Diss. (sammanfattning) Stockholm : Karol inst., 2004. / Härtill 6 uppsatser.

Doctor of Philosophy / Department of Anatomy and Physiology / Deryl L. Troyer / Umbilical cord matrix stem (UCMS) cells are derived from Wharton's jelly and have been shown to express genes characteristic of primitive stem cells. They can be isolated in large numbers in a short time and thus potentially represent an abundant source of cells for therapeutic use. We investigated the migratory nature of human UCMS cells towards MDA 231 human breast carcinoma cells in an in vitro model of cell migration; UCMS cells cultured with or without MDA 231 cells for 24 hours. Next, we evaluated the effect of chemokines, stromal derived factor 1 (SDF-1) and vascular endothelial growth factor (VEGF) on human UCMS cells by treating with increasing doses of SDF-1 and VEGF. UCMS cells were found to migrate towards MDA 231 cells in a dose dependent manner. Both SDF-1 and VEGF induced migration of UCMS cells in a dose dependent manner. These results suggest that MDA 231 cells might be releasing chemokine factors, such as SDF-1 and VEGF, which promote UCMS cell migration towards the tumor cells in vitro. Stem cells that migrate to tumors may allow targeted delivery of therapeutic agents that otherwise may have severe side effects. To evaluate the selective engraftment and therapeutic efficiency of human UCMS cells that were engineered to express interferon beta (UCMS-IFN-beta) MDA 231 cells (2,000,000) were intravenously injected into severe combined immune deficient (SCID) mice, followed by three weekly intravenous injections of fluorescently labeled UCMS-IFN-beta cells (500,000). To evaluate the synergistic effect of 5-Fluorouracil (5-FU) and IFN-beta, MDA 231 cells were intravenously injected into SCID mice, followed by three weekly intravenous injections of fluorescently labeled UCMS-IFN-beta cells and three weekly intra peritoneal injections of 5-FU. In both of the above experiments, mice were euthanized one week after the last UCMS cell transplant and lung weights were compared to the controls to determine the differences in tumor burden. After transplantation of UCMS-IFN-beta cells into MDA 231 tumor-bearing mice, UCMS cells were found near or within metastatic lung tumors but not in other tissues, and in these animals, the lung weight was significantly less than MDA 231 tumor-bearing animals that received saline injections. Histologically, there was significant reduction in the tumor area in MDA 231 tumor bearing lungs after UCMS-IFN-beta treatment. When 5-FU was given along with UCMS-IFN-beta cells, there was further reduction in tumor area. These results indicate that UCMS cells can potentially be used for targeted delivery of cancer therapeutics.

Introduction: Addition of a second drug used to be a strategy to achieve clinical stabilization of multiple sclerosis in many patients with on-going activity despite monotherapy. Modern immunosuppressive drugs used in monotherapy exert more specific mode of action. Methods: This retrospective observational study evaluated 5-year data from 85 patients with active multiple sclerosis despite monotherapy with either interferon beta or azathioprine, who received add-on azathioprine or interferon beta, respectively. In a subgroup of 23 patients 10- year data were analysed. In a second part of the study, a group of 126 patients switched either from interferon beta or glatiramer acetate to fingolimod was followed-up for one after the change of their treatment and a in a subgroup of 53 patients the 2-year data were assessed. Clinical (relapse frequency, disability) parameters were compared preceding and following the addition of second drug or the switch of treatment. Laboratory results and potential serious adverse events were evaluated in a group of patients with combination therapy. Results: The add-on treatment triggered a drop in annualised relapse rate by approximately 1.5 points sustained over 5 and 10 years. No effect on disability was observed. Simultaneously, white blood cell and lymphocyte counts...

