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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Etudes des protéines Patched et SUFU impliquées dans la voie de signalisation Hedgehog / Study of proteins Patched and SUFU involved in the hedgehog signaling pathway

Makamté Kemdib, Staëlle Sonia 20 March 2017 (has links)
Parmi les voies de signalisation, la voie hedgehog (HH) intervient dans la formation de la polarité segmentaire. Si elle est défectueuse, elle entraine plusieurs malformations. De nombreux cancers présentent une suractivation de cette voie. La voie HH activée par la fixation du ligand HH sur le récepteur Patched (hPtc) et fait intervenir plusieurs partenaires cytoplasmiques dont Supressor of Fused (SUFU).Peu de données moléculaires et structurales sont disponibles pour cette voie et pourtant, ces données sont nécessaires pour comprendre sans ambiguïté son fonctionnement. De plus, la voie HH a été proposée comme pouvant être la cible de traitements chimio thérapeutiques mais, la protéine hPtc est impliquée dans l’efflux des drogues anticancéreuses. Une inhibition de hPtc par la fixation de son ligand entraine l’inhibition de l’efflux de drogues. Néanmoins, le site de fixation de HH sur son récepteur n’a pas encore été déterminé.Durant cette thèse, les travaux effectués ont permis l’étude structurale de la protéine hPtc notamment la détermination du site de fixation de HH. Dans un deuxième volet de cette thèse, j’ai effectué des études structurales de certaines protéines SUFU.Dans un premier temps, je me suis concentrée sur les domaines extracellulaires de hPtc qui ont été décrits comme nécessaires pour la fixation du ligand HH. J’ai cloné une protéine chimère constituée de ces deux domaines liés par le lysozyme du phage T4 (hPtcD1D2). Cette construction a été exprimée dans la bactérie E.coli. Les conditions d’expression testées permettent d’obtenir la protéine sous forme de corps d’inclusion dans le cytoplasme de la bactérie. Dans un deuxième temps, j’ai cloné la protéine dans un vecteur d’expression en levure. De manière concomitante, j’ai exprimé la protéine hPtc tronquée de ses régions N et C terminales (hPtcΛNΛC). Ce sont des régions intrinsèquement désordonnées qui ne permettraient pas une bonne cristallisation de la protéine. L’expression a été effectuée dans la levure. La solubilisation de cette protéine membranaire est en cours d’expérimentation.Ce travail a permis de poser les bases de l’expression de hPtcD1D2 et de hPtcΛNΛC. Ceci va notamment permettre la surexpression de la protéine et sa cristallisation afin de déterminer sa structure 3D et de caractériser le site de fixation de son ligand.Enfin, j’ai entrepris des études structurales des protéines SUFU. Un nouveau site de fixation du Zn a été caractérisé. En effet, après purification de la protéine, j’ai effectué des mesures d’affinité à l’aide d’un composé colorimétrique, le PAR et des expériences de spectroscopie d’émission atomique dans lesquelles j’ai fait varier le pH et la concentration en Zn. Ainsi, j’ai pu déterminer que SUFU a une affinité nanomolaire pour le Zn meilleure à pH 8 qu’à pH 6,5. La fixation du Zn se ferait donc sur un site basique. La structure de SUFU a été publiée en 2013 par deux équipes, je me suis inspirée des conditions de cristallisation de ces deux articles, pour cristalliser SUFU en présence de Zn. Les expériences de dichroïsme circulaire ont permis d’affirmer que ces protéines sont organisées en hélices α et en feuillets β. De plus, grâce à la diffusion des rayons X aux petits angles, j’ai pu déterminer que dSUFU, hSUFU et zSUFU n’ont pas la même conformation en solution. Alors que SUFU de drosophile est un monomère globulaire, les protéines humaine et de poisson zèbre seraient plutôt allongées et dimériques. La région N-terminale potentiellement impliquée dans la dimérisation de hSUFU a été tronquée et hSUFUΛ30 présente des différences d’état d’oligomérisation. / The hedgehog (HH) signalling pathway is involved in the segmentary polarity formation. A dysfunction of this pathway is involved in several malformations. Many cancers are caused by an overactivation of this pathway. The HH signalling pathway is activated by the binding of HH on the receptor Patched (hPtc) and included many cytoplasmic partners such as Suppressor of Fused (SUFU). Few molecular and