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ResearcherID
- I-5818-2014 (1)
Background
Postherpetic neuralgia (PHN) is the painful complication of a varicella zoster virus reactivation. We investigated the systemic and local gene expression of pro- and anti-inflammatory cytokine expression in patients with PHN.
Methods
Thirteen patients with PHN at the torso (Th4-S1) were recruited. Skin punch biopsies were obtained from the painful and the contralateral painless body area for intraepidermal nerve fiber density (IENFD) and cytokine profiling. Additionally, blood was withdrawn for systemic cytokine expression and compared to blood values of healthy controls. We analyzed the gene expression of selected pro- and anti-inflammatory cytokines (tumor necrosis factor-alpha [TNF] and interleukins [IL]-1β, IL-2, and IL-8).
Results
IENFD was lower in affected skin compared to unaffected skin (p<0.05), while local gene expression of pro- and anti-inflammatory cytokines did not differ except for two patients who had 7fold higher IL-6 and 10fold higher IL-10 gene expression in the affected skin compared to the contralateral unaffected skin sample. Also, the systemic expression of cytokines in patients with PHN and in healthy controls was similar.
Conclusion
While the systemic and local expression of the investigated pro- and anti-inflammatory cytokines was not different from controls, this may have been influenced by study limitations like the low number of patients and different disease durations. Furthermore, other cytokines or pain mediators need to be considered.
High-Dose Capsaicin for the Treatment of Neuropathic Pain: What We Know and What We Need to Know
(2014)
Neuropathic pain is a frequent and disabling condition with diverse underlying etiologies and is often difficult to treat. Systemic drug treatment is often limited in efficacy. Furthermore, adverse effects may be a limiting factor when trying to reach the necessary dose. Analgesics that can be applied topically have the potential to largely overcome this problem. They may be of particular advantage in localized neuropathic pain syndromes such as postherpetic neuralgia or small fiber neuropathy. Capsaicin, the pungent component of chili peppers, is a natural ligand of the transient receptor potential vanilloid 1 channel and has long been used as topically applicable cream with concentrations of 0.025 to 0.075%. In 2009, a high-concentration transdermal capsaicin 8% patch (Qutenza ; Acorda Therapeutics, Inc., Ardsley, NY, USA; Astellas Pharma Europe Ltd., Chertsey, Surrey, UK) was introduced for the treatment of peripheral neuropathic pain syndromes other than of diabetic origin in adults. It has since been widely used in diverse neuropathic pain disorders. In this review article, we summarize current knowledge on Qutenza, its advantages and problems, and expose unmet needs.
Skin cytokine expression in patients with fibromyalgia syndrome is not different from controls
(2014)
Background
Fibromyalgia syndrome (FMS) is a chronic pain syndrome of unknown etiology. There is increasing evidence for small nerve fiber impairment in a subgroup of patients with FMS. We investigated whether skin cytokine and delta opioid receptor (DOR) gene expression in FMS patients differs from controls as one potential contributor to small nerve fiber sensitization.
Methods
We investigated skin punch biopsies of 25 FMS patients, ten patients with monopolar depression but no pain, and 35 healthy controls. Biopsies were obtained from the lateral upper thigh and lower calf. Gene expression of the pro-inflammatory cytokines tumor necrosis factor-alpha (TNF), interleukin (IL)-6, and IL-8 and of the anti-inflammatory cytokine IL-10 was analyzed using quantitative real-time PCR and normalizing data to 18sRNA as housekeeping gene. Additionally, we assessed DOR gene expression.
Results
All cytokines and DOR were detectable in skin samples of FMS patients, patients with depression, and healthy controls without intergroup difference. Also, gene expression was not different in skin of the upper and lower leg within and between the groups and in FMS patient subgroups.
Conclusions
Skin cytokine and DOR gene expression does not differ between patients with FMS and controls. Our results do not support a role of the investigated cytokines in sensitization of peripheral nerve fibers as a potential mechanism of small fiber pathology in FMS.
