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Institute
- Graduate School of Life Sciences (101)
- Physikalisches Institut (23)
- Institut für Anorganische Chemie (22)
- Medizinische Klinik und Poliklinik I (22)
- Theodor-Boveri-Institut für Biowissenschaften (21)
- Neurologische Klinik und Poliklinik (18)
- Medizinische Klinik und Poliklinik II (17)
- Institut für Informatik (14)
- Institut für Organische Chemie (13)
- Institut für Psychologie (13)
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (13)
- Lehrstuhl für Orthopädie (12)
- Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) (11)
- Institut für Geographie und Geologie (10)
- Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie (Chirurgische Klinik II) (10)
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie (9)
- Abteilung für Funktionswerkstoffe der Medizin und der Zahnheilkunde (8)
- Augenklinik und Poliklinik (8)
- Institut für Funktionsmaterialien und Biofabrikation (8)
- Institut für Physikalische und Theoretische Chemie (8)
- Kinderklinik und Poliklinik (8)
- Medizinische Fakultät (8)
- Betriebswirtschaftliches Institut (7)
- Institut für Anatomie und Zellbiologie (7)
- Institut für Mathematik (7)
- Institut für Pharmazie und Lebensmittelchemie (7)
- Institut für Theoretische Physik und Astrophysik (7)
- Institut für Virologie und Immunbiologie (7)
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (7)
- Lehrstuhl für Biochemie (7)
- Missionsärztliche Klinik (7)
- Poliklinik für Zahnärztliche Prothetik (7)
- Fakultät für Biologie (6)
- Graduate School of Science and Technology (6)
- Julius-von-Sachs-Institut für Biowissenschaften (6)
- Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie (6)
- Klinik und Poliklinik für Strahlentherapie (6)
- Klinik und Poliklinik für Thorax-, Herz- u. Thorakale Gefäßchirurgie (6)
- Deutsches Zentrum für Herzinsuffizienz (DZHI) (5)
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- Fakultät für Chemie und Pharmazie (4)
- Institut für Hygiene und Mikrobiologie (4)
- Institut für Klinische Neurobiologie (4)
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen (4)
- Klinik und Poliklinik für Nuklearmedizin (4)
- Lehrstuhl für Tissue Engineering und Regenerative Medizin (4)
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- Institut für Humangenetik (3)
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- Neurochirurgische Klinik und Poliklinik (3)
- Poliklinik für Zahnerhaltung und Parodontologie (3)
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- Urologische Klinik und Poliklinik (2)
- Comprehensive Cancer Center Mainfranken (1)
- Fakultät für Humanwissenschaften (Philos., Psycho., Erziehungs- u. Gesell.-Wissensch.) (1)
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- Volkswirtschaftliches Institut (1)
Sonstige beteiligte Institutionen
- Fraunhofer-Institut für Silicatforschung ISC (3)
- Helmholtz Institute for RNA-based Infection Research (HIRI) (2)
- Abteilung Molekulare Innere Medizin (1)
- Bugando Medical Center in Mwanza, Tansania (1)
- CHC Würzburg (Comprehensive Hearing Center) (1)
- Catholic University of Health and Allied Sciences in Mwanza, Tansania (1)
- Comprehensive Hearing Center (1)
- Department of Cellular Therapies, University of Navarra, Pamplona, Spain (1)
- Department of X-ray Microscopy, University of Würzburg, Würzburg, Germany (1)
- Deutsches Klimaservice Zentrum (GERICS) (1)
- EMBL Heidelberg (1)
- Early Clinical Trial Unit, Comprehensive Cancer Center Mainfranken (1)
- Experimentelle Tumorimmunologie, Frauenklinik, Universität Würzburg (1)
- Fraunhofer IOF (1)
- Fraunhofer Institut für Silicatforschung ISC (1)
- Hochschule Aalen (1)
