Changes in tumor stiffness for early prediction of tumor response to sorafenib: a proof-of-concept study with elastosonography in an animal model of Hepatocellular Carcinoma (HCC)

Background and aims: Sorafenib is the reference therapy for advanced Hepatocellular Carcinoma (HCC). No method exists to predict in the very early period subsequent individual response. Starting from the clinical experience in humans that subcutaneous metastases may rapidly change consistency under sorafenib and that elastosonography a new ultrasound based technique allows assessment of tissue stiffness, we investigated the role of elastonography in the very early prediction of tumor response to sorafenib in a HCC animal model. Methods: HCC (Huh7 cells) subcutaneous xenografting in mice was utilized. Mice were randomized to vehicle or treatment with sorafenib when tumor size was 5-10 mm. Elastosonography (Mylab 70XVG, Esaote, Genova, Italy) of the whole tumor mass on a sagittal plane with a 10 MHz linear transducer was performed at different time points from treatment start (day 0, +2, +4, +7 and +14) until mice were sacrified (day +14), with the operator blind to treatment. In order to overcome variability in absolute elasticity measurement when assessing changes over time, values were expressed in arbitrary units as relative stiffness of the tumor tissue in comparison to the stiffness of a standard reference stand-off pad lying on the skin over the tumor. Results: Sor-treated mice showed a smaller tumor size increase at day +14 in comparison to vehicle-treated (tumor volume increase +192.76% vs +747.56%, p=0.06). Among Sor-treated tumors, 6 mice showed a better response to treatment than the other 4 (increase in volume +177% vs +553%, p=0.011). At day +2, median tumor elasticity increased in Sor-treated group (+6.69%, range –30.17-+58.51%), while decreased in the vehicle group (-3.19%, range –53.32-+37.94%) leading to a significant difference in absolute values (p=0.034). From this time point onward, elasticity decreased in both groups, with similar speed over time, not being statistically different anymore. In Sor-treated mice all 6 best responders at day 14 showed an increase in elasticity at day +2 (ranging from +3.30% to +58.51%) in comparison to baseline, whereas 3 of the 4 poorer responders showed a decrease. Interestingly, these 3 tumours showed elasticity values higher than responder tumours at day 0. Conclusions: Elastosonography appears a promising non-invasive new technique for the early prediction of HCC tumor response to sorafenib. Indeed, we proved that responder tumours are characterized by an early increase in elasticity. The possibility to distinguish a priori between responders and non responders based on the higher elasticity of the latter needs to be validated in ad-hoc experiments as well as a confirmation of our results in humans is warranted.

Concept and realization of the A4 compton backscattering polarimeter at MAMI

The main concern of the A4 parity violation experiment at the Mainzer Microtron accelerator facility is to study the electric and magnetic contributions of strange quarks to the charge and magnetism of the nucleons at the low momentum transfer region. More precisely, the A4 collaboration investigates the strange quarks' contribution to the electric and magnetic vector form factors of the nucleons. Thus, it is important that the A4 experiment uses an adequate and precise non-destructive online monitoring tool for the electron beam polarization when measuring single spin asymmetries in elastic scattering of polarized electrons from unpolarized nucleons. As a consequence, the A4 Compton backscattering polarimeter was designed and installed such that we can take the absolute measurement of the electron beam polarization without interruption to the parity violation experiment. The present study shows the development of an electron beam line that is called the chicane for the A4 Compton backscattering polarimeter. The chicane is an electron beam transport line and provides an interaction region where the electron beam and the laser beam overlap. After studying the properties of beam line components carefully, we developed an electron beam control system that makes a beam overlap between the electron beam and the laser beam. Using the system, we can easily achieve the beam overlap in a short time. The electron control system, of which the performance is outstanding, is being used in production beam times. And the study presents the development of a scintillating fiber electron detector that reduces the statistical error in the electron polarization measurement. We totally redesigned the scintillating fiber detector. The data that were taken during a 2008 beam time shows a huge background suppression, approximately 80 percent, while leaving the Compton spectra almost unchanged when a coincidence between the fiber detector and the photon detector is used. Thus, the statistical error of the polarization measurement is reduced by about 40 percent in the preliminary result. They are the significant progress in measuring a degree of polarization of the electron beam.