A high load of white matter lesions and enlarged basilar arteries have been shown in selected patients with Fabry disease, a disorder associated with an increased stroke risk. We studied a large cohort of patients with Fabry disease to differentially investigate white matter lesion load and cerebral artery diameters. We retrospectively analyzed cranial magnetic resonance imaging scans of 87 consecutive Fabry patients, 20 patients with ischemic stroke, and 36 controls. We determined the white matter lesion load applying the Fazekas score on fluid-attenuated inversion recovery sequences and measured the diameters of cerebral arteries on 3D-reconstructions of the time-of-flight-MR-angiography scans. Data of different Fabry patient subgroups (males – females; normal – impaired renal function) were compared with data of patients with stroke and controls. A history of stroke or transient ischemic attacks was present in 4/30 males (13%) and 5/57 (9%) females with Fabry disease, all in the anterior circulation. Only one man with Fabry disease showed confluent cerebral white matter lesions in the Fazekas score assessment (1%). Male Fabry patients had a larger basilar artery (p<0.01) and posterior cerebral artery diameter (p<0.05) compared to male controls. This was independent of disease severity as measured by renal function and did not lead to changes in arterial blood flow properties. A basilar artery diameter of >3.2 mm distinguished between men with Fabry disease and controls (sensitivity: 87%, specificity: 86%, p<0.001), but not from stroke patients. Enlarged arterial diameters of the posterior circulation are present only in men with Fabry disease independent of disease severity.
Organic solar cells have great potential to become a low-cost and clean alternative to conventional photovoltaic technologies based on the inorganic bulk material silicon. As a highly promising concept in the field of organic photovoltaics, bulk heterojunction (BHJ) solar cells consist of a mixture of an electron donating and an electron withdrawing component. Their degree of intermixing crucially affects the generation of photocurrent. In this work, the effect of an altered blend morphology on polaron pair dissociation, charge carrier transport, and nongeminate recombination is analyzed by the charge extraction techniques time delayed collection field (TDCF) and open circuit corrected transient charge extraction (OTRACE). Different comparative studies cover a broad range of material systems, including polymer and small-molecule donors in combination with different fullerene acceptors. The field dependence of polaron pair dissociation is analyzed in blends based on the polymer pBTTT-C16, allowing a systematic tuning of the blend morphology by varying the acceptor type and fraction. The effect of both excess photon energy and intercalated phases are minor compared to the influence of excess fullerene, which reduces the field dependence of photogeneration. The study demonstrates that the presence of neat fullerene domains is the major driving force for efficient polaron pair dissociation that is linked to the delocalization of charge carriers. Furthermore, the influence of the processing additive diiodooctane (DIO) is analyzed using the photovoltaic blends PBDTTT-C:PC71BM and PTB7:PC71BM. The study reveals amulti-tiered alteration of the blend morphology of PBDTTT-C based blends upon a systematic increase of the amount of DIO. Domains on the hundred nanometers length scale in the DIO-free blend are identified as neat fullerene agglomerates embedded in an intermixed matrix. With the addition of the additive, 0.6% and 1% DIO already substantially reduces the size of these domains until reaching the optimum 3% DIO mixture, where a 7.1% power conversion efficiency is obtained. It is brought into connection with the formation of interpenetrating polymer and fullerene phases. Similar to PBDTTT-C, the morphology of DIO-free PTB7:PC71BM blends is characterized by large fullerene domains being decreased in size upon the addition of 3% DIO. OTRACE measurements reveal a reduced Langevin-type, super-second order recombination in both blends. It is demonstrated that the deviation from bimolecular recombination kinetics cannot be fully attributed to the carrier density dependence of the mobility but is rather related to trapping in segregated PC71BM domains. Finally, with regard to small-molecule donors, a higher yield of photogeneration and balanced transport properties are identified as the dominant factors enhancing the efficiency of vacuum deposited MD376:C60 relative to its solution processed counterpart MD376:PC61BM. The finding is explained by a higher degree of dimerization of the merocyanine dye MD376 and a stronger donor-acceptor interaction at the interface in the case of the vacuum deposited blend.
Microcin C (McC) is a peptide-nucleotide antibiotic produced by Escherichia coli cells harboring a plasmid-borne operon mccABCDE. The heptapeptide MccA is converted into McC by adenylation catalyzed by the MccB enzyme. Since MccA is a substrate for MccB, a mechanism that regulates the MccA/MccB ratio likely exists. Here, we show that transcription from a promoter located upstream of mccA directs the synthesis of two transcripts: a short highly abundant transcript containing the mccA ORF and a longer minor transcript containing mccA and downstream ORFs. The short transcript is generated when RNA polymerase terminates transcription at an intrinsic terminator located in the intergenic region between the mccA and mccB genes. The function of this terminator is strongly attenuated by upstream mcc sequences. Attenuation is relieved and transcription termination is induced when ribosome binds to the mccA ORF. Ribosome binding also makes the mccA RNA exceptionally stable. Together, these two effects-ribosome induced transcription termination and stabilization of the message-account for very high abundance of the mccA transcript that is essential for McC production. The general scheme appears to be evolutionary conserved as ribosome-induced transcription termination also occurs in a homologous operon from Helicobacter pylori.
