Azobenzol- und Perylendiimid-funktionalisierte Polyphenylen-Dendrimere

Die Dissertation 'Azobenzol- und Perylendiimid-funktionalisierte Polyphenylen-Dendrimere - Synthese, Charakterisierung und Eigenschaften' gliedert sich in vier Themengebiete. Der erste Abschnitt beschäftigt sich mit der Synthese unterschiedlich dichter Dendrimere um einen Azobenzol-Kern. Einkristallstrukturen und Molekülvisualisierungen verdeutlichen die dreidimensionale Gestalt der Dendrimere. Die Dendrimere zeigen erstmalig eine Abhängigkeit des Isomerisationsverhaltens von der das Chromophor umgebenden Struktur. Der zweite Abschnitt hat Interaktionen von Chromophoren, deren Distanz und Orientierung zueinander gezielt durch einen äußeren Impuls geändert werden können, zum Thema. Die Verbindung von Azobenzol und PMI führt durch deren gegenseitige Beeinflussung zu einem Verlust der charakteristischen Eigenschaften der Chromophore. Eine Oligo-L-Lysinkette, deren Enden mit NMI und PMI funktionalisiert sind, stellt ein FRET-System dar. Distanz und Orientierung der Chromophore zueinander werden durch den mittels TFE induzierten Übergang des Peptids vom Knäuel zur Helix verändert. Der dritte Abschnitt führt die Synthese von PDI-gekernten Dendrimeren durch Substitution in der bay-Region des Chromophors ein. Die Eignenschaften der Verbindungen wurden mittels optischer Methoden und cyclovoltammetrischen Studien untersucht. Weiter wurde die Oberflächenfunktionalisierung mit Aminosäuren und Oligopeptiden zu wasserlöslichen Dendrimeren mit hoher Oberflächenladung verfolgt. Das letzte Kapitel stellt Untersuchungen zur Organisation von Polyphenylen-Dendrimeren auf HOPG vor. Es lassen sich einerseits Nanofasern formieren, andererseits können auch geordnete Mono- und Multilagen erzeugt werden.

Interactive simulation of flexible parts

Computer simulations play an ever growing role for the development of automotive products. Assembly simulation, as well as many other processes, are used systematically even before the first physical prototype of a vehicle is built in order to check whether particular components can be assembled easily or whether another part is in the way. Usually, this kind of simulation is limited to rigid bodies. However, a vehicle contains a multitude of flexible parts of various types: cables, hoses, carpets, seat surfaces, insulations, weatherstrips... Since most of the problems using these simulations concern one-dimensional components and since an intuitive tool for cable routing is still needed, we have chosen to concentrate on this category, which includes cables, hoses and wiring harnesses. In this thesis, we present a system for simulating one dimensional flexible parts such as cables or hoses. The modeling of bending and torsion follows the Cosserat model. For this purpose we use a generalized spring-mass system and describe its configuration by a carefully chosen set of coordinates. Gravity and contact forces as well as the forces responsible for length conservation are expressed in Cartesian coordinates. But bending and torsion effects can be dealt with more effectively by using quaternions to represent the orientation of the segments joining two neighboring mass points. This augmented system allows an easy formulation of all interactions with the best appropriate coordinate type and yields a strongly banded Hessian matrix. An energy minimizing process accounts for a solution exempt from the oscillations that are typical of spring-mass systems. The use of integral forces, similar to an integral controller, allows to enforce exactly the constraints. The whole system is numerically stable and can be solved at interactive frame rates. It is integrated in the DaimlerChrysler in-house Virtual Reality Software veo for use in applications such as cable routing and assembly simulation and has been well received by users. Parts of this work have been published at the ACM Solid and Physical Modeling Conference 2006 and have been selected for the special issue of the Computer-Aided-Design Journal to the conference.