- Institut Ruđer Bošković, Zagreb, Croatia (1)
- Institut für Medizinische Mikrobiologie in Göttingen (1)
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- Interdisziplinäre Zentrum für Klinische Forschung (IZKF) (1)
- KfH Nierenzentrum (1)
- Klinik für Handchirurgie des Rhön-Klinikums Bad Neustadt an der Saale (1)
- Klinik für Kinder- und Jugendmedizin, Caritas-Krankenhaus Bad Mergentheim (1)
- Klinik und Poliklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie des Universitätsklinikums Würzburg (1)
- Lehrstuhl für Biochemie und molekulare Biologie (1)
- Lehrstuhl für Fernerkundung der Uni Würzburg, in Kooperation mit dem Deutschen Fernerkundungsdatenzentrum (DFD) des Deutschen Zentrums für Luft- und Raumfahrt (DLR) (1)
- Lehrstuhl für Tissue Engineering und Regenerative Medizin (TERM) (1)
- Nationales Referenzzentrum für Invasive Pilzinfektionen (NRZMyk) (1)
- Politecnico di Milano (1)
- Siemens Corporate Technology Munich (1)
- Translationale soziale Neurowissenschaften (1)
- University of Twente (The Netherlands) (1)
- Universität Duisburg-Essen, Institut für Molekularbiologie, AG Becker-Flegler (1)
- Universitätsklinikum Würzburg (1)
- Universitätsklinikum Würzburg (UKW) (1)
- ZVES Würzburg (Zentrum für vorsprachliche Entwicklung und Entwicklungsstörungen) (1)
- Zentrum für Interdisziplinäre Medizin der Uni Würzburg (1)
EU-Project number / Contract (GA) number
- 320377 (1)
Im Rahmen dieser Arbeit konnten Seltenerdmetallcyanoborate mit unterschiedlich funktionalisierten Anionen, beispielsweise Hydrido-, Fluoro- oder Perfluoralkylcyanoborat-Anionen, synthetisiert und vollständig charakterisiert werden. Lösungen der wasserfreien Komplexe Ln[BH2(CN)2]3 (Ln = La, Eu, Ho) in der korrespondierenden ionischen Flüssigkeit [EMIm][BH2(CN)2] konnten hinsichtlich Dichte Viskosität und Leitfähigkeit in Abhängigkeit der Konzentration des gelösten Komplexes untersucht werden. Alle Europiumkomplexe wurden hinsichtlich ihrer photochemischen Eigenschaften untersucht.
Weiterhin konnte im Rahmen dieser Arbeit die erste selektive Synthese des Hydroxytricyanoborat-Anions [B(OH)(CN)3]- vorgestellt werden. Ausgehend von der Brønstedsäure dieses Anions konnte die Synthese einer ganzen Reihe von Salzen und Komplexverbindungen, sowie von ionischen Flüssigkeiten mit diesem Anion realisiert werden.
Neurons are specialized cells dedicated to transmit the nerve impulses throughout the human body across specialized structures called synapses. At the synaptic terminals, a crosstalk between multiple macromolecules regulates the structure and function of the presynaptic nerve endings and the postsynaptic recipient sites.
Gephyrin is the central organizer at inhibitory postsynaptic specializations and plays a crucial role in the organization of these structures by anchoring GABAA receptors (GABAAR) and glycine receptors (GlyR) to the postsynaptic membrane. This 93 kDa protein features an N-terminal G domain and a C-terminal E domain and the latter interacts directly with the intracellular loop between transmembrane helices 3 and 4 of certain subunits of the GlyRs and GABAARs. Biochemical and structural analyses have already provided valuable insights into the gephyrin-GlyR interaction. Interestingly, biochemical studies on the gephyrin-GABAAR interaction demonstrated that the GABAARs also depend on the same binding site as the GlyRs for the interaction with the gephyrin, but the molecular basis for this receptor specific interaction of gephyrin was still unknown. Co-crystal structures of GephE-GABAAR α3- derived peptides with supporting biochemical data presented in this study deciphered the receptor-specific interactions of gephyrin in atomic detail.
