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Sonstige beteiligte Institutionen
Plant-derived natural products and their analogs continue to play an important role in the discovery of new drugs for the treatment of human diseases. Potentially promising representatives of secondary metabolites are the naphthylisoquinoline alkaloids, which show a broad range of activities against protozoan pathogens, such as plasmodia, leishmania, and trypanosoma. Due to the increasing resistance of those pathogens against current therapies, highly potent novel agents are still urgently needed. Thus, it is worthy to discover new naphthylisoquinoline alkaloids hopefully with pronounced bioactivities by isolation from plants or by synthesis. The naphthylisoquinoline alkaloids are biosynthetically related to another class of plant-derived products, the naphthoquinones, some of which have been recently found to display excellent anti-multiple myeloma activities without showing any cytotoxicities on normal blood cells. Multiple myeloma still remains incurable, although remissions may be induced with co-opted therapeutic treatments. Therefore, more potent naphthoquinones are urgently required, and can be obtained by isolation from plants or by synthesis. In detail, the results in this thesis are listed as follows: 1) Isolation and characterization of naphthylisoquinoline alkaloids from the stems of a Chinese Ancistrocladus tectorius species. Nine new naphthylisoquinoline alkaloids, named ancistectorine A1 (60), N-methylancistectorine A1 (61), ancistectorine A2 (62a), 5-epi-ancistectorine A2 (62b), 4'-O-demethylancistectorine A2 (63), ancistectorine A3 (64), ancistectorine B1 (65), ancistectorine C1 (66), and 5-epi-ancistrolikokine D (67) were isolated from the Chinese A. tectorius and fully characterized by chemical, spectroscopic, and chiroptical methods. Furthermore, the in vitro anti-infectious activities of 60-62 and 63-66 have been tested. Three of the metabolites, 61, 62a, and 62b, exhibited strong antiplasmodial activities against the strain K1 of P. falciparum without showing significant cytotoxicities. With IC50 values of 0.08, 0.07, and 0.03 μM, respectively, they were 37 times more active than the standard chloroquine (IC50 = 0.26 μM). Moreover, these three compounds displayed high antiplasmodial selectivity indexes ranging from 100 to 3300. According to the TDR/WHO guidelines, they could be considered as lead compounds. In addition, seven alkaloids, 69-74 (structures not shown here), were isolated from A. tectorius that were known, but new to the plant, together with another fourteen known compounds (of these, only the structures of the three main alkaloids, 5a, 5b, and 78 are shown here), which had been previously found in the plant. The three metabolites ancistrocladine (5a), hamatine (5b), and (+)-ancistrocline (78) were found to show no or moderate activities against the MM cell lines. 2) Isolation and characterization of naphthylisoquinoline alkaloids from the root bark of a new, botanically yet undescribed Congolese Ancistrocladus species. An unprecedented dimeric Dioncophyllaceae-type naphthylisoquinoline alkaloid, jozimine A2 (84), as first recognized by G. Bauckmann from an as yet undescribed Ancistrocladus species, was purified and characterized as part of this thesis. Its full structural assignment was achieved by spectroscopic and chiroptical methods, and further confirmed by an X-ray diffraction analysis, which had never succeeded for any other dimeric naphthylisoquinoline alkaloids before. Structurally, the dimer is composed of two identical 4'-O-demethyldioncophylline A halves, coupled through a sterically hindered central axis at C-3',3'' of the two naphthalene moieties. Pharmacologically, jozimine A2 (84) showed an extraordinary antiplasmodial activity (IC50 = 1.4 nM) against the strain NF54 of P. falciparum. Beside jozimine A2 (85), another new alkaloid, 6-O-demethylancistrobrevine C (84), and four known ones, ancistrocladine (5a), hamatine (5b), ancistrobrevine C (86), and dioncophylline A (6) were isolated from the Ancistrocladus species, the latter in a large quantity (~500 mg), showing that the plant produces Ancistrocladaceae-type, mixed-Ancistrocladaceae/Dioncophyllaceae-type, and Dioncophyllaceae-type naphthyl- isoquinoline alkaloids. Remarkably, it is one of the very few plants, like A. abbreviatus, and A. barteri, that simultaneously contain typical representatives of all the above three classes of alkaloids. 