Foliation boudinage

In this thesis foliation boudinage and related structures have been studied based on field observations and numerical modeling. Foliation boudinage occurs in foliated rocks independent of lithology contrast. The developing structures are called ‘Foliation boudinage structures (FBSs)’ and show evidence for both ductile and brittle deformation. They are recognized in rocks by perturbations in monotonous foliation adjacent to a central discontinuity, mostly filled with vein material. Foliation boudinage structures have been studied in the Çine Massif in SW-Turkey and the Furka Pass-Urseren Zone in central Switzerland. Four common types have been distinguished in the field, named after vein geometries in their boudin necks in sections normal to the boudin axis: lozenge-, crescent-, X- and double crescent- type FBSs. Lozengetype FBSs are symmetric and characterized by lozenge-shaped veins in their boudin neck with two cusps facing opposite sides. A symmetrical pair of flanking folds occurs on the two sides of the vein. Crescent-type FBSs are asymmetric with a single smoothly curved vein in the boudin neck, with vein contacts facing to one side. X- and double crescent- type FBSs are asymmetric. The geometry of the neck veins resembles that of cuspate-lobate structures. The geometry of flanking structures is related to the shape of the veins. The veins are mostly filled with massive quartz in large single crystals, commonly associated with tourmaline, feldspar and biotite and in some cases with chlorite. The dominance of large facetted single quartz crystals and spherulitic chlorite in the veins suggest that the minerals grew into open fluidfilled space. FLAC experiments show that fracture propagation during ductile deformation strongly influences the geometry of developing veins. The cusps of the veins are better developed in the case of propagating fractures. The shape of the boudin neck veins in foliation boudinage depends on the initial orientation and shape of the fracture, the propagation behaviour of the fracture, the geometry of bulk flow, and the stage at which mineral filling takes place. A two dimensional discrete element model was used to study the progressive development of foliation boudinage structures and the behavior of visco-elastic material deformed under pure shear conditions. Discrete elements are defined by particles that are connected by visco-elastic springs. Springs can break. A number of simulations was Abstract vii performed to investigate the effect of material properties (Young’s modulus, viscosity and breaking strength) and anisotropy on the developing structures. The models show the development of boudinage in single layers, multilayers and in anisotropic materials with random mica distribution. During progressive deformation different types of fractures develop from mode I, mode II to the combination of both. Voids develop along extension fractures, at intersections of conjugate shear fractures and in small pull-apart structures along shear fractures. These patterns look similar to the natural examples. Fractures are more localized in the models where the elastic constants are low and the competence contrast is high between the layers. They propagate through layers where the constants are high and the competence contrast is relatively low. Flow localize around these fractures and voids. The patterns similar to symmetric boudinage structures and extensional neck veins (e.g. lozenge type) more commonly develop in the models with lower elastic constants and anisotropy. The patterns similar to asymmetric foliation boudinage structures (e.g. X-type) develop associated with shear fractures in the models where elastic constants and anisotropy of the materials are relatively high. In these models boudin neck veins form commonly at pull-aparts along the shear fractures and at the intersection of fractures.

