Independent of ErbB1 gene copy number, EGF stimulates migration but is not associated with cell proliferation in non-small cell lung cancer

Abstract Background Lung cancer often exhibits molecular changes, such as the overexpression of the ErbB1 gene. ErbB1 encodes epidermal growth factor receptor (EGFR), a tyrosine kinase receptor, involved mainly in cell proliferation and survival. EGFR overexpression has been associated with more aggressive disease, poor prognosis, low survival rate and low response to therapy. ErbB1 amplification and mutation are associated with tumor development and are implicated in ineffective treatment. The aim of the present study was to investigate whether the ErbB1 copy number affects EGFR expression, cell proliferation or cell migration by comparing two different cell lines. Methods The copies of ErbB1 gene was evaluated by FISH. Immunofluorescence and Western blotting were performed to determine location and expression of proteins mentioned in the present study. Proliferation was studied by flow cytometry and cell migration by wound healing assay and time lapse. Results We investigated the activation and function of EGFR in the A549 and HK2 lung cancer cell lines, which contain 3 and 6 copies of ErbB1, respectively. The expression of EGFR was lower in the HK2 cell line. EGFR was activated after stimulation with EGF in both cell lines, but this activation did not promote differences in cellular proliferation when compared to control cells. Inhibiting EGFR with AG1478 did not modify cellular proliferation, confirming previous data. However, we observed morphological alterations, changes in microfilament organization and increased cell migration upon EGF stimulation. However, these effects did not seem to be consequence of an epithelial-mesenchymal transition. Conclusion EGFR expression did not appear to be associated to the ErbB1 gene copy number, and neither of these aspects appeared to affect cell proliferation. However, EGFR activation by EGF resulted in cell migration stimulation in both cell lines.

Manejo clínico de úlceras venosas na atenção primária à saúde

OBJETIVO: Discutir o manejo clínico de úlceras venosas realizado na atenção primária à saúde, com base na visão dos usuários que convivem com esta afecção. MÉTODOS: Estudo de natureza qualitativa exploratório, descritivo, realizado com 25 usuários adultos em tratamento nas Unidades de Saúde da Família. Os dados foram coletados no segundo semestre de 2008, utilizando-se um formulário estruturado com questões de caracterização sociodemográfica, tipo de limpeza, coberturas, uso de terapia compressiva, medicamentos e orientações prescritas. RESULTADOS: São usados para a limpeza produtos que agridem o tecido de granulação, como coberturas com várias substâncias, dentre elas o óleo de girassol e pomadas antibióticas; a maioria dos usuários não utiliza medidas para controle do edema. CONCLUSÃO: fazem-se necessárias a elaboração e a adoção de protocolos clínicos para o cuidado com úlceras venosas, bem como a capacitação permanente dos profissionais de saúde.

Sistematização de curativos para o tratamento clínico das feridas

O tratamento das feridas cutâneas inclui métodos clínicos e cirúrgicos, sendo o curativo um dos tratamentos clínicos mais frequentemente utilizados. Um vasto arsenal terapêutico composto por curativos passivos ou com princípios ativos é capaz de auxiliar na reparação do tegumento em diversas situações. Curativos visam a melhorar as condições do leito da ferida, podendo ser, em algumas ocasiões, o próprio tratamento definitivo, mas em muitas situações constituem apenas uma etapa intermediária para o tratamento cirúrgico. Curativos inteligentes e biológicos são hoje mais bem classificados como substitutos cutâneos e não serão considerados neste artigo. A escolha do curativo a ser utilizado deve ser baseada no conhecimento das bases fisiopatológicas da cicatrização e da reparação tecidual, sem nunca esquecer o quadro sistêmico do paciente.

How low-level laser therapy can change mechanical properties of cells.

