Evaluation von Effektivität und Sicherheit der niederfrequenten, transkraniellen Ultraschalltherapie beim Schlaganfall

In den westlichen Ländern nimmt die Zahl der Schlaganfall-Patienten stetig zu und zählt mittlerweilernzu einer der häufigsten Todesursachen. Derzeit ist die Rekanalisationstherapie mit demrnFibrinolytikum rt-PA die einzig zugelassene Therapie. Die Rekanalisationsrate ist oftmals inkomplettrnund aufgrund von möglichen Blutungskomplikationen die Therapie nicht bei allen Patientenrnmöglich. Daher ist es wichtig, Alternativtherapieansätze (z.B. Ultraschallthrombolyse) zurnentwickeln. Blutgerinnsel können mit Hilfe von Ultraschall in Schwingung gebracht und sornlysiert oder die Wirkung von rt-PA verstärkt werden. Die vorliegende Arbeit hatte die Evaluationrnvon Bioeffekten von 60 kHz Ultraschall an gesundem und ischämischem Hirngewebe zum Ziel.rnNeben tierexperimentellen Methoden kamen auch molekular-biologische Techniken zur Anwendung.rnDie erste Studie beschäftigte sich mit der Wirkung von 60 kHz (Intensität: 0,2 W/cm2 undrnDuty Cycle 50%) auf ischämisches Hirngewebe (permanent ischämisch und nach Reperfusion).rnLediglich nach Reperfusion und Ultraschallbehandlung war das Läsionsvolumen signifikantrnerhöht, so dass von einer besonderen Vulnerabilität des Hirngewebes nach Reperfusionrnauszugehen ist (Penumbraschädigung). In der neurologischen Beurteilung der Tiere zeigte sichrnbei allen Tieren mit permanenter Okklusion und etwa einem Drittel der Tiere nach Reperfusionrnund Ultraschallbehandlung eine Hörminderung. In der anschließenden Studie wurde diernUltraschallintensität erniedrigt und der Duty Cycle variiert. In einer publizierten in vitro Studiernkonnte die zunehmende Lyserate mit steigendem Duty Cycle nachgewiesen werden. DiernAuswertung ergab eine Abhängigkeit des Läsionsvolumens von der Länge des Duty Cycles. Derrndritte Teil der Arbeit befasst sich mit der Wirkung von Ultraschall auf die Genexpression. Hierzurnwurden gesunde Ratten mit Ultraschall verschiedener Frequenzen (60 kHz, 488 kHz und 3 MHz)rntranskraniell behandelt und 4 h bzw. 24 h nach der Behandlung getötet. Proben von ischämischenrnTieren dienten als positive Kontrollen. Aufgrund von Literaturrecherchen wurden mehrerernKandidatengene ermittelt. Die Messung der Ischämieproben ergab eine weitgehende Übereinstimmungrnmit der Literatur. Die Messungen an den mit 60 kHz behandelten Proben ergabenrnkaum Anzeichen für eine differenzielle Genregulation. Die Frequenz von 488 kHz zeigte diernmeisten Regulationen, gefolgt von der Behandlung mit 3 MHz. Dieses Ergebnis lässt vermuten,rndass es sich bei den detektierten Veränderungen um protektive Mechanismen handelt, da diesernFrequenzen bislang im Tierversuch als nebenwirkungsarm beschrieben wurden. Die Auswertungrnvon 60 kHz-Proben mit Affymetrix Arrays ergab lediglich einige wenige differentiell regulierternGene. Die Array-Experimente konnten nicht durch qPCR-Messungen bestätigt werden.

Radiolabeling of defined polymer architectures with fluorine-18 and iodine-131 for ex vivo and in vivo evaluation : visualization of structure-property relationships

