京都大学 / 新制・論文博士 / 博士(医学) / 乙第13557号 / 論医博第2286号 / 新制||医||1067(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 生田 宏一, 教授 伊藤 能永, 教授 森信 暁雄 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Mast cells are tissue resident members of the immune system. They have a wide range of functions and receptors including the FcεRI receptor, which gets activated by binding to IgE bound to an antigen. When the cells are activated in this manner, a process termed the LysRS- Ap4A-MITF signalling pathway occurs, resulting in the translocation of the Lys tRNA synthetase into the nucleus and an activation of its moonlighting activity - the production of diadenosine tetraphosphate (Ap4A). Ap4A is a dinucleoside polyphosphate, a type of ubiquitous molecule present in all domains of life. They are made up of two nucleosides joined together by a 5' to 5' phosphodiester bridge of variable lengths. Recently, these molecules have been shown to serve as non-canonical initiating nucleotides during bacterial transcription, where they function as 5' RNA caps, similar to the well-known 7- methylguanosine eukaryotic mRNA cap. In this thesis, I present proof of existence of Ap 4A capped RNA in mast cells, a previously unknown 5' RNA structure in eukaryotic cells, and I attempt to pinpoint its role in the activation of these cells and in the wider context of mast cell mediated immune response. Keywords: mast cells, RNA caps, Dinucleoside polyphosphates, Ap 4A, RNA modification, IgE, FcεRI receptor, Lysine tRNA synthetase

Following the discovery of mast cells (or mastzellen) by the prolific physician researcher, Paul Ehrlich, many advances have improved our understanding of these cells and their fascinating biology. The discovery of immunoglobulin E and receptors for IgE and IgG on mast cells heralded further in vivo and in vitro studies, using molecular technologies and gene knockout models. Mast cells express an array of inflammatory mediators including tryptase, histamine, cytokines, chemokines, and growth factors. They play a role in many varying disease states, from atopic diseases, parasitic infections, hematological malignancies, and arthritis to osteoporosis. This review will attempt to summarize salient evolving areas in mast cell research over the last few centuries that have led to our current understanding of this pivotal multifunctional cell.

Chronic urticaria (CU) is a mast cell-driven chronic inflammatory disease with a female predominance. Since CU affects mostly females in reproductive age, pregnancy is an important aspect to consider in the context of this disease. Sex hormones affect mast cell (MC) biology, and the hormonal changes that come with pregnancy can modulate the course of chronic inflammatory conditions, and they often do. Also, pregnancy-associated changes in the immune system, including local adaptation of innate and adaptive immune responses and skewing of adaptive immunity toward a Th2/Treg profile have been linked to changes in the course of inflammatory diseases. As of now, little is known about the effects of pregnancy on CU and the outcomes of pregnancy in CU patients. Also, there are no real-life studies to show the safety of urticaria medications during pregnancy. The recent PREG-CU study provided the first insights on this and showed that CU improves during pregnancy in half of the patients, whereas it worsens in one-third; and two of five CU patients experience flare-ups of their CU during pregnancy. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for urticaria recommends adopting the samemanagement strategy in pregnant and lactating CU patients; starting treatment with standard doses of second-generation (non-sedative) H1 antihistamines, to increase the dose up to 4-folds in case of no response, and to add omalizumab in antihistamine-refractory patients; but also emphasizes the lack of evidence-based information on the safety and efficacy of urticaria treatments during pregnancy. The PREG-CU study assessed treatments and their outcomes during pregnancy. Here, we review the reported effects of sex hormones and pregnancy-specific immunological changes on urticaria, we discuss the impact of pregnancy on urticaria, and we provide information and guidance on the management of urticaria during pregnancy and lactation.

No description available.

White-tailed deer (Odocoileus virginianus) are a common and important game species throughout much of the central Appalachian region. The central Appalachian region encompasses a wide variety of habitat conditions and spatial habitat arrangements that may influence deer populations and management as well as deer impacts to ecosystems. Locally to regionally, deer populations have had an increasingly negative effect on forest biodiversity and a growing influence on forest succession. In Virginia, the combination of these factors has prompted establishment of deer population management goals and policies designed to support conservation of biodiversity, forest regeneration, and continued hunting opportunities. However, limited information is available to inform broad-scale assessment of herbivory impacts. Likewise, lack of understanding about the spatial variability of herbivory across and among landscapes impedes consistent application of ecological measures under differing management scenarios and landscape conditions. I evaluated deer herbivory intensity, the predictability of browsing rates, and the relationships and possible interactions between deer body mass and potential food sources, winter severity, and deer population density in the central Appalachian Mountains of Virginia. My results provide support for the inclusion of spatial factors to help partition variation of deer herbivory to allow for improved precision and accuracy in the design of field herbivory impact assessment methods and improve their application across various landscape contexts. Also, effective broad-scale herbivory impact assessment should include spatially-balanced vegetation monitoring that accounts for regional differences in deer forage preference. Agriculture and other non-forest habitats may provide resources that result in larger deer body mass either directly through food items or indirectly through alteration of the remaining forest habitat such as through increased edge. This suggests that available food sources and habitat are related to deer physiological parameters in the central Appalachian region and vary across landscapes. Likewise, these factors can change or can be affected through management across time. As a result, spatial approaches for monitoring and analysis are required for effective management and understanding of deer populations and herbivory impacts to biodiversity. / Ph. D. / White-tailed deer (<i>Odocoileus virginianus</i>) are a common and important game species throughout much of the eastern United States including the central Appalachian Mountain region. The central Appalachian region encompasses a wide variety of habitat conditions and habitat arrangements that may influence deer populations and management as well as deer impacts to ecosystems. Deer consume a variety of plants and plant matter and overabundant deer populations have had a negative effect on forest plants and biodiversity. In Virginia, deer population management goals and policies have been designed to support conservation of biodiversity, forest regeneration, and continued hunting opportunities. However, limited information is available to managers to help them improve the assessment of herbivory impacts. Also, lack of understanding of how deer herbivory patterns change across the landscape complicates the use of ecological measures in different areas. I evaluated deer herbivory intensity, the predictability of herbivory rates, and the relationships and possible interactions between deer body condition and potential food sources, winter severity, and deer population density in the central Appalachian Mountains of Virginia. My results suggest that inclusion of spatial factors, such as the movement patterns of deer in the local area, may allow for improved precision and accuracy in the design of field herbivory impact assessment methods. Also, effective, broad-scale herbivory impact assessment should include spatially-balanced vegetation monitoring that accounts for regional differences in deer forage preference. Agriculture and other non-forest habitats may provide resources that result in heavier deer either directly through food items or indirectly through alteration of the remaining forest habitat such as through increased edge. As a result, spatial approaches for monitoring and analysis are required for effective management and understanding of deer populations and herbivory impacts to biodiversity.