Atomic force microscopy of biomimetic systems

This thesis was driven by the ambition to create suitable model systems that mimic complex processes in nature, like intramolecular transitions, such as unfolding and refolding of proteins, or intermolecular interactions between different cell compo-nents. Novel biophysical approaches were adopted by employing atomic force mi-croscopy (AFM) as the main measurement technique due to its broad diversity. Thus, high-resolution imaging, adhesion measurements, and single-molecule force distance experiments were performed on the verge of the instrumental capabilities. As first objective, the interaction between plasma membrane and cytoskeleton, me-diated by the linker protein ezrin, was pursued. Therefore, the adsorption process and the lateral organization of ezrin on PIP2 containing solid-supported membranes were characterized and quantified as a fundament for the establishment of a biomimetic model system. As second component of the model system, actin filaments were coated on functionalized colloidal probes attached on cantilevers, serving as sensor elements. The zealous endeavor of creating this complex biomimetic system was rewarded by successful investigation of the activation process of ezrin. As a result, it can be stated that ezrin is activated by solely binding to PIP2 without any further stimulating agents. Additional cofactors may stabilize and prolong the active conformation but are not essentially required for triggering ezrin’s transformation into an active conformation. In the second project, single-molecule force distance experiments were performed on bis-loop tetra-urea calix[4]arene-catenanes with different loading rates (increase in force per second). These macromolecules were specifically designed to investigate the rupture and rejoining mechanism of hydrogen bonds under external load. The entangled loops of capsule-like molecules locked the unbound state of intramolecular hydrogen bonds mechanically, rendering a rebinding observable on the experimental time scale. In conjunction with Molecular Dynamics simulations, a three-well potential of the bond rupture process was established and all kinetically relevant parameters of the experiments were determined by means of Monte Carlo simulations and stochastic modeling. In summary, it can be stated that atomic force microscopy is an invaluable tool to scrutinize relevant processes in nature, such as investigating activation mechanisms in proteins, as shown by analysis of the interaction between F-actin and ezrin, as well as exploring fundamental properties of single hydrogen bonds that are of paramount interest for the complete understanding of complex supramolecular structures.

Zur Struktur und Funktion der Typ-3-Kupferproteine sowie der Lichtsammlerkomplexe LHCI und LHCII

In der vorliegenden Arbeit wurden die bioinformatischen Methoden der Homologie-Modellierung und Molekularen Modellierung dazu benutzt, die dreidimensionalen Strukturen verschiedenster Proteine vorherzusagen und zu analysieren. Experimentelle Befunde aus Laborversuchen wurden dazu benutzt, die Genauigkeit der Homologie-Modelle zu erhöhen. Die Ergebnisse aus den Modellierungen wurden wiederum dazu benutzt, um neue experimentelle Versuche vorzuschlagen. Anhand der erstellten Modelle und bekannten Kristallstrukturen aus der Protein-Datenbank PDB wurde die Struktur-Funktionsbeziehung verschiedener Tyrosinasen untersucht. Dazu gehörten sowohl die Tyrosinase des Bakteriums Streptomyces als auch die Tyrosinase der Hausmaus. Aus den vergleichenden Strukturanalysen der Tyrosinasen resultierten Mechanismen für die Monophenolhydroxylase-Aktivität der Tyrosinasen sowie für den Import der Kupferionen ins aktive Zentrum. Es konnte der Beweis geführt werden, daß die Blockade des CuA-Zentrums tatsächlich der Grund für die unterschiedliche Aktivität von Tyrosinasen und Catecholoxidasen ist. Zum ersten Mal konnte mit der Maus-Tyrosinase ein vollständiges Strukturmodell einer Säugetier-Tyrosinase erstellt werden, das dazu in der Lage ist, die Mechanismen bekannter Albino-Mutationen auf molekularer Ebene zu erklären. Die auf der Basis des ermittelten 3D-Modells gewonnenen Erkenntnisse über die Wichtigkeit bestimmter Aminosäuren für die Funktion wurde durch gerichtete Mutagenese an der rekombinant hergestellten Maus-Tyrosinase getestet und bestätigt. Weiterhin wurde die Struktur der Tyrosinase des Krebses Palinurus elephas durch eine niedrigaufgelöste 3D-Rekonstruktion aus elektronenmikroskopischen Bildern aufgeklärt. Der zweite große Themenkomplex umfasst die Strukturanalyse der Lichtsammlerkomplexe LHCI-730 und LHCII. Im Falle des LHCII konnte der Oligomerisierungszustand der LHCMoleküle mit diskreten Konformationen des N-Terminus korreliert werden. Auch hier kam eine Kombination von Homologie-Modellierung und einer experimentellen Methode, der Elektronen-Spin-Resonanz-Messung, zum Einsatz. Die Änderung des Oligomerisierungszustands des LHCII kontrolliert den Energiezufluß zu den Photosystemen PS I und PS II. Des Weiteren wurde ein vollständiges Modell des LHCI-730 erstellt, um die Auswirkungen gerichteter Mutagenese auf das Dimerisierungsverhalten zu untersuchen. Auf Basis dieses Modells wurden die Wechselwirkungen zwischen den Monomeren Lhca1 und Lhca4 evaluiert und potentielle Bindungspartner identifiziert.

