Biochemistry in healthy and neoplastic human tissues: metabolic alteration revealed by HR-MAS nuclear magnetic resonance spectroscopy

This thesis is focused on the metabolomic study of human cancer tissues by ex vivo High Resolution-Magic Angle Spinning (HR-MAS) nuclear magnetic resonance (NMR) spectroscopy. This new technique allows for the acquisition of spectra directly on intact tissues (biopsy or surgery), and it has become very important for integrated metabonomics studies. The objective is to identify metabolites that can be used as markers for the discrimination of the different types of cancer, for the grading, and for the assessment of the evolution of the tumour. Furthermore, an attempt to recognize metabolites, that although involved in the metabolism of tumoral tissues in low concentration, can be important modulators of neoplastic proliferation, was performed. In addition, NMR data was integrated with statistical techniques in order to obtain semi-quantitative information about the metabolite markers. In the case of gliomas, the NMR study was correlated with gene expression of neoplastic tissues. Chapter 1 begins with a general description of a new “omics” study, the metabolomics. The study of metabolism can contribute significantly to biomedical research and, ultimately, to clinical medical practice. This rapidly developing discipline involves the study of the metabolome: the total repertoire of small molecules present in cells, tissues, organs, and biological fluids. Metabolomic approaches are becoming increasingly popular in disease diagnosis and will play an important role on improving our understanding of cancer mechanism. Chapter 2 addresses in more detail the basis of NMR Spectroscopy, presenting the new HR-MAS NMR tool, that is gaining importance in the examination of tumour tissues, and in the assessment of tumour grade. Some advanced chemometric methods were used in an attempt to enhance the interpretation and quantitative information of the HR-MAS NMR data are and presented in chapter 3. Chemometric methods seem to have a high potential in the study of human diseases, as it permits the extraction of new and relevant information from spectroscopic data, allowing a better interpretation of the results. Chapter 4 reports results obtained from HR-MAS NMR analyses performed on different brain tumours: medulloblastoma, meningioms and gliomas. The medulloblastoma study is a case report of primitive neuroectodermal tumor (PNET) localised in the cerebellar region by Magnetic Resonance Imaging (MRI) in a 3-year-old child. In vivo single voxel 1H MRS shows high specificity in detecting the main metabolic alterations in the primitive cerebellar lesion; which consist of very high amounts of the choline-containing compounds and of very low levels of creatine derivatives and N-acetylaspartate. Ex vivo HR-MAS NMR, performed at 9.4 Tesla on the neoplastic specimen collected during surgery, allows the unambiguous identification of several metabolites giving a more in-depth evaluation of the metabolic pattern of the lesion. The ex vivo HR-MAS NMR spectra show higher detail than that obtained in vivo. In addition, the spectroscopic data appear to correlate with some morphological features of the medulloblastoma. The present study shows that ex vivo HR-MAS 1H NMR is able to strongly improve the clinical possibility of in vivo MRS and can be used in conjunction with in vivo spectroscopy for clinical purposes. Three histological subtypes of meningiomas (meningothelial, fibrous and oncocytic) were analysed both by in vivo and ex vivo MRS experiments. The ex vivo HR-MAS investigations are very helpful for the assignment of the in vivo resonances of human meningiomas and for the validation of the quantification procedure of in vivo MR spectra. By using one- and two dimensional experiments, several metabolites in different histological subtypes of meningiomas, were identified. The spectroscopic data confirmed the presence of the typical metabolites of these benign neoplasms and, at the same time, that meningomas with different morphological characteristics have different metabolic profiles, particularly regarding macromolecules and lipids. The profile of total choline metabolites (tCho) and the expression of the Kennedy pathway genes in biopsies of human gliomas were also investigated using HR-MAS NMR, and microfluidic genomic cards. 1H HR-MAS spectra, allowed the resolution and relative quantification by LCModel of the resonances from choline (Cho), phosphorylcholine (PC) and glycerolphorylcholine (GPC), the three main components of the combined tCho peak observed in gliomas by in vivo 1H MRS spectroscopy. All glioma biopsies depicted an increase in tCho as calculated from the addition of Cho, PC and GPC HR-MAS resonances. However, the increase was constantly derived from augmented GPC in low grade NMR gliomas or increased PC content in the high grade gliomas, respectively. This circumstance allowed the unambiguous discrimination of high and low grade gliomas by 1H HR-MAS, which could not be achieved by calculating the tCho/Cr ratio commonly used by in vivo 1H MR spectroscopy. The expression of the genes involved in choline metabolism was investigated in the same biopsies. The present findings offer a convenient procedure to classify accurately glioma grade using 1H HR-MAS, providing in addition the genetic background for the alterations of choline metabolism observed in high and low gliomas grade. Chapter 5 reports the study on human gastrointestinal tract (stomach and colon) neoplasms. The human healthy gastric mucosa, and the characteristics of the biochemical profile of human gastric adenocarcinoma in comparison with that of healthy gastric mucosa were analyzed using ex vivo HR-MAS NMR. Healthy human mucosa is mainly characterized by the presence of small metabolites (more than 50 identified) and macromolecules. The adenocarcinoma spectra were dominated by the presence of signals due to triglycerides, that are usually very low in healthy gastric mucosa. The use of spin-echo experiments enable us to detect some metabolites in the unhealthy tissues and to determine their variation with respect to the healthy ones. Then, the ex vivo HR-MAS NMR analysis was applied to human gastric tissue, to obtain information on the molecular steps involved in the gastric carcinogenesis. A microscopic investigation was also carried out in order to identify and locate the lipids in the cellular and extra-cellular environments. Correlation of the morphological changes detected by transmission (TEM) and scanning (SEM) electron microscopy, with the metabolic profile of gastric mucosa in healthy, gastric atrophy autoimmune diseases (AAG), Helicobacter pylori-related gastritis and adenocarcinoma subjects, were obtained. These ultrastructural studies of AAG and gastric adenocarcinoma revealed lipid intra- and extra-cellularly accumulation associated with a severe prenecrotic hypoxia and mitochondrial degeneration. A deep insight into the metabolic profile of human healthy and neoplastic colon tissues was gained using ex vivo HR-MAS NMR spectroscopy in combination with multivariate methods: Principal Component Analysis (PCA) and Partial Least Squares Discriminant Analysis (PLS-DA). The NMR spectra of healthy tissues highlight different metabolic profiles with respect to those of neoplastic and microscopically normal colon specimens (these last obtained at least 15 cm far from the adenocarcinoma). Furthermore, metabolic variations are detected not only for neoplastic tissues with different histological diagnosis, but also for those classified identical by histological analysis. These findings suggest that the same subclass of colon carcinoma is characterized, at a certain degree, by metabolic heterogeneity. The statistical multivariate approach applied to the NMR data is crucial in order to find metabolic markers of the neoplastic state of colon tissues, and to correctly classify the samples. Significant different levels of choline containing compounds, taurine and myoinositol, were observed. Chapter 6 deals with the metabolic profile of normal and tumoral renal human tissues obtained by ex vivo HR-MAS NMR. The spectra of human normal cortex and medulla show the presence of differently distributed osmolytes as markers of physiological renal condition. The marked decrease or disappearance of these metabolites and the high lipid content (triglycerides and cholesteryl esters) is typical of clear cell renal carcinoma (RCC), while papillary RCC is characterized by the absence of lipids and very high amounts of taurine. This research is a contribution to the biochemical classification of renal neoplastic pathologies, especially for RCCs, which can be evaluated by in vivo MRS for clinical purposes. Moreover, these data help to gain a better knowledge of the molecular processes envolved in the onset of renal carcinogenesis.

