<p>Multiple myeloma (MM) is an incurable B-cell malignancy mainly localized to the bone marrow. Our aim was to examine the growth- and survival-promoting role of the IGF-IR and its downstream signaling components in MM cells to identify potential targets for therapy. </p><p>Octreotide, a somatostatin analog that has been demonstrated to interfere with the actions of IGF-I, induced growth inhibition in both IL-6-dependent and IL-6-independent MM cell lines expressing the somatostatin receptors sst2, sst3 and sst5. Additionally, a slight pro-apoptotic effect could be observed in a few cell lines. In primary MM cells octreotide induced apoptosis, an effect that was abrogated by exogenously added IGF-I, but not by IL-6.</p><p>Inhibition of IGF-I signaling in Karpas 707 cells, using either the anti-IGF-IR antibody αIR3 or the PI 3-K inhibitors LY294002 and wortmannin, increased sensitivity to apoptosis induced by dexamethasone. Exogenously added IGF-I prevented dexamethasone-induced apoptosis, an effect that could partly be mimicked by the pharmacological GSK-3β inhibitors LiCl and SB415286. Thus, we suggest the GSK-3β as an important mediator of the anti-apoptotic effects of IGF-IR signaling in MM.</p><p>Using rapamycin we selectively inhibited mTOR, a phosphoprotein downstream of the IGF-IR. In MM cell lines rapamycin induced G0/G1-arrest, an effect being associated with an increase of the cyclin-dependent kinase inhibitor p27 and a decrease of the cyclins D2, D3 and E. Interestingly, in primary MM cells rapamycin induced apoptosis. Moreover, rapamycin potentiated dexamethasone-induced apoptosis, an effect that was associated with a downregulation of the anti-apoptotic protein survivin. Strikingly, the combinatorial treatment with rapamycin and dexamethasone suppressed the anti-apoptotic effects of exogenously added IGF-I and IL-6, thus suggesting this drug-combination to be active also in vivo. </p><p>Two newly developed, selective IGF-I RTK inhibitors proved to be very effective in MM cell lines and in primary MM cells providing 50-90% growth inhibition within 48 h of incubation. The inhibitors induced massive apoptosis together with a prominent cell cycle arrest in the G2/M-phase. Importantly, the IGF-I RTK inhibitors downregulated the tyrosine phosphorylation of the IGF-IR β-chain but not of the insulin receptor β-chain. </p><p>In conclusion, the IGF-IR potently promotes growth and survival of MM cells. Therefore, interfering with the IGF-IR signaling pathway might be a suitable strategy to improve MM treatment.</p>

<p>Multiple myeloma (MM) is a virtually incurable B cell malignancy of the bone marrow. One important part of tumor progression and an obstacle for successful therapy is resistance to apoptosis. To combat this resistance, the mechanisms of apoptosis and survival in MM must be better defined. </p><p>In this thesis, we identified Fas up-regulation as a mechanism underlying interferon (IFN)-mediated sensitization to Fas-induced apoptosis in the MM cell line U-266-1970. IFN treatment induced activation of signal transducer and activator of transcription (Stat)1 but, intriguingly, also attenuated activation of MM survival factor Stat3. </p><p>Exploring the role of Stat1 further, we established sub-lines of U-266-1970 with a stable over-expression of Stat1 and of its active mutant Stat1C. These sub-lines displayed a decreased expression and activation of Stat3, and an altered expression of apoptosis-related genes Harakiri, Bcl-2 and Mcl-1. In a drug library screening, Stat1 over-expression was associated with an increased sensitivity to Fas-induced apoptosis and, conversely, an increased resistance to several drugs, including the cyclin dependent kinase (cdk)1 inhibitor CGP74514A. We conclude that Stat1 over-expression does not confer a general resistance or sensitivity to apoptosis in MM, but may strongly affect the response to some specific drugs.</p><p>We also explored the effects of picropodophyllin (PPP), an inhibitor of the insulin-like growth factor I (IGF-I) receptor tyrosine kinase (RTK), in MM. PPP selectively inhibited the IGF-I RTK activity without inhibiting the insulin RTK activity. Furthermore, PPP potently induced cell cycle arrest and apoptosis in all MM cell lines and patient samples tested, also in the presence of survival factors IGF-I and IL-6. We conclude that PPP has great therapeutic potential in MM </p><p>Finally, we examined the expression and regulation of the inhibitors of apoptosis proteins (IAPs) in a panel of MM cell lines and patient samples. The glucocorticoid dexamethasone, which is used in MM therapy, induced a transient up-regulation and a subsequent down-regulation of c-IAP2, as well as a down-regulation of XIAP, possibly influencing the sensitivity to apoptosis induced by this drug. Supporting this notion, abrogation of IGF-IR signaling by PPP, which sensitizes MM cells to dexamethasone-induced apoptosis, enhanced the down-regulation of c-IAP2 and XIAP.</p>

