872 resultados para Second generation


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Abstract Background There is an imperative necessity for alternative sources of energy able to reduce the world dependence of fossil oil. One of the most successful options is ethanol obtained mainly from sugarcane and corn fermentation. The foremost residue from sugarcane industry is the bagasse, a rich lignocellulosic raw material uses for the production of ethanol second generation (2G). New cellulolytic and hemicellulytic enzymes are needed, in order to optimize the degradation of bagasse and production of ethanol 2G. Results The ability to produce hemicellulases and related enzymes, suitable for lignocellulosic biomass deconstruction, was explored using 110 endophytic fungi and 9 fungi isolated from spoiled books in Brazil. Two initial selections were performed, one employing the esculin gel diffusion assay, and the other by culturing on agar plate media with beechwood xylan and liquor from the hydrothermal pretreatment of sugar cane bagasse. A total of 56 isolates were then grown at 29°C on steam-exploded delignified sugar cane bagasse (DEB) plus soybean bran (SB) (3:1), with measurement of the xylanase, pectinase, β-glucosidase, CMCase, and FPase activities. Twelve strains were selected, and their enzyme extracts were assessed using different substrates. Finally, the best six strains were grown under xylan and pectin, and several glycohydrolases activities were also assessed. These strains were identified morphologically and by sequencing the internal transcribed spacer (ITS) regions and the partial β-tubulin gene (BT2). The best six strains were identified as Aspergillus niger DR02, Trichoderma atroviride DR17 and DR19, Alternaria sp. DR45, Annulohypoxylon stigyum DR47 and Talaromyces wortmannii DR49. These strains produced glycohydrolases with different profiles, and production was highly influenced by the carbon sources in the media. Conclusions The selected endophytic fungi Aspergillus niger DR02, Trichoderma atroviride DR17 and DR19, Alternaria sp. DR45, Annulohypoxylon stigyum DR47 and Talaromyces wortmannii DR49 are excellent producers of hydrolytic enzymes to be used as part of blends to decompose sugarcane biomass at industrial level.

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Abstract BACKGROUND: There is an imperative necessity for alternative sources of energy able to reduce the world dependence of fossil oil. One of the most successful options is ethanol obtained mainly from sugarcane and corn fermentation. The foremost residue from sugarcane industry is the bagasse, a rich lignocellulosic raw material uses for the production of ethanol second generation (2G). New cellulolytic and hemicellulytic enzymes are needed, in order to optimize the degradation of bagasse and production of ethanol 2G. RESULTS: The ability to produce hemicellulases and related enzymes, suitable for lignocellulosic biomass deconstruction, was explored using 110 endophytic fungi and 9 fungi isolated from spoiled books in Brazil. Two initial selections were performed, one employing the esculin gel diffusion assay, and the other by culturing on agar plate media with beechwood xylan and liquor from the hydrothermal pretreatment of sugar cane bagasse. A total of 56 isolates were then grown at 29°C on steam-exploded delignified sugar cane bagasse (DEB) plus soybean bran (SB) (3:1), with measurement of the xylanase, pectinase, β-glucosidase, CMCase, and FPase activities. Twelve strains were selected, and their enzyme extracts were assessed using different substrates. Finally, the best six strains were grown under xylan and pectin, and several glycohydrolases activities were also assessed. These strains were identified morphologically and by sequencing the internal transcribed spacer (ITS) regions and the partial β-tubulin gene (BT2). The best six strains were identified as Aspergillus niger DR02, Trichoderma atroviride DR17 and DR19, Alternaria sp. DR45, Annulohypoxylon stigyum DR47 and Talaromyces wortmannii DR49. These strains produced glycohydrolases with different profiles, and production was highly influenced by the carbon sources in the media. CONCLUSIONS: The selected endophytic fungi Aspergillus niger DR02, Trichoderma atroviride DR17 and DR19, Alternaria sp. DR45, Annulohypoxylon stigyum DR47 and Talaromyces wortmannii DR49 are excellent producers of hydrolytic enzymes to be used as part of blends to decompose sugarcane biomass at industrial level.