Development of screening assays to test novel integrin antagonists in allergic inflammation

Aim of the research: to develop a prototype of homogeneous high-throughput screening (HTS) for identification of novel integrin antagonists for the treatment of ocular allergy and to better understand the mechanisms of action of integrin-mediated levocabastine antiallergic action. Results: This thesis provides evidence that adopting scintillation proximity assay (SPA) levocabastine (IC50=406 mM), but not the first-generation antihistamine chlorpheniramine, displaces [125I]fibronectin (FN) binding to human a4b1 integrin. This result is supported by flow cytometry analysis, where levocabastine antagonizes the binding of a primary antibody to integrin a4 expressed in Jurkat E6.1 cells. Levocabastine, but not chlorpheniramine, binds to a4b1 integrin and prevents eosinophil adhesion to VCAM-1, FN or human umbilical vein endothelial cells (HUVEC) cultured in vitro. Similarly, levocabastine affects aLb2/ICAM-1-mediated adhesion of Jurkat E6.1 cells. Analyzing the supernatant of TNF-a-treated (24h) eosinophilic cells (EoL-1), we report that levocabastine reduces the TNF-a-induced release of the cytokines IL-12p40, IL-8 and VEGF. Finally, in a model of allergic conjunctivitis, levocastine eye drops (0.05%) reduced the clinical aspects of the early and late phase reactions and the conjunctival expression of a4b1 integrin by reducing infiltrated eosinophils. Conclusions: SPA is a highly efficient, amenable to automation and robust binding assay to screen novel integrin antagonists in a HTS setting. We propose that blockade of integrinmediated cell adhesion might be a target of the anti-allergic action of levocabastine and may play a role in preventing eosinophil adhesion and infiltration in allergic conjunctivitis.

