Untersuchung der zellulären Antwort von Tumor und Endothelium auf radioaktive Bestrahlung in vitro und in vivo

Tumore des Kopf-Hals Bereiches sprechen aufgrund schneller Resistenzbildung häufig schlecht auf die derzeit praktizierten Bestrahlungstherapien an. Der Erfolg dieser Behandlung wird dabei maßgeblich durch die Strahlenresistenz des malignen Gewebes limitiert. Das Verständnis der zugrunde liegenden zellulären und molekularen Mechanismen ist diesbezüglich unvollständig. Die Resistenzzunahme während der klinischen Behandlung könnte durch die Selektion strahlenresistenter Einzelzellen verursacht werden oder durch die Aktivierung von Resistenzmechanismen. Im Rahmen dieser Arbeit wurde die bestrahlungsvermittelte Freisetzung möglicherweise protektiv wirkender Faktoren durch Tumorzelllinien des Kopf-Hals Bereiches untersucht. Durch Bestrahlung erfolgte eine Induktion von VEGF (vascular endothelial growth factor) und FGF-2 (fibroblast growth factor 2), IL-8 (Interleukin-8) und PGE2 (Prostaglandin E2). Die Untersuchung von VEGF und FGF-2 zeigte weiterhin ein zytoprotektives Potential dieser Faktoren, d.h. die T

Design of cell adhesive and angiogenic titanium surfaces for cellular stimulation

Die Förderung der Zelladhäsion durch sogenannte biomimetische Oberflächen wird in der Medizin als vielversprechender Ansatz gesehen, um Komplikationen wie z. B. Fremdkörperreaktionen nach der Implantation entgegenzuwirken. Neben der Immobilisierung einzelner Biomoleküle wie z. B. dem RGD-Peptid, Proteinen und Wachstumsfaktoren auf verschiedenen Materialien, konzentriert man sich derzeit in der Forschung auf die Co-Immobilisierung zweier Moleküle gleichzeitig. Hierbei werden die funktionellen Gruppen z. B. von Kollagen unter Verwendung von nur einer Kopplungschemie verwendet, wodurch die Kopplungseffizienz der einzelnen Komponenten nur begrenzt kontrollierbar ist. Das Ziel der vorliegenden Arbeit war die Entwicklung eines Immobilisierungsverfahrens, welches die unabhängige Kopplung zweier Faktoren kontrolliert ermöglicht. Dabei sollten exemplarisch das adhäsionsfördernde RGD-Peptid (Arginin-Glycin-Asparaginsäure) zusammen mit dem Wachstumsfaktor VEGF (Vascular Endothelial Growth Factor) auf Titan gebunden werden. In weiteren Experimenten sollten dann die pro-adhäsiven Faktoren Fibronektin, Kollagen, Laminin und Osteopontin immobilisiert und untersucht werden. rnDie Aminofunktionalisierung von Titan durch plasma polymerisierte Allylaminschichten wurde als Grundlage für die Entwicklung des nasschemischen Co-immobilisierungsverfahren verwendet. Für eine unabhängige und getrennte Anbindung der verschiedenen Biomoleküle stand in diesem Zusammenhang die Entwicklung eines geeigneten Crosslinker Systems im Vordergrund. Die Oberflächencharakterisierung der entwickelten Oberflächen erfolgte mittels Infrarot Spektroskopie, Surface Plasmon Resonance Spektroskopie (SPR), Kontaktwinkelmessungen, Step Profiling und X-Ray Photoelectron Spektroskopie (XPS). Zur Analyse der Anbindungsprozesse in Echtzeit wurden SPR-Kinetik Messungen durchgeführt. Die biologische Funktionalität der modifizierten Oberflächen wurde in vitro an Endothelzellen (HUVECs) und Osteoblasten (HOBs) und in vivo in einem Tiermodell-System an der Tibia von Kaninchen untersucht.rnDie Ergebnisse zeigen, dass alle genannten Biomoleküle sowohl einzeln auf Titan kovalent gekoppelt als auch am Bespiel von RGD und VEGF in einem getrennten Zwei-Schritt-Verfahren co-immobilisiert werden können. Des Weiteren wurde die biologische Funktionalität der gebundenen Faktoren nachgewiesen. Im Falle der RGD modifizierten Oberflächen wurde nach 7 Tagen eine geförderte Zelladhäsion von HUVECs mit einer signifikant erhöhten Zellbesiedlungsdichte von 28,5 % (p<0,05) gezeigt, wohingegen auf reinem Titan Werte von nur 13 % beobachtet wurden. Sowohl VEGF als auch RGD/VEGF modifizierte Proben wiesen im Vergleich zu Titan schon nach 24 Stunden eine geförderte Zelladhäsion und eine signifikant erhöhte Zellbesiedlungsdichte auf. Bei einer Besiedlung von 7,4 % auf Titan, zeigten VEGF modifizierte Proben mit 32,3 % (p<0,001) eine deutlichere Wirkung auf HUVECs als RGD/VEGF modifizierte Proben mit 13,2 % (p<0,01). Die pro-adhäsiven Faktoren zeigten eine deutliche Stimulation der Zelladhäsion von HUVECs und HOBs im Vergleich zu reinem Titan. Die deutlich höchsten Besiedlungsdichten von HUVECs konnten auf Fibronektin mit 44,6 % (p<0,001) und Kollagen mit 39,9 % (p<0,001) nach 24 Stunden beobachtet werden. Laminin zeigte keine und Osteopontin nur eine sehr geringe Wirkung auf HUVECs. Bei Osteoblasten konnten signifikant erhöhte Besiedlungsdichten im Falle aller pro-adhäsiven Faktoren beobachtet werden, jedoch wurden die höchsten Werte nach 7 Tagen auf Kollagen mit 90,6 % (p<0,001) und Laminin mit 86,5 % (p<0,001) im Vergleich zu Titan mit 32,3 % beobachtet. Die Auswertung der Tierexperimente ergab, dass die VEGF modifizierten Osteosyntheseplatten, im Vergleich zu den reinen Titankontrollen, eine gesteigerte Knochenneubildung auslösten. Eine solche Wirkung konnte für RGD/VEGF modifizierte Implantate nicht beobachtet werden. rnInsgesamt konnte gezeigt werden, dass mittels plasmapolymerisierten Allylamin Schichten die genannten Biomoleküle sowohl einzeln gebunden als auch getrennt und kontrolliert co-immobilisiert werden können. Des Weiteren konnte eine biologische Funktionalität für alle Faktoren nach erfolgter Kopplung in vitro gezeigt werden. Wider Erwarten konnte jedoch kein zusätzlicher biologischer Effekt durch die Co-immobilisierung von RGD und VEGF im Vergleich zu den einzeln immobilisierten Faktoren gezeigt werden. Um zu einer klinischen Anwendung zu gelangen, ist es nun notwendig, das entwickelte Verfahren in Bezug auf die immobilisierten Mengen der verschiedenen Faktoren hin zu optimieren. rn

