928 resultados para Cellular infiltration
Resumo:
A large body of literature documents in both mice and Drosophila the involvement of Insulin pathway in growth regulation, probably due to its role in glucose and lipid import, nutrient storage, and translation of RNAs implicated in ribosome biogenesis (Vanhaesebroeck et al. 2001). Moreover several lines of evidence implicate this pathway as a causal factor in cancer (Sale, 2008; Zeng and Yee 2007; Hursting et al., 2007; Chan et al., 2008). With regards to Myc, studies in cell culture have implied this family of transcription factors as regulators of the cell cycle that are rapidly induced in response to growth factors. Myc is a potent oncogene, rearranged and overexpressed in a wide range of human tumors and necessary during development. Its conditional knock-out in mice results in reduction of body weight due to defect in cell proliferation (Trumpp et al. 2001). Evidence from in vivo studies in Drosophila and mammals suggests a critical function for myc in cell growth regulation (Iritani and Eisenman 1999; Johnston et al. 1999; Kim et al. 2000; de Alboran et al. 2001; Douglas et al. 2001). This role is supported by our analysis of Myc target genes in Drosophila, which include genes involved in RNA binding, processing, ribosome biogenesis and nucleolar function (Orain et al 2003, Bellosta et al., 2005, Hulf et al, 2005). The fact that Insulin signaling and Myc have both been associated with growth control suggests that they may interact with each other. However, genetic evidence suggesting that Insulin signaling regulates Myc in vivo is lacking. In this work we were able to show, for the first time, a direct modulation of dMyc in response to Insulin stimulation/silencing both in vitro and in vivo. Our results suggest that dMyc up-regulation in response to DILPs signaling occurs both at the mRNA and potein level. We believe dMyc protein accumulation after Insulin signaling activation is conditioned to AKT-dependent GSK3β/sgg inactivation. In fact, we were able to demonstate that dMyc protein stabilization through phosphorylation is a conserved feature between Drosophila and vertebrates and requires multiple events. The final phosphorylation step, that results in a non-stable form of dMyc protein, ready to be degraded by the proteasome, is performed by GSK3β/sgg kinase (Sears, 2004). At the same time we demonstrated that CKI family of protein kinase are required to prime dMyc phosphorylation. DILPs and TOR/Nutrient signalings are known to communicate at several levels (Neufeld, 2003). For this reason we further investigated TOR contribution to dMyc-dependent growth regulation. dMyc protein accumulates in S2 cells after aminoacid stimulation, while its mRNA does not seem to be affected upon TORC1 inhibition, suggesting that the Nutrient pathway regulates dMyc mostly post-transcriptionally. In support to this hypothesis, we observed a TORC1-dependent GSK3β/sgg inactivation, further confirming a synergic effect of DILPs and Nutrients on dMyc protein stability. On the other hand, our data show that Rheb but not S6K, both downstream of the TOR kinase, contributes to the dMyc-induced growth of the eye tissue, suggesting that Rheb controls growth independently of S6K.. Moreover, Rheb seems to be able to regulate organ size during development inducing cell death, a mechanism no longer occurring in absence of dmyc. These observations suggest that Rheb might control growth through a new pathway independent of TOR/S6K but still dependent on dMyc. In order to dissect the mechanism of dMyc regulation in response to these events, we analyzed the relative contribution of Rheb, TOR and S6K to dMyc expression, biochemically in S2 cells and in vivo in morphogenetic clones and we further confirmed an interplay between Rheb and Myc that seems to be indipendent from TOR. In this work we clarified the mechanisms that stabilize dMyc protein in vitro and in vivo and we observed for the first time dMyc responsiveness to DILPs and TOR. At the same time, we discovered a new branch of the Nutrient pathway that appears to drive growth through dMyc but indipendently from TOR. We believe our work shed light on the mechanisms cells use to grow or restrain growth in presence/absence of growth promoting cues and for this reason it contributes to understand the physiology of growth control.