A vascularização tem um papel central na progressão tumoral e representa um alvo terapêutico de grande interesse. A inibição da angiogênese tem potencial de retardar a progressão tumoral e inibir metástase. Em decorrência disto, terapias anti-angiogênicas têm demonstrado ser promissora no controle do crescimento tumoral. Segundo a literatura, interferon-? (IFN?, ativador do sistema imune inato e adaptativo) e p19Arf (supressor de tumor e parceiro funcional de p53), quando estudados individualmente, alteram a vasculatura tumoral. Nosso grupo construiu e utilizou vetores adenovirais recombinantes portadores dos cDNAs de INFbeta e p19Arf e observou que a transferência desta combinação de genes induziu morte celular e diminuiu progressão tumoral, resultados foram observados em modelos murinos de melanoma B16 de terapia genica in situ, vacina profilática e vacina terapêutica. Neste trabalho, exploramos a ideia que a combinação dos vetores adenovirais portadores de INFbeta e p19Arf proporcionam efeitos anti-angiogênicos através de seu impacto em células endoteliais. Para averiguarmos essa hipótese, células endoteliais murinas (tEnd) foram transduzidas com os vetores adenovirais, revelando que o vetor Ad-p19 confere inibição da proliferação, formação de tubos, migração e induz aumento na expressão de genes relacionados a via de p53 e morte celular. O vetor Ad-IFNbeta sozinho ou adicionado em combinação com Ad-p19, não teve impacto significante nestes ensaios. Alternativamente, a influencia indireta, ou parácrina, nas células tEnd cultivadas juntamente com as células B16 transduzidas com os vetores adenovirais também foi investigada. Quando as células B16 foram transduzidas com Ad-IFNbeta ou a co-transdução Ad-IFNbeta+Ad-p19 em co-cultura com a linhagem tEnd, houve inibição da proliferação. Não observamos efeito inibitório na tEnd da co-cultura quando as células da B16 foram transduzidas somente com Ad-p19. Seguindo o ensaio de co-cultura, produzimos meio condicionado da B16 transduzida com os vetores e aplicamos esses meios nas células tEnd. Observamos que Ad-IFN, sozinho ou em combinação com Ad-19, diminuiu a viabilidade, proliferação e levou a morte das células tEnd. Neste trabalho, constamos que inibição de células endoteliais pode ser realizada por transdução direta com Ad-19 ou quando estas células são expostas ao ambiente modulado por células tumorais transduzidas com o vetor Ad-IFNbeta. Mesmo que a transferência gênica de ambos IFNbeta e p19Arf não demonstrou ser uma abordagem superior à aplicação dos genes isolados, observamos que nossa abordagem pode ter um impacto importante na inibição da angiogênese pelas células endoteliais / The vasculature plays a central role in tumor progression and represents a therapeutic target of great interest. Inhibition of angiogenesis has the potential to slow down tumor progression and inhibit metastasis. As a result, anti-angiogenic therapies have been shown to be promising for the control of tumor growth. According to the literature, interferon ? (IFN?, activator of the innate and adaptive immune systems) and p19Arf (tumor suppressor and functional partner of p53) when studied individually alter tumor vasculature. Our group has constructed and used recombinant adenovirus vectors carrying the cDNAs of INFbeta and p19Arf and noted that the transfer of this combination of genes induced cell death and decreased tumor progression, as observed in the B16 murine model of in situ melanoma gene therapy as well as prophylactic and therapeutic vaccine approaches. In this study, we explore the idea that the combination of adenoviral vectors bearing INFbeta and p19Arf produce anti-angiogenic effects due to their impact on endothelial cells. To test this hypothesis, murine endothelial cells (tEnd) were transduced with adenoviral vectors, revealing that Ad-p19 vector confers inhibition of proliferation, tube formation, migration and induces increased expression of genes related to the p53 cell death pathway. The Ad-IFNbeta vector alone had no significant impact on these tests. Alternatively, influences on paracrine effects are evaluated on endothelial cells co-cultured with B16 cells that were previously transduced with adenoviral vectors. When the B16 cells were transduced with Ad-IFNbeta or co-transduced with Ad-IFNbeta + Ad-p19, co-culture resulted in the inhibition of proliferation of the endothelial cells. When B16 cells were transduced with Ad-p19 only, co-culture did alter endothelial