VEGF incorporated into calcium phosphate ceramics promotes vascularisation and bone formation in vivo

Bone formation and osseointegration of biomaterials are dependent on angiogenesis and vascularization. Angiogenic growth factors such as vascular endothelial growth factor (VEGF) were shown to promote biomaterial vascularization and enhance bone formation. However, high local concentrations of VEGF induce the formation of malformed, nonfunctional vessels. We hypothesized that a continuous delivery of low concentrations of VEGF from calcium phosphate ceramics may increase the efficacy of VEGF administration.VEGF was co-precipitated onto biphasic calcium phosphate (BCP) ceramics to achieve a sustained release of the growth factor. The co-precipitation efficacy and the release kinetics of the protein were investigated in vitro. For in vivo investigations BCP ceramics were implanted into critical size cranial defects in Balb/c mice. Angiogenesis and microvascularization were investigated over 28 days by means of intravital microscopy. The formation of new bone was determined histomorphometrically. Co-precipitation reduced the burst release of VEGF. Furthermore, a sustained, cell-mediated release of low concentrations of VEGF from BCP ceramics was mediated by resorbing osteoclasts. In vivo, sustained delivery of VEGF achieved by protein co-precipitation promoted biomaterial vascularization, osseointegration, and bone formation. Short-term release of VEGF following superficial adsorption resulted in a temporally restricted promotion of angiogenesis and did not enhance bone formation. The release kinetics of VEGF appears to be an important factor in the promotion of biomaterial vascularization and bone formation. Sustained release of VEGF increased the efficacy of VEGF delivery demonstrating that a prolonged bioavailability of low concentrations of VEGF is beneficial for bone regeneration.

Safety and Efficacy of Ranibizumab in Diabetic Macular Edema (RESOLVE Study): A 12-month, randomized, controlled, double-masked, multicenter phase II study

The expression of vascular endothelial growth factor (VEGF) is elevated in diabetic macular edema (DME). Ranibizumab binds to and inhibits multiple VEGF variants. We investigated the safety and efficacy of ranibizumab in DME involving the foveal center.