Low level laser therapy is used as a treatment of several conditions, including inflammatory processes and wound healing. Possible changes in mechanical properties of cells, caused by illumination, are investigated with optical magnetic twisting cytometry (OMTC), which is a technique used to evaluate mechanical properties in cell culture. Ferromagnetic micro beads are bound to cell cytoskeleton, the beads are magnetized vertically and a horizontal twisting magnetic field is applied causing a torque that moves the beads and deforms the cell, the beads rotate and displace. Based on the lateral displacement of the beads, elastic shear and loss moduli are obtained. Samples of human bronchial epithelial cell culture were divided in two groups: one was illuminated with a 660 nm red laser, 30 mW power, 0.75 W/cm2 irradiance, during different time intervals, and the other one, the control group, was not illuminated. The values of the mechanical constants of the cells of the control group showed a tendency of increasing with the time out of the incubator. On the other hand, the illuminated group showed constancy on the behavior of both moduli, keeping the normal conditions of the cell culture. Those results indicate that illumination can induce cells to homeostasis, and OMTC is sensitive to observe departures from the steady conditions. Hence, OMTC is an important technique which can be used to aggregate knowledge on the light effect in cell cytoskeleton and even on the low level laser therapy mechanisms in inflammatory processes and/or wound healing.

How low-level laser therapy can change mechanical properties of cells.

Low level laser therapy is used as a treatment of several conditions, including inflammatory processes and wound healing. Possible changes in mechanical properties of cells, caused by illumination, are investigated with optical magnetic twisting cytometry (OMTC), which is a technique used to evaluate mechanical properties in cell culture. Ferromagnetic micro beads are bound to cell cytoskeleton, the beads are magnetized vertically and a horizontal twisting magnetic field is applied causing a torque that moves the beads and deforms the cell, the beads rotate and displace. Based on the lateral displacement of the beads, elastic shear and loss moduli are obtained. Samples of human bronchial epithelial cell culture were divided in two groups: one was illuminated with a 660 nm red laser, 30 mW power, 0.75 W/cm2 irradiance, during different time intervals, and the other one, the control group, was not illuminated. The values of the mechanical constants of the cells of the control group showed a tendency of increasing with the time out of the incubator. On the other hand, the illuminated group showed constancy on the behavior of both moduli, keeping the normal conditions of the cell culture. Those results indicate that illumination can induce cells to homeostasis, and OMTC is sensitive to observe departures from the steady conditions. Hence, OMTC is an important technique which can be used to aggregate knowledge on the light effect in cell cytoskeleton and even on the low level laser therapy mechanisms in inflammatory processes and/or wound healing.

L'infiammazione intestinale nell'animale sperimentale come modello per lo sviluppo di nuovi farmaci: ruolo della via tachichininergica nelle malattie infiammatorie intestinali

Background: Several lines of evidence showed that inflammation is associated with changes in the expression of tachykinins both in human and animal models. Tachykinins, including substance P (SP), are small peptides expressed in the extrinsic primary afferent nerve fibres and enteric neurons of the gut: they exert their action through three distinct receptors, termed NK1, NK2 and NK3. SP modulates intestinal motility and enteric secretion, acting preferentially through the NK1 receptor. SP neural network and NK1 receptor expression are increased in patients with inflammatory bowel disease, and similar changes were observed in experimental models of inflammation. The 2,4 Dinitrobenzene Sulphonic Acid (DNBS) model of colitis is useful to study innate immunity, non-specific inflammation and wound healing; it has been suggested that the transmural inflammation seen in this model resembles that found in Crohn’s disease and can therefore be used to study what cells and mediators are involved in this type of inflammation. Aim: To test the possible protective effect of the NK1 receptor antagonist SSR140333 on: 1) acute model of intestinal inflammation; 2) reactivation of DNBS-induced colitis in rats. Methods: Acute colitis was induced in male SD rats by intrarectal administration of DNBS (15 mg/rat in 50% ethanol). Reactivation of colitis was induced by intrarectal injections of DNBS on day 28 (7.5 mg/rat in 35% ethanol). Animals were sacrificed on day 6 (acute colitis) and 29 (reactivation of colitis). SSR140333 (10 mg/kg) was administered orally starting from the day before the induction of colitis for 7 days (acute colitis) or seven days before the reactivation of colitis. Colonic damage was assessed by means of macroscopic and microscopic scores, myeloperoxidase activity (MPO) and TNF-α tissue levels. Enzyme immunoassay was used to measure colonic substance P levels. Statistical analysis was performed using analysis of variance (one-way or two-way, as appropriate) with the Bonferroni’s correction for multiple comparisons. Results: DNBS administration impaired body weight gain and markedly increased all inflammatory parameters (p<0.01). Treatment with SSR140333 10 mg/kg significantly counteracted the impairment in body weight gain, decreased macroscopic and histological scores and reduced colonic myeloperoxidase activity (p<0.01). Drug treatment counteracted TNF-α tissue levels and colonic SP concentrations (acute model). Similar results were obtained administering the NK1 receptor antagonist SSR140333 (3 and 10 mg/kg) for 5 days, starting the day after the induction of colitis. Intrarectal administration of DNBS four weeks after the first DNBS administration resulted in reactivation of colitis, with increases in macroscopic and histological damage scores and increase in MPO activity. Preventive treatment with SSR140333 10 mg/kg decreased macroscopic damage score, significantly reduced microscopic damage score but did not affect MPO activity. Conclusions: Treatment with SSR140333 significantly reduced intestinal damage in acute model of intestinal inflammation in rats. The NK1 receptor antagonist SSR140333 was also able to prevent relapse in experimental colitis. These results support the hypothesis of SP involvement in intestinal inflammation and indicate that NK receptor antagonists may have a therapeutic potential in inflammatory bowel disease.