Die Kristallstruktur zweier Atmungsproteine: das Hämoglobin des Meerschweinchens und das 24-mere Hämocyanin des Kaiserskorpions

Im Verlauf der vorgestellten Arbeit konnten die Kristallstrukturen zweier Atmungsproteine gelöst werden. Da diese Strukturen mit verschiedenen Auflösungen gelöst wurden, wurden für die beiden Modelle unterschiedliche Methoden verwendet.rnrnDie Kristalle des Hämoglobins des Meerschweinchens Cavia porcellus erlaubten eine Messung von Streureflexen bis zu einer Auflösung von 1.7 Ǻ. Damit konnten das Molecular Replacement und das folgende Refinement mit geringen Vorgaben durchgeführt werden.rnAnhand der ermittelten Struktur konnte gezeigt werden, dass die Höhenadaptation des Hämoglobins des Meerschweinchens auf einer Stabilisierung des R2-Zustandes und einer gleichzeitigen Destabilisierung des T-Zustandes beruht. Die zu Grunde liegenden Aminosäureaustausche konnten identifiziert und der resultierende Mechanismus postuliert werden. Die Durchführung von Mutagenese-Experimenten am Hämoglobin des Meerschweinchens könnte die vorgestellte Hypothese bestätigen.rnrnDie Kristallstruktur des 24-meren Hämocyanins aus Pandinus imperator konnte durch eine Kombination von Röntgenkristallographie und Homologiemodellierung mit einer Auflösung von 6.5 Ǻ gelöst werden. Allerdings wäre die Bestimmung der Phasen durch Molecular Replacement ohne die vor kurzem publizierte Kryo-EM Struktur nicht möglich gewesen [Cong et al., 2009].rnDamit ist es durch die Kombination verschiedener Methoden erstmalig gelungen die Struktur eines Hämocyanins dieser Größe (Mw = 1.7 MDa) zu lösen. Die Auflösung von 6.5 Ǻ, eine für die Kristallographie relativ geringe Auflösung, erlaubte die Bestimmung des Cα-Traces des Proteins mit hoher Genauigkeit.rnDurch die Kristallstruktur konnte das zu Grunde liegende Kryo-EM Modell aus [Cong et al., 2009] bestätigt werden. Insbesondere die Position der α-Helices konnte mittels Kristallographie mit einer höheren Genauigkeit bestimmt werden. Durch die Verwendung von OMIT-Maps wurde sichergestellt, dass die Struktur nicht "kopiert" wurde. Die Übereinstimmung ist deshalb auf die Struktur des Hämocyanins im gemessenen Kristall zurückzuführen, nicht auf einen Bias bei der Auswertung.rnAnhand der Kristallstruktur konnten für die Kooperativität im Trimer potentiell entscheidende Aminosäuren identifiziert werden. Diese Aminosäuren könnten im Vergleich zur bekannten trimeren Struktur aus Limulus polyphemus zur Ausbildung zusätzlicher Bindungen zwischen den Untereinheiten führen. Diese Bindungen könnten eine wichtige Rolle beim Konformationsübergang zwischen dem T- und R-Zustand spielen.rn

Differential expression analysis for sequence count data via mixtures of negative binomials

