Riabilitazione protesica ed implanto-protesica di pazienti in età evolutiva affetti da Displasia Ectodermica

Introduction. Ectodermal Dysplasias are a heterogeneous group of inherited disorders characterized by dysplasia of tissues of ectodermal origin (hair, nails, teeth, skins and glands). Clinically, it may be divided into two broad categories: the X-linked hypoidrotic form and the hidrotic form. Hypohidrotic Ectodermal Dysplasia (H.E.D) is characterized by the triad oligo-anodontia, hypotricosis, hypo-anhydrosis (Christ-Siemens-Tourane syndrome). The incidence of HED is about 1/100,000. Mutation in the actodysplasin-A (EDA) and ectodysplasin-A receptor (EDAR) genes are responsible for X-linked and autosomal HED. The clinical features include sparse, fine hair, missing or conical-shaped teeth, decreased sweat and mucous glands, hypoplastic skin, and heat intolerance with exercise or increased ambient temperature. Complete or partial anodontia and malformation of teeth are the most frequent dental findings. Incisors and canines are often conical-shaped while primarily second molars, if present, are mostly affected by taurodontism. Treatment is supportive and includes protection from heat exposure, early prosthetic rehabilitation, skin, hair ear, nose and nail care, and genetic counseling for family planning. The diagnosis of HED in the neonatal and early infancy period may be difficult since sparse hair and absent teeth are normal finding at this age. In childhood the diagnosis is more easily made on the basis of history and clinical examination. Dental abnormalities are the most common complaint. Prosthetic rehabilitation has been recommended as an essential part of the management of HED because is important from functional, esthetic, and psychological standpoint. A team approach that includes input from a pediatric dentist, an orthodontist, a prosthodontist, and an oral and maxillofacial surgeon is necessary for a successful outcome. Conventional prosthodontic rehabilitation in young patient is often difficult because of the anatomical abnormalities of existing teeth and alveolar ridges. The conical shaped teeth and “knife-edge” alveolar ridges result in poor retention and instability of dentures. Moreover, denture must permit jaws expansion and a correct pattern of growth. Materials and Methods. Complete removable dentures were provided to allow for normal physiological development and a corrected masticatory function. Initial maxillary and mandibular impressions were made with smallest stock trays and irreversible hydrocolloid and then final impressions ware made with light-bodied polysulfide rubber base impression material. A base of autopolymerizing resin was constructed and a wax rim was added to the base. The patient’s vertical dimension of occlusion was established by assessing phonetic and esthetic criteria. Preliminary occlusal relations were recorded, and the mandibular cast was mounted on the articulator. Acrylic resin teeth specific for children dentures were selected and mounted. The dentures were tried in and, after proper adjustments, were inserted. The patients were monitored clinically every month to fit prostheses. Cephalometric radiographs were taken every 6 month with the prostheses in place in order to evaluate correct pattern of growth. Cephalometric measurements were realized and used to evaluate the effect of rehabilitation on craniofacial growth. Cephalometric measurements of sound patients were compared with ED patients. After two month expander screws (three-way screw in the upper denture and two-way the lower one)were inserted in each denture in order to permit the expansion of the denture and the jaws growth. Where conical teeth were present, composite crown were realized and luted to improve the esthetic and phonesis. In order to improve retention the placement of endosseous implants was carried out. TC 3D Accuitomo was performed and a resin model of mandibular bone of the patient was realized. At the age of 11 years two implants were inserted into anterior mandible in a child with anodontia. Despite a remarkable multi-dimensional atrophy of the mandibular alveolar process, the insertion of two tapered screw implants (SAMO Smiler, diameter 3.8, length 10 mm). After a submerged healing period of two-three month, the implants were exposed. Implants were connected with an expansion guide that permits mandibular growth and prosthetic retention. The amount of mandibular growth was also evaluate dusing the expansion guide. Results. Early oral rehabilitation improve oral function, phonesis and esthetic, reducing social impairment. Treated patients showed normal cephalometric measurement. Early rehabilitation is able to prevent the prognatissm of the mandibula . The number of teeth was significantly related to several changes in craniofacial morphology. Discussion. In the present study the 5,3% of ED patients showed hypodontia, the l’89,4% di oligodontia, and the 5,3% di anodontia. The cephalometric analysis supports that ED patients showed midface hypoplasia. ED groups showed an increased pogonion to nasion measurement than sound patients, indicative of class III tendency. The present study demonstrated that number of teeth was significantly correlated with deviation of cephalometric measurements from normality. Oligoanodontia is responsible for changing of cephalometric measuraments also on sagittal plane with a class III tendency. Maxillary jaw showed a retrused position related to the presence of hypodontia.