Peripheral arterial disease and diabetes: effects on endothelial progenitor cell differentiation and nitric oxide metabolism

In the recent years it is emerged that peripheral arterial disease (PAD) has become a growing health problem in Western countries. This is a progressive manifestation of atherothrombotic vascular disease, which results into the narrowing of the blood vessels of the lower limbs and, as final consequence, in critical leg ischemia. PAD often occurs along with other cardiovascular risk factors, including diabetes mellitus (DM), low-grade inflammation, hypertension, and lipid disorders. Patients with DM have an increased risk of developing PAD, and that risk increases with the duration of DM. Moreover, there is a growing population of patients identified with insulin resistance (IR), impaired glucose tolerance, and obesity, a pathological condition known as “metabolic syndrome”, which presents increased cardiovascular risk. Atherosclerosis is the earliest symptom of PAD and is a dynamic and progressive disease arising from the combination of endothelial dysfunction and inflammation. Endothelial dysfunction is a broad term that implies diminished production or availability of nitric oxide (NO) and/or an imbalance in the relative contribution of endothelium-derived relaxing factors. The secretion of these agents is considerably reduced in association with the major risks of atherosclerosis, especially hyperglycaemia and diabetes, and a reduced vascular repair has been observed in response to wound healing and to ischemia. Neovascularization does not only rely on the proliferation of local endothelial cells, but also involves bone marrow-derived stem cells, referred to as endothelial progenitor cells (EPCs), since they exhibit endothelial surface markers and properties. They can promote postnatal vasculogenesis by homing to, differentiating into an endothelial phenotype, proliferating and incorporating into new vessels. Consequently, EPCs are critical to endothelium maintenance and repair and their dysfunction contributes to vascular disease. The aim of this study has been the characterization of EPCs from healthy peripheral blood, in terms of proliferation, differentiation and function. Given the importance of NO in neovascularization and homing process, it has been investigated the expression of NO synthase (NOS) isoforms, eNOS, nNOS and iNOS, and the effects of their inhibition on EPC function. Moreover, it has been examined the expression of NADPH oxidase (Nox) isoforms which are the principal source of ROS in the cell. In fact, a number of evidences showed the correlation between ROS and NO metabolism, since oxidative stress causes NOS inactivation via enzyme uncoupling. In particular, it has been studied the expression of Nox2 and Nox4, constitutively expressed in endothelium, and Nox1. The second part of this research was focused on the study of EPCs under pathological conditions. Firstly, EPCs isolated from healthy subject were cultured in a hyperglycaemic medium, in order to evaluate the effects of high glucose concentration on EPCs. Secondly, EPCs were isolated from the peripheral blood of patients affected with PAD, both diabetic or not, and it was assessed their capacity to proliferate, differentiate, and to participate to neovasculogenesis. Furthermore, it was investigated the expression of NOS and Nox in these cells. Mononuclear cells isolated from peripheral blood of healthy patients, if cultured under differentiating conditions, differentiate into EPCs. These cells are not able to form capillary-like structures ex novo, but participate to vasculogenesis by incorporation into the new vessels formed by mature endothelial cells, such as HUVECs. With respect to NOS expression, these cells have high levels of iNOS, the inducible isoform of NOS, 3-4 fold higher than in HUVECs. While the endothelial isoform, eNOS, is poorly expressed in EPCs. The higher iNOS expression could be a form of compensation of lower eNOS levels. Under hyperglycaemic conditions, both iNOS and eNOS expression are enhanced compared to control EPCs, as resulted from experimental studies in animal models. In patients affected with PAD, the EPCs may act in different ways. Non-diabetic patients and diabetic patients with a higher vascular damage, evidenced by a higher number of circulating endothelial cells (CECs), show a reduced proliferation and ability to participate to vasculogenesis. On the other hand, diabetic patients with lower CEC number have proliferative and vasculogenic capacity more similar to healthy EPCs. eNOS levels in both patient types are equivalent to those of control, while iNOS expression is enhanced. Interestingly, nNOS is not detected in diabetic patients, analogously to other cell types in diabetics, which show a reduced or no nNOS expression. Concerning Nox expression, EPCs present higher levels of both Nox1 and Nox2, in comparison with HUVECs, while Nox4 is poorly expressed, probably because of uncompleted differentiation into an endothelial phenotype. Nox1 is more expressed in PAD patients, diabetic or not, than in controls, suggesting an increased ROS production. Nox2, instead, is lower in patients than in controls. Being Nox2 involved in cellular response to VEGF, its reduced expression can be referable to impaired vasculogenic potential of PAD patients.

