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Background
Therapeutic vaccination directed to induce an anti-tumoral T-cell response is a field of extensive investigation in the treatment of melanoma. However, many vaccination trials in melanoma failed to demonstrate a correlation between the vaccine-specific immune response and therapy outcome. This has been mainly attributed to immune escape by antigen loss, rendering us in the need of new vaccination targets.
Patients and methods
This phase-II trial investigated a peptide vaccination against survivin, an oncogenic inhibitor-of-apoptosis protein crucial for the survival of tumor cells, in HLA-A1/-A2/-B35-positive patients with treatment-refractory stage-IV metastatic melanoma. The study endpoints were survivin-specific T-cell reactivity (SSTR), safety, response, and survival (OS).
Results
Sixty-one patients (ITT) received vaccination therapy using three different regimens. 55 patients (PP) were evaluable for response and survival, and 41/55 for SSTR. Patients achieving progression arrest (CR + PR + SD) more often showed SSTRs than patients with disease progression (p = 0.0008). Patients presenting SSTRs revealed a prolonged OS (median 19.6 vs. 8.6 months; p = 0.0077); multivariate analysis demonstrated SSTR as an independent predictor of survival (p = 0.013). The induction of SSTRs was associated with gender (female vs. male; p = 0.014) and disease stage (M1a/b vs. M1c; p = 0.010), but not with patient age, HLA type, performance status, or vaccination regimen.
Conclusion
Survivin-specific T-cell reactivities strongly correlate with tumor response and patient survival, indicating that vaccination with survivin-derived peptides is a promising treatment strategy in melanoma.
Background
Therapeutic vaccination directed to induce an anti-tumoral T-cell response is a field of extensive investigation in the treatment of melanoma. However, many vaccination trials in melanoma failed to demonstrate a correlation between the vaccine-specific immune response and therapy outcome. This has been mainly attributed to immune escape by antigen loss, rendering us in the need of new vaccination targets.
Patients and methods
This phase-II trial investigated a peptide vaccination against survivin, an oncogenic inhibitor-of-apoptosis protein crucial for the survival of tumor cells, in HLA-A1/-A2/-B35-positive patients with treatment-refractory stage-IV metastatic melanoma. The study endpoints were survivin-specific T-cell reactivity (SSTR), safety, response, and survival (OS).
Results
Sixty-one patients (ITT) received vaccination therapy using three different regimens. 55 patients (PP) were evaluable for response and survival, and 41/55 for SSTR. Patients achieving progression arrest (CR + PR + SD) more often showed SSTRs than patients with disease progression (p = 0.0008). Patients presenting SSTRs revealed a prolonged OS (median 19.6 vs. 8.6 months; p = 0.0077); multivariate analysis demonstrated SSTR as an independent predictor of survival (p = 0.013). The induction of SSTRs was associated with gender (female vs. male; p = 0.014) and disease stage (M1a/b vs. M1c; p = 0.010), but not with patient age, HLA type, performance status, or vaccination regimen.
Conclusion
Survivin-specific T-cell reactivities strongly correlate with tumor response and patient survival, indicating that vaccination with survivin-derived peptides is a promising treatment strategy in melanoma.
Objective:
To determine the survival in a population of German patients with Duchenne muscular dystrophy.
Patients and methods:
Information about 94 patients born between 1970 and 1980 was obtained by telephone interviews and questionnaires. In addition to age of death or actual age during the investigation, data concerning clinical course and medical interventions were collected.
Results:
67 patients with molecularly confirmed diagnoses had a median survival of 24.0 years. Patients without molecular confirmation (clinical diagnosis only) had a chance of 67 % to reach that age. Grouping of our patient cohort according to the year of death (before and after 2000), ventilation was recognized as main intervention affecting survival with ventilated reaching a median survival of 27.0 years. For those without ventilation it was 19.0 years.
Conclusion and clinical relevance:
our study provides survival data for a cohort of DMD patients in Germany stratified by year of death. Median survival was 24.0 years in patients confirmed by molecular testing. Ventilated patients had a median survival of 27 years. We consider this piece of information helpful in the medical care of DMD patients.
