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Plasma glutamine levels in critically ill intensive care patients / Arista NienaberNienaber, Arista January 2015 (has links)
Background
Nutritional treatment in the intensive care unit (ICU) has evolved from meeting nutritional requirements to manipulating patient outcome. Pharmaconutrition, referring to nutrients that are applied for their pharmacological properties, forms part of the standard nutritional care plan. The most abundant amino acid in the body, glutamine, is also the most-researched pharmaconutrient. It is an independent predictor of mortality in ICU patients, at both deficient and very high levels. Glutamine supplementation is recommended in the ICU setting for its proven outcome benefits. However, recent data showed that glutamine supplementation increases mortality risk in certain patient groups. Moreover, it suggested that not all ICU patients are glutamine deficient. Therefore, the main aim of this study was to investigate the plasma glutamine levels of adult ICU patients, on admission to the ICU. In addition, to elucidate the profile of ICU patients that can be expected to present with a glutamine deficiency or excess, with regards to gender, diagnosis and inflammatory markers.
Methods
In this observational, cross-sectional study, 60 mixed ICU adult patients admitted to two hospitals in the North West province were included in the study group. Blood sampling was conducted within 24 hours following ICU admission, to determine plasma glutamine, interleukin (IL)-6 and C-reactive protein (CRP) levels. Plasma glutamine levels were compared with those of a control group of healthy individuals, matched by age, race, and gender. Gender-related differences in plasma glutamine levels were investigated, as well as differences between patients with various medical conditions. The relationship between plasma glutamine levels and IL-6 or CRP was examined. Additionally, a CRP concentration cut-off point at which glutamine becomes deficient was determined by means of a receiver operating characteristic (ROC) curve.
Results and discussion
Intensive care unit patients had significantly lower plasma glutamine levels than healthy individuals on day one of ICU admission (p < 0.0001). However, only 38.3% (n = 23) had deficient plasma glutamine levels (< 420 μmol/L), while 6.7% (n = 4) presented with supra-normal levels (> 930 μmol/L). No significant difference could be detected between the plasma glutamine levels of male and female ICU patients (p = 0.116). Likewise, levels between diagnosis categories were also not significantly different (p = 0.325). There was a significant inverse association between plasma glutamine levels and CRP concentrations (r = -0.44,
p < 0.05), and a trend towards an inverse association with IL-6 (r = - 0.23, p = 0.08). A CRP cut-off value of 95.5 mg/L was determined, above which plasma glutamine values became deficient; however, more research is needed to confirm this result.
Conclusion and recommendations
This research therefore showed that ICU patients, when compared with healthy individuals, had lower plasma glutamine levels on day one of admission to the ICU. However, not all were glutamine deficient, as the majority had normal and some presented with supra-normal plasma glutamine levels. An individualised approach should therefore be followed in identifying candidates for glutamine supplementation. The patients‟ condition alone may not be sufficient to predict glutamine status, but an association between plasma glutamine levels and CRP was firmly established, as well as a cut- off CRP-value above which glutamine can be expected to become deficient, which could be of use in this regard. / MSc (Dietetics), North-West University, Potchefstroom Campus, 2015
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Sensitization of dural afferents underlies migraine-related behavior following meningeal application of interleukin-6 (IL-6)Yan, Jin, Melemedjian, Ohannes, Price, Theodore, Dussor, Gregory January 2012 (has links)
BACKGROUND:Migraine headache is one of the most common neurological disorders, but the pathophysiology contributing to migraine is poorly understood. Intracranial interleukin-6 (IL-6) levels have been shown to be elevated during migraine attacks, suggesting that this cytokine may facilitate pain signaling from the meninges and contribute to the development of headache.METHODS:Cutaneous allodynia was measured in rats following stimulation of the dura with IL-6 alone or in combination with the MEK inhibitor, U0126. The number of action potentials and latency to the first action potential peak in response to a ramp current stimulus as well as current threshold were measured in retrogradely-labeled dural afferents using patch-clamp electrophysiology. These recordings were performed in the presence of IL-6 alone or in combination with U0126. Association between ERK1 and Nav1.7 following IL-6 treatment was also measured by co-immunoprecipitation.RESULTS:Here we report that in awake animals, direct application of IL-6 to the dura produced dose-dependent facial and hindpaw allodynia. The MEK inhibitor U0126 blocked IL-6-induced allodynia indicating that IL-6 produced this behavioral effect through the MAP kinase pathway. In trigeminal neurons retrogradely labeled from the dura, IL-6 application decreased the current threshold for action potential firing. In response to a ramp current stimulus, cells treated with IL-6 showed an increase in the numbers of action potentials and a decrease in latency to the first spike, an effect consistent with phosphorylation of the sodium channel Nav1.7. Pretreatment with U0126 reversed hyperexcitability following IL-6 treatment. Moreover, co-immunoprecipitation experiments demonstrated an increased association between ERK1 and Nav1.7 following IL-6 treatment.CONCLUSIONS:Our results indicate that IL-6 enhances the excitability of dural afferents likely via ERK-mediated modulation of Nav1.7 and these responses contribute to migraine-related pain behavior in vivo. These data provide a cellular mechanism by which IL-6 in the meninges causes sensitization of dural afferents therefore contributing to the pathogenesis of migraine headache.
