Adenoviral Gene Therapy for Advanced Head and Neck Cancer

Advanced stage head and neck cancers (HNC) with distant metastasis, as well as prostate cancers (PC), are devastating diseases currently lacking efficient treatment options. One promising developmental approach in cancer treatment is the use of oncolytic adenoviruses, especially in combination therapy with conventional cancer therapies. The safety of the approach has been tested in many clinical trials. However, antitumor efficacy needs to be improved in order to establish oncolytic viruses as a viable treatment alternative. To be able to test in vivo the effects on anti-tumor efficiency of a multimodal combination therapy of oncolytic adenoviruses with the standard therapeutic combination of radiotherapy, chemotherapy and Cetuximab monoclonal antibody (mAb), a xenograft HNC tumor model was developed. This model mimics the typical clinical situation as it is initially sensitive to cetuximab, but resistance develops eventually. Surprisingly, but in agreement with recent findings for chemotherapy and radiotherapy, a higher proportion of cells positive for HNC cancer stem cell markers were found in the tumors refractory to cetuximab. In vitro as well as in vivo results found in this study support the multimodal combination therapy of oncolytic adenoviruses with chemotherapy, radiotherapy and monoclonal antibody therapy to achieve increased anti-tumor efficiency and even complete tumor eradication with lower treatment doses required. In this study, it was found that capsid modified oncolytic viruses have increased gene transfer to cancer cells as well as an increased antitumor effect. In order to elucidate the mechanism of how oncolytic viruses promote radiosensitization of tumor cells in vivo, replicative deficient viruses expressing several promising radiosensitizing viral proteins were tested. The results of this study indicated that oncolytic adenoviruses promote radiosensitization by delaying the repair of DNA double strand breaks in tumor cells. Based on the promising data of the first study, two tumor double-targeted oncolytic adenoviruses armed with the fusion suicide gene FCU1 or with a fully human mAb specific for human Cytotoxic T Lymphocyte-Associated Antigen 4 (CTLA-4) were produced. FCU1 encodes a bifunctional fusion protein that efficiently catalyzes the direct conversion of 5-FC, a relatively nontoxic antifungal agent, into the toxic metabolites 5-fluorouracil and 5-fluorouridine monophosphate, bypassing the natural resistance of certain human tumor cells to 5-fluorouracil. Anti-CTLA4 mAb promotes direct killing of tumor cells via apoptosis and most importantly immune system activation against the tumors. These armed oncolytic viruses present increased anti-tumor efficacy both in vitro and in vivo. Furthermore, by taking advantage of the unique tumor targeted gene transfer of oncolytic adenoviruses, functional high tumor titers but low systemic concentrations of the armed proteins were generated. In addition, supernatants of tumor cells infected with Ad5/3-24aCTLA4, which contain anti-CTLA4 mAb, were able to effectively immunomodulate peripheral blood mononuclear cells (PBMC) of cancer patients with advanced tumors. -- In conclusion, the results presented in this thesis suggest that genetically engineered oncolytic adenoviruses have great potential in the treatment of advanced and metastatic HNC and PC.

Radikalcyklisering vid syntes av polycykliska indoler och pyrroler

I de senaste två decennierna har radikalcyklisering, intramolekylär radikaladdition, utvecklats till en viktig syntesmetod för polycykliska indoler och pyrroler. De erhållna produktmolekylerna eller deras derivat är ofta naturliga eller syntetiska alkaloider som väckt biologiskt eller medicinskt intresse. Avhandlingen behandlar både intramolekylära radikaladditioner av pyrrolyl-, indolyl- eller indolylacylradikaler till -bindningar och intramolekylära additioner av flera olika radikaler till indolens eller pyrrolens -system. Också cykliseringar som delreaktioner i radikalkaskader behandlas. Radikalreaktioner kan släckas både oxidativt och reduktivt. För att bibehålla heteroarenens aromaticitet måste cykliseringar till pyrrol- eller indolringen släckas oxidativt. Oxidativa radikaladditioner till aromater benämns homolytiska aromatiska substitutioner. Det finns olika sätt att erhålla en reaktantradikal från en radikalprekursor. I vissa fall har radikalprekursorn en mycket labil bindning som kan brytas fotokemiskt eller med hjälp av en initiator. Till exempel kol-svavelbindningen av en O-etyl-S-alkylxanthat kan brytas på detta sätt. Ofta används dock en radikalmediator för att bilda en reaktantradikal från dess prekursor. Mediatorer är ofta föreningar, som under reaktionsförhållandena själv bildar radikaler med en stor affinitet för en prekursors specifika atom eller atomgrupp vilken abstraheras. Således fungerar mediatorn som mellanhand vid bildning av reaktantradikalen. Exempel på mediatorer av detta slag som använts vid syntes av polycykliska pyrroler och indoler är tributyltennhydrid, hexabutylditenn, tris(trimetylsilyl)silan, tributylgermaniumhydrid, dicumylperoxid, trietylboran, natriumarensulfinater (med ättiksyra) och Se-fenyl-p-toluenselenosulfonat. Också dimetylsulfoxid kan ses som mediator då den bildar metylradikaler vid Fentonreaktion i lösningsmedlet. Övergångsmetallsalter kan även bilda reaktantradikalen från prekursorn genom enelektronoxidationer eller -reduktioner. Vid syntes av polycykliska pyrroler och indoler har reaktantradikalen bildats genom enelektronoxidationer med Mn(OAc)3 eller Ag2+ (Miniscireaktion) och elektronreduktioner med ett Ni(I)-komplex eller SmI2. Avhandlingen är indelad enligt reagenset eller reagensen, som åstadkommer bildning av reaktantradikalen vid syntes av polycykliska indoler och pyrroler. Cirka hälften av avhandlingen behandlar tributyltennhydridmedierade cykliseringar då reagenset trots dess toxicitet är det överlägset mest använda. Avhandlingen diskuterar mekanismen för bildning av reaktantradikalen från prekursorn, cykliseringen och dess möjliga regioselektivitet, andra radikalreaktioner vid radikalkaskader och hur produktradikalen släcks.