Multiple myeloma (MM) is an incurable B-cell malignancy mainly localized to the bone marrow. Our aim was to examine the growth- and survival-promoting role of the IGF-IR and its downstream signaling components in MM cells to identify potential targets for therapy. Octreotide, a somatostatin analog that has been demonstrated to interfere with the actions of IGF-I, induced growth inhibition in both IL-6-dependent and IL-6-independent MM cell lines expressing the somatostatin receptors sst2, sst3 and sst5. Additionally, a slight pro-apoptotic effect could be observed in a few cell lines. In primary MM cells octreotide induced apoptosis, an effect that was abrogated by exogenously added IGF-I, but not by IL-6. Inhibition of IGF-I signaling in Karpas 707 cells, using either the anti-IGF-IR antibody αIR3 or the PI 3-K inhibitors LY294002 and wortmannin, increased sensitivity to apoptosis induced by dexamethasone. Exogenously added IGF-I prevented dexamethasone-induced apoptosis, an effect that could partly be mimicked by the pharmacological GSK-3β inhibitors LiCl and SB415286. Thus, we suggest the GSK-3β as an important mediator of the anti-apoptotic effects of IGF-IR signaling in MM. Using rapamycin we selectively inhibited mTOR, a phosphoprotein downstream of the IGF-IR. In MM cell lines rapamycin induced G0/G1-arrest, an effect being associated with an increase of the cyclin-dependent kinase inhibitor p27 and a decrease of the cyclins D2, D3 and E. Interestingly, in primary MM cells rapamycin induced apoptosis. Moreover, rapamycin potentiated dexamethasone-induced apoptosis, an effect that was associated with a downregulation of the anti-apoptotic protein survivin. Strikingly, the combinatorial treatment with rapamycin and dexamethasone suppressed the anti-apoptotic effects of exogenously added IGF-I and IL-6, thus suggesting this drug-combination to be active also in vivo. Two newly developed, selective IGF-I RTK inhibitors proved to be very effective in MM cell lines and in primary MM cells providing 50-90% growth inhibition within 48 h of incubation. The inhibitors induced massive apoptosis together with a prominent cell cycle arrest in the G2/M-phase. Importantly, the IGF-I RTK inhibitors downregulated the tyrosine phosphorylation of the IGF-IR β-chain but not of the insulin receptor β-chain. In conclusion, the IGF-IR potently promotes growth and survival of MM cells. Therefore, interfering with the IGF-IR signaling pathway might be a suitable strategy to improve MM treatment.

Multiple myeloma (MM) is a virtually incurable B cell malignancy of the bone marrow. One important part of tumor progression and an obstacle for successful therapy is resistance to apoptosis. To combat this resistance, the mechanisms of apoptosis and survival in MM must be better defined. In this thesis, we identified Fas up-regulation as a mechanism underlying interferon (IFN)-mediated sensitization to Fas-induced apoptosis in the MM cell line U-266-1970. IFN treatment induced activation of signal transducer and activator of transcription (Stat)1 but, intriguingly, also attenuated activation of MM survival factor Stat3. Exploring the role of Stat1 further, we established sub-lines of U-266-1970 with a stable over-expression of Stat1 and of its active mutant Stat1C. These sub-lines displayed a decreased expression and activation of Stat3, and an altered expression of apoptosis-related genes Harakiri, Bcl-2 and Mcl-1. In a drug library screening, Stat1 over-expression was associated with an increased sensitivity to Fas-induced apoptosis and, conversely, an increased resistance to several drugs, including the cyclin dependent kinase (cdk)1 inhibitor CGP74514A. We conclude that Stat1 over-expression does not confer a general resistance or sensitivity to apoptosis in MM, but may strongly affect the response to some specific drugs. We also explored the effects of picropodophyllin (PPP), an inhibitor of the insulin-like growth factor I (IGF-I) receptor tyrosine kinase (RTK), in MM. PPP selectively inhibited the IGF-I RTK activity without inhibiting the insulin RTK activity. Furthermore, PPP potently induced cell cycle arrest and apoptosis in all MM cell lines and patient samples tested, also in the presence of survival factors IGF-I and IL-6. We conclude that PPP has great therapeutic potential in MM Finally, we examined the expression and regulation of the inhibitors of apoptosis proteins (IAPs) in a panel of MM cell lines and patient samples. The glucocorticoid dexamethasone, which is used in MM therapy, induced a transient up-regulation and a subsequent down-regulation of c-IAP2, as well as a down-regulation of XIAP, possibly influencing the sensitivity to apoptosis induced by this drug. Supporting this notion, abrogation of IGF-IR signaling by PPP, which sensitizes MM cells to dexamethasone-induced apoptosis, enhanced the down-regulation of c-IAP2 and XIAP.

