Magister Scientiae Dentium - MSc(Dent) / The Human Immunodeficient Virus (HIV) is escalating in South Africa at an alarming rate. The impact of HIV today and in the future could have grave consequences for the South African population as it affects adults in their most productive years. To ease costs on the health system, health workers should be familiar with HIV patients needs in general, and specifically in areas such as oral disease which can contribute to the wellness or ill health of the patient. This could facilitate more appropriate and cost effective care ofHIV patients. World-wide reports indicate that the HIV virus is more prevalent in females than males. Women are also experiencing greater virulence of HIV and therefore greater severity of the disease. This research assessed whether there were differences in the prevalence and severity of oral symptoms ofHIV positive men and women. Oral health practices were also examined. As oral disease is very prevalent in HIV positive persons and has been a neglected area for research and program development, it was included in this study. This study also aimed to assess the perceived needs of patients affected by HIV. Such a study presents HIV positive patients an opportunity to participate in a process which allows patients to voice their needs and problems, as well as be involved in setting priorities. The study sought to assess whether needs differed according to the patients gender, age and symptom levels. A needs questionnaire with five domains which included medical and oral needs, social, economic, psychological and informational domains of needs was developed. The measure also included a section on demographics and oral health questions, and was administered as a structured interview. The sample consisted of 338 HIV positive males and females residing in Cape Town and its environs and attending the Out Patients' Departments of three major provincial hospitals, as well as two community clinics during May to November of 1995.

No description available.

Doctor of Philosophy / Department of Anatomy and Physiology / Deryl L. Troyer / Many cell types were known to have migratory properties towards tumors and different research groups have shown reliable results regarding cells as delivery vehicles of therapeutics for targeted cancer treatment. Present report discusses proof of concept for 1. Cell mediated delivery of Magnetic nanoparticles (MNPs) and targeted Magnetic hyperthermia (MHT) as a cancer treatment by using in vivo mouse cancer models, 2. Cells surface engineering with chimeric proteins for targeted cancer treatment by using in vitro models. 1. Tumor homing cells can carry MNPs specifically to the tumor site and tumor burden will decrease after alternating magnetic field (AMF) exposure. To test this hypothesis, first we loaded Fe/Fe3O4 bi-magnetic NPs into neural progenitor cells (NPCs), which were previously shown to migrate towards melanoma tumors. We observed that NPCs loaded with MNPs travel to subcutaneous melanoma tumors. After alternating magnetic field (AMF) exposure, the targeted delivery of MNPs by the NPCs resulted in a mild decrease in tumor size (Chapter-2). Monocytes/macrophages (Mo/Ma) are known to infiltrate tumor sites, and also have phagocytic activity which can increase their uptake of MNPs. To test Mo/Ma-mediated MHT we transplanted Mo/Ma loaded with MNPs into a mouse model of pancreatic peritoneal carcinomatosis. We observed that MNP-loaded Mo/Ma infiltrated pancreatic tumors and, after AMF treatment, significantly prolonged the lives of mice bearing disseminated intraperitoneal pancreatic tumors (Chapter-3). 2. Targeted cancer treatment could be achieved by engineering tumor homing cell surfaces with tumor proteases cleavable, cancer cell specific recombinant therapeutic proteins. To test this, Urokinase and Calpain (tumor specific proteases) cleavable; prostate cancer cell (CaP) specific (CaP1 targeting peptide); apoptosis inducible (Caspase3 V266ED3)- rCasp3V266ED3 chimeric protein was designed in silico. Hypothesized membrane anchored chimeric protein (rCasp3V266ED3, rMcherry red) plasmids were constructed. Membrane anchoring and activity of designed proteins were analyzed in RAW264.7 Mo/Ma and HEK293 cells in vitro. Further, Urokinase (uPA) mediated cleavage and release of rCasp3V266ED3 from engineered cells was tested (Chapter-4). Animal models for cancer therapy are invaluable for preclinical testing of potential cancer treatments. Final chapter of present report shows evidence for immune-deficient line of pigs as a model for human cancers (Chapter-5)