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[EN]Seahorses husbandry constitute an innovative aspect on the recovery of wild populations. In this study, two aeration levels were tested (normal and strong) in seahorse juveniles fed on Artemia. Survival and growth were evaluated. The results showed higher survivals (11% average) with strong aerations levels after 90 days. In addition, these juveniles were able to reproduce after 4 months, denoting the early sexual maturation of this species. However, sizes of second-generation larvae at day 0 were smaller compared with those produced by their parents

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This study deals with the protection of social rights in Europe and aims to outline the position currently held by these rights in the EU law. The first two chapters provide an overview of the regulatory framework in which the social rights lie, through the reorganisation of international sources. In particular the international instruments of protection of social rights are taken into account, both at the universal level, due to the activity of the United Nations Organisation and of its specialized agency, the International Labour Organization, and at a regional level, related to the activity of the Council of Europe. Finally an analysis of sources concludes with the reconstruction of the stages of the recognition of social rights in the EU. The second chapter describes the path followed by social rights in the EU: it examines the founding Treaties and subsequent amendments, the Charter of Fundamental Social Rights of Workers of 1989 and, in particularly, the Charter of Fundamental Rights of the European Union, the legal status of which was recently treated as the primary law by the Treaty of Lisbon signed in December 2007. The third chapter is, then, focused on the analysis of the substantive aspects of the recognition of the rights made by the EU: it provides a framework of the content and scope of the rights accepted in the Community law by the Charter of Fundamental Rights, which is an important contribution to the location of the social rights among the fundamental and indivisible rights of the person. In the last section of the work, attention is focused on the two profiles of effectiveness and justiciability of social rights, in order to understand the practical implications of the gradual creation of a system of protection of these rights at Community level. Under the first profile, the discussion is focused on the effectiveness in the general context of the mechanisms of implementation of the “second generation” rights, with particular attention to the new instruments and actors of social Europe and the effect of the procedures of soft law. Second part of chapter four, finally, deals with the judicial protection of rights in question. The limits of the jurisprudence of the European Union Court of Justice are more obvious exactly in the field of social rights, due to the gap between social rights and other fundamental rights. While, in fact, the Community Court ensures the maximum level of protection to human rights and fundamental freedoms, social rights are often degraded into mere aspirations of EU institutions and its Member States. That is, the sources in the social field (European Social Charter and Community Charter) represent only the base for interpretation and application of social provisions of secondary legislation, unlike the ECHR, which is considered by the Court part of Community law. Moreover, the Court of Justice is in the middle of the difficult comparison between social values and market rules, of which it considers the need to make a balance: despite hesitancy to recognise the juridical character of social rights, the need of protection of social interests has justified, indeed, certain restrictions to the free movement of goods, freedom to provide services or to Community competition law. The road towards the recognition and the full protection of social rights in the European Union law appears, however, still long and hard, as shown by the recent judgments Laval and Viking, in which the Community court, while enhancing the Nice Charter, has not given priority to fundamental social rights, giving them the role of limits (proportionate and justified) of economic freedoms.

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Tale lavoro di ricerca ha indagato l’opera di sette scrittrici immigrate in Italia o nate da genitori immigrati che hanno composto in lingua italiana. Esse sono: Christiana de Caldas Brito, Cristina Ubax Ali Farah, Gabriella Kuruvilla, Ingy Mubiayi, Ornela Vorpsi, Laila Wadia, Jarmila Očkayová. La tesi consta di una premessa, un primo capitolo in cui sono riportate le interviste fatte alle scrittrici, un secondo capitolo di analisi dei loro testi, un terzo di riflessioni di teoria letteraria ed un quarto conclusivo. In appendice sono riportate integralmente le interviste.

