<p>This dissertation details the creation, validation, and characterization of a porcine ex-vivo culture model to study subcuteneous tissue. The viability of the model was assessed over seven days of culture by digestion and the proliferation and death of cells was monitored by immunohistochmeical labelling and image analysis. The model was then used in a timecourse proteomics experiment to characterize the effect of culture on subcutaneous proteome. The model was then compared to a commercially available human ex-vivo model with respect to viability and changes to the subcutaneous proteome. </p>

Yes / Two different types of dry powder inhalers (Easyhaler® and RS01®) were used in this work to evaluate the ex vivo and in vitro performance of a budesonide inhaled formulation with recrystallised mannitol, commercial DPI-grade mannitol, or lactose. The aerodynamic performance of the budesonide formulation with recrystallised mannitol was superior when RS01® was used (FPF = 45.8%) compared to Easyhaler® (FPF = 14%). However, the aerodynamic profile was very poor in both devices when commercial mannitol was used. Interestingly, the aerosol performance of the marketed budesonide formulation significantly improved when RS01® was used compared to Easyhaler® (the original device for the formulation). Due to the significant increases in the surface energy of the commercial mannitol formulation, the aerodynamic performance of the formulation was very poor. This work demonstrates the impact of inhaler devices on the performance of inhaled formulations and considers the particle surface energy during formulation development.

Currently available dry powder inhalers (DPIs) for drug delivery to the lungs require turbulent energy to generate and disperse aerosol particles in the respirable range ≤5μm during inhalation. The patient's inspiratory effort together with the resistance inside the device creates this energy. Different inhalers provide varying degrees of resistance to inhalation flow and require different inhalation techniques for the generation and delivery of drug fine particles in respirable size range to the lungs. The aim of this research programme was to identify the influence of inhalation flow, inhalation volume and the number of inhalations per dose on the ex-vivo dose emission and the in-vitro aerodynamic dose emission characteristics of the salbutamol Accuhaler®, Easyhaler®, and Clickhaler® and the terbutaline Turbuhaler® DPIs. A high-performance liquid chromatography method for the assay of salbutamol sulphate and terbutaline sulphate in aqueous samples was modified and accordingly validated. In-vitro dose emission of the four different DPIs was measured using the pharmacopoeia method with modifications to simulate varying inhalation flows within patient and between patients. The ranges of the total emitted dose (% nominal dose) at the inhalation flow range of 10 - 60 Lmin-1, following one and two inhalations per metered dose for 2L and 4L inhaled volumes were as follows: the Accuhaler (52.64- 85.11; 61.88-85.11 and 59.23-85.11; 62.81-85.11); the Easyhaler (68.35-91.99; 79.94-91.99 and 73.83-92.51; 80.40-92.51); the Clickhaler (46.55-96.49; 51.12-96.49 and 51.18-101.39; 59.71-101.39) as well as the Turbuhaler (46.08-88.13; 51.95-88.13 and 48.05-89.22; 48.64-89.22). The results highlight that the four inhalers have flow-dependent dose emission property to a varying degree using 2L and 4 L inhaled volumes. There was no significant difference in the total emitted dose between a 2L inhaled volume and a 4L inhaled volume at each inhalation flow. Furthermore, the total emitted dose from the Easyhaler®, Clickhaler®, and Turbuhaler® was significantly (p≤0.001) greater with two inhalations than one inhalation per metered dose across the range of inhalation flow (10-60) Lmin-1. This effect was only observed at inhalation flow less than 30 Lmin-1 with the Accuhaler®. Overall there is a significant difference in the total emitted dose. The ex-vivo dose emission of the four different DPIs has been determined using the In- Check Dial device to train twelve non-smoking healthy adult volunteers to inhale at slow (30 Lmin-1) and fast (60 L min-1) inhalation flows through the device with its dial set corresponding to each inhaler. Subsequently each volunteer inhaled at the trained inhalation flows through each active inhaler. The local ethics committee approval was obtained prior to the study and all volunteers gave signed informed consent. The results obtained demonstrate that the studied inhalers have flow-dependent dose emission, thereby enhancing confidence in the use of the In-Check Dial® to identify a patient's inhalation flows through a variety of DPIs. Also the total emitted dose determined by ex-vivo methodology was significantly (p≤0.05) greater with two inhalations than one inhalation per metered dose. The results of the in-vitro aerodynamic dose emission characteristics highlight that the fine particle dose (FPD) from the four studied inhalers is flow dependent. Also the minimum inhalation flow to generate the (FPD) with the appropriate characteristics for lung deposition has been identified to be 20 L min⁻¹ for the Accuhaler®, Easyhaler® and Clickhaler®, while that for the Turbuhaler® is about 30 L min⁻¹. Also the inhalation volume above 2L and the number of inhalations for each dose have respectively no significant (p≤0.05) influence on the FPD emitted from the four studied inhalers. The results support the present instructions to patients using these inhalers to inhale once for each dose as fast as they can.