"Water users must be efficient producers". Women's access to and use of land in Chókwè irrigation scheme, Mozambique

The irrigation scheme Eduardo Mondlane, situated in Chókwè District - in the Southern part of the Gaza province and within the Limpopo River Basin - is the largest in the country, covering approximately 30,000 hectares of land. Built by the Portuguese colonial administration in the 1950s to exploit the agricultural potential of the area through cash-cropping, after Independence it became one of Frelimo’s flagship projects aiming at the “socialization of the countryside” and at agricultural economic development through the creation of a state farm and of several cooperatives. The failure of Frelimo’s economic reforms, several infrastructural constraints and local farmers resistance to collective forms of production led to scheme to a state of severe degradation aggravated by the floods of the year 2000. A project of technical rehabilitation initiated after the floods is currently accompanied by a strong “efficiency” discourse from the managing institution that strongly opposes the use of irrigated land for subsistence agriculture, historically a major livelihood strategy for smallfarmers, particularly for women. In fact, the area has been characterized, since the end of the XIX century, by a stable pattern of male migration towards South African mines, that has resulted in an a steady increase of women-headed households (both de jure and de facto). The relationship between land reform, agricultural development, poverty alleviation and gender equality in Southern Africa is long debated in academic literature. Within this debate, the role of agricultural activities in irrigation schemes is particularly interesting considering that, in a drought-prone area, having access to water for irrigation means increased possibilities of improving food and livelihood security, and income levels. In the case of Chókwè, local governments institutions are endorsing the development of commercial agriculture through initiatives such as partnerships with international cooperation agencies or joint-ventures with private investors. While these business models can sometimes lead to positive outcomes in terms of poverty alleviation, it is important to recognize that decentralization and neoliberal reforms occur in the context of financial and political crisis of the State that lacks the resources to efficiently manage infrastructures such as irrigation systems. This kind of institutional and economic reforms risk accelerating processes of social and economic marginalisation, including landlessness, in particular for poor rural women that mainly use irrigated land for subsistence production. The study combines an analysis of the historical and geographical context with the study of relevant literature and original fieldwork. Fieldwork was conducted between February and June 2007 (where I mainly collected secondary data, maps and statistics and conducted preliminary visit to Chókwè) and from October 2007 to March 2008. Fieldwork methodology was qualitative and used semi-structured interviews with central and local Government officials, technical experts of the irrigation scheme, civil society organisations, international NGOs, rural extensionists, and water users from the irrigation scheme, in particular those women smallfarmers members of local farmers’ associations. Thanks to the collaboration with the Union of Farmers’ Associations of Chókwè, she has been able to participate to members’ meeting, to education and training activities addressed to women farmers members of the Union and to organize a group discussion. In Chókwè irrigation scheme, women account for the 32% of water users of the familiar sector (comprising plot-holders with less than 5 hectares of land) and for just 5% of the private sector. If one considers farmers’ associations of the familiar sector (a legacy of Frelimo’s cooperatives), women are 84% of total members. However, the security given to them by the land title that they have acquired through occupation is severely endangered by the use that they make of land, that is considered as “non efficient” by the irrigation scheme authority. Due to a reduced access to marketing possibilities and to inputs, training, information and credit women, in actual fact, risk to see their right to access land and water revoked because they are not able to sustain the increasing cost of the water fee. The myth of the “efficient producer” does not take into consideration the characteristics of inequality and gender discrimination of the neo-liberal market. Expecting small-farmers, and in particular women, to be able to compete in the globalized agricultural market seems unrealistic, and can perpetuate unequal gendered access to resources such as land and water.

Investigating the role of single point mutations in the human proteome: a computational study