Resumo:
The Ctr family is an essential part of the copper homeostasis machinery and its members share sequence homology and structural and functional features. Higher eukaryotes express two members of this family Ctr1 and Ctr2. Numerous structural and functional studies are available for Ctr1, the only high affinity Cu(I) transporter thus far identified. Ctr1 holigotrimers mediate cellular copper uptake and this protein was demonstrated to be essential for embryonic development and to play a crucial role in dietary copper acquisition. Instead very little is known about Ctr2, it bears structural homology to the yeast vacuolar copper transporter, which mediates mobilization of vacuolar copper stores. Recent studies using over-expressed epitope-tagged forms of human Ctr2 suggested a function as a low affinity copper transporter that can mediate either copper uptake from the extracellular environment or mobilization of lysosomal copper stores. Using an antibody that recognizes endogenous mouse Ctr2, we studied the expression and localization of endogenous mouse Ctr2 in cell culture and in mouse models to understand its regulation and function in copper homeostasis. By immunoblot we observed a regulation of mCtr2 protein levels in a copper and Ctr1 dependent way. Our observations in cells and transgenic mice suggest that lack of Ctr1 induces a strong downregulation of Ctr2 probably by a post-translational mechanism. By indirect immunofluorescence we observed an exclusive intracellular localization in a perinuclear compartment and no co-localization with lysosomal markers. Immunofluorescence experiments in Ctr1 null cells, supported by sequence analysis, suggest that lysosomes may play a role in mCtr2 biology not as resident compartment, but as a degradation site. In appendix a LC-mass method for analysis of algal biotoxins belonging to the family of PsP (paralytic shellfish poisoning) is described.
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In the present study we analyzed new neuroprotective therapeutical strategies in PD (Parkinson’s disease) and AD (Alzheimer’s disease). Current therapeutic strategies for treating PD and AD offer mainly transient symptomatic relief but it is still impossible to block the loss of neuron and then the progression of PD and AD. There is considerable consensus that the increased production and/or aggregation of α- synuclein (α-syn) and β-amyloid peptide (Aβ), plays a central role in the pathogenesis of PD, related synucleinopathies and AD. Therefore, we identified antiamyloidogenic compounds and we tested their effect as neuroprotective drug-like molecules against α-syn and β-amyloid cytotoxicity in PC12. Herein, we show that two nitro-catechol compounds (entacapone and tolcapone) and 5 cathecol-containing compounds (dopamine, pyrogallol, gallic acid, caffeic acid and quercetin) with antioxidant and anti-inflammatory properties, are potent inhibitors of α-syn and β-amyloid oligomerization and fibrillization. Subsequently, we show that the inhibition of α-syn and β-amyloid oligomerization and fibrillization is correlated with the neuroprotection of these compounds against the α-syn and β-amyloid-induced cytotoxicity in PC12. Finally, we focused on the study of the neuroprotective role of microglia and on the possibility that the neuroprotection properties of these cells could be use as therapeutical strategy in PD and AD. Here, we have used an in vitro model to demonstrate neuroprotection of a 48 h-microglial conditioned medium (MCM) towards cerebellar granule neurons (CGNs) challenged with the neurotoxin 6-hydroxydopamine (6-OHDA), which induces a Parkinson-like neurodegeneration, with Aβ42, which induces a Alzheimer-like neurodegeneration, and glutamate, involved in the major neurodegenerative diseases. We show that MCM nearly completely protects CGNs from 6-OHDA neurotoxicity, partially from glutamate excitotoxicity but not from Aβ42 toxin.