Effect of hypoxia and hyperglycemia on cell bioenergetics

Mitochondria have a central role in energy supply in cells, ROS production and apoptosis and have been implicated in several human disease and mitochondrial dysfunctions in hypoxia have been related with disorders like Type II Diabetes, Alzheimer Disease, inflammation, cancer and ischemia/reperfusion in heart. When oxygen availability becomes limiting in cells, mitochondrial functions are modulated to allow biologic adaptation. Cells exposed to a reduced oxygen concentration readily respond by adaptive mechanisms to maintain the physiological ATP/ADP ratio, essential for their functions and survival. In the beginning, the AMP-activated protein kinase (AMPK) pathway is activated, but the responsiveness to prolonged hypoxia requires the stimulation of hypoxia-inducible factors (HIFs). In this work we report a study of the mitochondrial bioenergetics of primary cells exposed to a prolonged hypoxic period . To shine light on this issue we examined the bioenergetics of fibroblast mitochondria cultured in hypoxic atmospheres (1% O2) for 72 hours. Here we report on the mitochondrial organization in cells and on their contribution to the cellular energy state. Our results indicate that prolonged hypoxia cause a significant reduction of mitochondrial mass and of the quantity of the oxidative phosphorylation complexes. Hypoxia is also responsible to damage mitochondrial complexes as shown after normalization versus citrate synthase activity. HIF-1α plays a pivotal role in wound healing, and its expression in the multistage process of normal wound healing has been well characterized, it is necessary for cell motility, expression of angiogenic growth factor and recruitment of endothelial progenitor cells. We studied hypoxia in the pathological status of diabetes and complications of diabetes and we evaluated the combined effect of hyperglycemia and hypoxia on human dermal fibroblasts (HDFs) and human dermal micro-vascular endothelial cells (HDMECs) that were grown in high glucose, low glucose concentrations and mannitol as control for the osmotic challenge.

Einfluss einer pharmazeutischen Betreuung auf den klinischen Verlauf und die Behandlungsergebnisse von Diabetikern mit Diabetischem Fußsyndrom (DFS)