cell behavior. Following the co-culture assay, we produce conditioned medium from B16 cells that were transduced with the vectors and applied the media on tEnd cells. We noted that conditioned medium derived from B16 transduced with Ad-IFN alone or in combination with Ad-19 decreased the viability and proliferation and induced cell death of tEnd. In this work, we show that inhibition of endothelial cells can be performed directly by transduction with Ad-19 or when such cells are exposed to the environment modulated by tumor cells transduced with Ad-IFNbeta. Even though the gene transfer of both IFNbeta and p19 was not found to be superior to the application of single genes, we observed that our approach may have an important impact on the inhibition of angiogenesis through endothelial cells

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Multiple Sclerosis (MS) is a Central Nervous System disease, mediated by the Immune System, whose symptoms occur in episodes of relapses. Interferon-beta (IFN-β) is considered a safe treatment for the reduction of relapses, but its mechanisms of action have not yet been clear. Studies have shown involvement of tumor necrosis factor alpha (TNF-α) and of Interleukin-10 (IL-10) in the immunopathogenesis of MS. The role of IL-32, a proinflammatory cytokine has role on several chronic inflammatory diseases, was not elucidated in MS. The effect of IFN-β on these cytokines and disease severity, as measured by the Expanded Disability Status Scale (EDSS), has not yet been established. Objective. The objective of the present study was to evaluate TNF-α, IL-10 and IL-32γ concentrations in the peripheral blood and gene expression of patients with IFN-β. Methods. The sample were patients of the Department of Neurology of the Clinics Hospital of the Federal University, and healthy individuals. Blood collection, blood culture with lipopolysaccharide (LPS), Toll 4 receptor agonist (TLR4), and PAM3Cys, TLR2 agonist, and the quantification of cytokines by real-time polymerase chain reaction were performed. Mann Whitney tests were used for statistical analysis of unpaired data, Wilcoxon for paired samples and Spearman's correlation test, adopting significance level p <0.05. Results. Of the 30 MS patients, 19 were treated with IFN-β and 11, untreated, with a mean age of 40.52 and 42 years, respectively, and female prevalence. TNF-α did not differ between groups but it was less produced after stimulation with Pam3Cys in treated patients compared to controls and untreated patients. IL- 10 concentrations were higher in cultures with LPS in patients treated compared to healthy controls. The mean EDSS of patients treated with IFN-β and untreated did not differ, and the correlation between and TNF-α and IL-10 concentrations produced in blood cultures and EDSS was not significant in the patients. There was a significant correlation between TNF-α concentrations and disease time in untreated patients in non-stimulated cultures and those with TLR2 agonist stimulus. Gene expression of IL-32γ was higher in IFN-β treated patients compared to controls. The gene expression of cytokines correlated positively and significantly in patients and controls and the IL-10 expression was correlated negative e significantly with the disease time in untreated patients. Conclusions. IFN-β reduced patients' response to Pam3Cys. IL-10 was higher in treated patients relative to controls. The correlations were not conclusive about the possible association between these cytokines and the clinic parameters of the disease. IL-32γ was higher in patients treated with IFN-β than in healthy subjects. / Introdução. A Esclerose Múltipla (EM) é uma doença do Sistema Nervoso Central, mediada pelo Sistema Imune,cujos sintomas ocorremem episódios de surtos.OInterferon-beta (IFN-β) é considerado um tratamento seguro para redução dos surtos, masseus mecanismos de ação ainda não foram bemesclarecidos. Estudos mostraram participaçãodo fator de necrose tumoral alfa (TNF-α) e da Interleucina-10 (IL-10) na imunopatogênese da EM. O papel da IL-32, citocina pró-inflamatória atuante emvárias doenças inflamatórias crônicas, não foi elucidado na EM. O efeito do IFN-β nestas citocinas e na gravidade da doença, medida pela Escala do Estado de Incapacidade Expandida (EDSS), ainda não foi estabelecido. Objetivo.O objetivo do presente estudo foi avaliar as concentrações de TNF-α, IL- 10 e IL-32γ no sangue periférico de pacientes com EM tratados com