Bacterial mastitis is caused by invasion of the udder, bacterial multiplication and induction of
inflammatory responses in the bovine mammary gland. Disease severity and the cause of disease are
influenced by environmental factors, the cow’s immune response as well as bacterial traits. Escherichia coli (E. coli) is one of the main causes of acute bovine mastitis, but although pathogenic E. coli strains can be classified into different pathotypes, E. coli causing mastitis cannot unambiguously be distinguished from commensal E. coli nor has a common set of virulence factors
been described for mastitis isolates. This project focussed on the characterization of virulence-
associated traits of E. coli mastitis isolates in comprehensive analyses under conditions either
mimicking initial pathogenesis or conditions that E. coli mastitis isolates should encounter while entering the udder. Virulence-associated traits as well as fitness traits of selected bovine mastitis or faecal E. coli strains were identified and analyzed in comparative phenotypic assays. Raw milk whey was introduced to
test bacterial fitness in native mammary secretion known to confer antimicrobial effects.
Accordingly, E. coli isolates from bovine faeces represented a heterogeneous group of which some
isolates showed reduced ability to survive in milk whey whereas others phenotypically resembled
mastitis isolates that represented a homogeneous group in that they showed similar survival and
growth characteristics in milk whey. In contrast, mastitis isolates did not exhibit such a uniform phenotype when challenged with iron shortage, lactose as sole carbon source and lingual
antimicrobial peptide (LAP) as a main defensin of milk. Reduced bacterial fitness could be related to LAP suggesting that bacterial adaptation to an intramammary lifestyle requires resistance to host
defensins present in mammary secretions, at least LAP.
E. coli strain 1303 and ECC-1470 lack particular virulence genes associated to mastitis isolates. To find out whether differences in gene expression may contribute to the ability of E. coli variants to cause mastitis, the transcriptome of E. coli model mastitis isolates 1303 and ECC-1470 were analyzed to
identify candidate genes involved in bacterium-host interaction, fitness or even pathogenicity during bovine mastitis.
DNA microarray analysis was employed to assess the transcriptional response of E. coli 1303 and
ECC-1470 upon cocultivation with MAC-T immortalized bovine mammary gland epithelial cells to
identify candidate genes involved in bacterium-host interaction. Additionally, the cell adhesion and invasion ability of E. coli strain 1303 and ECC-1470 was investigated. The transcriptonal response to the presence of host cells rather suggested competition for nutrients and oxygen between E. coli and MAC-T cells than marked signs of adhesion and invasion. Accordingly, mostly fitness traits that may also contribute to efficient colonization of the E. coli primary habitat, the gut, have been utilized by the mastitis isolates under these conditions. In this study, RNA-Seq was employed to assess the bacterial transcriptional response to milk whey.
According to our transcriptome data, the lack of positively deregulated and also of true virulence-associated determinants in both of the mastitis isolates indicated that E. coli might have adapted by other means to the udder (or at least mammary secretion) as an inflammatory site. We identified traits that promote bacterial growth and survival in milk whey. The ability to utilize citrate promotes fitness and survival of E. coli that are thriving in mammary secretions. According to our results, lactoferrin has only weak impact on E. coli in mammary secretions. At the same time bacterial determinants involved in iron assimilation were negatively regulated, suggesting that, at least during the first hours, iron assimilation is not a challenge to E. coli colonizing the mammary gland. It has been hypothesized that cellular iron stores cause temporary independency to extracellular accessible iron. According to our transcriptome data, this hypothesis was supported and places iron uptake
systems beyond the speculative importance that has been suggested before, at least during early
phases of infection. It has also been shown that the ability to resist extracytoplasmic stress, by oxidative conditions as well as host defensins, is of substantial importance for bacterial survival in mammary secretions.
In summary, the presented thesis addresses important aspects of host-pathogen interaction and
bacterial conversion to hostile conditions during colonization of the mastitis inflammatory site, the mammary gland.
Background: Evidence concerning the importance of glucose lowering in the prevention of cardiovascular (CV) outcomes remains controversial. Given the multi-faceted pathogenesis of atherosclerosis in diabetes, it is likely that any intervention to mitigate this risk must address CV risk factors beyond glycemia alone. The SGLT-2 inhibitor empagliflozin improves glucose control, body weight and blood pressure when used as monotherapy or add-on to other antihyperglycemic agents in patients with type 2 diabetes. The aim of the ongoing EMPA-REG OUTCOME (TM) trial is to determine the long-term CV safety of empagliflozin, as well as investigating potential benefits on macro-/microvascular outcomes.