Nuclear medicine imaging techniques such as PET are of increasing relevance in pharmaceutical research being valuable (pre)clinical tools to non-invasively assess drug performance in vivo. Therapeutic drugs, e.g. chemotherapeutics, often suffer from a poor balance between their efficacy and toxicity. Here, polymer based drug delivery systems can modulate the pharmacokinetics of low Mw therapeutics (prolonging blood circulation time, reducing toxic side effects, increasing target site accumulation) and therefore leading to a more efficient therapy. In this regard, poly-N-(2-hydroxypropyl)-methacrylamide (HPMA) constitutes a promising biocompatible polymer. Towards the further development of these structures, non-invasive PET imaging allows insight into structure-property relationships in vivo. This performant tool can guide design optimization towards more effective drug delivery. Hence, versatile radiolabeling strategies need to be developed and establishing 18F- as well as 131I-labeling of diverse HPMA architectures forms the basis for short- as well as long-term in vivo evaluations. By means of the prosthetic group [18F]FETos, 18F-labeling of distinct HPMA polymer architectures (homopolymers, amphiphilic copolymers as well as block copolymers) was successfully accomplished enabling their systematic evaluation in tumor bearing rats. These investigations revealed pronounced differences depending on individual polymer characteristics (molecular weight, amphiphilicity due to incorporated hydrophobic laurylmethacrylate (LMA) segments, architecture) as well as on the studied tumor model. Polymers showed higher uptake for up to 4 h p.i. into Walker 256 tumors vs. AT1 tumors (correlating to a higher cellular uptake in vitro). Highest tumor concentrations were found for amphiphilic HPMA-ran-LMA copolymers in comparison to homopolymers and block copolymers. Notably, the random LMA copolymer P4* (Mw=55 kDa, 25% LMA) exhibited most promising in vivo behavior such as highest blood retention as well as tumor uptake. Further studies concentrated on the influence of PEGylation (‘stealth effect’) in terms of improving drug delivery properties of defined polymeric micelles. Here, [18F]fluoroethylation of distinct PEGylated block copolymers (0%, 1%, 5%, 7%, 11% of incorporated PEG2kDa) enabled to systematically study the impact of PEG incorporation ratio and respective architecture on the in vivo performance. Most strikingly, higher PEG content caused prolonged blood circulation as well as a linear increase in tumor uptake (Walker 256 carcinoma). Due to the structural diversity of potential polymeric carrier systems, further versatile 18F-labeling strategies are needed. Therefore, a prosthetic 18F-labeling approach based on the Cu(I)-catalyzed click reaction was established for HPMA-based polymers, providing incorporation of fluorine-18 under mild conditions and in high yields. On this basis, a preliminary µPET study of a HPMA-based polymer – radiolabeled via the prosthetic group [18F]F-PEG3-N3 – was successfully accomplished. By revealing early pharmacokinetics, 18F-labeling enables to time-efficiently assess the potential of HPMA polymers for efficient drug delivery. Yet, investigating the long-term fate is essential, especially regarding prolonged circulation properties and passive tumor accumulation (EPR effect). Therefore, radiolabeling of diverse HPMA copolymers with the longer-lived isotope iodine-131 was accomplished enabling in vivo evaluation of copolymer P4* over several days. In this study, tumor retention of 131I-P4* could be demonstrated at least over 48h with concurrent blood clearance thereby confirming promising tumor targeting properties of amphiphilic HPMA copolymer systems based on the EPR effect.

Quantum Einstein gravity - advancements of heat kernel-based renormalization group studies

The asymptotic safety scenario allows to define a consistent theory of quantized gravity within the framework of quantum field theory. The central conjecture of this scenario is the existence of a non-Gaussian fixed point of the theory's renormalization group flow, that allows to formulate renormalization conditions that render the theory fully predictive. Investigations of this possibility use an exact functional renormalization group equation as a primary non-perturbative tool. This equation implements Wilsonian renormalization group transformations, and is demonstrated to represent a reformulation of the functional integral approach to quantum field theory.rnAs its main result, this thesis develops an algebraic algorithm which allows to systematically construct the renormalization group flow of gauge theories as well as gravity in arbitrary expansion schemes. In particular, it uses off-diagonal heat kernel techniques to efficiently handle the non-minimal differential operators which appear due to gauge symmetries. The central virtue of the algorithm is that no additional simplifications need to be employed, opening the possibility for more systematic investigations of the emergence of non-perturbative phenomena. As a by-product several novel results on the heat kernel expansion of the Laplace operator acting on general gauge bundles are obtained.rnThe constructed algorithm is used to re-derive the renormalization group flow of gravity in the Einstein-Hilbert truncation, showing the manifest background independence of the results. The well-studied Einstein-Hilbert case is further advanced by taking the effect of a running ghost field renormalization on the gravitational coupling constants into account. A detailed numerical analysis reveals a further stabilization of the found non-Gaussian fixed point.rnFinally, the proposed algorithm is applied to the case of higher derivative gravity including all curvature squared interactions. This establishes an improvement of existing computations, taking the independent running of the Euler topological term into account. Known perturbative results are reproduced in this case from the renormalization group equation, identifying however a unique non-Gaussian fixed point.rn