3) Semi-synthesis of jozimine A2 (85), 3'-epi-85, jozimine A3 (93) and other alkaloids from dioncophylline A (6). The dimeric naphthylisoquinoline alkaloids, jozimine A2 (85) and 3'-epi-85, constitute rewarding synthetic targets for a comparative analysis of their antiplasmodial activities and for a further confirmation of the assigned absolute configurations of the isolated natural product of 85. They were semi-synthesized in a four-step reaction sequence from dioncophylline A (6) in cooperation with T. Büttner. The key step was a biomimetic phenol-oxidative dimerization at C-3' of the N,O-dibenzylated derivative of 89 by utilizing Pb(OAc)4. This is the first time that the synthesis of such an extremely sterically hindered (four ortho-substituents) naphthylisoquinoline alkaloid – with three consecutive biaryl axes! – has been successfully achieved. A novel dimeric naphthylisoquinoline, jozimine A3 (93), bearing a 6',6''-central biaryl axis, was semi-synthesized from 5'-O-demethyldioncophylline A (90) by a similar biomimetic phenol-oxidative coupling reaction as a key step, by employing Ag2O. HPLC analysis with synthetic reference material of 3'-epi-85 and 93 for co-elution revealed that these two alkaloids clearly are not present in the crude extract of the Ancistrocladus species from which jozimine A2 (85) was isolated. This evidences that jozimine A2 (85) is very specifically biosynthesized by the plant with a high regio- and stereoslectivity. Remarkably, the two synthetic novel dimeric naphthylisoquinoline alkaloids 3'-epi-85 and 93 were found to display very good antiplasmodial activities, albeit weaker than that of the natural and semi-synthetic product 85. Additionally, the two compounds 3'-epi-85 and 93 possessed high or moderate selectivity indexes, which were much lower than that of 85. However, they can still be considered as new lead structures. Two unprecedented oxidative products of dioncophylline A, the diastereomeric dioncotetralones A (94a) and B (94b), were synthesized from dioncophylline A (6) in a one-step reaction. Remarkably, the aromatic properties in the “naphthalene” and the “isoquinoline” rings of 94a and 94b are partially lost and the “biaryl” axis has become a C,C-double bond, so that the two halves are nearly co-planar to each other, which has never been found among any natural or synthetic naphthylisoquinoline alkaloid. Their full structural characterization was accomplished by spectroscopic methods and quantum-chemical CD calculations (done by Y. Hemberger). The presumed reaction mechanism was proposed in this thesis. In addition, one of the two compounds, 94a, exhibited a highly antiplasmodial activity (IC50 = 0.09 μM) with low cytotoxicity, and thus, can be considered as a new promising lead structure. Its 2'-epi-isomer, 94b, was inactive, evidencing a significant effect of chirality on the bioactivity. Of a number of naphthylisoquinoline alkaloids tested against the multiple-myeloma cell lines, the three compounds, dioncophylline A (6), 4'-O-demethyldioncophylline A (89), and 5'-O-demethyldioncophylline A (90) showed excellent activities, even much stronger than dioncoquinones B (10), C (102), the epoxide 175, or the standard drug melphalan. 4) Isolation and characterization of bioactive naphthoquinones from cell cultures of Triphyophyllum peltatum. Three new naphthoquinones, dioncoquinones C (102), D (103), and E (104), the known 8-hydroxydroserone (105), which is new to this plant, and one new naphthol dimer, triphoquinol A (107), were isolated from cell cultures of T. peltatum in cooperation with A. Irmer. Dioncoquinone C (102) showed an excellent activity against the MM cells, very similar to that of the previously found dioncoquinone B (10), without showing any inhibitory effect on normal cells. The other three naphthoquinones, 103105, were inactive or only weakly active. 