Studio della funzionalità respiratoria in soggetti con sindrome di Turner

The aim of this study is to evaluate the pulmonary function in subjects with diagnosis of Turner Syndrome, in charge at the Syndromology Ward of the Paediatric Clinic of S.Orsola-Malpighi hospital. There are very few datas about lung function in patients with Turner syndrome’s genotype and phenotype in medical literature. Since the thorax of these subjects have peculiar anatomic shape (as “shield” or “overturned triangle”), we presupposed that these subjects could have also a peculiar respiratory function. Moreover we look for the possibility of correlation between pulmonary function and estroprogestinic replacement therapy and/or growth hormone (GH) replacement therapy. Material and methods: we studied 48 patients, with diagnosis of Turner Syndrome; they all made spirometry voluntarily and, when capable, also plethismografy. Results: - the parametres of pulmonary function are a little higher of the predicted values for age and sex but they are a little lower if they're corrected for each patient’s ideal high and weight: so we can conclude that in Turner Syndrme subjects pulmonary function is normal; -there’s not a statistically significant correlation between pulmonary function and GH therapy; -there’s not a statistically significant correlation between GH therapy’s length and pulmonary function except for Total Lung Capacity which increases with the number of years of GH therapy; - there’s not a statistically significant correlation between pulmonary function and estroprogestinic replacement herapy.

Recombinant expression of molluscan hemocyanin (KLH) substructures in a prokaryotic system: E. coli

The recombinant expression of 19 different substructures of KLH in the prokaryotic sys-tem E. coli has been successfully achieved: each one of the eight single FUs a to h of both isoforms, KLH1 and KLH2, two substructures consisting of two consecutive FUs (KLH1-bc and KLH1-gh) as well as a cDNA encompassing KLH1-abc. All recombinant proteins, fused to an N-terminal 6xHis tag, have successfully been detected by immuno precipitation using monoclonal α-His-antibodies and polyclonal α-KLH1- and α-KLH2-antibodies. One exception remained: SP-KLH2-a, which was not detected by the α-His-antibodies. This allows speculations as to whether the coexpressed signal peptide can lead, at one hand, to the secretion of the recombinant protein, and on the other to the simultaneous cut-off of the leader peptide, which results in the splitting off of even more N-terminal 6xHis tag, leading to failed recognition by the appropriate antibodies. The comparison of native KLH with recombinantly expressed prokaryotic (E. coli) and eukaryotic (Sf9 insect cells) KLH was done using FU-1h. The weak detection by the polyclonal α-KLH1-antibodies of both recombinantly expressed proteins showed that the native protein was the best recognized. For the prokaryotic one, both the denaturation applied for solubilisation of the bacterial inclusion bodies and the inability of bacterial cells to add N-linked glycosylation, are the reason for the poor hybridization. In contrast, KLH1-h expressed in eukaryotic insect cells is likely to be glycosylated. The incubation with the α-KLH1-antibodies resulting in the same weak detection, however, revealed that the linked carbohydrate side chains are not those expected. The establishment of SOE-PCR, together with further improvement, has enabled the generation of a clone encompassing the complete subunit KLH1-abcdefgh. The se-quence analysis compared to the original KLH1 sequence showed, however, that the resulting recombinant protein is defective in two histidines, required for the copper bind-ing sites in FU-1b and FU-1d and in three disulfide bridges (FU-1a, FU-1b and FU 1g). This is due to polymerase-related nucleotide exchanges, resulting in a changed amino acid sequence. Nevertheless, all eight potential N-glycosylation sites are present, leading to the speculation that the recombinant protein can in theory be fully glycosylated, which is the most important aspect for the clinical applicability of recombinant KLH as an im-munotherapeutic agent. The improvement of this method elaborated during the present work indicates bright prospects for the future generation of a correct cDNA sequence encoding for the complete KLH2 subunit.