Wie für viele andere Zivilisationskrankheiten werden auch für Atherosklerose und dadurch verursachte Erkrankungen wie Herzinfarkt oder Schlaganfall die Weichen mitunter schon vor der Geburt gestellt. Pränatale oder fetale Programmierung heißt der Mechanismus, durch den negative Umweltbedingungen während der Schwangerschaft, allen voran der Einfluss von Stresshormonen, auf die Entwicklung des Fetus wirken und die Prädisposition für spätere Erkrankungen schaffen können (SCHWAB 2009, SECKL 2001). Ziel der vorliegenden Arbeit war es, die Auswirkungen von Stress während der Schwangerschaft auf den Fettstoffwechsel der Nachkommen unter besonderer Berücksichtigung bekannter Herz-Kreislauf-Risikofaktoren zu untersuchen. Zu diesem Zweck wurde 28 Weißbüschelaffen (F0) während der Trächtigkeit eine Woche lang täglich Dexamethason (DEX) – ein synthetisches Glucocorticoid (GC), welches die Plazentaschranke passieren kann (TEGETHOFF et al. 2009) – oral verabreicht (BEINDORFF et al. 2006, EINSPANIER et al. 2006c). Die drei weiblichen Folgegenerationen DEX F1 (n = 5), DEX F2 (n = 6) und DEX F3 (n = 3) dieser Tiere wurden untersucht, wobei sich die Medikamentengabe auf die F0-Generation beschränkte und alle weiteren Trächtigkeiten ungestört verliefen. Im Alter von 3,3 bis 5,6 Jahren (DEX F1) bzw. von Geburt an bis 1,5 Jahre (DEX F2, DEX F3) wurden die Tiere wöchentlich gewogen. In Blutproben wurden einerseits Fettsäuren (FS), andererseits Cholesterol (CHOL), Triglyceride (TG) und Lipoproteine gemessen, wobei zwei Methoden – enzymatische Analyse nach Ultrazentrifugation und direkter Assay – zum Einsatz kamen. Alle Resultate wurden denen gesunder Kontrolltiere ähnlichen Alters (n = 12) gegenübergestellt. Die Körpermasse unterschied sich zu keinem Zeitpunkt signifikant zwischen den Nachkommen der mit DEX behandelten Tiere und den Kontrollgruppen. Entweder gab es keinen programmierten Effekt auf das Gewicht oder er wurde durch individuelle Schwankungen, möglicherweise verstärkt durch erhöhte Stressempfindlichkeit oder Hyperaktivität der DEX-Nachkommen (FRENCH et al. 2004, SCHWAB 2009) und damit einhergehende Tendenz zur Gewichtsabnahme (KAPLAN und SHELMIDINE 2010) maskiert. Beide Methoden zur Untersuchung des Lipoproteinprofils erschienen für Weißbüschelaffen geeignet und können für zukünftige Untersuchungen empfohlen werden. Bei den Kontrollgruppen fiel auf, dass ältere Tiere u. a. signifikant mehr LDL- und VLDL-CHOL, aber signifikant weniger HDL-TG und n3-FS hatten als jüngere, was auf ein wie beim Menschen mit dem Alter steigendes Herz-Kreislauf-Risiko (CARLSSON et al. 2010) schließen lässt. Sowohl DEX F2 als auch DEX F3 wiesen signifikant höhere Konzentrationen von LDL-CHOL, signifikant niedrigere Werte von HDL-TG, mehr Gesamt-CHOL sowie einen höheren Quotienten CHOL : HDL-CHOL im Blutplasma auf als die Kontrolltiere. Diese Parameter gehören zu den in der humanmedizinischen Diagnostik genutzten Herz-Kreislauf-Risikofaktoren und die Veränderungen weisen auf eine erhöhte Auftrittswahrscheinlichkeit kardiovaskulärer Erkrankungen hin (KANNEL et al. 1994, LUSIS et al. 2004, NCEP 2002). Zusätzlich fielen bei DEX F1, DEX F2 und DEX F3 im Vergleich zu den Kontrollen signifikant erniedrigte Gehalte an n3-FS auf, die u. a. für ihre antiphlogistische und kardioprotektive Wirkung bekannt sind (ALONSO et al. 2003, CALDER 2004, KINSELLA et al. 1990). Pränatale GC-Behandlung rief demzufolge über Veränderungen im Fettstoffwechsel ein erhöhtes