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Pertussis is a highly contagious acute respiratory disease of humans which is mainly caused by the gram-negative obligate human pathogen Bordetella pertussis. Despite the availability and extensive use of vaccines, the disease persists and has shown periodic re-emergence resulting in an estimated 640,000 deaths worldwide in 2014. The pathogen expresses various virulence factors that enable it to modulate the host immune response, allowing it to colonise the ciliated airway mucosa. Many of these factors also directly interfere with host signal transduction systems, causing damage to the ciliated airway mucosa and increase mucous production. Of the many virulence factors of B. pertussis, only the tracheal cytotoxin (TCT) is able to recapitulate the pathophysiology of ciliated cell extrusion and blebbing in animal models and in human nasal biopsies. Furthermore, due to the lack of appropriate human models and donor materials, the role of bacterial virulence factors has been extrapolated from studies using animal models infected with either B. pertussis or with the closely related species B. bronchiseptica which naturally causes respiratory infections in these animals and produces many similar virulence factors. Thus, in the present work, in vitro airway mucosa models developed by co-culturing human airway epithelia cells and fibroblasts from the conduction zone of the respiratory tract on a decellularized porcine small intestine submucosa scaffold (SISser®) were used, since these models have a high correlation to native human conducting zone respiratory epithelia. The major aim was to use the engineered airway mucosa models to elucidate the contribution of B. pertussis TCT in the pathophysiology of the disease as well as the virulence mechanism of B. pertussis in general. TCT and lipopolysaccharide (LPS) either alone or in combination were observed to induce epithelial cell blebbing and necrosis in the in vitro airway mucosa model. Additionally, the toxins induced viscous hyper-mucous secretion and significantly disrupted barrier properties of the in vitro airway mucosa models. This work also sought to assess the invasion and intracellular survival of B. pertussis in the polarised epithelia, which has been critically discussed for many years in the literature. Infection of the models with B. pertussis showed that the bacteria can adhere to the models and invade the epithelial cells as early as 6 hours post inoculation. Invasion and intracellular survival assays indicated the bacteria could invade and persist intracellularly in the epithelial cells for up to 3 days. Due to the novelty of the in vitro airway mucosa models, this work also intended to establish a method for isolating individual cells for scRNA-seq after infection with B. pertussis. Cold dissociation with Bacillus licheniformis subtilisin A was found to be capable of dissociating the cells without inducing a strong fragmentation, a problem which occurs when collagenase and trypsin/EDTA are used. In summary, the present work showed that TCT acts possibly in conjunction with LPS to disrupt the human airway mucosa much like previously shown in the hamster tracheal ring models and thus appears to play an important role during the natural B. pertussis infection. Furthermore, we established a method for infecting and isolating infected cells from the airway mucosa models in order to further investigate the effect of B. pertussis infection on the different cell populations in the airway by single cell analytics in the future.
Clinical practice in CMR with respect to cardiovascular disease is currently focused on tissue characterization, and cardiac function, in particular. In recent years MRI based diffusion tensor imaging (DTI) has been shown to enable the assessment of microstructure based on the analysis of Brownian motion of water molecules in anisotropic tissue, such as the myocardium. With respect to both functional and structural imaging, 7T MRI may increase SNR, providing access to information beyond the reach of clinically applied field strengths. To date, cardiac 7T MRI is still a research modality that is only starting to develop towards clinical application.
In this thesis we primarily aimed to advance methods of ultrahigh field CMR using the latest 7T technology and its application towards the functional and structural characterization of the myocardium.
Regarding the assessment of myocardial microstructure at 7T, feasibility of ex vivo DTI of large animal hearts was demonstrated. In such hearts a custom sequence implemented for in vivo DTI was evaluated and fixation induced alterations of derived diffusion metrics and tissue properties were assessed. Results enable comparison of prior and future ex vivo DTI studies and provide information on measurement parameters at 7T.
Translating developed methodology to preclinical studies of mouse hearts, ex vivo DTI provided highly sensitive surrogates for microstructural remodeling in response to subendocardial damage. In such cases echocardiography measurements revealed mild diastolic dysfunction and impaired longitudinal deformation, linking disease induced structural and functional alterations. Complementary DTI and echocardiography data also improved our understanding of structure-function interactions in cases of loss of contractile myofiber tracts, replacement fibrosis, and LV systolic failure.
Regarding the functional characterization of the myocardium at 7T, sequence protocols were expanded towards a dedicated 7T routine protocol, encompassing accurate cardiac planning and the assessment of cardiac function via cine imaging in humans.
This assessment requires segmentation of myocardial contours. For that, artificial intelligence (AI) was developed and trained, enabling rapid automatic generation of cardiac segmentation in clinical data. Using transfer learning, AI models were adapted to cine data acquired using the latest generation 7T system. Methodology for AI based segmentation was translated to cardiac pathology, where automatic segmentation of scar tissue, edema and healthy myocardium was achieved.
Developed radiofrequency hardware facilitates translational studies at 7T, providing controlled conditions for future method development towards cardiac 7T MRI in humans.
In this thesis the latest 7T technology, cardiac DTI, and AI were used to advance methods of ultrahigh field CMR. In the long run, obtained results contribute to diagnostic methods that may facilitate early detection and risk stratification in cardiovascular disease.
