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Short functional peptidic probes can maximize the potential of high-end microscopy techniques and multiplex imaging assays and provide new insights into normal and aberrant molecular, cellular and tissue function. Particularly, the visualization of inhibitory synapses requires protocol tailoring for different sample types and imaging techniques and relies either on genetic manipulation or on antibodies that underperform in tissue immunofluorescence. Starting from an endogenous activity-related ligand of gephyrin, a universal marker of the inhibitory post-synapse, I developed a short peptidic multivalent binder with exceptional affinity and selectivity to gephyrin. By tailoring fluorophores to the binder, I have obtained Sylite, a probe for the visualization of inhibitory synapses, with an outstanding signal-to-background ratio, that bests the “gold standard” gephyrin antibodies both in selectivity and in tissue immunofluorescence. In tissue Sylite benefits from simplified handling, provides robust synaptic labeling in record-short time and, unlike antibodies, is not affected by staining artefacts. In super-resolution microscopy Sylite precisely localizes the post-synapse and enables accurate pre- to post-synapse measurements. Combined with complimentary tracing techniques Sylite reveals inhibitory connectivity and profiles inhibitory inputs and synapse sizes of excitatory and inhibitory neurons in the periaqueductal gray brain region. Lastly, upon probe optimization for live cell application and with the help of novel thiol-reactive cell penetrating peptide I have visualized inhibitory synapses in living neurons. Taken together, my work provided a versatile probe for conventional and super-resolution microscopy and a workflow for the development and application of similar compact functional synthetic probes.
Platelets are anucleated cell fragments derived from megakaryocytes. They play a fundamental role in hemostasis, but there is rising evidence that they are also involved in immunological processes. Despite absence of a nucleus, human platelets are capable of de novo protein synthesis and contain a fully functional proteasome system, which is, in nucleated cells, involved in processes like cell cycle progression or apoptosis by its ability of protein degradation. The physiological significance of the proteasome system in human platelets is not yet fully understood and subject of ongoing research.
Therefore, this study was conducted with the intention to outline the role of the proteasome system for functional characteristics of human platelets. For experimentation, citrated whole blood from healthy donors was obtained and preincubated with proteasome inhibitors. In addition to the commonly used bortezomib, the potent and selective proteasome inhibitor carfilzomib was selected as a second inhibitor to rule out agent-specific effects and to confirm that observed changes are related to proteasome inhibition.
Irreversibly induced platelet activation and aggregation were not affected by proteasome blockade with bortezomib up to 24 hours. Conversely, proteasome inhibition led to enhanced threshold aggregation and agglutination up to 25 %, accompanied by partial alleviation of induced VASP phosphorylation of approximately 10-15 %. Expression of different receptors were almost unaffected. Instead, a significant increase of PP2A activity was observable in platelets after proteasome blockade, accompanied by facilitated platelet adhesion to coated surfaces in static experiments or flow chamber experiments.
Carfilzomib, used for the first time in functional experimentation with human platelets in vitro, led to a dose-dependent decrease of proteasome activity with accumulation of poly ubiquitylated proteins. Like bortezomib, carfilzomib treatment resulted in enhanced threshold aggregation with attenuated VASP phosphorylation.
As the main conclusion of this thesis, proteasome inhibition enhances the responsiveness of human platelets, provided by an alleviation of platelet inhibitory pathways and by an additional increase of PP2A activity, resulting in facilitated platelet adhesion under static and flow conditions. The proteasome system appears to be involved in the promotion of inhibitory counterregulation in platelets. The potential of proteasome inhibitors for triggering thromboembolic adverse events in patients must be clarified in further studies, in addition to their possible use for targeting platelet function to improve the hemostatic reactivity of platelets.
Abstract
Neuropathic pain affects 6.9 to 10% of the general population, arises from lesion or disease of the somatosensory nervous system and is still challenging to treat. Indeed, current treatments efficacy are relatively low and present strong side effects. To that extent, identifying new targets and developing new treatment strategies constitute a priority. The blood nerve barrier consists of the endoneurial micro-blood vessels and the perineurium sealed by tight junctions constituted of tight junction proteins such claudin-5 and claudin-1. As the functional blood nerve barrier allows nerve tissue protection from external elements and maintains homeostasis, a destabilization or a disruption leads to infiltration of immunocytes promoting neuroinflammation and increased inflammatory mediators that can sensitize nociceptors and enhance pain. Thus resealing the blood nerve barrier in case of neuropathic pain could be a possible treatment strategy.
Specialised proresolving mediators such lipoxin A4 and resolvin D1 are small lipids that bind to receptors such the formylpeptide recptor 2 (FPR2) and resolve inflammation. Specially resolvin D1 as anti-inflammatory and analgesic properties. Thus using resolvin D1 or eventually other specialized proresolving mediators in neuropathic pain could reseal the blood nerve barrier and resolve neuropathic pain. The present work aimed to characterize the blood nerve barrier in a preclinical model of diabetic polyneuropathy and nerve injury (chronic constriction injury) and to identify specialized proresolving mediators that seal the blood nerve barrier and thereby alleviate neuropathic pain.
In diabetic polyneuropathy, the blood nerve barrier is permeable only to small molecules, which is due to the loss of claudin-1 in the perineurium and a reduced number of blood vessel- associated macrophages. Interestingly, blood nerve barrier permeability did not occur until four to eight weeks after diabetes induction, whereas mechanical hyperalgesia was measurable as early as two weeks. This suggests a pain-maintaining rather than a pain-triggering role of the blood nerve barrier.
In case of chronic constriction injury, a resolution process of both mechanical and thermal hyperalgesia occurs between three to six weeks after injury. Here, the blood nerve barrier is permeable to both small and large molecules from the beginning. The pain recovery process occurs primarily in parallel with the sealing of the endoneurial barrier to large molecules such as fibrinogen from the plasma and its degradation. Perineurium is still permeable nine weeks after injury. Metabolomic analyses show that especially precursors of Resolvin D1 as well as its receptor FPR2, are upregulated at the beginning of pain resolution. Application of resolvin
D1 loaded nanoparticles or agonists of FPR2 at the injury site before the onset of pain resolution accelerates the process and fibrinogen is no longer detectable in the endoneurium. Depending on the nerve damage, the blood nerve barrier is affected to varying degrees. Direct mechanical trauma and the accompanying inflammation lead to a more pronounced and long-lasting permeability - independent hyperalgesia. Possibly permeability, at least for small molecules, is important for prolonged reparative processes. In the nerve, permeability of capillaries in particular depends not only on tight junctions but also on other cells: in addition to macrophages, pericytes could also have a sealing effect. Endoneurial fibrinogen triggers pain; the exact mechanism remains to be investigated. Resolvin-containing nanoparticles were particularly effective and could be used locally as they contain endogenous substances in non- toxic particles.