structural data are available on this pathway even if these data are important to fully understand the pathway functioning. Furthermore, the HH signalling pathway maybe be the target of chemotherapy treatments. However, hPtc is involved in drugs efflux. Inhibition of hPtc by the binding of its ligand HH may lead to this efflux inhibition. Yet, the binding site of HH on its receptor hPtc is not yet determined.During this thesis, the structural study of hPtc have been engaged especially the study of the binding site of HH. On the second hand, I have structurally studied some SUFU proteins.First of all, I have expressed the extracellular domains of hPtc. These domains have been described as necessary for HH binding. I have cloned a chimeric protein made by the extracellular domains of hPtc associated with the lysozyme T4 (hPtcD1D2). This protein have been expressed in the E.Coli bacteria. The protein expressed in inclusion bodies in the cytoplasm of the bacteria. In the other hand, I have cloned the protein in a yeast expression vector. Part of this, I have also expressed the protein hPtc without its N and C terminus regions (hPtcNC). These regions are intrinsically disrupted. They may lead to crystallization problems. The protein has been expressed in yeast.This work permits to expressed hPtcD1D2 and hPtcΛNΛC. This will lead to the expression of the protein and its crystallisation in order to determine its 3D structure and to characterize its ligand binding site.Finally, I structurally studied the protein SUFU. A novel Zn binding site has been characterized. In fact, after the protein purification, I have made affinity measures using a colorimetric compound, PAR. I also performed spectroscopic experiments in which I varied the pH and the Zn concentration. I determined the SUFU has a nanomolar affinity for the Zn best at pH 8 than pH 6.5. Indeed, the Zn binding site may be basic.The SUFU 3D structure has been published in 2013 by two teams. Inspired by their crystallization conditions, I crystallized SUFU with Zn. Circular dichroism experiments permitted to know that the proteins are organized in  helices and  sheets. Moreover, small angles X ray spectroscopy experiments show that dSUFU, hSUFU and zSUFU did not have the same conformation in solution. Drosophila SUFU is globular and human and zebrafish SUFU are long and dimeric. The N-terminal region involved in hSUFU has been removed and hSUFUΛ30 is present in different oligomerization forms.
12

Hedgehog signalling in lung development and airway regeneration

Uda Ho Unknown Date (has links)
Tumorigenesis is often caused by the dysregulation of developmental pathways that are activated during repair, a process that recapitulates development. The Hedgehog (Hh) pathway is a signalling pathway essential for cell patterning and identity during embryogenesis. Activation of Hh signalling has been reported in small cell lung cancer progression, but the role of the Hh receptor, Patched1 (Ptch1), remains poorly understood. Therefore, it is imperative that we understand how Ptch1 is involved in development and tissue repair in order to understand its roles in cancer. This project aimed to study the role of Ptch1 during the branching process of lung development and in the regeneration of airway epithelial cells. A conditional knockout approach was utilised to excise Ptch1 by crossing Ptch1 conditional mice with Dermo1-Cre mice (Dermo1Cre+/-;Ptch1lox/lox), thereby activating the Hh pathway in the mesenchyme, independent of ligand. Dermo1Cre+/-;Ptch1lox/lox embryos died at E12.0 and showed secondary lung branching arrest leading to lobe formation defects. Expression of Ptch1, Gli1 and Foxf1 were shown to be upregulated in both proximal and distal lung mesenchyme, indicating inappropriate pathway activation and disruption of the Hh gradient. Fgf10 expression was spatially reduced in Dermo1Cre+/-;Ptch1lox/lox lungs and the addition of Fgf10 to these lungs in culture showed partial restoration of branching, thus Hh signalling was shown to regulate branching via Fgf10. Due to the patterning defect associated with our in vivo model, we took an in vitro approach to delete Ptch1 in lung explants cultures. This also showed reduced branching and validated that mesenchymal proliferation was enhanced after Ptch1 deletion, consistent with the previously