Novel aryl beta-aminocarbonyl derivatives as inhibitors of Trypanosoma cruzi trypanothione reductase: binding mode revised by docking and GRIND2-based 3D-QSAR procedures

Trypanothione reductase has long been investigated as a promising target for chemotherapeutic intervention in Chagas disease, since it is an enzyme of a unique metabolic pathway that is exclusively present in the pathogen but not in the human host, which has the analog Glutathione reductase. In spite of the present data-set includes a small number of compounds, a combined use of flexible docking, pharmacophore perception, ligand binding site prediction, and Grid-Independent Descriptors GRIND2-based 3D-Quantitative Structure-Activity Relationships (QSAR) procedures allowed us to rationalize the different biological activities of a series of 11 aryl beta-aminocarbonyl derivatives, which are inhibitors of Trypanosoma cruzi trypanothione reductase (TcTR). Three QSAR models were built and validated using different alignments, which are based on docking with the TcTR crystal structure, pharmacophore, and molecular interaction fields. The high statistical significance of the models thus obtained assures the robustness of this second generation of GRIND descriptors here used, which were able to detect the most important residues of such enzyme for binding the aryl beta-aminocarbonyl derivatives, besides to rationalize distances among them. Finally, a revised binding mode has been proposed for our inhibitors and independently supported by the different methodologies here used, allowing further optimization of the lead compounds with such combined structure- and ligand-based approaches in the fight against the Chagas disease.

Previous Percutaneous Coronary Intervention as Risk Factor for Coronary Artery Bypass Grafting

Background: Percutaneous coronary intervention (PCI) has increased as the initial revascularization strategy in chronic coronary artery disease. Consequently, more patients undergoing coronary artery bypass grafting (CABG) have history of coronary stent. Objective: Evaluate the impact of previous PCI on in-hospital mortality after CABG in patients with multivessel coronary artery disease. Methods: Between May/2007 and June/2009, 1099 consecutive patients underwent CABG on cardiopulmonary bypass. Patients with no PCI (n=938, 85.3%) were compared with patients with previous PCI (n=161, 14.6%). Logistic regression models and propensity score matching analysis were used to assess the risk-adjusted impact of previous PCI on in-hospital mortality. Results: Both groups were similar, except for the fact that patients with previous PCI were more likely to have unstable angina (16.1% x 9.9%, p=0.019). In-hospital mortality after CABG was higher in patients with previous PCI (9.3% x 5.1%, p=0.034) and it was comparable with EuroSCORE and 2000 Bernstein-Parsonnet risk score. Using multivariate logistic regression analysis, previous PCI emerged as an independent predictor of postoperative in-hospital mortality (odds ratio 1.94, 95% CI 1.02-3.68, p=0.044) as strong as diabetes (odds ratio 1.86, 95% CI 1.07-3.24, p=0.028). After computed propensity score matching based on preoperative risk factors, in-hospital mortality remained higher among patients with previous PCI (odds ratio 3.46, 95% CI 1.10-10.93, p=0.034). Conclusions: Previous PCI in patients with multivessel coronary artery disease is an independent risk factor for in-hospital mortality after CABG. This fact must be considered when PCI is indicated as initial alternative in patients with more severe coronary artery disease. (Arq Bras Cardiol 2012;99(1):586-595)

Efficacy of brief alcohol screening intervention for college students (BASICS): a meta-analysis of randomized controlled trials

Background: Many studies reported that brief interventions are effective in reducing excessive drinking. This study aimed to assess the efficacy of a protocol of brief intervention for college students (BASICS), delivered face-to-face, to reduce risky alcohol consumption and negative consequences. Methods: A systematic review with meta-analysis was performed by searching for randomized controlled trials (RCTs) in Medline, PsycInfo, Web of Science and Cochrane Library databases. A quality assessment of RCTs was made by using a validated scale. Combined mean effect sizes, using meta-analysis random-effects models, were calculated. Results: 18 studies were included in the review. The sample sizes ranged from 54 to 1275 (median = 212). All studies presented a good evaluation of methodological quality and four were found to have excellent quality. After approximately 12 months of follow-up, students receiving BASICS showed a significant reduction in alcohol consumption (difference between means = -1.50 drinks per week, 95% CI: -3.24 to -0.29) and alcohol-related problems (difference between means = -0.87, 95% CI: -1.58 to -0.20) compared to controls. Conclusions: Overall, BASICS lowered both alcohol consumption and negative consequences in college students. Gender and peer factors seem to play an important role as moderators of behavior change in college drinking. Characteristics of BASICS procedure have been evaluated as more favorable and acceptable by students in comparison with others interventions or control conditions. Considerations for future researches were discussed.

