Synthese und Charakterisierung von HPMA-stabilisierten Kolloiden sowie deren Evaluierung in vitro und in vivo

Nanodimensionale Wirkstoff-Trägersysteme sind in der Lage, sowohl die Bioverfügbarkeit als auch das pharmakokinetische Profil von Wirkstoffen drastisch zu verbessern. Hauptgründe dafür sind eine erhöhte Plasma-Halbwertszeit durch die größenbedingte verminderte renale Ausscheidung und eine gesteigerte Anreicherung im Tumorgewebe durch den EPR-Effekt. Diese Arbeit beschreibt die Synthese und Entwicklung neuer kolloidaler Wirkstoff-Trägersysteme, welche biokompatibel, teilweise bioabbaubar und funktionalisierbar sind. Ein Fluoreszenzfarbstoff wurde als hydrophobes Wirkstoffmodell eingekapselt. Wohldefinierte, eng verteilte und funktionalisierbare HPMA-basierte Block- und statistische Copolymere unterschiedlicher Molekulargewichte (10-25 kDa) und hydrophiler/hydrophober Zusammensetzung (10-50 mol%) wurden mittels RAFT- Polymerisation in Kombination mit dem Reaktivesteransatz hergestellt und in Miniemulsionsprozesse eingesetzt, um ihre Stabilisierungseffizienz zu untersuchen. Dabei zeigte sich, dass die kleineren Copolymere (10 kDa) mit einem Einbau von 10 mol% LMA, sowohl im Modellsystem Polystyrol, als auch im bioabbaubaren PDLLA-System, besonders geeignet sind und ergaben monodisperse Kolloide im Größenbereich von 100 bis 300 nm. Die kolloidalen Systeme zeigten keine Wirkung auf die Zellviabilität. In Folge dessen wurde das Aggregationsverhalten in humanem Blutserum mittels DLS untersucht, wobei keine Interaktion mit Blutbestandteilen festgestellt werden konnte. Zellaufnahmestudien wurden an HeLa-Zellen durchgeführt, um das Schicksal der Kolloide in vitro zu untersuchen. Dabei wurden Kernmaterial, Hülle und das hydrophobe Wirkstoffmodell durch unterschiedliche Fluoreszenzmarkierung getrennt betrachtet. Das hydrophobe Wirkstoffmodell wurde allein durch Interaktion der Kolloide mit den Zellen übertragen, was für eine diffusionsbedingte, initiale, aber unspezifische Freisetzung spricht. Eine solche Freisetzungskinetik kann durch Verwendung von Nitroglycerin, als vasodilatierender Wirkstoff mit geringer unspezifischer Wirkung, ausgenutzt werden, um den EPR-Effekt zu unterstützen. Die Aufnahme des Partikels hingegen geschieht zeitverzögert. Das Schicksal der Kolloide (sowohl des Kern- und desrnHüllmaterials) wurde durch doppelte Fluoreszenzmarkierung untersucht. Dabei kam es zu einer intrazellulären Ablösung der stabilisierenden Block-Copolymere zwischen 8 und 24 h. Nach Aufklärung der Aufnahme- und Freisetzungskinetiken wurde nun die Körperverteilung der PS- und PDLLA-Kolloide nach 18F-Markierung mittels PET und ex vivo-Biodistributiosstudien untersucht. Dabei hatte das Kernmaterial einen Einfluss auf die Körperverteilung. PET-Studien in Mäusen zeigten, dass die stabilisierenden Block-Copolymere beider Kolloide ein starkes Signal in der Niere geben, wobei das der PS-Kolloide weiter ausgeprägt war. Darüber hinaus war eine Anreicherung dieser in Lunge, Leber und Milz festzustellen. Die Verdrängung der stabilisierenden Polymere durch die Interaktion mit Blutbestandteilen erklärt dabei das erhöhte Nieren- und Blasensignal der PS- Kolloide. Das Anreicherungsmuster der PDLLA-Kolloide hingegen zeigte neben der Nierenakkumulation eine erhöhte Blutaktivität und somit die gewünschten langzirkulierenden Eigenschaften. Diese Ergebnisse konnten auch mittels ex vivo- Biodistributionsstudien bestätigt werden. Um die Tumoranreicherung weiter zu verbessern wurde die Verwendung von Folat als Erkennungsstruktur am einfachen HPMA-Polymer untersucht. Die Konjugate zeigten eine erhöhte Anreicherung im Vergleich zu den Polymeren ohne Erkennungsstrukturen. Blockadestudien bestätigten die Selektivität der Anreicherung. Diese Daten zeigen das Potential der Folat-Erkennungsstruktur in vivo innerhalb kurzer Zeitfenster, welche nun auf kolloidale Systeme übertragen werden kann.