Autoimmune diseases, unwanted overshooting immune responses against self antigens, are due to an imbalance in immunity and tolerance. Although negatively impacting cancer prognosis, myeloid derived suppressor cells (MDSC), with their potent suppressive capabilities, might be applicable in a more beneficial light when applied in to autoimmunity. As previous shown MDSC have protective roles in Experimental Autoimmune Encephalomyelitis (EAE) (Zhu et al., 2007), the established inducible mouse model for the autoimmune disease multiple sclerosis (MS). This decrease in disease severity indicates in vitro generated immature myeloid cells (IMC) from bone marrow (BM) as precursors of MDSC are promising candidates for cellular therapy. Important to any cellular therapy by adoptive transfer, the major questions regarding IMC efficacy was addressed within the thesis. This thesis attempts to elucidate how IMC operate in EAE. This thesis defines the factors within the autoimmune microenvironment that lead to the activation of MDSC, where IMC home once delivered in vivo, and the protective mechanisms BMIMC employ. To emulate BM cells when they first enter circulation through the blood, IMC were injected intravenously (i.v.). IMC are protective with no regard to the various routes delivered (i.v., i.p.). They protect to a lesser extent when pre-activated before injection. IMC suppress by causing a delay and/or by decreasing the severity of the disease via a mechanism yet determined. To understand the migration pattern of IMC after i.v. injection, in vivo kinetics experiments employing bioluminescence imaging were performed. This techinique allows for whole in vivo mouse imaging daily, allowing the tracking of cell migration over days within a single mouse. During steady-state, BMIMC circulate and appear to accumulate in the spleen by day 4 after injection, whereas they alternatively home to inflammatory sites (immunization site), draining lymph nodes, and the spleen within mice with low grade EAE. Visualization of CMDiI-labelled BMIMC by fluorescence microscopy could locate IMC injected cells outside the white pulp, as they were colocalizing in the regions stained with CD169 or outside, but not within the follicles of spleens on day 4. Consistant with these findings, the attempt to analyze the phenotype of these cells by flow cytometry was problematic as these cells seem to adhere strongly to collagen also indicating the cells are located in the collagenous area of the marginal zone and the red pulp.To determine factors influencing MDSC activation, we utilized different stimuli through a high throughput method detecting release of nitric oxide (NO). Extracts from yeast, fungi, and bacteria were observed to activate MDSC to produce nitric oxide. Surprisingly, material mimicking viral DNA (CpG) and RNA (poly I:C), and several self glycolipids, could not activate the MDSC to produce NO. Upon attempts to understand synergistic effects between microbial pathogens and host cytokines, IFNg was determined to boost the signal of pathogen stimuli, whereas IL17, another cytokine which causes pathology during EAE, and IFNb, a drug used in therapy to treat MS, did not cause any additional effects. Activation of MDSC was determined by the microbial pathogens components LPS, curdlan, and zymosan, to induce upregulation of B7H1 on the cell surface. MDSC did not increase any co-stimulatory markers, such as CD40, CD80, CD86, CD70, or the co-inhibitory marker, PDL2. On day 1 after EAE induction, endogenous MDSC populations when stimulated showed an increase in B7H1 expression and a downregulation of CD80. After further analysis, these cells were concluded to be mostly granulocytic cells (Ly6G+). As the B7H1 ligand PD1 is upregulated in chronic diseases and correlates to an exhausted phenotype, the PD1 : B7H1 interaction was a good candidate for the mechanism our cells may employ for their suppressive capacity. To investigate this interaction, fixed BM-IMC deficient in B7H1 were incubated with restimulated memory T cells. IMC deficient in B7H1 resulted in a significant loss of T cell suppression, as compared to the wildtype control BMIMC. To assess this interaction in vivo, we injected wildtype (WT) and B7H1-/- IMC into mice followed by induction of EAE to assess whether B7H1 mediated this suppression. The lack of B7H1 did not alter their suppressive capacity under these conditions, contrary to other findings which have described this interaction to be important in their suppressive capacity when administered post EAE induction (Ioannou et al., 2012). Interestingly, EAE mice pre-treated with IMC had similar amounts of cytokine production in the CNS after restimulation. Spleens from IMC injected mice had increased amounts of Arg-1 suggesting suppression is via oxidation or recruitment by soluble mediators may lead to this protection. We speculate this may inhibit T cell reactivation in the CNS.