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Interleukin-6 Levels in Generalized and Localized Aggressive Periodontitis PatientsReddy, Bindu 01 January 2004 (has links)
AbstractINTERLEUKIN-6 LEVELS IN GENERALIZED AND LOCALIZED AGGRESSIVE PERIODONTITIS PATIENTSBy Bindu Reddy, D.D.S.A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at the Virginia Commonwealth UniversityVirginia Commonwealth University, 2004Major Director: Joseph V. Califano, D.D.S., Ph.D.Associate Professor, Department of Periodontics Periodontitis is an inflammatory disease involving the supporting structures of the dentition. Many studies have shown that there is a relationship between periodontal disease, the presence of pro-inflammatory cytokines, and systemic disease such as cardiovascular disease and diabetes mellitus. The purpose of this study was to measure serum Interleukin-6 levels in generalized and localized aggressive periodontitis and non-periodontitis patients and look for relationships with measures of disease severity. We also examined variables known to have a relationship with IL-6. A total of 172 subjects, comprising three periodontal subgroups, non-periodontitis (NP=61), generalized aggressive periodontitis (GAP=77), and localized aggressive periodontitis (LAP= 34), had serum samples evaluated for IL-6 levels using a highly sensitive ELISA test. The IL-6 levels were compared with clinical and demographic data including age, race, gender, number of teeth, probing depth, attachment loss, bleeding index, plaque index, gingival index, cotinine levels, smoking status, and CRP levels. Using multiple regression analysis, smoking status (p=0.0015) was the only variable found to have a significant relationship with IL-6 levels for all three groups.
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The effects of interleukin-6 on angiogenesisGopinathan, Ganga January 2014 (has links)
Elevated levels of the inflammatory cytokine interleukin-6, IL-6, have been linked with poor prognosis in ovarian cancer patients by influencing tumour growth, invasion, angiogenesis and chemo-resistance. A clinical trial conducted in parallel with pre-clinical studies showed an anti-IL-6 antibody to have some activity in ovarian cancer patients and in xenograft models, via reduction in pro-inflammatory and angiogenic factors such as TNF-α, IL-8 and VEGF. Anti-IL-6 treatment also showed significant reductions in vascular area with decreased expression of an angiogenic factor Jagged1. The aim of my study was to investigate the effects of IL-6 on normal and tumour angiogenesis. I found that recombinant IL-6 stimulates angiogenesis in mouse and rat aortic ring assays and that it can also stimulate growth and migration of endothelial cells in vitro. IL-6 has similar potency as VEGF in inducing vessel sprouting. IL-6 itself does not induce VEGF in the endothelial cells I tested. Investigation of the effects of IL-6 on vessel maturation revealed a significant reduction in pericyte coverage of vessels treated with IL-6 compared with VEGF. Collectively, these data led to my hypothesis that ‘IL-6 drives aberrant angiogenesis, independent of VEGF signalling’. Investigating the mechanism by which IL-6 drives angiogenesis and leads to defective pericyte formation, I showed a link between IL-6 and the Notch ligands, Jagged1 and DLL4. My data suggested that IL-6 could stimulate Jagged1 in endothelial cells, whereas VEGF induces DLL4, the Notch ligand known to be involved in inducing stalk phenotype. Exploring previous findings to get a better understanding of the interaction of Notch ligands and pericyte recruitment also suggested a role of Angiopoeitin-2 in relation to IL-6 signalling. These observations were extended in IGROV-1 ovarian cancer xenografts treated with an anti-IL-6 antibody and by analysis of gene expression datasets from ovarian cancer biopsies. My results suggest therapeutic potential of combining inhibitors of IL-6 and VEGF in ovarian cancer.
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Effekte von Hyper-IL-6 in der Vaccinia-Virus-vermittelten Krebstherapie / Effects of Hyper-IL-6 in vaccinia virus-mediated cancer therapySturm, Julia January 2011 (has links) (PDF)
In der vorliegenden Arbeit wurde ein onkolytisches Vaccinia-Virus unter Ausnutzung seiner Eigenschaft als Vektorsystem mit dem Designer-Zytokin Hyper-IL-6 ausgestattet (GLV 1h90). Bei Hyper IL 6 handelt es sich um ein Fusionsprotein bestehend aus humanem Interleukin-6 und der Liganden-Bindungsdomäne des löslichen Interleukin-6-Rezeptors, welche kovalent über einen flexiblen Linker miteinander verbunden sind. Dieses chimäre Designer-Zytokin erlaubt die Untersuchung von IL-6-Effekten, welche über das IL-6-Trans-Signaling vermittelt werden. Daraus ergibt sich einerseits eine beträchtliche Erweiterung des Wirkspektrums und darüber hinaus weist Hyper-IL-6 sowohl in vitro als auch in vivo eine 100-1000fach verstärkte biologische Aktivität auf. Aufgrund der Tatsache, dass Hyper-IL-6, neben seiner Tumor-inhibierenden Wirkung, eine Vielzahl weiterer Effekte zugeschrieben wird, wurde in dieser Arbeit durch die Kombination des Designer-Zytokins mit einem onkolytischen Vaccinia-Virus nicht nur additive Effekte auf die Tumorregression, sondern darüber hinaus auch mögliche systemisch-vermittelte Hyper-IL-6-Effekte untersucht. Nach intravenöser Injektion von GLV-1h90 in DU-145-Tumor-tragende Mäuse konnte neben der intratumoralen Replikation des Virus und der Expression des Markerproteins Ruc-GFP zusätzlich die Expression des integrierten Designer-Zytokins Hyper-IL-6 im Tumor nachgewiesen werden. Von entscheidender Bedeutung war der zusätzliche Nachweis des Designer-Zytokins in Serum-Proben von GLV-1h90-injizierten Mäusen. Nach einer aktiven Hyper-IL-6-Sekretion von infizierten Tumorzellen, bildet der Transport in die Blutbahn die Voraussetzung für systemisch-vermittelte Hyper-IL-6-Effekte. In dieser Arbeit wurde untersucht, ob sich durch die Überexpression von Hyper-IL-6 im Tumor, zusätzlich zu den onkolytischen Eigenschaften des Vaccinia-Virus, additive anti-Tumor-Effekte ergeben. Eine systemische Injektion von GLV 1h90 bzw. GLV 1h68 in DU-145-Tumor-tragende Mäuse führte zu einer signifikanten Reduktion des Tumorvolumens im Vergleich zu PBS-injizierten Mäusen. Neben Effekten, welche mit Entzündungsprozessen assoziiert sind, wie eine Rotfärbung der Haut, eine signifikanten Vergrößerung der Leber sowie eine massive Stimulation der Akute-Phase-Antwort in der Leber, konnte in GLV-1h90-injizierten Mäusen ein verbesserter Gesundheitszustand auf der Basis einer signifikanten Gewichtszunahme, verbunden mit einer beschleunigten Wundheilung Virus-induzierter Schwanzläsionen, beobachtet werden. Darüber hinaus konnte für Hyper-IL-6 eine Stimulierung der Megakaryopoese im Knochenmark nachgewiesen werden, welche zu einer signifikanten Erhöhung der Thrombozyten-Zahl im Blutkreislauf von GLV-1h90-injizierten Mäusen