The recent advent of Next-generation sequencing technologies has revolutionized the way of analyzing the genome. This innovation allows to get deeper information at a lower cost and in less time, and provides data that are discrete measurements. One of the most important applications with these data is the differential analysis, that is investigating if one gene exhibit a different expression level in correspondence of two (or more) biological conditions (such as disease states, treatments received and so on). As for the statistical analysis, the final aim will be statistical testing and for modeling these data the Negative Binomial distribution is considered the most adequate one especially because it allows for "over dispersion". However, the estimation of the dispersion parameter is a very delicate issue because few information are usually available for estimating it. Many strategies have been proposed, but they often result in procedures based on plug-in estimates, and in this thesis we show that this discrepancy between the estimation and the testing framework can lead to uncontrolled first-type errors. We propose a mixture model that allows each gene to share information with other genes that exhibit similar variability. Afterwards, three consistent statistical tests are developed for differential expression analysis. We show that the proposed method improves the sensitivity of detecting differentially expressed genes with respect to the common procedures, since it is the best one in reaching the nominal value for the first-type error, while keeping elevate power. The method is finally illustrated on prostate cancer RNA-seq data.

Antropologia del lavoro. Nuovi scenari di antropologia applicata

In questa tesi viene presentata una ricerca di campo che si configura come esempio di un’antropologia applicata alle dinamiche lavorative all’interno di un’azienda ICT italiana. Fulcro della trattazione è la riflessione sui diversi aspetti di un’analisi antropologica del clima aziendale, condotta sulla base di una rilevazione dei processi lavorativi presso una società italiana specializzata in progetti di digital marketing. Il lavoro associato alle tecnologie di ultima generazione non è impersonale o dettato soltanto da regole esterne, ma piuttosto un lavoro dal forte carattere rituale, sociale, morale e performativo, dove soggetti, ruoli, idee, scelte e problematiche si intrecciano secondo modalità uniche ed irripetibili, rintracciabili anche attraverso l’etnografia. E’ dunque necessario dare visibilità al ruolo attivo dei lavoratori nel loro essere contemporaneamente individui e soggetti che lavorano. Partendo da una riflessione su lavoro e tecnologia all’interno di un quadro interdisciplinare che vede coinvolte - insieme all’antropologia - la sociologia, l’economia e la storia, ci si sofferma sulle potenzialità dell’antropologia del lavoro. Dopo aver ripercorso tutti i passi della ricerca di campo presso l’azienda, viene condivisa una più ampia considerazione sul ruolo dell’antropologia applicata al lavoro in contesti aziendali. Infine l’esperienza di antropologa in azienda viene posta a confronto con un’altra attività svolta dalla stessa autrice in ambito accademico nel campo dell’antropologia dell’educazione. Gli studi presi in considerazione e le esperienze concrete offrono la possibilità di affrontare il tema dell’antropologia del lavoro all’interno di una più vasta riflessione sulla necessità di sviluppare un’antropologia applicata in Italia. Essa non occupa ancora un posto rilevante nello scenario della vita pubblica, ma molti sono gli sforzi che si stanno compiendo in questa direzione. Uno sguardo positivo verso il futuro e la consapevolezza di un’antropologia che è insieme azione, impegno, partecipazione e sperimentazione etnografica concludono la tesi.

Enantioselective CE analysis of hepatic ketamine metabolism in different species in vitro

Ketamine, an injectable anesthetic and analgesic consisting of a racemic mixture of S-and R-ketamine, is routinely used in veterinary and human medicine. Nevertheless, metabolism and pharmacokinetics of ketamine have not been characterized sufficiently in most animal species. An enantioselective CE assay for ketamine and its metabolites in microsomal preparations is described. Racemic ketamine was incubated with pooled microsomes from humans, horses and dogs over a 3 h time interval with frequent sample collection. CE data revealed that ketamine is metabolized enantioselectively to norketamine (NK), dehydronorketamine and three hydroxylated NK metabolites in all three species. The metabolic patterns formed differ in production rates of the metabolites and in stereoselectivity of the hydroxylated NK metabolites. In vitro pharmacokinetics of ketamine N-demethylation were established by incubating ten different concentrations of racemic ketamine and the single enantiomers of ketamine for 8 min and data modeling was based on Michaelis-Menten kinetics. These data revealed a reduced intrinsic clearance of the S-enantiomer in the racemic mixture compared with the single S-enantiomer in human microsomes, no difference in equine microsomes and the opposite effect in canine microsomes. The findings indicate species differences with possible relevance for the use of single S-ketamine versus racemic ketamine in the clinic.