Cardiac transplantation is the treatment of choice for eligible patients with advanced heart failure; however, it is limited by a critical shortage of suitable organs from traditional brain-dead donors. Organs donated following circulatory death (DCD) have been used to successfully expand the pool of organs available for kidney, liver, and lung transplantation; however, concerns regarding the severity of injury sustained by the heart following withdrawal of life sustaining therapy have deterred the clinical transplantation of DCD hearts. Investigations aiming to optimize the resuscitation, preservation, and evaluation of DCD hearts may facilitate the development of an evidence based protocol for DCD heart transplantation that can be translated to the clinical area and expand the donor pool. Therefore, the objectives of this thesis are to develop a clinically relevant large animal model of DCD and gain a greater understanding regarding the physiologic impact of donor extubation on the DCD heart, demonstrate as a ‘proof-of-concept’ that utilizing an approach to donor heart resuscitation, preservation, and evaluation that is tailored to the DCD context can facilitate successful transplantation, and finally to investigate ways to optimize the resuscitation, preservation, and evaluation of DCD hearts for transplantation. The results of this thesis may then be used to inform the development of an evidence-based protocol for DCD heart transplantation that can be translated to the clinical area. The clinical adoption of such a protocol has the potential to expand the donor pool and improve outcomes for patients with end-stage heart failure. / May 2017

Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Iveta Rajtmajerová Supervisor: PharmDr. Jana Pourová, Ph.D. Title of diploma thesis: The in vitro effects of selected fenolic substances on isolated rat vessels Silymarin flavonolignans are endowed with various aspects. Recently their hepatoprotective effect has been discussed widely as well as their positive influence on the cardiovascular system. This diploma thesis is concerned with the vasodilatory effects of silybin-A, silybin-B, silybin-A + B and isosilybin-A on rat aorta. The aim of this study was to test the vasodilatory effect of selected substances. The dependence of aortic relaxation on the increasing concentration of tested substances was measured. Isolated Wistar breed rat aorta was used. DRC curves were created and EC50 values were assessed from the obtained values of vessel tension. The results were evaluated subsequently. The vasodilator potential of silybin-A and isosilybin-A is comparable; hence the position of the substituents may be irrelevant in having any impact on relaxation of the vessels. Different vasodilatory effects of silybin-A and silybin-B have been observed thus, the relaxation could be stereoselective. The testing of the equimolar mixture of silybin-A and...

abstract: Cancer is a major public health challenge and the second leading cause of death in the United States. Large amount of effort has been made to achieve sensitive and specific detection of cancer, and to predict the course of cancer. Glycans are promising avenues toward the diagnosis and prognosis of cancer, because aberrant glycosylation is a prevalent hallmark of diverse types of cancer. A bottom-up “glycan node analysis” approach was employed as a useful tool, which captures most essential glycan features from blood plasma or serum (P/S) specimens and quantifies them as single analytical signals, to a lung cancer set from the Women Epidemiology Lung Cancer (WELCA) study. In addition, developments were performed to simplify a relatively cumbersome step involved in sample preparation of glycan node analysis. Furthermore, as a biomarker discovery research, one crucial concern of the glycan node analysis is to ensure that the specimen integrity has not been compromised for the employed P/S samples. A simple P/S integrity quality assurance assay was applied to the same sample set from WELCA study, which also afford the opportunity to evaluate the effects of different collection sites on sample integrity in a multisite clinical trial. Here, 208 samples from lung cancer patients and 207 age-matched controls enrolled in the WELCA study were analyzed by glycan node analysis. Glycan features, quantified as single analytical signals, including 2-linked mannose, α2‐6 sialylation, β1‐4 branching, β1‐6 branching, 4-linked GlcNAc, and outer-arm fucosylation, exhibited abilities to distinguish lung cancer cases from controls and predict survival in patients. To circumvent the laborious preparation steps for permethylation of glycan node analysis, a spin column-free (SCF) glycan permethylation procedure was developed, applicable to both intact glycan analysis or glycan node analysis, with improved or comparable permethylation efficiency relative to some widely-used spin column-based procedures. Biospecimen integrity of the same set of plasma samples from WELCA study was evaluated by a simple intact protein assay (ΔS-Cysteinylated-Albumin), which quantifies cumulative exposure of P/S to thawed conditions (-30 °C). Notable differences were observed between different groups of samples with various initial handling/storage conditions, as well as among the different collection sites. / Dissertation/Thesis / Doctoral Dissertation Biochemistry 2019