führte. Es ist von entscheidender Bedeutung anzumerken, dass alle beobachteten systemischen Hyper-IL-6-Effekte eine zeitliche Limitierung aufwiesen, welche sich höchstwahrscheinlich auf die Virus-bedingte Zerstörung Hyper IL 6-produzierender Tumorzellen zurückführen lässt. Dies impliziert zudem, dass eventuelle Komplikationen, welche durch die Überexpression des Designer-Zytokins hervorgerufen werden können, ebenfalls selbstlimitierend sind. Es konnte bereits mehrfach gezeigt werden, dass eine Kombinationstherapie aus onkolytischen Viren und Chemotherapie über synergistische Effekte zu einer signifikant verbesserten Tumorregression führt. Allerdings kommt es in Folge einer Chemotherapie oft zu einer Vielzahl von gefährlichen Nebenwirkungen, da alle schnell proliferierenden Zellen des Körpers betroffen sind. Thrombozytopenie ist eine der am häufigsten vorkommenden Nebenwirkung und beschreibt eine massive Reduktion der Thrombozyten-Zahl im Blut. Im Hinblick auf eine mögliche klinische Anwendung von GLV 1h90 wurde deshalb untersucht, ob in einer Kombinationstherapie mit Mitomycin C, neben einer Verstärkung der therapeutischen Effekte des Virus, basierend auf den beobachteten Hyper-IL-6-Effekten, zusätzlich der Gesundheitszustand der behandelten Mäuse verbessert werden kann. Die Experimente belegen, dass eine Kombination onkolytischer Vaccinia-Virus-Konstrukte mit Mitomycin C zu einer signifikant verbesserten Tumorregression im Vergleich zu den jeweiligen Monotherapien führt. Von bedeutender Relevanz war die Beobachtung, dass in einer Kombinationstherapie von Mitomycin C und GLV-1h90, im Gegensatz zu GLV-1h68, eine signifikante zeitliche Verkürzung der auftretenden Thrombozytopenie erreicht wird. Zusammenfassend konnte in dieser Arbeit gezeigt werden, dass eine systemische Injektion von GLV-1h90 zu einer funktionellen Expression des Designer-Zytokins Hyper-IL-6 führte, welches in der Lage ist eine erfolgreiche Kombinationstherapie aus einem onkolytischen Vaccinia-Virus und dem Chemotherapeutikum Mitomycin C durch eine Reduktion der Nebenwirkungen zusätzlich zu optimieren. / In this thesis, an oncolytic vaccinia virus was armed with the designer cytokine Hyper-IL-6 by recombinant integration (GLV-1h90), exploiting its features as a vector system. Hyper IL-6 is composed of human interleukin-6 (IL-6) and the cytokine-binding domain of its soluble receptor sIL-6R which are bond covalently by a flexible peptide linker. Hyper-IL-6 is a multifunctional cytokine which exhibits not only anti-tumor activity, but also a variety of other effects. For this reason, the combination of the designer cytokine and an oncolytic vaccinia virus was used to study possible improvements regarding tumor regression and more importantly additional systemically mediated Hyper IL-6 effects. In addition to intratumoral replication and visualization of the marker gene ruc-gfp, intratumoral expression of the inserted designer cytokine Hyper-IL-6 could be detected after systemic administration of GLV-1h90 into DU-145-tumor-bearing mice. Of special interest was the presence of hyper-IL-6 in blood serum samples of GLV-1h90-injected mice. Following active hyper-IL-6 secretion of infected tumor cells, the transport into the blood circulation is essential for its ability to induce signal transduction pathways outside the tumor. IL-6 is a pro-inflammatory cytokine which is postulated to exhibit both, tumor promoting as well as tumor inhibiting effects. However, growth or proliferation inhibition of tumors could only be observed after addition of soluble IL-6 receptor and is consequently associated with the IL 6-trans-signaling pathway. Therefore, the thesis deals with the question of whether overexpression of hyper-IL-6 can further enhance the pre-existing oncolytic effects of vaccinia virus. Systemic administration of either GLV-1h90 or GLV-1h68 led to significant tumor regression compared to PBS-treated mice. Comparison of the two viral constructs demonstrated a slightly increased oncolytic activity of GLV-1h90. However, further studies have to clarify to which extend this improvement is resulting from an intratumoral overexpression of hyper IL 6. Following the detection of hyper-IL-6 in the blood circulation as a consequence of GLV 1h90-mediated overexpression in the tumor, functionality of the designer cytokine was analyzed regarding systemically mediated effects. Besides effects which can be associated with inflammatory processes, such as red skin, significant enlargement of the liver as well as enormous stimulation of the acute-phase-response, GLV-1h90-injected mice showed improved healthiness. Health status was assessed by significant gain in body weight associated with accelerated epithelial barrier repair of virus-induced tail lesions. Moreover, it could be demonstrated that Hyper-IL-6 stimulates megakaryopoiesis in the bone marrow, which in turn leads to significantly elevated levels of blood platelets in GLV-1h90-injected mice. It is particularly important to note that all observed systemic Hyper-IL-6 effects occurred only temporarily, which could be explained by virus-mediated oncolysis, reducing the amount of viable Hyper-IL-6 producing tumor cells. The results also implicate that potential complications associated with the overexpression of the designer cytokine can be self-limiting due to the destruction of the virus replication site. Recently, we and others demonstrated that the combination of oncolytic virotherapy and chemotherapy could lead to synergistic interactions that ultimately result in enhanced tumor regression. On the other hand, chemotherapy is often associated with serious side effects, since all fast proliferating cells are affected. Among the most frequently observed adverse effects is thrombocytopenia, which is characterized by a massive reduction of blood platelets. With regard to a possible clinical application of GLV 1h90, combination therapy of the hyper IL 6 encoding vaccinia-virus strain and the chemotherapeutic agent mitomycin C was investigated. Besides therapeutic effects of the virus, the issue was addressed, whether the health status of mice can be improved based on the observed hyper-IL-6 effects. Experimental results clearly demonstrated that combination therapy of mitomycin C and oncolytic vaccinia viruses led to a significantly improved DU-145 tumor regression compared to the respective monotherapies. Of particular importance was the finding that as compared to GLV-1h68, a combination of GLV-1h90 and mitomycin C reduced the time interval during which treated mice suffered from thrombocytopenia significantly. Taken together, this thesis revealed that systemic injection of GLV-1h90 leads to functional expression of the designer cytokine hyper-IL-6, which is able to further optimize the already effective combination therapy of the oncolytic virus GLV-1h90 and the chemotherapeutic agent mitomycin C by reducing of serious adverse effects.