In the post genomic era with the massive production of biological data the understanding of factors affecting protein stability is one of the most important and challenging tasks for highlighting the role of mutations in relation to human maladies. The problem is at the basis of what is referred to as molecular medicine with the underlying idea that pathologies can be detailed at a molecular level. To this purpose scientific efforts focus on characterising mutations that hamper protein functions and by these affect biological processes at the basis of cell physiology. New techniques have been developed with the aim of detailing single nucleotide polymorphisms (SNPs) at large in all the human chromosomes and by this information in specific databases are exponentially increasing. Eventually mutations that can be found at the DNA level, when occurring in transcribed regions may then lead to mutated proteins and this can be a serious medical problem, largely affecting the phenotype. Bioinformatics tools are urgently needed to cope with the flood of genomic data stored in database and in order to analyse the role of SNPs at the protein level. In principle several experimental and theoretical observations are suggesting that protein stability in the solvent-protein space is responsible of the correct protein functioning. Then mutations that are found disease related during DNA analysis are often assumed to perturb protein stability as well. However so far no extensive analysis at the proteome level has investigated whether this is the case. Also computationally methods have been developed to infer whether a mutation is disease related and independently whether it affects protein stability. Therefore whether the perturbation of protein stability is related to what it is routinely referred to as a disease is still a big question mark. In this work we have tried for the first time to explore the relation among mutations at the protein level and their relevance to diseases with a large-scale computational study of the data from different databases. To this aim in the first part of the thesis for each mutation type we have derived two probabilistic indices (for 141 out of 150 possible SNPs): the perturbing index (Pp), which indicates the probability that a given mutation effects protein stability considering all the “in vitro” thermodynamic data available and the disease index (Pd), which indicates the probability of a mutation to be disease related, given all the mutations that have been clinically associated so far. We find with a robust statistics that the two indexes correlate with the exception of all the mutations that are somatic cancer related. By this each mutation of the 150 can be coded by two values that allow a direct comparison with data base information. Furthermore we also implement computational methods that starting from the protein structure is suited to predict the effect of a mutation on protein stability and find that overpasses a set of other predictors performing the same task. The predictor is based on support vector machines and takes as input protein tertiary structures. We show that the predicted data well correlate with the data from the databases. All our efforts therefore add to the SNP annotation process and more importantly found the relationship among protein stability perturbation and the human variome leading to the diseasome.

Equine and human mutual welfare: a whole subject? Critical aspects and possible strategies in equine-assisted activities and therapies

General aim of the study is equine welfare, particularly concerning different husbandry methodic and inter-specific relational factors. Specific aim is the evaluation of possible mutual (to humans and to equines) benefits and the analysis of critical factors/strength points, of human-horse relationship within Therapeutic Riding context (TR). The peculiarities of human-horse relationship (compared to the bond with “Pet”) are analyzed, concerning their socio-anthropological, psychological, psycho-dynamic distinctive characteristics. 8 European representative therapeutic riding centers (TRC) were therefore selected (on the basis of their different animals’ husbandry criteria, and of the different rehabilitative methodologies adopted). TRC were investigated through 2 different questionnaires, specifically settled to access objective/subjective animal welfare parameters; the quality of human-horse relationship; technicians’ emotional experienced. 3 Centers were further selected, and behavioral (145 hours of behavioral recording) and physiological parameters (heart rate and heart rate variability) were evaluated, aimed to access equine welfare and horses’ adaptive responses/coping (towards general environment and towards TR job). Moreover a specific “handling-task” was ideated and experimented, aimed to measure the quality of TR technicians-horses relationship. We did therefore evaluate both the individual horses’ responses and the possible differences among Centers. Data collected highlight the lack of univocal standardized methodic, concerning the general animals’ management and the specific methodologies (aimed to improve animal welfare and to empower TR efficacy). Some positive and some critical aspects were detected concerning TR personnel-horse relationship. Another experimental approach did evaluate the efficacy (concerning the mutual benefits’ empowerment) of an “ethologically-fitted” TR intervention, aimed to educate children to and through the relationship with horses. Our data evidenced that the improvement of human horse relationship, through structured educational programs for TR personnel might have important consequences both to human and equine welfare.

Giustizia sanitaria e diseguaglianze globali in salute: il caso dell'aiuto allo sviluppo in sanità

Life expectancy at birth is the average number of years that a group of people born in the same year should live. The estimate for those born in 2010 is 80.2 years for Italy. On the other side of the chart are a number of countries in sub Saharan Africa. Haiti is in last place: children born in this country in 2010 have a life expectancy by an average of even 30 years, fifty in less than peers born in Italy. From a bioethical point of view, the first question that arises is: Is it right? Is it right that there is such inequality in health? The answer is simple: it is not right. But if we ask ourselves what are the best solution to remedy this situation, the answers become more than one. The differences in life expectancy depends on many factors, including no doubt the effectiveness of health systems. The scope of this work is precisely that of justice in health care and how the different general concepts related to it can be applied in health care settings with very limited financial and human resources. The first chapter describes the main inequalities in global health. The second discusses the main theories of justice. In the next chapter we reason on official development assistance and health cooperation. In the fourth we analyze the contribution of theories of justice through such issues as equity in health, the right of access to health services and right to health. In the fifth chapter the aim is to reason about global justice, the role of health in this context and how the official development assistance in health can contribute.