A Decision-Tree-Based Approach to Smoke Spike Detection in a Heavy-Duty Diesel Engine

Smoke spikes occurring during transient engine operation have detrimental health effects and increase fuel consumption by requiring more frequent regeneration of the diesel particulate filter. This paper proposes a decision tree approach to real-time detection of smoke spikes for control and on-board diagnostics purposes. A contemporary, electronically controlled heavy-duty diesel engine was used to investigate the deficiencies of smoke control based on the fuel-to-oxygen-ratio limit. With the aid of transient and steady state data analysis and empirical as well as dimensional modeling, it was shown that the fuel-to-oxygen ratio was not estimated correctly during the turbocharger lag period. This inaccuracy was attributed to the large manifold pressure ratios and low exhaust gas recirculation flows recorded during the turbocharger lag period, which meant that engine control module correlations for the exhaust gas recirculation flow and the volumetric efficiency had to be extrapolated. The engine control module correlations were based on steady state data and it was shown that, unless the turbocharger efficiency is artificially reduced, the large manifold pressure ratios observed during the turbocharger lag period cannot be achieved at steady state. Additionally, the cylinder-to-cylinder variation during this period were shown to be sufficiently significant to make the average fuel-to-oxygen ratio a poor predictor of the transient smoke emissions. The steady state data also showed higher smoke emissions with higher exhaust gas recirculation fractions at constant fuel-to-oxygen-ratio levels. This suggests that, even if the fuel-to-oxygen ratios were to be estimated accurately for each cylinder, they would still be ineffective as smoke limiters. A decision tree trained on snap throttle data and pruned with engineering knowledge was able to use the inaccurate engine control module estimates of the fuel-to-oxygen ratio together with information on the engine control module estimate of the exhaust gas recirculation fraction, the engine speed, and the manifold pressure ratio to predict 94% of all spikes occurring over the Federal Test Procedure cycle. The advantages of this non-parametric approach over other commonly used parametric empirical methods such as regression were described. An application of accurate smoke spike detection in which the injection pressure is increased at points with a high opacity to reduce the cumulative particulate matter emissions substantially with a minimum increase in the cumulative nitrogrn oxide emissions was illustrated with dimensional and empirical modeling.

A global ”imaging” view on systems approaches in immunology

The immune system exhibits an enormous complexity. High throughput methods such as the "-omic'' technologies generate vast amounts of data that facilitate dissection of immunological processes at ever finer resolution. Using high-resolution data-driven systems analysis, causal relationships between complex molecular processes and particular immunological phenotypes can be constructed. However, processes in tissues, organs, and the organism itself (so-called higher level processes) also control and regulate the molecular (lower level) processes. Reverse systems engineering approaches, which focus on the examination of the structure, dynamics and control of the immune system, can help to understand the construction principles of the immune system. Such integrative mechanistic models can properly describe, explain, and predict the behavior of the immune system in health and disease by combining both higher and lower level processes. Moving from molecular and cellular levels to a multiscale systems understanding requires the development of methodologies that integrate data from different biological levels into multiscale mechanistic models. In particular, 3D imaging techniques and 4D modeling of the spatiotemporal dynamics of immune processes within lymphoid tissues are central for such integrative approaches. Both dynamic and global organ imaging technologies will be instrumental in facilitating comprehensive multiscale systems immunology analyses as discussed in this review.