One of the features that defines humans as extraordinarily social beings is their striking susceptibility to the gaze of others. The research reported in this dissertation was undertaken to advance our understanding of the role of gaze cues in low-level attentional and higher-order cognitive processes. In particular, effects of gaze were examined with regard to three aspects of human cognition: (1) social attention, (2) social interaction and (3) social understanding. Chapter 1 consists of three manuscripts that investigate the boundary conditions of attention capture by direct gaze and how gaze direction is integrated with facial context information. Manuscript 1 and 2 suggest two necessary requirements for attention capture by direct gaze: a meaningful holistic facial context and sharp foveal vision, respectively. Manuscript 3 shows approach/avoidance-congruency effects between gaze direction and emotion expression on attention. Chapter 2 of this dissertation explores the role of gaze in more naturalistic social scenarios. Manuscript 4 demonstrates that gaze behavior during a conversation shapes our perception of another person. Manuscript 5 builds on these findings by showing that these perceptions define our willingness to act in a prosocial way towards our interaction partner. Finally, chapter 3 adopts a broader perspective on social cognition research with a special focus on methodological aspects. Manuscript 6 is a review highlighting the significance of methodological aspects in social cognition research and stressing the importance of sophisticated decisions on task and stimulus materials. Manuscript 7 introduces a new instrument for the assessment of social understanding in adolescents. Initial application in a young sample group indicates that an understanding of another person’s mental states is a capacity that is still developing throughout adolescence. Both manuscripts of this final chapter include eye tracking data that suggest a relationship between gaze behavior and social understanding, a finding that further emphasizes the complex and multifaceted nature of social cognition. I conclude from the findings of this dissertation that research can benefit from adopting a broad view in terms of methodological as well as temporal aspects in order to capture human social cognition in its entirety.
Cellular growth and proliferation are among the most important processes for cells and
organisms. One of the major determinants of these processes is the amount of proteins
and consequently also the amount of ribosomes. Their synthesis involves several hundred
proteins and four different ribosomal RNA species, is highly coordinated and very
energy-demanding. However, the molecular mechanims of transcriptional regulation of
the protein-coding genes involved, is only poorly understood in mammals.
In this thesis, unbiased genome-wide knockout reporter screens were performed, aiming
to identify previously unknown transcriptional regulators of ribosome biogenesis
factors (RiBis), which are important for the assembly and maturation of ribosomes,
and ribosomal proteins (RPs), which are ribosomal components themself. With that
approach and follow-up (validation) experiments, ALDOA and RBM8A among others,
could be identified as regulators of ribosome biogenesis.
Depletion of the glycolytic enzyme ALDOA led to a downregulation of RiBi- and RPpromoter
driven reporters on protein and transcript level, as well as to a downregulation
of ribosome biogenesis gene transcripts and of mRNAs of other genes important for
proliferation.
Reducing the amount of the exon junction complex protein RBM8A, led to a more prominent
downregulation of one of the fluorescent reporters, but this regulation was independent
of the promoter driving the expression of the reporter. However, acute protein
depletion experiments in combination with nascent RNA sequencing (4sU-Seq)
revealed, that mainly cytosolic ribosomal proteins (CRPs) were downregulated upon
acute RBM8A withdrawal. ChIP experiments showed RBM8A binding to promoters of
RP genes, but also to other chromatin regions. Total POL II or elongating and initiating
POL II levels were not altered upon acute RBM8A depletion.
These data provide a starting point for further research on the mechanisms of transcriptional
regulation of RP and RiBi genes in mammals.
Depressive disorders represent one of the main sources for the loss of healthy years of life. One of the reasons for this circumstance is the recurrent course of these disorders, which can be interrupted by current therapeutic approaches, especially in the shortterm, but seem to be maintained at least in part in the long-term. Subsequently, on one hand, this thesis deals with methodological measurement issues in the longitudinal prediction of depressive courses. On the other hand, it addresses two currently discussed neuroscience-based treatment approaches, which are investigated experimentally in a basic-psychological manner and reviewed in the light of their potential to translate results to the application in patient care. These two approaches each address potential mechanisms that may negatively impact long-term disease trajectories: First, stable endophenotypes for vulnerability factors that could regain control over the organism and reactivate maladaptive experiences, or behaviors with increasing temporal distance from therapeutic methods are focused on. In the studies presented, these were influenced by a recently rediscovered method of neuromodulation (transcranial low-intensity focused ultrasound) which is discussed in light of its unique capability to address even deepest, subcortical regions at a high spatial resolution. Lastly, as a second approach, an experimental design for the use of reconsolidation interference is presented, which could provide a first insight into the applicability of corresponding protocols in the field of depressive disorders and thus contribute to the modification, instead of inhibition, of already mentioned endophenotypes. In sum, methodological considerations for monitoring and predicting long-term courses of depression are deducted before two approaches are discussed that could potentially exert positive influences on the recurrent nature of depressive symptoms on their own, in combination with each other, or as augmentation for existing therapeutic procedures.
Ubiquitylation is a protein post translational modification, in which ubiquitin is covalently attached to target protein substrates resulting in diverse cellular outcomes. Besides ubiquitin, various ubiquitin-like proteins including FAT10 exist, which are also conjugated to target proteins. The underlying modification mechanisms are conserved. In the initial step, ubiquitin or a ubiquitin-like protein is thioester-linked to a catalytic cysteine in the E1activating enzyme in an ATP-dependent manner. The respective protein modifier is then transferred to an E2 conjugating enzyme in a transthioesterification reaction. Finally, an E3 ubiquitin ligase E3 catalyzes the covalent attachment of the protein modifier to a substrate. In the case of ubiquitin, multiple ubiquitin molecules can be attached to a substrate in the form of either linear or branched polyubiquitin chains but also as single ubiquitin modifications. Depending on the nature of the ubiquitin chain, the substrates are destined to various cellular processes such as their targeted destruction by the proteasome but also non-degradative outcomes may occur.
As stated above FAT10 is a ubiquitin-like protein modifier which typically targets proteins for proteasomal degradation. It consists of two ubiquitin-like domains and is mainly expressed in cells of the human immune system. The reported involvement of FAT10 modifications in cancers and other diseases has caught the attention of the scientific community as an inhibition of the FAT10ylation process may provide avenues for novel therapeutic approaches. UBA6 is the E1 activating enzyme that resides at the apex of the FAT10 proteasomal degradation pathway. UBA6 not only recognizes FAT10 but can also activate ubiquitin as efficiently as the ubiquitin specific E1 UBA1. The dual specificity of UBA6 may complicate the inhibition FAT10ylation since targeting the active site of UBA6 will also inhibit the UBA6-catalyzed ubiquitin activation. Therefore, it is important to understand the underlying principles for the dual specificity of UBA6 prior to the development of compounds interfering with FAT10ylation.
In this thesis important novel insights into the structure and function of UBA6 were derived by X-ray crystallography and biochemical methods. The first crystal structure of UBA6 reveals the multidomain architecture of this enzyme in atomic detail. The enzyme is composed of a rigid core including its active and inactive adenylation domains as well as a 4 helix bundle. Overall, the molecule adopts a “Y” shape architecture with the core at the base and the first and second catalytic half domains forming one arm of the “Y” and the ubiquitin fold domain constituting the other arm. While UBA6 shares the same domain architecture as UBA1, substantial differences were revealed by the crystal structure. In particular, the first catalytic half domain undergoes a significant shift to a position more distal from the core. This rigid body movement is assumed to generate room to accommodate the second ubiquitin-like domain of FAT10. Differences are also observed in a hydrophobic platform between the core and the first catalytic half domain and the adenylation active site in the core, which together from the binding sites for ubiquitin and FAT10. Site directed mutagenesis of key residues in these areas altered the UBA6-catalyzed activation of ubiquitin and FAT10. UBA6 variants were generated with the goal of trying to block the activation of FAT10 while still maintaining that of ubiquitin activation, in order to fully explain the dual specificity of UBA6. However, none of these mutations could block the activation of FAT10, while some of these UBA6 variants blocked ubiquitin activation. Preliminary inhibition assays with a group of E1 inhibitors belonging to the adenosyl sulfamate family demonstrated potent inhibition of FAT10ylation for two compounds. The dual specificity of UBA6 hence needs to be further examined by biochemical and structural methods. In particular, the structure of a complex between UBA6 and ubiquitin or FAT10 would provide key insights for further biochemical studies, ultimately allowing the targeted inhibition of the FAT10ylation machinery.
