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Echinococcus multilocularis is the causative agent of alveolar echinococcosis (AE), a life-threatening disease with limited options of chemotherapeutic treatment. Anti-AE chemotherapy is currently based on a single class of drugs, the benzimidazoles. Although acting parasitocidic in vitro, benzimidazoles are merely parasitostatic during in vivo treatment of AE and cause severe site effects. In the case of operable lesions, the resection of parasite tissue needs to be supported by a prolonged chemotherapy. Thus, the current treatment options for AE are inadequate and require alternatives. In the present work, the flatworm signaling pathways were analyzed to establish potential targets for novel therapeutic approaches. I focused on factors that are involved in development and proliferation of E. multilocularis using molecular, biochemical and cell biological methods. Among the analysed factors were three MAP kinases of the parasite, EmMPK1, an Erk-1/2 orthologue, EmMPK2, a p38 orthologue and EmMPK3, an Erk7/8 orthologue. Further, I identified and characterized EmMKK2, a MEK1/2 orthologue of the parasite, which, together with the known kinases EmRaf and EmMPK1, forms an Erk1/2-like MAPK module. Moreover, I was able to demonstrate several influences of host growth factors such as EGF (epidermal growth factor) and insulin on worm signaling mechanisms and larval growth, including the phosphorylation of Elp, an ezrin-radixin-moesin like protein, EmMPK1, EmMPK3 and increased mitotic activity of Echinococcus cells. In addition, several substances were examined for their efficacy against the parasite including (i) general tyrosine kinase inhibitors (PP2, leflunamide), (ii) compounds designed to inhibit the activity of receptor tyrosine kinases, (iii) anti-neoplastic agents (miltefosine, perifosine), (iv) serine/threonine kinase inhibitors that have been designed to block the Erk1/2 MAPK cascade and (v) inhibitors of p38 MAPKs. In these studies, EmMPK2 proved to be a promising drug target for the following reasons. Amino acid sequence analysis disclosed several differences to human p38 MAPKs, which is likely to be the reason for the observed enhanced basal activity of recombinant EmMPK2 towards myelin basic protein in comparison to human recombinant p38 MAPK-α. In addition, the prominent auto-phosphorylation activity of the recombinant EmMPK2 protein together with the absence of an interaction with the Echinococcus MKKs suggest a different mechanism of regulation compared to the human enzyme. EmMPK2 activity could be effectively inhibited in vitro and in cultivated metacestode vesicles by treatment with SB202190 and ML3403, two ATP-competitive pyridinyl imidazole inhibitors of p38 MAPKs, in a concentration-dependent manner. Moreover, both compounds, in particular ML3403, caused parasite vesicle inactivation at concentrations which did not affect cultured mammalian cells. Likewise, during the cultivation of Echinococcus primary cells, the presence of ML3403 prevented the generation of new vesicles. Targeting members of the EGF signaling pathway, particulary of the Erk1/2-like MAPK cascade, with Raf and MEK inhibitors prevented the phosphorylation of EmMPK1 in metacestodes cultivated in vitro. However, although parasite growth was prevented under these conditions, the structural integrity of the metacestode vesicles maintained during long-term cultivation in the presence of the MAPK cascade inhibitors. Similar results were obtained when studying the effects of other drugs mentioned above. Taken together, several targets could be identified that reacted with high sensitivity to the presence of inhibitory substances, but did not cause the parasite’s death with one exception, the pyridinyl imidazoles. Based on the presented data, I suggest pyridinyl imidazoles as a novel class of anti-Echinococcus drugs and imply EmMPK2 as survival signal mediating factor, the inhibition of which could be used for the treatment of AE.
According to the hygiene hypothesis, the exposure to infectious agents in early childhood prevents the development of allergen-specific Th2 immune responses because it establishes Th1-based immunity or alternatively, induces the generation of T regulatory cells. Based on this theory, the present study pretended to identify promising microorganism-derived vaccine candidates against allergic asthma in the murine model. In the first part of this work, the efficacy of four different known Th1-inducing adjuvants, i.e. live BCG, heat-killed BCG, CpG and PPD, as components of vaccines aimed at inhibiting allergic asthma was compared. All the adjuvants were effective in inhibiting the development of allergen-induced airway eosinophilia, mucus production, and with the exception of PPD also airway hyperreactivity (AHR), when they were applied together with OVA/alum. Suppression of airway eosinophilia was not observed in IFN-gamma- or IL-12-deficient mice (hk-BCG, CpG-ODN and PPD). Interestingly, live BCG was still able to suppress allergen-induced Th2 responses in the absence of either IFN-gamma or IL-12. The effect of live BCG was also independent on IL-10-, TLR-2-, TLR-4- or MyD88-mediated signaling. When mice vaccinated with the different adjuvants together with OVA/alum were subjected to a second period of OVA/alum immunization, only live and hk-BCG were able to efficiently suppress the development of airway inflammation. This effect could be adoptively transferred by CD4+ T cells. Taken together our data suggest that live BCG>>hk-BCG>CpG>PPD are effective in suppressing allergen-induced Th2 responses. Secondly, the evaluation of a dendritic cell-based vaccination strategy leading to the induction of allergen-specific Th1 cells to protect against the development of allergen-specific Th2 responses was performed. The application of OVA-pulsed BM-DC maturated with CpG was unable to reduce airway eosinophilia and inflammation in OVA-immunized mice. OVA-specific IgG1 or IgE serum levels were also not reduced. The experiments using LC pulsed with OVA yielded similar results. However, the mice vaccinated with CpG/OVA pulsed BM-DC had greatly enhanced levels of OVA-specific IgG2a in the serum, suggesting the induction of allergen-specific Th1 responses in vivo. Thus, these data suggest that the vaccination of mice with OVA-pulsed BM-DC matured with CpG or OVA-pulsed LC did not result in a reduction of allergen-specific Th2 responses in a murine model of severe atopic asthma. Lastly, NES, an excretory/secretory product derived from the helminth Nippostrongylus brasiliensis was evaluated as a new potential adjuvant to prevent the development of allergic responses. The application of NES together with OVA/alum greatly inhibited the development of airway eosinophilia, airway goblet cell metaplasia and mucus production and the development of airway hyperreactivity after metacholine challenge. Furthermore, OVA-specific IgG1 and IgE levels in the serum were also strongly reduced. NES preparations contained small amounts of endotoxin, which may explain these results. However, the suppressive effects of NES on the development of allergen-specific Th2 responses was independent upon IFN-gamma or TLR-4 and still observed in mice treated with LPS-depleted NES. NES reduced OVA-induced Th2 responses also in a IL-10-independent manner. In addition, the digestion with proteinase K or the heat-treatment of NES did not abolish its ability to inhibit allergen-induced Th2 responses. Interestingly, NES suppress OVA-specific Th2 responses in vivo in the presence of a strong NES-specific Th2 environment. Taken together our results suggest that the helminth N. brasiliensis secretes substances which interfere with the development of allergic Th2 responses. In summary, distinct substances derived from microorganisms or helminths which may be used as potential adjuvants to prevent the development of allergic Th2 responses were identified. These findings contribute to the design of efficient vaccines protecting humans from developing allergic asthma.