'Defending the rights'. An integrated model of collective action for "public water" in Italy

In many communities, supplying water for the people is a huge task and the fact that this essential service can be carried out by the private sector respecting the right to water, is a debated issue. This dissertation investigates the mechanisms through which a 'perceived rights violation' - which represents a specific form of perceived injustice which derives from the violation of absolute moral principles – can promote collective action. Indeed, literature on morality and collective action suggests that even if many people apparently sustain high moral principles (like human rights), only a minority decides to act in order to defend them. Taking advantage of the political situation in Italy, and the recent mobilization for "public water" we hypothesized that, because of its "sacred value", the perceived violation of the right to water facilitates identification with the social movement and activism. Through five studies adopting qualitative and quantitative methods, we confirmed our hypotheses demonstrating that the perceived violation of the right to water can sustain activism and it can influence vote intentions at the referendum for 'public water'. This path to collective action coexists with other 'classical' predictors of collective action, like instrumental factors (personal advantages, efficacy beliefs) and anger. The perceived rights violation can derive both from personal values (i.e. universalism) and external factors (i.e. a mobilization campaign). Furthermore, we demonstrated that it is possible to enhance the perceived violation of the right to water and anger through a specifically designed communication campaign. The final chapter summarizes the main findings and discusses the results, suggesting some innovative line of research for collective action literature.

La salute: un diritto o un lusso?

Il diritto a un minimo decente di assistenza sanitaria – spesso chiamato, più semplicemente, diritto alla salute – fa parte dei cosiddetti diritti di seconda generazione, cioè quelli che richiedono un impegno attivo da parte dello stato per assicurare ad ogni cittadino la possibilità di una vita dignitosa. Il diritto alla salute si trova enunciato nei più importanti documenti internazionali, a partire dalla Dichiarazione universale dei diritti dell’uomo (1948), e nella maggior parte delle costituzioni nazionali, compresa quella italiana. Tuttavia, nel Sud del mondo, la sua applicazione è ostacolata da un gran numero di fattori (povertà, guerre, corruzione politica, ecc.); cosicché la maggior parte degli esseri umani vive in società prive di un sistema sanitario nazionale, cadendo vittima di malattie facilmente curabili o prevenibili. Per affrontare questo problema, la cooperazione sanitaria internazionale ha sperimentato nel tempo due diverse forme di intervento: una incentrata sulla diffusione dell’assistenza sanitaria di base (come raccomandato dalla Conferenza di Alma-Ata del 1978), l’altra sui cosiddetti “programmi verticali”, i quali agiscono su singole malattie o branche della sanità. Nessuno dei due approcci però ha prodotto i risultati sperati. L’Ong italiana Emergency propone un modello di cooperazione sanitaria per molti aspetti innovativo: esso si fonda su progetti autogestiti e totalmente gratuiti (che vanno dalla pediatria alla chirurgia di guerra alla cardiochirurgia) ed è capace di incidere sul tessuto sociale nel quale si inserisce, fino ad influenzare le scelte politiche delle autorità locali. Solamente intervenendo in un modo simile sui determinanti sociali della salute, sembra possibile migliorare realmente lo stato di salute delle popolazioni più povere e garantire così la prima delle condizioni necessarie perché ogni persona abbia la possibilità di vivere una vita decente.

Il corpo e l'individuo tra proprietà ed autodeterminazione. Con particolare riferimento al fenomeno delle biobanche

La bioetica è il luogo ideale per cercare risposte ai grandi interrogativi concernenti la vita, la morte e la cura dell'essere umano. I recenti dibattiti sull'uso, ed il temuto abuso, del corpo umano in medicina hanno messo in evidenza la necessità di una discussione approfondita sul potere di scelta che l'individuo può esercitare sulla propria mente e sul proprio corpo. Spinta dal desidero di indagare l'estensione di tale potere di scelta ho voluto analizzare le tematiche riguardanti “il corpo”, “l'individuo”, “la proprietà” e “l'autodeterminazione”. L'analisi è stata condotta individuando alcuni dei differenti significati che questi termini assumono nei diversi ambiti che la bioetica lambisce e mostrando, in particolare, la visione di tale realtà attraverso le lenti del giurista. A chi appartiene il corpo? Chi ha il potere di decidere su di esso? Il potere di scelta valica gli antichi i confini legati al corpo del paziente e coinvolge tessuti, organi e cellule staccati dal corpo umano, parti che un tempo erano considerati scarti operatori sono oggi divenuti tesori inestimabili per la ricerca. L'importanza assunta dai campioni biologici ha portato alla creazione di biobanche nelle quali sono raccolti, catalogati e il DNA studiato in campioni biologici Le biobanche riflettono le tensioni della bioetica e del biodititto. Lo studio delle biobanche riguarda, tra l'altro, la riceca dell'equilibrio tra le diverse esigenze meritevoli di tutela: in primo luogo il diritto alla privacy, diritto a che le “proprie informazioni” non vengano divulgate ed il diritto a non essere discriminato ed in secondo luogo le necessità dettate dalla ricerca e dalla scienza medica. Nel 2009 la rivista Times messo biobanche tra le 10 idee in grado di cambiare il mondo anche in considarazione della medicina personalizzata e del fatto che costituiscono una la speranza per la ricerca contro le malattie attuali e future.