Risiko für Herz-Kreislauf-Erkrankungen bei ihren weiblichen Nachkommen F1 bis F3 hervor. Dies lässt auf epigenetische Effekte schließen, welche in weiterführenden Untersuchungen genauer erforscht werden sollten. / As for many other civilization diseases, the way for atherosclerosis and hence heart attack and stroke can be paved even before birth. The mechanism by which negative environmental circumstances, first of all the influence of stress hormones, can alter the development of the fetus and cause a predisposition for diseases later in life is called prenatal or fetal programming (SCHWAB 2009, SECKL 2001). The aim of the present study was to investigate the consequences of stress during pregnancy on lipid metabolism of the offspring with special regard to known cardiovascular risk factors. Therefore, 28 common marmosets (F0) were given dexamethasone (DEX) – a synthetic glucocorticoid (GC) with the ability to pass the placenta easily (TEGETHOFF et al. 2009) – orally, once daily for one week during gestation (BEINDORFF et al. 2006, EINSPANIER et al. 2006c). The three female filial generations DEX F1 (n = 5), DEX F2 (n = 6) and DEX F3 (n = 3) of those monkeys were investigated. Only the F0 generation was treated with DEX, while all of the following pregnancies remained undisturbed. At the age of 3.3 up to 5.6 years (DEX F1) and from birth until 1.5 years (DEX F2, DEX F3), respectively, the animals were weighed weekly. Blood samples were analyzed on the one hand for fatty acids (FA), on the other hand for cholesterol (CHOL), triglycerides (TG) and lipoproteins using two different methods – enzymatic analysis after ultracentrifugation and direct assay. All results were compared to those of healthy controls of similar age (n = 12). Body mass of the offspring of dams prenatally treated with DEX was not significantly different from that of the controls at any point of time. Either there was no programming effect on weight or it was masked by individual fluctuations, maybe potentiated by hyperactivity or a higher sensitivity to stress of the DEX offspring (FRENCH et al. 2004, SCHWAB 2009) and hence a tendency to loose weight (KAPLAN and SHELMIDINE 2010). Both methods for lipoprotein analysis seemed to be suitable for the common marmoset and can be recommended for future investigations. In the controls, older animals showed significantly more LDL and VLDL CHOL, but significantly less HDL TG and n3 FA than younger ones, which points out to a cardiovascular risk rising with age as in humans (CARLSSON et al. 2010). DEX F2 and DEX F3 had significantly higher concentrations of LDL CHOL, significantly lower levels of HDL TG, more total CHOL and a higher ratio of CHOL : HDL CHOL in blood plasma than the controls. Those parameters are well-known human medicine cardiovascular risk factors and the aberrations detected indicate a higher probability of developing cardiovascular diseases (KANNEL et al. 1994, LUSIS et al. 2004, NCEP 2002). Additionally, compared to the controls, all DEX generations F1 to F3 showed significantly lower levels of n3 FA, which are known for their antiinflammatory and cardioprotective effects amongst others (ALONSO et al. 2003, CALDER 2004, KINSELLA et al. 1990). Consequently, prenatal treatment with GC caused an increased risk for cardiovascular diseases in the female offspring F1 up to F3 via alteration of lipid metabolism. This points out to epigenetic effects, which require further investigation.