Untersuchung zur endogenen Bildung von oxidativen DNA-Schäden in vivo und in vitro

In dieser Arbeit sollte der Einfluss einer Überproduktion von humaner Superoxiddismutase 1 (hSOD1) auf die Spiegel der DNA-Schäden in verschiedenen Geweben von transgenen Mäusen untersucht werden. Tiere die eine Defizienz des Ogg1- und Csb- Proteins aufweisen und deshalb oxidative Purinmodifikationen nicht oder nur schwer reparieren können, akkumulieren 8-oxoG im Laufe ihres Lebens (Osterod, et al. 2001). Aus diesem Grund sind diese ein gutes Modell, um protektive Eigenschaften von Antioxidantien wie z.B. Substanzen oder Enzymen zu untersuchen. Fusser, et al. 2011 konnten beispielsweise zeigen, dass das pflanzliche Polyphenol Resveratrol die endogenen Spiegel an 8-oxoG sowie die spontanen Mutatiosraten im Lac I - Gen senken kann. Um den Einfluss von hSOD1 in vivo zu untersuchen, wurden in zwei Zuchtschritten 4 Mausgenotypen generiert, nämlich (Csb -/- Ogg1 -/- und Csb +/- Ogg1 +/- Mäuse jeweils mit ohne hSOD1 Überexpression). Diese wurden in verschiedenen Altersstufen auf die Basalspiegel an oxidativen Schäden (Einzelstrangbrüche und Fpg-sensitive Läsionen) in der Leber, der Niere und der Milz untersucht. Die Genotypen wurden zunächst charakterisiert und die hSOD1-Überexpression mittels qRT-PCR, Western Blot und Enzymaktivitätsbestimmung verifiziert. Es konnte an diesen Tieren erstmalig gezeigt werden, dass SOD die Generierung von DNA-Schäden in vivo mit zunehmendem Alter der Tiere senkt und dass deshalb Superoxid eine der reaktiven Sauerstoffspezies ist, die unter physiologischen Bedingungen für die DNA-Schäden verantwortlich ist. Außerdem kann ein möglicher toxischer Effekt der Überproduktion von SOD ausgeschlossen werden. Erhöhte Spiegel an oxidativen DNA-Schäden durch womöglich erhöhte Spiegel an H2O2 konnten in dieser Studie nicht beobachtet werden. Eine Messung der Genexpression anderer antioxidativer Enzyme wie Katalase, SOD2 und SOD3, GPX oder HO1 sind an diesem Effekt nicht beteiligt. Auch konnte kein Einfluss des redoxsensitiven Transkriptionsfaktors Nrf2 gezeigt werden. rnUm mögliche Quellen der für die oxidativ gebildeten DNA-Schäden verantwortlichen ROS zu identifizieren, wurde der Einfluss des Dopaminstoffwechsels untersucht. Während des Dopaminmetabolismus werden intrazellulär Reaktive Sauerstoffspezies (H2O2 und O2.-) gebildet und tragen sehr wahrscheinlich zur Entstehung von neurodegenerativen Erkrankungen wie Parkinson bei. In dem gängigen Parkinson-Zellkulturmodell SH-SY5Y konnte keine Erhöhung von oxidativen Schäden in nukleärer DNA nach Dopaminbehandlung nachgewiesen werden. Eine Überexpression der Dopaminmetabolisierenden Enzyme MAO-A und MAO-B zeigen bei niedrigen Dosen Dopamin eine leichte jedoch nicht signifikante Erhöhung der Fpg-sensitiven Modifikationen. Die Überproduktion des Dopamintransporters zeigte keinen Effekt nach Dopaminzugabe. Es kann geschlussfolgert werden, dass durch erhöhte MAO-A und MAO-B endogen ROS gebildet werden, die die Bildung Fpg-sensitiver Läsionen hervorrufen. Bei hohen Dosen und langer Inkubationszeit steht die Dopaminautoxidation, anschließende Neuromelaninbildung und als Konsequenz Apoptose im Vordergrund.rn