MDSCs are suppressive immune cells with a high relevance in various pathologies including cancer, autoimmunity, and chronic infections. Surface marker expression of MDSCs resembles monocytes and neutrophils which have immunostimulatory functions instead of suppressing T cells. Therefore, finding specific surface markers for MDSCs is important for MDSC research and therapeutic MDSC manipulation. In this study, we analyzed if the integrin VLA-1 has the potential as a novel MDSC marker. VLA-1 was expressed by M-MDSCs but not by G-MDSCs as well as by Teff cells. VLA-1 deficiency did not impact iNOS expression, the distribution of M-MDSC and G-MDSC subsets, and the suppressive capacity of MDSCs towards naïve and Teff cells in vitro. In mice, VLA-1 had no effect on the homing capability of MDSCs to the spleen, which is a major reservoir for MDSCs. Since the splenic red pulp contains collagen IV and VLA-1 binds collagen IV with a high affinity, we found MDSCs and Teff cells in this area as expected. We showed that T cell suppression in the spleen, indicated by reduced T cell recovery and proliferation as well as increased apoptosis and cell death, partially depended on VLA-1 expression by the MDSCs. In a mouse model of multiple sclerosis, MDSC injection prior to disease onset led to a decrease of the disease score, and this effect was significantly reduced when MDSCs were VLA-1 deficient. The expression of Sema7A by Teff cells, a ligand for VLA-1 which is implicated in negative T cell regulation, resulted in a slightly stronger Teff cell suppression by MDSCs compared to Sema7A deficient T cells. Live cell imaging and intravital 2-photon microscopy showed that the interaction time of MDSCs and Teff cells was shorter when MDSCs lacked VLA 1 expression, however VLA-1 expression had no impact on MDSC mobility. Therefore, the VLA-1-dependent interaction of MDSC and Teff cells on collagen IV in the splenic red pulp is implicated MDSC-mediated Teff cell suppression.
Mineral biocements are brittle materials, which usually results in catastrophic failure during mechanical loading. Here, previous works demonstrated the feasibility of reducing brittleness by a dual-setting approach, in which a silica sol was simultaneously gelled during the setting of a brushite forming cement. The current thesis aimed at further improving this concept by both using a novel silicate based cement matrix for an enhanced bonding between cement and silica matrix as well as multifunctional silica precursors to increase the network density of the gel. Due to its well-known biocompatibility and osteogenic regeneration capacity, baghdadite was chosen as mineral component of such composites. This required in a first approach the conversion of baghdadite ceramics into self-setting cement formulations. This was investigated initially by using baghdadite as reactive filler in a brushite forming cement (Chapter 4). Here, the ß-TCP component in a equimolar mixture of ß-TCP and acidic monocalcium phosphate anhydrous was subsequently replaced by baghdadite at various concentrations (0, 5, 10, 20, 30, 50, and 100 wt%) to study the influence on physicochemical cement properties such as mechanical performance, radiopacity, phase composition and microstructure. X-ray diffraction profiles demonstrated the dissolution of baghdadite during the cement reaction without affecting the crystal structure of the precipitated brushite phase. In addition, EDX analysis showed that calcium is homogeneously distributed in the cement matrix, while zirconium and silicon form cluster-like aggregates ranging in size from a few micrometers to more than 50 µm. X-ray images and µ-CT analyses indicate improved X-ray visibility with increased incorporation of baghdadite in brushite cement, with an aluminum equivalent thickness nearly doubling at a baghdadite content of 50 wt%. At the same time, the compressive strength of brushite cement increased from 12.9 ± 3.1 MPa to 21.1 ± 4.1 MPa at a baghdadite content of 10 wt%. Cell culture medium conditioned with powdered brushite cement approached physiological pH values when increasing amounts of baghdadite were added to the cement (pH = 6.47 for pure brushite, pH = 7.02 for brushite with 20 wt% baghdadite substitution). Baghdadite substitution also affected the ion content in the culture medium and thus the proliferation activity of primary human osteoblasts in vitro. The results demonstrated for the first time the suitability of baghdadite as a reactive cement additive for improving the radiopacity, mechanical performance, and cytocompatibility of brushite cements.
A second approach (Chapter 5) aimed to produce single component baghdadite cements by an increase of baghdadite solubility to initiate a self-setting cement reaction. For this, the material was mechanically activated by longer grinding times of up to 24h leading to both a decrease in particle and crystallite size as well as a partial amorphization of baghdadite. Baghdadite cements were formed by adding water at a powder to liquid ratio of 2.0 g/ml. Maximum compressive strengths were determined to be ~2 MPa after 3 days of setting for a 24-hour ground material. Inductively coupled plasma mass spectrometry (ICP-MS) measurements showed an incongruent dissolution profile of the set cements, with preferential dissolution of calcium and only minor release of zirconium ions. Cement formation occurs under alkaline conditions, with the unground raw powder resulting in a pH of 11.9 during setting, while prolonged grinding increases the pH to about 12.3.
Finally, mechanically activated baghdadite cements were combined with inorganic silica networks (Chapter 6) to create dual-setting cements with a further improvement of mechanical performance. While a modification of the cement pastes with a TEOS derived sol was already thought to improve strength, it was hypothesized that using multi-arm silica precursors can further enhance their mechanical performance due to a higher network density. In addition, this should also reduce pore size of both gels and cement and hence will be able to adjust the release kinetics of incorporated drugs. For this, multi-armed silica precursors were synthesized by the reaction of various multivalent alcohols (ethylene glycol, glycerine, pentaerythrit) with an isocyanate modified silica precursor. After hydrolysis under acidic conditions, the sols were mixed with baghdadite cement powders in order to allow a simultaneous gel formation and cement setting. Since the silica monomers have a high degree of linkage sites, this resulted in a branched network that interpenetrated with the growing cement crystals. In addition to minor changes in the crystalline phase composition as determined by X-ray diffraction, the novel composites exhibited improved mechanical properties with up to 20 times higher compressive strength and further benefit from an about 50% lower overall porosity than the reference pure baghdadite cement. In addition, the initial burst release of the model drug vancomycin was completely inhibited by the added silica matrix. This observation was verified by testing for the antimicrobial activity with Staphylococcus aureus by measuring the inhibition zones of selected samples after 24 h and 48 h, whereas the antimicrobial effectiveness of a constant vancomycin release could be demonstrated.
The current thesis clearly demonstrated the high potential of baghdadite as a cement formulation for medical application. The initially poor mechanical properties of such cements can be overcome by special processing techniques or by combination with silica networks. The achieved mechanical performance is > 10 MPa and hence suitable for bone replacement under non-load bearing conditions. The high intrinsic radiopacity as well as the alkaline pH during setting may open the way ahead to further dental applications, e.g. as root canal sealers or filler in dental composites. Here, the high pH is thought to lead to antimicrobial properties of such materials similar to commonly applied calcium hydroxide or calcium silicates, however combined with an intrinsic radiopacity for X-ray imaging. This would simplify such formulations to single component materials which are less susceptible to demixing processes during transport, storage or processing.