Tensile strength of flexor tendon repair using barbed suture material in a dynamic ex vivo model. The purpose of this study was to compare two sutures; a knotted polydioxane with a knotless barbed in a 4-strand Kirchmayr-Kessler suture technique. Human flexor digitorum tendons were separated into four groups. Group 1 - polydioxane; Group 2 - barbed suture; Group 3 and 4 - same as group 1 and 2 with an additional peripheral running suture. In each group the repaired tendons were subjected to linear and cyclical loads. No difference in maximum tensile strength after linear and cyclical force could be detected between the knotted polydioxane suture and the knotless barbed suture. On linear force tests an additional circumferential repair increased the maximum tensile strength of both sutures. Cyclical force loading did not lead to a reduction of maximum strength. Following linear and cyclical loading the 4-strand barbed suture achieved maximum tensile strengths comparable to the 4-strand repair using the polydioxane suture. Barbed suture repair may offer the advantage of knotless suture techniques. / In einem ex vivo Modell wurde die Stabilität verschiedener Beugesehnennähte mit unterschiedlichen Nahtmaterialien und -methoden verglichen. Darunter eine knotenlose Technik mit Nahtmaterial mit Widerhaken. Des weiteren wurde der Stabilitätsvorteil durch eine zusätzliche Feinadaptionsnaht getestet. Angelehnt an eine frühe postoperative aktive Nachbehandlung wurde auch ein dynamisches Testmodell mit zyklischer Vorbelastung angewendet.

Human umbilical cord blood, an alternate source of haematopoietic stem cells (HSC), has been successfully used to reconstitute haematopoiesis in both related and unrelated transplant recipients. However, because CB has fewer total cells (and as a consequence fewer HSC and progenitor cells) CB transplant recipients often experience delayed engraftment as compared with that seen in bone marrow or mobilized peripheral blood transplant recipients. Delayed engraftment exposes patients to an increased risk of infection and bleeding. Cytokine-mediated expansion has been investigated to improve engraftment after CB HSC transplantation as a means to expand the total cell number and both the HSC and progenitors populations. However, its effect on HSC function remains controversial. We hypothesise that if cytokine-mediated expansion promotes divisional recruitment and multilineage differentiation it causes changes in phenotype and cell cycle related gene expression which may be detrimental to the engraftment capacity of haematopoietic cells. Therefore we investigated the relationship between cell division, phenotype and engraftment potential of CB CD34+ cells following cytokine-mediated expansion. High resolution cell division tracking using the fluorescent dye CFSE was used to monitor changes as a consequence of cytokine-mediated expansion in phenotype and function in CB CD34+ cells. Cytokine-mediated expansion caused upregulation of lineage and proliferation markers and adhesion molecules and downregulation of putative stem cell markers with concomitant cell division. However, these changes in phenotype as a consequence of cytokine-mediated expansion may not reflect or be predictive of a functional change in the expanded population. Cytokine-mediated expansion of CB CD34+ also caused changes in cell cycle related gene expression of G1 phase regulators. CB CD34+ cells exhibited expression of all D cyclins, albeit at different levels and p21WAF1 was differentially expressed across CB samples. The effect of cell division on the engraftment potential as a consequence of cytokine-mediated expansion was examined in CB CD34+. Cytokine-mediated expansion of CB CD34+ cells reduced, but did not completely eliminate engraftment potential, as a proportion of the expanded and divided cell populations retained their ability to engraft the NOD-SCID mouse. Overall, this study confirms reports in the literature that cytokine-mediated expansion induces changes in the phenotype of HSC and compromises their in vivo function.