A vasculatura tumoral é estrutural e funcionalmente anormal em relação à vasculatura de órgãos normais, resultando em regiões de heterogeneidade intratumoral para concentração de oxigênio, nutrientes e células inflamatórias. Com isso a vascularização disfuncional muitas vezes leva à administração ineficiente de drogas, comprometendo portanto a eficácia do tratamento. Recentemente, foi demonstrado que terapias antiangiogênicas e exercícios físicos poderiam \"normalizar\" a vasculatura tumoral, melhorando a sobrevida em pacientes com câncer. No entanto seria importante analisar se em melanomas portadores da mutação BRAFV600E, que são altamente resistentes a terapia, se o exercício promoveria a normalização vascular. Este trabalho teve como objetivo analisar o impacto do exercício físico voluntário na função vascular de melanomas humanos com mutação BRAFV600E em camundongos imunodeficientes (BALB/c Nude). Em relação ao crescimento tumoral, não observamos diferenças significativas entre os grupos dos animais exercitados e sedentários, tampouco diferença nos níveis de expressão de genes característicos de macrófagos M1 e M2 no microambiente tumoral desses animais. Por outro lado, a análise de expressão de genes nas células tumorais demonstrou que 8 genes foram diferencialmente expressos no Grupo exercitado ( < 4 km) em relação ao Grupo Sedentário, dentre os quais: FLOT2, STK4, STAT3, LATS1, PTEN, MCL1, PCNA e ACTA2. Em adição, não observamos diferenças significativas no percentual de área necrótica, hipóxica e vasos CD31 positivos. Desse modo, concluímos que o exercício físico induz um aumento nos níveis de expressão de genes envolvidos em modificações epigenéticas, apoptose, proliferação e sobrevivência, ciclo celular e motilidade célula / The tumor vasculature is structurally and functionally abnormal in relation to the vasculature of normal organs, resulting in regions of intratumoral heterogeneity for oxygen parcial pressure, nutrients and inflammatory cells. Thus dysfunctional vascularization often leads to inefficient drug delivery, thereby compromising the efficacy of treatment. Recently, it has been demonstrated that anti-angiogenic therapies and physical exercises could \"normalize\" tumor vasculature, improving survival in patients with cancer. However, it would be important to analyze in BRAFV600E melanoma tumors, which are highly resistant to therapy, whether exercise would promote vascular normalization. Based on this, this work aimed to analyze the impact of voluntary physical exercise on the vascular function of human melanomas with BRAFV600E mutation in immunodeficient mice (BALB / c Nude). In relation to the tumor growth, we did not observe significant differences between the groups of the exercised and sedentary animals, neither difference in the expression levels of genes characteristic of M1 and M2 macrophages in the tumor microenvironment of these animals. On the other hand, analysis of gene expression in tumor cells showed that 8 genes were differentially expressed in the exercised group ( < 4 km) in comparision to the Sedentary Group, among them: FLOT2, STK4, STAT3, LATS1, PTEN, MCL1, PCNA and ACTA2. In addition, we did not observe any significant differences in the percentage of necrotic, hypoxic area and CD31 positive vessels. Thus, we concluded that physical exercise induces an increase in the expression levels of genes involved in epigenetic modifications, apoptosis, proliferation and survival, cell cycle and cell motility

Die Entwicklung innovativer Therapiekonzepte für die Knochenregeneration erfordert validierte segmentale Knochendefekt-Tiermodelle. Dabei ist das Mausmodell für die präklinische Testung von zentraler Bedeutung, jedoch fehlen in der wissenschaftlichen Literatur bislang Angaben zu validierten, extern stabilisierenden kritischen segmentalen Knochendefektmodellen an der immundefizienten Maus. Das Ziel dieser Arbeit war daher die Entwicklung und in vivo Evaluierung eines zuverlässigen und einfach zu handhabenden Modells für extern stabilisierte kritische Knochendefekte an der immundefizienten Maus. Dreißig männliche nu/nu-Mäuse (40,7±2,8 g, 95±2,6 d) wurden mittels Isofluraninhalation narkotisiert und anschließend ein externer Fixateur (MouseExFix, RISystem, AO Research Institute Davos, Schweiz) am rechten Femur angebracht. Femorale Knochendefekte der Länge 1 mm (n=10), 2 mm (n=10) und 3 mm (n=10) wurden erzeugt. Der Wundverschluss erfolgte mit Einzelknopfnähten. Röntgenaufnahmen wurden unmittelbar