First contact imaging of nanoparticular siRNA – From synthesis to application of a prodye concept

Delivery of therapeutic nucleic acid based drugs is still very demanding and difficult to manage and monitor. For this reason, a precise method for the monitoring of RNAi pathways is necessary. This thesis explores a new approach for sensing of potentially therapeutic nucleic acids, using the interaction of so called prodyes with intracellular enzymes in a prodrug manner. To realize this concept, some non-fluorescent, fluorescein based asymmetric dyes were synthesized and their spectroscopic characteristics were studied. Azide-alkyne Click chemistry was applied for conjugation purposes, using a new protocol at weak acidic pH to get intact prodye constructs. Both, an electrophoretic mobility shift assay with polyacrylamide gels and in-cuvette experiments showed remarkable OFF-to-ON behavior of these new siRNA constructs under physiological conditions. After salt-free purification, subsequent hybridization to double-stranded ribonucleic acids and nanoformulation to lipoplexes, the prodye conjugated siRNA was examined in cellular uptake studies for First Contact Imaging. The investigated siRNA-prodye conjugates showed strong sensitivity to esterases, being hydrolyzed at the biolabile function and developing a strong fluorescence which was verified in bulk. As an optimization, a new profluorescent molecule system was designed and synthesized, which has a carbonate as biolabile 6’ protecting group and a highly water soluble 3’ clickable linker. This new non-fluorescent but colored prodye showed 12 - 320 times increased fluorescence intensities between OFF- and ON- states, depending to the deprotection method. This is the first reported molecule model of an asymmetric profluorescent fluorescein, having the very favorable 3’ & 6’ functions.

Individualisierte Krebstherapie : präklinischer „proof of concept“ einer mutationsspezifischen Immuntherapie