The outcome of the innate immune response to biomaterials mainly determines whether the material will be incorporated in the body to fulfill its desired function or, when it gets encapsulated, will be rejected in the worst case. Macrophages are key players in this process, and their polarization state with either pro- (M1), anti-inflammatory (M2), or intermediate characteristics is crucial for deciding on the biomaterial’s fate. While a transient initial pro-inflammatory state is helpful, a prolonged inflammation deteriorates the proper healing and subsequent regeneration. Therefore, biomaterial-based polarization may aid in driving macrophages in the desired direction. However, the in vivo process is highly complex, and a mono-culture of macrophages in vitro displays only one part of the cellular system, but, to this date, there is a lack of established co-cultures to assess the immune response to biomaterials. Thus, this thesis aimed to establish a functional co-culture system of human macrophages and human mesenchymal stromal cells (hMSCs) to improve the assessment of the immune response to biomaterials in vitro. Together with macrophages, hMSCs are involved in tissue regeneration and inflammatory reactions and can modulate the immune response. In particular, endogenously derived hMSCs considerably contribute to the successful engrafting of biomaterials. This thesis focused on poly(ε-caprolactone) (PCL) fiber-based scaffolds produced by the technique of melt electrowriting (MEW) as biomaterial constructs. Via this fabrication technique, uniform, precisely ordered scaffolds varying in geometry and pore size have been created in-house.
To determine the impact of scaffold geometries and pore sizes on macrophages, mono-cultures incubated on scaffolds were conducted. As a pre-requisite to achieve a functional co-culture system on scaffolds, setups for direct and indirect systems in 2D have initially been established. These setups were analyzed for the capability of cell-cell communication. In parallel, a co-culture medium suitable for both cell types was defined, prior to the establishment of a step-by-step procedure for the co-cultivation of human macrophages and hMSCs on fiber-based scaffolds.
Regarding the scaffold morphologies tested within this thesis to improve M2-like polarization, box-shaped scaffolds outperformed triangular-, round- or disordered-shaped ones. Upon further investigation of scaffolds with box-shaped pores and precise inter-fiber spacing from 100 µm down to only 40 µm, decreasing pore sizes facilitated primary human macrophage elongation accompanied by their differentiation towards the M2 type, which was most pronounced for the smallest pore size of 40 µm. To the best of my knowledge, this was the first time that the elongation of human macrophages in a 3D environment has been correlated to their M2-like polarization. Thus, these results may set the stage for the design, the assessment, and the selection of new biomaterials, which can positively affect the tissue regeneration.
The cell communication of both cell types, detected via mitochondria exchange in direct and indirect co-cultures systems, took place in both directions, i.e., from hMSCs to macrophages and vice versa. Thereby, in direct co-culture, tunneling nanotubes enabled the transfer from one cell type to the respective other, while in indirect co-culture, a non-directional transfer through extracellular vesicles (EVs) released into the medium seemed likely. Moreover, the phagocytic activity of macrophages after 2D co-cultivation and hence immunomodulation by hMSCs increased with the highest phagocytic rate after 48 h being most pronounced in direct co-cultivation.
As the commonly used serum supplements for macrophages and hMSCs, i.e., human serum (hS) and fetal calf serum (FCS), respectively, failed to support the respective other cell type during prolonged cultivation, these sera were replaced by human platelet lysate (hPL), which has been proven to be the optimal supplement for the co-cultivation of human macrophages with hMSCs within this thesis. Thereby, the phenotype of both cell types, the distribution of both cell populations, the phagocytic activity of macrophages, and the gene expression profiles were maintained and comparable to the respective standard mono-culture conditions. This was even true when hPL was applied without the anticoagulant heparin in all cultures with macrophages, and therefore, heparin was omitted for further experiments comprising hPL and macrophages.
Accordingly, a step-by-step operating procedure for the co-cultivation on fiber-based scaffolds has been established comprising the setup for 3D cultivation as well as the description of methods for the analysis of phenotypical and molecular changes upon contact with the biomaterial. The evaluation of the macrophage response depending on the cultivation with or without hMSCs and either on scaffolds or on plastic surfaces has been successfully achieved and confirmed the functionality of the suggested procedures.
In conclusion, the functional co-culture system of human macrophages and hMSCs established here can now be employed to assess biomaterials in terms of the immune response in a more in vivo-related way. Moreover, specifically designed scaffolds used within the present thesis showed auspicious design criteria positively influencing the macrophage polarization towards the anti-inflammatory, pro-healing type and might be adaptable to other biomaterials in future approaches.
Hence, follow-up experiments should focus on the evaluation of the co-culture outcome on promising scaffolds, and the suggested operating procedures should be adjusted to further kinds of biomaterials, such as cements or hydrogels.
Functions of bounded variation are most important in many fields of mathematics. This thesis investigates spaces of functions of bounded variation with one variable of various types, compares them to other classical function spaces and reveals natural “habitats” of BV-functions. New and almost comprehensive results concerning mapping properties like surjectivity and injectivity, several kinds of continuity and compactness of both linear and nonlinear operators between such spaces are given. A new theory about different types of convergence of sequences of such operators is presented in full detail and applied to a new proof for the continuity of the composition operator in the classical BV-space. The abstract results serve as ingredients to solve Hammerstein and Volterra integral equations using fixed point theory. Many criteria guaranteeing the existence and uniqueness of solutions in BV-type spaces are given and later applied to solve boundary and initial value problems in a nonclassical setting.
