Der Einfluss von Chemotherapeutika mit Hypoxie-induzierbarer Faktor (HIF)-modulierendem Potential sowie eines Verlustes des HIF-Regulators von Hippel-Lindau (VHL) auf den Phänotyp und die Funktion dendritischer Zellen

Der Transkriptionsfaktor Hypoxie-induzierbarer Faktor (HIF) gibt dem Organismus die Möglichkeit, sich auf zellulärer Ebene an unterschiedliche Sauerstoffverhältnisse anzupassen. Vor allem Tumorzellen weisen aufgrund ihres ungeregelten Wachstums und der daraus resultierenden unzureichenden Durchblutung (hypoxisches Milieu) eine erhöhte HIF-Expression auf. Die erhöhte HIF-Expression stellt somit ein interessantes Ziel in der Tumortherapie dar. Dendritische Zellen (DCs) besitzen eine bedeutende Rolle in der Generierung und Modulierung von Antitumor-Immunantworten. Aus diesem Grund ist es überaus wichtig zu wissen, welche Effekte Antitumor-Agenzien, im Besonderen HIF-Inhibitoren, auf DCs und somit auch auf die Generierung von adäquaten Immunantworten besitzen.rnIm ersten Teil dieser Arbeit wurde aus diesem Grund der Einfluss der Antitumor-Agenzien Geldanamycin (GA) und Topotecan (TPT) auf den Phänotyp und die Funktion von DCs untersucht. Hierfür wurden Monozyten aus humanen, mononukleären, peripheren Blutzellen isoliert und unter DC-differenzierenden Konditionen kultiviert. Diese immaturen monozytenabgeleiteten DCs (Mo-DCs) wurden mithilfe eines Reifungscocktails ausgereift. Die Applikation der Antitumor-Agenzien erfolgte während der Differenzierungs- bzw. Ausreifungsphase. Abhängig vom Reifungsgrad der Mo-DCs konnte ein differentieller Einfluss von GA bzw. TPT auf die DC-Aktivierung beobachtet werden. Eine Behandlung von unstimulierten Mo-DCs mit GA resultierte in einer partiellen DC-Aktivierung basierend auf einem noch unbekannten Mechanismus. Ebenso führte eine Behandlung von unstimulierten Mo-DCs mit TPT zu einer funktionellen Aktivierung der DCs, die mit einer vermehrten AKT-Expression korrelierte. Die jeweilige Koapplikation der Antitumor-Agenzien mit dem DC-Reifungscocktail führte zu einer reduzierten DC-Aktivierung, die sich in einer verminderten NF-κB-Aktivierung, einer verringerten Oberflächenexpression der getesteten kostimulatorischen Moleküle, einer verringerten Migrationsfähigkeit und einem reduzierten Zellstimulierungspotential widerspiegelte.rnDie autosomal dominant vererbte Tumorerkrankung von Hippel-Lindau (VHL) wird häufig durch genetische Mutationen des als HIF-Negativregulator fungierenden VHL-Gens hervorgerufen. Patienten, die an dem VHL-Syndrom erkrankt sind, weisen oft benigne oder maligne Tumore und Zysten in den verschiedensten Organsystemen auf. Wie schon zuvor erwähnt, besitzen DCs eine essentielle Rolle in der Initiierung und Aufrechterhaltung von Antitumor-Immunantworten. Deshalb wurde im zweiten Abschnitt der vorliegenden Arbeit untersucht, inwieweit ein partieller Verlust von VHL Auswirkungen auf die Ausprägung desrnPhänotyps und der Funktion von DCs hat. Mittels Cre/lox-Technologie wurden transgene Mäuse mit einem heterozygoten Verlust von Exon 1 bzw. Exon 2 des VHL-Gens generiert. Aus diesen Mäusen wurden Knochenmarkszellen isoliert und unter DC-differenzierenden Konditionen kultiviert. Die immaturen knochenmarkabgeleiteten DCs (BM-DCs) wurden mit LPS ausgereift. Weder der heterozygote Verlust von Exon 1 noch von Exon 2 des VHL-Gens bewirkte eine Veränderung der Oberflächenmarkerexpression, der in vitro-Migrations- undrnEndozytosekapazität, sowie der allogenen T-Zellstimulierungskapazität. Allerdings zeigten Mäuse mit einem partiellen Verlust von Exon 2 im Vergleich zu Kontrollmäusen nach Immunisierung und Provokation mit dem Modellallergen OVA eine verminderte Atemwegshyperreaktion, die möglicherweise auf die beobachtete Abnahme der Migrationsfähigkeit in vivo und die verminderte OVA-spezifische T-Zellstimulierungskapazität der DCs zurückzuführen ist.