Onchocerciasis, the world's second-leading infectious cause of blindness in humans
–prevalent in Sub-Saharan Africa – is caused by Onchocerca volvulus (O. volvulus), an
obligatory human parasitic filarial worm. Commonly known as river blindness,
onchocerciasis is being targeted for elimination through ivermectin-based mass
drug administration programs. However, ivermectin does not kill adult parasites,
which can live and reproduce for more than 15 years within the human host. These
impediments heighten the need for a deeper understanding of parasite biology and
parasite-human host interactions, coupled with research into the development of
new tools – macrofilaricidal drugs, diagnostics, and vaccines. Humans are the only
definitive host for O. volvulus. Hence, no small-animal models exist for propagating
the full life cycle of O. volvulus, so the adult parasites must be obtained surgically
from subcutaneous nodules. A two-dimensional (2D) culture system allows that
O. volvulus larvae develop from the vector-derived infective stage larvae (L3) in vitro
to the early pre-adult L5 stages. As problematic, the in vitro development of
O. volvulus to adult worms has so far proved infeasible. We hypothesized that an
increased biological complexity of a three-dimensional (3D) culture system will
support the development of O. volvulus larvae in vitro. Thus, we aimed to translate
crucial factors of the in vivo environment of the developing worms into a culture
system based on human skin. The proposed tissue model should contain 1. skinspecific
extracellular matrix, 2. skin-specific cells, and 3. enable a direct contact of
larvae and tissue components. For the achievement, a novel adipose tissue model
was developed and integrated to a multilayered skin tissue comprised of epidermis,
dermis and subcutis. Challenges of the direct culture within a 3D tissue model
hindered the application of the three-layered skin tissue. However, the indirect coculture
of larvae and skin models supported the growth of fourth stage (L4) larvae in
vitro. The direct culture of L4 and adipose tissue strongly improved the larvae
survival. Furthermore, the results revealed important cues that might represent the
initial encapsulation of the developing worm within nodular tissue. These results
demonstrate that tissue engineered 3D tissues represent an appropriate in vitro
environment for the maintenance and examination of O. volvulus larvae.
Social contact is an integral part of daily life. Its health-enhancing effects include reduced negative affective experiences of fear and anxiety, a phenomenon called social buffering. This dissertation studied different forms of social contact and their anxiety-buffering effects with diverse methodologies.
The laboratory-based first study investigated minimal social contact in the context of pain relief learning. Results showed that the observed decreased autonomic and increased subjective fear responses following pain relief learning were independent of social influence. The minimalistic and controlled social setting may have prevented social buffering. Study 2 targeted social buffering in daily life using Ecological Momentary Assessment. We repeatedly assessed individuals’ state anxiety, related cardiovascular responses, and aspects of social interactions with smartphones and portable sensors on five days. Analyses of over 1,500 social contacts revealed gender-specific effects, e.g., heart rate-reducing effects of familiarity in women, but not men. Study 3 examined anxiety, loneliness, and related social factors in the absence of social contact due to social distancing. We constructed and validated a scale measuring state and trait loneliness and isolation, and analysed its link to mental health. Results include a social buffering-like relation of lower anxiety with more trait sociability and sense of belonging.
In sum, the studies showed no fear reduction by minimal social contact, but buffering effects relating to social and personal factors in more complex social situations. Anxiety responses during daily social contacts were lower with more familiar or opposite-gender interaction partners. During limited social contact, lower anxiety related to inter-individual differences in sociability, social belonging, and loneliness. By taking research from lab to life, this dissertation underlined the diverse nature of social contact and its relevance to mental health.
The mammalian central clock, located in the suprachiasmatic nucleus (SCN) of the anterior hypothalamus, controls circadian rhythms in behaviour such as the sleep-wake cycle. It is made up of approximately 20,000 heterogeneous neurons that can be classified by their expression of neuropeptides. There are three major populations: AVP neurons (arginine vasopressin), VIP neurons (vasoactive intestinal peptide), and GRP neurons (gastrin releasing peptide). How these neuronal clusters form functional units to govern various aspects of rhythmic behavior is poorly understood. At a molecular level, biological clocks are represented by transcriptional-posttranslational feedback loops that induce circadian oscillations in the electrical activity of the SCN and hence correlate with behavioral circadian rhythms. In mammals, the sleep wake cycle can be accurately predicted by measuring electrical muscle and brain activity. To investigate the link between the electrical activity of heterogeneous neurons of the SCN and the sleep wake cycle, we optogenetically manipulated AVP neurons in vivo with SSFO (stabilized step function opsin) and simultaneously recorded an electroencephalogram (EEG) and electromyogram (EMG) in freely moving mice. SSFO-mediated stimulation of AVP positive neurons in the anterior hypothalamus increased the total amount of wakefulness during the hour of stimulation. Interestingly, this effect led to a rebound in sleep in the hour after stimulation. Markov chain sleep-stage transition analysis showed that the depolarization of AVP neurons through SSFO promotes the transition from all states to wakefulness. After the end of stimulation, a compensatory increase in transitions to NREM sleep was observed. Ex vivo, SSFO activation in AVP neurons causes depolarization and modifies the activity of AVP neurons. Therefore, the results of this thesis project suggest an essential role of AVP neurons as mediators between circadian rhythmicity and sleep-wake behaviour.
Mass spectrometry-based quantification of steroids for the diagnostic workup of adrenal tumors
(2023)
Tumors of the adrenal gland belong to the most frequent neoplasms in humans with a prevalence of 3–10 % in adults. The aim of the diagnostic workup is the identification of potentially hormone-secreting and / or malignant tumors, because most of these tumors will require surgical resection. Malignant adrenocortical carcinomas (ACC) are very rare and associated with a poor prognosis in advanced stages, therefore, an early and accurate diagnosis is crucial.
Within this thesis, two liquid chromatography tandem mass spectrometry (LC-MS/MS) methods for the quantification of steroids in different biomaterials were developed to improve the diagnostic workup of adrenal tumors.
First, an LC-MS/MS method for the simultaneous quantification of cortisol and dexamethasone in serum samples after dexamethasone suppression test (DST) was developed, validated, and applied to 400 clinical samples. Newly established method-specific threshold concentrations for cortisol and dexamethasone increased DST specificity from 67.5 % to 92.4 % while preserving 100 % sensitivity.
Second, an LC-MS/MS method for the quantification of eleven urinary steroids was developed and validated to improve the differentiation between ACC and adrenocortical adenomas (ACA). A decision tree requiring only two steroids was trained for classification and tested based on 24 h urine samples from 268 patients with adrenal tumor. Malignancy was excluded with a negative predictive value of 100 % in an independent validation cohort of 84 samples of 24-h urine. A newly proposed simplified diagnostic workflow with urinary steroid profiling as first tier test could obviate additional adrenal-specific imaging in 42 of 64 patients with ACA.
The new DST method is already in clinical use at the University Hospital Würzburg, whereas the classification model based on urinary steroid profiling will require prospective validation in a larger cohort.