IFN-β e não tratados. Métodos.Foram recrutados portadores da doença, no Serviço de Neurologia do Hospital das Clínicas da Universidade Federal,e indivíduos sadios. Foi feita a coleta de sangue, hemoculturas com lipopolissacarídeo (LPS), agonista do receptor do tipo Toll 4 (TLR4), e PAM3Cys, agonista de TLR2, e a quantificação gênica das citocinas por reação em cadeia da polimerase em tempo real. Foram utilizados os testes Mann Whitney, para análise estatísticados dados não pareados, Wilcoxon para as amostras pareadas e o teste de correlação de Spearman, adotando nível de significância p<0,05. Resultados. Dos 30 pacientes com EM, 19 eram tratados com IFN-β e 11, não tratados, com idade média de 40,52 e 42 anos, anos, respectivamente, e prevalência do sexo feminino. As concentrações de IL-10 foram mais elevadasnas culturas dos pacientes tratados com IFN-β estimuladas com LPS comparado aos controles sadios.TNF-α não diferiu entre os grupos, mas foi menos produzido após estimulação com Pam3Cys nos pacientes tratados comparado aos controles e aos pacientes não tratados. O EDSS médio dos pacientes tratados com IFN-β e dos não tratados não diferiu, e a correlação entre e as concentrações de TNFα e IL-10 produzidas nas hemoculturas e o EDSS não foi significante nos pacientes. Houve correlação significante entre as concentrações de TNF-α e o tempo de doença nos pacientes não tratados nas culturas não estimuladas e naquelas com estímulo de agonista de TLR2. A expressão gênica de IL-32γ foi mais elevada nos pacientes tratados com IFN-β comparado aos controles. As expressões gênicas das citocinas se correlacionaram positiva e significantemente nos pacientes e controles e a expressão de IL-10 se correlacionou negativa e significantemente com o tempo de doença nos pacientes não tratados. Conclusões. O IFN-β reduziu a resposta dos pacientes ao Pam3Cys. IL-10 foi mais elevada nos pacientes tratados em relação aos controles. As correlações não foram conclusivas sobre a possível associação entre essas citocinas e os parâmetros clínicos da doença. IL-32γ foi mais elevada nos pacientes tratados com IFN-β em relação às pessoas sadias.

A vascularização tem um papel central na progressão tumoral e representa um alvo terapêutico de grande interesse. A inibição da angiogênese tem potencial de retardar a progressão tumoral e inibir metástase. Em decorrência disto, terapias anti-angiogênicas têm demonstrado ser promissora no controle do crescimento tumoral. Segundo a literatura, interferon-? (IFN?, ativador do sistema imune inato e adaptativo) e p19Arf (supressor de tumor e parceiro funcional de p53), quando estudados individualmente, alteram a vasculatura tumoral. Nosso grupo construiu e utilizou vetores adenovirais recombinantes portadores dos cDNAs de INFbeta e p19Arf e observou que a transferência desta combinação de genes induziu morte celular e diminuiu progressão tumoral, resultados foram observados em modelos murinos de melanoma B16 de terapia genica in situ, vacina profilática e vacina terapêutica. Neste trabalho, exploramos a ideia que a combinação dos vetores adenovirais portadores de INFbeta e p19Arf proporcionam efeitos anti-angiogênicos através de seu impacto em células endoteliais. Para averiguarmos essa hipótese, células endoteliais murinas (tEnd) foram transduzidas com os vetores adenovirais, revelando que o vetor Ad-p19 confere inibição da proliferação, formação de tubos, migração e induz aumento na expressão de genes relacionados a via de p53 e morte celular. O vetor Ad-IFNbeta sozinho ou adicionado em combinação com Ad-p19, não teve impacto significante nestes ensaios. Alternativamente, a influencia indireta, ou parácrina, nas células tEnd cultivadas juntamente com as células B16 transduzidas com os vetores adenovirais também foi investigada. Quando as células B16 foram transduzidas com Ad-IFNbeta ou a co-transdução Ad-IFNbeta+Ad-p19 em co-cultura com a linhagem tEnd, houve inibição da proliferação. Não observamos efeito inibitório na tEnd da co-cultura quando as células da B16 foram transduzidas somente com Ad-p19. Seguindo o ensaio de co-cultura, produzimos meio condicionado da B16 transduzida com os vetores e aplicamos esses meios nas células tEnd. Observamos que Ad-IFN, sozinho ou em combinação com Ad-19, diminuiu a viabilidade, proliferação e levou a morte das células tEnd. Neste trabalho, constamos que inibição de células endoteliais pode ser realizada por transdução direta com Ad-19 ou quando estas células são