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Desmosomen sind hoch organisierte adhäsive interzelluläre Verbindungen, die benachbarte Zellen durch Verankerung mit den Intermediärfilamenten des Zytoskeletts miteinander verknüpfen und so Zellen und Geweben Stabilität verleihen. Die Adhäsionsmoleküle der Desmosomen sind die desmosomalen Cadherine. Diese transmembranen Glykoproteine gehen im Interzellulärraum Verbindungen mit den desmosomalen Cadherinen der Nachbarzelle ein und sind im zytoplasmatischen Bereich Anheftungspunkte für weitere an der Desmosomenbildung beteiligte Proteine. Ziel dieser Arbeit war die Untersuchung der Rolle von Desmoglein 2 (Dsg 2), einem in allen Epithelien exprimierten desmosomalen Cadherin. Da der konstitutive knock out von Dsg 2 embryonal letal ist, wurde im Rahmen dieser Doktorarbeit eine transgene Maus generiert, in der die Reduktion von Dsg 2 temporär regulierbar war (konditionaler knock down). Dazu wurde der Mechanismus der RNA Interferenz genutzt, wodurch Sequenz-spezifische, post-transkriptionelle Regulation von Genen möglich ist. Unter Verwendung eines über Cre/lox-induzierbaren Vektors wurden transgene Mäuse generiert, welche nach Induktion Dsg 2 shRNA exprimieren, die in der Zelle in siRNA umgewandelt wird und zum Abbau der Dsg 2 mRNA führt. Durch Verpaarung der generierten Dsg 2 knock down Maus mit der über Tamoxifen induzierbaren Cre Deleter knock in Mauslinie Rosa26CreERT2 konnte deutliche Reduktion der Dsg 2 Proteinmenge in Leber, Darm und Herz erreicht werden. In Immunfärbungen der Leber wurde zudem eine reduzierte Desmosomenbildung durch Expression der Dsg 2 shRNA detektiert. Die für diese Versuche generierte und getestete Rosa26CreERT2 Mauslinie ermöglichte jedoch nicht in allen Zellen eines Gewebes die komplette Aktivierung der Cre Rekombinase und damit die Expression der shRNA. Dadurch entstanden mosaikartige Wildtyp/knock down-Gewebe, in denen noch ausreichend Desmosomen gebildet wurden, um die Gewebestabilität und -struktur zu erhalten. Für eine funktionale Untersuchung von Dsg 2 in Zusammenhang mit der chronisch entzündlichen Darmerkrankung Colitis ulcerosa wurden die Dsg 2 knock down Mäuse mit Darm-spezifischen, induzierbaren Cre Deleter Mäusen (VillinCreERT2) verpaart. Nach Aktivierung der Cre Rekombinase mittels Tamoxifen wurde in bitransgenen Tieren über Gabe von Azoxymethan (AOM) und Dextransodiumsulfat (DSS) Colitis ulcerosa induziert. Diese entzündliche Erkrankung des Darms ist mit der Induktion von Darmtumoren assoziiert. Bereits nach einmaliger Induktion mit AOM/DSS wurde in der ersten endoskopischen Untersuchung eine starke Entzündung des Darmgewebes und die Ausbildung von flächig wachsenden Tumoren in den Dsg 2 knock down Tieren hervorgerufen. Es ist anzunehmen, dass durch knock down von Dsg 2, und die damit verbundene verminderte Desmosomenbildung und Zelladhäsion, Infiltration von Bakterien durch die epitheliale Barriere des Darms möglich war, und so die Entzündungsreaktion in der Darmmukosa verstärkte. In Zusammenhang mit Verlust der epithelialen Festigkeit durch verringerte Zellkontakte kam es zur Hyperproliferation der Darmmukosa, die sich in Ausbildung von flächigen Tumoren äußerte. In weiteren Experimenten müssen nun die Tumore und das entzündete Gewebe der Colitis-induzierten Mäuse mittels Immunfluoreszenz untersucht werden, um Veränderungen in der Desmosomenformation in situ detektieren zu können. Des Weiteren sind Verpaarungen der Dsg 2 knock down Maus mit anderen Cre Rekombinase exprimierenden Mauslinien möglich, um den Einfluss von Dsg 2 auch in anderen Geweben, beispielsweise im Herzen, zu untersuchen. Die hier vorgelegte Arbeit zeigt also erstmalig den ursächlichen Zusammenhang zwischen Dsg 2 und dem Auftreten von Colitis-assoziierten Tumoren in einem konditionalen RNAi-vermittelten knock down Tiermodell. Die Etablierung dieser Maus ist somit das erste konditionale Mausmodell, welches die bei vielen Krebspatienten gefundenen flachzellig wachsenden Tumore in vivo rekapituliert. Vorausschauend kann man sagen, dass mit Hilfe des im Rahmen dieser Doktorarbeit entwickelten Tiermodells wichtige Erkenntnisses über die Pathologie von Darmtumoren erbracht werden können, die unser Verständnis der Colitis-induzierten Tumorentstehung verbessern.