Health and fitness benefits of a resistance training intervention performed in the workplace

Zavanela, PM, Crewther, BT, Lodo, L, Florindo, AA, Miyabara, EH, and Aoki, MS. Health and fitness benefits of a resistance training intervention performed in the workplace. J Strength Cond Res 26(3): 811-817, 2012-This study examined the effects of a workplace-based resistance training intervention on different health-, fitness-, and work-related measures in untrained men (bus drivers). The subjects were recruited from a bus company and divided into a training (n = 48) and control (n = 48) groups after initial prescreening. The training group performed a 24-week resistance training program, whereas the control group maintained their normal daily activities. Each group was assessed for body composition, blood pressure (BP), pain incidence, muscular endurance, and flexibility before and after the 24-week period. Work absenteeism was also recorded during this period and after a 12-week follow-up phase. In general, no body composition changes were identified in either group. In the training group, a significant reduction in BP and pain incidence, along with improvements in muscle endurance and flexibility were seen after 24 weeks (p < 0.05). There were no changes in these parameters in the control group, and the between-group differences were all significant (p < 0.05). A reduction in worker absenteeism rate was also noted in the training (vs. control) group during both the interventional and follow-up periods (p < 0.05). In conclusion, it was found that a periodized resistance training intervention performed within the workplace improved different aspects of health and fitness in untrained men, thereby potentially providing other work-related benefits. Thus, both employers and employees may benefit from the setup, promotion, and support of a work-based physical activity program involving resistance training.

EVIDENCE-BASED PRACTICES PUBLISHED IN BRAZIL: IDENTIFICATION AND ANALYSIS STUDIES ABOUT HUMAN HEALTH PREVENTION

Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.

Cardiometabolic risk reduction through lifestyle intervention programs in the Brazilian public health system

Public health strategies to reduce cardiovascular morbidity and mortality should focus on global cardiometabolic risk reduction. The efficacy of lifestyle changes to prevent type 2 diabetes have been demonstrated, but low-cost interventions to reduce cardiometabolic risk in Latin-America have been rarely reported. Our group developed 2 programs to promote health of high-risk individuals attending a primary care center in Brazil. This study compared the effects of two 9-month lifestyle interventions, one based on medical consultations (traditional) and another with 13 multi-professional group sessions in addition to the medical consultations (intensive) on cardiometabolic parameters. Adults were eligible if they had pre-diabetes (according to the American Diabetes Association) and/or metabolic syndrome (International Diabetes Federation criteria for Latin-America). Data were expressed as means and standard deviations or percentages and compared between groups or testing visits. A p-value < 0.05 was considered significant. Results: 180 individuals agreed to participate (35.0% men, mean age 54.7 ± 12.3 years, 86.1% overweight or obese). 83 were allocated to the traditional and 97 to the intensive program. Both interventions reduced body mass index, waist circumference and tumor necrosis factor-α. Only intensive program reduced 2-hour plasma glucose and blood pressure and increased adiponectin values, but HDL-cholesterol increased only in the traditional. Also, responses to programs were better in intensive compared to traditional program in terms of blood pressure and adiponectin improvements. No new case of diabetes in intensive but 3 cases and one myocardial infarction in traditional program were detected. Both programs induced metabolic improvement in the short-term, but if better results in the intensive are due to higher awareness about risk and self-motivation deserves further investigation. In conclusion, these low-cost interventions are able to minimize cardiometabolic risk factors involved in the progression to type 2 diabetes and/or cardiovascular disease.

Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial

Abstract Introduction Several studies have shown that maximizing stroke volume (or increasing it until a plateau is reached) by volume loading during high-risk surgery may improve post-operative outcome. This goal could be achieved simply by minimizing the variation in arterial pulse pressure (ΔPP) induced by mechanical ventilation. We tested this hypothesis in a prospective, randomized, single-centre study. The primary endpoint was the length of postoperative stay in hospital. Methods Thirty-three patients undergoing high-risk surgery were randomized either to a control group (group C, n = 16) or to an intervention group (group I, n = 17). In group I, ΔPP was continuously monitored during surgery by a multiparameter bedside monitor and minimized to 10% or less by volume loading. Results Both groups were comparable in terms of demographic data, American Society of Anesthesiology score, type, and duration of surgery. During surgery, group I received more fluid than group C (4,618 ± 1,557 versus 1,694 ± 705 ml (mean ± SD), P < 0.0001), and ΔPP decreased from 22 ± 75 to 9 ± 1% (P < 0.05) in group I. The median duration of postoperative stay in hospital (7 versus 17 days, P < 0.01) was lower in group I than in group C. The number of postoperative complications per patient (1.4 ± 2.1 versus 3.9 ± 2.8, P < 0.05), as well as the median duration of mechanical ventilation (1 versus 5 days, P < 0.05) and stay in the intensive care unit (3 versus 9 days, P < 0.01) was also lower in group I. Conclusion Monitoring and minimizing ΔPP by volume loading during high-risk surgery improves postoperative outcome and decreases the length of stay in hospital. Trial registration NCT00479011

The double task of preventing malnutrition and overweight: a quasi-experimental community-based trial

Background: The Maternal-Child Pastoral is a volunteer-based community organization of the Dominican Republic that works with families to improve child survival and development. A program that promotes key practices of maternal and child care through meetings with pregnant women and home visits to promote child growth and development was designed and implemented. This study aims to evaluate the impact of the program on nutritional status indicators of children in the first two years of age. Methods: A quasi-experimental design was used, with groups paired according to a socioeconomic index, comparing eight geographical areas of intervention with eight control areas. The intervention was carried out by lay health volunteers. Mothers in the intervention areas received home visits each month and participated in a group activity held biweekly during pregnancy and monthly after birth. The primary outcomes were length and body mass index for age. Statistical analyses were based on linear and logistic regression models. Results: 196 children in the intervention group and 263 in the control group were evaluated. The intervention did not show statistically significant effects on length, but point estimates found were in the desired direction: mean difference 0.21 (95%CI −0.02; 0.44) for length-for-age Z-score and OR 0.50 (95%CI 0.22; 1.10) for stunting. Significant reductions of BMI-for-age Z-score (−0.31, 95%CI −0.49; -0.12) and of BMI-for-age > 85th percentile (0.43, 95%CI 0.23; 0.77) were observed. The intervention showed positive effects in some indicators of intermediary factors such as growth monitoring, health promotion activities, micronutrient supplementation, exclusive breastfeeding and complementary feeding. Conclusions: Despite finding effect measures pointing to effects in the desired direction related to malnutrition, we could only detect a reduction in the risk of overweight attributable to the intervention. The findings related to obesity prevention may be of interest in the context of the nutritional transition. Given the size of this study, the results are encouraging and we believe a larger study is warranted.

A behavioral intervention in a cohort of Japanese-Brazilians at high cardiometabolic risk

OBJECTIVE: To assess the effect of a health promotion program on cardiometabolic risk profile in Japanese-Brazilians. METHODS: A total of 466 subjects from a study on diabetes prevalence conducted in the city of Bauru, southeastern Brazil, in 2000 completed a 1-year intervention program (2005-2006) based on healthy diet counseling and physical activity. Changes in blood pressure and metabolic parameters in the 2005-2006 period were compared with annual changes in these same variables in the 2000-2005 period. RESULTS: During the intervention, there were greater annual reductions in mean (SD) waist circumference [-0.5(3.8) vs. 1.2(1.2) cm per year, p<0.001], systolic blood pressure [-4.6(17.9) vs. 1.8(4.3) mmHg per year, p<0.001], 2-hour plasma glucose [-1.2(2.1) vs. -0.2(0.6) mmol/L per year, p<0.001], LDL-cholesterol [-0.3(0.9) vs. -0.1(0.2) mmol/L per year, p<0.001] and Framingham coronary heart disease risk score [-0.25(3.03) vs. 0.11(0.66) per year, p=0.02] but not in triglycerides [0.2(1.6) vs. 0.1(0.42) mmol/L per year, p<0.001], and fasting insulin level [1.2(5.8) vs. -0.7(2.2) IU/mL per year, p<0.001] compared with the pre-intervention period. Significant reductions in the prevalence of impaired fasting glucose/impaired glucose tolerance and diabetes were seen during the intervention (from 58.4% to 35.4%, p<0.001; and from 30.1% to 21.7%, p= 0.004, respectively). CONCLUSIONS: A one-year community-based health promotion program brings cardiometabolic benefits in a high-risk population of Japanese-Brazilians.