postoperativ und im Folgenden alle zwei Wochen innerhalb des Beobachtungszeitraums von zwölf Wochen angefertigt und im Hinblick auf Knochenregeneration und –fusion ausgewertet. Weiterhin wurden histomorphologische, histomorphometrische, immunhistochemische und µCT-Analysen zur dreidimensionalen und zellulären Beurteilung der Knochenheilung angefertigt. Alle Tiere überlebten die Operation. Sechs Tiere starben innerhalb des Beobachtungszeitraums als Folge von starkem Blutverlust (n=1), Infektion (n=1), Pinlockerung, welche die Euthanasie erforderlich machte (n=2) und durch Komplikationen bei der Anästhesie (n=2). Die µCT-Analyse nach zwölf Wochen zeigte, dass 3/8 der 1 mm-Defekte, 5/8 der 2 mm-Defekte und 8/8 der 3 mm-Defekte eine Pseudarthrose aufwiesen. Das mittlere Defektvolumen stieg signifikant (p<0,001) mit der Größe des Defektes und betrug 0,36±0,42 mm³ (1 mm-Gruppe), 1,4±0,88 mm³ (2 mm-Gruppe), bzw. 2,88±0,28 mm³ (3 mm-Gruppe). Die mittlere Defektgröße verringerte sich entsprechend um 77,6% (1 mm-Gruppe), 56,8% (2 mm-Gruppe), bzw. 28,6% (3 mm-Gruppe). Die histomorphologischen, histomorphometrischen und immunhistochemischen Analysen zeigten keine statistisch signifikanten Unterschiede zwischen den drei experimentellen Gruppen. Das verwendete MouseExFix-System ist ein zuverlässiges und einfach zu handhabendes Verfahren zur Stabilisierung eines kritischen segmentalen Knochendefekts an der immundefizienten Maus, wenn ein 3 mm-Defekt erzeugt wird. Das im Rahmen der Studie entwickelte und validierte murine extern stabilisierte, segmentale kritische Knochendefektmodell ermöglicht die präklinische Evaluierung von Konzepten zur lokalen Knochenregeneration inklusive der Verwendung allo- und xenogener Zellen. / The development of innovative therapies for bone regeneration requires the use of advanced site-specific bone defect small animal models. In this context, murine models are of major importance as they allow for sufficient sample sizes prior to preclinical testing using larger animals. Owing to the small dimensions of the murine femur only a few custom fabricated fixation devices have been described in the literature so far. The aim of this investigation was to develop and validate a new, externally fixated critical size bone defect model for immunodeficient mice. Thirty male nu/nu mice (40.7 ± 2.8 g, 95 ± 2.6 days old) were anesthetized by isoflurane inhalation and an external fixation device (MouseExFix, RISystem, AO Research Institute Davos, Switzerland) was attached to the right femur. Femoral bone defects of 1 mm (n=10), 2 mm (n=10) and 3 mm (n=10) were created. Wounds were closed without any additional treatment. X-ray films obtained immediately after surgery and every 2 weeks postoperatively during the 12 week postoperative observation period were evaluated for bony regeneration and fusion. Furthermore, histomorphology, histomorphometry, immunohistochemistry and µCT analysis were performed. All of the animals survived the operation. Twenty four out of 30 animals reached the twelfth postoperative week. µCT analyses after twelve weeks showed that 3/8 of the 1 mm defects, 5/8 of the 2 mm defects and 8/8 of the 3 mm defects remained as nonunions. The defect volume was 0.36 ± 0.42 mm³ (1 mm group), 1.40 ± 0.88 mm³ (2 mm group), and 2.88 ± 0.28 mm³ (3 mm group) (p<0.001, between all groups). The defect size decreased by 77.6% (1-mm group), 56.8% (2-mm group) and 28.6% (3-mm group) (p=0.152, between all groups). Our method using the MouseExFix device has proven to be a reliable and easy-to-handle external fixation system for the stabilization of critical-size segmental bone defects in immundeficient mice when 3 mm defects are generated. This mouse model allows for high-throughput translational evaluation of concepts for site-specific bone regeneration including strategies using allogenic and xenogenic cell types.

The development of immune response accountable for the ability to control Cryptosporidium muris TS03 infection was studied using immunocompetent and various types of immunodeficient mouse models. Subsequently the immune response was characterized by analysis of leukocyte infiltration and cytokine production in gastric epithelium. Moreover, the potentiality of immunocompetent mice to develop effective immune response to C. andersoni LI03 infection with consequent protection to consequent infection of the same mice with C. muris TS03 was also studied by monitoring oocysts shedding, leukocyte infiltration of the gastric mucosa and cytokine production in ex vivo cultures of splenocytes.