Resumo:
The detection of Colorectal Cancer (CRC), at early stages, is one of the proven strategies resulting in a higher cure rate. In recent years, several studies have appeared identifying potential cancer markers in serum, plasma and stool in an attempt to improve actual screening procedures. Thus, the aim of the study was (1) Evaluate MN frequency, (2) Evaluate plasma ultrafiltrate capacity to induce MN formation, (3) Evaluate SEPT9 and NOTCH3 promoter methylation profile in peripheral blood lymphocytes from subjects resulted positive to fecal occult blood test and examined by colonoscopy. MN frequency was significantly higher in subjects with histological diagnosis of CRC and adenoma than control (p ≤ 0.001 and p ≤ 0.01, respectively). About, CF-MN analysis, a statistically significant difference was observed between CRC and control (p ≤ 0.05). On the other hand, SEPT9 and NOTCH3 promoter methylation status was significantly lower in CRC subjects than controls; additionally, NOTCH3 promoter methylation status was significantly lower in CRC subjects than adenoma subjects (p ≤ 0.01). The results obtained allow conclude that MN frequency varies according CRC pathologic status and, together with other variables, is a valid biomarker for adenoma and CRC risk. Additionally, the plasma of patients affected with CRC not only serve as a biomarker for oxidative stress but also as biomarker of genetic damage correlated with the carcinogenic process that verifies in colon-rectum. SEPT9 and NOTCH3 promoter methylation status, at peripheral blood level, varies according hystopathological changes observed in colon-rectum, suggesting that promoter methylation profile of these genes could be a reliable biomarker for CRC risk.
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Staphylococcus aureus alpha-hemolysin was the first bacterial toxin recognized to form pores in the plasma membrane of eukaryotic cells. It is secreted as a water-soluble monomer that upon contact with target membranes forms an amphiphatic heptameric beta-barrel which perforates the bilayer. As a consequence, red cells undergo colloidosmotic lyses, while some nucleated cells may succumb to necrosis or programmed cell death. However, most cells are capable of repairing a limited number of membrane lesions, and then respond with productive transcriptional activation of NF-kB. In the present study, by using microarray and semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR), data from a previously performed serial analysis of gene expression (SAGE) were extended and verified, revealing that immediate early genes (IEGs) such as c-fos, c-jun and egr-1 are strongly induced at 2-8 h after transient toxin treatment. Activating protein 1 (AP-1: c-Fos, c-Jun) binding activity was increased accordingly. As IEGs are activated by growth factors, these findings led to the discovery that -toxin promotes cell cycle progression of perforated cells in an EGFR-dependent fashion. Although the amount of c-fos mRNA rose rapidly after toxin treatment, c-Fos protein expression was observed only after a lag of about 3 h. Since translation consumes much ATP, which transiently drops after transient membrane perforation, the suspicion arised that membrane-perforation caused global, but temporary downregulation of translation. In fact, eIF2α became heavily phosphorylated minutes after cells had been confronted with the toxin, resulting in shutdown of protein synthesis before cellular ATP levels reached the nadir. GCN2 emerged as a candidate eIF2α kinase, since its expression rapidly increased in toxin-treated cells. Two hours after toxin treatment, GADD34 transcripts, encoding a protein that targets the catalytic subunit of protein phosphatase 1 (PP1) to the endoplasmic reticulum, were overexpressed. This was followed by dephosphorylation of eIF2α and resumption of protein synthesis. Addition of tautomycetin, a specific inhibitor of PP1, led to marked hyperphosphorylation of eIF2α and significantly reduced the drop of ATP-levels in toxin-treated cells. A novel link between two major stress-induced signalling pathways emerged when it was found that both translational arrest and restart were under the control of stress-activated protein kinase (SAPK) p38. The data provide an explanation for the indispensible role of p38 for defence against the archetypal threat of membrane perforation by agents that produce small transmembrane-pores.