Glioblastoma (GB) is the most aggressive malignant adult brain tumour with a median survival rate of only 15 months. GB tumours are characterized by necrotic and hypoxic core, which leads to nutrient deficient areas contributing to invasive, diffuseinfiltrative and angiogenic nature of these tumours. Cells exposed to nutrient deficient conditions and are known to reprogram their metabolism to produce or procure macro molecules from their environment. This makes cancer cells uniquely dependent on transcriptional regulators and a window of opportunity to target them. Sterol regulatory element binding protein 1 (SREBP1) is a transcriptional regulator of de-novo fatty acid synthesis in cells. The aim of this thesis was to investigate if SREBP1 was involved in restructuring the transcriptional regulation of genes involved in fatty acid biosynthesis upon low serum condition, in mediating interaction with other cell types in the tumour bulk such as endothelial cells, in regulating cancer stem like cells and finally to study its upstream regulation in GB. Global transcriptional analysis on GB cells exposed to low serum conditions revealed that SREBP1 regulated several fatty acid biosynthesis and phospholipid metabolic processes. PLA2G3 was identified as a novel target of SREBP1 in GB that was uniquely regulated in low serum condition. Analysis of total fatty acid and lipid species revealed that loss of SREBP1 in low serum condition changes the proportion of saturated, MUFAs and PUFAs. These changes were not specific to loss of PLA2G3 but as a result of downregulation of many genes regulated by SREBP1 in the fatty acid biosynthetic pathway. Next, treatment of HUVEC’s (endothelial cells) with condition medium from SREBP1-silenced U87 cells inhibited sprouting and tube formation capacity compared to the control condition, emphasizing the role of SREBP1 in angiogenesis and release of signalling mediators. Further, SREBP1 was shown to be important for proliferation of patient derived stem like cells and becomes indispensable for forming neurospheres in long term cultures, indicating its role in maintaining stemness. Also, inhibition of SREBP function by blocking the esterification of cholesterol using inhibitors targeting SOAT1 showed impairment in the viability of GB cells exposed to serum-depleted condition. Overall, SREBP1 plays an important role in maintaining tumour growth in nutrient deficient conditions and help in interaction with tumour microenvironment contributing to the aggressiveness of this tumour and poses itself as an attractive and unique target for GB treatment
Diabetes mellitus is an incurable, metabolic disease, which is associated with severe long-term complications. The in vitro generation of pancreatic β-cells from human induced pluripotent stem cells (hiPSCs) represent a promising strategy for a curative therapy of diabetes mellitus. However, current differentiation strategies largely fail to produce functional β-cells in vitro and require an additional in vivo transplantation to achieve terminal maturation. Previous studies demonstrated a beneficial effect of the extracellular matrix (ECM) on the survival and sustained function of adult, isolated islets of Langerhans. This raises the question whether organ-specific cell-ECM interactions might represent the missing link driving the final stage of β-cell development. In order to address this issue, this study investigated the impact of the pancreas ECM on in vitro β-cell differentiation and its use for the establishment of a pancreatic endocrine organ model.
To this purpose, a pancreas-specific ECM scaffolds (PanMa) was derived from porcine pancreata using whole organ decellularization with Sodium Deoxycholate. In a first step, the generated PanMa was thoroughly characterized using (immuno-) histological stainings, scanning electron microscopy and DNA quantification as well as perfusion and recellularization experiments with endothelial cells. Based on these data, a scoring system (PancScore) for a standardized PanMa generation was developed. Next, the generated PanMa was tested for the presence of tissue-specific ECM features. Therefore, the biophysical and physico-structural characteristics, such as rigidity, porosity and hygroscopy were analyzed using rheological measurements, particle diffusion analyses as well as a water evaporation assay and compared to the properties of ECM scaffolds derived from porcine small intestine (SISser) and lung (LungMa) to examine organ-specific scaffold cues. Following the thorough scaffold characterization, the impact of the PanMa on pluripotency and early development of hiPSC was studied. To this purpose, gene and protein expression of hiPSCs during maintenance culture and spontaneous differentiation on the PanMa were assessed. In a next step, the impact of the PanMa on the pancreatic endocrine differentiation of hiPSCs was tested. Therefore, the PanMa was used as a liquid media supplement or as a solid scaffold during the directed differentiation of hiPSC towards either pancreatic hormone-expressing cells (Rezania et al. 2012; Rezania et al. 2014) or maturing β-cells (Rezania et al. 2014). The impact of the PanMa on the generated cells was examined by gene expression analysis, immunohistochemical staining of important stage markers, as well as glucose stimulated insulin secretion assays. In a last part of this study, the potential of the PanMa for the prolonged culture of hiPSC derived endocrine cells for the establishment of an in vitro organ model of the endocrine pancreas was examined. Therefore, a PanMa-derived hydrogel was generated and used for the encapsulation and culture of hiPSC-derived hormone-expressing cells (HECs). The influence of the PanMa-hydrogel culture was analyzed on gene, protein and functional level by gene expression analysis, immunohistochemical stainings and glucose stimulated insulin secretion.
Whole organ decellularization resulted in the generation of an acellular PanMa scaffold, with low amounts of residual DNA and a preserved ECM micro- and ultrastructure, including important ECM components, such as collagen I, III and IV. Furthermore, the PanMa maintained an intact vessel system and was verified as cytocompatible as demonstrated by the successful recellularization of the arterial system with human endothelial cells. In comparison to SISser and LungMa, the PanMa was characterized as a relative soft, hygroscopic scaffold with a collagen-fiber based structure. Furthermore, the findings indicate that the ECM-specific properties have a relevant effect on the stem cell character and early multi-lineage decisions of hiPSCs. In this regard, maintenance of hiPSCs on the PanMa resulted in a slightly changed expression of pluripotency genes (OCT4, SOX2 and NANOG) and a weak immunohistochemical signal for NANOG protein, indicating a PanMa-dependent impact on hiPSC pluripotency. Strikingly, this presumption was corroborated by the finding that culture on the PanMa promoted an endodermal development of hiPSCs during spontaneous differentiation. In line with that, pancreatic differentiation of hiPSC on both the PanMa and SISser resulted in a significant decrease of glucagon and somatostatin gene expression as well as an unaltered insulin expression, suggesting an ECM-driven suppression of the development of non β-cell endocrine cells. However, this change did not result in an improved glucose stimulated insulin secretion of the generated HECs. Moreover, use of the PanMa as a hydrogel allowed prolonged culture of these cells in a defined culture system. HECs were viable after 21 days of culture, however already showed an altered islet morphology as well as a slightly decreased glucose stimulated insulin secretion.
Altogether, this study demonstrates a relevant biological effect of tissue specific ECM cues on the in vitro differentiation of hiPSCs. More specifically, the data indicate an involvement of the ECM in the endocrine commitment of hiPSC-derived pancreatic cells during directed differentiation highlighting the ECM as an important regulator of pancreatic development. Collectively, these findings emphasize the relevance of the ECM for the fabrication of functional hiPSC-derived cell types and suggest a much stronger consideration of organ specific ECM cues for tissue engineering approaches as well as clinical translation in regenerative medicine.