expostas ao ambiente modulado por células tumorais transduzidas com o vetor Ad-IFNbeta. Mesmo que a transferência gênica de ambos IFNbeta e p19Arf não demonstrou ser uma abordagem superior à aplicação dos genes isolados, observamos que nossa abordagem pode ter um impacto importante na inibição da angiogênese pelas células endoteliais / The vasculature plays a central role in tumor progression and represents a therapeutic target of great interest. Inhibition of angiogenesis has the potential to slow down tumor progression and inhibit metastasis. As a result, anti-angiogenic therapies have been shown to be promising for the control of tumor growth. According to the literature, interferon ? (IFN?, activator of the innate and adaptive immune systems) and p19Arf (tumor suppressor and functional partner of p53) when studied individually alter tumor vasculature. Our group has constructed and used recombinant adenovirus vectors carrying the cDNAs of INFbeta and p19Arf and noted that the transfer of this combination of genes induced cell death and decreased tumor progression, as observed in the B16 murine model of in situ melanoma gene therapy as well as prophylactic and therapeutic vaccine approaches. In this study, we explore the idea that the combination of adenoviral vectors bearing INFbeta and p19Arf produce anti-angiogenic effects due to their impact on endothelial cells. To test this hypothesis, murine endothelial cells (tEnd) were transduced with adenoviral vectors, revealing that Ad-p19 vector confers inhibition of proliferation, tube formation, migration and induces increased expression of genes related to the p53 cell death pathway. The Ad-IFNbeta vector alone had no significant impact on these tests. Alternatively, influences on paracrine effects are evaluated on endothelial cells co-cultured with B16 cells that were previously transduced with adenoviral vectors. When the B16 cells were transduced with Ad-IFNbeta or co-transduced with Ad-IFNbeta + Ad-p19, co-culture resulted in the inhibition of proliferation of the endothelial cells. When B16 cells were transduced with Ad-p19 only, co-culture did alter endothelial cell behavior. Following the co-culture assay, we produce conditioned medium from B16 cells that were transduced with the vectors and applied the media on tEnd cells. We noted that conditioned medium derived from B16 transduced with Ad-IFN alone or in combination with Ad-19 decreased the viability and proliferation and induced cell death of tEnd. In this work, we show that inhibition of endothelial cells can be performed directly by transduction with Ad-19 or when such cells are exposed to the environment modulated by tumor cells transduced with Ad-IFNbeta. Even though the gene transfer of both IFNbeta and p19 was not found to be superior to the application of single genes, we observed that our approach may have an important impact on the inhibition of angiogenesis through endothelial cells

No description available.

Urinvägsinfektioner (UVI) är ett vanligt hälsoproblem som drabbar miljontals människor. Den allvarligaste formen, akut pyelonefrit (APN) kan ge svåra komplikationer. Urinvägspatogena Escherichia coli (UPEC) som orsakar APN uttrycker P fimbrier som specifikt binder till glykosphingolipider på ytan av uroepitelceller. Det sätter igång en toll-like receptor 4 (TLR4) beroende men LPS-oberoende immunreaktion. Den roll som interferon beta (IFN-β) spelar vid bakterieinfektioner är inte helt klarlagd men studier som gjorts på IFN-β knockoutmöss visade på en ökad infektionsbenägenhet och svåra njursymptom vid infektion med UPEC. IFN-β uttrycket i uroepitelceller som svar på bakterieinfektion undersöktes. För att ta reda på om uttrycket är P fimbrieberoende infekterades humana A498 njurcarcinomceller med den P fimbrieförsedda pyelonefritstammen CFT073 eller den icke-virulenta asymtomatisk bakterieuristammen E. coli 83972 och inkuberades i 1,5 respektive 4 timmar. Som kontroll användes celler som enbart behandlats med PBS. Uttrycket av IFN-β analyserades med immunofluorescens (IF) och konfokalmikroskopi, samt med Western blot. Resultaten från konfokalmikroskopi visade att celler som exponerats för CFT073 under 4 timmar uttryckte mest IFN-β medan cellerna som utsatts för E. coli 83972 visade på ett omvänt förhållande. Western blot visade på högst uttryck i de E. coli 83972-behandlade cellerna. IFN-β uttrycktes i alla celler, inklusive kontrollcellerna, i någon utsträckning. Det kan betyda att IFN-β