The role of interleuchin 6 (IL-6) in the promotion of an aggressive and stem cell-like phenotype in human breast cancer cells and in stem/progenitor cells expanded in vitro as mammospheres

High serum levels of Interleukin-6 (IL-6) correlate with poor outcome in breast cancer patients. However no data are available on the relationship between IL-6 and stem/progenitor cells which may fuel the genesis of breast cancer in vivo. Herein, we address this issue in mammospheres (MS), multi-cellular structures enriched in stem/progenitor cells of the mammary gland, and also in MCF-7 breast cancer cells. We show that MS from node invasive breast carcinoma tissues express IL-6 mRNA at higher levels than MS from matched non-neoplastic mammary glands. We find that IL-6 mRNA is detectable only in basal-like breast carcinoma tissues, an aggressive variant showing stem cell features. Our results reveal that IL-6 triggers a Notch-3-dependent up-regulation of the Notch ligand Jagged-1, whose interaction with Notch-3 promotes the growth of MS and MCF-7 derived spheroids. Moreover, IL-6 induces a Notch-3-dependent up-regulation of the carbonic anhydrase IX gene, which promotes a hypoxia-resistant/invasive phenotype in MCF-7 cells and MS. Finally, an autocrine IL-6 loop relies upon Notch-3 activity to sustain the aggressive features of MCF-7-derived hypoxia-selected cells. In conclusion, our data support the hypothesis that IL-6 induces malignant features in Notch-3 expressing, stem/progenitor cells from human ductal breast carcinoma and normal mammary gland.

Vorkommen und Charakterisierung von Ecdysiotropinen bei männlichen Imagines der Mittelmeerfeldgrille Gryllus bimaculatus de Geer

Das Vorkommen von Häutungshormonen in adulten Insekten, insbesondere solcher, die eine lange Imaginalphase durchlaufen, wirft die Frage nach der Regulation der Ecdysteroidsynthese außerhalb der Prothorakaldrüse auf. Unter diesem Gesichtspunkt kann Gryllus bimaculatus mit einem ausgesprochen langen Adultstadium und rapiden zeitlichen Veränderungen des Ecdysontiters als ein geeignetes Versuchsobjekt angesehen werden.Der vorliegenden Dissertation liegt die Arbeitshypothese zugrunde, daß die Ecdysteroid-Synthese bzw. Sekretion von Adultgeweben in männlichen Imagines der Mittelmeerfeldgrille durch Neuropeptide hormonell reguliert wird. Als Quelle für die Ecdysteroidsynthese wurde auf Grund immunohistochemischer Befunde sowie der Ergebnisse von Sekretionsprofil-Analysen unter anderem die Oenocyten in Betracht gezogen.Zur Überprüfung dieser Hypothese wurde ein in vitro Bioassay entwickelt, der es ermöglichte, die Wirkung von extrahierten Substanzen auf die Hormonsynthese mittels RIA/HPLC zu bestimmen. Aus Köpfen adulter G. bimaculatus ließen sich durch HP-SEC Faktoren isolieren, die die Ecdysteroidsekretion in Oenocyten und Tergiten stimulierten, die aber keinen Einfluß auf die Hormonsekretion von Fettgewebe sowie der Prothorakaldrüsen hatten. Die Wirkung des aufgereinigten Extraktes in Oenocyten war zeit- und dosis-abhängig. Die ecdysiotropen Faktoren besaßen ein Molekulargewicht zwischen 26,5 und 30 kDa. Die Größe der Molmasse der ecdysiotropen Faktoren entsprach somit bei adulten männlichen Grillen etwa dem des Neurohormons PTTH bei Lepidopteren. Dennoch zeigten Antikörper, die gegen PTTH von Bombyx mori gerichtet waren im Western-Blot keine Bindung an Gryllus bimaculatus Kopfextrakte. Die Sekretionsprodukte von Oenocyten, die mit Ecdysiotropinen behandelt waren, wurden durch RP- und NP-HPLC identifiziert. Es konnten zwei zusätzliche Peaks neben einem deutlichen Anstieg von 20-Hydroxyecdyson nachgewiesen werden. Auf Grund identischer Retentionszeiten mit Referenzsubstanzen handelt es sich bei einem Peak vermutlich um Makisteron A.Obwohl die Applikation von Azadirachtin in G. bimaculatus zu einer Senkung des Hämolymph-Ecdysteroidgehalts führte, konnte keine Anreicherung von Ecdysiotropinen erzielt werden.Die die Ecdysteroidsekretion-beeinflussenden Faktoren waren resistent gegen Kochen und Alkylierung aber nicht stabil gegen Reduzierung durch DTT und Behandlung mit Neuramidase. Damit konnte gezeigt werden, daß das Vorhandensein von Disulfidbrücken und Oligosaccharidketten für die biologische Aktivität notwendig ist.Die Aminosäuresequenz-Analyse und der enzymatische Verdau der stimulierenden Faktoren durch Exopeptidasen wiesen auf geschützte N- und C-Termini hin. Ferner wurden einige interne Peptidfragmente von fünf Proteinbanden sequenziert, die keine Homologie zu bereits bekannten regulatorischen Neuropeptiden zeigten. Als einziges bekanntes Protein aus diesem Bereich konnte das „14-3-3-like Protein“ mit Hilfe MALDI-MS identifiziert werden.Die Stimulierung der Ecdysteroidsekretion in Oenocyten von G. bimaculatus durch Oenocyten-stimulierende Faktoren (OSF) aus Kopfextrakten konnte mittels Signalstoff-Effektoren in vitro nachgeahmt werden. Außerdem wurde mit Hilfe eines RRA nachgewiesen, daß der intrazelluläre cAMP-Spiegel von Oenocyten durch OSF erhöht wird. Daraus kann geschlossen werden, daß cAMP als „Second Messenger“ an der Wirkung der OSF beteiligt ist. Calcium-Ionen schienen für die Ecdysteroidsekretion notwendig zu sein. Allerdings führte eine artifizielle Erhöhung der intrazellulären Calcium-Konzentration durch das Ionophor Ionomycin zu einer Hemmung der Sekretion. Schließlich wird ein Modell zur Erklärung des Wirkmechanismus von OSF in Gryllus bimaculatus postuliert und diskutiert.