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Cross Reacting Material 197(CRM197) is a Diphteria toxin non toxic mutant that had shown anti-tumor activity in mice and humans. CRM197 is utilized as a specific inhibitor of heparin-binding epidermal growth factor (HB-EGF), that competes for the epidermal growth factor receptor (EGFR), overexpressed in colorectal cancer and implicated in its progression. We evaluated the effects of CRM197 on HT-29 human colon cancer cell line behaviour and, for CRM197 recognized ability to inhibit HB-EGF, its possible effects on EGFR activation. In particular, while HT-29 does not show any reduction of viability after CRM197 treatment, or changes in cell cycle distribution, in EGFR localization or activation, they show a change in gene expression profile analyzed by microarray. This is the first study where the CRM197 treatment on HT-29 show the alteration of a specific and selected number of genes.
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My Doctorate Research has been focused on the evaluation of the pharmacological activity of a natural extract of chestnut wood (ENC) towards the cardiovascular and gastrointestinal system and on the identification of the active compounds. The ENC has been shown to contain more than 10% (w/w) of phenolic compounds, of which tannins as Vescalgin and Castalgin are the more representative. ENC cardiovascular effects have been investigated in guinea pig cardiac preparations; furthermore its activity has been evalueted in guinea pig aorta strips. ENC induced transient negative chronotropic effect in isolated spontaneously beating right atria and simultaneously positive inotropic effect in left atria driven at 1 Hz. Cardiac cholinergic receptors are not involved in the negative chronotropic effect and positive inotropic effects are not related to adrenergic receptors. In vascular smooth muscle, natural extract of chestnut did not significantly change the contraction induced by potassium (80 mM) or that induced by noradrenaline (1μM). In guinea pig ileum, ENC reduced the maximum response to carbachol in a concentrationdependent manner and behaved as a reversible non competitive antagonist. In guinea pig ileum, the antispasmodic activity of ENC showed a significant antispasmodic activity against a variety of different spasmogenic agents including histamine, KCl, BaCl2. In guinea pig proximal colon, stomach and jejunum, ENC reduced the maximum response to carbachol in a concentrationdependent manner and behaved as a reversible non competitive antagonist. ENC contracted gallbladder guinea pig in a reversible and concentration-dependent manner. This effect does not involve cholinergic and cholecystokinin receptors and it is reduced by nifedipine. ENC relaxed Oddi sphincter smooth muscle. The cholecystokinetic and Oddi sphincter relaxing activities occurred also in guinea pigs fed a lithogenic diet. The cholecystokinetic occurred also in human gallbladder. The Fractionation of the extract led to the identification of the active fraction.
Resumo:
IL-33/ST2 axis is known to promote Th2 immune responses and has been linked to several autoimmune and inflammatory disorders, including inflammatory bowel disease (IBD), and recent evidences show that it can regulate eosinophils (EOS) infiltration and function. Based also on the well documented relationship between EOS and IBD, we assessed the role of IL-33-mediated eosinophilia and ileal inflammation in SAMP1/YitFc (SAMP) murine model of Th1/Th2 chronic enteritis, and we found that IL-33 is related to inflammation progression and EOS infiltration as well as IL-5 and eotaxins increase. Administering IL-33 to SAMP and AKR mice augmented eosinophilia, eotaxins mRNA expression and Th2 molecules production, whereas blockade of ST2 and/or typical EOS molecules, such as IL-5 and CCR3, resulted in a marked decrease of inflammation, EOS infiltration, IL-5 and eotaxins mRNA expression and Th2 cytokines production. Human data supported mice’s showing an increased colocalization of IL-33 and EOS in the colon mucosa of UC patients, as well as an augmented IL-5 and eotaxins mRNA expression, when compared to non-UC. Lastly we analyzed SAMP raised in germ free (GF) condition to see the microbiota effect on IL-33 expression and Th2 responses leading to chronic intestinal inflammation. We found a remarkable decrease in ileal IL-33 and Th2 cytokines mRNA expression as well as EOS infiltration in GF versus normal SAMP with comparable inflammatory scores. Moreover, EOS depletion in normal SAMP didn’t affect IL-33 mRNA expression. These data demonstrate a pathogenic role of IL-33-mediated eosinophilia in chronic intestinal inflammation, and that blockade of IL-33 and/or downstream EOS activation may represent a novel therapeutic modality to treat patients with IBD. Also they highlight the gut microbiota role in IL-33 production, and the following EOS infiltration in the intestinal mucosa, confirming that the microbiota is essential in mounting potent Th2 response leading to chronic ileitis in SAMP.