Einfluss einer Pharmazeutischen Betreuung auf den klinischen Verlauf und die Behandlungsergebnisse von Diabetikern mit Diabetischem Fußsyndrom (DFS) Hintergrund/Rationale: In Deutschland gibt es etwa 6 Millionen Diabetiker und die Tendenz ist steigend. Das Diabetische Fußsyndrom (DFS) stellt eine häufige und besonders gravierende Folgeerkrankung des Diabetes mellitus dar. Jährlich werden in Deutschland ca. 45.000 Amputationen aufgrund des DFS bei Diabetikern durchgeführt. Es verursacht bei den Patienten physische und psychische Beeinträchtigungen und produziert hohe Krankheitskosten. Der Prävention, der Behandlung und der Rezidivprophylaxe des DFS kommt daher ein hoher Stellenwert zu. Ziel dieser Arbeit war es, ein klinisch-pharmazeutisches Betreuungsprogramm für Patienten mit DFS zu erarbeiten und den Einfluss der Pharmazeutischen Betreuung, speziell einer intensivierten Patientenschulung, auf klinische und soziale Behandlungsergebnisse hin zu untersuchen. Es sollte geklärt werden, ob eine zusätzliche pharmazeutische Betreuung Einfluss auf den Wundheilungsverlauf und die Abheilungsrate der Fußläsionen von Diabetikern mit DFS nehmen kann. Methoden: 52 Patienten mit DFS wurden in eine randomisierte, kontrollierte Studie eingeschlossen und im Verhältnis 1:1 einer Interventions- oder Kontrollgruppe zugeteilt. Die Interventionsgruppe wurde kontinuierlich durch einen Apotheker zusätzlich individuell betreut (Anleitung zum sachgerechten Umgang mit Arzneimitteln, Medizinprodukten und Therapiemaßnahmen), die Kontrollgruppe erhielt die übliche medizinische Betreuung. Die Auswirkungen der Intervention auf den klinischen Verlauf der beobachteten Fußläsionen, die Rezidivfreiheit und Rehospitalisierungsrate, aber auch auf die Patientenzufriedenheit, das Patientenwissen und die Lebensqualität wurden untersucht. Jeder Patient wurde über einen Zeitraum von 12 Monaten beobachtet. Ergebnisse: Die Studienergebnisse belegen einen positiven Einfluss der Pharmazeutischen Betreuung auf die klinischen Endpunkte der Diabetiker mit DFS. Die Wundheilung der Läsionen in der Interventionsgruppe, bezogen auf Abheilungsdauer und -rate, konnte klinisch positiv beeinflusst werden. Des weiteren konnte in der Interventionsgruppe die Anzahl an neu aufgetretenen Läsionen, sowie weiterer Krankenhausaufenthalte um jeweils fast 50% verringert werden. Durch die Pharmazeutische Betreuung konnte die Patientenzufriedenheit mit der Behandlung deutlich gesteigert werden. Entsprechendes fand sich für das Patientenwissen und die Lebensqualität.

Studio del ruolo della Protein chinasi B/Akt nella migrazione di Cellule Staminali Mesenchimali umane

Le cellule staminali/stromali mesenchimali umane (hMSC) sono attualmente applicate in diversi studi clinici e la loro efficacia è spesso legata alla loro capacità di raggiungere il sito d’interesse. Poco si sa sul loro comportamento migratorio e i meccanismi che ne sono alla base. Perciò, questo studio è stato progettato per comprendere il comportamento migratorio delle hMSC e il coinvolgimento di Akt, nota anche come proteina chinasi B. L’espressione e la fosforilazione della proteinchinasi Akt è stata studiata mediante Western blotting. Oltre al time-lapse in vivo imaging, il movimento cellulare è stato monitorato sia mediante saggi tridimensionali, con l’uso di transwell, che mediante saggi bidimensionali, attraverso la tecnica del wound healing. Le prove effettuate hanno rivelato che le hMSC hanno una buona capacità migratoria. E’ stato osservato che la proteinchinasi B/Akt ha elevati livelli basali di fosforilazione in queste cellule. Inoltre, la caratterizzazione delle principali proteine di regolazione ed effettrici, a monte e a valle di Akt, ha permesso di concludere che la cascata di reazioni della via di segnale anche nelle hMSC segue un andamento canonico. Specifici inibitori farmacologici sono stati utilizzati per determinare il potenziale meccanismo coinvolto nella migrazione cellulare e nell'invasione. L’inibizione della via PI3K/Akt determina una significativa riduzione della migrazione. L’utilizzo di inibitori farmacologici specifici per le singole isoforme di Akt ha permesso di discriminare il ruolo diverso di Akt1 e Akt2 nella migrazione delle hMSC. E’ stato infatti dimostrato che l'inattivazione di Akt2, ma non quella di Akt1, diminuisce significativamente la migrazione cellulare. Nel complesso i risultati ottenuti indicano che l'attivazione di Akt2 svolge un ruolo critico nella migrazione della hMSC; ulteriori studi sono necessari per approfondire la comprensione del fenomeno. La dimostrazione che l’isoforma Akt2 è necessaria per la chemiotassi diretta delle hMSC, rende questa chinasi un potenziale bersaglio farmacologico per modulare la loro migrazione.