Correlation between insulin resistance and treatment-resistant acne

Physiologically during puberty and adolescence, when juvenile acne usually appears, the response to a glucose load is increased if compared to the one observed in adult and at pre-pubertal age, while insulin sensitivity is reduced. Insulin is a hormone that acts at different levels along the axis which controls the sex hormones. It increases the release of LH and FSH by pituitary gland, stimulates the synthesis of androgens in the gonads and stimulates the synthesis of androgenic precursors in adrenal glands. Finally, it acts in the liver by inhibiting the synthesis of Sex Hormone Binding Globulin (SHBG). Insulin is also able to act directly on the production of sebum and amplify the effects of Iinsulin Growth Factor-1 in the skin, inhibiting the synthesis of its binding protein (IGF Binding Protein-1). In female subjects with acne and Polycystic Ovary Syndrome (PCOS) insulin resistance is a well known pathogenetic factor, while the relationship between acne and insulin resistance has been poorly investigated in males so far. The purpose of this study is to investigate the correlation between insulin resistance and acne in young males who do not respond to common therapies. Clinical and biochemical parameters of glucose, lipid metabolism, androgens and IGF-1 were evaluated. Insulin resistance was estimated by Homeostasis Model assessment (HOMA-IR) and Oral Glucose Tolerance Test was also performed. We found that subjects with acne had higher Sistolic and Diastolic Blood Pressure, Waist/Hip Ratio, Waist Circumference, 120' OGTT serum insulin and serum IGF-1 and lower HDL-cholesterol than subjects of comparable age and gender without acne. The results thus obtained confirmed what other authors have recently reported about a metabolic imbalance in young males with acne. Furthermore, these results support the hypothesis that insulin resistance might play an important role in the pathogenesis of treatment-resistant acne in males.

CYP17A1 polymorphisms and clinical outcome of patients with metastatic castration-resistant prostate cancer treated with abiraterone

Background. Abiraterone acetate is a potent inhibitor of cytochrome P450 17 α-hydrolase (CYP17A1) that causes a reduction in the synthesis of testosterone in the adrenal glands, testes and tumor microenvironment. Blocking androgen production, abiraterone has been shown to prolong progression-free survival (PFS) and overall survival (OS) in patients with metastatic castration-resistant prostate cancer (CRPC) previously submitted to chemotherapy. The aim of our study was to verify the role of single nucleotide polymorphisms (SNPs) in predicting clinical outcome in CRPC patients treated with abiraterone after chemotherapy. Methods. We analyzed 48 CRPC consecutive patients treated with abiraterone after at least one chemotherapeutic regimen with docetaxel. DNA was extracted from peripheral blood and genotyped for four polymorphisms in the CYP17A1 gene (rs743572, rs10883783, rs17115100, rs284849). PFS and OS survival curves were used to identify statistical associations between haplotypes and clinical outcome. Results. Forty-eight Caucasian patients with metastatic CRPC treated with abiraterone were genotyped for polymorphisms in the CYP17A1 gene. All samples were evaluable for both sequencing and TaqMan Genotyping assay. The CRPC patients treated with abiraterone had a median PFS and OS of 7.6 months (95% CI: 4.3-10.5) and 17.6 months (95% CI: 10.5-19.0), respectively Statistical analyses highlighted a difference approaching statistical significance (log-rank test p = 0.0534) between rs10883783 and PFS. Other polymorphisms were not associated with a benefit from treatment with abiraterone. Conclusions. In our case series of 48 treated patients, rs10883783 only was identified as a possible predictive marker, results showing a trend toward statistical significance. Further analysis of this polymorphism is needed in larger series of patients to confirm our findings.