även induceras på någon alternativ väg och/eller att det uttrycks konstitutivt av njurepitelceller. / Urinary tract infections (UTI) are a common health concern and affect millions of people. The most severe form of UTI, acute pyelonephritis (APN) is associated with serious complications. Uropathogenic Escherichia coli (UPEC) that cause APN express P fimbriae which specifically bind to glycosphingolipid molecules on the surface of urothelial cells. This triggers a toll-like receptor 4 (TLR4) mediated but LPS-independent innate immune response. The role of interferon beta (IFN-β) in bacterial infections is not well known but experiments with IFN-β knockout mice have shown an increased susceptibility and severe kidney pathology when infected with UPEC. IFN-β induction in urothelial cells in response to bacterial infection was investigated. To find out whether this response is P fimbriae dependent, A498 human kidney carcinoma epithelial cells were exposed to the P fimbriated CFT073 pyelonephritis strain or the non-virulent E. coli 83972 asymptomatic bacteriuria strain and incubated for 1.5 and 4 hours. For control, cells were treated with PBS alone. The IFN-β expression was analysed using immunofluorescence (IF) and confocal microscopy, and Western blot. Confocal microscopy results showed that the response to bacteria was both time- and dose-dependent. The highest IFN-β expression was detected in cells exposed to CFT073 for 4 hours, while cells exposed to E. coli 83972 showed an inverse relationship. Western blot analysis revealed that the highest expression was in the E. coli 83972 stimulated cells. IFN-β was expressed in all cells to some degree, including control cells. This could imply that IFN-β is induced by some other means and/or is constitutively expressed by kidney epithelial cells.

Background: In patients with multiple sclerosis (MS), non-adherence to disease-modifying drug therapy is associated with an increased rate of MS relapses. Early identification of patients at risk of non-adherence would allow provision of timely and individualized support. The aim of the BETAPREDICT study was to investigate potential predictors of adherence in patients with MS in Germany treated with interferon β-1b (IFNβ-1b) using the BETACONNECT® autoinjector. Methods: BETAPREDICT was a national, multi-center, prospective, non-interventional, single-arm, 24-month cohort study of patients with relapsing–remitting MS or clinically isolated syndrome receiving IFNβ-1b via the BETACONNECT® autoinjector (ClinicalTrials.gov: NCT02486640). Injection data were captured by the autoinjector. The primary objective was to determine baseline predictors of compliance, persistence, and adherence to IFNβ-1b treatment after 12- and 24 months using multivariable-adjusted regression. Secondary objectives included evaluation of satisfaction with the autoinjector, injection site pain, vitamin and nutrient supplementation, clinical course, and patient-related outcome measures. Results: Of 165 patients enrolled, 153 were available for analysis (120 with autoinjector data). Seventy-two patients left the study prematurely. Compliance (N = 120), persistence (N = 153), and adherence (N = 120) at 24 months were 89.1, 53.6, and 41.7%, respectively. Compliance at 12- and 24 months was predicted by intake of vitamin D supplements and absence of specific injection site reactions. Positive predictors of persistence included age (at 12- and 24 months) and previous duration of treatment (at 12 months), while intake of vitamins/nutrients other than vitamin D was a negative predictor (at 12 months). Positive predictors of adherence at 24 months were age and being experienced with IFNβ-1b. Higher scores in specific SF-36 subscales were positive predictors of medication-taking behavior at 24 months. Satisfaction with the autoinjector was high at baseline and 24 months (median score: 9 out of 10). Conclusions: Compliance with IFNβ-1b treatment among participants still under observation remained high over a 24-month period, while persistence and adherence continuously declined. Multiple factors affected medication-taking behavior, including patient characteristics, treatment history, injection site reactions, patients’ perception of their health and support programs. The importance of these factors may differ among patients according to their individual situation.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed June 6, 2008). Includes bibliographical references.