Kristallisation der Arbutin-Synthase und der Strictosidin Glukosidase - zwei Enzyme aus dem sekundären Glykosidstoffwechsel von Rauvolfia serpentina

Kristallisation der Arbutin-Synthase und der Strictosidin Glukosidase - zwei Enzyme aus dem sekundären Glykosidstoffwechsel von Rauvolfia serpentina Die vorliegende Arbeit befasst sich mit der Kristallisation und der strukturellen Auswertung der Arbutin-Synthase (AS) und der Strictosidin Glukosidase (SG). Beide Enzyme stammen aus der Medizinalpflanze Rauvolfia serpentina. Für die Kristallisation der Arbutin-Synthase wurden ca. 2500 verschiedene Beding-ungen experimentell untersucht. Für einige dieser Experimente wurde das Enzym molekularbiologisch und chemisch verändert. Trotzdem konnten keine Kristalle erhalten werden. Die bei diesen Veränderungen erhaltenen Ergebnisse wurden anhand von Vergleichen mit Strukturen anderer Glykosyltransferasen der gleichen Familie analysiert. Bei der Reinigung der AS konnte mit verschiedenen Trennsystemen nie eine homogene Lösung produziert werden. Der wahrscheinliche Grund für diese schlechte Isolierbarkeit, und damit der wahrscheinliche Grund für die schwierige Kris-tallisation, liegt in der überdurchschnittlich hohen Anzahl an Cysteinen in der Proteinsequenz. Mit den Aminosäuren Cys171, Cys253 und Cys461 wurden drei Cysteine gefunden, die einem Strukturvergleich nach an der Proteinoberfläche liegen und möglicherweise durch Quervernetzungen mit anderen Proteinmolekülen ein heterogenes Gemisch bilden, das nicht geordnet kristallisieren kann. Durch gezielte Mutationen dieser drei Aminosäuren könnte die Kristallisation zukünftig ermöglicht werden. Für die SG waren bereits Bedingungen bekannt bei denen nicht vermessbare Enzymkristalle (Nadeln) wuchsen. In weit gefächerten Versuchen konnten diese Kristalle jedoch nicht zu 3D-Wachstum angeregt werden. Es wurden mit einem HTS-Screening neue Bedingungen zur Kristallisation gefunden. Anschließend konnten die native Struktur und der Strictosidin/Enzym-Komplex vermessen und aufgeklärt werden. Die SG gehört zur Familie 1 der Glukosidasen (GH-1) und besitzt die in dieser Familie konservierte (beta/alpha)8-Barrel-Faltung. Im Vergleich mit 16 bekannten Glykosidasen der Familie GH-1 wurde die Substratbindung untersucht. Dabei wurde die in der Familie konservierte Zuckerbindung vorgefunden, jedoch große Unterschiede in der Aglykonbindung entdeckt. Es wurden Bedingungen für die Konformationsänderung des Trp388 erkannt. Diese Konformationsänderung dirigiert den Aglykonteil des Substrates auf verschiedene Seiten der Substratbindungstasche und teilt so die Familie GH-1 in zwei Gruppen.

Role of αvβ3 – Integrin and TLR2 in the innate response to Herpes Simplex Virus infection and Delivery of retargeted oncolytic Herpes Simplex via carrier cells

In the first part of my thesis I studied the mechanism of initiation of the innate response to HSV-1. Innate immune response is the first line of defense set up by the cell to counteract pathogens infection and it is elicited by the activation of a number of membrane or intracellular receptors and sensors, collectively indicated as PRRs, Patter Recognition Receptors. We reported that the HSV pathogen-associated molecular patterns (PAMP) that activate Toll-like receptor 2 (TLR2) and lead to the initiation of innate response are the virion glycoproteins gH/gL and gB, which constitute the conserved fusion core apparatus across the Herpesvirus. Specifically gH/gL is sufficient to initiate a signaling cascade which leads to NF-κB activation. Then, by gain and loss-of-function approaches, we found that αvβ3-integrin is a sensor of and plays a crucial role in the innate defense against HSV-1. We showed that αvβ3-integrin signals through a pathway that concurs with TLR2, affects activation/induction of interferons type 1, NF-κB, and a polarized set of cytokines and receptors. Thus, we demonstrated that gH/gL is sufficient to induce IFN1 and NF-κB via this pathway. From these data, we proposed that αvβ3-integrin is considered a class of non-TLR pattern recognition receptors. In the second part of my thesis I studied the capacity of human mesenchymal stromal cells isolated by fetal membranes (FM-hMSCs) to be used as carrier cells for the delivery of retargeted R-LM249 virus. The use of systemically administrated carrier cells to deliver oncolytic viruses to tumoral targets is a promising strategy in oncolytic virotherapy. We observed that FM-hMSCs can be infected by R-LM249 and we optimized the infection condition; then we demonstrate that stromal cells sustain the replication of retargeted R-LM249 and spread it to target tumoral cells. From these preliminary data FM-hMSCs resulted suitable to be used as carrier cells