Neurotrophic factors and their receptors

Four GDNF ligands (GDNF, neurturin, artemin and persephin), and mesencephalic astrocyte-derived neurotrophic factor (MANF) and conserved dopamine neurotrophic factor (CDNF) protect midbrain dopaminergic neurons that degenerate in Parkinson's disease. Each GDNF ligand binds a specific coreceptor GDNF family receptor α (GFRα), leading to the formation of a heterotetramer complex, which then interacts with receptor tyrosine kinase RET, the signalling receptor. The present thesis describes the structural and biochemical characterization of the GDNF2-GFRα12 complex and the MANF and CDNF proteins. Previous and current mutation data and comparison between GDNF-GFRα1 and artemin-GFRα3 binding interfaces show that N162GFRα1, I175GFRα1, V230GFRα1, Y120GDNF and L114GDNF are the specificity determinants among different ligand-coreceptor pairs. The structure suggests that sucrose octasulphate, a heparin mimic, interacts with a region R190-K202 within domain 2 of GFRα1. Mutating these residues on the GFRα1 surface, which are not in the GDNF binding region, affected RET phosphorylation, which provides a putative RET binding region in domain 2 and 3 of GFRα1. The structural comparison of the GDNF-GFRα1 and artemin-GFRα3 complexes shows a difference in bend angle between the ligand monomers. This variation in bend angle of the ligand may affect the kinetics of RET phosphorylation. To confirm that the difference is not due to crystallization artefacts, I crystallized the GDNF-GFRα1 complex without SOS in different cell dimensions. The structure of the second GDNF-GFRα1 complex is very similar to the previous one, suggesting that the difference between the artemin-GFRα3 and GDNF-GFRα1 complexes are intrinsic, not due to crystal packing. Finally, MANF and CDNF are bifunctional proteins with extracellular neurotrophic activity and ER resident cytoprotective role. The crystal structures of MANF and CDNF are presented here. Intriguingly, the structures of both the neurotrophic factors do not show structural similarity to any of previously known growth factor superfamilies; instead they are similar to saposins, the lipid-binding proteins. The N-terminal domain of MANF and CDNF contain conserved lysines and arginines on its surface, which may interact with negatively charged head groups of phospholipids, as saposins do. Thus MANF and CDNF may provide neurotrophic activities by interacting with a lipo-receptor. The structure of MANF shows a CXXC motif forming internal disulphide bridge in the natively unfolded C-terminus. This motif is common to reductases and disulphide isomerases. It is thus tempting to speculate that the CXXC motif of MANF and CDNF may be involved in oxidative protein folding, which may explain its cytoprotective role in the ER.

Politiikan paluu : Globalisaatioliike ja julkisuus

The struggle over globalization has arguably been the most important debate in world politics of the 2000 s. This study maps the origins of this debate, its most important actors and its results so far. The focus is on the Global Justice Movement which launched the globalization debate to the mass media spotlight. Particular attention is given to the World Social Forum, the movement s global gathering, analyzed as a new form of global publics. The mediation of the debates initiated by these publics to the Finnish national context is analyzed at two levels: First, through forums for policy debate such as the Helsinki Process on Globalization and Democracy and second, through the public debate in the Finnish mass media. The study proves many common assumptions about the Global Justice Movement wrong. Rather than being a marginal actor, the movement is the initiator of the whole debate. Combining expert knowledge to carnevalistic demonstrations rarely seen in Finland, the movement gains more public attention and more members in Finland than in many other European countries. The political and economic elites are not just adversaries of the movement. Rather, the Finnish elite is divided in two. Some top politicians starting from the president and the minister for foreign affairs adopt many of the movement s claims. Later, the business elite, with support from the nation s largest newspaper, begins a counterattack to challenge the movement and its allies. The return of politics staged by the movement is, first and foremost, a phenomenon in the public sphere. Two downward trends, the decline of party politics and the traditionally strong Finnish field of politically oriented civic associations remain unchanged. This allows for the conclusion that we are witnessing a move from organizational politics towards politics in the public sphere. The study develops a theoretical perspective on social movements as actors in the public sphere. It argues that movements have, in fact, played an important role in the very development of the democratic public sphere as we know it. In the light of this observation, the study assesses the potentials and the pitfalls of social movements and their related publics to global democracy. Methodologically, the most important contribution is the development of Public Justifications Analysis, a method for analyzing political claims in media debates and the ways in which these claims are justified.