Die Schleimkeratine TK-alpha and TK-gamma des Zebrabärblings Danio rerio

Die Schleimkeratine TKα und TKγ aus dem Schleimaal Eptatretus stoutii besitzten für Keratine außergewöhnliche Eigenschaften. In speziellen Drüsen reifen die Schleimkeratine zu 3 µm dicken und bis zu 60 cm langen kabelartigen Filamenten heran und werden anschließend zur Feindabwehr ins umgebende Wasser extrazellulär sezerniert, wodurch die viskoelastischen Eigenschaften des Schleims modifiziert werden. Mittlerweile wurden die Schleimkeratine auch in höheren Wirbeltiergruppen (Knochenfische und Amphibien) entdeckt. Zu Beginn meiner Promotion war jedoch bis auf EST-Verteilungsprofile noch nichts über die Expression und Funktion der Schleimkeratine in diesen Organismen bekannt. rnIm Rahmen meiner Arbeit wurden die Schleimkeratine TKα und TKγ erstmalig im Zebrabärbling Danio rerio identifiziert und näher charakterisiert. Mittels rekombinanter Expression wurden TKα und TKγ in ausreichenden Mengen hergestellt und auf ihre Bindungseigenschaften hin untersucht. Hierbei konnte ich zeigen, dass TKα und TKγ einerseits miteinander Heteromere formen und andererseits, dass das TKα in der Lage ist, auch homopolymere Strukturen auszubilden. Letztere Eigenschaft wurde bisher noch bei keinem bekannten cytoplasmatischen Keratin beschrieben. Ergänzend zu diesen Untersuchungen wurde eine Expressionsanalyse durchgeführt. Hierbei konnte gezeigt werden, dass die Schleimkeratine im Zebrabärbling nicht extrazellulär sezerniert werden und zum anderen keine höheren, kabelartigen Strukturen ausformen. Vielmehr werden die Schleimkeratine bei adulten Tieren in den basalen Zellschichten der Epidermis exprimiert, welche keinen mechanischen Schutz in Form von Schuppen aufweisen (Stirnhautepidermis, Epidermis in Geweben zwischen den Flossenstrahlen). Innerhalb dieser Zellen formen die Schleimkeratine ein filamentöses Netzwerk aus, dass sich an der basalen Zellseite konzentriert. Eine mögliche Funktion von TKα und TKγ könnte demnach in der Erhöhung der mechanischen Integrität von stark beanspruchten Geweben liegen, die keinen Schutz in Form von Schuppen aufweisen. So werden TKα und TKγ in larvalen Entwicklungsstadien in der Epidermis, sowie im mechanisch stark beanspruchten Notochord koexprimiert. rnDa das Notochord im Zebrabärbling auch in entwicklungsbiologischen Vorgängen eine entscheidende Rolle spielt und weiterhin in aktuellen Untersuchungen am glatten Krallen-frosch Xenopus laevis Funktionen der Schleimkeratine TKα und TKγ innerhalb von Degenerationsprozessen während der Metamorphose nachgewiesen werden konnten, sind auch im Zebrabärbling Danio rerio Funktionen der Schleimkeratine TKα und TKγ im Rahmen von Entwicklungsprozessen denkbar.rn

Gestione pre, intra e post-operatoria del cane sottoposto ad ipofisectomia transfenoidale