reported role of Hh signalling in mesenchymal cell survival. Small cell lung cancer originates in the proximal lung and has been linked to aberrant repair processes. Therefore, Hh signalling in proximal airway repair was investigated. Ptch1 expressing cells were detected in the bronchial epithelium and stroma during homeostasis. But these cells were not detected following polidocanol-induced injury in the murine nasal septum and lung. However during naphthalene-induced repair, Ptch1 expressing cells were detected in the regenerating bronchial epithelium, suggesting that Hh dependent progenitors respond specifically to naphthalene-induced damage and perhaps are pulmonary neuroendocrine or variant Clara cells. Therefore, this project has provided insight into how Ptch1 patterns lung branching and lobe specification during development and also highlights the importance of Ptch1 in pulmonary epithelial regeneration.
13

Role nových profibrotických molekul v patogenezi systémové sklerodermie. / The role of new profibrotic molecules in the pathogenesis of systemic sclerosis.

Šumová, Barbora January 2018 (has links)
Systemic sclerosis (SSc) is immune-mediated fibrotic disease of unknown aetiology. Among the dominant pathogenic manifestations of SSc belong vascular changes, production of autoantibodies, activation of innate and adaptive immune responses and fibrotic processes. Transforming growth factor beta (TGF-β) has been identified as a central profibrotic factor stimulating fibroblasts to produce collagen. There are, however, a number of other mediators involved in the pathogenesis of SSc. Mutual activation and amplification of these molecules and their cascades may be a central mechanism of the SSc pathogenesis. Hedgehog (Hh) canonical signalling pathway plays an important role in the development and progression of fibrotic diseases. Expression of Hh target genes can be regulated through a canonical or non-canonical signalling cascade. The non-canonical activation of GLI transcription factors by TGF-β has not yet been investigated in SSc. The substantial part of this thesis is focused on the study of the mutual interaction of TGF-β and Hh signalling pathway. In vitro analysis confirmed TGF- β/SMAD3 dependent activation of GLI2 in dermal fibroblasts. Fibroblasts specific knockout of GLI2 prevented the development of experimental fibrosis in vivo. Combined targeting of canonical and non-canonical Hh...
14

Structural and functional studies of the hedgehog signalling pathway

Whalen, Daniel M. January 2012 (has links)
Hedgehog (Hh) morphogens play fundamental roles in development whilst dysregulation of Hh signalling leads to disease. Multiple receptors are involved in the modulation of Hh morphogens at the cell surface. Among these, the interactions of Hh ligands with glycosaminoglycan (GAG) (for example heparan or chondroitin sulphate) chains of proteoglycans in the extracellular matrix play a key role in shaping morphogen gradients and fulfil important functions in signal transduction. Several high resolution crystal structures of Sonic Hh (Shh)-GAG complexes have been determined. The interaction determinants, confirmed by binding studies and mutagenesis reveal a novel Hh site for GAG interactions, which appears to be common to all Hh proteins. This novel site is supported by a wealth of published functional data, and resides in a hot spot region previously found to be crucial for Hh receptor binding. Crystal packing analysis combined with analytical ultracentrifugation on Hh-GAG complexes suggest a potential mechanism for GAG-dependent multimerisation. A key step in the Hh pathway is the transduction of the Hh signal into the receiving cell. The Hh signal transducer, Smoothened, is a key target drug target in the pathway with several modulators in clinical trials, despite an absence of structural data. Smoothened is required to activate all levels of Hh signalling. Recent evidence points to the conserved N-terminal ectodomain (ECD) in regulating Smo activity, from vertebrates to invertebrates. Despite the central importance of the ECD, its precise function remains elusive. A crystal structure of the ECD at 2.2 Å resolution is reported here. Structural analysis and biophysical experiments are discussed with reference to the potential function of this intriguing domain.