Evolutionary methods for self-organizing cooperation in peer-to-peer networks

The Peer-to-Peer network paradigm is drawing the attention of both final users and researchers for its features. P2P networks shift from the classic client-server approach to a high level of decentralization where there is no central control and all the nodes should be able not only to require services, but to provide them to other peers as well. While on one hand such high level of decentralization might lead to interesting properties like scalability and fault tolerance, on the other hand it implies many new problems to deal with. A key feature of many P2P systems is openness, meaning that everybody is potentially able to join a network with no need for subscription or payment systems. The combination of openness and lack of central control makes it feasible for a user to free-ride, that is to increase its own benefit by using services without allocating resources to satisfy other peers’ requests. One of the main goals when designing a P2P system is therefore to achieve cooperation between users. Given the nature of P2P systems based on simple local interactions of many peers having partial knowledge of the whole system, an interesting way to achieve desired properties on a system scale might consist in obtaining them as emergent properties of the many interactions occurring at local node level. Two methods are typically used to face the problem of cooperation in P2P networks: 1) engineering emergent properties when designing the protocol; 2) study the system as a game and apply Game Theory techniques, especially to find Nash Equilibria in the game and to reach them making the system stable against possible deviant behaviors. In this work we present an evolutionary framework to enforce cooperative behaviour in P2P networks that is alternative to both the methods mentioned above. Our approach is based on an evolutionary algorithm inspired by computational sociology and evolutionary game theory, consisting in having each peer periodically trying to copy another peer which is performing better. The proposed algorithms, called SLAC and SLACER, draw inspiration from tag systems originated in computational sociology, the main idea behind the algorithm consists in having low performance nodes copying high performance ones. The algorithm is run locally by every node and leads to an evolution of the network both from the topology and from the nodes’ strategy point of view. Initial tests with a simple Prisoners’ Dilemma application show how SLAC is able to bring the network to a state of high cooperation independently from the initial network conditions. Interesting results are obtained when studying the effect of cheating nodes on SLAC algorithm. In fact in some cases selfish nodes rationally exploiting the system for their own benefit can actually improve system performance from the cooperation formation point of view. The final step is to apply our results to more realistic scenarios. We put our efforts in studying and improving the BitTorrent protocol. BitTorrent was chosen not only for its popularity but because it has many points in common with SLAC and SLACER algorithms, ranging from the game theoretical inspiration (tit-for-tat-like mechanism) to the swarms topology. We discovered fairness, meant as ratio between uploaded and downloaded data, to be a weakness of the original BitTorrent protocol and we drew inspiration from the knowledge of cooperation formation and maintenance mechanism derived from the development and analysis of SLAC and SLACER, to improve fairness and tackle freeriding and cheating in BitTorrent. We produced an extension of BitTorrent called BitFair that has been evaluated through simulation and has shown the abilities of enforcing fairness and tackling free-riding and cheating nodes.