A deficiência de hormônio de crescimento (DGH) é a deficiência mais comum entre os hormônios pituitários. A terapia utilizada atualmente consiste de injeções diárias de hormônio de crescimento humano recombinante (r-hGH), entretanto esta terapia apresenta alguns inconvenientes, como a necessidade de frequentes injeções de r-hGH durante um longo período de vida, dependendo da severidade da deficiência, e o alto custo do hormônio, em razão dos dispendiosos processos de purificação. Uma alternativa ao tratamento padrão seria aquele no qual fossem evitados estes tipos de inconvenientes e o processo de liberação da proteína fosse sustentável, por um longo período e promovesse níveis normais e sustentáveis do fator de crescimento semelhante à insulina I (IGF-I), o principal mediador dos efeitos do GH. Uma alternativa é a terapia gênica in vivo, baseada na administração de DNA plasmidial em diversos órgãos/tecidos, seguida de eletroporação. É considerada uma metodologia bastante promissora e que tem sido alvo de vários estudos para diversos tipos de deficiências sistêmicas. Neste trabalho foram realizadas diversas administrações de um plasmídeo contendo o gene do hormônio de crescimento humano, nos músculos quadríceps exposto ou tibial anterior sem exposição, seguidas de eletroporação, em camundongos anões e imunodeficientes (lit/scid) com 40-80 dias de idade, na tentativa de obter uma correção fenotípica do nanismo, mediante a avaliação de parâmetros de crescimento. A administração deste plasmídeo no músculo tibial anterior, em camundongos com a idade inicial de 40 dias, foi capaz de proporcionar uma normalização dos níveis de mIGF-I, quando comparados aos dos camundongos não-deficientes de GH. Além disso, foram obtidos valores de catch-up dos parâmetros de crescimento longitudinal de 36-77%. Visando uma maior eficiência na expressão de GH, foram construídos plasmídeos parentais, e a partir destes, foram produzidos minicírculos de DNA com os promotores do CMV e Ubiquitina C e com os cDNAs de hGH e mGH. Estes minicírculos de DNA foram transfectados em células HEK 293 e foram até 2 vezes mais eficientes em relação aos plasmídeos convencionais com o promotor do CMV. Estes dados são bastantes promissores e abrem caminho para ensaios mais eficientes, utilizando este tipo de protocolo de terapia gênica para a DGH, visando uma normalização de todos os parâmetros de crescimento. / The human growth hormone deficiency (GHD) is the most common deficiency related to pituitary hormones. The current therapy is based on daily injections of recombinant human growth hormone (r-hGH). This therapy, however, presents some disadvantages, as the need for frequent injections of r-hGH during a long life time, depending on the deficiency severity and the high cost of this hormone, due to the expensive purification processes. An alternative to the standard treatment should be to avoid these inconveniences via a sustainable hormone release, acting for a long time and providing normal and sustainable levels of insulin-like growth factor-I (IGF-I). A possible alternative is in vivo gene therapy, based on the administration of plasmid DNA in several organs/tissues, followed by electroporation. This methodology is considered very promising and has been the target of many different studies for several types of systemic deficiencies. In the present work several administrations of a plasmid containing the human growth hormone gene were carried out, in the exposed quadriceps or non-exposed tibialis cranialis muscle, followed by electroporation, using immunodeficient dwarf mice 40-80 days old. The goal was to obtain a phenotypic correction of dwarfism, through the evaluation of different growth parameters. The administration of this plasmid, in the tibialis cranialis muscle of 40 day old mice, was able to provide a normalization of mIGF-I levels, when compared to non GHD mice. Furthermore, catch-up increases of longitudinal growth parameters of 36-77% were obtained. Aiming a high efficiency on GH expression, parental plasmids were constructed and from these DNA minicircles were generated with CMV and Ubiquitin C promoter and hGH or mGH cDNA sequences. These DNA minicircles were transfected into HEK 293 cells and were even 2 times moren efficient than conventional plasmids with CMV promoter. This data are very promising and pave the way for more efficient assays utilizing this type of gene therapy protocol for GHD, aiming at a normalization of all growth parameters.