Synthetische Glycopeptide mit Sulfatyl-Lewis X-Struktur als potenzielle Inhibitoren der Zelladhäsion

Zelladhäsionsprozesse sind von großer Bedeutung für zahlreiche biologische Prozesse, wie etwa die Immunantwort, die Wundheilung und die Embryogenese. Außerdem spielen sie eine entscheidende Rolle im Verlauf inflammatorischer Prozesse. An der Zelladhäsion sind verschiedene Klassen von Adhäsionsmolekülen beteiligt. Die erste leichte „rollende“ Adhäsion von Leukozyten am Ort einer Entzündung wird durch die Selektine vermittelt. Diese binden über die Kohlenhydrat-Strukturen Sialyl-Lewisx und Sialyl-Lewisa über eine calciumabhängige Kohlenhydrat-Protein-Bindung an ihre spezifischen Liganden und vermitteln so den ersten Zellkontakt, bevor andere Adhäsionsmoleküle (Cadherine, Integrine) die feste Adhäsion und den Durchtritt durch das Endothel bewirken. Bei einer pathogenen Überexpression der Selektine kommt es jedoch zu zahlreichen chronischen Erkrankungen wie z. B. rheumatoider Arthritis, Erkrankungen der Herzkranzgefäße oder dem Reperfusions-syndrom. Außerdem wird eine Beteiligung der durch die Selektine vermittelten Zellkontakte bei der Metastasierung von Karzinomzellen angenommen. Ein Ansatzpunkt für die Behandlung der oben genannten Erkrankungen ist die Gabe löslicher kompetitiver Inhibitoren für die Selektine. Ziel der Arbeit war die Modifikation des Sialyl-Lewisx-Leitmotivs zur Steigerung der metabolischen Stabilität und dessen Einbau in die Peptidsequenz aus der für die Bindung verantwortlichen Domäne des endogenen Selektin-Liganden PSGL-1. Dazu wurden mit einer modifizierten Lewisx-Struktur glycosylierte Aminosäurebausteine dargestellt (Abb.1). Die Verwendung von Arabinose und des Sulfatrestes anstelle von Fusose und Sialinsäure sollte außerdem zu einer gesteigerten metabolischen Stabilität des synthetischen Liganden beitragen. Die so erhaltenen Glycosylaminosäuren sollten nun in die Festphasenpeptidsynthese eingesetzt werden. Aufgrund der großen säurelabilität konnte hier nicht auf das Standartverfahren (Wang-Harz, Abspaltung mit TFA) zurückgegriffen werden. Deshalb kam ein neuartiges UV-labiles Ankersystem zum Einsatz. Dazu wurde ein Protokoll für die Synthese und Abspaltung von Peptiden an diesem neuen System entwickelt. Daran gelang die Synthese des nichtglycosylierten Peptidrückgrats sowie eines mit der dem sulfatierten Lewisx-Motiv versehenen Glycopeptids. Ein vierfach sulfatiertes Glycopeptid, welches durch den Einsatz von im Vorfeld chemisch sulfatierer Tyrosin-Bausteinen dargestellt werden sollte, konnte massenspektrometrisch nachgewiesen werden.

Analisi proteomica dei meccanismi sottesi alla malatia da reflusso gastroesofageo

La malattia da reflusso gastroesofageo (GERD) si divide in due categorie: malattia non erosiva (NERD) ed erosiva (ERD). Questi due fenotipi di GERD mostrano caratteristiche patofisiologiche e cliniche differenti. NERD è la forma più comune. Anche se ERD e NERD sono difficili da distinguere a livello clinico, la forma NERD possiede caratteristiche fisiologiche, patofisiologiche, anatomiche, e istologiche uniche. La replicazione cellulare dello strato basale si pensa sia una delle cause implicate nella resistenza della mucosa e nella difesa strutturale dell’epitelio. Diversi studi hanno dimostrato che la proliferazione cellulare è ridotta nella mucosa esofagea esposta ad insulti acidi e peptici cronici, in pazienti GERD, in più uno studio recente ha dimostrato che il recettore per i cannabinoidi CB1 era implicato nella riparazione delle ferite nella mucosa del colon. Sulla base di questi dati abbiamo valutato la presenza del recettore CB1 in biopsie della mucosa esofagea, di pazienti ERD, NERD e di controlli sani, tramite analisi Western Blot, Immunoistochimica e Real-Time PCR, dimostrando per la prima volta la presenza di questo recettore nell’epitelio dell’esofago e una riduzione dei suoi livelli di espressione nei pazienti ERD, camparati con i NERD e con i controlli sani. Successivamente, per chiarire meglio i meccanismi molecolari che caratterizzano ERD e NERD, abbiamo effettuato un analisi proteomica con la tecnica shotgun, la quale ha evidenziato un patter proteico di 33 proteine differenzialmente espresse in pazienti NERD vs ERD, sette delle quali confermate in wester Blot, e quattro in immunoistochimica. Concludendo i nostri risultati hanno confermato che ERD e NERD sono due entità distinte a livello proteico, e hanno proposto dei candidati biomarker per la diagnosi differenziale di ERD e NERD.