5) Establishment of a new strategy for a synthetic access to dioncoquinones B (10) and C (102) on a large scale for in vivo experiments and for the synthesis of their analogs for first SAR studies. Before the synthesis of dioncoquinone B (10) described in this thesis, two synthetic pathways had previously been established in our group. The third approach described here involved the preparation of the joint synthetic intermediate 42 with the previous two routes. The tertiary benzamide 135 was ortho-deprotonated by using s-BuLi/TMEDA, followed by transmetallation with MgBr2▪2Et2O, and reaction with 2-methylallyl bromide (139). It resulted in the formation of ortho-allyl benzamide 140, which was cyclized by using methyl lithium to afford the naphthol 42. This strategy proved to be the best among the established three approaches with regard to its very low number of steps and high yields. By starting with 136, this third strategy yielded the related bioactive natural product, dioncoquinone C (102), which was accessed by total synthesis for the first time. To identify the pharmacophore of the antitumoral naphthoquinones, a library of dioncoquinone B (10) and C (102) analogs were synthesized for in vitro testing. Among the numerous naphthoquinones tested, the synthetic 7-O-demethyldioncoquinone C (or 7-O-hydroxyldioncoquinone B) (145), constitutes another promising basic structure to develop a new anti-MM agent. Furthermore, preliminary SAR results evidence that the three hydroxy functions at C-3, C-5, and C-6 are essential for the biological properties as exemplarily shown through the compounds 10, 102, and 145. All other mixed OH/OMe- or completely OMe-substituted structures were entirely inactive. By a serendipity the expoxide 175 was found to display the best anti-MM activity of all the tested isolated metabolites from T. peltatum, the synthesized naphthoquinones, and their synthetic intermediates. Toxic effects of 175 on normal cells were not observed, in contrast to the high toxicities of all other epoxides. Thus, the anti-MM activity of 175 is of high selectivity. The preliminary SAR studies revealed that the 6-OMe group in 175 is required, thus differed with the above described naphthoquinones (where 6-OH is a requisite in 10, 102, and 145), which evidenced potentially different modes of action for these two classes of compounds. 6) The first attempted total synthesis of the new naturally occurring triphoquinone (187a), which was recently isolated from the root cultures of T. peltatum in our group. A novel naphthoquinone-naphthalene dimer, 187a (structure shown in Chapter 10), was isolated in small quantities from the root cultures of T. peltatum. Thus, its total synthesis was attempted for obtaining sufficient amounts for selected biotestings. The key step was planned to prepare the extremely sterically hindered (four ortho-substituents) binaphthalene 188 by a coupling reaction between the two 2-methylnaphthalene derivatives. Test reactions involving a system of two simplified 2-methylnaphthylboron species and 2-methylnaphthyl bromide proved the Buchwald ligand as most promising. The optimized conditions were then applied to the two true - highly oxygenated - coupling substrates, between the 2-methylnaphthylboron derivatives 210, 211, 213, or 214 and the 2-methylnaphthyl iodides (or bromides) 215 (206), 215 (206), 212 (205), or 212 (205), respectively. Unfortunately, this crucial step failed although various bases and solvent systems were tested. This could be due to the high electron density of the two coupling substrates, both bearing strongly OMOM/OMe-donating function groups. Therefore, a more powerful catalyst system or an alternative synthetic strategy must be explored for the total synthesis of 187a. 7) Phytochemical investigation of the Streptomyces strain RV-15 derived from a marine sponge. Cyclodysidins A-D (216-219), four new cyclic lipopeptides with a- and ß-amino acids, were isolated from the Streptomyces strain RV15 derived from a marine sponge by Dr. U. Abdelmohsen. Their structures were established as cyclo-(ß-AFA-Ser-Gln-Asn-Tyr-Asn-Ser-Thr) by spectroscopic analysis using 2D NMR techniques and CID-MS/MS in the course of this thesis. In conclusion, the present work contributes to the discovery of novel antiplasmodial naphthylisoquinoline alkaloids and antitumoral naphthoquinones, which will pave the way for future studies on these two classes of compounds.