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Determination of the hypertrophic potential of Oncostatin M on rat cardiac cells and the characterisation of the receptor complexes utilised by rat Oncostatin M / Erforschung des hypertrophen Potentials von Oncostatin M auf Ratten-Herzzellen und die Charakterisierung der Rezeptorkomplexe, welche von Ratten-Oncostatin M genutzt werdenDrechsler, Johannes January 2012 (has links) (PDF)
Interleukin-6 (IL-6), oncostatin M (OSM), leukaemia inhibitory factor (LIF) and cardiotrophin-1 (CT-1) are members of the IL-6-type cytokine family that is characterised by sharing the common receptor subunit gp130. While the involvement of these polypeptides in cell differentiation, cell survival, proliferation, apoptosis, inflammation, haematopoiesis, immune response and acute phase reaction has already been demonstrated, the description of their role in development and progression of cardiac hypertrophy is still rather limited. A model has been postulated that declares the transient expression of IL-6-type cytokines as protective, while a continuous cardiac secretion of these proteins seems to be rather harmful for the heart. Within the first part of the study (results 4.1, 4.2 and 4.3) it was shown that OSM induces hypertrophy of primary neonatal rat cardiomyocytes (NRCM), just as its related cytokines LIF, CT-1 and hIL-6/hsIL-6R (hsIL-6R, human soluble IL-6 receptor). Regarding the hypertrophic potentials the LIFR/gp130 utilising cytokines (hLIF, hOSM and hCT-1) are stronger inducers than the OSMR/gp130 utilising mOSM. Human IL-6/hsIL-6R which signals via a gp130 homodimer has the weakest hypertrophic effect. The thorough analysis of typical signalling pathways initiated by IL-6-type cytokines revealed that STAT3 phosphorylation at Y705 seems to be the most important hypertrophy promoting pathway. In addition and in contrast to published work, we clearly demonstrate that classical IL-6 signalling (upon pure IL-6 treatment) has no hypertrophic effect on cardiomyocytes, because they lack sufficient amounts of the membrane-bound IL-6R. This is also true for neonatal rat cardiac fibroblasts (NRCFB). Since these cells can also influence cardiac hypertrophy, signalling pathways and target genes were additionally examined in NRCFB in response to OSM, LIF and IL-6/sIL-6R. One of the key findings of this thesis is the selective change in expression of cytokines and receptors of the IL-6 family in both cell types upon IL-6-type cytokine stimulation. A striking difference between NRCM and NRCFB is the fact that the target gene induction in NRCM is of similar duration upon mOSM and hIL-6/hsIL-6R treatment, while hIL-6/hsIL-6R is capable of promoting the induction of OSMR and IL-6 significantly longer in NRCFB. By searching for transcription factors or intermediate cytokines which could be responsible for this difference, a strong correlation between increased Il6 transcription and amount of mRNA levels for C/EBPβ and C/EBPδ was observed in response to IL-6/sIL-6R stimulation. Interestingly, mOSM also mediates the induction of C/EBPβ and δ, but the initiation is significantly less efficient than in response to IL-6/sIL-6R. Therefore, we assume that mOSM stimulation fails to reach threshold values required for a prolonged IL-6 secretion. Since we additionally observe a slight IL-6R mRNA upregulation in NRCFB, we assume that the combination of IL-6, LIF, C/EBPβ, C/EBPδ and IL-6R expression might be responsible for the observed different kinetics with which IL-6 and OSM stimulate NRCFB. In addition to the aforementioned proteins, members of the renin-angiotensin system seem to support the IL-6-type cytokine mediated hypertrophy. Since it has already been shown that angiotensin II vice versa induces IL-6 expression in NRCM and NRCFB, this enhanced expression of AT1α and ACE could be of crucial interest for the hypertrophy supporting phenotype. The second part of the presented work dealt with the characterisation of the receptor complexes of rat OSM. The central question of this analysis was, whether rOSM, just like mOSM, only binds the type II (OSMR/gp130) receptor complex or is able to utilise the type II and type I (LIFR/gp130) receptor complex. Using different experimental approaches (knock-down of the OSMR expression by RNA interference, blocking of the LIFR by LIF-05, an antagonistic LIF variant, and generation of stably transfected Ba/F3 cells expressing the newly cloned rat OSMR/gp130 or LIFR/gp130 receptor complex) we can clearly show that rat OSM surprisingly utilises both, the type I and type II receptor complex. Therefore it closely mimics the human situation. Furthermore, rOSM displays cross-species activities and stimulates cells of human as well as murine origin. Its signaling capacities closely mimic those of human OSM in cell types of different origin in the way that strong activation of the JAK/STAT, the MAP kinase as well as the PI3K/Akt pathways can be observed. Therefore, the results obtained in the last section of this thesis clearly