Cataract is one of the leading causes of vision loss worldwide. The rate of cataract surgery has been steadily increasing. Toxic Anterior Segment Syndrome (TASS) is a sterile inflammatory response in the anterior segment of the eye that may occur following cataract surgery. When left untreated, it can lead to permanent vision loss. Corneal endothelial cells are the cells most affected by TASS. These cells are unable to reproduce in vivo and consequently once the density of these cells drops below a certain level, vision is reduced and cannot be reversed. The damage is thought to be mediated by cytokines and endotoxins, primarily through the NF-κΒ pathway. It is hypothesized that anti-inflammatory drug delivery intraocular lenses may help reduce the occurrence of TASS and consequent vision loss. In this research thesis project, an in vitro model was developed as a tool to select drug and delivery material to be used in an anti-TASS ophthalmic biomaterial. In an attempt to find a novel and more effective approach to TASS prevention, dexamethasone, a potent anti-inflammatory steroid drug, was compared to triptolide, a cytokine inhibitor; aprotinin, a general protease inhibitor; and PPM-18, a NF-κΒ inhibitor. To assess the efficacy of these drugs, an in vitro assay using human umbilical vein endothelial cells (HUVEC) and lipopolysaccharide as a stimulant was developed. Cell response to dexamethasone (10 nM), triptolide (3 nM), aprotinin (20 μM) and PPM-18 (10 μM) with or without LPS was characterized by cell viability and flow cytometry analysis of cell activation. Activation was characterized using markers for cell adhesion and activation ICAM-1, PECAM-1, VCAM-1, β1-integrin, CD44 and E-selectin. Following preliminarily testing, the efficacy of dexamethasone (10 nM) and PPM-18 (10 μM) loaded polymer (PDMS) and copolymer (PDMS/pNIPAAm) interpenetrating polymer networks were evaluated over a 4 day release period. The results from soluble drug and LPS (100 ng/mL) testing indicated no decrease in cell viability after 24 h. Dexamethasone, triptolide, aprotinin, and PPM-18 did not reduce the significant ICAM-1 upregulation seen in HUVECs after exposure to LPS for 4 days. PPM-18 in combination with LPS significantly upregulated E-selectin iv and CD44 from unstimulated HUVEC cells. The polymer materials without drug loading did not influence the cell phenotype. However, PPM-18 delivering polymer and copolymer materials significantly upregulated VCAM-1, CD44 when compared to all other treatments. Propidium iodide uptake in HUVEC exposed to PPM-18 drug delivering polymer and copolymer treatments indicated that these treatments caused cell necrosis. None of the drugs, or the drug delivering materials were shown to counteract the upregulation seen from LPS stimulation of HUVEC cells. Future work should focus on validating the in vitro model to more closely replicate the in vivo environment of the anterior segment with the use of primary bovine corneal endothelial cells.

Both stroke and depression are major health problems in the elderly. In this study, the prevalence of major depression after stroke was investigated in a well-defined sample of acute stroke patients (n=80), followed up at 3 months, 1 year, 2 and 3 years after the stroke event. Links to biological and psychosocial factors were examined. Hypercortisolism was studied by the dexamethasone suppression test and compared with healthy elderly. Living conditions (including demographic caracteristics, economic resources, health, functional ability, activity/leisure, social network) and life satisfaction were described before and after stroke in relation to a general elderly population. Demographic caracteristics, economic resources, social network and psychiatric morbidity prestroke did not differ from the general elderly population. Already prior to the stroke, patients reported more health problems and lower functional ability in many aspects of daily life, more passive leisure time and a lower global life satisfaction. After stroke, contacts with children were maintained, whilst contacts outside the family declined and remained lower than in the general elderly population. Stroke involved a marked reduction in global life satisfaction. Poor life satisfaction at 1 year remained poor for the entire three years; these stroke victims had a higher frequency of major depression early after stroke. The prevalence of major depression was 25% at the acute stage, 31% at 3 months, decreased to 16% at 1 year, was 19% at 2 years and increased to 29% at 3 years. The most important predictors of immediate major depression were left anterior brain lesion, dysphasia, and living alone. Dependence in self-care ability and loss of social contacts outside the family were the most important predictors at 3 months. From 1 year onwards, loss of social contacts contributed most to depression and at 3 years also cerebral atrophy. Sixty percent of patients with early depression (0-3 months) had recovered at 1 year; those not recovered at 1 year had a high risk of chronicitation. Hypercortisolism as measured by the dexamethasone suppression test was associated with major depression late (3 years) but not early (0-3 months) after stroke. At 3 years, the dexamethasone suppression test had a sensitivity of 70%, a specificity of 97%, a positive predictive value of 88%, a negative predicitive value of 91%, and a diagnostic accuracy of 90%. Nonsuppression of dexamethasone at 3 months was a significant predictor of major depression at 3 years. / <p>Härtill 5 uppsatser</p> / digitalisering@umu