Background: Perfusion-cardiovascular magnetic resonance (CMR) is generally accepted as an alternative to SPECT to assess myocardial ischemia non-invasively. However its performance vs gated-SPECT and in sub-populations is not fully established. The goal was to compare in a multicenter setting the diagnostic performance of perfusion-CMR and gated-SPECT for the detection of CAD in various populations using conventional x-ray coronary angiography (CXA) as the standard of reference.
Methods: In 33 centers (in US and Europe) 533 patients, eligible for CXA or SPECT, were enrolled in this multivendor trial. SPECT and CXA were performed within 4 weeks before or after CMR in all patients. Prevalence of CAD in the sample was 49% and 515 patients received MR contrast medium. Drop-out rates for CMR and SPECT were 5.6% and 3.7%, respectively (ns). The study was powered for the primary endpoint of non-inferiority of CMR vs SPECT for both, sensitivity and specificity for the detection of CAD (using a single-threshold reading), the results for the primary endpoint were reported elsewhere. In this article secondary endpoints are presented, i.e. the diagnostic performance of CMR versus SPECT in subpopulations such as multi-vessel disease (MVD), in men, in women, and in patients without prior myocardial infarction (MI). For diagnostic performance assessment the area under the receiver-operator-characteristics-curve (AUC) was calculated. Readers were blinded versus clinical data, CXA, and imaging results.
Results: The diagnostic performance (= area under ROC = AUC) of CMR was superior to SPECT (p = 0.0004, n = 425) and to gated-SPECT (p = 0.018, n = 253). CMR performed better than SPECT in MVD (p = 0.003 vs all SPECT, p = 0.04 vs gated-SPECT), in men (p = 0.004, n = 313) and in women (p = 0.03, n = 112) as well as in the non-infarct patients (p = 0.005, n = 186 in 1-3 vessel disease and p = 0.015, n = 140 in MVD).
Conclusion: In this large multicenter, multivendor study the diagnostic performance of perfusion-CMR to detect CAD was superior to perfusion SPECT in the entire population and in sub-groups. Perfusion-CMR can be recommended as an alternative for SPECT imaging.
In cultured motoneurons of a mouse model for the motoneuron disease spinal muscular atrophy (SMA), reduced levels of the protein SMN (survival of motoneurons) cause defects in axonal growth. This correlates with reduced β-actin mRNA and protein in growth cones, indicating that anterograde transport and local translation of β-actin mRNA are crucial for motoneuron function. However, direct evidence that indeed local translation is a physiological phenomenon in growth cones of motoneurons was missing. Here, a lentiviral GFP-based reporter construct was established to monitor local protein synthesis of β-actin mRNA. Time-lapse imaging of fluorescence recovery after photobleaching (FRAP) in living motoneurons revealed that β-actin is locally translated in the growth cones of embryonic motoneurons. Interestingly, local translation of the β-actin reporter construct was differentially regulated by different laminin isoforms, indicating that laminins provide extracellular cues for the regulation of local translation in growth cones. Notably, local translation of β-actin mRNA was deregulated when motoneurons of a mouse model for type I SMA (Smn-/-; SMN2) were analyzed. In situ hybridization revealed reduced levels of β-actin mRNA in the axons of Smn-/-; SMN2 motoneurons. The distribution of the β-actin mRNA was not modified by different laminin isoforms as revealed by in situ hybridization against the mRNA of the eGFP encoding element of the β-actin reporter. In case of the mRNA of α-actin and γ-actin isoforms, the endogenous mRNA did not localize to the axons and the localization pattern was not affected by the SMN levels expressed in the cell. Taken together our findings suggest that regulation of local translation of β-actin in growth cones of motoneurons critically depends on laminin signaling and the amount of SMN protein. Embryonic stem cell (ESC)-derived motoneurons are an excellent in vitro system to sort out biochemical and cellular pathways which are defective in neurodegenerative diseases like SMA. Here, a protocol for the differentiation and antibody-mediated enrichment of ESC-derived motoneurons is presented, which was optimized during the course of this study. Notably, this study contributes the production and purification of highly active recombinant sonic hedgehog (Shh), which was needed for the efficient differentiation of mouse ESCs to motoneurons. ESC-derived motoneurons will now offer high amounts of cellular material to allow the biochemical identification of disease-relevant molecular components involved in regulated local protein synthesis in axons and growth cones of motoneurons.