A deficiência de hormônio de crescimento (DGH) é a deficiência mais comum entre os hormônios pituitários. A terapia utilizada atualmente consiste de injeções diárias de hormônio de crescimento humano recombinante (r-hGH), entretanto esta terapia apresenta alguns inconvenientes, como a necessidade de frequentes injeções de r-hGH durante um longo período de vida, dependendo da severidade da deficiência, e o alto custo do hormônio, em razão dos dispendiosos processos de purificação. Uma alternativa ao tratamento padrão seria aquele no qual fossem evitados estes tipos de inconvenientes e o processo de liberação da proteína fosse sustentável, por um longo período e promovesse níveis normais e sustentáveis do fator de crescimento semelhante à insulina I (IGF-I), o principal mediador dos efeitos do GH. Uma alternativa é a terapia gênica in vivo, baseada na administração de DNA plasmidial em diversos órgãos/tecidos, seguida de eletroporação. É considerada uma metodologia bastante promissora e que tem sido alvo de vários estudos para diversos tipos de deficiências sistêmicas. Neste trabalho foram realizadas diversas administrações de um plasmídeo contendo o gene do hormônio de crescimento humano, nos músculos quadríceps exposto ou tibial anterior sem exposição, seguidas de eletroporação, em camundongos anões e imunodeficientes (lit/scid) com 40-80 dias de idade, na tentativa de obter uma correção fenotípica do nanismo, mediante a avaliação de parâmetros de crescimento. A administração deste plasmídeo no músculo tibial anterior, em camundongos com a idade inicial de 40 dias, foi capaz de proporcionar uma normalização dos níveis de mIGF-I, quando comparados aos dos camundongos não-deficientes de GH. Além disso, foram obtidos valores de catch-up dos parâmetros de crescimento longitudinal de 36-77%. Visando uma maior eficiência na expressão de GH, foram construídos plasmídeos parentais, e a partir destes, foram produzidos minicírculos de DNA com os promotores do CMV e Ubiquitina C e com os cDNAs de hGH e mGH. Estes minicírculos de DNA foram transfectados em células HEK 293 e foram até 2 vezes mais eficientes em relação aos plasmídeos convencionais com o promotor do CMV. Estes dados são bastantes promissores e abrem caminho para ensaios mais eficientes, utilizando este tipo de protocolo de terapia gênica para a DGH, visando uma normalização de todos os parâmetros de crescimento. / The human growth hormone deficiency (GHD) is the most common deficiency related to pituitary hormones. The current therapy is based on daily injections of recombinant human growth hormone (r-hGH). This therapy, however, presents some disadvantages, as the need for frequent injections of r-hGH during a long life time, depending on the deficiency severity and the high cost of this hormone, due to the expensive purification processes. An alternative to the standard treatment should be to avoid these inconveniences via a sustainable hormone release, acting for a long time and providing normal and sustainable levels of insulin-like growth factor-I (IGF-I). A possible alternative is in vivo gene therapy, based on the administration of plasmid DNA in several organs/tissues, followed by electroporation. This methodology is considered very promising and has been the target of many different studies for several types of systemic deficiencies. In the present work several administrations of a plasmid containing the human growth hormone gene were carried out, in the exposed quadriceps or non-exposed tibialis cranialis muscle, followed by electroporation, using immunodeficient dwarf mice 40-80 days old. The goal was to obtain a phenotypic correction of dwarfism, through the evaluation of different growth parameters. The administration of this plasmid, in the tibialis cranialis muscle of 40 day old mice, was able to provide a normalization of mIGF-I levels, when compared to non GHD mice. Furthermore, catch-up increases of longitudinal growth parameters of 36-77% were obtained. Aiming a high efficiency on GH expression, parental plasmids were constructed and from these DNA minicircles were generated with CMV and Ubiquitin C promoter and hGH or mGH cDNA sequences. These DNA minicircles were transfected into HEK 293 cells and were even 2 times moren efficient than conventional plasmids with CMV promoter. This data are very promising and pave the way for more efficient assays utilizing this type of gene therapy protocol for GHD, aiming at a normalization of all growth parameters.