During homeostatic expansion, peripheral T cells proliferate in response to lymphopenia, in the absence of cognate antigen or costimulatory signals. Host CD8 reconstitution following hematopoietic cell transplantation (HCT) involves the de novo-generation of T cells in addition to the homeostatic expansion of mature donor T cells present in the graft and donor lymphocyte infusion as well as host T cells that survive conditioning. Although it is well appreciated that CD8 homeostatic expansion contributes to host CD8 reconstitution following HCT, the factors governing the extent of the contribution by donor CD8 homeostatic expansion to host reconstitution have not been precisely and systematically examined. The ex vivo generation of memory CD8 T cells specific for an epitope of the immunodominant minor histocompatibility antigen H60 was demonstrated. By adapting a previously described culture system designed to generate large numbers of transgenic memory CD8 T cells, memory CD8 cells (TM) specific for a physiological antigen were elicited from a heterogeneous population of CD8 T cells. The ex vivo-generated antigen-specific memory CD8 cells were then expanded under conditions of lymphopenia in ablatively conditioned syngeneic transplant recipients and found to persist greater than 2 months post-transplant. These findings support the notion that the transplantation of small numbers ex vivo-generated memory CD8 cells, specific for a physiologically relevant antigen, can help restore host immune function following HCT. Transplant conditions were found to modulate the contribution of homeostatically expanded donor CD8 TM to the host CD8 compartment. Varying the conditioning intensity, timing of infusion, and infusion dose affected the kinetics of expansion as well as the homeostatic set-point. In my HCT model, delayed infusions of 3 weeks and transplantation of small numbers of donor CD8 T cells resulted in significant contributions to host CD8 T cell compartment. These findings could be applied clinically to enhance the effectiveness of clinical immunotherapy in restoring host immune function post-transplant. Moreover, transplantation of varying doses of donor CD8 TM demonstrated there was maximal donor contribution to host CD8 reconstitution. Finally, the homeostatic expansion, persistence, and function of transgenic memory and naïve CD8 populations were investigated following transplantation into ablatively conditioned syngeneic recipients. Both donor CD8 populations underwent 2 weeks of expansion post-transplant. The naïve CD8 population reproducibly achieved higher homeostatic numbers than the memory CD8 population. By one month post-HCT, the transplanted naïve CD8 populations also exhibited a memory CD8 phenotype. Moreover, the CD8 TN→TM population mediated an effective response to a primary challenge, comparable to the antigen-experienced memory CD8 population. Thus, regardless of the state of differentiation of the donor CD8 population at the time of transplant, donor CD8 homeostatic expansion contributes a memory CD8 cells population, able to mediating effective immune responses, to host reconstitution.

Tissue engineering and ex vivo gene therapy can be used synergically as tool to regenerate bone, which overcome the problems of currently available bone replacements. Recently, a new source of mesenchymal stromal cells (MSCs) has been found in the umbilical cord; human umbilical cord perivascular cells (HUCPVCs) provide an alternative to bone marrow derived MSCs and due to their easy harvest, fast expansion, and non-immunogeneic and immunomodulatory phenotype we hypothesized that HUCPVCs are a putative candidate cell source for osteogenic ex vivo gene therapy. This work proposes the generation of cocktails of genetically modified HUCPVCs and their cryopreservation as an “off the shelf” therapeutic. This approach involves the engineering of osteogenic cell populations, by genetically modifying HUCPVCs using recombinant adenoviruses to deliver four fundamental genes for bone formation: bone morphogenetic protein 2 (BMP-2), runt-related transcription factor 2 (Runx2), Osterix (OSX/SP7) transcription factor and vascular endothelial growth factor (VEGF). Our results show that HUCPVCs can be efficiently modified by adenoviruses and can be cryopreserved without affecting the production efficiency and bioactivity of proteins of interest produced by the cells. Moreover, overexpression of BMP2, Runx2 and SP7 enhances ALP activity levels in HUCPVCs and upregulates ALP, OPN, COL1A1 and OCN gene expression; data that provides the first evidence of the effects of combinational expression of BMP2, Runx2 and SP7. Furthermore, we report for the first time the genetic modification of human BMSCs to express SP7 and Runx2, which enhances their ALP activity and matrix mineralization capacity.