suggest that rat disease models would allow evaluation of the relevance of OSM for human biology much better than murine models. / Interleukin-6 (IL-6), Oncostatin M (OSM), Leukämie inhibierender Faktor (LIF) und Cardiotrophin-1 (CT-1) sind Mitglieder der IL-6-Typ Zytokin-Familie, welche durch die gemeinsame Nutzung der Rezeptoruntereinheit gp130 charakterisiert ist. Während eine Beteiligung dieser Proteine bei Zelldifferenzierung, Zellüberleben, Proliferation, Apoptose, Entzündung, Hämatopoese, Immunantwort und Akut-Phase-Reaktion bereits gezeigt wurde, ist die Beschreibung ihrer Rolle bei der Entstehung und dem Fortschreiten der kardialen Hypertrophie deutlich limitierter. Es wurde bereits ein Modell postuliert, nach dem die kurzzeitige Expression dieser Zytokine schützend wirkt, während eine andauernde kardiale Sekretion eher schädlich für das Herz zu sein scheint. Im ersten Teil der Arbeit (Ergebnisse 4.1, 4.2 und 4.3) konnte gezeigt werden, dass OSM wie auch seine verwandten Zytokine LIF, CT-1 und hIL-6/hsIL-6R (hsIL-6R, humaner löslicher IL-6 Rezeptor) Hypertrophie-induzierend auf primäre neonatale Ratten-Kardiomyozyten (NRCM) wirkt. Hinsichtlich ihres hypertrophen Potentials sind die Zytokine, welche über LIFR/gp130 signalisieren (hLIF, hOSM und hCT-1), die stärkeren Induktoren im Vergleich zu mOSM, welches den OSMR/gp130 Rezeptorkomplex bindet. Die Stimulation mit humanem IL-6/hsIL-6R hatte hingegen die schwächste hypertrophe Wirkung. Unsere genaue Analyse der typischen IL-6-Typ Zytokin vermittelten Signalwege enthüllte die Phosphorylierung von STAT3 an Y705 als offenkundig wichtigsten hypertrophen Weg. Zusätzlich dazu konnten wir auch zeigen, dass klassisches IL-6 Signalling (ohne sIL-6R) keinen hypertrophen Einfluss auf NRCM hat, da diesen Zellen ausreichende Mengen des membranständigen IL-6R fehlen. Diese Beobachtung steht in klarem Kontrast zu bereits publizierten Arbeiten. In den ebenfalls untersuchten neonatalen Ratten-Kardiofibroblasten (NRCFB) verhält es sich, was den IL-6R angeht, genauso wie in NRCM. Da auch diese Zellen eine kardiale Hypertrophie mit beeinflussen können, wurden in ihnen die gleichen Signalwege und Zielgene nach Stimulation mit OSM, LIF und IL-6/sIL-6R untersucht. Die selektive Expressionsregulation von Zytokinen und Rezeptoren der IL-6-Familie in beiden Zelltypen nach IL-6-Typ Zytokin Stimulation ist hierbei einer unserer wichtigsten Befunde. Ein gravierender Unterschied zwischen NRCM und NRCFB besteht darin, dass die mOSM und hIL-6/hsIL-6R vermittelte Geninduktion in NRCM von vergleichbarer Dauer ist, wohingegen sie sich in NRCFB unterscheidet. Bei der Suche nach Transkriptionsfaktoren oder intermediären Zytokinen, welche für diesen Unterschied verantwortlich sein könnten, beobachteten wir nach IL-6/sIL-6R Stimulation eine deutliche Korrelation zwischen der Il6-Transkription und den mRNA Mengen von C/EBPβ und C/EBPδ. Auch OSM ist in der Lage beide Transkriptionsfaktoren zu induzieren, jedoch viel ineffizienter als IL-6/sIL-6R. Wir vermuten, dass mOSM einen bestimmten Schwellenwert, der für die verlängerte IL-6 Sekretion benötigt wird, nicht erreicht. Da wir zusätzlich noch eine schwache Zunahme der IL-6R mRNA in NRCFB beobachten konnten, gehen wir davon aus, dass die Expression von IL-6, LIF, C/EBPβ, C/EBPδ und IL-6R für die unterschiedlichen Kinetiken, mit denen IL-6 und OSM NRCFB stimulieren, verantwortlich sein dürfte. Es scheinen auch Mitglieder des Renin-Angiotensin-Systems die IL-6-Typ Zytokin vermittelte Hypertrophie zu unterstützen. Da schon gezeigt wurde, dass Angiotensin II reziprok die IL-6 Expression induziert, könnte diese verstärkte Synthese von AT1α und ACE von größter Bedeutung für den Hypertrophie-unterstützenden Phänotyp sein. Der zweite Teil der Arbeit (4.4) beschäftigte sich mit der Charakterisierung der Rezeptorkomplexe des Ratten-OSM. Die zentrale Frage hierbei bestand darin, ob rOSM wie mOSM nur den Typ II (OSMR/gp130) Rezeptorkomplex bindet, oder wie das hOSM sowohl den Typ II als auch den Typ I (LIFR/gp130) Rezeptorkomplex benutzen kann. Mit Hilfe unterschiedlicher experimenteller Strategien (knock-down der OSMR Expression durch RNA-Interferenz, LIFR-Blockade durch antagonistisches LIF-05, und die Generierung von stabil transfizierten Ba/F3-Zellen, welche die hierzu klonierten OSMR/gp130 oder LIFR/gp130 Rezeptorkomplexe der Ratte exprimieren) konnten wir eindeutig zeigen, dass Ratten-OSM überraschenderweise beide Rezeptorkomplexe benutzt. In dieser Hinsicht verhält sich es sich wie das humane Homolog. Des Weiteren besitzt Ratten-OSM Kreuz-Spezies-Aktivität und stimuliert humane und murine Zellen. Das Signal-Potential von rOSM ist dem von humanem OSM auf Zellen unterschiedlichen Ursprungs sehr ähnlich. Das Zytokin ist befähigt JAK/STAT, MAP Kinase und PI3K/Akt Signalwege potent zu aktivieren. Deshalb deuten die Daten des zweiten Teils dieser Arbeit darauf hin, dass Krankheitsmodelle in Ratten die Evaluierung der Relevanz des OSM für die humane Biologie deutlich besser widerspiegeln würden als murine Modelle.