In its moonlighting function, gephyrin also catalyzes the terminal step of the evolutionarily conserved molybdenum cofactor biosynthesis. Molybdenum, an essential transition element has to be complexed with a pterin-based cofactor resulting in the formation of the molybdenum cofactor (Moco). Moco is an essential component at the active site of all molybdenum-containing enzymes with the exception of nitrogenase. Mutations in enzymes involved in this pathway lead to a rare yet severe disease called Moco deficiency, which manifest itself in severe neurodevelopmental abnormalities and early childhood death. Moco biosynthesis follows a complex multistep pathway, where in the penultimate step, the N-terminal G domain of gephyrin activates the molybdopterin to form an adenylated molybdopterin intermediate. In the terminal step, this intermediate is then transferred to the C-terminal E domain of gephyrin, which catalyzes the metal insertion and deadenylation reaction to form active Moco. Previous biochemical and structural studies provided valuable insights into the penultimate step of the Moco biosynthesis but the terminal step remained elusive. Through the course of my dissertation, I crystallized the C-terminal E domain in the apo-form as well as in complex with ADP and AMP. These structures shed lightonto the deadenylation reaction and the formation of a ternary E-domain-ADP-Mo/W complex and thus provide structural insight into the metal insertion mechanism. Moreover, the structures also provided molecular insights into a mutation leading to Moco deficiency. Finally, ternary
complexes of GephE, ADP and receptor-derived peptides provided first clues regarding the integration of gephyrin’s dual functionality.
In summary, during the course of the dissertation I was able to derive high resolution structural insights into the interactions between gephyrin and GABAARs, which explain the receptor-specific interaction of gephyrin and, furthermore, these studies can be extended in the future to understand GABAAR subunit-specific interactions of gephyrin. Finally, the understanding of Moco biosynthesis shed light on the molecular basis of the fatal Moco deficiency.
Methionine is the first amino acid of every newly synthesised protein. In combination with its role as precursor for the vital methyl-group donor S-adenosylmethionine, methionine is essential for every living cell. The opportunistic human pathogen Staphylococcus aureus is capable of synthesising methionine de novo, when it becomes scarce in the environment. All genes required for the de novo biosynthesis are encoded by the metICFE-mdh operon, except for metX. Expression is controlled by a hierarchical network with a methionyl-tRNA-specific T-box riboswitch (MET-TBRS) as centrepiece, that is also referred to as met leader (RNA). T-box riboswitches (TBRS) are regulatory RNA elements located in the 5’-untranslated region (5’-UTR) of genes. The effector molecule of T-box riboswitches is uncharged cognate tRNA. The prevailing mechanism of action is premature termination of transcription of the nascent RNA in the absence of the effector (i.e. uncharged cognate tRNA) due to formation of a hairpin structure, the Terminator stem. In presence of the effector, a transient stabilisation of the alternative structure, the Antiterminator, enables transcription of the downstream genes (‘read-through’). Albeit, after the read-through the thermodynamically more stable Terminator eventually forms. The Terminator and the Antiterminator are two mutually exclusive structures. Previous work of the research group showed that in staphylococci the MET-TBRS ensures strictly methionine-dependent control of met operon expression. Uncharged methionyl-tRNA that activates the system is only present in sufficient amounts under methionine-deprived conditions. In contrast to other bacterial TBRS, the staphylococcal MET-TBRS has some characteristic features regarding its length and predicted secondary structure whose relevance for the function are yet unkown.
Aim of the present thesis was to experimentally determine the structure of the met leader RNA and to investigate the stability of the met operon-specific transcripts in the context of methionine biosynthesis control. Furthermore, the yet unknown function of the mdh gene within the met operon was to be determined.
In the context of this thesis, the secondary structure of the met leader was determined employing in-line probing. The structural analysis revealed the presence of almost all highly conserved T-box riboswitch structural characteristics. Furthermore, three additional stems, absent in all T-box riboswitches analysed to date, could be identified. Particularly remarkable is the above average length of the Terminator stem which renders it a potential target of the double-strand-specific endoribonuclease III (RNase III). The RNase III-dependent cleavage of the met leader could be experimentally verified by the use of suitable mutants. Moreover, the exact cleavage site within the Terminator was determined.