Aujourd'hui, l'un des modèles de souris humanisées le plus robuste est obtenu en injectant des cellules souches hématopoïétiques humaines (HSC) issues de foie fœtal humain et en implantant du thymus fœtal autologue. Ce modèle, appelé BLT (Bone marrow/Liver/Thymus), s'est révélé capable de supporter une reconstitution, une maturation et une sélection optimales des cellules T. Les souris BLT sont utilisées pour de nombreuses études telles que la compréhension de la biologie du VIH ou plus récemment en médecine régénérative. Grâce à ce modèle, nous avons pu d’une part étudier le rôle des cellules dendritiques plasmacytoïdes (pDC) lors de l’infection par le VIH mais aussi mieux comprendre la formation in vivo de tératomes lors de l’utilisation d’iPSC. Cependant, l'une des principales limites de cette technique réside dans l'obtention du tissu fœtal. Ici, nous avons décrit un nouveau protocole de souris humanisées greffées avec du thymus humain en utilisant des matériaux plus accessibles: du thymus humain retiré lors d’une chirurgie cardiaque chez des nouveaux-nés ou des enfants, et des HSC de sang de cordon. Des morceaux de ces thymus ont été implantés dans les quadriceps de souris immunodéficientes, après avoir été mis en culture. Ces souris CCST (Cord blood and Cardiac Surgery Thymus) ont permis une prise de greffe importante et un meilleur développement des lymphocytes T humains que les souris humanisées sans thymus. Les lymphocytes T des souris CCST et BLT ont montré une fonction similaire, évaluée par des tests de prolifération ex vivo et par rejet de lignées de cellules leucémiques allogéniques in vivo. Nous avons testé l’intérêt de cette nouvelle stratégie dans le modèle de l’infection au VIH-1, qui représente le modèle type de l’utilité des BLT. Nous avons montré que les souris CCST sont sensibles à l'infection par le VIH-1 par voie muqueuse ou intrapéritonéale, comme l'indique la détection de l'ADN du VIH et des cellules p24 +, similairement aux souris BLT. Les souris CCST ont présenté des réponses de lymphocytes T spécifiques du VIH-1 ex vivo plus efficaces que les BLT. Lors du traitement antirétroviral, les souris CCST, comme les BLT, ont vu leur charge virale diminuer. Ces résultats démontrent que les souris CCST représentent une alternative au modèle de souris BLT classique. Ces thymus, éthiquement plus facile à obtenir, peuvent être utilisés pour générer un grand nombre de souris par rapport aux thymus fœtaux. / Immunodeficient mice engrafted with human immune system provide an exciting in vivo model for a better understanding of its functioning and for development of new therapies. Today, one of the most robust humanized mouse model is achieved by injecting human hematopoietic stem cells (HSC) from fetal liver along with an implantation of autologous fetal thymic tissue. This model, called BLT, was shown to be able to support an optimal T cell reconstitution, maturation and selection. BLT mice are extensively used for many studies such as understanding HIV biology or in regenerative medicine. Indeed, our work used BLT mice on one hand to study the role of plasmacytoid dendritic cells (pDC) during the HIV infection and on the other hand to better understand the formation of teratomes from iPSCs in vivo. However, one of the biggest limitations of this technique is the procurement of the fetal tissue. Here we describe a new protocol to do humanized mice engrafted with human thymus pieces by using more accessible materials: human thymus obtained during cardiac surgery and cord blood HSC. Indeed, thymus is spontaneously removed during cardiac surgery in neonates and young children, thus it is an easy and ethical way to obtain this tissue. Those thymuses pieces were implanted in the quadriceps of a immunodeficient mice, after being put in culture. CCST mice (Cord blood and Cardiac Surgery Thymus) exhibited a significant engraftment of T-cells, compared to humanized mice without thymus. T-cells from both CCST and BLT mice showed a similar function as evaluated by proliferation assays upon PHA stimulation ex vivo and rejection of allogeneic leukemic cells lines in vivo. CCST mice were susceptible to HIV-1 infection via mucosal or intraperitoneal route, as shown by detectable viral load, HIV DNA and p24+ cells, at similar levels to those of BLT mice. Importantly, CCST mice displayed more effective ex vivo HIV-1-specific T-cell responses compared to BLT. Upon antiretroviral treatment, CCST mice, like BLT, were able to diminish the viral load. Our data suggest that CCST mice represent an alternative to the regular BLT mouse model. Those easy-to-access thymuses can be used to generate a large number of mice compared to fetal thymuses.