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Effect of cytokine inhibition on peripheral memory B cells in patients with Rheumatoid arthtritis / Auswirkung der Zytokinhemmung auf periphere Gedächtnis B-Zellen in Patienten mit rheumatoider ArthritisMahmood, Zafar January 2015 (has links) (PDF)
Objective: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disease. Enhanced B cell activity has been proposed in the pathogenesis of RA along with different pro-inflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α), critically involved in chronic inflammation. Biological agents targeting these cytokines IL-6 and TNF-α have considerably advanced treatment of autoimmunity. Enhanced B cell activity, particularly memory B cells gained particularly interest in evaluating response during therapies from biologics. Human peripheral memory B cells can be distinguished by the phenotypic expression of CD27 and IgD defining three major B cell subpopulations: CD27+IgD+ pre-switch, CD27+IgD- post-switch and CD27-IgD- double negative (DN) memory B cells. Therefore, we analyzed different memory populations during cytokine inhibition by using tocilizumab (anti-IL-6R, TCZ) and adalimumab (anti-TNF-α, ADA), with focus on DN B cells Suspended. DN B cells lacking the conventional memory marker CD27, but due to their mutational Ig repertoire (IgR) considered in the memory compartment. However, only scare data are available for this DN subpopulation in RA.
Methods: Phenotype analysis of activation markers (CD95 and ki-67) of B cell and their subsets were compared in RA patients (median age ~56 years) and in HD. DN memory B cells were phenotypically analyzed from RA patients during IL-6R or TNF-α inhibition at baseline week 12, week 24 and 1 year. Single B cell PCR approach was used to study Ig- receptors VH genes and isotype specific genes. Nonparametric Wilcoxon matched pair test and Mann-Whitney U test was used for statistical analysis by using GraphPadPrism 5. Univariate logistic regression was used to calculate odd ratios and correlation using Pearson r using SPSS statistics 22.
Results: Surface and intracellular staining of B cells showed a significantly higher percentage of CD95 and ki-67 expressions in RA, which was highest in post-switch memory B cells followed by pre-switch and DN memory B cells. During cytokines (IL-6R & TNF-α) inhibition, both CD95 and ki-67 expression were significantly reduced at week 12 and 24 along with reduction in their clinical parameters like DAS28, CRP, ESR. Furthermore, the phenotypic analysis in 107 RA patients and 49 healthy donors (HD) showed a significantly expanded population of DN B cells in RA which contain a heterogeneous mixture of IgA, IgG and IgM expressing cells with a clear dominance of IgG+ cells. Pre-therapy analysis of rearranged IgR sequences from patients (n=9) revealed that DN B cells carry rearranged heavy chain gene sequences with a diversified mutational pattern consistent with memory B cells. In contrast to tumor necrosis factor alpha (TNF-alpha) inhibition, a significant reduction in mutational frequency of BCR gene rearrangements at week 12, 24 and 1 year (p < 0.0001) was observed by in vivo IL-6R inhibition. These changes were observed for all BCR isotypes IgG, IgA and IgM at week 12, 24 and 1 year (p < 0.0001). IgA-RF, IgA serum level and IgA+ DN B cells decreased significantly (p < 0.05) at week 12 and week 24 during TCZ. Patients with a good European league against rheumatism (EULAR) response to TCZ had less DN B cells at baseline as compared to moderate responders (p = 0.006). Univariate logistic regression analysis revealed that the frequency of DN B cells at baseline is inversely correlated to a subsequent good EULAR response (p = 0.024) with an odds ratio of 1.48 (95% confidence interval as 1.05-2.06).