Die vorliegende Arbeit beschäftigt sich mit der Frage, inwieweit quantitative Genexpressionsstudien an postmortalen humanen Proben mit erhöhtem Postmortalintervall und somit möglicherweise verminderter RNA-Integrität realisierbar sind und in Zukunft als zusätzliches diagnostisches Werkzeug zur Determinierung der Todesursache im forensischen Kontext herangezogen werden können. Dafür wurden in mehreren Teilstudien Faktoren untersucht, die die Verlässlichkeit quantitativer Genexpressionsdaten beeinflussen können. Es konnte zunächst für postmortales Skelettmuskelgewebe festgestellt werden, dass Verstorbene mit erhöhtem BMI statistisch signifikant niedrigere RIN-Werte aufweisen als normalgewichtige Personen. Zudem wurde eine Korrelation zwischen dem Gewebetyp und der Integrität der daraus extrahierten RNA gefunden. Unter Anwendung der in dieser Arbeit gewählten Extraktionsmethode scheint postmortales Skelettmuskelgewebe für Genexpressionsstudien an Autopsiematerial besonders geeignet. Dagegen wurde im vorliegenden Probengut kein Zusammenhang zwischen verminderter RNA-Integrität und Parametern wie Geschlecht, PMI, Sterbealter, Dauer der Agonie und Todesursache gefunden. In einer weiteren Teilstudie wurde anhand von postmortalem Herzmuskel-, Skelettmuskel- und Gehirngewebe aus einer Auswahl von zehn funktionell verschiedenen endogenen Kontrollgenen HMBS, UBC, SDHA und TBP als die Gene mit der größten postmortalen Transkriptstabilität identifiztiert. Zudem konnte gezeigt werden, dass die Verwendung von vier stabilen endogenen Kontrollen am untersuchten Probenmaterial eine verlässliche Datennormalisierung erlaubt. Die validierten Kontrollgene können auch zukünftig für quantitative Genexpressionsstudien eingesetzt werden, solange die untersuchte Probenzusammensetzung der hier vorgestellten ähnelt. Für die Todesursache sowie für den Body Mass Index des Probenspenders wurde in der vorliegenden Arbeit ein statistisch signifikanter Einfluss auf das Expressionslevel instabiler Gene festgestellt. Diese Parameter sind daher geeignet, die gefundenen Instabilitäten möglicher Kontrollgene zu erklären. Die Ergebnisse der vorliegenden Arbeit lassen des Weiteren darauf schließen, dass das Erstellen von Degradierungslinien aus kommerziell erhältlicher RNA für jedes verwendete qPCR-Assay ein wichtiges Instrument der Qualitätsprüfung ist. Mit der Degradierungslinie kann die Detektionsgrenze des verwendeten qPCR-Assays validiert werden kann. Nur so ist die Festlegung des Bereichs möglich, in dem ein verändertes Expressionslevel tatsächlich mit dem Einfluss eines spezifischen Parameters in Verbindung gebracht werden kann und klar von einer nur scheinbaren Genexpressionsänderung unterscheidbar ist, die durch eine Degradierung der Probe vorgetäuscht wird. Zudem scheint es praktikabel, in zukünftigen Studien nur Proben mit ähnlichen Integritäten miteinander zu vergleichen. Pathologische Prozesse im menschlichen Körper, auch solche, die die Funktion von Organen sowie die Morphologie betreffen, sind hoch komplex und können interindividuell variieren, weshalb die Genexpression im forensischen Kontext ergänzende Hinweise auf die Diagnose liefern könnte. Als erstes anwendungsbezogenes Beispiel wurde in der vorliegenden Arbeit der Einfluss von Hypoxie auf das Transkriptlevel von HIF-1α, VEGF und SLC2A1 untersucht. Bei Normalisierung der Daten gegen vier stabile Kontrollgene ergaben sich anhand der untersuchten Gewebeproben Hinweise auf eine todesursachenbezogene Hochregulierung der drei Zielgene. Die Studie unterstrich die besondere Bedeutung der gewählten Normalisierungsstrategie. Wurden die Daten nur gegen GAPDH als einzelnes, nicht validiertes Kontrollgen normalisiert, deuteten die Ergebnisse eine überraschende Herunterregulierung der Zielgene an. Als mögliche Ursache für diese scheinbare Diskrepanz kommt die im weiteren Verlauf dieser Studie nachgewiesene Instabilität infolge einer Co-Regulation von GAPDH unter hypoxischen Bedingungen in Betracht. Mit dem Fernziel postmortale Genexpressionsstudien als zusätzliches Instrument in der forensischen Todesursachenbestimmung einzusetzen, schafft die vorliegende Arbeit durch die Einführung von validierten Kontrollgenen sowie durch die Analyse weiterer Einfluss nehmender Faktoren eine Basis für die verlässliche Durchführung künftiger Genexpressionsstudien an humanem Autopsiegewebe.