Die Entwicklung innovativer Therapiekonzepte für die Knochenregeneration erfordert validierte segmentale Knochendefekt-Tiermodelle. Dabei ist das Mausmodell für die präklinische Testung von zentraler Bedeutung, jedoch fehlen in der wissenschaftlichen Literatur bislang Angaben zu validierten, extern stabilisierenden kritischen segmentalen Knochendefektmodellen an der immundefizienten Maus. Das Ziel dieser Arbeit war daher die Entwicklung und in vivo Evaluierung eines zuverlässigen und einfach zu handhabenden Modells für extern stabilisierte kritische Knochendefekte an der immundefizienten Maus. Dreißig männliche nu/nu-Mäuse (40,7±2,8 g, 95±2,6 d) wurden mittels Isofluraninhalation narkotisiert und anschließend ein externer Fixateur (MouseExFix, RISystem, AO Research Institute Davos, Schweiz) am rechten Femur angebracht. Femorale Knochendefekte der Länge 1 mm (n=10), 2 mm (n=10) und 3 mm (n=10) wurden erzeugt. Der Wundverschluss erfolgte mit Einzelknopfnähten. Röntgenaufnahmen wurden unmittelbar postoperativ und im Folgenden alle zwei Wochen innerhalb des Beobachtungszeitraums von zwölf Wochen angefertigt und im Hinblick auf Knochenregeneration und –fusion ausgewertet. Weiterhin wurden histomorphologische, histomorphometrische, immunhistochemische und µCT-Analysen zur dreidimensionalen und zellulären Beurteilung der Knochenheilung angefertigt. Alle Tiere überlebten die Operation. Sechs Tiere starben innerhalb des Beobachtungszeitraums als Folge von starkem Blutverlust (n=1), Infektion (n=1), Pinlockerung, welche die Euthanasie erforderlich machte (n=2) und durch Komplikationen bei der Anästhesie (n=2). Die µCT-Analyse nach zwölf Wochen zeigte, dass 3/8 der 1 mm-Defekte, 5/8 der 2 mm-Defekte und 8/8 der 3 mm-Defekte eine Pseudarthrose aufwiesen. Das mittlere Defektvolumen stieg signifikant (p<0,001) mit der Größe des Defektes und betrug 0,36±0,42 mm³ (1 mm-Gruppe), 1,4±0,88 mm³ (2 mm-Gruppe), bzw. 2,88±0,28 mm³ (3 mm-Gruppe). Die mittlere Defektgröße verringerte sich entsprechend um 77,6% (1 mm-Gruppe), 56,8% (2 mm-Gruppe), bzw. 28,6% (3 mm-Gruppe). Die histomorphologischen, histomorphometrischen und immunhistochemischen Analysen zeigten keine statistisch signifikanten Unterschiede zwischen den drei experimentellen Gruppen. Das verwendete MouseExFix-System ist ein zuverlässiges und einfach zu handhabendes Verfahren zur Stabilisierung eines kritischen segmentalen Knochendefekts an der immundefizienten Maus, wenn ein 3 mm-Defekt erzeugt wird. Das im Rahmen der Studie entwickelte und validierte murine extern stabilisierte, segmentale kritische Knochendefektmodell ermöglicht die präklinische Evaluierung von Konzepten zur lokalen Knochenregeneration inklusive der Verwendung allo- und xenogener Zellen.:1 Einleitung 1 1.1 Hintergrund 1 1.2 Das Mausmodell 2 1.3 Übersicht Tierversuche mit Knochendefekten 5 1.4 Frakturheilung 6 1.4.1 Allgemeines 6 1.4.2 Räumliche Gliederung 7 1.4.3 Expression von Proteinen der extrazellulären Matrix 8 1.4.4 Das Vier-Phasen-Modell der Frakturheilung 9 1.4.5 Das anabolisch/ katabolische Modell der Frakturheilung 12 1.4.6 Beeinflussung der Frakturheilung 12 1.4.7 Das Diamantkonzept 14 1.5 Osteosynthesesysteme 14 1.6 Pseudarthrosen 15 1.6.1 Definition 15 1.6.2 Ätiologie 16 1.6.3 Klassifikation 16 1.6.4 Therapie 17 2 Material und Methoden 19 2.1 Versuchstiere 19 2.2 Operationsvorbereitung 19 2.3 Operationsablauf 20 2.4 Postoperatives Vorgehen 27 2.5 Verlaufskontrolle 28 2.6 Entnahme der Präparate 29 2.7 Anfertigung der µCT-Aufnahmen 30 2.8 Anfertigung der histologischen Schnitte 30 2.8.1 Bearbeitung der Femora 30 2.8.2 verwendete Färbungen 31 2.9 Beurteilung der Schnitte 32 2.9.1 Histologische Beurteilung 32 2.9.2 Histomorphometrische Beurteilung 33 2.10 Statistik 33 3 Ergebnisse 34 3.1 Überlebensraten und Gewichtsverlauf 34 3.2 Röntgenauswertung 35 3.3 CT-Auswertung 38 3.4 Histologische Auswertung 41 3.5 Histomorphometrische Auswertung 44 3.5.1 TRAP 44 3.5.2 Osteocalcin 46 3.5.3 Osteopontin 47 3.5.4 Osteonectin 48 4 Diskussion 50 4.1 Diskussion etablierter Modelle für kritische Knochendefekte 50 4.1.1 Diskussion der Konzeption der Modelle 50 4.1.2 Diskussion der durchgeführten Anästhesieverfahren 54 4.1.3 Diskussion der Ergebnisse 55 4.1.4 Diskussion der Defektlängen 56 4.1.5 Diskussion der verschiedenen Osteosynthesesysteme 57 4.1.6 Diskussion der Ausfaller 59 4.2 Anwendung und Nutzen immundefizienter Tiermodelle 60 4.3 Vergleich des tibialen und des femoralen murinen Frakturmodells 63 4.4 Diskussion der Beurteilung der Knochenheilung mittels bildgebender und histologischer Verfahren 63 4.5 Anwendungsmöglichkeiten 65 4.6 