Conclusion: Both anti-TNF-α and anti-IL-6R could reduce higher B cell activity and improve disease activity tremendously in RA patients. The heterogeneous DN B cell compartment is expanded in RA and dominated by IgG isotype. TCZ can modulate the mutational status of DN Ig isotype receptors over 1 year. Interestingly, the frequency of DN B cells in RA may serve as a baseline predictor of subsequent EULAR response to TCZ. / Die rheumatoide Arthritis (RA) ist eine chronische, systemische, und entzündliche Autoimmunerkrankung. Es wird angenommen, dass neben verschiedenen inflammatorischen Zytokinen wie beispielsweise Interleukin-6 (IL-6) und Tumor Nekrose Faktor alpha (TNF-α) auch eine verstärkte Aktivität von B-Zellen in chronischen Entzündungsprozessen involviert ist. Biologische Agenzien, die gezielt gegen die Zytokine IL-6 und TNF-α gerichtet sind, haben die Behandlungsmöglichkeiten der Autoimmunerkrankungen wesentlich vorangetrieben. Derzeit rückt eine verstärkte B-Zell Aktivität, insbesondere die von Gedächtnis B-Zellen, bei der Evaluierung von Reaktionen auf biologische Therapien in den Focus des Interesses. Humane periphere Gedächtnis B-Zellen können anhand der Expression von CD27 und IgD phänotypisch charakterisiert werden und lassen sich dadurch in drei Subpopulationen einteilen: CD27+IgD+ prä-switch, CD27+IgD- post-switch und CD27-IgD- doppelt negative (DN) Gedächtnis B-Zellen. Wir untersuchten die verschiedenen Gedächtnis B-Zell-Populationen während der Zytokininhibierung mittels Tocilizumab (anti-IL-6R, TCZ) und Adalimumab (anti-TNF-α, ADA), wobei der Focus auf DN B-Zellen lag. DN B-Zellen fehlt der konventionelle Gedächtniszellen-Marker CD27, sie werden aber aufgrund ihres mutierten Ig-Repertoires (IgR) den Gedächtniszellen zugeordnet. Für diese DN B-Zell Subpopulation gibt es allerdings bislang nur wenige Daten im Zusammenhang mit RA.
Die B-Zell Subpopulationen von RA Patienten (durchschnittliches Alter ~56 Jahre) und gesunden Spendern (englisch: healthy donors, HD) gleichen Alters als Kontrolle, wurden hinsichtlich der Aktivierungsmarker, CD95 und ki-67, phänotypisch analysiert und verglichen. DN Gedächtnis B-Zellen von RA Patienten wurden phänotypisch zu Beginn der IL-6R oder TNF-α Inhibition, nach 12 und 24 Wochen sowie 1 Jahr nach Behandlungsbeginn bestimmt. Es wurden Einzel-PCR Analysen von B-Zellen durchgeführt, um die VH Gene der Ig-Rezeptoren und spezifische Gene zu typisieren. Für die statistischen Auswertungen wurde in GraphPad Prism 5 der‚nonparametric Wilcoxon matched pair test‘ und der‚ Mann-Whitney U test‘ verwendet. Die eindimensionale logistische Regression wurde angewandt, um Odd-Ratio und Korrelationen mittels Pearson r in SPSS Statistik 22 zu berechnen.
Die phänotypische Analyse der Oberflächen und intrazellulären Färbungen der B-Zellen ergab einen signifikant erhöhten Prozentsatz der CD95 und ki-67-Expression in RA-Patienten, wobei die Expression am höchsten in post-switch Gedächtnis B-Zellen, gefolgt von prä-switch und DN Gedächtnis B-Zellen, war. Während der Zytokin-Inhibierung (IL-6R & TNF-α) war sowohl die CD95 als auch ki-67-Expression zum Zeitpunkt Woche 12 und Woche 24 signifikant reduziert, einhergehend mit der Verringerung klinischer Parameter wie DAS28, CRP und ESR. Weiterhin zeigte die phänotypische Analyse von 86 RA-Patienten und 49 HD eine deutlich expandierte DN B-Zell Population in RA-Patienten. Diese setzte sich aus einer heterogenen Mischung von IgA, IgG und IgM exprimierenden Zellen zusammen, wobei IgG+ B-Zellen deutlich dominierten.
Die Analyse von neu-gruppierten IgR Sequenzen von B-Zellen aus RA Patienten (n=9) vor Therapiebeginn zeigte, dass DN B-Zellen umgruppierte Gensequenzen der schweren Ketten mit diversen Mutationsmustern tragen, wie es bei Gedächtnis B-Zellen der Fall ist. Im Gegensatz zur TNF-α-Hemmung ist bei der in vivo IL-6R-Inhibierung eine signifikante Reduktion der Mutationsrate innerhalb der umgruppierten der Gene der B-Zell Rezeptoren (BCR) nach 12 und 24 Wochen sowie nach 1 Jahr (p<0,0001) zu beobachten. Diese Änderungen waren bei allen BCR Isotypen IgG, IgA und IgM bei Woche 12, 24 und 1 Jahr (p<0.0001) zu sehen. IgA-RF, IgA-Serum Spiegel sowie IgA+ DN B Zellen nahmen 12 und 24 Wochen nach Beginn der Behandlung mit TCZ signifikant ab (p<0,05). Patienten mit einer guten klinischen Besserung (EULAR Antwort) auf TCZ hatten weniger DN B-Zellen vor Therapiebeginn im Blut als Patienten, die eine moderate Reaktion zeigten. Univariate logistische Regressionsanalysen zeigten, dass die Frequenz von DN B-Zellen vor Therapiebeginn invers mit einer sich anschließenden guten EULAR Antwort korreliert. Die Odds Ratio war 1,48 (95% Konfidenz Intervall wie 1,05-2,06).
Im Ergebnis hat die Studie Phänotypen von aktivierten Gedächtnis B-Zellen und deren Untergruppen in Patienten mit aktiver RA nachgewiesen. Die höhere Expression des Oberflächenmarker CD95 und des intrazellulären Marker ki-67 spiegelt die Krankheitsaktivität wieder und korreliert mit dieser positiv. Signifikant höhere Populationen von CD27-IgD- DN B-Zellen in der RA stehen jedoch unabhängig von der Krankheitsaktivität in Bezug zum Ansprechen auf die Therapie. Diese erhöhten DN B-Zellen sind eine Mischung aus somatisch mutierten Isotyp IgG, IgA und IgM exprimierenden Zellen, wobei IgG Isotypen dominieren. Die TCZ Therapie bewirkt insbesondere eine Abnahme der Frequenzen von IgA+ DN Gedächtnis B-Zellen, zusammen mit einer Abnahme des Serum-IgA und RF-IgA-Spiegels. Auf molekularer Ebene ist zu sehen, dass mutierte DN B Zellen geringere Mutationen aufweisen als prä-switch und post-switch B-Zellen. Interessanterweise sind IgA+ DN B-Zellen am meisten unter allen 3 Isotypen mutiert. Die TCZ Therapie reduziert die Mutationsrate, auch innerhalb der RGYW Hotspots, in allen DN B-Zell Isotypen über einen Zeitraum von einem Jahr. Eine geringe Anzahl von DN Gedächtnis B-Zellen vor Therapiebeginn mit TCZ (anti-IL-6R) war mit einer verbesserten klinischen Antwort korreliert. Auf Grundlage dieser aktuellen Ergebnisse erscheinen DN Gedächtnis B-Zellen als möglicher Biomarker Kandidaten zu sein, um eine Reaktion auf eine TCZ Therapie anzuzeigen.