Development of in vitro methods to test acetabular prosthetic reconstructions (messa a punto di metodi in vitro per la caratterizzazione biomeccanica di ricostruzioni acetabolari)

The revision hip arthroplasty is a surgical procedure, consisting in the reconstruction of the hip joint through the replacement of the damaged hip prosthesis. Several factors may give raise to the failure of the artificial device: aseptic loosening, infection and dislocation represent the principal causes of failure worldwide. The main effect is the raise of bone defects in the region closest to the prosthesis that weaken the bone structure for the biological fixation of the new artificial hip. For this reason bone reconstruction is necessary before the surgical revision operation. This work is born by the necessity to test the effects of bone reconstruction due to particular bone defects in the acetabulum, after the hip prosthesis revision. In order to perform biomechanical in vitro tests on hip prosthesis implanted in human pelvis or hemipelvis a practical definition of a reference frame for these kind of bone specimens is required. The aim of the current study is to create a repeatable protocol to align hemipelvic samples in the testing machine, that relies on a reference system based on anatomical landmarks on the human pelvis. In chapter 1 a general overview of the human pelvic bone is presented: anatomy, bone structure, loads and the principal devices for hip joint replacement. The purpose of chapters 2 is to identify the most common causes of the revision hip arthroplasty, analysing data from the most reliable orthopaedic registries in the world. Chapter 3 presents an overview of the most used classifications for acetabular bone defects and fractures and the most common techniques for acetabular and bone reconstruction. After a critical review of the scientific literature about reference frames for human pelvis, in chapter 4, the definition of a new reference frame is proposed. Based on this reference frame, the alignment protocol for the human hemipelvis is presented as well as the statistical analysis that confirm the good repeatability of the method.

The influence of saliva on the dissolution of calcium fluoride after application of different fluoride gels in vitro

OBJECTIVE: To determine the formation and dissolution of calcium fluoride on the enamel surface after application of two fluoride gel-saliva mixtures. METHOD AND MATERIALS: From each of 80 bovine incisors, two enamel specimens were prepared and subjected to two different treatment procedures. In group 1, 80 specimens were treated with a mixture of an amine fluoride gel (1.25% F-; pH 5.2; 5 minutes) and human saliva. In group 2, 80 enamel blocks were subjected to a mixture of sodium fluoride gel (1.25% F; pH 5.5; 5 minutes) and human saliva. Subsequent to fluoride treatment, 40 specimens from each group were stored in human saliva and sterile water, respectively. Ten specimens were removed after each of 1 hour, 24 hours, 2 days, and 5 days and analyzed according to potassium hydroxide-soluble fluoride. RESULTS: Application of amine fluoride gel resulted in a higher amount of potassium hydroxide-soluble fluoride than did sodium fluoride gel 1 hour after application. Saliva exerted an inhibitory effect according to the dissolution rate of calcium fluoride. However, after 5 days, more than 90% of the precipitated calcium fluoride was dissolved in the amine fluoride group, and almost all potassium hydroxide-soluble fluoride was lost in the sodium fluoride group. Calcium fluoride apparently dissolves rapidly, even at almost neutral pH. CONCLUSION: Considering the limitations of an in vitro study, it is concluded that highly concentrated fluoride gels should be applied at an adequate frequency to reestablish a calcium fluoride-like layer.

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.

Nanotoxicology: a perspective and discussion of whether or not in vitro testing is a valid alternative