Self-Organizing Mechanisms for Task Allocation in a Knowledge-Based Economy

A prevalent claim is that we are in knowledge economy. When we talk about knowledge economy, we generally mean the concept of “Knowledge-based economy” indicating the use of knowledge and technologies to produce economic benefits. Hence knowledge is both tool and raw material (people’s skill) for producing some kind of product or service. In this kind of environment economic organization is undergoing several changes. For example authority relations are less important, legal and ownership-based definitions of the boundaries of the firm are becoming irrelevant and there are only few constraints on the set of coordination mechanisms. Hence what characterises a knowledge economy is the growing importance of human capital in productive processes (Foss, 2005) and the increasing knowledge intensity of jobs (Hodgson, 1999). Economic processes are also highly intertwined with social processes: they are likely to be informal and reciprocal rather than formal and negotiated. Another important point is also the problem of the division of labor: as economic activity becomes mainly intellectual and requires the integration of specific and idiosyncratic skills, the task of dividing the job and assigning it to the most appropriate individuals becomes arduous, a “supervisory problem” (Hogdson, 1999) emerges and traditional hierarchical control may result increasingly ineffective. Not only specificity of know how makes it awkward to monitor the execution of tasks, more importantly, top-down integration of skills may be difficult because ‘the nominal supervisors will not know the best way of doing the job – or even the precise purpose of the specialist job itself – and the worker will know better’ (Hogdson,1999). We, therefore, expect that the organization of the economic activity of specialists should be, at least partially, self-organized. The aim of this thesis is to bridge studies from computer science and in particular from Peer-to-Peer Networks (P2P) to organization theories. We think that the P2P paradigm well fits with organization problems related to all those situation in which a central authority is not possible. We believe that P2P Networks show a number of characteristics similar to firms working in a knowledge-based economy and hence that the methodology used for studying P2P Networks can be applied to organization studies. Three are the main characteristics we think P2P have in common with firms involved in knowledge economy: - Decentralization: in a pure P2P system every peer is an equal participant, there is no central authority governing the actions of the single peers; - Cost of ownership: P2P computing implies shared ownership reducing the cost of owing the systems and the content, and the cost of maintaining them; - Self-Organization: it refers to the process in a system leading to the emergence of global order within the system without the presence of another system dictating this order. These characteristics are present also in the kind of firm that we try to address and that’ why we have shifted the techniques we adopted for studies in computer science (Marcozzi et al., 2005; Hales et al., 2007 [39]) to management science.

From inverted pendulum to N-link chain: inertial sensors-based assessment of movement kinematics and dynamics for functional evaluation and rehabilitation

Despite several clinical tests that have been developed to qualitatively describe complex motor tasks by functional testing, these methods often depend on clinicians' interpretation, experience and training, which make the assessment results inconsistent, without the precision required to objectively assess the effect of the rehabilitative intervention. A more detailed characterization is required to fully capture the various aspects of motor control and performance during complex movements of lower and upper limbs. The need for cost-effective and clinically applicable instrumented tests would enable quantitative assessment of performance on a subject-specific basis, overcoming the limitations due to the lack of objectiveness related to individual judgment, and possibly disclosing subtle alterations that are not clearly visible to the observer. Postural motion measurements at additional locations, such as lower and upper limbs and trunk, may be necessary in order to obtain information about the inter-segmental coordination during different functional tests involved in clinical practice. With these considerations in mind, this Thesis aims: i) to suggest a novel quantitative assessment tool for the kinematics and dynamics evaluation of a multi-link kinematic chain during several functional motor tasks (i.e. squat, sit-to-stand, postural sway), using one single-axis accelerometer per segment, ii) to present a novel quantitative technique for the upper limb joint kinematics estimation, considering a 3-link kinematic chain during the Fugl-Meyer Motor Assessment and using one inertial measurement unit per segment. The suggested methods could have several positive feedbacks from clinical practice. The use of objective biomechanical measurements, provided by inertial sensor-based technique, may help clinicians to: i) objectively track changes in motor ability, ii) provide timely feedback about the effectiveness of administered rehabilitation interventions, iii) enable intervention strategies to be modified or changed if found to be ineffective, and iv) speed up the experimental sessions when several subjects are asked to perform different functional tests.

Performance based earthquake engineering: Il metodo P.E.E.R. applicazione su un caso di studio.