VEGF-A promotes intussusceptive angiogenesis in the developing chicken chorioallantoic membrane

To assess the impact of vascular endothelial growth factor (VEGF) on intussusceptive angiogenesis.

Clinical outcome with bevacizumab in patients with recurrent high-grade glioma treated outside clinical trials

Patients with recurrent high-grade glioma (HGG) have a poor prognosis and there is no defined standard of care. High levels of vascular endothelial growth factor (VEGF) expressed in HGG make the anti-VEGF monoclonal antibody bevacizumab (BEV) of particular interest.

Behavior of SD-OCT-detected hyperreflective foci in the retina of anti-VEGF-treated patients with diabetic macular edema

Hyperreflective foci (HFs) are observable within the neurosensory retina in diabetic macular edema (DME) using spectral domain optical coherence tomography (SD-OCT). HFs have also been seen in wet age-related macular degeneration (AMD), although the origin is still unknown; however, they reduced significantly during anti-VEGF (vascular endothelial growth factor) therapy, and their baseline amount seemed to correlate with treatment success. In this study the behavior of HFs was evaluated during anti-VEGF therapy for DME.

Expression of HB-EGF by retinal pigment epithelial cells in vitreoretinal proliferative disease

The heparin-binding epidermal growth factor-like growth factor (HB-EGF) has been implicated in wound-healing processes of various tissues. However, it is not known whether HB-EGF may represent a factor implicated in overstimulated wound-healing processes of the retina during proliferative retinopathies. Therefore, we investigated whether human retinal pigment epithelial (RPE) cells, which are crucially involved in proliferative retinopathies, express and respond to HB-EGF. RPE cells express mRNAs for various members of the EGF-related growth factor family, among them for HB-EGF, as well as for the EGF receptors ErbB1, -2, -3, and -4. The gene expression of HB-EGF is stimulated in the presence of transforming and basic fibroblast growth factors and by oxidative stress and is suppressed during chemical hypoxia. Exogenous HB-EGF stimulates proliferation and migration of RPE cells and the gene and protein expression of the vascular endothelial growth factor (VEGF). HB-EGF activates at least three signal transduction pathways in RPE cells including the extracellular signal-regulated kinases (involved in the proliferation-stimulating action of HB-EGF), p38 (mediates the effects on chemotaxis and secretion of VEGF), and the phosphatidylinositol-3 kinase (necessary for the stimulation of chemotaxis). In epiretinal membranes of patients with proliferative retinopathies, HB-EGF immunoreactivity was partially colocalized with the RPE cell marker, cytokeratins; this observation suggests that RPE cell-derived HB-EGF may represent one factor that drives the uncontrolled wound-healing process of the retina. The stimulating effect on the secretion of VEGF may suggest that HB-EGF is also implicated in the pathological angiogenesis of the retina.

Pericytes and the pathogenesis of diabetic retinopathy

Pericytes provide vascular stability and control endothelial proliferation. Pericyte loss, microaneurysms, and acellular capillaries are characteristic for the diabetic retina. Platelet-derived growth factor (PDGF)-B is involved in pericyte recruitment, and brain capillaries of mice with a genetic ablation of PDGF-B show pericyte loss and microaneurysms. We investigated the role of capillary coverage with pericytes in early diabetic retinopathy and the contribution to proliferative retinopathy using mice with a single functional allele of PDGF-B (PDGF-B(+/-) mice). As assessed by quantitative morphometry of retinal digest preparations, pericyte numbers in nondiabetic PDGF-B(+/-) mice were reduced by 30% compared with wild-type mice, together with a small but significant increase in acellular capillaries. Pericyte numbers were reduced by 40% in diabetic wild-type mice compared with nondiabetic wild-type controls. Pericyte numbers were decreased by 50% in diabetic PDGF-B(+/-) mice compared with nondiabetic wild-type littermates, and the incidence of acellular capillaries was increased 3.5-fold when compared with nondiabetic PDGF-B(+/-) mice. To investigate the effect of pericyte loss in the context of ongoing angiogenesis, we subjected mice to hypoxia-induced proliferative retinopathy. As a result, PDGF-B(+/-) mice developed twice as many new blood vessels as their wild-type littermates. We conclude that retinal capillary coverage with pericytes is crucial for the survival of endothelial cells, particularly under stress conditions such as diabetes. At high vascular endothelial growth factor levels, such as those in the retinopathy of prematurity model, pericyte deficiency leads to reduced inhibition of endothelial proliferation in vivo.