Sindrome da insensitività completa agli androgeni e massa ossea. Valutazione basale e longitudinale dopo oltre 12 mesi di terapia estrogenica

L’osso è un tessuto target per estrogeni ed androgeni ma l’azione singola e la sinergia tra i due non sono compresi interamente. Le donne affette da Sindrome da Insensititvità Completa agli Androgeni (CAIS) hanno un cariotipo 46XY ma presentano una completa inattività del recettore degli androgeni. Nello studio abbiamo valutato la densità minerale ossea (BMD) in un gruppo di donne adulte CAIS sottoposte a gonadectomia al momento della prima visita e dopo almeno 12 mesi di terapia estrogenica. Il principale obiettivo è stato di valutare se, nelle donne CAIS, una ottimale estrogenizzazione fosse sufficiente a mantenere/ripristinare una adeguata BMD. 24 donne CAIS sono state sottoposte a DXA lombare e femorale all'arruolamento nello studio (t1), dopo terapia estrogenica di 12mesi(t2) e oltre (t>2). Sono state valutate: BMD(g/cm2) e Zscore lombare e femorale (a t1,t2 e t>2) E’ stato considerato se fossero rilevanti l’essere (gruppo1) o meno (gruppo 2) in terapia ormonale al t1 e l’età della gonadectomia. Risultati: Al t1 BMD e Zscore lombari e femorale erano significativamente ridotti rispetto alla popolazione controllo nel campione totale (lombare 0,900+0,12; -1,976+0,07, femorale 0,831 + 0,14; -1,385+0,98), nel gruppo 1 (lombare 0,918+0,116;-1,924+0,79, femorale 0,824+0,13;-1,40+1,00) e nel gruppo 2 (lombare 0.845+0,11 -2,13+1,15, femorale 0,857+0,17;-1,348+1,05) Al t2 e t>2 la BMD lombare è risultata significativamente aumentata (p=0,05 e p=0,02). Zscore lombare, BMD e Zscore femorale non hanno dimostrato variazioni significative. L’aver effettuato la gonadectomia in età post puberale è associato a Zscore lombare e femorale più elevati al t1. Nelle donne CAIS la terapia estrogenica è indispensabile per prevenire un'ulteriore perdita di BMD ma, da sola, non sembra in grado di ripristinare normali valori di BMD.I risultati del nostro studio supportano la tesi che gli androgeni, mediante l’azione recettoriale, abbiano un' azione diretta nel raggiungere e mantenere la BMD.

Adulthood with Turner Syndrome: Quality of life, psychosocial adjustment and clinical management in 70 Italian women

Abstract Background: Turner syndrome (TS) is a chromosomal abnormality (total or partial absence of one of the sexual chromosomes in some or all cells of the body), which affects approximately 1:2000 female. Principal characteristics are short stature and gonadal disgenesis. Clinical management consist of Growth Hormone (GH) treatment and oestrogen replacement therapy (HRT), to induce development of secondary characteristics and to avoid the sequelae of oestrogen deficiency. Aim of the study: To assess clinical management, quality of life (QoL) and general psychosocial adjustment of women with TS. Population: 70 adult Caucasian females with TS (mean age: 27.8, ± 7.6; range 18-48 y.). Setting: Specialist service for Rare Disease care, University Hospital. Methods: Subjects were required to fill in questionnaires collecting ASR, WHOQOL, and 8 open questions. Data were compared with those of the Italian population or to those collected in a comparison group (70 healthy females, mean age: 27.9, ±7.3, range 21-48 y.). Results: Women with TS are educated as well as the Italian Population, but they have a less successful professional life. They show good QoL in general, but they appeared less satisfied in social area. They had statistically higher scores than the comparison group for depression, anxiety and withdrawal. Are less involved in a love relationship. Diagnosis communication was mostly performed by doctors or parents, satisfaction was higher when information was given by parents. Main preoccupation about TS are infertility, feeling of being different and future health problem. Conclusions: Italian people with TS were generally well adapted and have a good QoL, but lived more often with parents and show impaired sentimental and sexual life. They have higher degree of psychological distress compared to a comparison group. Psychological intervention should firstly address parents in order to encourage an open communication on diagnosis issues and on sexual education.