La navigazione nella chirurgia oncologica ortopedica: Applicazione ed implementazione di nuove tecnologie per il trattamento chirurgico dei tumori dell'apparato muscolo-scheletrico, studio pilota

Nel presente progetto di ricerca, da novembre 2011 a novembre 2013 , sono stati trattati chirurgicamente, con l’assistenza del navigatore , pazienti con tumori ossei primitivi degli arti, del bacino e del sacro, analizzando i risultati degli esami istologici dei margini di resezione del tumore e i risultati clinici e radiografici. Materiali e metodi : Abbiamo analizzato 16 pazienti 9 maschi e 7 femmine , con un'età media di 31 anni (range 12-55 ). Di tutti i pazienti valutati 8 avevano una localizzazione agli arti inferiori , 4 al bacino e 4 all'osso sacro . Solo quelli con osteosarcoma parostale , Cordoma e Condrosarcoma non sono stati sottoposti a terapia antiblastica . Solo un paziente è stato sottoposto a radioterapia postoperatoria per una recidiva locale . Tutti gli altri pazienti non sono stati trattati con la radioterapia per l’ adeguatezza dei margini di resezione . Non ci sono state complicanze intraoperatorie . Nel periodo postoperatorio abbiamo osservato una vescica neurologica , una paresi sciatica, due casi di infezione di cui una superficiale e una profonda, tutti e quattro i pazienti con sarcoma sacrale sviluppati hanno avuto ritardato della guarigione della ferita e di questi tre hanno avuto incontinenza sfinterica. In tutti i casi si è ottenuta una eccellente risultato clinico e radiografico , con soddisfazione del paziente , corretto contatto tra l'osteotomia e l'impianto che apparivano stabili ai primi controlli ambulatoriali ( FU 19 mesi). Risultati: La chirurgia assistita da calcolatore ha permesso di migliorare l’esecuzione delle resezioni ossee prevista dal navigatore. Questa tecnologia è valida e utile per la cure dei tumori dell’apparato scheletrico, soprattutto nelle sedi anatomiche più complesse da trattare come la pelvi, il sacro e nelle resezioni intercalari difficoltose nell’ottenere un margine di resezione ampio e quindi di salvare l’articolazione e l’arto stesso.

Etablierung eines In-vivo-Modells zur Untersuchung der Rolle epidermaler Langerhanszellen bei der Entstehung der Transplantat-gegen-Wirt-Erkrankung nach allogener Blutstammzelltransplantation