Escherichia coli Nissle 1917 (EcN) gehört zu den am besten untersuchten und charakterisierten probiotischen Bakterienstämmen. Seit Beginn des letzten Jahrhunderts wird er als Medikament eingesetzt, um verschiedene Darmerkrankungen wie z.B. Diarrhöe, entzündliche Darmerkrankungen und Verstopfung zu behandeln. Die Flagelle des EcN vermittelt Beweglichkeit und kann die Produktion von humanem β-Defensin 2 (hBD2) durch Epithelzellen induzieren. Somit ist dieses Organell direkt in die probiotische Funktion des EcN involviert. Es konnte gezeigt werden, dass die Flagellen anderer Bakterien, wie z.B. dem probiotischen Stamm Bacillus cereus CH oder den pathogenen Stämmen Pseudomonas aeruginosa und Clostridium difficile, die Adhäsion an intestinalen Mucus, welcher von Epithelzellen sekretiert wird, vermitteln. Allerdings blieb unklar, welcher Teil der Flagelle an welche Mucuskomponente bindet. Die Fähigkeit effizient an Wirtgewebe zu adhärieren wird als wichtiges Attribut eines probiotischen Stammes angesehen. Ex vivo Adhäsionsstudien mit Kryoschnitten humaner Darmbiopsien haben gezeigt, dass die Flagelle des EcN in die effiziente Adhäsion an humanes Darmgewebe involviert sein muss. Aus diesem Grund wurde in dieser Arbeit die Funktion der Flagelle des EcN als Adhäsin untersucht. Zunächst wurde die hyperflagellierte Variante EcN ATHF isoliert und durch verschiedene Experimente, z.B. Schwärmagartests und Elektronenmikroskopie, charakterisiert. Weitere ex vivo Adhäsionsstudien mit EcN ATHF zeigten eine höhere Adhäsionseffizienz dieser hyperflagellierten Variante und bestätigten damit die Rolle der Flagelle bei der effizienten Adhäsion von EcN an die Kryoschnitte der humanen Darmbiopsien. Interessanterweise fungierte die Flagelle in in vitro Studien mit den humanen Epithelzellen Caco-2 und T24 nicht als Adhäsin. Diese Unterschiede zwischen den in vitro und ex vivo Studien führten zu der Annahme, dass die Flagelle des EcN in vivo die Adhäsion an Mucus vermittelt, welcher von den Caco-2- und T24-Zellen nicht produziert wird, aber in den Kryoschnitten der Darmbiopsien nachgewiesen wurde. Diese Vermutung wurde durch in vitro Adhäsionsstudien mit der Mucin-produzierenden Epithelzelllinie LS174-T bestätigt, da die Flagellen für eine effektive Adhäsion an diese Zellen essentiell waren. Zudem reduzierte die Präinkubation flagellierter EcN-Stämme mit Mucin2 ihre Adhäsionseffizienz an Kryoschnitte humaner Darmbiopsien. Um die direkte Interaktion zwischen Flagellen des EcN Wildtyps und Mucus zu zeigen, wurde ein ELISA etabliert. Es konnte eine direkte konzentrationsabhängige Interaktion zwischen isolierten Flagellen des EcN Wildtyps und Mucin2, bzw. humanem Mucus (Kolon) beobachtet werden. Interessanterweise konnte keine Interaktion zwischen isolierten Flagellen des EcN Wildtyps und murinem Mucus (Duodenum, Ileum, Caecum, Colon) festgestellt werden. Dies weist darauf hin, dass die Mucuszusammensetzung zwischen verschiedenen Spezies variiert. Verschiedene Kohlenhydrate, welche bekannte Mucusbestandteile sind, wurden auf ihre Interaktion mit der Flagelle von EcN getestet und Gluconat wurde als ein Rezeptor identifiziert. Die Präinkubation isolierter Flagellen mit Gluconat reduzierte ihre Interaktion mit Mucin2, bzw. humanem Mucus signifikant. Zudem wurde die oberflächenexponierte Domäne D3 des Flagellins, der Hauptuntereinheit der Flagelle, als möglicher Interaktionspartner von Mucin2, bzw. humanem Mucus ausgeschlossen. Flagellen, die aus einer Domäne D3 Deletionsmutante isoliert wurden, zeigten sogar eine effizientere Bindung an Mucin2, bzw. humanen Mucus. Weiterhin konnte gezeigt werden, dass Änderungen des pH-Wertes signifikante Effekte auf die Interaktion zwischen Mucus und isolierten Flagellen hatten, vermutlich aufgrund von Konformationsänderungen. Zusammenfassend wurde in dieser Arbeit