Methods: Patients who were drug naive (HbA(1c) >= 7.0% and <= 9.0%), or on background glucose-lowering therapy (HbA(1c) >= 7.0% and <= 10.0%), and were at high risk of CV events, were randomized (1:1:1) and treated with empagliflozin 10 mg, empagliflozin 25 mg, or placebo (double blind, double dummy) superimposed upon the standard of care. The primary outcome is time to first occurrence of CV death, non-fatal myocardial infarction, or non-fatal stroke. CV events will be prospectively adjudicated by an independent Clinical Events Committee. The trial will continue until >= 691 confirmed primary outcome events have occurred, providing a power of 90% to yield an upper limit of the adjusted 95% CI for a hazard ratio of <1.3 with a one-sided a of 0.025, assuming equal risks between placebo and empagliflozin (both doses pooled). Hierarchical testing for superiority will follow for the primary outcome and key secondary outcomes (time to first occurrence of CV death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for unstable angina pectoris) where non-inferiority is achieved.
Results: Between Sept 2010 and April 2013, 592 clinical sites randomized and treated 7034 patients (41% from Europe, 20% from North America, and 19% from Asia). At baseline, the mean age was 63 +/- 9 years, BMI 30.6 +/- 5.3 kg/m(2), HbA1c 8.1 +/- 0.8%, and eGFR 74 +/- 21 ml/min/1.73 m(2). The study is expected to report in 2015.
Discussion: EMPA REG OUTCOME (TM) will determine the CV safety of empagliflozin in a cohort of patients with type 2 diabetes and high CV risk, with the potential to show cardioprotection.
In this work the synthesis of dendritic macromolecules and small redox cascades was reported and studies of their energy and electron transfer properties discussed.
The chromophores in the dendrimers and the redox cascades are linked via triazoles, which were built up by CuAAC. Thereby, a synthetic concept based on building blocks was implemented, which allowed the exchange of all basic components. Resulting structures include dendrimers composed exclusively of TAAs (G1–G3), dendrimers with an incorporated spirobifluorene core (spiro-G1 and spiro-G2) and the donor-acceptor dendrimer D-A-G1, in which the terminal groups are exchanged by NDIs.
Furthermore, a series of model compounds was synthesised in order to achieve a better understanding of the photophysical processes in the dendrimers.
A modification of the synthetic concept for dendrimers enabled the synthesis of a series of donor-acceptor triads (T-Me, T-Cl and T-CN) consisting of two TAA donors and one NDI acceptor unit. The intermediate TAA chromophore ensured a downhill redox gradient from the NDI to the terminal TAA, which was proved by cyclic voltammetry measurements. The redox potential of the intermediate TAA was adjusted by different redox determining substituents in the “free” p-position of the TAA. Additionally, two dyads (Da and Db) were synthesised which differ in the junction of the triazole to the TAA or the NDI, respectively. In these cascades a nodal-plane along the N-N-axes in the NDI and a large twist angle between the NDI and the N-aryl substituent guaranteed a small electronic coupling.
The photophysical investigations of the dendrimers focused on the homo-energy transfer properties in the TAA dendrimers G1–G3. Steady-state emission spectroscopy revealed that the emission takes place from a charge transfer state. The polar excited state resulted in a strong Stokes shift of the emission, which in turn led to a small spectral overlap integral between the absorption of the acceptor and the emission of the donor in the solvent relaxed state. According to the Förster theory, the overlap integral strongly determines the energy transfer rate. Fluorescence up-conversion measurements showed a strong and rapid initial fluorescence anisotropy decay and a much slower decrease on the longer time scale. The experiment revealed a fast energy transfer in the first 2 ps followed by a much slower energy hopping. Time resolved emission spectra (TRES) of the model compound M indicated a solvent relaxation on the same time scale as the fast energy transfer.
The Förster estimation of energy transfer rates in G1 explains fast energy transfer in the vibrotionally relaxed state before solvent relaxation starts. Thereby, the emission spectrum of G1 in cyclohexane served as the time zero spectrum. Thus, solvent relaxation and fast energy transfer compete in the first two ps after excitation and it is crucial to discriminate between energy transfer in the Franck-Condon and in the solvent relaxed state. Furthermore, this finding demonstrates that fast energy transfer occurs even in charge transfer systems where a large Stokes shift prevents an effective spectral overlap integral if there is a sufficient overlap integral in before solvent relaxation.