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Einfluss von Stickstoffdioxid auf die Zytokininduktion nasaler Epithelzellen bei Exposition mit dem Hausstaubmilbenallergen Der p 1 / Influence of nitrogen dixoide on the cytokine induction of nasal epithelial cells by exposition with the house dust mite allergen Der p 1Paulus, Michael Georg January 2017 (has links) (PDF)
Stickstoffdioxid ist ein Luftschadstoff, der mit dem Auftreten von allergischen Atemwegserkrankungen assoziiert ist. In dieser Studie wurde ein möglicher proallergischer Effekt von Stickstoffdioxid auf die durch eine Hausstaubmilbenallergie verursachte allergische Rhinitis untersucht. Primärzellkulturen aus nasalen Epithelzellen wurden einer einstündigen Gasexposition mit 0,1 ppm, 1 ppm und 10 ppm Stickstoffdioxid unterzogen, gefolgt von einer Exposition mit dem Hausstaubmilbenallergen Der p 1. Zellkulturen, die einer kombinierten Exposition aus 0,1 ppm Stickstoffdioxid und Der p 1 oder 1 ppm Stickstoffdioxid unterzogen wurden, zeigten eine erhöhte Induktion der Zytokine IL-6 und IL-8. Kein Effekt war bei einer reinen Exposition mit Der p 1 oder einer reinen Gasexposition zu beobachten. Über eine verstärkte Induktion von IL-6 und IL-8 kann Stickstoffdioxid einen proinflammatorischen Einfluss auf das Entzündungsgeschehen der allergischen Rhinitis nehmen und die Entstehung einer Sensibilisierungsreaktion fördern. Ein proinflammatorischer Effekt wurde bereits bei einer Stickstoffdioxidkonzentration von 0,1 ppm nachgewiesen, welche in Ballungsräumen von Industriestaaten regelmäßig erreicht wird. / Nitrogen dioxide is an airborne pollutant which is associated with the prevalence of allergic airway disease. This study investigated a possible proallergic effect of nitrogen dioxide on the allergic rhintis caused by a house dust mite allergy. Primary cell cultures of human nasal epithelial cells were exposed with 0,1 ppm, 1 ppm or 10 ppm nitrogen dioxide for one hour, followed by an exposition with the house dust mite allergen Der p 1. Cell cultures who were exposed with 0,1 ppm or 1 ppm nitrogen dioxide and Der p 1 showed an increase in the induction of the cytokines IL-6 und IL-8. No effect was observed in cells only exposed to Der p 1 or only exposed to nitrogen dioxide. By increasing the production of these cytokines, nitrogen dioxide can possibly enhance the underlying immune response which leads to allergic inflammation and sensitization. A proinflammatoric effect was demonstrated at 0,1 ppm nitrogen dioxide, a concentration which is common in urban areas of industrialized nations.
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Detection of insulin receptor, epidermal growth factor receptor, and interleukin-6 on individual mouse embryos by immuno-polymerase chain reaction /Xu, Kun, January 2001 (has links)
Thesis (Ph. D.) in Biochemistry and Molecular Biology--University of Maine, 2001. / Includes vita. Includes bibliographical references (leaves 143-156).
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Acupuncture for Symptom Management in a Menopausal Population: An Exploration of Mechanism and ExperienceWright, Cheryl LeAnn January 2009 (has links)
This early phase study examined the effects of a series of ten standard-protocol acupuncture treatments over four weeks in 12 healthy, but symptomatic, menopausal women. Two biologic markers, heart rate variability to evaluate effects of acupuncture on the autonomic nervous system as it relates specifically to the heart, and interleukin 6, a proinflammatory cytokine, to capture physiologic impact of acupuncture on the immune-inflammatory response, were collected.Women who exhibited significant menopausal symptoms, as measured by a minimum score of 22 out of a possible 44 points on the Menopause Rating Scale (MRS), underwent 10 sessions of a standard acupuncture point protocol intervention over a four-week period. Symptoms were evaluated for 28 days using the MRS. After the intervention was complete, one final open-ended question was asked of each participant to explore subjective experiences not captured by the validated instrument. Physiologic measurements included a 30-minute continuous measure of electrocardiogram data before and during acupuncture, as well as pre and post acupuncture measures of serum interleukin 6 at the first and final acupuncture treatment. Heart rate variability was assessed using spectral analysis, and interleukin 6 changes were measured using ELISA. Analysis included linear regression, Wilcoxon Signed Ranks test and Spearman correlation coefficients.After the acupuncture intervention, menopausal symptoms improved significantly. Heart rate variability did not show consistent or predictable intra or inter-subject changes, however several components of HRV, interleukin 6 and symptoms were found to have significant correlations.A larger study was deemed feasible. Menopause symptoms improved. Heart rate variability showed no consistent changes or trends. Interleukin 6 decreased in seven subjects, between the first and tenth acupuncture treatment, but did not reach statistical significance.This small project suggests that heart rate variability, when measured at each acupuncture treatment, does not change in a consistent or predictable manner. Rather, acupuncture may provide a modulating influence that depends on the body's functional state at each treatment.
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