15

Einflüsse der kommensalen Mikrobiota und der Altered Schaedler Flora auf epitheliale Entzündungsprozesse und die Morphologie der Dünndarmmukosa

Bayer, Franziska 16 June 2023 (has links)
Einleitung: Das Darmmikrobiom, ein hochkomplexes Ökosystem an Mikroorganismen, geht eine lebenslange wechselseitige Beziehung mit seinem Wirt ein und beeinflusst wesentlich dessen Darmreifung post partum. Dazu interagieren Darmbakterien direkt und indirekt mit den intestinalen Stammzellen in den Krypten und regulieren Zellteilung und -differenzierung, wobei die Mechanismen nicht abschließend geklärt sind. Das Darmmikrobiom stellt eine wichtige Quelle für Mikroben-assoziierte molekulare Muster (MAMPs) dar, die von Mustererkennungsrezeptoren wie den Toll-like-Rezeptoren (TLR) auf den intestinalen Epithelzellen erkannt werden können. Somit können TLR auf den intestinalen Epithelzellen eine mögliche Verbindung zwischen Darmmikrobiom und Anpassungsreaktionen der Dünndarmmorphologie darstellen. Ziele der Untersuchung: Folgende Hypothesen sollten untersucht werden: 1. Die Anwesenheit von Darmbakterien beeinflusst die Morphologie der Dünndarmschleimhaut. 2. Diese Wirkung wird über Toll-like-Rezeptoren und den Hedgehog-Signalweg in Epithelzellen vermittelt. 3. Über diese Signalwege werden auch funktionelle Eigenschaften wie die Durchlässigkeit der Darmbarriere verändert. Tiere, Material und Methoden: Zur Untersuchung des Einflusses des Mikrobioms wurden in einem gnotobiotischen Mausmodell keimfreie Tiere mit dem minimalen mikrobiellen Konsortium Altered Schaedler Flora (ASF) besiedelt. Die ASF, welche sich aus acht definierten Bakterienarten zusammensetzt, wurde aus dem Caecum ASF-besiedelter C3H/HeNTac-Mäuse entnommen und männlichen und weiblichen keimfreien C57BL/6J-Mäusen appliziert. Der Nachweis der Bakterienspezies erfolgte aus bakterieller DNA, die aus frischen Kotpellets isoliert wurde. Der Vergleich wurde zwischen Dünndärmen ASF-kolonisierter Mäuse (n = 13), keimfreien Tieren (n = 8), konventionell gehaltenen (n = 7) und einer Gruppe Antibiotika-behandelter Mäuse (n = 8) durchgeführt. Zur Untersuchung des Einflusses der Toll-like-Rezeptoren TLR2 und TLR4 wurden epithelspezifische TLR2-defiziente (TLR2ΔIEC) bzw. TLR4-defiziente Mäuse (TLR4ΔIEC) verwendet und mit ihren jeweiligen Wildtyp-Geschwistertieren (WT) verglichen. Die morphometrische Eigenschaften des Dünndarms wurden anhand von histologischen Schnitten untersucht, die mit Hämatoxylin-Eosin oder Periodic-Acid-Schiff gefärbt waren. Hierbei wurden u.a. Mukosahöhe und Villuslänge gemessen sowie die Anzahl der Epithelzellen und Anzahl der Becherzellen pro Villus gezählt. Weiterhin wurden sowohl in Dünndarmgewebe als auch in isolierten intestinalen Epithelzellen mittels qPCR die mRNAExpression der Liganden des Hedgehog (Hh)-Signalwegs Sonic Hedgehog (Shh) und Indian Hedgehog (Ihh) sowie Hedgehog-Zielgene wie Glioma-associated oncogene transcription factor 1 (Gli-1), Patched-1 (Ptch-1) und Hedgehog Interacting Protein (Hhip) untersucht. In einem Teil der Tiere wurde der Hedgehog-Signalweg durch Applikation des Inhibitors Vismodegib gehemmt. Ein möglicher Einfluss auf die Permeabilität des Dünndarms wurde über die mRNA-Expression diverser Tight Junction-Proteine wie Occludin oder Claudin-4 sowie durch einen Permeabilitätsassay mit FITC-Dextran untersucht. Gruppenvergleiche wurden mit einer einfaktoriellen Varianzanalyse (ANOVA) und Holm-Šídák post-hoc Test bzw. zwischen den TLR2ΔIEC oder TLR4ΔIEC und WT-Mäusen mittels zweiseitigem ungepaarten t-Test durchgeführt. Unterschiede wurden bei P < 0,05 als statistisch signifikant betrachtet. Ergebnisse: Durch den Nachweis aller acht Bakterienarten