Computer Science approaches (software, database, management systems) are powerful tools to boost research. Here they are applied to metabolic modelling in infections as well as health care management. Starting from a comparative analysis this thesis shows own steps and examples towards improvement in metabolic modelling software and health data management. In section 2, new experimental data on metabolites and enzymes induce high interest in metabolic modelling including metabolic flux calculations. Data analysis of metabolites, calculation of metabolic fluxes, pathways and their condition-specific strengths is now possible by an advantageous combination of specific software. How can available software for metabolic modelling be improved from a computational point of view? A number of available and well established software solutions are first discussed individually. This includes information on software origin, capabilities, development and used methodology. Performance information is obtained for the compared software using provided example data sets. A feature based comparison shows limitations and advantages of the compared software for specific tasks in metabolic modeling. Often found limitations include third party software dependence, no comprehensive database management and no standard format for data input and output. Graphical visualization can be improved for complex data visualization and at the web based graphical interface. Other areas for development are platform independency, product line architecture, data standardization, open source movement and new methodologies. The comparison shows clearly space for further software application development including steps towards an optimal user friendly graphical user interface, platform independence, database management system and third party independence especially in the case of desktop applications. The found limitations are not limited to the software compared and are of course also actively tackled in some of the most recent developments. Other improvements should aim at generality and standard data input formats, improved visualization of not only the input data set but also analyzed results. We hope, with the implementation of these suggestions, metabolic software applications will become more professional, cheap, reliable and attractive for the user. Nevertheless, keeping these inherent limitations in mind, we are confident that the tools compared can be recommended for metabolic modeling for instance to model metabolic fluxes in bacteria or metabolic data analysis and studies in infection biology. ...
Synthesis and Investigation of Borylene Complexes: from Borylene Transfer to Borylene Catenation
(2012)
Within the scope of this thesis, the area of borylene transfer has been broadened by including transition-metal alkynyl complexes and metal-carbon double bonds as borylene acceptors. In addition to double salt elimination, halide abstraction and dehydrogenation processes, a novel high-yield synthetic procedure for terminal borylene complexes was established, i.e. salt elimination and subsequent silylhalogenide liberation. Accordingly, it was possible to prepare [(OC)3(Me3P)Fe=BDur] as a rare example of a neutral arylborylene species. Moreover, this compound has been demonstrated to possess great potential for metathesis reactions and the functionalization of polycyclic aromatic hydrocarbons such as naphthalene. Moreover, it could undergo a phosphine-borylene exchange reaction, yielding the iron bis(borylene) complex [(OC)3Fe(BDur){BN(SiMe3)2}], which has turned out to be applicable for preparation of 1,4-diboracyclohexadiene and unprecedented 1,4-dibora-1,3-butadiene complexes, thus establishing a new type of borylene transfer. Most interestingly, upon transfer of further borylene moieties into the coordination sphere of iron, borylene-catenation was accomplished in a highly controlled manner.
Diese Arbeit beschäftigt sich mit Untersuchungen zur Synthese und Reaktivität von Ruthenium(II)- und Eisen(II)-Komplexen welche durch Alkyl-subsituierte N-Heterozyklische-Carben Liganden stabilisiert werden. Ein besonderes Augenmerk liegt hierbei auf dem synthetischen Zugang von Rutheniumverbindungen jenseits der Metathese-Katalysatoren.
Langzeitbetreuung von Kindern und Jugendlichen mit Erkrankungen aus dem rheumatischen Formenkreis
(2012)
Die juvenilen rheumatischen Erkrankungen sind häufiger, als von Laien angenommen wird. In der vorliegenden Studie werden Patienten der Kinderklinik und Polyklinik der Universität Würzburg genauer betrachtet um mögliche Verlaufsparameter retrospektiv auswerten zu können. Es zeigt sich, dass weibliche Patienten als häufiger von JIA-Erkrankungen betroffene länger therapiert wurden als die männlichen Patienten. Dabei erhielten sie länger NSAR und Steroide sowie häufiger MTX. Die Wahrscheinlichkeit eine Remission zu erreichen war im untersuchten Kollektiv nicht per se vom Geschlecht abhängig, jedoch geschätzt nach Kaplan und Meier zu Ungunsten der Mädchen, wie laut Literatur zu erwarten. Nicht bestätigen ließ sich ein negativer Zusammenhang zwischen erhöhten Entzündungswerten zu Beginn der Erkrankung und einer Remission im Verlauf. Weiterhin nicht bestätigen ließ sich eine generell geringere Remissionswahrscheinlichkeit bei Polyarthritis. Als prädiktive Marker für eine häufigere Remission können nach unseren Ergebnissen nun theoretisch das männliche Geschlecht (nach Kaplan und Meier) sowie erhöhte Entzündungswerte zu Beginn der Erkrankung angenommen werden. Wobei eine Remission häufiger auftrat, je schneller nach Krankheitsbeginn der Patient „an der richtigen Adresse“ vorgestellt wurde.