The unusual immediate separation of the met leader from the met operon mRNA via the RNase III cleavage within the Terminator stem induces the rapid degradation of the met leader RNA and, most likely, that of the 5’-region of the met mRNA. The met mRNA is degraded from its 5’-end by the exoribonuclease RNase J. The stability of the met mRNA was found to vary over the length of the transcript with an instable 5’-end (metI and metC) and a longer half-life towards the 3’-end (metE and mdh). The varying transcript stability is reflected by differences in the available cellular protein levels. The obtained data suggest that programmed mRNA degradation is another level of regulation in the complex network of staphylococcal de novo methionine biosynthesis control.
In addition, the MET-TBRS was studied with regard to a future use as a drug target for novel antimicrobial agents. To this end, effects of a dysregulated methionine biosynthesis on bacterial growth and survival were investigated in met leader mutants that either caused permanent transcription of the met operon (‘ON’) or prevented operon transcription (‘OFF’), irrespective of the methionine status in the cell. Methionine deprivation turned out to be a strong selection pressure, as ‘OFF’ mutants acquired adaptive mutations within the met leader to restore met operon expression that subsequently re-enabled growth.
The second part of the thesis was dedicated to the characterisation of the Mdh protein that is encoded by the last gene of the met operon and whose function is unknown yet. At first, co-transcription and -expression with the met operon could be demonstrated. Next, the Mdh protein was overexpressed and purified and the crystal structure of Mdh was solved to high resolution by the Kisker research group (Rudolf-Virchow-Zentrum Würzburg). Analysis of the structure revealed the amino acid residues crucial for catalytic activity, and zinc was identified as a co-factor of Mdh. Also, Mdh was shown to exist as a dimer. However, identification of the Mdh substrate was, in the context of this thesis, (still) unsuccessful. Nevertheless, interactions of Mdh with enzymes of the met operon could be demonstrated by employing the bacterial two-hybrid system. This fact and the high conservation of mdh/Mdh on nucleotide and amino acid level among numerous staphylococcal species suggests an important role of Mdh within the methionine metabolism that should be a worthwhile subject of future research.
The interaction of bacterial pathogens and the human host is a complex process that has shaped both organisms on a molecular, cellular and population level. When pathogenic bacteria infect the human body, a battle ensues between the host immune system and the pathogen. In order to escape an immune response and to colonize the host, pathogenic bacteria have developed diverse virulence strategies and some pathogens even replicate within host cells. For survival and propagation within the dynamic environment of a host cell, these bacteria interfere with the regulation of host pathways, such as the cell cycle, for their own benefit.
The intracellular pathogen Salmonella Typhimurium invades eukaryotic cells and resides and replicates in a modified vacuolar compartment in which it is protected from the innate immune response. To this end, it employs a set of virulence factors that help to invade cells (SPI-1 effectors) and to hijack and modify the host endolysosomal system, in order to stabilize and mature its vacuolar niche (SPI-2 effectors). Previous studies have shown that Salmonella arrests host cells in G2/M phase and that Salmonella infected cells progress faster from G1 into S phase, suggesting that the G1 phase is disadvantageous for Salmonella infection. In fact, it has already been observed that Salmonella replication is impaired in G1 arrested cells. However, the reason for this impairment remained unclear.
The current study addressed this question for the first time and revealed that the highly adapted, intracellular lifestyle of Salmonella is drastically altered upon G1 arrest of the host cell. It is shown that proteasomal degradation in G1 arrested cells is delayed and endolysosomal and autophagosomal trafficking is compromised. Accordingly, processing of lysosomal proteins is insufficient and lysosomal activity is decreased; resulting in uneven distribution and accumulation of endolysosomes and autophagosomes, containing undegraded cargo. The deregulation of these cellular signaling pathways affects maturation of the Salmonella containing vacuole (SCV). For the first time it is shown that acidification of SCVs is impaired upon G1 arrest. Thus, an important environmental factor for the switch from SPI-1 to SPI-2 gene expression is
missing and the SPI-2 system is not activated. Consequently, targeting and modification of host cell structures by SPI-2 effectors e.g. recruitment of endolysosomal membrane proteins, like LAMP1, or exchange of endosomal cargo, is compromised.