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Family businesses have acquired a very specific gravity in the economy of occidental countries, generating most of the employment and the richness for the last ages. In Spain Family Businesses represent the 65% about the total of enterprises with 1,5 million companies. They give employment to 8 million people, the 80% of the private employment and develop the 65% of the Spanish GNP (Gross National Product). Otherwise, the family business needs a complete law regulation that gives satisfaction to their own necessities and challenges. These companies have to deal with national or international economic scene to assure their permanency and competitiveness. In fact, the statistics about family companies have a medium life of 35 years. European family businesses success their successor process between a 10 and 25%. It’s said: first generation makes, second generation stays, third generation distributes. In that sense, the Recommendation of the European Commission of December 7º 1994 about the succession of the small and medium companies has reformed European internal orders according to make easier successor process and to introduce practices of family companies’ good government. So, the Italian law, under the 14th Law, February 2006, has reformed its Covil Code, appearing a new concept, called “Patto di famiglia”, wich abolish the prohibition as laid dwon in the 458 article about successors’ agreements, admitting the possibility that testator guarantees the continuity of the company or of the family society, giving it, totally or in part, to one or various of its descendents. On other hand, Spain has promulgated the 17th Royal Decree (9th February 2007), that governs the publicity of family agreements (Protocolos familiars). These “protocolo familiar” (Family Agreement) are known as accord of wills, consented and accepted unanimously of all the family members and the company, taking into account recommendations and practices of family company’s good government.

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Triplex cell vaccine is a cancer immunopreventive cell vaccine that can prevent almost completely mammary tumor onset in HER-2/neu transgenic mice. A future translation of cancer immunoprevention from preclinical to clinical studies should take into account several aspects. The work reported in this thesis deals with the study of three of these aspects: vaccine schedule, activity in a therapeutic set-up and second-generation DNA vaccines. An important element in determining human acceptance and compliance of a treatment protocol is the number of vaccinations. In order to improve the vaccination schedule a minimal protocol was searched, i.e. a schedule consisting of a lower number of administrations than standard protocol but with a similar efficacy. A candidate optimal protocol was identified by the use of an in silico model, SimTriplex simulator. The in vivo test of this schedule in HER-2/neu transgenic mice only partially confirmed in silico predictions. This result shows that in silico models have the potential ability to aid in searching of optimal treatment protocols, provided that they will be further tuned on experimental data. As a further result this preclinical study highlighted that kinetic of antibody response plays a major role in determining cancer prevention, leading to the hypothesis of a threshold that must be reached rapidly and maintained lifetime. Early clinical trials would be performed in a therapeutic, rather than preventive, setting. Thus, the activity of Triplex vaccine was investigated against experimental lung metastases in HER-2/neu transgenic mice in order to evaluate if the immunopreventive Triplex vaccine could be effective also against a pre-existing tumor mass. This preclinical model of aggressive metastatic development showed that the vaccine was an efficient treatment also 4 for the cure of micrometastases. However the immune mechanisms activated against tumor mass were not antibody dependent, i.e. different from those preventing the onset of primary mammary carcinoma. DNA vaccines could be more easily used than cellular ones. A second generation of Triplex vaccine based on DNA plasmids was evaluated in an aggressive preclinical model (BALBp53neu female mice) and compared with the preventive ability of cellular Triplex vaccine. It was observed that Triplex DNA vaccine was as effective as Triplex cell vaccine, exploiting a more restricted immune stimulation.