To reach their target site, systemic pesticides must enter the plant from a spray droplet applied in the field. The uptake of an active ingredient (AI) takes place via the barrier-forming cuticular membrane, which is the outermost layer of the plant, separating it from the surrounding environment. Formulations are usually used which, in addition to the AI, also contain stabilizers and adjuvants. Adjuvants can either have surface-active properties or they act directly as barrier-modifying agents. The latter are grouped in the class of accelerating adjuvants, whereby individual variants may also have surface-active properties. The uptake of a pesticide from a spray droplet depends essentially on its permeability through the cuticular barrier. Permeability defines a combined parameter, which is the product of AI mobility and AI solubility within the cuticle. In recent decades, several tools have been developed that allowed the determination of individual parameters of organic compound penetration across the cuticular membrane. Nevertheless, earlier studies showed that mainly cuticular waxes are the barrier-determining component of the cuticular membrane and additionally, it was shown that mainly the very-long-chain aliphatic compounds (VLCAs) are responsible for establishing an effective barrier. However, the barrier-determining role of the individual VLCAs, being classified according to their respective functional groups, is still unknown.
Therefore, the following objectives were pursued and achieved in this work: (1) A new ATR-FTIR-based approach was developed to measure the temperature-dependent real-time diffusion kinetics of organic models for active ingredients (AIs) in paraffin wax, exclusively consisting of very-long chain alkanes. (2) The developed ATR-FTIR approach was applied to determine the diffusion kinetics of self-accelerating adjuvants in cuticular model waxes of different VLCA composition. At the same time, wax-specific changes were recorded in the respective IR spectra, which provided information about the respective wax modification. (3) The ATR-FTIR method was used to characterize the diffusion kinetics, as well as to determine the wax-specific sorption capacities for an AI-modeling organic compound and water in cuticular model waxes after adjuvant treatment. Regarding the individual chemical compositions and structures, conclusions were drawn about the adjuvant-specific modes of action (MoA).
In the first chapter, the ATR-FTIR based approach to determine organic compound diffusion kinetics in paraffin wax was successfully established. The diffusion kinetics of the AI modelling organic compounds heptyl parabene (HPB) and 4-cyanophenol (CNP) were recorded, comprising different lipophilicities and molecular volumes typical for AIs used in pesticide formulations. Derived diffusion coefficients ranged within 10-15 m2 s-1, thus being thoroughly higher than those obtained from previous experiments using an approach solely investigating desorption kinetics in reconstituted cuticular waxes. An ln-linear dependence between the diffusion coefficients and the applied diffusion temperature was demonstrated for the first time in cuticular model wax, from which activation energies were derived. The determined activation energies were 66.2 ± 7.4 kJ mol-1 and 56.4 ± 9.8 kJ mol-1, being in the expected range of already well-founded activation energies required for organic compound diffusion across cuticular membranes, which again confirmed the significant contribution of waxes to the cuticular barrier. Deviations from the assumed Fickian diffusion were attributed to co-occurring water diffusion and apparatus-specific properties.
In the second and third chapter, mainly the diffusion kinetics of accelerating adjuvants in the cuticular model waxes candelilla wax and carnauba wax were investigated, and simultaneously recorded changes in the wax-specific portion of the IR spectrum were interpreted as indications of plasticization. For this purpose, the oil derivative methyl oleate, as well as the organophosphate ester TEHP and three non-ionic monodisperse alcohol ethoxylates (AEs) C12E2, C12E4 and C12E6 were selected. Strong dependence of diffusion on the respective principal components of the mainly aliphatic waxes was demonstrated. The diffusion kinetics of the investigated adjuvants were faster in the n-alkane dominated candelilla wax than in the alkyl ester dominated carnauba wax. Furthermore, the equilibrium absorptions, indicating equilibrium concentrations, were also higher in candelilla wax than in carnauba wax. It was concluded that alkyl ester dominated waxes feature higher resistance to diffusion of accelerating adjuvants than alkane dominated waxes with shorter average chain lengths due to their structural integrity. This was also found either concerning candelilla/policosanol (n-alcohol) or candelilla/rice bran wax (alkyl-esters) blends: with increasing alcohol concentration, the barrier function was decreased, whereas it was increased with increasing alkyl ester concentration. However, due to the high variability of the individual diffusion curves, only a trend could be assumed here, but significant differences were not shown. The variability itself was described in terms of fluctuating crystalline arrangements and partial phase separation of the respective wax mixtures, which had inevitable effects on the adjuvant diffusion. However, diffusion kinetics also strongly depended on the studied adjuvants. Significantly slower methyl oleate diffusion accompanied by a less pronounced reduction in orthorhombic crystallinity was found in carnauba wax than in candelilla wax, whereas TEHP diffusion was significantly less dependent on the respective wax structure and therefore induced considerable plasticization in both waxes. Of particular interest was the AE diffusion into both waxes. Differences in diffusion kinetics were also found here between candelilla blends and carnauba wax. However, these depended equally on the degree of ethoxylation of the respective AEs. The lipophilic C12E2 showed approximately Fickian diffusion kinetics in both waxes, accompanied by a drastic reduction in orthorhombic crystallinity, especially in candelilla wax, whereas the more hydrophilic C12E6 showed significantly retarded diffusion kinetics associated with a smaller effect on orthorhombic crystallinity. The individual diffusion kinetics of the investigated adjuvants sometimes showed drastic deviations from the Fickian diffusion model, indicating a self-accelerating effect. Hence, adjuvant diffusion kinetics were accompanied by a distinct initial lag phase, indicating a critical concentration in the wax necessary for effective penetration, leading to sigmoidal rather than to exponential diffusion kinetics.
The last chapter dealt with the adjuvant-affected diffusion of the AI modelling CNP in candelilla and carnauba wax. Using ATR-FTIR, diffusion kinetics were recorded after adjuvant treatment, all of which were fully explicable based on the Fickian model, with high diffusion coefficients ranging from 10-14 to 10-13 m2 s-1. It is obvious that the diffusion coefficients presented in this work consistently demonstrated plasticization induced accelerated CNP mobilities. Furthermore, CNP equilibrium concentrations were derived, from which partition- and permeability coefficients could be determined. Significant differences between diffusion coefficients (mobility) and partition coefficients (solubility) were found on the one hand depending on the respective waxes, and on the other hand depending on treatment with respective adjuvants. Mobility was higher in candelilla wax than in carnauba wax only after methyl oleate treatment. Treatment with TEHP and AEs resulted in higher CNP mobility in the more polar alkyl ester dominated carnauba wax. The partition coefficients, on the other hand, were significantly lower after methyl oleate treatment in both candelilla and carnauba wax as followed by TEHP or AE treatment. Models were designed for the CNP penetration mode considering the respective adjuvants in both investigated waxes. Co-penetrating water, which is the main ingredient of spray formulations applied in the field, was likely the reason for the drastic differences in adjuvant efficacy. Especially the investigated AEs favored an enormous water uptake in both waxes with increasing ethoxylation level. Surprisingly, this effect was also found for the lipophilic TEHP in both waxes. This led to the assumption that the AI permeability is not exclusively determined by adjuvant induced plasticization, but also depends on a “secondary plasticization”, induced by adjuvant-attracted co-penetrating water, consequently leading to swelling and drastic destabilization of the crystalline wax structure.
The successful establishment of the presented ATR-FTIR method represents a milestone for the study of adjuvant and AI diffusion kinetics in cuticular waxes. In particular, the simultaneously detectable wax modification and, moreover, the determinable water uptake form a perfect basis to establish the ATR-FTIR system as a universal screening tool for wax-adjuvants-AI-water interaction in crop protection science.