A big emphasis is put on a clear and detailed discussion. Many pictures and synoptic tables help to visualize and summarize the most important ideas. Over 160 examples and counterexamples illustrate the many abstract results and how delicate some of them are.
Aims
Ischaemic stroke (IS) might induce alterations of cardiac function. Prospective data on frequency of cardiac dysfunction and heart failure (HF) after IS are lacking. We assessed prevalence and determinants of diastolic dysfunction (DD), systolic dysfunction (SD), and HF in patients with acute IS.
Methods and results
The Stroke‐Induced Cardiac FAILure in mice and men (SICFAIL) study is a prospective, hospital‐based cohort study. Patients with IS underwent a comprehensive assessment of cardiac function in the acute phase (median 4 days after IS) including clinical examination, standardized transthoracic echocardiography by expert sonographers, and determination of blood‐based biomarkers. Information on demographics, lifestyle, risk factors, symptoms suggestive of HF, and medical history was collected by a standardized personal interview. Applying current guidelines, cardiac dysfunction was classified based on echocardiographic criteria into SD (left ventricular ejection fraction < 52% in men or <54% in women) and DD (≥3 signs of DD in patients without SD). Clinically overt HF was classified into HF with reduced, mid‐range, or preserved ejection fraction. Between January 2014 and February 2017, 696 IS patients were enrolled. Of them, patients with sufficient echocardiographic data on SD were included in the analyses {n = 644 patients [median age 71 years (interquartile range 60–78), 61.5% male]}. In these patients, full assessment of DD was feasible in 549 patients without SD (94%). Prevalence of cardiac dysfunction and HF was as follows: SD 9.6% [95% confidence interval (CI) 7.6–12.2%]; DD in patients without SD 23.3% (95% CI 20.0–27.0%); and clinically overt HF 5.4% (95% CI 3.9–7.5%) with subcategories of HF with preserved ejection fraction 4.35%, HF with mid‐range ejection fraction 0.31%, and HF with reduced ejection fraction 0.78%. In multivariable analysis, SD and fulfilment of HF criteria were associated with history of coronary heart disease [SD: odds ratio (OR) 3.87, 95% CI 1.93–7.75, P = 0.0001; HF: OR 2.29, 95% CI 1.04–5.05, P = 0.0406] and high‐sensitive troponin T at baseline (SD: OR 1.78, 95% CI 1.31–2.42, P = 0.0003; HF: OR 1.66, 95% CI 1.17–2.33, P = 0.004); DD was associated with older age (OR 1.08, 95% CI 1.05–1.11, P < 0.0001) and treated hypertension vs. no hypertension (OR 2.84, 95% CI 1.23–6.54, P = 0.0405).
Conclusions
A substantial proportion of the study population exhibited subclinical and clinical cardiac dysfunction. SICFAIL provides reliable data on prevalence and determinants of SD, DD, and clinically overt HF in patients with acute IS according to current guidelines, enabling further clarification of its aetiological and prognostic role.
Objectives: We compared the effect of different didactic formats - e - learning and role-playing - on medical students' knowledge and counselling skills in smoking cessation training.
Methods: At a German medical school, 145 third-year students were randomly allocated to attend an online course with video examples or an attendance course with role-playing. Students were trained in smoking cessation counselling according to the 5A's (ask, advise, assess, assist, arrange) for approximately 90 minutes. Practical skills were measured in an objective structured clinical examination (OSCE) and represent the primary endpoint of this prospective comparative study. Additionally, changes in theoretic knowledge were assessed by pre - and post - interventional questionnaires and a final written exam.
Results: In the OSCE, overall scores were higher in the attendance group (Mdn=70.8 % vs. 62.8 %; U=119; p=.087, n=36), but a statistical advantage was only found in one single counselling sequence (“Assist”: Mdn=66.7 % vs. 51.4 %; p = .049) and the rating of the standardised patients (M=4.7 vs. 4.2 out of 5 points, t(27.836)=2.0, p=.028). Students’ results (n=130) from self-assessment and written exams suggest that both approaches are equally well suited to increase theoretical knowledge. The online course was more time efficient (90 vs. 73 minutes).
Conclusions: Seminar and web-based training seem equally well suited for transferring knowledge and skills on tobacco cessation counselling. Considering their particular strengths, these two teaching approaches could be combined.
Background
Landscape composition is known to affect both beneficial insect and pest communities on crop fields. Landscape composition therefore can impact ecosystem (dis)services provided by insects to crops. Though landscape effects on ecosystem service providers have been studied in large-scale agriculture in temperate regions, there is a lack of representation of tropical smallholder agriculture within this field of study, especially in sub-Sahara Africa. Legume crops can provide important food security and soil improvement benefits to vulnerable agriculturalists. However, legumes are dependent on pollinating insects, particularly bees (Hymenoptera: Apiformes) for production and are vulnerable to pests. We selected 10 pigeon pea (Fabaceae: Cajunus cajan (L.)) fields in Malawi with varying proportions of semi-natural habitat and agricultural area within a 1 km radius to study: (1) how the proportion of semi-natural habitat and agricultural area affects the abundance and richness of bees and abundance of florivorous blister beetles (Coleoptera: Melloidae), (2) if the proportion of flowers damaged and fruit set difference between open and bagged flowers are correlated with the proportion of semi-natural habitat or agricultural area and (3) if pigeon pea fruit set difference between open and bagged flowers in these landscapes was constrained by pest damage or improved by bee visitation.