L’approccio chirurgico agli adenomi ipofisari ACTH secernenti è la terapia d’elezione nell’uomo. L’ipofisectomia transfenoidale è invece una tecnica poco diffusa in ambito veterinario. La terapia più diffusa nel cane con ipercortisolismo ipofisi dipendente (PDH) è di tipo medico e prevede la somministrazione di farmaci inibitori della sintesi del cortisolo. Gli adenomi ipofisari possono aumentare di volume e determinare una conseguente sintomatologia neurologica; in questi casi le uniche opzioni terapeutiche sono rappresentate dall’asportazione chirurgica della neoplasia e dalla radioterapia. Nella presente tesi vengono descritti 8 interventi di ipofisectomia transfenoidale effettuati su 7 cani con macroadenoma ipofisario presso il Dipartimento di Scienze Mediche Veterinarie dell’Università di Bologna. La difficoltà maggiore per il chirurgo è rappresentata dalla localizzazione della fossa ipofisaria rispetto ai punti di repere visibile in tomografia computerizzata o in risonanza magnetica nucleare, oltre ai problemi di sanguinamento durante la rimozione della neoplasia. Nel periodo post-operatorio maggiori complicazioni si riscontrano in soggetti con adenomi ipofisari di maggiori dimensioni. Al contrario, in presenza di adenomi di dimensioni più contenute, la ripresa post-operatoria risulta più rapida e il tasso di successo maggiore. Al fine di poter eseguire nel cane l’exeresi mirata della sola neoplasia ipofisaria, al pari di quanto avviene nell’uomo, è stato condotto uno studio sulla tomografia computerizzata (TC) in 86 cani con PDH. Il protocollo TC non ha tuttavia permesso di individuare con precisione la posizione della neoplasia per guidare il chirurgo nella sua rimozione. In due casi riportati nel presente lavoro si è verificata una recidiva della neoplasia ipofisaria. In un soggetto si è optato per il reintervento, mentre nell’altro caso per la radioterapia. Entrambe le opzioni hanno garantito una buona qualità di vita per più di un anno dall’intervento terapeutico. Questi casi clinici dimostrano come il reintervento e la radioterapia possano essere considerate valide opzioni in caso di recidiva.

Ein räumliches Orientierungsgedächtnis im Zentralkomplex von Drosophila melanogaster und die spezifische Rolle von ellipsoid-body-open

In der vorliegenden Arbeit wurden zwei Strukturmutationslinien von Drosophila melanogaster, grf und ebo, hinsichtlich ihres Lauf- und Orientierungsverhaltens im Buridanschen sowie im Detour-Paradigma untersucht. Als Kernthema der Arbeit entwickelte sich rasch die molekulare Analyse von ebo in Bezug auf das räumliche Orientierungsgedächtnis, da ebo-mutante Fliegen Letzteres nicht zeigen. Durch Wiederherstellen der EBO-Funktion kann der Verhaltensphänotyp der ebo-Mutante in jeder Ringneuronengruppe des Ellipsoidkörpers gerettet werden, jedoch nicht der Strukturdefekt. Zudem wird zur Ausbildung des Orientierungsgedächtnisses EBO nicht während der Entwicklung, sondern akut benötigt. Aufgrund der Tatsache, dass ebo für das nukleäre Protein Exportin6 codiert, und selbiges für den Export von Aktin-Profilin-Komplexen aus dem Zellkern verantwortlich ist (STÜVEN ET AL., 2003), zeigen ebo-Tiere nukleäre Aktin-Akkumulationen sowohl während der Entwicklung in Speicheldrüsen als auch im adulten Gehirn, was mittels Expression eines Actin::GFP-Fusionsproteins gezeigt wurde. Die genetischen Interaktionsexperimente zeigen, dass der anatomische Defekt von ebo durch eine reduzierte Aktin-Polymerisation erfolgt, für den Verhaltensphänotyp jedoch die Aktin-Anreicherung in den Zellkernen von Ringneuronen des Ellipsoidkörpers ursächlich ist. Die erstaunliche Redundanz der Ringneurone in Bezug auf die Rettung des Verhaltensphänotyps legt nahe, dass diffusible Faktoren eine wichtige Rolle für die Ausbildung eines Orientierungsgedächtnisses spielen. Bezüglich dieser Hypothese konnte nachgeweisen werden, dass durch FMRFamid-RNAi in R2- und R4-Ringneuronen des Ellipsoidkörpers das Orientierungsgedächtnis zerstört wird. Eine daraufhin durchgeführte Antikörperfärbung gegen pro-FMRFa in wildtypischen und ebo-mutanten Gehirnen ergab jedoch keine Verschiedenheit die Menge oder Lokalisation betreffend. Die bei ebo vorhandene Anreicherung von Aktin im Zellkern bewirkt, dass die Aktin-Monomere im Nucleus an den Cofaktor dMRTF (Mrtf) binden und diesen somit inaktivieren. Dadurch kann der Transkriptionsfaktor dSRF (bs) nicht mehr durch dMRTF aktiviert werden, was den Orientierungsgedächtnis-Verlust bewirkt. Da es jedoch unwahrscheinlich ist, dass ein Gedächtnis, welches nur wenige Sekunden andauert, von Transkriptionsregulation abhängt, könnte dSRF auch die Genexpression von Molekülen, die schnelle Veränderungen synaptischer Transmission der Ringneurone vermitteln, modulieren. Für die Zukunft wäre es demnach von enormer Bedeutung, weitere Zielgene von dSRF aufzuklären und zu analysieren.