Schlussfolgerungen 66 5 Zusammenfassung 67 5.1 In deutscher Sprache 67 5.2 In englischer Sprache 68 6 Literaturverzeichnis 70 7 Anhang 92 7.1 Danksagung 92 7.2 Lebenslauf 93 7.3 Veröffentlichungen 95 7.4 Wertetabellen 96 7.5 Erklärungen zur Eröffnung des Promotionsverfahrens 109 / The development of innovative therapies for bone regeneration requires the use of advanced site-specific bone defect small animal models. In this context, murine models are of major importance as they allow for sufficient sample sizes prior to preclinical testing using larger animals. Owing to the small dimensions of the murine femur only a few custom fabricated fixation devices have been described in the literature so far. The aim of this investigation was to develop and validate a new, externally fixated critical size bone defect model for immunodeficient mice. Thirty male nu/nu mice (40.7 ± 2.8 g, 95 ± 2.6 days old) were anesthetized by isoflurane inhalation and an external fixation device (MouseExFix, RISystem, AO Research Institute Davos, Switzerland) was attached to the right femur. Femoral bone defects of 1 mm (n=10), 2 mm (n=10) and 3 mm (n=10) were created. Wounds were closed without any additional treatment. X-ray films obtained immediately after surgery and every 2 weeks postoperatively during the 12 week postoperative observation period were evaluated for bony regeneration and fusion. Furthermore, histomorphology, histomorphometry, immunohistochemistry and µCT analysis were performed. All of the animals survived the operation. Twenty four out of 30 animals reached the twelfth postoperative week. µCT analyses after twelve weeks showed that 3/8 of the 1 mm defects, 5/8 of the 2 mm defects and 8/8 of the 3 mm defects remained as nonunions. The defect volume was 0.36 ± 0.42 mm³ (1 mm group), 1.40 ± 0.88 mm³ (2 mm group), and 2.88 ± 0.28 mm³ (3 mm group) (p<0.001, between all groups). The defect size decreased by 77.6% (1-mm group), 56.8% (2-mm group) and 28.6% (3-mm group) (p=0.152, between all groups). Our method using the MouseExFix device has proven to be a reliable and easy-to-handle external fixation system for the stabilization of critical-size segmental bone defects in immundeficient mice when 3 mm defects are generated. This mouse model allows for high-throughput translational evaluation of concepts for site-specific bone regeneration including strategies using allogenic and xenogenic cell types.:1 Einleitung 1 1.1 Hintergrund 1 1.2 Das Mausmodell 2 1.3 Übersicht Tierversuche mit Knochendefekten 5 1.4 Frakturheilung 6 1.4.1 Allgemeines 6 1.4.2 Räumliche Gliederung 7 1.4.3 Expression von Proteinen der extrazellulären Matrix 8 1.4.4 Das Vier-Phasen-Modell der Frakturheilung 9 1.4.5 Das anabolisch/ katabolische Modell der Frakturheilung 12 1.4.6 Beeinflussung der Frakturheilung 12 1.4.7 Das Diamantkonzept 14 1.5 Osteosynthesesysteme 14 1.6 Pseudarthrosen 15 1.6.1 Definition 15 1.6.2 Ätiologie 16 1.6.3 Klassifikation 16 1.6.4 Therapie 17 2 Material und Methoden 19 2.1 Versuchstiere 19 2.2 Operationsvorbereitung 19 2.3 Operationsablauf 20 2.4 Postoperatives Vorgehen 27 2.5 Verlaufskontrolle 28 2.6 Entnahme der Präparate 29 2.7 Anfertigung der µCT-Aufnahmen 30 2.8 Anfertigung der histologischen Schnitte 30 2.8.1 Bearbeitung der Femora 30 2.8.2 verwendete Färbungen 31 2.9 Beurteilung der Schnitte 32 2.9.1 Histologische Beurteilung 32 2.9.2 Histomorphometrische Beurteilung 33 2.10 Statistik 33 3 Ergebnisse 34 3.1 Überlebensraten und Gewichtsverlauf 34 3.2 Röntgenauswertung 35 3.3 CT-Auswertung 38 3.4 Histologische Auswertung 41 3.5 Histomorphometrische Auswertung 44 3.5.1 TRAP 44 3.5.2 Osteocalcin 46 3.5.3 Osteopontin 47 3.5.4 Osteonectin 48 4 Diskussion 50 4.1 Diskussion etablierter Modelle für kritische Knochendefekte 50 4.1.1 Diskussion der Konzeption der Modelle 50 4.1.2 Diskussion der durchgeführten Anästhesieverfahren 54 4.1.3 Diskussion der Ergebnisse 55 4.1.4 Diskussion der Defektlängen 56 4.1.5 Diskussion der verschiedenen Osteosynthesesysteme 57 4.1.6 Diskussion der Ausfaller 59 4.2 Anwendung und Nutzen immundefizienter Tiermodelle 60 4.3 Vergleich des tibialen und des femoralen murinen Frakturmodells 63 4.4 Diskussion der Beurteilung der Knochenheilung mittels bildgebender und histologischer Verfahren 63 4.5 Anwendungsmöglichkeiten 65 4.6 Schlussfolgerungen 66 5 Zusammenfassung 67 5.1 In deutscher Sprache 67 5.2 In englischer Sprache 68 6 Literaturverzeichnis 70 7 Anhang 92 7.1 Danksagung 92 7.2 Lebenslauf 93 7.3 Veröffentlichungen 95 7.4 Wertetabellen 96 7.5 Erklärungen zur Eröffnung des Promotionsverfahrens 109