Food safety and zoonotic enteric pathogens: sources, risk factors and transmission routes of human salmonellosis and campylobacteriosis

Salmonella and Campylobacter are common causes of human gastroenteritis. Their epidemiology is complex and a multi-tiered approach to control is needed, taking into account the different reservoirs, pathways and risk factors. In this thesis, trends in human gastroenteritis and food-borne outbreak notifications in Italy were explored. Moreover, the improved sensitivity of two recently-implemented regional surveillance systems in Lombardy and Piedmont was evidenced, providing a basis for improving notification at the national level. Trends in human Salmonella serovars were explored: serovars Enteritidis and Infantis decreased, Typhimurium remained stable and 4,[5],12:i:-, Derby and Napoli increased, suggesting that sources of infection have changed over time. Attribution analysis identified pigs as the main source of human salmonellosis in Italy, accounting for 43–60% of infections, followed by Gallus gallus (18–34%). Attributions to pigs and Gallus gallus showed increasing and decreasing trends, respectively. Potential bias and sampling issues related to the use of non-local/non-recent multilocus sequence typing (MLST) data in Campylobacter jejuni/coli source attribution using the Asymmetric Island (AI) model were investigated. As MLST data become increasingly dissimilar with increasing geographical/temporal distance, attributions to sources not sampled close to human cases can be underestimated. A combined case-control and source attribution analysis was developed to investigate risk factors for human Campylobacter jejuni/coli infection of chicken, ruminant, environmental, pet and exotic origin in The Netherlands. Most infections (~87%) were attributed to chicken and cattle. Individuals infected from different reservoirs had different associated risk factors: chicken consumption increased the risk for chicken-attributed infections; animal contact, barbecuing, tripe consumption, and never/seldom chicken consumption increased that for ruminant-attributed infections; game consumption and attending swimming pools increased that for environment-attributed infections; and dog ownership increased that for environment- and pet-attributed infections. Person-to-person contacts around holiday periods were risk factors for infections with exotic strains, putatively introduced by returning travellers.

Identification and functional characterization of human cytomegalovirus Fc binding proteins

ABSTRACT Human cytomegalovirus (HCMV) employs many different mechanisms to escape and subvert the host immune system surveillance. Among these different mechanisms the role of human IgG Fc receptors (FcγR) in HCMV pathogenesis is still unclear. In mammalians, FcγRs are expressed on the surface of all haematopoietic cells and have a multifaceted role in regulating the activity of antibodies to generate a well-balanced immune response. Viral proteins with Fcγ binding ability are highly diffuse among herpesviruses. They interfere with the host receptors functions in order to counteract immune system recognition. So far, two human HCMV Fcγ binding proteins have been described: UL119 and RL11. This work was aimed to the identification and characterization of HCMV Fcγ binding proteins. The study is divided in two parts: first the characterization of UL119 and RL11; second the identification and characterization of novel HCMV Fcγ binding proteins. Regarding the first part, we demonstrated that both UL119 and RL11 internalize Fcγ fragments from transfected cells surface through a clathrin dependent pathway. In infected cells both proteins were found in the viral assembly complex and on virions surface as envelope associated glycoproteins. Moreover, internalized Fcγ in infected cells do not undergo lysosomal degradation but rather traffic in early endosomes up to the viral assembly complex. Regarding the second part, we were able to identify two novels Fcγ binding protein coded by CMV: RL12 and RL13. The latter was also further characterized as recombinant protein in terms of cellular localization, Fc binding site and IgG internalization ability. Finally binding specificity of both RL12 and RL13 seems to be confined to human IgG1 and IgG2. Taken together, these data show that HCMV codes for up to 4 FcγR and that they could have a double role both on virus and on infected cells.