Die Expression und Regulation der CYP3A in menschlicher Haut

In Leber und Dünndarm bauen CYP3A-Enzyme eine Vielzahl von Fremdstoffen ab, die in den Körper gelangt sind. Zudem aber sind diese Enzyme auch in anderen Organen, wie der Haut exprimiert. Doch weder die genaue Zusammensetzung der CYP3A-Isozyme noch deren physiologische Rolle in der Haut sind bisher bekannt. Basierend auf begrenzten in vitro-Daten ist eine Rolle der CYP3A in der kutanen Vitamin D-Synthese denkbar. Auf der anderen Seite könnten die kutanen CYP3A auch lokal oder systemisch verabreichte Medikamente in der Haut verstoffwechseln und so zur Entstehung immunologischer und nicht-immunologischer unerwünschter Arzneimittelwirkungen beitragen, von denen sich bis zu 45 % in der Haut manifestieren.rnDie Arbeitshypothese dieses Projekts war, dass die CYP3A die kutane Synthese von Vitamin D regulieren. In dieser Funktion wurden sie zur Vermeidung von Vitamin D-Mangel-Erkrankungen wie Rachitis oder Osteomalazie in Europäern negativ selektiert. rnDie Expression und Regulation der CYP3A wurde in Hautbiopsien, einer Zelllinie epidermalen Ursprungs und primären Hautzellen wie auch in transgenen Mäusen untersucht. Die metabolische Aktivität der CYP3A gegenüber den kutanen Vitamin D-Vorstufen wurde mit Hilfe rekombinant exprimierter Enzyme untersucht. CYP3A5-mRNA war die häufigste der CYP3A in humanen Hautproben und überstieg die von CYP3A4 um das Dreifache, die von CYP3A7 um das 130-Fache. Damit entsprach diese 1,3 %, 0,01 % bzw. 0,01 % der jeweiligen hepatischen Genexpression. Die Expression von CYP3A43 war zu vernachlässigen. CYP3A5 zeigte eine bimodale Expression sowohl auf mRNA- als auch auf Proteinebene. So zeigten Träger der Wildtyp-Allels *1 eine 3,3-fach höhere mRNA- und 1,8-fach höhere Proteinmenge als homozygote Träger des Nullallels *3. CYP3A4/7- und CYP3A5-Protein wurde v. a. in den Keratinozyten der Epidermis und den Talgdrüsen, also den Bereichen der kutanen Vitamin D-Synthese lokalisiert. Die CYP3A5-Expression wurde ferner in der Haut transgener Mäusen gezeigt, die das Reportergen Luziferase unter Kontrolle des humanen CYP3A5-Promoters exprimieren. Verglichen mit der Leber war die kutane Expression des Vitamin D-Rezeptors (VDR) 100-fach höher, die der Xenosensoren CAR und PXR vergleichbar bzw. zu vernachlässigen. Dementsprechend erhöhte die Behandlung mit 1,25-Dihydroxyvitamin D, dem aktiven Vitamin D-Hormon, und dessen Vorstufen außer 7-Dehydrocholesterol, jedoch nicht der PXR-Ligand Rifampicin, die Expression der CYP3A. Wie in Zwei-Hybrid-Experimenten gezeigt, wurden die Effekte des 1,25-Dihydroxyvitamin D und dessen Vorstufen alleinig durch VDR vermittelt. Die Effektstärke hingegen war abhängig von Zellspender, Zellpassage und Zelltypus. Alle drei CYP3A-Isozyme metabolisieren Vitamin D zu einem oder mehreren unbekannten Metaboliten, jedoch nicht zu 25-Hydroxyvitamin D, dem direkten Vorläufer des aktiven Vitamin D. rnZusammengefasst legen die Daten nahe, dass die kutanen CYP3A, allen voran CYP3A5, die Vitamin D-Homöostase durch VDR-vermittelte Induktion des Abbaus von Vitamin D-Vorstufen regulieren. Dies zusammen mit Sequenzdaten liefert starke Indizien für Vitamin D als treibende Kraft der Selektion des CYP3A-Lokus in Europäern. Der Einfluss der CYP3A-Expression auf selektiv wirksame, klinisch relevante Knochenveränderungen wie Rachitis oder Osteomalazie müssen folgen.rn