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Great strides have been made in the last few years in the pharmacological treatment of neuropsychiatric disorders, with the introduction into the therapy of several new and more efficient agents, which have improved the quality of life of many patients. Despite these advances, a large percentage of patients is still considered “non-responder” to the therapy, not drawing any benefits from it. Moreover, these patients have a peculiar therapeutic profile, due to the very frequent application of polypharmacy, attempting to obtain satisfactory remission of the multiple aspects of psychiatric syndromes. Therapy is heavily individualised and switching from one therapeutic agent to another is quite frequent. One of the main problems of this situation is the possibility of unwanted or unexpected pharmacological interactions, which can occur both during polypharmacy and during switching. Simultaneous administration of psychiatric drugs can easily lead to interactions if one of the administered compounds influences the metabolism of the others. Impaired CYP450 function due to inhibition of the enzyme is frequent. Other metabolic pathways, such as glucuronidation, can also be influenced. The Therapeutic Drug Monitoring (TDM) of psychotropic drugs is an important tool for treatment personalisation and optimisation. It deals with the determination of parent drugs and metabolites plasma levels, in order to monitor them over time and to compare these findings with clinical data. This allows establishing chemical-clinical correlations (such as those between administered dose and therapeutic and side effects), which are essential to obtain the maximum therapeutic efficacy, while minimising side and toxic effects. It is evident the importance of developing sensitive and selective analytical methods for the determination of the administered drugs and their main metabolites, in order to obtain reliable data that can correctly support clinical decisions. During the three years of Ph.D. program, some analytical methods based on HPLC have been developed, validated and successfully applied to the TDM of psychiatric patients undergoing treatment with drugs belonging to following classes: antipsychotics, antidepressants and anxiolytic-hypnotics. The biological matrices which have been processed were: blood, plasma, serum, saliva, urine, hair and rat brain. Among antipsychotics, both atypical and classical agents have been considered, such as haloperidol, chlorpromazine, clotiapine, loxapine, risperidone (and 9-hydroxyrisperidone), clozapine (as well as N-desmethylclozapine and clozapine N-oxide) and quetiapine. While the need for an accurate TDM of schizophrenic patients is being increasingly recognized by psychiatrists, only in the last few years the same attention is being paid to the TDM of depressed patients. This is leading to the acknowledgment that depression pharmacotherapy can greatly benefit from the accurate application of TDM. For this reason, the research activity has also been focused on first and second-generation antidepressant agents, like triciclic antidepressants, trazodone and m-chlorophenylpiperazine (m-cpp), paroxetine and its three main metabolites, venlafaxine and its active metabolite, and the most recent antidepressant introduced into the market, duloxetine. Among anxiolytics-hypnotics, benzodiazepines are very often involved in the pharmacotherapy of depression for the relief of anxious components; for this reason, it is useful to monitor these drugs, especially in cases of polypharmacy. The results obtained during these three years of Ph.D. program are reliable and the developed HPLC methods are suitable for the qualitative and quantitative determination of CNS drugs in biological fluids for TDM purposes.

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A series of oligo-phenylene dendronised conjugated polymers was prepared. The divergent synthetic approach adopted allowed for the facile synthesis of a range of dendronised monomers from a common intermediate, e.g. first and second generation fluorene. Only the polymerisation of the first generation and alkylarylamine substituted dendronised fluorene monomers yielded high molecular weight materials, attributed to the low solubility of the remaining dendronised monomers. The alkylarylamine substituted dendronised poly(fluorene) was incorporated into an organic light emitting diode (OLED) and exhibited an increased colour stability in air compared to other poly(fluorenes). The concept of dendronisation was extended to poly(fluorenone), a previously insoluble material. The synthesis of the first soluble poly(fluorenone) was achieved by the incorporation of oligo-phenylene dendrons at the 4-position of fluorenone. The dendronisation of fluorenone allowed for a polymer with an Mn of 4.1 x 104 gmol-1 to be prepared. Cyclic voltammetry of the dendronised poly(fluorenone) showed that the electron affinity of the polymer was high and that the polymer is a promising n-type material. A dimer and trimer of indenofluorene (IF) were prepared from the monobromo IF. These oligomers were investigated by 2-dimensional wide angle x-ray spectroscopy (2D-WAXS), polarised optical microscopy (POM) and dielectric spectroscopy, and found to form highly ordered smetic phases. By attaching perylene dye as the end-capper on the IF oligomers, molecules that exhibited efficient Förster energy transfer were obtained. Indenofluorene monoketone, a potential defect structure for IF based OLED’s, was synthesised. The synthesis of this model defect structure allowed for the long wavelength emission in OLED’s to be identified as ketone defects. The long wavelength emission from the indenofluorene monoketone was found to be concentration dependent, and suggests that aggregate formation is occurring. An IF linked hexa-peri-hexabenzocoronene (HBC) dimer was synthesised. The 2D-WAXS images of this HBC dimer demonstrate that the molecule exhibits intercolumnar organisation perpendicular to the extrusion direction. POM images of mixtures of the HBC dimer mixed with an HBC with a low isotropic temperature demonstrated that the HBC dimer is mixing with the isotropic HBC.

