Abteilung für Molekulare Innere Medizin (in der Medizinischen Klinik und Poliklinik II)
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- 2015 (4) (remove)
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- Journal article (3)
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Keywords
- bone disease (2)
- multiple myeloma (2)
- positron emission tomography (2)
- Apoptose (1)
- CXCR4 (1)
- CXCR4/SDF-1 (1)
- FDG PET/CT (1)
- NFkB-Signalling (1)
- Nekroptose (1)
- Nekrose (1)
Multiple myeloma (MM) remains an essentially incurable hematologic malignancy. However, new treatment modalities and novel drugs have been introduced and thus additional tools for therapy monitoring are increasingly needed. Therefore, we evaluated the radiotracers \(^{11}\)C-Methionine (paraprotein-biosynthesis) and \(^{18}\)F-FDG (glucose-utilization) for monitoring response to anti-myeloma-therapy and outcome prediction. Influence of proteasome-inhibition on radiotracer-uptake of different MM cell-lines and patient-derived CD138\(^{+}\) plasma cells was analyzed and related to tumor-biology. Mice xenotransplanted with MM. 1S tumors underwent MET- and FDG-\(\mu\)PET. Tumor-to-background ratios before and after 24 h, 8 and 15 days treatment with bortezomib were correlated to survival. Treatment reduced both MET and FDG uptake; changes in tracer-retention correlated with a switch from high to low CD138-expression. In xenotransplanted mice, MET-uptake significantly decreased by 30-79% as early as 24 h after bortezomib injection. No significant differences were detected thus early with FDG. This finding was confirmed in patient-derived MM cells. Importantly, early reduction of MET-but not FDG-uptake correlated with improved survival and reduced tumor burden in mice. Our results suggest that MET is superior to FDG in very early assessment of response to anti-myeloma-therapy. Early changes in MET-uptake have predictive potential regarding response and survival. MET-PET holds promise to individualize therapies in MM in future.
Die vorliegende Arbeit behandelt TRAIL-induzierte Apoptose und Nekroptose in verschiedenen Zelllinien. Im Speziellen wurden die verschiedenen Funktionen des TNF receptor-associated factor 2 (TRAF2) untersucht. Hierzu wurde ein transienter Knockdown etabliert und dessen Wirkung auf die Suszeptibilität der Zellen gegenüber dem Zytokin TRAIL untersucht. Es konnte gezeigt werden, dass ein Knockdown von TRAF2 nicht nur zur Sensitivierung für Apoptose führt, sondern auch in Nekroptose-kompetenten Zellen zu einer Verstärkung der durch Caspaseinhibition mittels zVAD-fmk nach TRAIL-Stimulation induzierten Nekroptose führt. Mittels des Zytokins Fc-TWEAK wurde Fn14-vermittelt TRAF2 aus dem Zytosol in ein Triton X100-unlösliches Kompartiment rekrutiert und dadurch physiologisch depletiert. Dies führte zwar kaum zu gesteigerter TRAIL-abhängiger Apoptose, sensitivierte jedoch analog zum TRAF2-Knockdown RIP3-exprimierende Zellen für Nekroptose. Durch Vergleich RIP3-negativer (HeLa-Leervektor) mit RIP3-exprimierenden Zellen (HeLa RIP3, HT29, HaCaT) konnte die Essentialität von RIP3 für die Nekroptose herausgestellt werden und Einsatz des RIP1-Kinase-Inhibitors Necrostatin-1 sowie des MLKL-Inhibitors Necrosulfonamide belegte die Beteiligung der Nekroptosomkomponenten RIP1 und MLKL. Antagonismus putativen autokrinen TNFs bewies, dass es sich bei dem durch Fc-TWEAK verstärkten Zelltod um einen direkten TRAIL-Effekt handelte und Inhibition kanonischen NFkBs durch IKK2-Inhibitor TPCA-1, dass die TRAF2-Knockdown-vermittelte Sensitivierung gegenüber TRAIL nicht auf verändertes NFkB-Signalling zurückzuführen ist. Einsatz des SMAC-Mimetikums BV6 rekapitulierte zudem stark das im TRAF2-Knockdown Gesehene und unterstrich die Bedeutung der cIAPs. Immunpräzipitation von Caspase 8 unter nekroptotischen Bedingungen zeigte bei TRAF2-Knockdown eine Depletion von TRAF2 und cIAP1/2 sowie RIP1 und RIP3 aus dem Komplex mit Caspase 8. Insgesamt wird deutlich, dass TRAF2 einerseits antiapoptotisch wirkt als K48-Ubiquitinligase, die die Halbwertszeit aktiver Caspase 8-Komplexe determiniert und andererseits eine antinekroptotische Funktion hat, da es durch Rekrutierung von cIAP1/2 an RIP1 die TRAIL-induzierte Nekroptose verhindert, wenn die Caspasen inhibiert sind.
CXCR4 is a G-protein-coupled receptor that mediates recruitment of blood cells toward its ligand SDF-1. In cancer, high CXCR4 expression is frequently associated with tumor dissemination andpoor prognosis. We evaluated the novel CXCR4 probe [\(^{68}\)Ga]Pentixafor for invivo mapping of CXCR4 expression density in mice xenografted with human CXCR4-positive MM cell lines and patients with advanced MM by means of positron emission tomography (PET). [\(^{68}\)Ga]Pentixafor PET provided images with excellent specificity and contrast. In 10 of 14 patients with advanced MM [\(^{68}\)Ga]Pentixafor PET/CT scans revealed MM manifestations, whereas only nine of 14 standard [\(^{18}\)F]fluorodeoxyglucose PET/CT scans were rated visually positive. Assessment of blood counts and standard CD34\(^{+}\) flow cytometry did not reveal significant blood count changes associated with tracer application. Based on these highly encouraging data on clinical PET imaging of CXCR4 expression in a cohort of MM patients, we conclude that [\(^{68}\)Ga]Pentixafor PET opens a broad field for clinical investigations on CXCR4 expression and for CXCR4-directed therapeutic approaches in MM and other diseases.
Background
Animal models have been instrumental in defining thrombus formation, including the role of platelet surface glycoprotein (GP) receptors, in acute ischemic stroke (AIS). However, the involvement of GP receptors in human ischemic stroke pathophysiology and their utility as biomarkers for ischemic stroke risk and severity requires elucidation.
Aims
To determine whether platelet GPIb and GPIIb/IIIa receptors are differentially expressed in patients with AIS and chronic cerebrovascular disease (CCD) compared with healthy volunteers (HV) and to identify predictors of GPIb and GPIIb/IIIa expression.
Methods
This was a case-control study of 116 patients with AIS or transient ischemic attack (TIA), 117 patients with CCD, and 104 HV who were enrolled at our University hospital from 2010 to 2013. Blood sampling was performed once in the CCD and HV groups, and at several time points in patients with AIS or TIA. Linear regression and analysis of variance were used to analyze correlations between platelet GPIb and GPIIb/IIIa receptor numbers and demographic and clinical parameters.
Results
GPIb and GPIIb/IIIa receptor numbers did not significantly differ between the AIS, CCD, and HV groups. GPIb receptor expression level correlated significantly with the magnitude of GPIIb/IIIa receptor expression and the neutrophil count. In contrast, GPIIb/IIIa receptor numbers were not associated with peripheral immune-cell sub-population counts. Creactive protein was an independent predictor of GPIIb/IIIa (not GPIb) receptor numbers.
Conclusions
Platelet GPIb and GPIIb/IIIa receptor numbers did not distinguish between patient or control groups in this study, negating their potential use as a biomarker for predicting stroke risk.