Carcinoma ex pleomorphic adenoma in a minor salivary gland: report of a case

BACKGROUND: Carcinoma ex pleomorphic adenoma is exceedingly rare in minor salivary glands of the oral cavity. We present a case of carcinoma ex pleomorphic adenoma (CEPA) of the buccal mucosa in a 47-year-old Turkish patient. The buccal mass was of a size of 1.5 cm located in the left cheek. Pleomorphic adenoma was the tentative diagnosis. METHODS: The tumor was removed under local anesthesia. Histopathologic evaluation revealed a preexisting pleomorphic adenoma associated with adenoid tumor component with tubulo-cystic and papillary or pseudopapillary structures; CEPA was diagnosed. Capsular integrity was incomplete with infiltration by islands of metaplastic/dysplastic epithelium. RESULTS: Secondary surgery of the site was performed. No tumor tissue could be detected in the resection specimen. The patient is free of recurrence since 9 months.

Pheochromocytoma in rats with multiple endocrine neoplasia (MENX) shares gene expression patterns with human pheochromocytoma

Pheochromocytomas are rare neoplasias of neural crest origin arising from chromaffin cells of the adrenal medulla and sympathetic ganglia (extra-adrenal pheochromocytoma). Pheochromocytoma that develop in rats homozygous for a loss-of-function mutation in p27Kip1 (MENX syndrome) show a clear progression from hyperplasia to tumor, offering the possibility to gain insight into tumor pathobiology. We compared the gene-expression signatures of both adrenomedullary hyperplasia and pheochromocytoma with normal rat adrenal medulla. Hyperplasia and tumor show very similar transcriptome profiles, indicating early determination of the tumorigenic signature. Overrepresentation of developmentally regulated neural genes was a feature of the rat lesions. Quantitative RT-PCR validated the up-regulation of 11 genes, including some involved in neural development: Cdkn2a, Cdkn2c, Neurod1, Gal, Bmp7, and Phox2a. Overexpression of these genes precedes histological changes in affected adrenal glands. Their presence at early stages of tumorigenesis indicates they are not acquired during progression and may be a result of the lack of functional p27Kip1. Adrenal and extra-adrenal pheochromocytoma development clearly follows diverged molecular pathways in MENX rats. To correlate these findings to human pheochromocytoma, we studied nine genes overexpressed in the rat lesions in 46 sporadic and familial human pheochromocytomas. The expression of GAL, DGKH, BMP7, PHOX2A, L1CAM, TCTE1, EBF3, SOX4, and HASH1 was up-regulated, although with different frequencies. Immunohistochemical staining detected high L1CAM expression selectively in 27 human pheochromocytomas but not in 140 nonchromaffin neuroendocrine tumors. These studies reveal clues to the molecular pathways involved in rat and human pheochromocytoma and identify previously unexplored biomarkers for clinical use.

Expression, localization, and functional model of cholesterol transporters in lactating and nonlactating mammary tissues of murine, bovine, and human origin

Members of the ATP-binding cassette (ABC) transporters play a pivotal role in cellular lipid efflux. To identify candidate cholesterol transporters implicated in lipid homeostasis and mammary gland (MG) physiology, we compared expression and localization of ABCA1, ABCG1, and ABCA7 and their regulatory genes in mammary tissues of different species during the pregnancy-lactation cycle. Murine and bovine mammary glands (MGs) were investigated during different functional stages. The abundance of mRNAs was determined by quantitative RT-PCR. Furthermore, transporter proteins were localized in murine, bovine, and human MGs by immunohistochemistry. In the murine MG, ABCA1 mRNA abundance was elevated during nonlactating compared with lactating stages, whereas ABCA7 and ABCA1 mRNA profiles were not altered. In the bovine MG, ABCA1, ABCG1, and ABCA7 mRNAs abundances were increased during nonlactating stages compared with lactation. Furthermore, associations between mRNA levels of transporters and their regulatory genes LXRalpha, PPARgamma, and SREBPs were found. ABCA1, ABCG1, and ABCA7 proteins were localized in glandular MG epithelial cells (MEC) during lactation, whereas during nonlactating stages, depending on species, the proteins showed distinct localization patterns in MEC and adipocytes. Our results demonstrate that ABCA1, ABCG1, and ABCA7 are differentially expressed between lactation and nonlactating stages and in association with regulatory genes. Combined expression and localization data suggest that the selected cholesterol transporters are universal MG transporters involved in transport and storage of cholesterol and in lipid homeostasis of MEC. Because of the species-specific expression patterns of transporters in mammary tissue, mechanisms of cholesterol homeostasis seem to be differentially regulated between species.