Energy transfer upon excitation was also observed in the spiro dendrimers spiro-G1 and spiro-G2 and identified by steady-state emission anisotropy measurements. It was assumed that the energy in spiro-G1 is completely distributed over the entire molecule while the energy in spiro-G2 is probably distributed over only one individual branch. This finding was based on a more polarised emission of spiro-G2 compared to spiro-G1. This issue has to be ascertained by e.g. time resolved emission anisotropy measurements in further energy transfer studies.
Concerning the electron transfer properties of TAA-triazole systems the radical cations of G1–G2, spiro-G1 and spiro-G2 and of the model compound M were investigated by steady-state absorption spectroscopy. Experiments showed that the triazole bridge exhibits small electronic communication between the adjacent chromophores but still possesses sufficient electronic coupling to allow an effective electron transfer from one chromophore to the other.
Due to the high density of chromophores, their D-A-D structure and their superficial centrosymmetry, the presented dendrimers are prospective candidates for two-photon absorption applications.
The dyads, triads and the donor-acceptor dendrimer D-A-G1 were investigated regarding their photoinduced electron transfer properties and the effects that dominate charge separation and charge recombination in these systems.
The steady-state absorption spectra of all cascades elucidated a superposition of the absorption characteristics of the individual subunits and spectra indicated that the chromophores do not interact in the electronic ground state.
Time resolved transient absorption spectroscopy of the cascades was performed in the fs- and ns-time regime in MeCN and toluene as solvent. Measurements revealed that upon with 28200 cm-1 (355) nm and 26300 cm-1 (380 nm), respectively, an electron is transferred from the TAA towards the NDI unit yielding a CS state. In the triads at first a CS1 state is populated, in which the NDI is reduced and the intermediate TAA1 is oxidised. Subsequently, an additional electron transfer from the terminal TAA2 to TAA1 led to the fully CS2 state. Fully CS states of the dyads and triads exhibit lifetimes in the ns-time regime. In contrast for Db in MeCN, a lifetime of 43 ps was observed for the CS state together with the population of a 3NDI state. The signals of the other CS states decay biexponentially, which is a result of the presence of the 1CS and the 3CS states. While magnetic field dependent measurements of Db did not show an effect due to the large singlet-triplet splitting, T-CN exhibited a strong magnetic field dependence which is an evidence for the 1CS/3CS assignment. Further analysis of the singlet-triplet dynamics are required and are currently in progress.
Charge recombination occurred in the Marcus inverted region for compounds solved in toluene and in the Marcus normal region for MeCN as solvent. However, a significant inverted region effect was observed only for Db. Triads are probably characterised by charge recombination rates in the inverted and in the normal region near to the vertex of the Marcus parabola. Hence the inverted region effect is not pronounced and the rate charge recombination rates are all in the same magnitude. However, compared to the charge recombination rate of Db the enlarged spatial distance between the terminal TAA and the NDI in the fully CS2 states in the triads resulted in reduced charge recombination rates by ca. one order of magnitude.
More important than a small charge recombination rate is an overall lifetime of the CS states and this lifetime can significantly be enhanced by the population of the 3CS state. The reported results reveal that a larger singlet-triplet splitting in the dyads led to a CS state lifetime in the us time regime while a lifetime in the ns-time regime was observed in cases of the triads. Moreover, the singlet-triplet splitting was found to be solvent dependent in the triads, which is a promising starting point for further investigations concerning singlet-triplet splitting.
The donor-acceptor dendrimer D-A-G1 showed similar characteristics to the dyads. The generation of a CS state is assumed due to a clear NDI radical anion band in the transient absorption spectrum. Noteworthy, the typical transient absorption band of the TAA radical cation is absent for D A-G1 in toluene. Bixon-Jortner analysis yielded a similar electronic coupling in D-A-G1 compared to the dyads. However, the charge recombination rate is smaller than of Db due to a more energetic CS state, which in the inverted region slows down charge recombination. In combination a singlet-triplet splitting similar to the dyads prolongs the CS state lifetime up to 14 us in diluted solution. Both effects result in an even better performance of D-A-G1 concerning energy conversion. D A-G1 is therefore a promising key structure for further studies on light harvesting applications. In a prospective study a second generation donor-acceptor dendrimer D-A-G2 might be an attractive structure accessible by “click reaction” of 13 and 8. D-A-G2 is expected to exhibit a downhill oriented gradient of CS states as assumed from the CV studies on G1–G3.