In addition, degradation of Salmonella SPI-1 effectors by the host proteasome is delayed. Their prolonged presence sustained the recruitment of early endosomes and contributed to the SCV remaining in an early, vulnerable maturation stage. Finally, it was shown that SCV membrane integrity is compromised; the early SCV ruptures and bacteria are released into the cytoplasm. Depending on the host cell type, SPI-2 independent, cytoplasmic replication is promoted. This might favor bacterial spreading, dissemination into the tissue and provide an advantage in host colonization.
Overall, the present study establishes a link between host cell cycle regulation and the outcome of Salmonella infection. It fills the gap of knowledge as to why the host cell cycle stage is of critical importance for Salmonella infection and sheds light on a key aspect of host-pathogen interaction.
The genetic modification of T cells for the expression a chimeric antigen receptor (CAR) endows them with a new specificity for an antigen. Adoptive immunotherapy with CD19-CAR T cells has achieved high rates of sustained complete remissions in B cell malignancies. However, the downregulation or loss of the targeted antigen after mono-specific CAR T cell therapy, e.g. against CD19 or CD22, has been reported. Targeting multiple antigens on tumour cells, sequentially or simultaneously, could overcome this limitation. Additionally, targeting multiple antigens with CAR T cells could drive the translation from hematologic malignancies to prevalent solid cancers, which often express tumour-associated antigens heterogeneously. We hypothesised that expression of a universal CAR, which can be programmed with hapten-like molecules, could endow T cells with specificities for multiple antigens.
In this study we introduce a novel chemically programmable CAR (cpCAR) based on monoclonal antibody h38C2. Our data show, that cpCARs form a reversible chemical bond to molecules containing a diketone-group and therefore can be programmed to acquire multiple specificities. We programmed cpCAR T cells with hapten-like compounds against integrins αvβ3 and α4β1 as well as the folate receptor. We observed tumour cell lysis, IFN ɣ and IL-2 production and proliferation of programmed cpCAR T cells against tumour cells expressing the respective target antigen in vitro.
As a reference to cpCARs programmed against αvβ3, we further introduced novel conventional αvβ3-CARs. These CARs, based on humanised variants of monoclonal antibody LM609 (hLM609), directly bind to integrin αvβ3 via their scFv. The four αvβ3-CAR constructs comprised either an scFv with higher affinity (hLM609v7) or lower affinity (hLM609v11) against αvβ3 integrin and either a long (IgG4 hinge, CH2, CH3) or short (IgG4 hinge) extracellular spacer. We selected the hLM609v7-CAR with short spacer, which showed potent anti-tumour reactivity both in vitro and in a murine xenograft model, for comparison with the cpCAR programmed against αvβ3. Our data show specific lysis of αvβ3-positive tumour cells, cytokine production and proliferation of both hLM609-CAR T cells and cpCAR T cells in vitro. However, conventional hLM609-CAR T cells mediated stronger anti-tumour effects compared to cpCAR T cells in the same amount of time. In line with the in vitro data, complete destruction of tumour lesions in a murine melanoma xenograft model was only observed for mice treated with conventional αvβ3-CAR T cells.
Collectively, we introduce a cpCAR, which can be programmed against multiple tumour antigens, and hLM609-CARs specific for the integrin αvβ3. The cpCAR technology bears the potential to counteract current limitations, e.g. antigen loss, of current monospecific CAR T cell therapy. Targeting αvβ3 integrin with CAR T cells could have clinical applications in the treatment of solid malignancies, because αvβ3 is not only expressed on a variety of solid malignancies, but also on tumour-associated vasculature and fibroblast.