Methods
We performed three, ten-minute, 15 m, transects per field to assess blister beetle abundance and bee abundance and richness. Bees were captured and identified to (morpho)species. We assessed the proportion of flowers damaged by beetles during the flowering period. We performed a pollinator and pest exclusion experiment on 15 plants per field to assess whether fruit set was pollinator limited or constrained by pests.
Results
In our study, bee abundance was higher in areas with proportionally more agricultural area surrounding the fields. This effect was mostly driven by an increase in honeybees. Bee richness and beetle abundances were not affected by landscape characteristics, nor was flower damage or fruit set difference between bagged and open flowers. We did not observe a positive effect of bee density or richness, nor a negative effect of florivory, on fruit set difference.
Discussion
In our study area, pigeon pea flowers relatively late—well into the dry season. This could explain why we observe higher densities of bees in areas dominated by agriculture rather than in areas with more semi-natural habitat where resources for bees during this time of the year are scarce. Therefore, late flowering legumes may be an important food resource for bees during a period of scarcity in the seasonal tropics. The differences in patterns between our study and those conducted in temperate regions highlight the need for landscape-scale studies in areas outside the temperate region.
Two series of organic–inorganic composite materials were synthesized through solvothermal imine condensation between diketopyrrolopyrrole dialdehyde DPP-1 and 5,10,15,20-tetrakis(4-aminophenyl)porphyrin (TAPP) in the presence of varying amounts of either amino- or carboxy-functionalized superparamagnetic iron oxide nanoparticles (FeO). Whereas high FeO loading induced cross-linking of the inorganic nanoparticles by amorphous imine polymers, a lower FeO content resulted in the formation of crystalline covalent organic framework domains. All hybrid materials were analyzed by magnetization measurements, powder X-ray diffraction, electron microscopy, IR, and UV/Vis absorption spectroscopy. Crystallinity, chromophore stacking, and visible absorption features are directly correlated to the mass fraction of the components, thus allowing for a fine-tuning of materials properties.
Many species synchronize reproductive behavior with a particular phase of the lunar cycle to increase reproductive success. In humans, a lunar influence on reproductive behavior remains controversial, although the human menstrual cycle has a period close to that of the lunar cycle. Here, we analyzed long-term menstrual recordings of individual women with distinct methods for biological rhythm analysis. We show that women’s menstrual cycles with a period longer than 27 days were intermittently synchronous with the Moon’s luminance and/or gravimetric cycles. With age and upon exposure to artificial nocturnal light, menstrual cycles shortened and lost this synchrony. We hypothesize that in ancient times, human reproductive behavior was synchronous with the Moon but that our modern lifestyles have changed reproductive physiology and behavior.
High attrition-rates entailed by drug testing in 2D cell culture and animal models stress the need for improved modeling of human tumor tissues. In previous studies our 3D models on a decellularized tissue matrix have shown better predictivity and higher chemoresistance. A single porcine intestine yields material for 150 3D models of breast, lung, colorectal cancer (CRC) or leukemia. The uniquely preserved structure of the basement membrane enables physiological anchorage of endothelial cells and epithelial-derived carcinoma cells. The matrix provides different niches for cell growth: on top as monolayer, in crypts as aggregates and within deeper layers. Dynamic culture in bioreactors enhances cell growth. Comparing gene expression between 2D and 3D cultures, we observed changes related to proliferation, apoptosis and stemness. For drug target predictions, we utilize tumor-specific sequencing data in our in silico model finding an additive effect of metformin and gefitinib treatment for lung cancer in silico, validated in vitro. To analyze mode-of-action, immune therapies such as trispecific T-cell engagers in leukemia, as well as toxicity on non-cancer cells, the model can be modularly enriched with human endothelial cells (hECs), immune cells and fibroblasts. Upon addition of hECs, transmigration of immune cells through the endothelial barrier can be investigated. In an allogenic CRC model we observe a lower basic apoptosis rate after applying PBMCs in 3D compared to 2D, which offers new options to mirror antigen-specific immunotherapies in vitro. In conclusion, we present modular human 3D tumor models with tissue-like features for preclinical testing to reduce animal experiments.
Background: Computed tomography (CT) pulmonary angiography is the diagnostic reference standard in suspected pulmonary embolism (PE). Favorable results for dual-energy CT (DECT) images have been reported for this condition. Nowadays, dual-energy data acquisition is feasible with different technical options, including a single-source split-filter approach. Therefore, the aim of this retrospective study was to investigate image quality and radiation dose of thoracic split-filter DECT in comparison to conventional single-energy CT in patients with suspected PE.
Methods: A total of 110 CT pulmonary angiographies were accomplished either as standard single-energy CT with automatic tube voltage selection (ATVS) (n=58), or as split-filter DECT (n=52). Objective [pulmonary artery CT attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)] and subjective image quality [four-point Likert scale; three readers (R)] were compared among the two study groups. Size-specific dose estimates (SSDE), dose-length-product (DLP) and volume CT dose index (CTDIvol) were assessed for radiation dose analysis.