Current therapeutic strategies efficiently improve survival in patients after myocardial infarction (MI). Nevertheless, long-term consequences such as heart failure development, are still one of the leading causes of death worldwide. Inflammation is critically involved in the cardiac healing process after MI and has a dual role, contributing to both tissue healing and tissue damage. In the last decade, a lot of attention was given to targeting inflammation as a potential therapeutic approach in MI, but the poor understanding of inflammatory cell heterogeneity and function is a limit to the development of immune modulatory strategies. The recent development of tools to profile immune cells with high resolution has provided a unique opportunity to better understand immune cell heterogeneity and dynamics in the ischemic heart.
In this thesis, we employed single-cell RNA-sequencing combined with detection of epitopes by sequencing (CITE-seq) to refine our understanding of neutrophils and monocytes/macrophages heterogeneity and dynamic after experimental myocardial infarction.
Neutrophils rapidly invade the infarcted heart shortly after ischemic damage and have previously been proposed to display time-dependent functional heterogeneity. At the single-cell level, we observed dynamic transcriptional heterogeneity in neutrophil populations during the acute post-MI phase and defined previously unknown cardiac neutrophil states. In particular, we identified a locally acquired SiglecFhi neutrophil state that displayed higher ROS production and phagocytic ability compared to newly recruited neutrophils, suggesting the acquisition of specific function in the infarcted heart. These findings highlight the importance of the tissue microenvironment in shaping neutrophil response.
From the macrophage perspective, we characterized MI-associated monocyte-derived macrophage subsets, two with a pro-inflammatory gene signature (MHCIIhiIl1βhi) and three Trem2hi macrophage populations with a lipid associated macrophage (LAM) signature, also expressing pro-fibrotic and tissue repair genes. Combined analysis of blood monocytes and cardiac monocyte/macrophages indicated that the Trem2hi LAM signature is acquired in the infarcted heart.
We furthermore characterized the role of TREM2, a surface protein expressed mainly in macrophages and involved in macrophage survival and function, in the post-MI macrophage response and cardiac repair. Using TREM2 deficient mice, we demonstrate that acquisition of the LAM signature in cardiac macrophages after MI is partially dependent on TREM2. While their cardiac function was not affected, TREM2 deficient mice showed reduced collagen deposition in the heart after MI. Thus, our data in Trem2-deficient mice highlight the role of TREM2 in promoting a macrophage pro-fibrotic phenotype, in line with the pro-fibrotic/tissue repair gene signature of the Trem2hi LAM-signature genes.
Overall, our data provide a high-resolution characterization of neutrophils and macrophage heterogeneity and dynamics in the ischemic heart and can be used as a valuable resource to investigate how these cells modulate the healing processes after MI. Furthermore, our work identified TREM2 as a regulator of macrophage phenotype in the infarcted heart
The nervous system relies on an orchestrated assembly of complex cellular entities called neurons, which are specifically committed to information management and transmission. Inter-neuronal communication takes place via synapses, membrane-membrane junctions which ensure efficient signal transfer. Synaptic neurotransmission involves release of presynaptic neurotransmitters and their reception by cognate receptors at postsynaptic terminals. Inhibitory neurotransmission is primarily mediated by the release of neurotransmitters GABA (γ-Aminobutyric acid) and glycine, which are precisely sensed by GABA type-A receptors (GABAARs) and glycine receptors (GlyRs), respectively. GABAAR assembly and maintenance is coordinated by various postsynaptic neuronal factors including the scaffolding protein gephyrin, the neuronal adaptor collybistin (CB) and cell adhesion proteins of the neuroligin (NL) family, specifically NL2 and NL4.
At inhibitory postsynaptic specializations, gephyrin has been hypothesized to form extended structures underneath the plasma membrane, where its interaction with the receptors leads to their stabilization and impedes their lateral movement. Gephyrin mutations have been associated with various brain disorders, including autism, schizophrenia, Alzheimer’s disease, and epilepsy. Furthermore, gephyrin loss is lethal and causes mice to die within the first post-natal day. Gephyrin recruitment from intracellular deposits to postsynaptic membranes primarily relies on the adaptor protein CB.
As a moonlighting protein, CB, a guanine nucleotide exchange factor (GEF), also catalyzes a nucleotide exchange reaction, thereby regenerating the GTP-bound state of the small GTPase Cdc42 from its GDP-bound form. The CB gene undergoes alternative splicing with the majority of CB splice variants featuring an N-terminal SH3 domain followed by tandem Dbl-homology (DH) and pleckstrin-homology (PH) domains. Previous studies demonstrated that the most widely expressed, SH3-domain containing splice variant (CB2SH3+) preferentially adopts a closed conformation, in which the N-terminally located SH3 domain forms intra-molecular interaction with the DH-PH domain tandem. Previous cell-based studies indicated that SH3 domain-encoding CB variants remain untargeted and colocalize with intracellular gephyrin deposits and hence require additional factors which interact with the SH3 domain, thus inducing an open or active conformation. The SH3 domain-deficient CB isoform (CB2SH3-), on the contrary, adopts an open conformation, which possess enhanced postsynaptic gephyrin-clustering and also effectively replenishes the GTP-bound small GTPase-Cdc42 from its GDP-bound state.
Despite the fundamental role of CB as a neuronal adaptor protein maintaining the proper function of inhibitory GABAergic synapses, its interactions with the neuronal scaffolding protein gephyrin and other post synaptic neuronal factors remain poorly understood. Moreover, CB interaction studies with the small GTPase Cdc42 and TC10, a closely related member of Cdc42 subfamily, remains poorly characterized. Most importantly, the roles of the neuronal factors and small GTPases in CB conformational activation have not been elucidated.
This PhD dissertation primarily focuses on delineating the molecular basis of the interactions between CB and postsynaptic neuronal factors. During the course of my PhD dissertation, I engineered a series of CB FRET (Förster Resonance Energy Transfer) sensors to characterize the CB interaction with its binding partners along with outlining their role in CB conformational activation. Through the aid of these CB FRET sensors, I analyzed the gephyrin-CB interaction, which, due to technical limitations remained unaddressed for more than two decades (refer Chapter 2 for more details). Subsequently, I also unraveled the molecular basis of the interactions between CB and the neuronal cell adhesion factor neuroligin 2 (refer chapter 2) and the small GTPases Cdc42 and TC10 (refer chapter 3) and describe how these binding partners induce a conformational activation of CB.
In summary, this PhD dissertation provides strong evidence of a closely knit CB communication network with gephyrin, neuroligin and the small GTPase TC10, wherein CB activation from closed/inactive to open/active states is effectively triggered by these ligands.
The present cumulative dissertation summarizes three clinical studies, which examine
subgroups of patients within the fibromyalgia syndrome (FMS). FMS entails chronic pain and
associated symptoms, and its pathophysiology is incompletely understood (1). Previous studies
show that there is a subgroup of patients with FMS with objective histological pathology of the
small nerve fibers of the peripheral nervous system (PNS). Another subgroup of FMS patients
does not show any signs of pathological changes of the small nerve fibers. The aim of this
dissertation was to compare FMS patients with healthy controls, and these two FMS subgroups
for differences in the central nervous system (CNS) in order to explore possible interactions
between PNS and the CNS. Regarding the CNS, differences of FMS patients with healthy
controls have already been found in studies with small sample sizes, but no subgroups have yet
been identified. Another aim of this thesis was to test whether the subgroups show a different
response to different classes of pain medication. The methods used in this thesis are structural
and functional magnetic resonance imaging (MRI), magnetic resonance diffusion imaging and
magnetic resonance spectroscopy. For the evaluation of clinical symptoms, we used
standardized questionnaires. The subgroups with and without pathologies of the PNS were
determined by skin biopsies of the right thigh and lower leg based on the intraepidermal nerve
fiber density (IENFD) of the small nerve fibers.