The systemic angiogenic response during bone healing

INTRODUCTION: Angiogenesis is known to be a critical and closely regulated step during bone formation and fracture healing driven by a complex interaction of various cytokines. Delays in bone healing or even nonunion might therefore be associated with altered concentrations of specific angiogenic factors. These alterations might in turn be reflected by changes in serum concentrations. METHOD: To determine physiological time courses of angiogenic cytokines during fracture healing as well as possible changes associated with failed consolidation, we prospectively collected serum samples from patients who had sustained surgical treatment for a long bone fracture. Fifteen patients without fracture healing 4 months after surgery (nonunion group) were matched to a collective of 15 patients with successful healing (union group). Serum concentrations of angiogenin (ANG), angiopoietin 2 (Ang-2), basic fibroblast growth factor (bFGF), platelet derived growth factor AB (PDGF-AB), pleiotrophin (PTN) and vascular endothelial growth factor (VEGF) were measured using enzyme linked immunosorbent assays over a period of 24 weeks. RESULTS: Compared to reference values of healthy uninjured controls serum concentrations of VEGF, bFGF and PDGF were increased in both groups. Peak concentrations of these cytokines were reached during early fracture healing. Serum concentrations of bFGF and PDGF-AB were significantly higher in the union group at 2 and 4 weeks after the injury when compared to the nonunion group. Serum concentrations of ANG and Ang-2 declined steadily from the first measurement in normal healing fractures, while no significant changes over time could be detected for serum concentrations of these factures in nonunion patients. PTN serum levels increased asymptotically over the entire investigation in timely fracture healing while no such increase could be detected during delayed healing. CONCLUSION: We conclude that fracture healing in human subjects is accompanied by distinct changes in systemic levels of specific angiogenic factors. Significant alterations of these physiologic changes in patients developing a fracture nonunion over time could be detected as early as 2 (bFGF) and 4 weeks (PDGF-AB) after initial trauma surgery.

Mechanistic and therapeutic implications of angiogenesis in endometriosis

Like tumor metastases, endometriotic implants require neovascularization to proliferate and invade into ectopic sites within the host. Endometrial tissue, with its robust stem cell populations and remarkable regenerative capabilities, is a rich source of proangiogenic factors. Among the most potent and extensively studied of these proteins, vascular endothelial growth factor has emerged as a critical vasculogenic regulator in endometriosis. Accordingly, angiogenesis of the nascent endometriotic lesion has become an attractive target for novel medical therapeutics and strategies to inhibit vascular endothelial growth factor action. Vascular endothelial growth factor gene regulation in endometrial and endometriosis cells by nuclear receptors, other transcription factors, and also by infiltrating immune cells is emphasized. New data showing that oxidative and endoplasmic reticulum stress increase vascular endothelial growth factor expression are provided. Finally, we review the clinical implications of angiogenesis in this condition and propose potential antiangiogenic therapies that may become useful in the control or eradication of endometriotic lesions.

Effects of Combined Bevacizumab and Paclitaxel on Tumor Interstitial Fluid Pressure in a Preclinical Breast Cancer Model

Effects of Combined Bevacizumab and Paclitaxel on Tumor Interstitial Fluid Pressure in a Preclinical Breast Cancer Model by Ricardo H. Alvarez Several mechanisms of cell resistance are often accountable for unsuccessful chemotherapy against cancer. Another reason, which has received increased attention, is the inefficient transport of anticancer drugs into tumor tissue. These impaired transports of chemotherapy into the tumor have been attributed to abnormal microvasculature and to pathologically increased tumor hypertension also called: interstitial fluid pressure (IFP). The pathophysiological processes leading to elevated tumor IFP are poorly understood. Here, in a preclinical breast cancer model, it is argued that a condition of raised IFP is a major factor in preventing optimal access of systemically administered chemotherapy agents. In our experimental model, we used a GILM2 human breast cancer in xenografts; mice were treated with different doses of paclitaxel –a widely used antimicrotubular agent, and bevacizumab –monoclonal antibody against vascular endothelial growth factor (VEGF). The proposed research project is designed to test the hypothesis that paclitaxel in combination with bevacizumab decreases the tumor IPF by restoring tumor permeability and increasing chemotherapy delivery. We demonstrated that the combination of paclitaxel and bevacizumab produced greater tumor control than either agent given alone and this combination reduced the IFP, producing an increment of 75% of apoptosis compared with the control arm. In addition, the intra-tumor paclitaxel quantification by liquid chromatography/Mass Spectrometry (LC/MS) demonstrated that lower dose of both agents showed a synergistic effect compared with high dose of treatment, where there is no significantly increase of paclitaxel into the tumor. These preclinical results are likely to have broad implications for the utility of anti-angiogenic therapies alone and in combination with chemotherapeutic agents.