Results: Split-filter DECT images yielded 67.7% higher SNR (27.0 vs. 16.1; P<0.001) and 61.9% higher CNR (22.5 vs. 13.9; P<0.001) over conventional single-energy images, whereas CT attenuation was significantly lower (344.5 vs. 428.2 HU; P=0.013). Subjective image quality was rated good or excellent in 93.0%/98.3%/77.6% (R1/R2/R3) of the single-energy CT scans, and 84.6%/82.7%/80.8% (R1/R2/R3) of the split-filter DECT scans. SSDE, DLP and CTDIvol were significantly lower for conventional single-energy CT compared to split-filter DECT (all P<0.05), which was associated with 26.7% higher SSDE.
Conclusions: In the diagnostic workup of acute PE, the split-filter allows for dual-energy data acquisition from single-source single-layer CT scanners. The existing opportunity to assess pulmonary “perfusion” based on analysis of iodine distribution maps is associated with higher radiation dose in terms of increased SSDE than conventional single-energy CT with ATVS. Moreover, a proportion of up to 3.8% non-diagnostic examinations in the current reference standard test for PE is not negligible.
Single mRNA molecules are frequently detected by single molecule fluorescence in situ hybridization (smFISH) using branched DNA technology. While providing strong and background-reduced signals, the method is inefficient in detecting mRNAs within dense structures, in monitoring mRNA compactness and in quantifying abundant mRNAs. To overcome these limitations, we have hybridized slices of high pressure frozen, freeze-substituted and LR White embedded cells (LR White smFISH). mRNA detection is physically restricted to the surface of the resin. This enables single molecule detection of RNAs with accuracy comparable to RNA sequencing, irrespective of their abundance, while at the same time providing spatial information on RNA localization that can be complemented with immunofluorescence and electron microscopy, as well as array tomography. Moreover, LR White embedding restricts the number of available probe pair recognition sites for each mRNA to a small subset. As a consequence, differences in signal intensities between RNA populations reflect differences in RNA structures, and we show that the method can be employed to determine mRNA compactness. We apply the method to answer some outstanding questions related to trans-splicing, RNA granules and mitochondrial RNA editing in single-cellular trypanosomes and we show an example of differential gene expression in the metazoan Caenorhabditis elegans.
Having control over the landscape played an important role in the geography and economy of Egypt from the predynastic period onwards. Especially from the beginning of the Old Kingdom, we have evidence that kings created new places (funerary domains) called (centers) and (Ezbah) for the equipment of the building projects of the royal tomb and the funerary cult of the king, as well as to ensure the eternal life of both kings and individuals. Kings used these localities in order to do so, and they oftentimes expanded the border of an existing nome and created new establishments. Consequently, these establishments were united or divided into new nomes. The paper discusses the geography of Lower Egypt and the associated royal domains in the early Fifth Dynasty based on the new discoveries from the causeway of Sahura at Abusir.
Prospective longitudinal follow‐up of left ventricular ejection fraction (LVEF) trajectories after acute cardiac decompensation of heart failure is lacking. We investigated changes in LVEF and covariates at 6‐months' follow‐up in patients with a predischarge LVEF ≤40%, and determined predictors and prognostic implications of LVEF changes through 18‐months' follow‐up.
Methods and Results
Interdisciplinary Network Heart Failure program participants (n=633) were categorized into subgroups based on LVEF at 6‐months' follow‐up: normalized LVEF (>50%; heart failure with normalized ejection fraction, n=147); midrange LVEF (41%–50%; heart failure with midrange ejection fraction, n=195), or persistently reduced LVEF (≤40%; heart failure with persistently reduced LVEF , n=291). All received guideline‐directed medical therapies. At 6‐months' follow‐up, compared with patients with heart failure with persistently reduced LVEF, heart failure with normalized LVEF or heart failure with midrange LVEF subgroups showed greater reductions in LV end‐diastolic/end‐systolic diameters (both P<0.001), and left atrial systolic diameter (P=0.002), more increased septal/posterior end‐diastolic wall‐thickness (both P<0.001), and significantly greater improvement in diastolic function, biomarkers, symptoms, and health status. Heart failure duration <1 year, female sex, higher predischarge blood pressure, and baseline LVEF were independent predictors of LVEF improvement. Mortality and event‐free survival rates were lower in patients with heart failure with normalized LVEF (P=0.002). Overall, LVEF increased further at 18‐months' follow‐up (P<0.001), while LV end‐diastolic diameter decreased (P=0.048). However, LVEF worsened (P=0.002) and LV end‐diastolic diameter increased (P=0.047) in patients with heart failure with normalized LVEF hospitalized between 6‐months' follow‐up and 18‐months' follow‐up.
Conclusions
Six‐month survivors of acute cardiac decompensation for systolic heart failure showed variable LVEF trajectories, with >50% showing improvements by ≥1 LVEF category. LVEF changes correlated with various parameters, suggesting multilevel reverse remodeling, were predictable from several baseline characteristics, and were associated with clinical outcomes at 18‐months' follow‐up. Repeat hospitalizations were associated with attenuation of reverse remodeling."