Da nicht-synonyme tumorspezifische Punktmutationen nur in malignen Geweben vorkommen und das veränderte Proteinprodukt vom Immunsystem als „fremd“ erkannt werden kann, stellen diese einen bisher ungenutzten Pool von Zielstrukturen für die Immuntherapie dar. Menschliche Tumore können individuell bis zu tausenden nicht-synonymer Punktmutationen in ihrem Genom tragen, welche nicht der zentralen Immuntoleranz unterliegen. Ziel der vorliegenden Arbeit war die Hypothese zu untersuchen, dass das Immunsystem in der Lage sein sollte, mutierte Epitope auf Tumorzellen zu erkennen und zu klären, ob auf dieser Basis eine wirksame mRNA (RNA) basierte anti-tumorale Vakzinierung etabliert werden kann. Hierzu wurde von Ugur Sahin und Kollegen, das gesamte Genom des murinen B16-F10 Melanoms sequenziert und bioinformatisch analysiert. Im Rahmen der NGS Sequenzierung wurden mehr als 500 nicht-synonyme Punktmutationen identifiziert, von welchen 50 Mutationen selektiert und durch Sanger Sequenzierung validiert wurden. rnNach der Etablierung des immunologischen Testsysteme war eine Hauptfragestellung dieser Arbeit, die selektierten nicht-synonyme Punktmutationen in einem in vivo Ansatz systematisch auf Antigenität zu testen. Für diese Studien wurden mutierte Sequenzen in einer Länge von 27 Aminosäuren genutzt, in denen die mutierte Aminosäure zentral positioniert war. Durch die Länge der Peptide können prinzipiell alle möglichen MHC Klasse-I und -II Epitope abgedeckt werden, welche die Mutation enthalten. Eine Grundidee des Projektes Ansatzes ist es, einen auf in vitro transkribierter RNA basierten oligotopen Impfstoff zu entwickeln. Daher wurden die Impfungen naiver Mäuse sowohl mit langen Peptiden, als auch in einem unabhängigen Ansatz mit peptidkodierender RNA durchgeführt. Die Immunphänotypisierung der Impfstoff induzierten T-Zellen zeigte, dass insgesamt 16 der 50 (32%) mutierten Sequenzen eine T-Zellreaktivität induzierten. rnDie Verwendung der vorhergesagten Epitope in therapeutischen Vakzinierungsstudien bestätigten die Hypothese das mutierte Neo-Epitope potente Zielstrukturen einer anti-tumoralen Impftherapie darstellen können. So wurde in therapeutischen Tumorstudien gezeigt, dass auf Basis von RNA 9 von 12 bestätigten Epitopen einen anti-tumoralen Effekt zeigte.rnÜberaschenderweise wurde bei einem MHC Klasse-II restringierten mutiertem Epitop (Mut-30) sowohl in einem subkutanen, als auch in einem unabhängigen therapeutischen Lungenmetastasen Modell ein starker anti-tumoraler Effekt auf B16-F10 beobachtet, der dieses Epitop als neues immundominantes Epitop für das B16-F10 Melanom etabliert. Um den immunologischen Mechanismus hinter diesem Effekt näher zu untersuchen wurde in verschieden Experimenten die Rolle von CD4+, CD8+ sowie NK-Zellen zu verschieden Zeitpunkten der Tumorentwicklung untersucht. Die Analyse des Tumorgewebes ergab, eine signifikante erhöhte Frequenz von NK-Zellen in den mit Mut-30 RNA vakzinierten Tieren. Das NK Zellen in der frühen Phase der Therapie eine entscheidende Rolle spielen wurde anhand von Depletionsstudien bestätigt. Daran anschließend wurde gezeigt, dass im fortgeschrittenen Tumorstadium die NK Zellen keinen weiteren relevanten Beitrag zum anti-tumoralen Effekt der RNA Vakzinierung leisten, sondern die Vakzine induzierte adaptive Immunantwort. Durch die Isolierung von Lymphozyten aus dem Tumorgewebe und deren Einsatz als Effektorzellen im IFN-γ ELISPOT wurde nachgewiesen, dass Mut-30 spezifische T-Zellen das Tumorgewebe infiltrieren und dort u.a. IFN-γ sekretieren. Dass diese spezifische IFN-γ Ausschüttung für den beobachteten antitumoralen Effekt eine zentrale Rolle einnimmt wurde unter der Verwendung von IFN-γ -/- K.O. Mäusen bestätigt.rnDas Konzept der individuellen RNA basierten mutationsspezifischen Vakzine sieht vor, nicht nur mit einem mutations-spezifischen Epitop, sondern mit mehreren RNA-kodierten Mutationen Patienten zu impfen um der Entstehung von „escape“-Mutanten entgegenzuwirken. Da es nur Erfahrung mit der Herstellung und Verabreichung von Monotop-RNA gab, also RNA die für ein Epitop kodiert, war eine wichtige Fragestellungen, inwieweit Oligotope, welche die mutierten Sequenzen sequentiell durch Linker verbunden als Fusionsprotein kodieren, Immunantworten induzieren können. Hierzu wurden Pentatope mit variierender Position des einzelnen Epitopes hinsichtlich ihrer in vivo induzierten T-Zellreaktivitäten charakterisiert. Die Experimente zeigten, dass es möglich ist, unabhängig von der Position im Pentatop eine Immunantwort gegen ein Epitop zu induzieren. Des weiteren wurde beobachtet, dass die induzierten T-Zellfrequenzen nach Pentatop Vakzinierung im Vergleich zur Nutzung von Monotopen signifikant gesteigert werden kann.rnZusammenfassend wurde im Rahmen der vorliegenden Arbeit präklinisch erstmalig nachgewiesen, dass nicht-synonyme Mutationen eine numerisch relevante Quelle von Zielstrukturen für die anti-tumorale Immuntherapie darstellen. Überraschenderweise zeigte sich eine dominante Induktion MHC-II restringierter Immunantworten, welche partiell in der Lage waren massive Tumorabstoßungsreaktionen zu induzieren. Im Sinne einer Translation der gewonnenen Erkenntnisse wurde ein RNA basiertes Oligotop-Format etabliert, welches Eingang in die klinische Testung des Konzeptes fand.rn

Il concetto del "ma" e la musica di Tōru Takemitsu: traduzione di "The concept of 'ma' and the music of Takemitsu" di Jonathan L. Chenette

Lo scopo di questa tesi è di esplorare l'importanza del concetto giapponese del "ma" nella musica tradizionale, in particolare in quella del compositore Tōru Takemitsu, tramite la traduzione del saggio "The concept of 'ma' and the music of Tōru Takemitsu" (Jonathan L. Chenette, 1982) dall'inglese all'italiano. L'elaborato partirà da un'introduzione generale sul concetto del "ma" nella mentalità giapponese, per proseguire con la biografia di Tōru Takemitsu e una panoramica dei motivi che hanno portato a scegliere la traduzione del saggio di Chenette. Dopo la traduzione in sé e per sé e il commento della stessa, sarà anche fornito in appendice un glossario inglese-italiano della terminologia musicale utilizzata dall'autore all'interno del saggio.