Einfluss subviraler Partikel des humanen Cytomegalovirus auf die Induktion der antiviralen Immunantwort

Das humane Cytomegalovirus (HCMV) ist ein opportunistischer Krankheitserreger, der insbesondere bei Patienten mit unreifem oder geschwächtem Immunsystem schwere, teilweise lebensbedrohliche Erkrankungen verursacht. Aufgrund der klinischen Relevanz wird die Entwicklung einer Impfung gegen HCMV mit großem Nachdruck verfolgt. Subvirale Partikel des HCMV, sogenannte Dense Bodies (DB), stellen eine vielversprechende Impfstoff-Grundlage dar. Die innere Struktur der Partikel besteht aus viralen Proteinen, die als dominante Antigene der zellulären Immunantwort gegen HCMV identifiziert wurden. Die äußere Hülle der Partikel entspricht der Virushülle, sie enthält die viralen Oberflächenproteine als Zielantigene der neutralisierenden Antikörper (NTAk)-Antwort in ihrer natürlichen Konformation. Die für ein Totantigen außergewöhnlich hohe Immunogenität der Partikel wurde bereits in Vorarbeiten dokumentiert. Ein Ziel dieser Arbeit war es, den molekularen Hintergrund für die herausragenden, immunogenen Eigenschaften von DB aufzuklären. Im ersten Teil der Arbeit wurde daher die Hypothese geprüft, dass DB geeignet sind, die Ausreifung und Aktivierung von dendritischen Zellen (DC) zu vermitteln und damit deren Fähigkeit zur Antigenpräsentation zu stimulieren. Derart aktivierten DC kommt eine wichtige Rolle beim Priming der T-lymphozytären Immunantwort zu. In der Tat konnte gezeigt werden, dass die Behandlung von unreifen dendritischen Zellen (iDC) mit DB zu verstärkter Expression von solchen Molekülen auf der DC-Oberfläche führt, die mit Ausreifung der Zellen verknüpft sind. Der Nachweis der verstärkten Freisetzung proinflammatorischer Zytokine belegte die Aktivierung der Zellen im Sinne einer entzündlichen Reaktion. Die erfolgreiche Stimulation von CD4 und CD8 T-Lymphozyten durch DB-behandelte DC belegte schließlich die funktionelle Relevanz der Ergebnisse. Zusammengefasst konnten in diesem Abschnitt der Arbeit die molekularen Grundlagen der adjuvanten Wirkung von DB aufgeklärt werden. rnIn einem zweiten Abschnitt wurde die NTAk-Antwort nach DB-Immunisierung näher untersucht. Der humoralen Immunantwort kommt eine entscheidende Bedeutung bei der Prävention der HCMV-Übertragung zu. Hier galt es zu prüfen, welchen Einfluss stammspezifische Unterschiede in der Expression viraler Oberflächenproteine auf die Induktion der NTAk-Antwort nach DB-Immunisierung nehmen. Im Fokus stand dabei die variable Expression des pentameren Proteinkomplexes aus den viralen Proteinen gH/gL/pUL128-UL131A. Dieser Komplex wird nur von kliniknahen HCMV-Stämmen (HCMVKlin) exprimiert und ist für deren breiten Zelltropismus verantwortlich. Der pentamere Komplex fehlte in allen bisherigen Analysen der DB-Immunogenität, die auf der Grundlage von Laborstämmen des HCMV (HCMVLab) durchgeführt worden waren. Ein erster Versuchsansatz zeigte, dass die NTAk-Antwort, die durch DB von HCMVLab (DBLab) induziert wird, auch gegen die Infektion mit HCMVKlin einen gewissen Schutz vermittelt. Dies war ein überraschender Befund, da Antikörpern gegen den pentameren Komplex eine entscheidende Rolle bei der Neutralisation von HCMVKlin zugeschrieben wurde. Die Ergebnisse zeigten jedoch, dass Antikörper gegen andere Zielstrukturen zur Neutralisation von HCMVKlin beitragen. Hieraus resultierte unmittelbar die Frage, inwieweit eine Aufnahme des pentameren Komplexes in einen DB-basierten Impfstoff überhaupt notwendig war. Um dies zu beantworten war es notwendig, DB herzustellen, die den pentameren Komplex enthielten. Hierzu wurde ein HCMVLab durch Mutagenese des 235 kpb Genoms so modifiziert, dass von dem resultierenden Stamm der pentamere Komplex exprimiert wurde. In gereinigten DB dieses Stammes konnten die Komponenten des pentameren Komplexes nachgewiesen werden. Die Seren von Tieren, die mit DB dieses neuen Stammes immunisiert wurden, zeigten in der Tat eine deutlich gesteigerte Kapazität zur Neutralisation von HCMVKlin auf verschiedenen Zielzellen. Diese Ergebnisse unterstreichen schlussendlich, dass die Expression des pentameren Komplexes einen Vorteil bei der Induktion der antiviralen NTAk-Antwort erbringt. Zusammengefasst liefern die Erkenntnisse aus dieser Arbeit einen wichtigen Beitrag zum Verständnis der immunogenen Wirkung von DB. Auf dieser Grundlage war es nunmehr möglich, ein Projekt zur Austestung der DB-Vakzine in einer ersten klinischen Studie zu initiieren.