Despite the many proposed advantages related to nanotechnology, there are increasing concerns as to the potential adverse human health and environmental effects that the production of, and subsequent exposure to nanoparticles (NPs) might pose. In regard to human health, these concerns are founded upon the plethora of knowledge gained from research relating to the effects observed following exposure to environmental air pollution. It is known that increased exposure to environmental air pollution can cause reduced respiratory health, as well as exacerbate pre-existing conditions such as cardiovascular disease and chronic obstructive pulmonary disease. Such disease states have also been associated with exposure to the NP component contained within environmental air pollution, raising concerns as to the effects of NP exposure. It is not only exposure to accidentally produced NPs however, which should be approached with caution. Over the past decades, NPs have been specifically engineered for a wide range of consumer, industrial and technological applications. Due to the inevitable exposure of NPs to humans, owing to their use in such applications, it is therefore imperative that an understanding of how NPs interact with the human body is gained. In vivo research poses a beneficial model for gaining immediate and direct knowledge of human exposure to such xenobiotics. This research outlook however, has numerous limitations. Increased research using in vitro models has therefore been performed, as these models provide an inexpensive and high-throughput alternative to in vivo research strategies. Despite such advantages, there are also various restrictions in regard to in vitro research. Therefore, the aim of this review, in addition to providing a short perspective upon the field of nanotoxicology, is to discuss (1) the advantages and disadvantages of in vitro research and (2) how in vitro research may provide essential information pertaining to the human health risks posed by NP exposure.

New exposure system to evaluate the toxicity of (scooter) exhaust emissions in lung cells in vitro

A constantly growing number of scooters produce an increasing amount of potentially harmful emissions. Due to their engine technology, two-stroke scooters emit huge amounts of adverse substances, which can induce adverse pulmonary and cardiovascular health effects. The aim of this study was to develop a system to expose a characterized triple cell coculture model of the human epithelial airway barrier, to freshly produced and characterized total scooter exhaust emissions. In exposure chambers, cell cultures were exposed for 1 and 2 h to 1:100 diluted exhaust emissions and in the reference chamber to filtered ambient air, both controlled at 5% CO(2), 85% relative humidity, and 37 degrees C. The postexposure time was 0-24 h. Cytotoxicity, used to validate the exposure system, was significantly increased in exposed cell cultures after 8 h postexposure time. (Pro-) inflammatory chemo- and cytokine concentrations in the medium of exposed cells were significantly higher at the 12 h postexposure time point. It was shown that the described exposure system (with 2 h exposure duration, 8 and 24 h postexposure time, dilution of 1:100, flow of 2 L/min as optimal exposure conditions) can be used to evaluate the toxic potential of total exhaust emissions.

Enantioselective CE analysis of hepatic ketamine metabolism in different species in vitro

Ketamine, an injectable anesthetic and analgesic consisting of a racemic mixture of S-and R-ketamine, is routinely used in veterinary and human medicine. Nevertheless, metabolism and pharmacokinetics of ketamine have not been characterized sufficiently in most animal species. An enantioselective CE assay for ketamine and its metabolites in microsomal preparations is described. Racemic ketamine was incubated with pooled microsomes from humans, horses and dogs over a 3 h time interval with frequent sample collection. CE data revealed that ketamine is metabolized enantioselectively to norketamine (NK), dehydronorketamine and three hydroxylated NK metabolites in all three species. The metabolic patterns formed differ in production rates of the metabolites and in stereoselectivity of the hydroxylated NK metabolites. In vitro pharmacokinetics of ketamine N-demethylation were established by incubating ten different concentrations of racemic ketamine and the single enantiomers of ketamine for 8 min and data modeling was based on Michaelis-Menten kinetics. These data revealed a reduced intrinsic clearance of the S-enantiomer in the racemic mixture compared with the single S-enantiomer in human microsomes, no difference in equine microsomes and the opposite effect in canine microsomes. The findings indicate species differences with possible relevance for the use of single S-ketamine versus racemic ketamine in the clinic.

Dimethyloxalylglycine stabilizes HIF-1α in cultured human endothelial cells and increases random-pattern skin flap survival in vivo

The goal of this study was to evaluate in vitro and in vivo the effects of up-regulation of the proangiogenic hypoxia inducible factor (HIF)-1α induced by dimethyloxalylglycine on endothelial cell cultures and on skin flap survival.

A protective antiarrhythmic role of ursodeoxycholic acid in an in vitro rat model of the cholestatic fetal heart