Colon cancer cells produce immunoregulatory glucocorticoids

Glucocorticoids (GC) have important anti-inflammatory and pro-apoptotic activities. Initially thought to be exclusively produced by the adrenal glands, there is now increasing evidence for extra-adrenal sources of GCs. We have previously shown that the intestinal epithelium produces immunoregulatory GCs and that intestinal steroidogenesis is regulated by the nuclear receptor liver receptor homolog-1 (LRH-1). As LRH-1 has been implicated in the development of colon cancer, we here investigated whether LRH-1 regulates GC synthesis in colorectal tumors and whether tumor-produced GCs suppress T-cell activation. Colorectal cancer cell lines and primary tumors were found to express steroidogenic enzymes and regulatory factors required for the de novo synthesis of cortisol. Both cell lines and primary tumors constitutively produced readily detectable levels of cortisol, as measured by radioimmunoassay, thin-layer chromatography and bioassay. Whereas overexpression of LRH-1 significantly increased the expression of steroidogenic enzymes and the synthesis of cortisol, downregulation or inhibition of LRH-1 effectively suppressed these processes, indicating an important role of LRH-1 in colorectal tumor GC synthesis. An immunoregulatory role of tumor-derived GCs could be further confirmed by demonstrating a suppression of T-cell activation. This study describes for the first time cortisol synthesis in a non-endocrine tumor in humans, and suggests that the synthesis of bioactive GCs in colon cancer cells may account as a novel mechanism of tumor immune escape.

Preponderance of cells with stem cell characteristics in metastasising mouse mammary tumours induced by deregulated EphB4 and ephrin-B2 expression

We have previously shown that EphB4 and ephrin-B2 are differentially expressed in the mammary gland and that their deregulated expression in the mammary epithelium of transgenic mice leads to perturbations of the mammary parenchyma and vasculature. In addition, overexpression of EphB4 and expression of a truncated ephrin-B2 mutant, capable of receptor stimulation but incapable of reverse signalling, confers a metastasising phenotype on NeuT initiated mouse mammary tumours. We have taken advantage of this transgenic tumour model to compare stem cell characteristics between the non-metastasising and metastasising mammary tumours. We analysed the expression of the proliferation attenuating p21(waf) gene, which was significantly increased in the metastasising tumours. Moreover, we compared the expression of CK-19, Sca-1, CD24 and CD49f as markers for progenitor cells exhibiting a decreasing differentiation grade. Sca-1 expressing cells were the earliest progenitors detected in the non-metastasising NeuT induced tumours. The metastasising NeuT/EphB4 tumours were enriched in CD24 expressing cells, whereas the metastasising NeuT/truncated ephrin-B2 tumours contained in addition significant amounts of CD49f expressing cells. The same cell populations were also enriched in mammary glands of single transgenic MMTV-EphB4 and MMTV-truncated ephrin-B2 females indicating that deregulated EphB4-ephrin-B2 signalling interferes with the homeostasis of the stem/progenitor cell pool before tumour formation is initiated. Since the same cell populations are enriched in the normal tissue, primary mammary tumours and metastases we conclude that these progenitor cells were the origin of tumour formation and that this change in the tumour origin has led to the acquisition of the metastatic tumour phenotype.

Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging?

Dual-energy CT provides information about how substances behave at different energies, the ability to generate virtual unenhanced datasets, and improved detection of iodine-containing substances on low-energy images. Knowing how a substance behaves at two different energies can provide information about tissue composition beyond that obtainable with single-energy techniques. The term K edge refers to the spike in attenuation that occurs at energy levels just greater than that of the K-shell binding because of the increased photoelectric absorption at these energy levels. K-edge values vary for each element, and they increase as the atomic number increases. The energy dependence of the photoelectric effect and the variability of K edges form the basis of dual-energy techniques, which may be used to detect substances such as iodine, calcium, and uric acid crystals. The closer the energy level used in imaging is to the K edge of a substance such as iodine, the more the substance attenuates. In the abdomen and pelvis, dual-energy CT may be used in the liver to increase conspicuity of hypervascular lesions; in the kidneys, to distinguish hyperattenuating cysts from enhancing renal masses and to characterize renal stone composition; in the adrenal glands, to characterize adrenal nodules; and in the pancreas, to differentiate between normal and abnormal parenchyma.