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Low density lipoprotein (LDL) wird in der Arterienwand enzymatisch gespalten. Das Produkt, E-LDL, enthält neben freiem Cholesterol unveresterte Fettsäuren und induziert die Produktion von Interleukin 8 (IL-8) in Endothelzellen. Der Transkriptionsfaktor nuclear factor-kappaB (NF-κB), der das IL-8-Gen normalerweise reguliert, wurde durch E-LDL jedoch nicht aktiviert: Das veränderte Lipoprotein bewirkte im Gegenteil eine Hemmung von NF-κB vor dessen Translokation in den Zellkern. In E-LDL enthaltene freie Fettsäuren waren für die Hemmung verantwortlich. Dagegen aktivierte E-LDL den Transkriptionsfaktor AP-1, wie durch Phosphorylierung von c-jun gezeigt wurde. IL-8 lockt polymorphkernige Granulozyten (PMN) an, die jedoch in der frühen atherosklerotischen Läsion nicht vorkommen. Die vorliegende Arbeit bietet eine mögliche Erklärung für ihre Abwesenheit: PMN zeigten sich wesentlich empfindlicher gegenüber der Toxizität von E-LDL als Makrophagen. Es ist denkbar, daß sie in die Läsion zwar einwandern, nach ihrem raschen Tod dort jedoch nicht mehr detektiert werden können. E-LDL aktivierte PMN, wie durch Superoxidbildung und Peroxidasefreisetzung gezeigt wurde. Sowohl Aktivierung als auch Toxizität wurden von den in E-LDL enthaltenen freien Fettsäuren verursacht, die eine direkte Schädigung der Zellmembran bewirkten. Die E-LDL-bedingte Freisetzung proinflammatorischer Substanzen aus PMN könnte ein Grund dafür sein, daß die Depletion dieser Zellen die Läsionsentwicklung hemmt.
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Cellular response to γ-rays is mediated by ATM-p53 axis. When p53 is phosphorylated, it can transactivate several genes to induce permanent cell cycle arrest (senescence) or apoptosis. Epithelial and mesenchymal cells are more resistant to radiation-induced apoptosis and respond mainly by activating senescence. Hence, tumor cells in a senescent state might remain as “dormant” malignant in fact through disruption of p53 function, cells may overcome growth arrest. Oncocytic features were acquired in the recurring neoplasia after radiation therapy in patient with colonrectal cancer. Oncocytic tumors are characterized by aberrant biogenesis and are mainly non-aggressive neoplasms. Their low proliferation degree can be explained by chronic destabilization of HIF1α, which presides to adaptation to hypoxia and also plays a pivotal role in hypoxia-related radio-resistance. The aim of the present thesis was to verify whether mitochondrial biogenesis can be induced following radiation treatment, in relation of HIF1α status and whether is predictive of a senescence response. In this study was demonstrate that mitochondrial biogenesis parameters like mitochondrial DNA copy number could be used for the prediction of hypoxic status of tissue after radiation treatment. γ-rays induce an increase of mitochondrial mass and function, in response to a genotoxic stress that pushes cells into senescence. Mitochondrial biogenesis is only indirectly regulated by p53, whose activation triggers a MDM2-mediated HIF1α degradation, leading to the release of PGC-1β inhibition by HIF1α. On the other hand, this protein blunts the mitochondrial response to γ-rays as well as the induction of p21-mediated cell senescence, indicating prevalence of the hypoxic over the genotoxic response. Finally in vivo, post-radiotherapy mtDNA copy number increase well correlates with lack of HIF1α increase in the tissue, concluding this may be a useful molecular tool to infer the trigger of a hypoxic response during radiotherapy, which may lead to failure of activation of senescence.