In the course of this work, a total of three photocatalytically active dyads for proton reduction could be synthesized together with the associated individual components. Two of them, D1 and D2, comprised a [Ru(bpy)3]2+ photosensitizer and D3 an [Ir(ppy)2bpy]+ photosensitizer. A Ppyr3-substituted propyldithiolate [FeFe] complex was used as catalyst in all systems. The absorption spectroscopic and electrochemical investigations showed that an inner-dyadic electronic coupling is effectively prevented in the dyads due to conjugation blockers within the bridging units used. The photocatalytic investigations exhibited that all dyad containing two-component systems (2CS) showed a significantly worse performance than the corresponding bimolecular three-component systems (3CS). Transient absorption spectroscopy showed that the 2CS behave very similarly to the associated multicomponent systems during photocatalysis. The electron that was intended for the intramolecular transfer from the photosensitizer unit to the catalyst unit within the dyads remains at the photosensitizer for a relatively long time, analogous to the 3CS and despite the covalently bound catalyst. It is therefore assumed that this intramolecular electron transfer is likely to be hindered as a result of the weak electronic coupling caused by the bridge units used. Instead, the system bypasses this through an intermolecular transfer to other dyad molecules in the immediate vicinity. In addition, with the help of emission quenching experiments and electrochemical investigations, it could be clearly concluded that all investigated systems proceed via the reductive quenching mechanism during photocatalysis.
The nuclear envelope serves as important mRNA surveillance system. In yeast and humans, several control mechanisms act in parallel to prevent nuclear export of unprocessed mRNAs. However, trypanosomes lack homologues to most of the proteins involved. In addition, gene expression in trypanosomes relies almost completely on post-transcriptional regulation as they transcribe mRNAs as long polycistrons, which are subsequently processed into individual mRNA molecules by trans-splicing. As trans-splicing is not error-free, unspliced mRNAs may be recognized and prevented from reaching the cytoplasm by a yet unknown mechanism.
When trans-splicing is inhibited in trypanosomes, the formation of a novel RNA granule type at the cytoplasmic periphery of the nucleus, so called nuclear periphery granules (NPGs) was previously observed. To identify potential regulators of nuclear export control, changes in protein localization which occur when trans-splicing is inhibited, were globally analyzed during this work. For this, trypanosome nuclei were purified under conditions maintaining NPG attachment to the nucleus, in the absence and presence of trans-splicing. Mass spectrometry analyses identified 128 proteins which are specifically enriched in nuclear preparations of cells inhibited for trans-splicing. Amongst them are proteins, which change their localization to the nucleus or to the nuclear pores as well as many proteins that move into NPGs. Some of these proteins are promising candidates for nuclear export control proteins, as the changes in localization (to the nucleus or nuclear pores) were specific to the accumulation of unspliced mRNAs. The NPG proteome almost exclusively contains proteins involved in mRNA metabolism, mostly unique to trypanosomes, notably major translation initiation factors were absent. These data indicate that NPGs are RNP complexes which have started or completed nuclear export, but not yet entered translation. As a byproduct of these proteomic studies, a high-quality dataset of the yet unknown T. brucei nuclear proteome is provided, closing an important gap in knowledge to study trypanosome biology, in particular nuclear related processes.
NPGs were characterized in more detail by microscopy. The granules are cytoplasmic and present in at least two different trypanosome life cycle stages. There are at least two distinct granule subsets, with differences in protein composition. A closer analysis of NPGs by electron microscopy revealed that the granules are electron dense structures, which are connected to nuclear pores by string-like structures.
In order to approach the function of NPGs, on the one hand, the hypothesis that NPGs might be related to perinuclear germ granules of adult gonads of C. elegans was tested: we found no relation between the two granule types. On the other hand, initial single molecule mRNA FISH experiments performed in trypanosomes showed no accumulation of unspliced transcripts in NPGs, arguing against an involvement of the granules in mRNA quality control.
The tropomysin receptor kinase B (TrkB), the receptor for the neurotrophin brain-derived neurotrophic factor (BDNF), plays an important role in neuronal survival, neuronal differentiation, and cellular plasticity. Conventionally, TrkB activation is induced by binding of BDNF at extracellular sites and subsequent dimerization of receptor monomers. Classical Trk signaling concepts have failed to explain ligand-independent signaling of intracellular TrkB or oncogenic NTRK-fusion proteins. The intracellular activation domain of TrkB consists of a tyrosine kinase core, with three tyrosine (Y) residues at positions 701, 705 and 706, that catalyzes the phosphorylation reaction between ATPγ and tyrosine. The release of cisautoinhibition of the kinase domain activates the kinase domain and tyrosine residues outside of the catalytic domain become phosphorylated. The aim of this study was to find out how ligand-independent activation of TrkB is brought about. With the help of phosphorylation mutants of TrkB, it has been found that a high, local abundance of the receptor is sufficient to activate TrkB in a ligand-independent manner. This self-activation of TrkB was blocked when either the ATP-binding site or Y705 in the core domain was mutated. The vast majority of this self-active TrkB was found at intracellular locations and was preferentially seen in roundish cells, lacking filopodia. Live cell imaging of actin dynamics showed that self-active TrkB changed the cellular morphology by reducing actin filopodia formation. Signaling cascade analysis confirmed that self-active TrkB is a powerful activator of focal adhesion kinase (FAK). This might be the reason why self-active TrkB is able to disrupt actin filopodia formation. The signaling axis from Y705 to FAK could be mimicked by expression of the soluble, cytosolic TrkB kinase domain. However, the signaling pathway was inactive, when the TrkB kinase domain was targeted to the plasmamembrane with the help of artificial myristoylation membrane anchors. A cancer-related intracellular NTRK2-fusion protein (SQSTM1-NTRK2) also underwent constitutive kinase activation. In glioblastoma-like U87MG cells, self-active TrkB kinase reduced cell migration. These constitutive signaling pathways could be fully blocked within minutes by clinically approved, anti-tumorigenic Trk inhibitors. Moreover, this study found evidences for constitutively active, intracellular TrkB in tissue of human grade IV glioblastoma. In conclusion, the data provide an explanation and biological function for selfactive, constitutive TrkB kinase domain signaling, in the absence of a ligand.