in den Kotproben der behandelten Mäuse konnte die erfolgreiche Übertragung der ASF auf die Empfängertiere nachgewiesen werden. Hinsichtlich Mukosahöhe, Villuslänge, Anzahl der Epithelzellen und der Becherzellen wiesen keimfreie gegenüber konventionell gehaltenen Mäusen signifikant höhere Werte auf. Die Kolonisierung mit ASF führte zu einer signifikanten Verringerung dieser Merkmale, so dass sie sich denen der konventionell gehaltenen Tiere annäherten. Die mRNA-Expression der Hh-Liganden Shh und Ihh war sowohl im Dünndarm als auch in isolierten intestinalen Epithelzellen ASF-besiedelter Mäuse signifikant erhöht. Die Hh-Zielgene Gli-1, Ptch-1 und Hhip waren auf mRNA-Ebene im Dünndarm ASF-besiedelter Mäuse ebenfalls signifikant höher exprimiert. Mukosahöhe, Epithelzellzahl und Villuslänge waren im Jejunum von TLR2ΔIEC- und TLR4ΔIEC-Mäusen gegenüber ihren WT-Geschwistern signifikant höher. Während bei TLR2ΔIEC-Mäusen außer Shh alle untersuchten Hh-Zielgene vermehrt exprimiert waren, waren bei TLR4ΔIEC-Mäusen die gleichen Gene signifikant weniger exprimiert. Wurde hingegen der Hh-Signalweg in konventionell gehaltenen C57BL/6-Mäusen mit Vismodegib inhibiert, waren der Expression der Hh-Zielgene, des TLR2 und des TLR4 signifikant vermindert. Sowohl die Hemmung des Hh-Signalwegs mit Vismodegib als auch das Fehlen der epithelialen TLR2 oder TLR4 bedingte eine verminderte Expression von Tight Junction-Proteinen, die mit einer erhöhten Darmpermeabilität einherging. Konventionell gehaltene Mäuse hatten sowohl gegenüber keimfreien als auch gegenüber mit ASF besiedelten Tieren eine signifikant niedrigere Expression von Tight Junction-Proteinen, was mit einer signifikant höheren Darmpermeabilität verbunden war. Schlussfolgerungen: Zusammenfassend lassen die Ergebnisse dieser Studie darauf schließen, dass Darmbakterien über intestinale TLR2 und TLR4 den Hh-Signalweg regulieren und darüber die Morphologie der Dünndarmmukosa als auch deren funktionelle Eigenschaften wie die Durchlässigkeit der Darmbarriere beeinflussen. / Introduction: The intestinal microbiome, a highly complex ecosystem of microorganisms, enters into a lifelong reciprocal relationship with its host and significantly influences its intestinal maturation postpartum. To this end, intestinal bacteria interact directly and indirectly with intestinal stem cells in the crypts and regulate cell division and differentiation, although the mechanisms are not conclusively understood. The intestinal microbiome represents an important source of microbeassociated molecular patterns (MAMPs) that can be recognized by pattern recognition receptors such as Toll-like-Receptors (TLRs) on intestinal epithelial cells. Thus, TLRs on intestinal epithelial cells may represent a potential link between gut microbiome and adaptation responses of small intestinal morphology. Aims: The following hypotheses should be investigated: 1. The presence of intestinal bacteria affects the morphology of the small intestinal mucosa. 2. This effect is mediated via Toll-like-Receptors and the Hedgehog signaling pathway in epithelial cells. 3. Functional properties such as the permeability of the intestinal barrier are also altered via these signaling pathways. Animals, materials and methods: To investigate the influence of the microbiome, germ-free animals were colonized with the minimal microbial consortium Altered Schaedler Flora (ASF) in a gnotobiotic mouse model. The ASF, which is composed of eight defined bacterial species, was harvested from the caecum of ASF-colonized C3H/HeNTac mice and applied to male and female germ-free C57BL/6J mice. Bacterial species were detected from bacterial DNA isolated