ChronOS Inject in Children with Benign Bone Lesions – Does It Increase the Healing Rate?

Benign bone lesions in children although rare, can result in a pathological fracture. Although their etiology and pathogenesis are not yet entirely clear, the phenomenon of spontaneous healing is well known. Nevertheless, some benign bone lesions are unlikely to heal spontaneously due to the patient's age or high risk of fracture and deformity due to the lesion's location or size. The following study presents our results after treatment of these bone cysts with chronOS Inject.

Loss of 15-Hydroxyprostaglandin Dehydrogenase Increases Prostaglandin E2 in Pancreatic Tumors

Prostaglandin E2 (PGE2) is a product of cyclooxygenase (COX) and PGE synthase (PGES) and deactivated by 15-hydroxyprostaglandin dehydrogenase (PGDH). Down-regulation of PGDH contributes to PGE2 accumulation in lung and colon cancers but has not been identified in pancreatic cancer.

Benign neonatal sleep myoclonus: a review of the literature

OBJECTIVE: Neurologically normal term infants sometimes present with repetitive, rhythmic myoclonic jerks that occur during sleep. The condition, which is traditionally resolved by 3 months of age with no sequelae, is termed benign neonatal sleep myoclonus. The goal of this review was to synthesize the published literature on benign neonatal sleep myoclonus. METHODS: The US National Library of Medicine database and the Web-based search engine Google, through June 2009, were used as data sources. All articles published after the seminal description in 1982 as full-length articles or letters were collected. Reports that were published in languages other than English, French, German, Italian, Portuguese, or Spanish were not considered. RESULTS: We included 24 reports in which 164 term-born (96%) or near-term-born (4%) infants were described. Neonatal sleep myoclonus occurred in all sleep stages, disappeared after arousal, and was induced by rocking the infant or repetitive sound stimuli. Furthermore, in affected infants, jerks stopped or even worsened by holding the limbs or on medication with antiepileptic drugs. Finally, benign neonatal sleep myoclonus did not resolve by 3 months of age in one-third of the infants. CONCLUSIONS: This review provides new insights into the clinical features and natural course of benign neonatal sleep myoclonus. The most significant limitation of the review comes from the small number of reported cases.

Extensive extranodal metastases of basal-like breast cancer with predominant myoepithelial spindle cell differentiation

A differentiation towards myoepithelial cells has been demonstrated in several types of lesions in the breast. These include multifocal myoepitheliomatosis, the rare mixed tumor or pleomorphic adenoma, adenoid cystic carcinoma, adenomyoepithelioma and myoepithelial carcinoma (malignant myoepithelioma). Myoepithelial carcinoma is the only lesion purely composed of myoepithelial cells. All these tumors are benign and/or of low-grade malignancy, with the exception of malignant myoepithelioma. In contrast to the statement of the current World Health Organization (WHO), recent studies have reported that regional and distant metastases may occur in about 50% of pure myoepithelial carcinomas. The presented case of a breast carcinoma with dominant myoepithelial/spindle cell differentiation in a 58-year-old woman is an excellent example to document the highly aggressive biological behavior of this tumor phenotype. Despite an extensive chemotherapy and radiotherapy, the tumor was rapidly progressive, forming a finally exulcerating local tumor relapse and widespread metastases to the myocardium, lungs, liver, kidneys and skin. Similarities in morphology and biological behavior compared to patients with "triple-negative" (hormone receptor and Her2) monophasic sarcomatoid carcinomas and pure spindle cell sarcomas are discussed.