1) In the first MRI study, 43 female patients with the diagnosis of FMS and 40 healthy
control subjects, matched in age and body mass index, were examined with different MRI
sequences. Cortical thickness was investigated by structural T1 imaging, white matter integrity
by diffusion tensor imaging and functional connectivity within neuronal networks by functional
resting state MRI. Compared to the controls, FMS patients had a lower cortical volume in
bilateral frontotemporoparietal regions and the left insula, but a higher cortical volume in the
left pericalcarine cortex. Compared to the subgroup without PNS pathology, the subgroup with
PNS pathology had lower cortical volume in both pericalcarine cortices. Diffusion tensor
imaging revealed an increased fractional anisotropy (FA) of FMS patients in corticospinal
pathways such as the corona radiata, but also in regions of the limbic systems such as the fornix
and cingulum. Subgroup comparison again revealed lower mean FA values of the posterior
thalamic radiation and the posterior limb of the left internal capsule in the subgroup with PNS
pathology. In the functional connectivity analysis FMS patients, compared to controls, showed
a hypoconnectivity between the right median frontal gyrus and the posterior cerebellum and
the right crus cerebellum, respectively. In the subgroup comparisons, the subgroup with PNS
pathology showed a hyperconnectivity between both inferior frontal gyri, the right posterior
parietal cortex and the right angular gyrus. In summary, these results show that differences in
brain morphology and functional connectivity exist between FMS patients with and without
PNS pathology. These differences were not associated with symptom duration or severity and,
in some cases, have not yet been described in the context of FMS. The differences in brain
morphology and connectivity between subgroups could also lead to a differential response to
treatment with centrally acting drugs. Further imaging studies with FMS patients should take
into account this heterogeneity of FMS patient cohorts.
2) Following the results from the first MRI study, drug therapies of FMS patients and
their treatment response were compared between PNS subgroups. As there is no licensed drug
for FMS in Europe, the German S3 guideline recommends amitriptyline, duloxetine and
pregabalin for temporary use. In order to examine the current drug use in FMS patients in
Germany on a cross-sectional basis, 156 patients with FMS were systematically interviewed.
The drugs most frequently used to treat pain in FMS were non-steroidal anti-inflammatory
drugs (NSAIDs) (28.9%), metamizole (15.4%) and amitriptyline (8.8%). Pain relief assessed by
patients on a numerical rating scale from 0-10 averaged 2.2 points for NSAIDs, 2.0 for
metamizole and 1.5 for amitriptyline. Drugs that were discontinued for lack of efficacy and not
for side effects were acetaminophen (100%), flupirtine (91.7%), selective serotonin reuptake
inhibitors (81.8%), NSAIDs (83.7%) and weak opioids (74.1%). Patients were divided into
subgroups with and without PNS pathology as determined by skin biopsies. We found no
differences in drug use and effect between the subgroups. Taken together, these results show
that many FMS patients take medication that is not in accordance with the guidelines. The
reduction of symptoms was best achieved with metamizole and NSAIDs. Further longitudinal
studies on medication in FMS are necessary to obtain clearer treatment recommendations.
3) Derived from previous pharmacological and imaging studies (with smaller case
numbers), there is a hypothesis in the FMS literature that hyperreactivity of the insular cortex
may have an impact on FMS. The hyperreactivity seems to be due to an increased concentration
of the excitatory neurotransmitter glutamate in the insular cortex of FMS patients. The
hypothesis is supported by magnetic resonance spectroscopy studies with small number of
cases, as well as results from pharmacological studies with glutamate-inhibiting medication.
Studies from animal models have also shown that an artificially induced increase in glutamate
in the insular cortex can lead to reduced skin innervation. Therefore, the aim of this study was
to compare glutamate and GABA concentrations in the insular cortex of FMS patients with
those of healthy controls using magnetic resonance imaging. There was no significant
difference of both neurotransmitters between the groups. In addition, there was no correlation
between the neurotransmitter concentrations and the severity of clinical symptoms. There
were also no differences in neurotransmitter concentrations between the subgroups with and
without PNS pathology. In conclusion, our study could not show any evidence of a correlation
of glutamate and GABA concentrations with the symptoms of FMS or the pathogenesis of
subgroups with PNS pathologies.
The monarch butterfly (Danaus plexippus) performs one of the most astonishing behaviors in the animal kingdom: every fall millions of these butterflies leave their breeding grounds in North Amerika and migrate more than 4.000 km southwards until they reach their overwintering habitat in Central Mexico. To maintain their migratory direction over this enormous distance, the butterflies use a time-compensated sun compass. Beside this, skylight polarization, the Earth’s magnetic field and specific mountain ranges seem to guide the butterflies as well the south. In contrast to this fascinating orientation ability, the behavior of the butterflies in their non-migratory state received less attention. Although they do not travel long distances, they still need to orient themselves to find food, mating partners or get away from competitors. The aim of the present doctoral thesis was to investigate use of visual cues for orientation in migrating as well as non-migrating monarch butterflies. For this, field experiments investigating the migration of the butterflies in Texas (USA) were combined with experiments testing the orientation performance of non-migratory butterflies in Germany.
In the first project, I recorded the heading directions of tethered butterflies during their annual fall migration. In an outdoor flight simulator, the butterflies maintained a southwards direction as long as they had a view of the sun’s position. Relocating the position of the sun by 180° using a mirror, revealed that the sun is the animals’ main orientation reference. Furthermore, I demonstrated that when the sun is blocked and a green light stimulus (simulated sun) is introduced, the animals interpreted this stimulus as the ‘real’ sun. However, this cue was not sufficient to set the migratory direction when simulated as the only visual cue in indoor experiments. When I presented the butterflies a linear polarization pattern additionally to the simulated sun, the animals headed in the correct southerly direction showing that multiple skylight cues are required to guide the butterflies during their migration.
In the second project, I, furthermore, demonstrated that non-migrating butterflies are able to maintain a constant direction with respect to a simulated sun. Interestingly, they ignored the spectral component of the stimulus and relied on the intensity instead. When a panoramic skyline was presented as the only orientation reference, the butterflies maintained their direction only for short time windows probably trying to stabilize their flight based on optic-flow information. Next, I investigated whether the butterflies combine celestial with local cues by simulating a sun stimulus together with a panoramic skyline. Under this conditions, the animals’ directedness was increased demonstrating that they combine multiple visual cues for spatial orientation.
Following up on the observation that a sun stimulus resulted in a different behavior than the panoramic skyline, I investigated in my third project which orientation strategies the butterflies use by presenting different simulated cues to them. While a bright stripe on a dark background elicited a strong attraction of the butterflies steering in the direction of the stimulus, the inverted version of the stimulus was used for flight stabilization. In contrast to this, the butterflies maintained arbitrary directions with a high directedness with respect to a simulated sun. In an ambiguous scenery with two identical stimuli (two bright stripes, two dark stripes, or two sun stimuli) set 180° apart, a constant flight course was only achieved when two sun stimuli were displayed suggesting an involvement of the animals’ internal compass. In contrast, the butterflies used two dark stripes for flight stabilization and were alternatingly attracted by two bright stripes. This shows that monarch butterflies use stimulus-dependent orientation strategies and gives the first evidence for different neuronal pathways controlling the output behavior.