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La mia tesi si riallaccia al dibattito teorico-letterario contemporaneo sulla possibilità di un approccio cognitivo alla narrativa e alla letteratura in particolare. Essa si propone di esplorare il rapporto tra narrazione ed esperienza, ridefinendo il concetto di “esperienzialità” della narrativa introdotto da Monika Fludernik nel suo Towards a “Natural” Narratology (1996). A differenza di Fludernik, che ha identificato l’esperienzialità con la rappresentazione dell’esperienza dei personaggi, la mia trattazione assegna un ruolo di primo piano al lettore, cercando di rispondere alla domanda: perché leggere una storia è – o si costituisce come – un’esperienza? L’intuizione dietro tutto ciò è che le teorizzazioni dell’esperienza e della coscienza nella filosofia della mente degli ultimi venti anni possano gettare luce sull’interazione tra lettori e testi narrativi. Il mio punto di riferimento principale è la scienza cognitiva “di seconda generazione”, secondo cui l’esperienza è un relazionarsi attivo e corporeo al mondo. La prima parte del mio studio è dedicata all’intreccio tra la narrativa e quello che chiamo lo “sfondo esperienziale” di ogni lettore, un repertorio di esperienze già note ai lettori attraverso ripetute interazioni con il mondo fisico e socio-culturale. Mi soffermo inoltre sul modo in cui relazionarsi a un testo narrativo può causare cambiamenti e slittamenti in questo sfondo esperienziale, incidendo sulla visione del mondo del lettore. Mi rivolgo poi al coinvolgimento corporeo del lettore, mostrando che la narrativa può attingere allo sfondo esperienziale dei suoi fruitori anche sul piano dell’esperienza di base: le simulazioni corporee della percezione contribuiscono alla nostra comprensione delle storie, incidendo sia sulla ricostruzione dello spazio dell’ambientazione sia sulla relazione intersoggettiva tra lettori e personaggi. Infine, mi occupo del rapporto tra l’esperienza della lettura e la pratica critico-letteraria dell’interpretazione, sostenendo che – lungi dal costituire due modalità opposte di fruizione dei testi – esse sono intimamente connesse.

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La tesi intitolata "Dalla «postmémoire» alla scrittura dell’oblio nell’opera di Sylvie Germain" si pone l’obbiettivo di analizzare l’opera della scrittrice francese contemporanea Sylvie Germain alla luce di alcune elaborazioni teoriche sulla dialettica memoria/oblio. Basandoci sulle principali teorie-guida relative alla «memoria culturale» teorizzate da Maurice Halbwachs,Pierre Nora,Tzvetan Todorov,Paul Ricoeur e Aleida Assmann,la nostra analisi si è successivamente concentrata sugli studi condotti attorno al concetto di «postmemory» elaborato dalla studiosa americana Marianne Hirsch. Scopo di questa prospettiva critica è quello di leggere l'opera germainiana come espressione di una «affiliative postmemory», risultato della connessione generazionale di coloro che non hanno vissuto direttamente un trauma con la «literal second generation». Attraverso un approccio interdisciplinare che ha coinvolto gli studi sulla memoria culturale in rapporto alla questione del gender, si è inoltre evidenziata la specificità del ruolo rivestito dai personaggi femminili nei romanzi di Germain che assumono un peso determinante nella trasmissione della memoria individuale e collettiva, studio che ci ha permesso di sottolineare la funzione attiva svolta dalle protagoniste delle opere della scrittrice. Nella fase conclusiva sono state esaminate le opere più recenti di Sylvie Germain pubblicate tra il 2008 e il 2011 in cui l’autrice sembra avvertire la necessità di controbilanciare il peso della «troppa memoria» con una giusta dose di oblio. Sono state inoltre affrontate la questione della responsabilità etica e l’idea di debito nei confronti della memoria familiare e collettiva: la scrittura stessa diventa così per Germain lo strumento attraverso il quale l’autrice assume il ruolo di passeuse de mémoire per le generazioni future.