L’approccio performance-based nell’Ingegneria sismica è una metodologia di progetto che tiene esplicitamente in conto la performance dell’edificio tra i criteri progettuali. Nell’ambito dei metodi PBEE (Performance-Based Earthquake Engineering) di seconda generazione, quello proposto dal PEER (Pacific Earthquake Engineering Research Center) risulta essere il più diffuso. In esso la performance dell’edificio oggetto di studio viene valutata in termini quantitativi secondo le 3D’s (dollars, deaths, downtime – soldi, decessi, inutilizzo), quantità di notevole interesse per l’utente finale. Il metodo si compone di quattro step, indipendenti tra loro fino alla sintesi finale. Essi sono: l’analisi di pericolosità, l’analisi strutturale, l’analisi di danno, l’analisi delle perdite o di loss. Il risultato finale è la curva di loss, che assegna ad ogni possibile perdita economica conseguente all’evento sismico una probabilità di superamento nell’arco temporale di riferimento. Dopo la presentazione del metodo PEER, si è provveduto ad una sua applicazione su di un caso di studio, nella fattispecie un telaio piano di quattro campate, multipiano, in calcestruzzo armato, costruito secondo le norme del ’92. Per l’analisi di pericolosità si è fatto ricorso alle mappe di pericolosità disponibili sul sito INGV, mentre per l’analisi strutturale si è utilizzato il software open-source OpenSees. Le funzioni di fragilità e quelle di loss sono state sviluppate facendo riferimento alla letteratura scientifica, in particolare il bollettino Fib numero 68 “Probabilistic performance-based seismic design”. In questa sede ci si è concentrati unicamente sulla stima delle perdite economiche, tralasciando le altre due variabili decisionali. Al termine del procedimento si è svolta un’analisi di sensitività per indagare quali parametri influenzino maggiormente la curva di loss. Data la curva di pericolosità, il legame EDP(IM) e la deformazione ultima a collasso risultano essere i più rilevanti sul risultato dell’analisi.

Indagini forensi in tema di scambio di file pedopornografici mediante software di file sharing a mezzo peer-to-peer

La prova informatica richiede l’adozione di precauzioni come in un qualsiasi altro accertamento scientifico. Si fornisce una panoramica sugli aspetti metodologici e applicativi dell’informatica forense alla luce del recente standard ISO/IEC 27037:2012 in tema di trattamento del reperto informatico nelle fasi di identificazione, raccolta, acquisizione e conservazione del dato digitale. Tali metodologie si attengono scrupolosamente alle esigenze di integrità e autenticità richieste dalle norme in materia di informatica forense, in particolare della Legge 48/2008 di ratifica della Convenzione di Budapest sul Cybercrime. In merito al reato di pedopornografia si offre una rassegna della normativa comunitaria e nazionale, ponendo l’enfasi sugli aspetti rilevanti ai fini dell’analisi forense. Rilevato che il file sharing su reti peer-to-peer è il canale sul quale maggiormente si concentra lo scambio di materiale illecito, si fornisce una panoramica dei protocolli e dei sistemi maggiormente diffusi, ponendo enfasi sulla rete eDonkey e il software eMule che trovano ampia diffusione tra gli utenti italiani. Si accenna alle problematiche che si incontrano nelle attività di indagine e di repressione del fenomeno, di competenza delle forze di polizia, per poi concentrarsi e fornire il contributo rilevante in tema di analisi forensi di sistemi informatici sequestrati a soggetti indagati (o imputati) di reato di pedopornografia: la progettazione e l’implementazione di eMuleForensic consente di svolgere in maniera estremamente precisa e rapida le operazioni di analisi degli eventi che si verificano utilizzando il software di file sharing eMule; il software è disponibile sia in rete all’url http://www.emuleforensic.com, sia come tool all’interno della distribuzione forense DEFT. Infine si fornisce una proposta di protocollo operativo per l’analisi forense di sistemi informatici coinvolti in indagini forensi di pedopornografia.