Die Fanconi-Anämie (FA) ist eine seltene, heterogene Erbkrankheit. Sie weist ein sehr variables klinisches Erscheinungsbild auf, das sich aus angeborenen Fehlbildungen, hämatologischen Funktionsstörungen, einem erhöhten Risiko für Tumorentwicklung und endokrinen Pathologien zusammensetzt. Die Erkrankung zählt zu den genomischen Instabilitätssyndromen, welche durch eine fehlerhafte DNA-Schadensreparatur gekennzeichnet sind. Bei der FA zeigt sich dies vor allem in einer charakteristischen Hypersensitivität gegenüber DNA-quervernetzenden Substanzen (z. B. Mitomycin C, Cisplatin). Der zelluläre FA-Phänotyp zeichnet sich durch eine erhöhte Chromosomenbrüchigkeit und einen Zellzyklusarrest in der G2-Phase aus. Diese Charakteristika sind bereits spontan vorhanden und werden durch Induktion mit DNA-quervernetzenden Substanzen verstärkt. Der Gendefekt ist dabei in einem der 22 bekannten FA-Gene (FANCA, -B, -C, -D1, -D2, -E, -F, -G, -I, -J, -L, -M, -N, -O, -P, -Q, -R, -S, -T, -U, -V, -W) oder in noch unbekannten FA-Genen zu finden. Die FA-Gendefekte werden mit Ausnahme von FANCR (dominant-negative de novo Mutationen) und FANCB (X-chromosomal) autosomal rezessiv vererbt. Die FA-Genprodukte bilden zusammen mit weiteren Proteinen den FA/BRCA-Signalweg. Das Schlüsselereignis dieses Signalwegs stellt die Monoubiquitinierung von FANCD2 und FANCI (ID2-Komplex) dar. Ausgehend davon lässt sich zwischen upstream- und downstream-gelegenen FA-Proteinen unterscheiden. Letztere sind direkt an der DNA-Schadensreparatur beteiligt. Zu den upstream-gelegenen Proteinen zählt der FA-Kernkomplex, der sich aus bekannten FA-Proteinen und aus FA-assoziierten-Proteinen (FAAPs) zusammensetzt und für die Monoubiquitinierung des ID2-Komplexes verantwortlich ist. Für FAAPs wurden bisher keine pathogenen humanen Mutationen beschrieben. Zu diesen Proteinen gehört auch FAAP100, das mit FANCB und FANCL innerhalb des FA-Kernkomplexes den Subkomplex LBP100 bildet.
Durch die vorliegende Arbeit wurde eine nähere Charakterisierung dieses Proteins erreicht. In einer Amnion-Zelllinie konnte eine homozygote Missense-Mutation identifiziert werden. Der Fetus zeigte einen typischen FA-Phänotyp und auch seine Zellen wiesen charakteristische FA-Merkmale auf. Der zelluläre Phänotyp ließ sich durch FAAP100WT komplementieren, sodass die Pathogenität der Mutation bewiesen war. Unterstützend dazu wurden mithilfe des CRISPR/Cas9-Systems weitere FAAP100-defiziente Zelllinien generiert. Diese zeigten ebenfalls einen typischen FA-Phänotyp, welcher sich durch FAAP100WT komplementieren ließ. Die in vitro-Modelle dienten als Grundlage dafür, die Funktion des FA-Kernkomplexes im Allgemeinen und die des Subkomplexes LBP100 im Besonderen besser zu verstehen. Dabei kann nur durch intaktes FAAP100 das LBP100-Modul gebildet und dieses an die DNA-Schadensstelle transportiert werden. Dort leistet FAAP100 einen essentiellen Beitrag für den FANCD2-Monoubiquitinierungsprozess und somit für die Aktivierung der FA-abhängigen DNA-Schadensreparatur. Um die Funktion von FAAP100 auch in vivo zu untersuchen, wurde ein Faap100-/--Mausmodell generiert, das einen mit anderen FA-Mausmodellen vergleichbaren, relativ schweren FA-Phänotyp aufwies. Aufgrund der Ergebnisse lässt sich FAAP100 als neues FA-Gen klassifizieren. Zudem wurde die Rolle des Subkomplexes LBP100 innerhalb des FA-Kernkomplexes weiter aufgeklärt. Beides trägt zu einem besseren Verständnis des FA/BRCA-Signalweges bei. Ein weiterer Teil der vorliegenden Arbeit beschäftigt sich mit der Charakterisierung von FAAP100138, einer bisher nicht validierten Isoform von FAAP100. Durch dieses Protein konnte der zelluläre FA-Phänotyp von FAAP100-defizienten Zelllinien nicht komplementiert werden, jedoch wurden Hinweise auf einen dominant-negativen Effekt von FAAP100138 auf den FA/BRCA-Signalweg gefunden. Dies könnte zu der Erklärung beitragen, warum und wie der Signalweg, beispielsweise in bestimmtem Gewebearten, herunterreguliert wird. Zudem wäre eine Verwendung in der Krebstherapie denkbar.