Resumo:
This was a retrospective study including ninety samples of dogs with a histological diagnosis of intermediate grade cutaneous mast cell tumour (MCT). The objectives of the study were to validate Minichromosome Maintenance Protein 7 (MCM7) as a prognostic marker in MCTs and to compare the ability of mitotic index (MI), Ki67 and MCM7 to predict outcome. The median survival for the entire population was not reached at 2099 days. The mean survival time was 1708 days. Seventy-two cases were censored after a median follow up of 1136 days and eighteen dogs died for causes related to the MCT after a median of 116 days. For each sample MI, Ki67 and MCM7 were determined. The Receiver Operating Characteristic (ROC) curve was obtained for each prognostic marker to evaluate the performance of the test, expressed as area under the curve, and whether the published threshold value was adequate. Kaplan-Meier and corresponding logrank test for MI, Ki67 and MCM7 as binary variables was highly significant (P<0.0001). Multivariable regression analysis of MI, Ki67 and MCM7 corrected for age and surgical margins indicated that the higher risk of dying of MCT was associated with MCM7 > 0.18 (Hazard Ration [HR] 14.7; P<0.001) followed by MI > 5 (HR 13.9; P<0.001) and Ki67 > 0.018 (HR 8.9; P<0.001). Concluding, the present study confirmed that MCM7 is an excellent prognostic marker in cutaneous MCTs being able to divide Patnaik intermediate grade tumours in two categories with different prognosis. Ki67 was equally good confirming its value as a prognostic marker in intermediate grade MCTs. The mitotic index was extremely specific, but lacked of sensitivity. Interestingly, mitotic index, Ki67 and MCM7 were independent from each other suggesting that their combination would improve their individual prognostic value.
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Ein neuer Ansatz der immunologischen Krebstherapie ist die Verwendung der bispezifischen, trifunktionalen Antikörper catumaxomab (anti-EpCAM x anti-CD3) und ertumaxomab (anti-Her2/neu x anti-CD3). Die Bispezifität besteht in der Bindung eines Tumor-assoziierten Antigens (EpCAM bzw. Her2/neu) und des CD3 Moleküls auf der Oberfläche von T-Zellen. Darüber hinaus stellt die Interaktion des Fc-Teils mit FcγRI/IIa/III positiven akzessorischen Immunzellen die dritte Funktion der Antikörper dar. Diese einzigartige Kombination ermöglicht theoretisch die Ausbildung eines Tri-Zell-Komplexes. In klinischen Studien konnte bereits die Wirksamkeit beider Antikörper nachgewiesen werden. Die eigentlichen Wirkmechanismen der trifunktionalen Antikörper jedoch sind noch nicht ausreichend bekannt. Um die Wechselwirkung zwischen den stark EpCAM- und schwach Her2/neu-positive FaDu- sowie den stabil mit humanem Her2/neu transfizierten FaDu E593-Tumorzellen, peripheren Blutmonozyten (PBMC) und trifunktionalen Antikörpern systematisch zu untersuchen wurde ein 3D-Tumormodell, die so genannten multizellulären Tumorsphäroide (MCTS), angewandt. Als Endpunkte zur Beurteilung der Therapieeffizienz dienten das Volumenwachstum der Sphäroide, sowie die Klonogenität und die Zellvitalität. Zur Beurteilung der PBMC-Penetration in die Sphäroide erfolgten immunhistochemische Färbungen und molekularbiologische Nachweise der Abwehrzellantigene. Entsprechend wurden in den Sphäroiden die Proliferationsrate über eine Ki67-Färbung sowie die