Liganden und Rezeptoren der TNF-Familie regulieren eine Vielzahl zellulärer Prozesse, darunter Apoptose und Immunprozesse. TNF-Liganden kommen in Form löslicher und membranständiger trimerer Moleküle vor, wobei die trimere Organisation durch die konservierte THD vermittelt wird. Im Gegensatz zu den membranständigen Molekülen können lösliche TNF-Liganden nicht immer an ihren TNF-Rezeptor binden oder ihn effektiv aktivieren. Für zwei solcher inaktiven TNF-Liganden, nämlich TRAIL und CD95L, konnte gezeigt werden, dass durch sekundäre Oligomerisierung oder durch artifizielle Herstellung einer Membranständigkeit mittels Antikörperdomänen gegen zelloberflächenexprimierte Proteine hochaktive Ligandenvarianten generiert werden können. Inwieweit sich diese Verfahren auf die T-Zell-kostimulatorischen TNF-Liganden OX40L, 41BBL und CD27L übertragen lassen, wurde in dieser Arbeit untersucht. Lösliche Flag- und Flag-TNC-Varianten von OX40L und 41BBL zeigten eine gute Bindung an die Rezeptoren OX40 und 41BB. Die lösliche Variante Flag-CD27L konnte nicht an ihren Rezeptor CD27 binden. Dies war aber nach Einführung der trimerstabilisierenden TNC-Domäne möglich. Eine effektive Aktivierung ihres Rezeptors, nachgewiesen durch Analyse der IL8-Induktion, bewirkten die löslichen TNF-Ligandenvarianten nur nach sekundärer Oligomerisierung mittels des Flag-spezifischen Antikörpers M2. Eine ähnlich gute TNFR-Aktivierung ließ sich durch Einführung der hexamerisierenden Fc-Domäne erzielen. Fc-Flag-OX40L und Fc-Flag-41BBL induzierten bereits ohne sekundäre Quervernetzung effektiv IL8. Die Hexamerisierung alleine reichte für die lösliche CD27L-Variante nicht aus, hier war zusätzlich zur Fc- wiederum auch die TNC-Domäne erforderlich, um die Bindung an CD27 und eine schwache IL8-Induktion zu erzielen. Für die FAP-bindenden Fusionsproteine antiFAP-Flag- OX40L, antiFAP-Flag-41BBL und antiFAP-Flag-TNC-CD27L war die Bindung an OX40, 41BB und CD27 sowie an FAP nachweisbar. Erst durch die artifizielle Membranständigkeit nach Bindung an FAP konnten diese Fusionsproteine über ihren Rezeptor effektiv IL8 induzieren. Zusammenfassend ließ sich somit zeigen, dass sich schwach oder nicht aktive lösliche Ligandenvarianten von OX40L und 41BBL durch sekundäre Oligomerisierung, durch die Fc-Hexamerisierungsdomäne und durch artifizielle Membranständigkeit in hochaktive Liganden verwandeln lassen. Lösliche CD27L-Varianten benötigen zusätzlich die trimerstabilisierende TNC-Domäne, um CD27 binden und aktivieren zu können. Für das bessere Verständnis der Ligand-Rezeptor-Interaktionen wurden zusätzlich OX40L-, 41BBL- und CD27L-Fusionsproteine mit der hochaktiven Gaussia princeps Luziferase (GpL) generiert, um Gleichgewichtsbindungs-, Dissoziationsstudien und homologe Kompetitionsassays durchführen zu können. Für die Fusionsproteine GpL-Flag-TNC-OX40L, GpL-Flag-TNC-41BBL und GpL-Flag-TNC-CD27L konnte gezeigt werden, dass die IL8-Induktion nicht von der Rezeptorbelegung abhängt, sondern von der sekundären Oligomerisierung, da bei gleicher Rezeptorbelegung durch sekundär quervernetzte TNF-Liganden mehr IL8 induziert wird, die Rezeptoraktivierung also qualitativ besser sein muss.