Herein described is the discovery of three novel types of dimeric naphthylisoquinoline alkaloids, named mbandakamines, cyclombandakamines, and spirombandakamines. They were found in the leaves of a botanically as yet unidentified, potentially new Ancistrocladus species, collected in the rainforest of the Democratic Republic of the Congo (DRC). Mbandakamines showed an exceptional 6′,1′′-coupling, in the peri-position neighboring one of the outer axes, leading to an extremely high steric hindrance at the central axis, and to U-turn-like molecular shape, which – different from all other dimeric NIQs, whose basic structures are all quite linear – brings three of the four bicyclic ring systems in close proximity to each other. This created an unprecedented follow-up chemistry, involving ring closure reactions, leading to two further, structurally even more intriguing subclasses, the cyclo- and the spirombandakamines, displaying eight stereogenic elements (the highest total number ever found in naphthylisoquinoline alkaloids). The metabolites exhibited pronounced antiplasmodial and antitrypanosomal activities. Likewise reported in this doctoral thesis are the isolation and structural elucidation of naphthylisoquinoline alkaloids from two further potentially new Ancistrocladus species from DRC. Some of these metabolites have shown pronounced antiausterity activities against human pancreatic cancer PANC-1 cells.
Ants belong to the most successful insects living on our planet earth. One criterion of their tremendous success is the division of labor among workers that can be related to age (age¬– or temporal polyethism) and/ or body size (size–related polymorphism). Young ants care for the queen and brood in the nest interior and switch to foraging tasks in the outside environment with ongoing age. This highly flexible interior–exterior transition probably allows the ant workers to properly match the colony needs and is one of the most impressive behaviors a single worker undergoes during its life. As environmental stimuli are changing with this transition, workers are required to perform a new behavioral repertoire. This requires significant adaptions in sensory and higher¬–order integration centers in the brain, like the mushroom bodies. Furthermore, foragers need proper time measuring mechanisms to cope with daily environmental changes and to adapt their own mode of life. Therefore, they possess a functional endogenous clock that generates rhythms with a period length of approximately 24 hours. The species–rich genus of Camponotus ants constitute a rewarding model to study how behavioral duties of division of labor were performed and modulated within the colony and how synaptic plasticity in the brain is processed, as they can divide their labor to both, age and body size, simultaneously.
In my PhD thesis, I started to investigate the behavioral repertoire (like foraging and locomotor activity) of two sympatric Camponotus species, C. mus and C. rufipes workers under natural and under controlled conditions. Furthermore, I focused on the division of labor in C. rufipes workers and started to examine structural and ultrastructural changes of neuronal architectures in the brain that are accompanied by the interior–exterior transition of C. rufipes ants.
In the first part of my thesis, I started to analyze the temporal organization of task allocation throughout the life of single C. rufipes workers. Constant video–tracking of individually labeled workers for up to 11 weeks, revealed an age–related division of labor of interior and exterior workers. After emergence, young individuals are tended to by older ones within the first 48 hours of their lives before they themselves start nurturing larvae and pupae. Around 52% switch to foraging duties at an age of 14–20 days. The workers that switched to foraging
tasks are mainly media–sized workers and seem to be more specialized than nurses. Variations in proportion and the age of switching workers between and within different subcolonies indicate how highly flexible and plastic the age–related division of labor occurs in this ant species. Most of the observed workers were engaged in foraging tasks exclusively during nighttime. As the experiments were conducted in the laboratory, they are completely lacking environmental stimuli of the ants´ natural habitat.
I therefore asked in a second study, how workers of the two closely related Camponotus species, C. rufipes and C. mus, adapt their daily activity patterns (foraging and locomotor activity) under natural (in Uruguay, South America) and controlled (in the laboratory) conditions to changing thermal conditions. Monitoring the foraging activity of both Camponotus species in a field experiment revealed, that C. mus workers are exclusively diurnal, whereas C. rufipes foragers are predominantly nocturnal. However, some nests showed an elevated daytime activity, which could be an adaption to seasonally cold night temperatures. To further investigate the impact of temperature and light on the differing foraging activity patterns in the field, workers of both Camponotus species were artificially exposed to different thermal regimes in the laboratory, simulating local winter and summer conditions. Here again, C. mus workers display solely diurnal locomotor activity, whereas workers of C. rufipes shifted their locomotor activity from diurnal under thermal winter conditions to nocturnal under thermal summer conditions. Hence, the combination of both, field work and laboratory studies, shows that daily activity is mostly shaped by thermal conditions and that temperature cycles are not just limiting foraging activity but can be used as zeitgeber to schedule the outside activities of the nests.