Intrahepatic cholestasis of pregnancy may be complicated by fetal arrhythmia, fetal hypoxia, preterm labor, and, in severe cases, intrauterine death. The precise etiology of fetal death is not known. However, taurocholate has been demonstrated to cause arrhythmia and abnormal calcium dynamics in cardiomyocytes. To identify the underlying reason for increased susceptibility of fetal cardiomyocytes to arrhythmia, we studied myofibroblasts (MFBs), which appear during structural remodeling of the adult diseased heart. In vitro, they depolarize rat cardiomyocytes via heterocellular gap junctional coupling. Recently, it has been hypothesized that ventricular MFBs might appear in the developing human heart, triggered by physiological fetal hypoxia. However, their presence in the fetal heart (FH) and their proarrhythmogenic effects have not been systematically characterized. Immunohistochemistry demonstrated that ventricular MFBs transiently appear in the human FH during gestation. We established two in vitro models of the maternal heart (MH) and FH, both exposed to increasing doses of taurocholate. The MH model consisted of confluent strands of rat cardiomyocytes, whereas for the FH model, we added cardiac MFBs on top of cardiomyocytes. Taurocholate in the FH model, but not in the MH model, slowed conduction velocity from 19 to 9 cm/s, induced early after depolarizations, and resulted in sustained re-entrant arrhythmias. These arrhythmic events were prevented by ursodeoxycholic acid, which hyperpolarized MFB membrane potential by modulating potassium conductance. CONCLUSION: These results illustrate that the appearance of MFBs in the FH may contribute to arrhythmias. The above-described mechanism represents a new therapeutic approach for cardiac arrhythmias at the level of MFB.

Soluble CD163 is not increased in visceral fat and steatotic liver and is even suppressed by free fatty acids in vitro

Visceral fat differs from subcutaneous fat by higher local inflammation and increased release of IL-6 and free fatty acids (FFA) which contribute to hepatic steatosis. IL-6 has been shown to upregulate the monocyte/macrophage specific receptor CD163 whose soluble form, sCD163, is increased in inflammatory diseases. Here, it was analyzed whether CD163 and sCD163 are differentially expressed in the human fat depots and fatty liver. CD163 mRNA and protein were similarly expressed in paired samples of human visceral and subcutaneous fat, and comparable levels in portal venous and systemic venous blood of liver-healthy controls indicate that release of sCD163 from visceral adipose tissue was not increased. CD163 was also similarly expressed in steatotic liver when compared to non-steatotic tissues and sCD163 was almost equal in the respective sera. Concentrations of sCD163 were not affected when passing the liver excluding substantial hepatic removal/release of this protein. A high concentration of IL-6 upregulated CD163 protein while physiological doses had no effect. However, sCD163 was not increased by any of the IL-6 doses tested. FFA even modestly decreased CD163 and sCD163. The anti-inflammatory mediators fenofibrate, pioglitazone, and eicosapentaenoic acid (EPA) did not influence sCD163 levels while CD163 was reduced by EPA. These data suggest that in humans neither visceral fat nor fatty liver are major sources of sCD163.

Enantioselective capillary electrophoresis for the assessment of CYP3A4-mediated ketamine demethylation and inhibition in vitro

Enantioselective CE with sulfated cyclodextrins as chiral selectors was used to determine the CYP3A4-catalyzed N-demethylation kinetics of ketamine to norketamine and its inhibition in the presence of ketoconazole in vitro. Ketamine, a chiral phencyclidine derivative, was incubated with recombinant human CYP3A4 from a baculovirus expression system as racemic mixture and as single enantiomer. Alkaline liquid/liquid extracts of the samples were analyzed with a pH 2.5 buffer comprising 50 mM Tris and phosphoric acid together with either multiple isomer sulfated β-cyclodextrin (10 mg/mL) or highly sulfated γ-cyclodextrin (2%, w/v). Data obtained in the absence of ketoconazole revealed that the N-demethylation occurred stereoselectively with Michaelis-Menten (incubation of racemic ketamine) and Hill (separate incubation of single enantiomers) kinetics. Data generated in the presence of ketoconazole as the inhibitor could best be fitted to a one-site competitive model and inhibition constants were calculated using the equation of Cheng and Prusoff. No stereoselective difference was observed, but inhibition constants for the incubation of racemic ketamine were found to be larger compared with those obtained with the incubation of single ketamine enantiomers.