RNA degradation differentially affects quantitative mRNA measurements of endogenous reference genes in human placenta

It has been highlighted that RNA quality and appropriate reference gene selection is crucial for the interpretation of RT-qPCR results in human placental samples. In this context we investigated the effect of RNA degradation on the mRNA abundance of seven frequently used reference genes in 119 human placental samples. Combining RNA integrity measurements, RT-qPCR analysis and mathematical modeling we found major differences regarding the effect of RNA degradation on the measured expression levels between the different reference genes. Furthermore, we demonstrated that a modified RNA extraction method significantly improved RNA quality and consequently increased transcript levels of all reference genes.

Low-temperature evolution of the Morondava rift basin shoulder in western Madagascar: An apatite fission track study

[1] The evolution of the rift shoulder and the sedimentary sequence of the Morondava basin in western Madagascar was mainly influenced by a Permo-Triassic continental failed rift (Karroo rift), and the early Jurassic separation of Madagascar from Africa. Karroo deposits are restricted to a narrow corridor along the basement-basin contact and parts of this contact feature a steep escarpment. Here, apatite fission track (AFT) analysis of a series of both basement and sediment samples across the escarpment reveals the low-temperature evolution of the exhuming Precambrian basement in the rift basin shoulder and the associated thermal evolution of the sedimentary succession. Seven basement and four Karroo sediment samples yield apparent AFT ages between ∼330 and ∼215 Ma and ∼260 and ∼95 Ma, respectively. Partially annealed fission tracks and thermal modeling indicate post-depositional thermal overprinting of both basement and Karroo sediment. Rocks presently exposed in the rift shoulder indicate temperatures of >60°C associated with this reheating whereby the westernmost sample in the sedimentary plain experienced almost complete resetting of the detrital apatite grains at temperatures of about ∼90–100°C. The younging of AFT ages westward indicates activity of faults, re-activating inherited Precambrian structures during Karroo sedimentation. Furthermore, our data suggest onset of final cooling/exhumation linked to (1) the end of Madagascar's drift southward relative to Africa during the Early Cretaceous, (2) activity of the Marion hot spot and associated Late Cretaceous break-up between Madagascar and India, and (3) the collision of India with Eurasia and subsequent re-organization of spreading systems in the Indian Ocean.

Cost-effectiveness of pharmacogenetic testing to predict treatment response to angiotensin-converting enzyme inhibitor

OBJECTIVE: This study aimed to assess the potential cost-effectiveness of testing patients with nephropathies for the I/D polymorphism before starting angiotensin-converting enzyme (ACE) inhibitor therapy, using a 3-year time horizon and a healthcare perspective. METHODS: We used a combination of a decision analysis and Markov modeling technique to evaluate the potential economic value of this pharmacogenetic test by preventing unfavorable treatment in patients with nephropathies. The estimation of the predictive value of the I/D polymorphism is based on a systematic review showing that DD carriers tend to respond well to ACE inhibitors, while II carriers seem not to benefit adequately from this treatment. Data on the ACE inhibitor effectiveness in nephropathy were derived from the REIN (Ramipril Efficacy in Nephropathy) trial. We calculated the number of patients with end-stage renal disease (ESRD) prevented and the differences in the incremental costs and incremental effect expressed as life-years free of ESRD. A probabilistic sensitivity analysis was conducted to determine the robustness of the results. RESULTS: Compared with unselective treatment, testing patients for their ACE genotype could save 12 patients per 1000 from developing ESRD during the 3 years covered by the model. As the mean net cost savings was euro 356,000 per 1000 patient-years, and 9 life-years free of ESRD were gained, selective treatment seems to be dominant. CONCLUSION: The study suggests that genetic testing of the I/D polymorphism in patients with nephropathy before initiating ACE therapy will most likely be cost-effective, even if the risk for II carriers to develop ESRD when treated with ACE inhibitors is only 1.4% higher than for DD carriers. Further studies, however, are required to corroborate the difference in treatment response between ACE genotypes, before genetic testing can be justified in clinical practice.