There are a number of links between the endocrine system and the nervous system. In this study, the impact of ischemic stroke on the endocrine system was investigated. Elderly volunteers were studied because data regarding the influence of advanced age on endocrine parameters were lacking. Only small differences in pituitary-thyroid and pituitary-adrenal hormone axes were found between two groups of elderly patients, 60 and 80 years of age. The 80-year-old age group had a lower thyrotropin response to thyrotropin releasing hormone (TRH) and a decline in dopamine excretion. Patients with acute ischemic stroke showed a pronounced hypercortisolism studied by the dexamethasone test and urine free cortisol measurements. In multiple regression analyses, postdexamethasone cortisol levels were positively correlated to proximity of the lesion to the frontal pole of the brain and disorientation. Urine cortisol levels were predicted by limb paresis, disorientation and body temperature. High cortisol excretion was associated with a worse functional outcome. Norepinephrine excretion was correlated to urine cortisol levels and to motor impairment. Patients with acute stroke had elevated free thyroxin indices. A paradoxical growth hormone response to TRH was found in the majority of stroke patients. In a multiple regression model disorientation was negatively correlated to thyrotropin response after TRH and positively correlated to prolactin response. Growth hormone response to TRH was associated with extensive paresis. In a cohort study diabetic and non-diabetic patients were prospectively studied after an initial stroke. Diabetes mellitus adversely influenced survival, the risk for a recurrent stroke and myocardial infarction. / <p>S. 1-66: sammanfattning, s. 69-190: 6 uppsatser</p> / digitalisering@umu

Cataract is one of the leading causes of vision loss worldwide. The rate of cataract surgery has been steadily increasing. Toxic Anterior Segment Syndrome (TASS) is a sterile inflammatory response in the anterior segment of the eye that may occur following cataract surgery. When left untreated, it can lead to permanent vision loss. Corneal endothelial cells are the cells most affected by TASS. These cells are unable to reproduce in vivo and consequently once the density of these cells drops below a certain level, vision is reduced and cannot be reversed. The damage is thought to be mediated by cytokines and endotoxins, primarily through the NF-κΒ pathway. It is hypothesized that anti-inflammatory drug delivery intraocular lenses may help reduce the occurrence of TASS and consequent vision loss. In this research thesis project, an in vitro model was developed as a tool to select drug and delivery material to be used in an anti-TASS ophthalmic biomaterial. In an attempt to find a novel and more effective approach to TASS prevention, dexamethasone, a potent anti-inflammatory steroid drug, was compared to triptolide, a cytokine inhibitor; aprotinin, a general protease inhibitor; and PPM-18, a NF-κΒ inhibitor. To assess the efficacy of these drugs, an in vitro assay using human umbilical vein endothelial cells (HUVEC) and lipopolysaccharide as a stimulant was developed. Cell response to dexamethasone (10 nM), triptolide (3 nM), aprotinin (20 μM) and PPM-18 (10 μM) with or without LPS was characterized by cell viability and flow cytometry analysis of cell activation. Activation was characterized using markers for cell adhesion and activation ICAM-1, PECAM-1, VCAM-1, β1-integrin, CD44 and E-selectin. Following preliminarily testing, the efficacy of dexamethasone (10 nM) and PPM-18 (10 μM) loaded polymer (PDMS) and copolymer (PDMS/pNIPAAm) interpenetrating polymer networks were evaluated over a 4 day release period. The results from soluble drug and LPS (100 ng/mL) testing indicated no decrease in cell viability after 24 h. Dexamethasone, triptolide, aprotinin, and PPM-18 did not reduce the significant ICAM-1 upregulation seen in HUVECs after exposure to LPS for 4 days. PPM-18 in combination with LPS significantly upregulated E-selectin iv and CD44 from unstimulated HUVEC cells. The polymer materials without drug loading did not influence the cell phenotype. However, PPM-18 delivering polymer and copolymer materials significantly upregulated VCAM-1, CD44 when compared to all other treatments. Propidium iodide uptake in HUVEC exposed to PPM-18 drug delivering polymer and copolymer treatments indicated that these treatments caused cell necrosis. None of the drugs, or the drug delivering materials were shown to counteract the upregulation seen from LPS stimulation of HUVEC cells. Future work should focus on validating the in vitro model to more closely replicate the in vivo environment of the anterior segment with the use of primary bovine corneal endothelial cells.

Thesis (Ph.D.)--University of South Florida, 2004. / Includes vita. Includes bibliographical references (leaves 144-164).