Molekulare Ursachen und therapeutische Intervention bei der Alzheimer-Demenz

Ein charakteristisches, neuropathologisches Merkmal der Alzheimer-Demenz (AD), der am häufigsten vorkommenden Demenz-Form des Menschen, ist das Auftreten von senilen Plaques im Gehirn der Patienten. Hierbei stellt das neurotoxische A-beta Peptid den Hauptbestandteil dieser Ablagerungen dar. Einen Beitrag zu der pathologisch erhöhten A-beta Generierung liefert das verschobene Expressionsgleichgewicht der um APP-konkurrierenden Proteasen BACE-1 und ADAM10 zu Gunsten der beta-Sekretase BACE-1. In der vorliegenden Dissertation sollten molekulare Mechanismen identifiziert werden, die zu einem pathologisch veränderten Gleichgewicht der APP-Spaltung und somit zum Entstehen und Fortschritt der AD beitragen. Des Weiteren sollten Substanzen identifiziert werden, die durch Beeinflussung der Genexpression einer der beiden Proteasen das physiologische Gleichgewicht der APP-Prozessierung wiederherstellen können und somit therapeutisch einsetzbar sind.rnAnhand eines „Screenings“ von 704 Transkriptionsfaktoren wurden 23 Faktoren erhalten die das Verhältnis ADAM10- pro BACE-1-Promotor Aktivität beeinflussten. Exemplarisch wurden zwei der molekularen Faktoren auf ihren Wirkmechanismus untersucht: Der TF „X box binding protein-1“ (XBP-1), der die so genannte „unfolded protein response“ (UPR) reguliert, erhöhte die Expression von ADAM10 in Zellkultur-Experimenten. Die Menge dieses Faktors war in AD-Patienten im Vergleich zu gesunden, Alters-korrelierten Kontrollen signifikant erniedrigt. Im Gegensatz dazu verminderte der Seneszenz-assoziierte TF „T box 2“ (Tbx2) die Menge an ADAM10 in SH-SY5Y Zellen. Die Expression des Faktors selbst war in post-mortem Kortexgewebe von AD-Patienten erhöht. Zusätzlich zu den TFs konnten in einer Kooperation mit dem Helmholtz Zentrum München drei microRNAs (miRNA 103, 107, 1306) bioinformatisch prädiziert und experimentell validiert werden, die die Expression des humanen ADAM10 reduzierten.rnIm Rahmen dieser Arbeit konnten damit körpereigene Faktoren identifiziert werden, die die Menge an ADAM10 regulieren und folglich potenziell an der Entstehung der gestörten Homöostase der APP-Prozessierung beteiligt sind. Somit ist die AD auch im Hinblick auf eine A-beta-vermittelte Pathologie als multifaktorielle Krankheit zu verstehen, in der verschiedene Regulatoren zur gestörten APP-Prozessierung und somit zur pathologisch gesteigerten A-beta Generierung beitragen können. rnEine pharmakologische Erhöhung der ADAM10 Genexpression würde zu der Freisetzung von neuroprotektivem APPs-alpha und gleichzeitig zu einer reduzierten A-beta Generierung führen. Deshalb war ein weiteres Ziel dieser Arbeit die Evaluierung von Substanzen mit therapeutischem Potenzial im Hinblick auf eine erhöhte ADAM10 Expression. Von 640 FDA-zugelassenen Medikamenten einer Substanz-Bibliothek wurden 23 Substanzen identifiziert, die die Menge an ADAM10 signifikant steigerten während die Expression von BACE-1 und APP unbeeinflusst blieb. In Zusammenarbeit mit dem Institut für Pathologie (Johannes Gutenberg Universität Mainz) wurde ein Zellkultur-basiertes Modell etabliert, um die Permeationsfähigkeit der potenziellen Kandidaten-Substanzen über die Blut-Hirn Schranke (BHS) zu untersuchen. Von den 23 Medikamenten konnten neun im Rahmen des etablierten Modells als BHS-gängig charakterisiert werden. Somit erfüllen diese verbleibenden Medikamente die grundlegenden Anforderungen an ein AD-Therapeutikum. rnADAM10 spaltet neben APP eine Vielzahl anderer Substrate mit unterschiedlichen Funktionen in der Zelle. Zum Beispiel reguliert das Zelladhäsionsmolekül Neuroligin-1 (NL-1), das von ADAM10 prozessiert wird, die synaptische Funktion exzitatorischer Neurone. Aus diesem Grund ist die Abschätzung potenzieller, Therapie-bedingter Nebenwirkungen sehr wichtig. Im Rahmen eines Forschungsaufenthalts an der Universität von Tokio konnte in primären, kortikalen Neuronen der Ratte bei einer Retinoid-induzierten Erhöhung von ADAM10 neben einer vermehrten alpha-sekretorischen APP-Prozessierung auch eine gesteigerte Spaltung von NL-1 beobachtet werden. Dies lässt vermuten, dass bei einer Behandlung mit dem Retinoid Acitretin neben einer vermehrten APP-Spaltung durch ADAM10 auch die Regulation glutamaterger Neurone durch die Spaltung von NL-1 betroffen ist. Anhand eines geeigneten Alzheimer-Tiermodells sollten diese Befunde weiter analysiert werden, um so auf einen sicheren therapeutischen Ansatz bezüglich einer vermehrten ADAM10 Genexpression schließen zu können.rn