Die vorliegende retrospektive Arbeit zeigt die Einsatzmöglichkeiten der funktionellen Magnetresonanzurographie bei Kindern auf. Mit Hilfe der verwendeten Software lassen sich die funktionellen Aspekte der Untersuchung wenig zeitintensiv bearbeiten und die Ergebnisse anschaulich und verständlich darstellen. Die Beurteilung der funktionellen Ergebnisse erlaubt aus der Zusammenschau von errechneten definierten metrischen Daten der Untersuchung und der Kurvenanalyse eine Aussage zur seitengetrennten Nierenfunktion. Diese korreliert gut mit dem klinischen Ergebnis und der MAG 3 Szintigraphie als Standardverfahren. Als Funktionsparameter zur Unterscheidung zwischen normal funktionierender und dekompensierter obstruierter Nierenuretereinheit dient in erster Linie die renale Transitzeit des Kontrastmittels RTT. Durch Einführung einer Pseudonativsequenz konnten im Patientenkollektiv Untersuchungen der Auswertung zugeführt werden, die primär nicht auszuwerten waren. Eine Korrelation der errechneten Patlakzahl mit der geschätzten glomulären Filtrationsrate ließ sich in unserem Kollektiv nicht nachweisen. Insgesamt ist das Verfahren im klinischen Alltag weiter zu evaluieren, Prospektive Studien sollten eine eventuelle Überlegenheit dieser strahlenfreien Methode gegenüber der Szintigraphie als zentrale Fragestellung überprüfen.
Streptococcus pneumoniae (Pneumococcus) is one of the leading causes of childhood meningitis,pneumonia and sepsis. Despite the availability of childhood vaccination programs and antimicrobial agents, childhood pneumococcal meningitis is still a devastating illness with mortality rates among the highest of any cause of bacterial meningitis. Especially in low-income countries, where medical care is less accessible, mortality rates up to 50 % have been reported. In surviving patients, neurological sequelae, including hearing loss, focal neurological deficits and cognitive impairment, is reported in 30 to 50 %. Growing resistance of pneumococci towards conventional antibiotics emphasize the need for effective therapies and development of effective vaccines against Streptococcus pneumoniae. One major virulence factor of Streptococcus pneumoniae is the protein toxin Pneumolysin (PLY). PLY belongs to a family of structurally related toxins, the so-called cholesterol-dependent cytolysins (CDCs). Pneumolysin is produced by almost all clinical isolates of the bacterium. It is expressed during the late log phase of bacterial growth and gets released mainly through spontaneous autolysis of the bacterial cell. After binding to cholesterol in the host cell membranes, oligomerization of up to 50 toxin monomers and rearrangement of the protein structure, PLY forms large pores, leading to cell lysis in higher toxin concentrations. At sub-lytic concentrations, however, PLY mediates several other effects, such as activation of the classic complement pathway and the induction of apoptosis. First experiments with pneumococcal strains, deficient in pneumolysin, showed a reduced virulence of the organism, which emphasizes the contribution of this toxin to the course of bacterial meningitis and the urgent need for the understanding of the multiple mechanisms leading to invasive pneumococcal disease. The aim of this thesis was to shed light on the contribution of pneumolysin to the course of the disease as well as to the mental illness patients are suffering from after recovery from pneumococcal meningitis. Therefore, we firstly investigated the effects of sub-lytic pneumolysin concentrations onto primary mouse neurons, transfected with a GFP construct and imaged with the help of laser scanning