Our current data demonstrate that besides the known risk factors, including apical aneurysm, reduced left ventricular longitudinal systolic function (MAPSE) and advanced diastolic dysfunction, Right ventricular dysfunction as determined by reduced tricuspid annular plane systolic excursion (TAPSE) or right ventricular fractional area change (RV_FAC) is independently associated with left ventricular thrombus formation in acute anterior myocardial infarction patients, especially in the setting of anterior myocardial infarction without the formation of an apical aneurysm. This study suggests that besides left ventricular abnormalities, right ventricular dysfunction likewise contributes LVT formation in patients with acute anterior myocardial infarction.
Ziel der Studie: Evaluation der Effektivität und Sicherheit des Kollagen-Crosslinkings der Hornhaut mit Riboflavin und UV-A (CXL) bei progressivem Keratokonus über einen Nachbeobachtungszeitraum von bis zu 10 Jahren.
Design: Retrospektive klinische Längsschnittstudie
Methoden: 131 Augen von 131 Patienten (männlich:weiblich = 95:36) erhielten an der Universitäts-Augenklinik Würzburg zwischen 2006 und 2016 ein Kollagen-Crosslinking (CXL) nach dem Dresdner Standardprotokoll, bestehend aus einer Abrasio, Applikation von iso-osmolaren Riboflavin/Dextran-Augentropfen für 30 min und anschließender UV-A-Bestrahlung mit 3 mW/cm2 für 30 min. Die retrospektive Nachbeobachtung betrug 1 (n=103 Augen) bis maximal 10 Jahre (n=44 Augen). Einschlusskriterien waren eine Zunahme des maximalen Hornhautkrümmungsradius (Kmax, gemessen mittels Pentacam HR) >1 dpt und eine Hornhautdicke >400 µm nach Abrasio. Für parametrische bzw. nichtparametrische Daten wurde der T-Test bzw. der Wilcoxon-Vorzeichen-Rangsummentest durchgeführt.
Ergebnisse: 1 bis 3 Jahre präoperativ nahm der Median von Kmax und K2 signifikant um 1,5 dpt (p=0,001) und 1,1 dpt (p<0,001) bis zur Behandlung zu. Die apikale Hornhautdicke nahm nach 1-3 Jahren präoperativ um 12 µm ab (p=0,003).
Postoperativ stieg der Median von K2 zunächst bis nach 1 Jahr um 0,1 dpt, nahm dann aber über den weiteren Nachbeobachtungszeitraum kontinuierlich ab, nach 10 Jahren lag er um 0,85 dpt (p=0,021) unter dem Ausgangswert. Die mittlere apikale Hornhautdicke nahm nach 3, 7 bzw. 10 Jahren um 11 µm (p<0,001), 9 µm (p=0,014) und 3 µm (p=0,358) ab. Der mediane Kmax zeigte Schwankungen ohne signifikante Veränderung. Der mittlere bestkorrigierte Visus (logMAR) nahm nach 5 Jahren signifikant um 0,13 und nach 10 Jahren um 0,08 ab (p=0,013 und p=0,010).