from fresh fecal pellets. Comparison was made between small intestines of ASF-colonized mice (n = 13), germ-free animals (n = 8), conventionally housed (n = 7), and a group of antibiotic-treated mice (n = 8). To investigate the influence of Toll-like-Receptors TLR2 and TLR4, epithelial-specific TLR2-deficient (TLR2ΔIEC) or TLR4-deficient mice (TLR4ΔIEC) were used and compared with their respective wild-type (WT) littermates. Morphometric characteristics of the small intestine were examined using histological sections stained with hematoxylin-eosin or periodic-acid-Schiff. Here, mucosa height and villus length were measured, and the number of epithelial cells and number of goblet cells per villus were counted, among other measurements. Furthermore, mRNA expression of the ligands of the Hedgehog (Hh) signaling pathway Sonic Hedgehog (Shh) and Indian Hedgehog (Ihh) as well as Hedgehog target genes such as Gliomaassociated oncogene transcription factor 1 (Gli-1), Patched-1 (Ptch-1) and Hedgehog Interacting Protein (Hhip) were examined in small intestinal tissue as well as in isolated intestinal epithelial cells by qPCR. In a subset of animals, Hedgehog signaling was inhibited by application of the inhibitor Vismodegib. A possible influence on small intestinal permeability was investigated by mRNA expression of various tight junction proteins such as Occludin or Claudin-4 and by permeability assay with FITC-dextran. Group comparisons were performed with a one-way analysis of variance (ANOVA) and Holm-Šídák post-hoc test or between the TLR2ΔIEC or TLR4ΔIEC and WT mice by two-tailed unpaired t test. Differences were considered statistically significant at P < 0.05. Results: Detection of all eight bacterial species in the fecal samples of treated mice demonstrated successful transfer of ASF to recipient animals. In terms of mucosa height, villus length, number of epithelial cells and goblet cells, germ-free mice had significantly higher values compared to conventionally housed mice. Colonization with ASF significantly decreased these characteristics to approach those of conventionally housed animals. The mRNA expression of the Hh ligands Shh and Ihh was significantly increased in the small intestine as well as in isolated intestinal epithelial cells of ASF colonized mice. The Hh target genes Gli-1, Ptch-1, and Hhip were also significantly higher expressed at the mRNA level in the small intestine of ASF-colonized mice. Mucosa height, epithelial cell number, and villus length were significantly higher in the jejunum of TLR2ΔIEC and TLR4ΔIEC mice compared with their WT littermates. Whereas in TLR2ΔIEC mice, except for Shh, all Hh target genes examined were increased in expression, the same genes were significantly less expressed in TLR4ΔIEC mice. In contrast, when the Hh pathway was inhibited with Vismodegib in conventionally maintained C57BL/6J mice, the expression of Hh target genes, TLR2, and TLR4 were significantly decreased. Both inhibition of the Hh pathway with Vismodegib and absence of epithelial TLR2 or TLR4 caused decreased expression of tight junction proteins, which was associated with increased intestinal permeability. Conventionally housed mice had significantly lower expression of tight junction proteins compared with both germ-free and ASF-populated animals, which was associated with significantly higher intestinal permeability. Conclusions: In summary, the results of this study suggest that intestinal bacteria regulate the Hh signaling pathway via intestinal TLR2 and TLR4 and thereby influence the morphology of the small intestinal mucosa as well as its functional properties such as intestinal barrier permeability.