Internalized somatostatin receptor subtype 2 in neuroendocrine tumors of octreotide-treated patients

Somatostatin receptor subtype 2 (sst(2)) is widely expressed in neuroendocrine tumors and can be visualized immunohistochemically at the cell membrane for diagnostic purposes. Recently, it has been demonstrated in animal sst(2) tumor models in vivo that somatostatin analog treatment was able to induce a complete internalization of the tumor sst(2).

In vitro and in vivo characterization of novel 18F-labeled bombesin analogues for targeting GRPR-positive tumors

The gastrin-releasing peptide receptor (GRPR) is overexpressed on a number of human tumors and has been targeted with radiolabeled bombesin analogues for the diagnosis and therapy of these cancers. Seven bombesin analogues containing various linkers and peptide sequences were designed, synthesized, radiolabeled with (18)F, and characterized in vitro and in vivo as potential PET imaging agents. Binding studies displayed nanomolar binding affinities toward human GRPR for all synthesized bombesin analogues. Two high-affinity peptide candidates 6b (K(i) = 0.7 nM) and 7b (K(i) = 0.1 nM) were chosen for further in vivo evaluation. Both tracers revealed specific uptake in GRPR-expressing PC-3 tumors and the pancreas. Compared to [(18)F]6b, compound [(18)F]7b was characterized by superior tumor uptake, higher specificity of tracer uptake, and more favorable tumor-to-nontarget ratios. In vivo PET imaging allowed for the visualization of PC-3 tumor in nude mice suggesting that [(18)F]7b is a promising PET tracer candidate for the diagnosis of GRPR-positive tumors in humans.

Chickenpox is not always benign: postvaricella purpura fulminans requires prompt and aggressive treatment

We present 2 patients, who were admitted owing to rapidly progressing purpuric lesions due to postvaricella purpura fulminans, a coagulopathy leading to life- or limb-threatening thrombosis caused by a severe transient autoimmune protein S deficiency. Laboratory results were being consistent with disseminated intravascular coagulation secondary to protein S deficiency; treatment with fresh frozen plasma, intravenous immunoglobulins, and prednisone was started. In our experience, a prompt therapy may limit the course and the extent of the disease. We present a review of the topic with supporting literature for the therapeutic options. Therefore, we should be reminded that purpura fulminans is a rare but severe complication of chickenpox, which demands quick action.

Radiolabeled bicyclic somatostatin-based analogs: a novel class of potential radiotracers for SPECT/PET of neuroendocrine tumors

A variety of radiolabeled somatostatin analogs have been developed for targeting of somatostatin receptor (sst)-positive tumors. Bicyclic somatostatin-based radiopeptides have not been studied yet. Hypothesizing that the introduction of conformational constraints may lead to receptor subtype selectivity or may help to delineate structural features determining pansomatostatin potency, we developed and evaluated first examples of this new class of potential radiotracers for imaging or therapy of neuroendocrine tumors.

INI1 (BAF 47) immunohistochemistry is an essential diagnostic tool for children with hepatic tumors and low alpha fetoprotein

Malignant rhabdoid tumor (MRT) of the liver is a rare malignancy with grave prognosis. This entity should be considered in the differential diagnosis of any aggressive liver tumor with low levels of alpha fetoprotein. We report 2 cases of hepatic MRT presenting in infancy. In these 2 cases, we show that loss of INI1 facilitates making the correct diagnosis of primary hepatic MRT utilizing BAF 47 (INI1 gene product) immunostains. Difficulty encountered in making this rare diagnosis, including the need for repeated biopsies, can be avoided if MRT is considered in the differential diagnosis early on and BAF 47 immunohistochemistry is ordered.