dieses Ziel zu erreichen, wurden geeignete Kulturbedingungen gesucht, die die Lebensfähigkeit beider Zelltypen unterstützen und gleichzeitig die adipogene Differenzierung nicht beeinträchtigen. Nach dem Ausschluss von EGF (epidermaler Wachstumsfaktor) aus dem Co-Kulturmedium wurde eine substantielle adipogene Reifung der ASC beobachtet. Im nächsten Schritt wurde ein großes dezellularisiertes jejunales Darmsegment (Länge 8 cm) mit der schon existenten Gefäßstruktur und dem arteriellen und venösen Gefäßstiel an den spezialangefertigten Bioreaktor angeschlossen. Nach der erfolgreichen Wiederbesiedelung der Gefäßstrukturen mit Endothelzellen wurde das Darmlumen mit ASC besiedelt, welche anschließend adipogen induziert wurden. Histologische und molekulare Untersuchungen konnten die adipogenen Reifung und die Existenz von besiedelten Gefäßen im hergestellten Konstrukt bestätigen. Besonders erwähnenswert ist die Beobachtung der Co-Lokalisierung von adipogen differenzierenden ASC und Endothelzellen in vasculären Netzwerken. Somit wurde zum ersten Mal - basierend auf einem dezellularisierten Schweinedarm - ein vaskularisiertes Fettgewebskonstrukt in vitro hergestellt. Da dieses Konstrukt an das Versorgungssystem angeschlossen oder mit dem Blutkreislauf des Patienten verbunden werden kann, ist es vielfältig einsetzbar, zum Beispiel in der plastisch-rekonstruktiven Chirurgie, als Modell in der Grundlagenforschung oder als ein in vitro Medikamenten-Testsystem. Zusammengefasst, wurde in der vorgelegten Arbeit ein vielversprechendes Ersatzmaterial für die Rekonstruktion des Unterhautfettgewebes für die unteren und oberen Extremitäten entwickelt, und zum ersten Mal erfolgreich, so weit in der Literatur bekannt, ein Fettgewebskonstrukt mit integriertem vaskularisiertem Netzwerk in vitro generiert. KW - Tissue Engineering KW - Fettgewebe KW - Extrazelluläre Matrix KW - Vascularisation KW - adipose tissue engineering KW - subcutaneous fat layer KW - scar revision surgery KW - vascularized fat construct KW - Bioreactor System KW - extracellular matrix KW - adipose tissue Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-104676 ER - TY - JOUR A1 - Hartrampf, Philipp E. A1 - Weinzierl, Franz-Xaver A1 - Seitz, Anna Katharina A1 - Kübler, Hubert A1 - Essler, Markus A1 - Buck, Andreas K. A1 - Werner, Rudolf A. A1 - Bundschuh, Ralph A. T1 - Any decline in prostate-specific antigen levels identifies survivors scheduled for prostate-specific membrane antigen-directed radioligand therapy JF - The Prostate N2 - Background Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) is increasingly incorporated in the therapeutic algorithm of patients with metastatic castration-resistant prostate cancer (mCRPC). We aimed to elucidate the predictive performance of early biochemical response for overall survival (OS). Materials and Methods In this bicentric analysis, we included 184 mCRPC patients treated with \(^{177}\)Lu-PSMA RLT. Response to treatment was defined as decrease in prostate-specific antigen (PSA) levels 8 weeks after the first cycle of RLT (any decline or >50% according to Prostate Cancer Working Group 3). OS of responders and nonresponders was then compared using Kaplan–Meier curves and log-rank comparison. Results A total of 114/184 patients (62.0%) showed any PSA decline (PSA response >50%, 55/184 [29.9%]). For individuals exhibiting a PSA decline >50%, OS of 19 months was significantly longer relative to nonresponders (13 months; hazard ratio of death [HR] = 0.64, 95% confidence interval [95% CI] = 0.44–0.93; p = 0.02). However, the difference was even more pronounced for any PSA decline, with an OS of 19 months in responders, but only 8 months in nonresponders (HR = 0.39, 95% CI = 0.25–0.60; p < 0.001). Conclusions In mCRPC patients scheduled for RLT, early biochemical response was tightly linked to prolonged survival, irrespective of the magnitude of PSA decline. As such, even in patients with PSA decrease of less than 50%, RLT should be continued. KW - prostate cancer KW - theranostics KW - PSMA‐617 KW - PSA response KW - PSMA I&T Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318766 VL - 82 IS - 14 SP - 1406 EP - 1412 ER - TY - JOUR A1 - Lapa, Constantin A1 - Herrmann, Ken A1 - Schirbel, Andreas A1 - Hänscheid, Heribert A1 - Lückerath, Katharina A1 - Schottelius, Margret A1 - Kircher, Malte A1 - Werner, Rudolf A. A1 - Schreder, Martin A1 - Samnick, Samuel A1 - Kropf, Saskia A1 - Knop, Stefan A1 - Buck, Andreas K. A1 - Einsele, Hermann A1 - Wester, Hans-Juergen A1 - Kortüm, K. Martin T1 - CXCR4-directed endoradiotherapy induces high response rates in extramedullary relapsed multiple myeloma JF - Theranostics N2 - C-X-C-motif chemokine receptor 4 (CXCR4) is a key factor for tumor growth and metastasis in several types of human cancer. We have recently reported promising first-in-man experience with CXCR4-directed endoradiotherapy (ERT) in multiple myeloma (MM). Eight heavily pretreated MM patients underwent a total of 10 ERT cycles (7 patients with 1 cycle and a single patient with 3 cycles). ERT was administered in combination with chemotherapy and autologous stem cell support. End points were occurrence and timing of adverse events, progression-free and overall survival. ERT was overall well tolerated without any unexpected acute adverse events or changes in vital signs. With absorbed tumor doses >30-70 Gy in intra- or extramedullary lesions, significant anti-myeloma activity was observed with 1 patient achieving complete remission and 5/8 partial remission. Directly after ERT major infectious complications were seen in one patient who died from sepsis 22 days after ERT, another patient with high tumor burden experienced lethal tumor lysis syndrome. Median progression-free survival was 54 days (range, 13-175), median overall survival was 223 days (range, 13-313). During follow-up (6 patients available), one patient died from infectious complications, 2/8 from disease progression, the remaining 3/8 patients are still alive. CXCR4-directed ERT was well-tolerated and exerted anti-myeloma activity even at very advanced stage MM with presence of extramedullary disease. Further assessment of this novel treatment option is highly warranted. KW - medicine KW - multiple myeloma KW - PET KW - CXCR4 KW - theranostics Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-172095 VL - 7 IS - 6 ER -