Il volto europeo del reato di negazionismo tra richieste di incriminazione UE e principi fondamentali CEDU

La presente indagine mira ad esaminare, in chiave innovativa, i rapporti tra l’Europa ed un reato prettamente europeo: il negazionismo. Sviluppatosi in maniera assolutamente predominante nel nostro continente, le ragioni della sua diffusione sono molteplici. Al di là della lotta a razzismo ed antisemitismo, il motivo principale va identificato nel ruolo “fondativo” che riveste la memoria dell’Olocausto in Europa, collocata nel cuore dell’universo valoriale su cui si reggono i due principali attori europei, ovverosia l’Unione europea e la Corte europea dei diritti dell’uomo. La ricerca, dunque, ruota attorno a due poli tematici. Da un lato, sono state esaminate le politiche normative dell’Unione europea in materia di razzismo e xenofobia, entro cui spicca la promozione dell’incriminazione del negazionismo “allargato”, cioè esteso alle condotte di negazione non solo dell’Olocausto, ma anche degli altri crimini internazionali. Dall’altro lato, l’analisi della trentennale giurisprudenza della Corte di Strasburgo in materia ha evidenziato come, con riguardo alle manifestazioni negazioniste, sia stato elaborato uno “statuto speciale”, che si risolve nel perentorio diniego di tutela per questa categoria di opinioni, sottratte a monte all’ordinario giudizio di bilanciamento in quanto giudicate incompatibili con i valori sottesi alla CEDU. Lo scopo di questo lavoro riposa nel tentativo di individuare le interazioni tra questi due sistemi istituzionali, per interpretare una tendenza che converge con nettezza verso un incremento della repressione penale della parola. Da questo complesso intreccio di norme e principi, di hard law e soft law, sarà possibile enucleare la natura giuridica ed il contenuto delle richieste di incriminazione rivolte agli Stati membri. Una volta appurato che agli Stati è concesso di restringere il campo di applicazione del reato di negazionismo, adottando degli indici di pericolosità delle condotte, sarà analizzata la tenuta di questi “elementi opzionali del reato” alla luce dei principi penalistici di tassatività, materialità, offensività e laicità.

Von der geographischen Analyse über die Bestandsaufnahme der anzutreffenden Krankheiten und der Anwendung traditioneller Medizin zu einem geomedizinischen Informationssystem am Beispiel einer Bergregion im Kabupaten Sikka (Insel Flores, Indonesien)

Im Rahmen der interdisziplinären Zusammenarbeit zur Durchsetzung des »Menschenrecht Gesundheit« wurde ein geomedizinisches Informationssystem erstellt, das auf die nordexponierten Bergdörfer zwischen 350 m ü. NN und 450 m ü. NN des Kabupaten Sikka auf der Insel Flores in Indonesien anwendbar ist. Es wurde eine Analyse der Zeit-Raum-Dimension der Gesundheitssituation in Wololuma und Napun Lawan - exemplarisch für die nordexponierten Bergdörfer - durchgeführt. Im Untersuchungsraum wurden Gesundheitsgefahren und Gesundheitsrisiken analysiert, Zonen der Gefahren herausgearbeitet und Risikoräume bewertet. Trotz eines El Niño-Jahres waren prinzipielle Bezüge der Krankheiten zum jahreszeitlichen Rhythmus der wechselfeuchten Tropen zu erkennen. Ausgehend von der Vermutung, dass Krankheiten mit spezifischen Klimaelementen korrelieren, wurden Zusammenhänge gesucht. Für jede Krankheit wurden Makro-, Meso- und Mikrorisikoräume ermittelt. Somit wurden Krankheitsherde lokalisiert. Die Generalisierung des geomedizinischen Informationssystems lässt sich auf der Makroebene auf die nordexponierten Bergdörfer zwischen 350 m ü. NN und 450 m ü. NN des Kabupaten Sikka übertragen. Aus einer Vielzahl von angetroffenen Krankheiten wurden sechs Krankheiten selektiert. Aufgrund der Häufigkeitszahlen ergibt sich für das Gesundheitsrisiko der Bevölkerung eine Prioritätenliste:rn- Dermatomykosen (ganzjährig)rn- Typhus (ganzjährig)rn- Infektionen der unteren Atemwege (Übergangszeit)rn- Infektionen der oberen Atemwege (Übergangszeit)rn- Malaria (Regenzeit)rn- Struma (ganzjährig)rnDie Hauptrisikogruppe der Makroebene ist die feminine Bevölkerung. Betroffen sind weibliche Kleinkinder von null bis sechs Jahren und Frauen ab 41 Jahren. Die erstellten Karten des zeitlichen und räumlichen Verbreitungsmusters der Krankheiten und des Zugangs zu Gesundheitsdienstleistungen dienen Entscheidungsträgern als Entscheidungshilfe für den Einsatz der Mittel zur Primärprävention. Die Geographie als Wissenschaft mit ihren Methoden und dem Zeit-Raum-Modell hat gezeigt, dass sie die Basis für die interdisziplinäre Forschung darstellt. Die interdisziplinäre Zusammenarbeit zur Gesundheitsforschung im Untersuchungszeitraum 2009 hat sich bewährt und muss weiter ausgebaut werden. Die vorgeschlagenen Lösungsmöglichkeiten dienen der Minimierung des Gesundheitsrisikos und der Gesundheitsvorsorge. Da die Systemzusammenhänge der Ätiologie der einzelnen Krankheiten sehr komplex sind, besteht noch immer sehr großer Forschungsbedarf. rnDas Ergebnis der vorliegenden Untersuchung zeigt, dass Wasser in jeder Form die primäre Ursache für das Gesundheitsrisiko der Bergdörfer im Kabupaten Sikka auf der Insel Flores in Indonesien ist.rnDer Zugang zu Wasser ist unerlässlich für die Verwirklichung des »Menschenrecht Gesundheit«. Das Recht auf Wasser besagt, dass jeder Mensch Zugang zu nicht gesundheitsgefährdendem, ausreichendem und bezahlbarem Wasser haben soll. Alle Staaten dieser Erde sollten sich dieser Forderung verpflichtet fühlen.rn