Der Anteil der Non-Responder, definiert durch einen postoperativen Anstieg von Kmax>2 dpt, nahm von 16% nach 5 auf 33% nach 10 Jahren zu. Risikofaktoren waren ein junges Alter, hoher Astigmatismus, eine dünne Hornhaut und atopische Dermatitis. 4 Augen erhielten im Verlauf komplikationslos eine Revernetzung, woraufhin sich keine weitere Krankheitsprogression zeigte.
Fazit: Die CXL-Behandlung kann die Progression des Keratokonus verlangsamen oder stoppen. Allerdings war ab 5 Jahren nach dem Eingriff eine Abnahme des Anteils der Responder zu beobachten. Regelmäßige Nachkontrollen sollten daher besonders auch im Langzeitverlauf durchgeführt werden, um eine erneute Progression frühzeitig erkennen und behandeln zu können.
Platelets, derived from megakaryocytes (MKs) in the bone marrow (BM), are small, anucleated cells that circulate in the bloodstream and are critical for thrombosis and hemostasis. Megakaryo- and subsequent thrombopoiesis are highly orchestrated processes involving the differentiation and maturation of MKs from hematopoietic stem cells (HSCs), after which MKs are able to release platelets into the bloodstream, a process termed proplatelet formation (PPF). Here, the MK penetrates the endothelial lining and releases cytoplasmic portions (proplatelets) into the blood stream, which finally mature into platelets within the ciruculation. PPF requires an extensive crosstalk as well as a tight regulation of the MK cytoskeleton, in which small GTPases of the Rho family, such as RhoA and Cdc42 are critically involved and play opposing roles. MK and platelet specific Cdc42 or RhoA-deficiency in mice results in macrothrombocytopenia. Moreover, RhoA deficient mice displayed a frequent mislocalization of entire MKs into BM sinusoids, a finding that was reverted upon concomitant lack of Cdc42 but accompanied by an aggravated macrothrombocytopenia. Whether receptors are involved in the process of transendothelial MK migration, however, remained unclear.
In the first part of this thesis, a centrifugation-based method (‘spin isolation’) to harvest murine BM cells was established, which not only reduces experimental time, costs and animals but is also highly suitable for studies on primary and in vitro cultured BM-derived cells. The spin isolation was used particularly for MK studies during the course of the thesis.
In the second part of this thesis, a MK- and platelet-specific RhoA/Cdc42 double-deficiency was shown to result in reduced expression of a variety of MK-specific glycoproteins and cytoskeletal regulators of importance during MK maturation and PPF, a phenotype culminating in virtually abolished platelet biogenesis. We thus uncovered that RhoA/Cdc42-regulated gene expression is a prerequisite for cytoplasmic MK maturation, but dispensable for endomitosis.
In the third part of this thesis we analyzed mice double-deficient in RhoA and prominent MK receptors which are potentially involved in the regulation of PPF in the BM environment. We were able to show that integrins as well as the inhibitory receptor G6b-B are dispensable for transendothelial migration of RhoA-deficient MKs. Surprisingly however, the myelofibrosis and concomitant osteosclerosis observed in G6b-B single-deficient mice was attenuated in RhoA/G6b B double-deficient mice, thus implying an important role of RhoA during myelofibrotic disease progression. BM transplantation experiments furthermore revealed that not only the macrothrombocytopenia but also the transmigration of RhoA-deficient MKs is due to cell-intrinsic defects and not related to possible Pf4-Cre off-target effects in non-hematopoietic cells.
In the last part of this study we demonstrated that the new approach for MK- and platelet-specific gene ablatation using Gp1ba-Cre deleter mice is associated with intrinsic MK defects and in addition results in insufficient depletion of RhoA compared to the Pf4-Cre model, positioning the latter still as the gold standard for studying MK biology.