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L’oggetto dell’analisi si situa all’intersezione di diversi ambiti disciplinari: letteratura, scienze dell’educazione, sociologia, psicologia. Nel presente lavoro, viene privilegiata un’analisi tematica della narrativa e la definizione identitaria delle “infanzie migranti” viene declinata seguendo percorsi di lettura che mettano in risalto alcune prospettive ricorrenti nei romanzi. Il corpus letterario selezionato include alcuni romanzi scritti in lingua inglese da sei scrittrici di origine indiana, in particolare Jamila Gavin, Rachna Gilmore, Anjali Banerjee, Rukhsana Khan, Ravinder Randhawa e Meera Syal. Nel primo capitolo si tracciano le premesse teoriche e metodologiche del lavoro, definendo il genere della letteratura per l’infanzia e interrogandoci sulle sue specificità in un contesto postcoloniale qual è quello indiano. Il secondo capitolo è dedicato alla definizione identitaria delle seconde generazioni, in particolar modo di quelle indo-britanniche e indo-canadesi, cui appartengono i protagonisti dei romanzi presi in esame. Nel terzo capitolo viene posta attenzione agli elementi che concorrono alla definizione identitaria dei giovani protagonisti dei romanzi, i quali si interrogano sul loro essere e sull’appartenenza interculturale. I dialoghi intergenerazionali tra i protagonisti e i nonni - o altre figure di guida - permettono alle scrittrici di raccontare la storia dell’India coloniale e della lotta per l’indipendenza dal punto di vista degli esclusi dalla storiografia ufficiale. Nel capitolo conclusivo si argomenta invece come la definizione identitaria si attui per mezzo dello spazio, tramite l’appartenenza ai luoghi, spazi caricati di significato, e per mezzo del viaggio, che può essere reale, immaginario o iniziatico. In tutti i casi, il viaggio porta alla scoperta del Sé, di un’identità ibrida e molteplice da parte dei personaggi.

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Il diritto a un minimo decente di assistenza sanitaria – spesso chiamato, più semplicemente, diritto alla salute – fa parte dei cosiddetti diritti di seconda generazione, cioè quelli che richiedono un impegno attivo da parte dello stato per assicurare ad ogni cittadino la possibilità di una vita dignitosa. Il diritto alla salute si trova enunciato nei più importanti documenti internazionali, a partire dalla Dichiarazione universale dei diritti dell’uomo (1948), e nella maggior parte delle costituzioni nazionali, compresa quella italiana. Tuttavia, nel Sud del mondo, la sua applicazione è ostacolata da un gran numero di fattori (povertà, guerre, corruzione politica, ecc.); cosicché la maggior parte degli esseri umani vive in società prive di un sistema sanitario nazionale, cadendo vittima di malattie facilmente curabili o prevenibili. Per affrontare questo problema, la cooperazione sanitaria internazionale ha sperimentato nel tempo due diverse forme di intervento: una incentrata sulla diffusione dell’assistenza sanitaria di base (come raccomandato dalla Conferenza di Alma-Ata del 1978), l’altra sui cosiddetti “programmi verticali”, i quali agiscono su singole malattie o branche della sanità. Nessuno dei due approcci però ha prodotto i risultati sperati. L’Ong italiana Emergency propone un modello di cooperazione sanitaria per molti aspetti innovativo: esso si fonda su progetti autogestiti e totalmente gratuiti (che vanno dalla pediatria alla chirurgia di guerra alla cardiochirurgia) ed è capace di incidere sul tessuto sociale nel quale si inserisce, fino ad influenzare le scelte politiche delle autorità locali. Solamente intervenendo in un modo simile sui determinanti sociali della salute, sembra possibile migliorare realmente lo stato di salute delle popolazioni più povere e garantire così la prima delle condizioni necessarie perché ogni persona abbia la possibilità di vivere una vita decente.