16

Vismodegib – Inhibitor des Hedgehog-Signaltransduktionsweges – in der ex-vivo-Chemoresponsetestung bei Kopf-Hals-Tumoren

Liebig, Hannes 28 September 2023 (has links)
Purpose: The Hedgehog-signalling pathway (Hh) is frequently active in head and neck squamous cell carcinoma (HNSCC). Overexpressed Hh associates with poor prognosis. The Hh inhibitor vismodegib targets smoothened (SMO) and, based on molecular data, may prevent resistance to EGFR targeting. Methods: To elucidate potential roles of vismodegib in HNSCC therapy, its sole effects and those combined with cisplatin, docetaxel, and cetuximab on HNSCC cell lines were assessed by MTT metabolisation and BrdU incorporation. Colony formation (CF) of primary HNSCC cells was studied utilizing the FLAVINO-protocol. Combinatory effects were analysed regarding antagonism, additivity or synergism. Associations between the ex vivo detected mode of action of vismodegib with other treatments related to patient characteristics were assessed and progression-free survival (PFS) in patient groups compared using Kaplan-Meier curves. Results: Vismodegib suppressed BrdU incorporation significantly stronger than MTT turnover; CF was significantly inhibited at ≥20 µM vismodegib while concentrations <20 µM acted hormetic. Combining 20 µM vismodegib plus docetaxel (T), cisplatin (P), and cetuximab (E), additively enhanced antitumoral activity in HNSCC samples from patients with superior PFS highlighting a potential role for ex-vivo testing of this combination for use as a prognostic classifier. Conclusion: We provide ex-vivo evidence for vismodegib’s potential in HNSCC therapies especially if combined with cetuximab, cisplatin and docetaxel.:Abkürzungsverzeichnis 1 Einleitung 1.1 Kopf-Hals-Tumore 1.1.1 Therapie von Kopf-Hals-TumoreN 1.1.2 Limitationen der etablierten Therapien 1.2 Eingesetzte Chemotherapeutika 1.2.1 Cisplatin 1.2.2 Docetaxel 1.2.3 Cetuximab 1.3 Hedgehog-Signaltransduktionsweg 1.3.1 Hedgehog-Signalweg und Karzinogenese 1.3.2 Vermittlung von Tumortherapieresistenz durch den Hedgehog-Signalweg 1.3.3 Zielgerichtete Tumortherapie durch Blockade des Hedgehog-Signalweges 1.4 Vismodegib 1.5 Ex-Vivo-Chemoresponse-Testung mittels FLAVINO-Assay 1.6 Zusammenfassung der Rationale der Untersuchung 1.7 Aufgabenstellung der Promotionsarbeit 2 Publikation 2.1 Reduzierte Proliferation und Koloniebildung von Plattenepithelkarzinomen der Kopf Hals Region unter dualer Inhibition des EGFR- und Hedgehog-Signalweges 3 Zusammenfassung der Arbeit 4 Literaturverzeichnis 5 Anlagen 5.1 Darstellung des Eigenanteils 5.2 Erklärung über die eigenständige Abfassung der Arbeit 5.3 Lebenslauf 5.4 Publikationen 5.5 Danksagung

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