confocal microscopy. We discovered two major morphological changes in the dendrites of primary mouse neurons: The formation of focal swellings along the dendrites (so-called varicosities) and the reduction of dendritic spines. To study these effects in a more complex system, closer to the in vivo situation, we established a reproducible method for acute brain slice culturing. With the help of this culturing method, we were able to discover the same morphological changes in dendrites upon challenge with sub-lytic concentrations of pneumolysin. We were able to reverse the seen alterations in dendritic structure with the help of two antagonists of the NMDA receptor, connecting the toxin´s mode of action to a non-physiological stimulation of this subtype of glutamate receptors. The loss of dendritic spines (representing the postsynapse) in our brain slice model could be verified with the help of brain slices from adult mice, suffering from pneumococcal meningitis. By immunohistochemical staining with an antibody against synapsin I, serving as a presynaptic marker, we were able to identify a reduction of synapsin I in the cortex of mice, infected with a pneumococcal strain which is capable of producing pneumolysin. The reduction of synapsin I was higher in these brain slices compared to mice infected with a pneumococcal strain which is not capable of producing pneumolysin, illustrating a clear role for the toxin in the reduction of dendritic spines. The fact that the seen effects weren´t abolished under calcium free conditions clarifies that not only the influx of calcium through the pneumolysin-pore is responsible for the alterations. These findings were further supported by calcium imaging experiments, where an inhibitor of the NMDA receptor was capable of delaying the time point, when the maximum of calcium influx upon PLY challenge was reached. Additionally, we were able to observe the dendritic beadings with the help of immunohistochemistry with an antibody against MAP2, a neuron-specific cytoskeletal protein. These observations also connect pneumolysin´s mode of action to excitotoxicity, as several studies mention the aggregation of MAP2 in dendritic beadings in response to excitotoxic stimuli. All in all, this is the first study connecting pneumolysin to excitotoxic events, which might be a novel chance to tie in other options of treatment for patients suffering from pneumococcal meningitis.
Das Ziel dieser Arbeit war in erster Linie die Untersuchung von follikulären Adnextumoren hinsichtlich ihrer Gefäßdichten. Hier sollte beurteilt werden, inwiefern die Zahl der Gefäße eine Bedeutung für Diagnostik, Prognose und Einteilung der trichogenen Tumoren hat. Darüber hinaus sollten die erhobenen klinischen Daten der Patienten verglichen werden und der diagnostische Wert einiger immunhistologischer Unterscheidungsmöglichkeiten besprochen werden. Aus dem Archiv der Universitäts-Hautklinik Würzburg der Jahre 2000 bis 2008 wurden 112 Präparate entnommen, darunter 35 solide und 15 sklerodermiforme Basalzellkarzinome, 17 Pinkus-Tumoren, 20 Trichoblastome, elf Trichoepitheliome, sechs desmoplastische Trichoepitheliome und acht Trichofollikulome. Es erfolgte eine immunhistochemische Färbung mit dem Antikörper CD31 und eine Zählung der Gefäße bei 200facher Vergrößerung. Das durchschnittliche Alter der Patienten mit solidem Basalzellkarzinom lag bei 75,1 Jahren, mit sklerodermiformem bei 76,1 Jahren. Die Pinkus-Tumoren wurden mit 60,6 Jahren entfernt, die Trichoblastome mit 57,0, die Trichofollikulome mit 56,4, die Trichoepitheliome mit 46,7 und die desmoplastischen Trichoepitheliome mit 47,2 