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Our view of Globular Clusters has deeply changed in the last decade. Modern spectroscopic and photometric data have conclusively established that globulars are neither coeval nor monometallic, reopening the issue of the formation of such systems. Their formation is now schematized as a two-step process, during which the polluted matter from the more massive stars of a first generation gives birth, in the cluster innermost regions, to a second generation of stars with the characteristic signature of fully CNO-processed matter. To date, star-to-star variations in abundances of the light elements (C, N, O, Na) have been observed in stars of all evolutionary phases in all properly studied Galactic globular clusters. Multiple or broad evolutionary sequences have also been observed in nearly all the clusters that have been observed with good signal-to-noise in the appropriate photometric bands. The body of evidence suggests that spreads in light-element abundances can be fairly well traced by photometric indices including near ultraviolet passbands, as CNO abundance variations affect mainly wavelengths shorter than ~400 nm owing to the rise of some NH and CN molecular absorption bands. Here, we exploit this property of near ultraviolet photometry to trace internal chemical variations and combined it with low resolution spectroscopy aimed to derive carbon and nitrogen abundances in order to maximize the information on the multiple populations. This approach has been proven to be very effective in (i) detecting multiple population, (ii) characterizing their global properties (i.e., relative fraction of stars, location in the color-magnitude diagram, spatial distribution, and trends with cluster parameters) and (iii) precisely tagging their chemical properties (i.e., extension of the C-N anticorrelation, bimodalities in the N content).