Proof of concept di una mano ad azionamento bilaterale per l'impiego nei settori della Robotica e della Protesica.

A partire dal concept ideato dall’ing. Emanuele Gruppioni, ricercatore presso il Centro Protesi stesso, l’obiettivo del lavoro è rappresentato dallo studio di fattibilità, dalla realizzazione e dalla messa in opera della suddetta mano, che presenta come caratteristica peculiare e innovativa un azionamento bilaterale che le consente di essere ambidestra. Questo azionamento è attuato da due cavi posti in ogni dito, che grazie all’azione dei motori inseriti nel palmo vengono riavvolti su delle pulegge consentendo la flessione delle dita in una direzione o nell’altra, in una struttura di mano nella quale non sono quindi individuabili a priori le tipiche ragioni palmare e dorsale. Questo tipo di azionamento in futuro potrebbe essere rielaborato nell’ottica di avere un’unica protesi di mano che possa essere utilizzata sia da pazienti destrimani sia mancini, o, in alternativa, di avere un dispositivo protesico che ampli le funzionalità di presa rispetto alla mano umana.

Pro-inflammatory biomarkers during experimental gingivitis in patients with type 1 diabetes mellitus: a proof-of-concept study

To compare gingival crevicular fluid (GCF) biomarker levels and microbial distribution in plaque biofilm (SP) samples for subjects with type 1 diabetes (T1DM) versus healthy subjects without diabetes during experimental gingivitis (EG).

A smooth transition protocol for patients with multifocal motor neuropathy going from intravenous to subcutaneous immunoglobulin therapy: an open-label proof-of-concept study

Intravenous immunoglobulin (IVIG) is the first-line therapy for multifocal motor neuropathy (MMN). This open-label multi-centre study (NCT00701662) assessed the efficacy, safety, and convenience of subcutaneous immunoglobulin (SCIG) in patients with MMN over 6 months, as an alternative to IVIG. Eight MMN patients (42-66 years), on stable IVIG dosing, received weekly SCIG at doses equivalent to previous IVIG using a "smooth transition protocol". Primary efficacy endpoint was the change from baseline to week 24 in muscle strength. Disability, motor function, and health-related quality of life (HRQL) endpoints were also assessed. One patient deteriorated despite dose increase and was withdrawn. Muscle strength, disability, motor function, and health status were unchanged in all seven study completers who rated home treatment as extremely good. Four experienced 18 adverse events, of which only two were moderate. This study suggests that MMN patients with stable clinical course on regular IVIG can be switched to SCIG at the same monthly dose without deterioration and with a sustained overall improvement in HRQL.

Recruitment dynamics of the grove-dominant tree Microberlinia bisulcata in African rain forest: extending the light response versus adult longevity trade-off concept

In groves of ectomycorrhizal caesalpiniaceous species in the Atlantic coastal forest of Central Africa the dominant tree Microberlinia bisulcata, which is shade-intolerant as a seedling but highly light-responding as a sapling, shows very limited regeneration. M. bisulcata saplings were mapped in an 82.5-ha plot at Korup and found to be located significantly far (>40 m) away from adults, a result confirmed by direct testing in a second 56-ha plot. Sapling growth over 6 years, the distribution of newly emerging seedlings around adults, recruitment of saplings in a large opening and the outward extent of seedlings at the grove edge were also investigated. Two processes appear to have been operating: (1) a very strong and consistent restriction of the very numerous seedlings establishing after masting close to adults, and (2) a strong but highly spatially variable promotion of distant survivors by increased light from the deaths of large trees of species other than M. bisulcata (which itself has very low mortality rate). This leads to an apparent escape-from-adults effect. To maintain saplings in the shade between multiple short periods of release ectomycorrhizal connections to other co-occurring caesalp species may enable a rachet-type mechanism. The recorded sapling dynamics currently contribute an essential part of the long-term cycling of the groves. M. bisulcata is an interesting example of an important group of tropical trees, particularly in Africa, which are both highly light-demanding when young yet capable also of forming very large forest emergents. To more comprehensively explain tropical tree responses, the case is made for adding a new dimension to the trade-off concept of early tree light-response versus adult longevity.