Exercise-induced growth hormone response in euglycaemia and hyperglycaemia in patients with Type 1 diabetes mellitus

To compare exercise-induced growth hormone (GH) response in patients with Type 1 diabetes during stable euglycaemic and hyperglycaemic conditions.

23Na MR imaging at 7 T after knee matrix-associated autologous chondrocyte transplantation: preliminary results

To evaluate the feasibility of sodium 7-T magnetic resonance (MR) imaging in repaired tissue and native cartilage of patients after matrix-associated autologous chondrocyte transplantation (MACT) and compare results with delayed gadolinium-enhanced MR imaging of cartilage (dGEMRIC) at 3 T.

Feasibility of texture analysis for the assessment of biochemical changes in meniscal tissue on T1 maps calculated from delayed gadolinium-enhanced magnetic resonance imaging of cartilage data: comparison with conventional relaxation time measurements

To (1) establish the feasibility of texture analysis for the in vivo assessment of biochemical changes in meniscal tissue on delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), and (2) compare textural with conventional T1 relaxation time measurements calculated from dGEMRIC data ("T1(Gd) relaxation times").

Lumbar intervertebral disc abnormalities: comparison of quantitative T2 mapping with conventional MR at 3.0 T

To assess the relationship of morphologically defined lumbar disc abnormalities with quantitative T2 mapping.

Evaluation of cartilage repair tissue after matrix-associated autologous chondrocyte transplantation using a hyaluronic-based or a collagen-based scaffold with morphological MOCART scoring and biochemical T2 mapping: preliminary results

In cartilage repair, bioregenerative approaches using tissue engineering techniques have tried to achieve a close resemblance to hyaline cartilage, which might be visualized using advanced magnetic resonance imaging.

Quantitative T2 mapping of knee cartilage: differentiation of healthy control cartilage and cartilage repair tissue in the knee with unloading - initial results

Purpose: To prospectively determine on T2 cartilage maps the effect of unloading during a clinical magnetic resonance (MR) examination in the postoperative follow-up of patients after matrix-associated autologous chondrocyte transplantation (MACT) of the knee joint. Materials and Methods: Ethical approval for this study was provided by the local ethics commission, and written informed consent was obtained. Thirty patients (mean age, 35.4 years +/- 10.5) with a mean postoperative follow-up period of 29.1 months +/- 24.4 were enrolled. A multiecho spin-echo T2-weighted sequence was performed at the beginning (early unloading) and end (late unloading) of the MR examination, with an interval of 45 minutes. Mean and zonal region of interest T2 measurements were obtained in control cartilage and cartilage repair tissue. Statistical analysis of variance was performed. Results: The change in T2 values of control cartilage (early unloading, 50.2 msec +/- 8.4; late unloading, 51.3 msec +/- 8.5) was less pronounced than the change in T2 values of cartilage repair tissue (early unloading, 51.8 msec +/- 11.7; late unloading, 56.1 msec +/- 14.4) (P = .024). The difference between control cartilage and cartilage repair tissue was not significant for early unloading (P = .314) but was significant for late unloading (P = .036). Zonal T2 measurements revealed a higher dependency on unloading for the superficial cartilage layer. Conclusion: Our results suggest that T2 relaxation can be used to assess early and late unloading values of articular cartilage in a clinical setting and that the time point of the quantitative T2 measurement affects the differentiation between native and abnormal articular cartilage. (c) RSNA, 2010.

T2 and T2* mapping in patients after matrix-associated autologous chondrocyte transplantation: initial results on clinical use with 3.0-Tesla MRI

To use T2 and T2* mapping in patients after matrix-associated autologous chondrocyte transplantation (MACT) of the knee, and to compare and correlate both methodologies.

The in vivo effects of unloading and compression on T1-Gd (dGEMRIC) relaxation times in healthy articular knee cartilage at 3.0 Tesla

The purpose was to investigate the in vivo effects of unloading and compression on T1-Gd relaxation times in healthy articular knee cartilage.