Libertà di espressione e sorveglianza globale

La presente tesi ha come scopo quello di individuare alcune problematiche relative all’esercizio e alla limitazione del diritto alla libertà di espressione nel contesto delle attività globali di sorveglianza e controllo delle tecnologie dell’informazione e della comunicazione. Tali attività, poste in essere da parte degli Stati e da parte degli operatori privati, sono favorite dal nebuloso rapporto tra norme di fonte pubblica, privata e informatica, e sono invece osteggiate dal ricorso, collettivo e individuale, alle possibilità offerte dalle tecnologie stesse per la conduzione di attività in anonimato e segretezza. La sorveglianza globale nel contesto delle privatizzazioni si serve del codice e dell’autonomia privata, così come la resistenza digitale ricorre alle competenze informatiche e agli spazi di autonomia d’azione dell’individuo. In questo contesto, la garanzia dell’esistenza e dell’esercizio dei diritti fondamentali dell’individuo, tra tutti il diritto alla libertà di espressione e il diritto alla tutela della riservatezza, passa per l’adozione di tecniche e pratiche di autotutela attraverso l’utilizzo di sistemi di cifratura e comunicazioni anonime. L’individuo, in questo conflitto tecnico e sociale, si trova a dover difendere l’esercizio dei propri diritti e finanche l’adempimento ai propri doveri, quando attinenti a particolari figure professionali o sociali, quali avvocati, operatori di giustizia, giornalisti, o anche semplicemente genitori. In conclusione dell’elaborato si propongono alcune riflessioni sulla formazione della cittadinanza e del mondo professionale, da parte dei giuristi delle nuove tecnologie, all’uso cosciente, consapevole e responsabile delle nuove tecnologie dell’informazione, con lo stimolo ad orientare altresì le proprie attività alla tutela e alla promozione dei diritti umani fondamentali, democratici, costituzionali, civili e sociali.

Diritti umani e diritto alla salute - la questione dell’accesso ai farmaci come un problema di Giustizia Globale

Riconosciuto il problema dell’accesso ai farmaci come un problema di giustizia globale, la dissertazione, da un lato, è incentrata sullo studio dei diritti umani e sul diritto alla salute da una prospettiva giusfilosofica e, dall’altro, è finalizzata ad analizzare la disciplina brevettuale internazionale, sia approfondendo gli interessi realmente in gioco, sia studiando la struttura economica del brevetto stesso. Si è cercato quindi di guardare a tali interessi da una nuova prospettiva, ipotizzando una gerarchia di valori che sia completa e coerente con gli obiettivi che la dottrina, la giurisprudenza, nonché il diritto internazionale formalmente enunciano. Il progetto di ricerca vuole, in definitiva, arrivare a proporre nuove soluzioni giuridiche al problema dell’accesso ai farmaci. La dissertazione svolge pertanto uno studio critico della proposta di Thomas Pogge, di natura politica e giuridica e sorretta da istanze filosofiche, volta alla soluzione del problema dell’accesso ai farmaci, i.e. l’Health Impact Fund (HIF). Proposta che pone radicalmente in discussione, anche concretamente, il dogma del monopolio concesso con la privativa quale ricompensa per i costi di R&D sostenuti dai titolari dei brevetti e che pone, invece, l’accento sull’effettivo impatto sulla salute globale di ogni singola invenzione. Analizzandone approfonditamente gli aspetti più rilevanti, si passano poi in rassegna, criticamente, le proposte, alternative o di riforma, del sistema di proprietà intellettuale, volte al miglioramento dell’accesso ai farmaci; a tal proposito, si propone quindi una riforma transitoria della disciplina brevettuale, c.d. Trading Time for Space (TTS), che prevede un allungamento temporale dell’esclusiva brevettuale (Time) in cambio della vendita da parte del titolare della privativa del farmaco ad un prezzo accessibile nei Paesi in via di sviluppo (Space).