Jahren. Bei den soliden bzw. sklerodermiformen Basalzellkarzinomen überwog der Männeranteil mit 57,1% bzw. 73,3%, bei den Trichoblastomen sogar mit 75,0%. Bei den Pinkus-Tumoren waren dagegen 70,6% der Patienten weiblichen Geschlechts, bei den Trichofollikulomen 87,5%, bei den Trichoepitheliomen 72,7% und bei den desmoplastischen Trichoepitheliomen 83,3%. Die häufigste Lokalisation der soliden und sklerodermiformen Basalzellkarzinome war mit 65,7% und 86,7% das Gesicht, wie auch bei Trichofollikulomen (75,0%), Trichoepiteliomen (72,7%) und desmoplastischen Trichoepitheliomen (83,3%). Trichoblastome traten zu 65,0% am Kopf und zu 35,0% an Rumpf und Extremitäten auf, wo sich alle Pinkus-Tumoren befanden. Die durchschnittliche Gefäßdichte für alle Tumoren beträgt peritumoral 19,9, im Tumor 3,1 und im Gesunden 8,8. Die Werte im tumorfreien Gewebe bewegen sich, für die einzelnen Tumoren aufgeschlüsselt, in einem engen Rahmen zwischen 7,1 und 10,4. Die soliden Basazellkarzinome und die Trichoblastome haben im Tumor selbst durchschnittlich nur 1,5 bzw. 1,7 Gefäße pro Gesichtsfeld, Trichofollikulome 2,8, Pinkus-Tumoren 3,4, Trichoepitheliome 4,5, sklerodermiforme Basalzellkarzinome 5,5 und desmoplastische Trichoepitheliome sogar 7,3. Für die Gefäßdichte im peritumoralen Gewebe lässt sich ein signifikanter Unterschied erkennen zwischen den soliden und sklerodermiformen Basalzellkarzinomen mit 24,7 bzw. 24,1 auf der einen Seite und den Trichoblastomen (15,3), Trichofollikulomen (14,5), Trichoepitheliomen (14,3) und desmoplastischen Trichoepitheliomen (13,1) auf der anderen Seite. Die Pinkus-Tumoren stehen mit einem Wert von 19,7 zwischen den beiden Gruppen. Bis auf kleinere Abweichungen stimmen die klinischen Daten mit Angaben in der Literatur überein, so dass davon ausgegangen werden kann, dass die ausgewählten Tumoren die Entitäten gut repräsentieren. Als Unterscheidungsmöglichkeiten, die die Immunhistologie bietet, sind in erster Linie der Androgen-Rezeptor und die Merkel-Zellen zu nennen. Basalzellkarzinome sind positiv für den Androgen-Rezeptor und negativ für Merkel-Zellen, während bei den benignen trichogenen Tumoren dieses Verhältnis genau umgekehrt ist. CD10, CD34 und bcl-2 hingegen scheinen die Tumoren nur sehr unsicher voneinander zu trennen. Die Expression der Zytokeratine weist sogar auf einen gemeinsamen Entwicklungsweg der Tumoren hin. Die Pinkus-Tumoren sind sowohl positiv für Androgen-Rezeptoren als auch für Merkel-Zellen und stehen somit zwischen den Basalzellkarzinomen und den benignen follikulären Adnextumoren. Die Gefäßdichte liegt peritumoral deutlich höher als im gesunden Gewebe und spiegelt damit wider, dass Tumoren eine bessere Gefäßversorgung für ihr Wachstum benötigen als normalerweise in der Haut vorhanden. Im Tumor selbst geht ein solides Wachstumsmuster mit wenigen Gefäßen und ein Wachstum in schmalen Strängen mit mehr Gefäßen einher. Peritumoral zeigen die Basalzellkarzinome entsprechend ihrem malignen Potential eine signifikant höhere Gefäßdichte als die benignen Tumoren. Daraus lässt sich ableiten, dass die Gefäßdichte das biologische Verhalten der Tumoren zeigt und damit, zusammen mit anderen Faktoren, zu Diagnostik und Prognose herangezogen werden kann. Auch hinsichtlich der Gefäßdichte zeigen die Pinkus-Tumoren kein eindeutiges Verhalten und lassen sich weder den Basalzellkarzinomen noch den benignen trichogenen Tumoren zuordnen. Während die sonstigen Ergebnisse das Konzept von Ackerman bezüglich der Einteilung der Tumoren in Trichoblastom und trichoblastisches Karzinom (Basalzellkarzinom) stützen, betont dies einmal mehr die Zwischenstellung der Pinkus-Tumoren.