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Der Erfolg einer Schizophrenie-Behandlung ist zum größten Teil abhängig vom Ansprechen des Patienten auf seine antipsychotische Medikation. Welches Medikament und welche Dosis bei einem individuellen Patienten wirksam sind, kann derzeit erst nach mehrwöchiger Behandlung beurteilt werden. Ein Grund für variierendes Therapieansprechen sind variable Plasmakonzentrationen der Antipsychotika. Ziel dieser Arbeit war es, zu untersuchen, in wieweit der Therapieerfolg zu einem frühen Zeitpunkt der Behandlung durch objektive Symptomerfassung vorhersagbar ist und welche Faktoren die hohe Variabilität der Antipsychotikaspiegel im Blut beeinflussen. rnEine 18-monatige naturalistische klinische Studie an schizophrenen Patienten wurde durchgeführt, um folgende Fragen zu beantworten: Kann man das Therapieansprechen prädizieren und welche Instrumente sind dafür geeignet? Die Psychopathologie wurde anhand zweier Messskalen (Brief Psychiatric Rating Scale, BPRS und Clinical Global Impressions, CGI) wöchentlich ermittelt, um die Besserung der Krankheitssymptome im Verlauf von 8 Wochen zu bewerten. Therapiebegleitend wurden noch die Serum-Konzentrationen der Antipsychotika gemessen. Objektive Symptomerfassung durch BPRS oder CGI waren als Messinstrumente geeignet, Therapieansprechen vorherzusagen. Bezogen auf den Behandlungsbeginn war eine Verminderung der Symptome hoch prädiktiv für späteres Therapieversagen oder -ansprechen. Eine Verminderung um mehr als 36,5% auf der BPRS Skala in Woche 2 wurde als signifikanter Schwellenwert für Nichtansprechen ermittelt. Patienten, deren Symptombesserung unterhalb des Schwellenwertes lag, hatten eine 11,2-fach höhere Wahrscheinlichkeit, am Ende der Studie nicht auf ihre medikamentöse Therapie anzusprechen als die Patienten, die sich um mindestens 36,5% verbesserten. Andere Faktoren, wie Alter, Geschlecht, Dauer der Erkrankung oder Anzahl der stationären Aufenthalte hatten keinen Einfluss auf die Prädiktion des Therapieansprechens. Therapeutische Antipsychotika-Spiegel übten einen positiven Einfluss auf die Ansprechrate aus. Bei Patienten mit therapeutischen Spiegeln war das Ansprechen rascher und die Ansprechrate größer als unter denjenigen deren Spiegel außerhalb der therapeutisch üblichen Bereiche lag. rnEine wichtige Voraussetzung für den Einsatz von TDM ist das Vorhandensein einer präzisen, reproduzierbaren, zeit- und kostensparenden analytischen Methode zur quantitativen Bestimmung der untersuchten Substanzen. Die Entwicklung und Validierung einer solchen geeigneten Methode wurde für den Nachweis von Haloperidol vorgenommen. Eine HPLC-Methode mit Säulenschaltung erwies sich für TDM geeignet. rnBasierend auf den Ergebnissen der eigenen klinischen Studie zur Response Prädiktion wurde untersucht, welche Faktoren die Variabilität der Pharmakokinetik von Antipsychotika beeinflussen. Die Variabilität der Pharmakokinetik ist ein Grund für fehlendes oder unzureichendes Ansprechen. Es wurde zum einen der Einfluss der galenischen Formulierung auf die Freisetzung und zum anderen der Einfluss von entzündlichen Prozessen auf die Metabolisierung eines Antipsychotikums untersucht. Dazu wurden Patientendaten retrospektiv ausgewertet.rnDie Analyse von 247 Serumspiegeln von Patienten, die mit Paliperidon in OROS®Formulierung, einer neu eingeführten Retardform, behandelt wurden, zeigte, dass die intraindividuelle Variabilität der Talspiegel (Vk) von Paliperidon 35% betrug. Er war damit vergleichbar wie für nicht retardiertes Risperidon 32% (p=n.s.). Die Retardierung hatte demnach keinen Varianz mindernden Effekt auf die Talspiegel des Antipsychotikums. Der Wirkstoff-Konzentrations-Bereich lag bei 21-55 ng/ml und entsprach ebenfalls nahezu dem therapeutischen Bereich von Risperidon (20-60 ng/ml). rnEntzündliche Prozesse können die Metabolisierung von Medikamenten verändern. Dies wurde bisher für Medikamente nachgewiesen, die über CYP1A2 abgebaut werden. Durch die eigene Analyse von 84 Patienten-Serumspiegeln konnte festgestellt werden, dass die Metabolisierung von Quetiapin während eines entzündlichen Prozesses beeinträchtigt war, wahrscheinlich durch Hemmung von CYP3A4. Dies sprach dafür, dass auch Wirkstoffe, die über CYP3A4 abgebaut werden, während eines entzündlichen Prozesses im Körper in ihrer Pharmakokinetik beeinträchtigt sein können. Aus diesem Grund sollte während einer Infektion unter der Therapie mit Quetiapin besonders auf die Nebenwirkungen geachtet werden und der Serumspiegel sollte in dieser Zeit überwacht werden, um den Patienten vor eventuellen Nebenwirkungen oder sogar Intoxikationen zu schützen. rnDie Befunde dieser Arbeit zeigen, dass bei einer Behandlung schizophrener Patienten mit Antipsychotika die Messung der Psychopathologie zur Vorhersage des Therapieansprechens und die Messung der Blutspiegel zur Identifizierung von Faktoren, die die pharmakokinetische Variabilität bedingen, geeignet sind. Objektive Symptomerfassung und Therapeutisches Drug Monitoring sind demnach Instrumente, die für die Steuerung der antipsychotischen Pharmakotherapie genutzt werden sollten.rn