Apoptoserate über eine FragEL-Markierung identifiziert. Die Aktivität der PBMC wurde durch die Bestimmung ausgewählter Zytokine (ELISA) und der Zellzahl aus den Medienüberständen charakterisiert. Die an den FaDu- und E593-Sphäroiden erzielten Ergebnisse zeigten, dass catumaxomab und ertumaxomab eine konzentrations- und zeitabhängige Abnahme des Sphäroidvolumens bewirkten. Die Schrumpfung der Tumorsphäroide ging mit einer Reduktion des proliferativen und mit einer Steigerung des apoptotischen Tumorzellanteils einher. Die histologischen Befunde weisen darauf hin, dass die Volumenreduktion durch eine gesteigerte Anzahl infiltrierender Leukozyten bedingt ist. Auf verschiedenen Methoden basierende Analysen der Immunzellsubtypen zeigten eine dominierende Infiltration von zytotoxischen T-Zellen in die Tumorsphäroide. Der Aktivitätsnachweis der T-Zellen wurde über die Detektion der IL-2 mRNA und des sekretierten Zytokins erbracht. Einen zusätzlichen Hinweis auf eine zelluläre Immunantwort liefert das Zytokinmuster mit hohen Konzentrationen an IFN-γ. Der direkte Vergleich beider Antikörper zeigte, dass der anti-tumorale Effekt abhängig von der Antigenexpression auf den Tumorzellen war. Die Analyse von Medienüberständen wies auf eine mehrheitlich höhere Zytokinausschüttung in Gegenwart des Tumorantigens hin. Sphäroid-Kokulturen, die mit dem parentalen anti-EpCAM Antikörper behandelt wurden, zeigten keine Volumenreduktion. Im Gegensatz dazu führte der parentale CD3-Antikörper, das CD3- und Tumorzell-bindende catumaxomab F(ab')2 Fragment oder eine Kombination beider parentaler Antikörper zu einer anti-tumoralen Wirkung, die jedoch nicht so stark war wie die des trifunktionalen Antikörpers catumaxomab. Demnach ist für catumaxomab gezeigt, dass für die Effektivität des Antikörpers die Trifunktionalität unabdingbar ist. Daraus leitet sich ab, dass die Aktivierung der Abwehrzellen durch kostimulatorische Signale notwendig ist und über die Tumorantigenbindung Mechanismen wie ADCC (antibody-dependent cellular cytotoxicity) zum Tragen kommen. Die Experimente mit gleichzeitiger Gabe von trifunktionalen Antikörpern und Immunsuppressiva haben gezeigt, dass eine Kombination beider Agenzien möglich ist. Die Konzentrationen sind jedoch sorgfältig derart zu wählen, dass die Zytokinausschüttung und die damit verbundenen Nebenwirkungen reduziert sind, ohne dass die anti-tumorale Wirkung der Antikörper maßgeblich beeinflusst wird. T-Zellen bedienen sich nach Aktivierung für die rasche Proliferation einer gesteigerten aeroben Glykolyse. Unter Behandlung der Kokulturen mit catumaxomab konnte im Vergleich zu anderen immunstimulatorischen Agenzien die größte Steigerung der Laktatproduktion bzw. der Azidifizierungs- und Sauerstoffverbrauchsrate detektiert werden. Diese Effekte weisen auf eine metabolische Aktivierung der PBMC durch catumaxomab hin. Das von den Tumorzellen abgegebene Laktat kann die Immunzellen jedoch inhibieren. Daher wäre die Kombination mit Glykolyseinhibitoren ein möglicher Ansatz, um die Therapieeffizienz weiter zu steigern. Darüber hinaus konnte gezeigt werden, dass eine Komedikation der trifunktionalen Antikörper mit Chemotherapeutika zu einer gesteigerter Wirkung führte. Insgesamt liegt die Zukunft der Immuntherapien wohl in der Kombination mit anderen Wirkstoffklassen, die anti-tumorale Effekte verstärken oder immunsupprimierende Mechanismen inhibieren.