Dendritische Zellen der Haut, wie z.B. die Langerhanszellen (LC) der Epidermis, sind potente antigenpräsentierende Zellen (APC). Nach allogener Blutstammzelltransplantation (engl.: hematopoietic stemm cell transplantation, HSCT) persistieren Empfänger-APC und können Spender-T-Zellen aktivieren. Somit spielen dendritische Zellen eine kritische Rolle bei der Initiierung von akuter Transplantat-Gegen-Wirt-Reaktion (engl.: graft-versus-host-disease, GvHD).rnIn der vorliegenden Arbeit wurde ein Modellsystem entwickelt, welches humane Haut in einem Xenotransplantationsmodell nutzt, um die Wechselwirkung dieser gewebsständigen APC mit alloreaktiven T-Zellen zu untersuchen. Dafür wurden humane Resthautpräparate von subkutanem Gewebe befreit und intraskaptulär auf immunsupprimierte NOD/LtSz-scid IL2R#-null Mäuse (NSG) transplantiert. Diesen Tieren fehlen funktionale T-, B- und NK-Zellen, und sie tolerieren somit ein xenogenes Transplantat. Im Vergleich zu anderen immundefizienten Stämmen, haben sie eine erhöhte Lebenserwartung und es ist zudem möglich humane Hämatopoese durch Stammzellgabe zu etablieren.rnPublizierte Methoden der Hauttransplantation wurden für diese Arbeit optimiert und weiterentwickelt. So konnte die Erfolgsrate von 44% auf bis zu 95% gesteigert werden. Erste Untersuchungen fokussierten den Einfluss der Wundheilung auf die Verteilung dermaler Zellpopulationen, wie z.B. CD11c positive APC, und die Population der LC in der Epidermis. Während der ersten Wochen der Wundheilung war ein vorübergehendes Verschwinden der LC aus der Epidermis zu beobachten. Im Gegensatz dazu waren CD11c positive dermale Zellen permanent detektierbar. Die zu späteren Zeitpunkten festgestellte Repopulation der Epidermis mit LC unterstützt die Hypothese einer lokalen Vorläuferzelle. Die vorgelegten Daten und die lokale proliferative Aktivität dieser Zellen unterstreichen ihre Unabhängigkeit vom peripheren Blut. Versuche, eine Depletion der LC mittels UVC-Bestrahlung zu erreichen, gelangen nicht. Auch dies spricht für das Vorhandensein eines lokalen Vorläufers.rnZur Induktion von GvHD in der transplantierten Haut wurden in vitro DC des Hautspenders generiert und damit HLA-disparate T-Zellen stimuliert. Auf diese Weise sollte eine maximale Alloreaktivität gegen das Hauttransplantat generiert werden. In allen vorgestellten Systemen ließ sich nach Infusion der T-Lymphozyten in transplantierte Tiere, eine T-Zellinduzierte inflammatorische Reaktion auslösen. Optisch war eine deutliche Rötung des Transplantats feststellbar. Diese war jedoch nur in den Proben besonders deutlich, welche T-Zellen mit vorheriger in vitro Stimulation durch DC des Hautspenders erhalten hatten. Histologisch konnten Anzeichen einer Entzündung nachgewiesen werden. Neben Akanthose und Hyperparakeratose, waren deutliche T-Zellinfiltrate detektierbar. Auch Spaltbildung und Ablösung der Epidermis, sowie vereinzelte Apoptosen der epidermalen Zellen wiesen auf eine GvHD artige Entzündung hin.rnEine weitere Beobachtung nach T-Zellgabe, war die Depletion der LC aus der Epidermis. Auch konnte durch spätere T-Zellgaben keine weitere Hautrötung ausgelöst werden. Dies belegt die Funktion der LC als primäre Zielzelle der alloreaktiven T-Zellen. Unterstrichen wird dies durch Verwendung einer LC defizienten Haut, welche keine Hautrötung oder Anzeichen einer Entzündung entwickelte.rnZusammenfassend wurde für diese Arbeit ein Modellsystem entwickelt, welches es erlaubt Untersuchungen entzündlicher Hautkrankheiten unter Berücksichtigung hautständiger APC durchzuführen. Dabei kann dieses Modell in Zukunft für die Untersuchung von APC modulierenden Agenzien genutzt werden, da präklinische Modelle für spezies-spezifische Therapien bislang fehlten. Das Entstehen einer Entzündung könnte so verhindert oder eine Behandlung ermöglicht werden.

Designing an antimicrobial and cell-adhesive multilayer via plasma polymerization

In dieser Arbeit wurden Oberflächenmodifizierungen entwickelt, die sowohl rnzelladhäsive als auch antimikrobielle Eigenschaften tragen. Rasche Zelladhäsion rnund Wundheilung ist gewünscht für Biomaterialien, da sonst das Material als rnFremdkörper erkannt werden würde und Infektionskeime in die Kavität zwischen rnMaterial und Gewebe eindringen könnten. Plasmapolymerisation dient hierbei als rnBeschichtungsverfahren, da es ein breites Spektrum an Materialien beschichten rnkann unabhängig von dessen Beschaffenheit. Als zelladhäsive Schicht wurde rnplasmapolymerisiertes Allylamin gewählt, da es zellfreundlich ist und dabei rnweitere nasschemische Modifikationen, wie die Anbindung von Fibronektin, rnzulässt. Dabei dient es zugleich als Barriereschicht für darunterliegende zink- und silberhaltige Filme, die der Beschichtung durch Freisetzung von Silber und Zink antimikrobielle Eigenschaften verleihen. Die Schichtsysteme wurden rnspektroskopisch und mikroskopisch untersucht sowie zelladhäsive und rnantimikrobielle Wirkung mit verschiedenen Zell- und Bakterientypen getestet.