Enamel loss and adhesive remnants following bracket removal and various clean-up procedures in vitro

This study evaluated the enamel loss and composite remnants after debonding and clean-up. The tested null hypothesis is that there are no differences between different polishing systems regarding removing composite remnants without damaging the tooth surface. Brackets were bonded to 75 extracted human molars and removed after a storage period of 100 hours. The adhesive remnant index (ARI) was evaluated. The clean-up was carried out with five different procedures: 1. carbide bur; 2. carbide bur and Brownie and Greenie silicone polishers; 3. carbide bur and Astropol polishers; 4. carbide bur and Renew polishers; and 5. carbide bur, Brownie, Greenie and PoGo polishers. Silicone impressions were made at baseline (T0) and after debonding (T1) and polishing (T2) to produce plaster replicas. The replicas were analysed with a three-dimensional laser scanner and measured with analytical software. Statistical analysis was performed with the Kruskal-Wallis test and pairwise Wilcoxon tests with Bonferroni-Holm adjustment (α = 0.05). Enamel breakouts after debonding were detectable in 27 per cent of all cases, with a mean volume loss of 0.02 mm(3) (±0.03 mm(3)) and depth of 44.9 μm (±48.3 μm). The overall ARI scores was 3 with a few scores of 1 and 2. The composite remnants after debonding had a mean volume of 2.48 mm(3) (±0.92 mm(3)). Mean volume loss due to polishing was 0.05 mm(3) (±0.26 mm(3)) and the composite remnants had a mean volume of 0.22 mm(3) (±0.32 mm(3)). There were no statistically significant differences in volumetric changes after polishing (P = 0.054) between the different clean-up methods. However, sufficient clean-up without enamel loss was difficult to achieve.

Efficacy of taurolidine against periodontopathic species--an in vitro study

The antimicrobial effect of taurolidine was tested against periodontopathic species in comparison to chlorhexidine digluconate in the presence or absence of serum. Minimal inhibitory concentrations (MIC), microbiocidal concentrations (MBC), as well as killing were determined against 32 different microbial strains including 3 Porphyromonas gingivalis, 3 Aggregatibacter actinomycetemcomitans, and 15 potentially superinfecting species with and without 25% v/v human serum. The MIC(50) of taurolidine against the tested microbial strains was 0.025% and the MIC(90) 0.05%. The respective values for the MBCs were 0.05% and 0.1%. Addition of 25% serum (heat-inactivated) did not change the MIC and MBC values of taurolidine. In contrast, MICs and MBCs of chlorhexidine (CHX) increased by two steps after addition of serum. Taurolidine killed microorganisms in a concentration and time-dependent manner, the killing rate of 1.6% taurolidine was 99.08% ± 2.27% in mean after 2 h. Again, killing activity of taurolidine was not affected if serum was added, whereas addition of inactivated serum clearly reduced the killing rate of all selected bacterial strains by CHX. Therefore, taurolidine possesses antimicrobial properties which are not reduced in the presence of serum as a main component in gingival crevicular fluid and wound fluid. Taurolidine may have potential as an antimicrobial agent in non-surgical and surgical periodontal treatment.

Infiltration of Natural Caries Lesions in Relation to Their Activity Status and Acid Pretreatment in vitro

This study aimed at testing how active and inactive enamel caries lesions differ by their degree of resin infiltration, and whether the choice of acid pretreatment plays a crucial role. Four examiners assessed 104 human molars and premolars with noncavitated enamel lesions and classified them as 'active' or 'inactive' using the Nyvad criteria. Forty-five teeth were included in this study after independent unanimous lesion activity assessment. Lesions were cut perpendicularly into 2 halves. Each half lesion was pretreated with either 15% hydrochloric acid or 35% phosphoric acid. The lesions were infiltrated after staining with rhodamine isothiocyanate. Thin sections of 100 µm were prepared and the specimens were bleached with 30% hydrogen peroxide. The specimens were then counterstained with sodium fluorescein, subjected to confocal laser scanning microscopy and analyzed quantitatively. Outcome parameters were maximum and average infiltration depths as well as relative penetration depths and areas. In active lesions no significant difference of percentage maximum penetration depth and percentage average penetration depth between lesions pretreated with hydrochloric or phosphoric acid could be observed. In inactive lesions, however, phosphoric acid pretreatment resulted in significantly lower penetration compared to hydrochloric acid pretreatment. Surface conditioning with hydrochloric acid led to similar infiltration results in active and inactive lesions. Moreover, inactive lesions showed greater variability in all assessed infiltration parameters than did active lesions. In conclusion, caries lesion activity and acid pretreatment both influenced the infiltration. The use of phosphoric acid to increase permeability of the surface layer of active lesions should be further explored.