Effect of VEGF treatment on the blood-spinal cord barrier permeability in experimental spinal cord injury: dynamic contrast-enhanced magnetic resonance imaging.

Compromised blood-spinal cord barrier (BSCB) is a factor in the outcome following traumatic spinal cord injury (SCI). Vascular endothelial growth factor (VEGF) is a potent stimulator of angiogenesis and vascular permeability. The role of VEGF in SCI is controversial. Relatively little is known about the spatial and temporal changes in the BSCB permeability following administration of VEGF in experimental SCI. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) studies were performed to noninvasively follow spatial and temporal changes in the BSCB permeability following acute administration of VEGF in experimental SCI over a post-injury period of 56 days. The DCE-MRI data was analyzed using a two-compartment pharmacokinetic model. Animals were assessed for open field locomotion using the Basso-Beattie-Bresnahan score. These studies demonstrate that the BSCB permeability was greater at all time points in the VEGF-treated animals compared to saline controls, most significantly in the epicenter region of injury. Although a significant temporal reduction in the BSCB permeability was observed in the VEGF-treated animals, BSCB permeability remained elevated even during the chronic phase. VEGF treatment resulted in earlier improvement in locomotor ability during the chronic phase of SCI. This study suggests a beneficial role of acutely administered VEGF in hastening neurobehavioral recovery after SCI.

Prognostic role of FGFR1 amplification in early-stage non-small cell lung cancer.

Background:Recently, fibroblast growth factor receptor 1 (FGFR1) was discovered in squamous cell carcinomas (SCC) of the lung with FGFR1 amplification described as a promising predictive marker for anti-FGFR inhibitor treatment. Only few data are available regarding prevalence, prognostic significance and clinico-pathological characteristics of FGFR1-amplified and early-stage non-small cell lung carcinomas (NSCLC). We therefore investigated the FGFR1 gene status in a large number of well-characterised early-stage NSCLC.Methods:FGFR1 gene status was evaluated using a commercially available fluorescent in situ hybridisation (FISH) probe on a tissue microarray (TMA). This TMA harbours 329 resected, formalin-fixed and paraffin-embedded, nodal-negative NSCLC with a UICC stage I-II. The FISH results were correlated with clinico-pathological features and overall survival (OS).Results:The prevalence of an FGFR1 amplification was 12.5% (41/329) and was significantly (P<0.0001) higher in squamous cell carcinoma (SCC) (20.7%) than in adenocarcinoma (2.2%) and large cell carcinoma (13%). Multivariate analysis revealed significantly (P=0.0367) worse 5-year OS in patients with an FGFR1-amplified NSCLC.Conclusions:FGFR1 amplification is common in early-stage SCC of the lung and is an independent and adverse prognostic marker. Its potential role as a predictive marker for targeted therapies or adjuvant treatment needs further investigation.

Soluble FLT1 binds lipid microdomains in podocytes to control cell morphology and glomerular barrier function.

Vascular endothelial growth factor and its receptors, FLK1/KDR and FLT1, are key regulators of angiogenesis. Unlike FLK1/KDR, the role of FLT1 has remained elusive. FLT1 is produced as soluble (sFLT1) and full-length isoforms. Here, we show that pericytes from multiple tissues produce sFLT1. To define the biologic role of sFLT1, we chose the glomerular microvasculature as a model system. Deletion of Flt1 from specialized glomerular pericytes, known as podocytes, causes reorganization of their cytoskeleton with massive proteinuria and kidney failure, characteristic features of nephrotic syndrome in humans. The kinase-deficient allele of Flt1 rescues this phenotype, demonstrating dispensability of the full-length isoform. Using cell imaging, proteomics, and lipidomics, we show that sFLT1 binds to the glycosphingolipid GM3 in lipid rafts on the surface of podocytes, promoting adhesion and rapid actin reorganization. sFLT1 also regulates pericyte function in vessels outside of the kidney. Our findings demonstrate an autocrine function for sFLT1 to control pericyte behavior.