Once an individual worker switches from indoor duties to exterior foraging tasks, it is confronted with an entirely new set of sensory information. To cope with changes of the environmental conditions and to facilitate the behavioral switch, workers need a highly flexible and plastic neuronal system. Hence, my thesis further focuses on the underlying neuronal adaptations of the visual system, including the optic lobes as the primary visual neuropil and the mushroom bodies as secondary visual brain neuropil, that are accompanied with the behavioral switch from nursing to foraging. The optic lobes as well as the mushroom bodies of light–deprived workers show an `experience–independent´ volume increase during the first two weeks of adulthood. An additional light exposure for 4 days induces an `experience–dependent´ decrease of synaptic complexes in the mushroom body collar,
followed by an increase after extended light exposure for 14 days. I therefore conclude, that the plasticity of the central visual system represents important components for the optimal timing of the interior–exterior transitions and flexibility of the age–related division of labor. These remarkable structural changes of synaptic complexes suggest an active involvement of the mushroom body neuropil in the lifetime plasticity that promotes the interior–exterior transition of Camponotus rufipes ants. Beside these investigations of neuronal plasticity of synaptic complexes in the mushroom bodies on a structural level, I further started to examine mushroom body synaptic structures at the ultrastructural level. Until recently, the detection of synaptic components in projection neuron axonal boutons were below resolution using classical Transmission Electron Microscopy. Therefore, I started to implement Electron Tomography to increase the synaptic resolution to understand architectural changes in neuronal plasticity process. By acquiring double tilt series and consecutive computation of the acquired tilt information, I am now able to resolve individual clear–core and dense–core vesicles within the projection neuron cytoplasm of C. rufipes ants. I additionally was able to reveal single postsynaptic Kenyon cell dendritic spines (~62) that surround one individual projection neuron bouton. With this, I could reveal first insights into the complex neuronal architecture of single projection neuron boutons in the olfactory mushroom body lip region. The high resolution images of synaptic architectures at the ultrastructural level, received with Electron Tomography would promote the understanding of architectural changes in neuronal plasticity.
In my PhD thesis, I demonstrate that the temporal organization within Camponotus colonies involves the perfect timing of different tasks. Temperature seems to be the most scheduling abiotic factors of foraging and locomotor activity. The ants do not only need to adapt their behavioral repertoire in accordance to the interior–exterior switch, also the parts in the peripheral and central that process visual information need to adapt to the new sensory environment.
The transcription factor NRF2 is considered as the master regulator of cytoprotective and ROS-detoxifying gene expression. Due to their vulnerability to accumulating reactive oxygen species, melanomas are dependent on an efficient oxidative stress response, but to what extent melanomas rely on NRF2 is only scarcely investigated so far. In tumor entities harboring activating mutations of NRF2, such as lung adenocarcinoma, NRF2 activation is closely connected to therapy resistance. In melanoma, activating mutations are rare and triggers and effectors of NRF2 are less well characterized.
This work revealed that NRF2 is activated by oncogenic signaling, cytokines and pro-oxidant triggers, released cell-autonomously or by the tumor microenvironment. Moreover, silencing of NRF2 significantly reduced melanoma cell proliferation and repressed well-known NRF2 target genes, indicating basal transcriptional activity of NRF2 in melanoma. Transcriptomic analysis showed a large set of deregulated gene sets, besides the well-known antioxidant effectors. NRF2 suppressed the activity of MITF, a marker for the melanocyte lineage, and induced expression of epidermal growth factor receptor (EGFR), thereby stabilizing the dedifferentiated melanoma phenotype and limiting pigmentation markers and melanoma-associated antigens. In general, the dedifferentiated melanoma phenotype is associated with a reduced tumor immunogenicity. Furthermore, stress-inducible cyclooxygenase 2 (COX2) expression, a crucial immune-modulating gene, was regulated by NRF2 in an ATF4-dependent manner. Only in presence of both transcription factors was COX2 robustly induced by H2O2 or TNFα. COX2 catalyzes the first step of the prostaglandin E2 (PGE2) synthesis, which was described to be associated with tumor immune evasion and reduction of the innate immune response.
In accordance with these potentially immune-suppressive features, immunocompetent mice injected with NRF2 knockout melanoma cells had a strikingly longer tumor-free survival compared to NRF2-proficient cells. In line with the in vitro data, NRF2-deficient tumors showed suppression of COX2 and induction of MITF. Furthermore, transcriptomic analyses of available tumors revealed a strong induction of genes belonging to the innate immune response, such as RSAD2 and IFIH1. The expression of these genes strongly correlated with immune evasion parameters in human melanoma datasets and NRF2 activation or PGE2 supplementation limited the innate immune response in vitro.
In summary, the stress dependent NRF2 activation stabilizes the dedifferentiated melanoma phenotype and facilitates the synthesis of PGE2. As a result, NRF2 reduces gene expression of the innate immune response and promotes the generation of an immune-cold tumor microenvironment. Therefore, NRF2 not only elevated the ROS resilience, but also strongly contributed to tumor growth, maintenance, and immune control in cutaneous melanoma.