die Flagelle als neues und scheinbar wichtigstes Adhäsin in vivo für den probiotischen Stamm EcN identifiziert. Hierfür wurden sowohl eine hyperflagellierte Variante, eine ΔfliC Mutante, sowie der dazugehörige komplementierte Stamm verwendet. EcN ist zudem der erste probiotische Stamm für den eine direkte Bindung der Flagellen an humanen Mucus nachgewiesen werden konnte. Die Mucuskomponente Gluconat konnte dabei als wichtiger Rezeptor identifiziert werden. Da einige pathogene Bakterien ihre Flagelle zur Adhäsion an Wirtsgewebe nutzen, könnte dieses Organell EcN dazu befähigen, mit Pathogenen um die erfolgreiche Kolonisierung des Darms zu konkurrieren, was als wichtige Eigenschaft eines Probiotikums betrachtet wird.
Spreading drug resistances among Gram-negative pathogens and the paucity of new agents on the antibacterial drug market against these tenacious bacteria create a pressing need for the development of new antibiotics. The bacterial fatty acid biosynthesis pathway FAS-II, especially the enoyl-ACP reductase catalyzing the last step of the elongation cycle, is an established drug target against tuberculosis but has not been extensively exploited for drug design against other bacterial pathogens. In this thesis the enoyl-ACP reductases of the Gram-negative biothreat organisms Burkholderia pseudomallei and Yersinia pestis were targeted in a structure-based drug design approach. The structure of the most recently identified enoyl-ACP isoenzyme FabV was characterized by X-ray crystallography and could be determined in three different states. FabV from B. pseudomallei was obtained in the apo-form of the enzyme, whereas FabV from Y. pestis was characterized in a binary complex with the cofactor NADH as well as in a ternary complex with NADH and the triclosan-based 2-pyridone inhibitors PT172 and PT173. Analysis of the FabV structure revealed the typical fold of the short chain dehydrogenase/reductase superfamily with the NADH-binding Rossmann fold and a substrate-binding pocket with a conserved active site geometry compared to the related isoenzyme FabI. Additional structural elements of FabV are located around the active site. The monomeric form of the enzyme is thereby stabilized and the substrate-binding loop is kept in a closed, helical conformation. The ternary complexes of FabV exhibited a similar inhibitor-binding mode as observed for triclosan inhibition in FabI and point to a potential substrate-binding mechanism. B. pseudomallei possesses FabI as an additional enoyl-ACP reductase isoenzyme, which was structurally characterized in the apo form and in ternary complexes with NAD+ and the diphenyl ether inhibitors triclosan, PT02, PT12 or PT404 as well as the 4-pyridone inhibitor PT155. The structural data of the ternary enoyl-ACP reductases complexes of B. pseudomallei and Y. pestis hold the promise for the possibility to develop antibacterials targeting FabV or even both isoenzymes, FabI and FabV, based on the triclosan scaffold.
Effective treatment of infections caused by the bacterium Staphylococcus aureus remains a worldwide challenge, in part due to the constant emergence of new strains that are resistant to antibiotics. The serine/threonine kinase PknB is of particular relevance to the life cycle of S. aureus as it is involved in the regulation of purine biosynthesis, autolysis, and other central metabolic processes of the bacterium. We have determined the crystal structure of the kinase domain of PknB in complex with a non-hydrolyzable analog of the substrate ATP at 3.0 angstrom resolution. Although the purified PknB kinase is active in solution, it crystallized in an inactive, autoinhibited state. Comparison with other bacterial kinases provides insights into the determinants of catalysis, interactions of PknB with ligands, and the pathway of activation.