Die Anaphylaxie, eine potentiell lebensbedrohliche Reaktion, kann durch Kofaktoren beeinflusst werden. ACE-Inhibitoren, ß-Blocker und Acetylsalicylsäure (ASS) werden häufig in der Therapie von Herz-Kreislauferkrankungen eingesetzt. In der vorliegenden Arbeit wurde überprüft, ob diese anaphylaktische Reaktionen begünstigen. Das Modell der passiv systemischen Anaphylaxie (PSA) wurde speziell angepasst, um die Behandlung einer Herz-Kreislauf-Therapie nachzubilden. Die orale Gabe von Metoprolol oder Ramipril verstärkte die Anaphylaxie geringfügig. Die Kombination der Medikamente steigerte die Anaphylaxie deutlich, was im Modell der passiv kutanen Anaphylaxie (PCA) bestätigt werden konnte. Gleichzeitig waren Mastzellmediatoren im Serum der Tiere erhöht. Die Inkubation muriner Mastzellen (MZ) mit den Medikamenten, steigerte die FcεRI-vermittelten Histaminfreisetzung in vitro. ASS-Vorbehandlung der Mäuse verstärkte die Ausprägung der PSA und der PCA, was mit einer Steigerung von MZ-Mediatoren im Serum assoziiert war. Die FcεRI-induzierte Histaminfreisetzung muriner MZ wurde hingegen nach ASS-Inkubation gehemmt, was auf einen indirekten Mechanismus hinweist. Die Reduktion der Prostaglandine (PG) durch ASS ist mit einer gesteigerten Leukotriensynthese verbunden. Der Leukotrienantagonist Montelukast konnte die, durch ASS verstärkte, PSA nicht mildern, was zeigt, dass dieser Effekt unabhängig von Leukotrienen ist. PGE2 kann die MZ-Degranulation über EP1-EP4-Rezeptoren modulieren. Tatsächlich schwächten EP3- und EP4-Rezeptoragonisten die durch ASS gesteigerte Anaphylaxie ab. PGE2 nimmt somit eine wichtige Rolle in der pro-anaphylaktischen Wirkung von ASS ein. Zusammenfassend wurde erstmals gezeigt, dass Metoprolol und Ramipril die Anaphylaxie über eine Steigerung der MZ-Reaktivität verstärken. ASS hingegen erhöht anaphylaktische Reaktionen über einen indirekt steigernden Effekt auf die MZ. PGE2 ist zumindest teilweise an der pro-anaphylaktischen Wirkung von ASS beteiligt. / Cofactors contribute to the severity of anaphylaxis, a potential life-threatening hypersensitivity reaction. ACE-inhibitors, ß-blockers and acetylsalicylic acid (asa) are frequently used drugs in cardiovascular therapy. Whether they affect systemic anaphylactic reactions has been addressed within this thesis. To this aim, the passive systemic anaphylaxis model (PSA) was employed here and specially designed to mimic a long term treatment in cardiovascular therapy. The data demonstrate that oral treatment of mice with ramipril or metoprolol alone slightly aggravated anaphylaxis. However, the combination clearly potentiated anaphylactic reactions, which was also confirmed in the passive cutaneous anaphylaxis model (PCA). In line with this, elevated amounts of mast cell (MC) mediators were detected in mice sera upon combined drug treatment. In vitro, FcεRI-mediated histamine release of murine MCs was likewise enhanced by the respective drugs. Pre-treatment of mice with asa aggravated the symptoms of PSA and PCA; simultaneously MC-mediators in sera were elevated. In contrast, FcεRI-mediated histamine release of MCs was reduced by asa in vitro, pointing to an indirect mechanism. Asa reduces prostaglandins (PGs) and increases leukotriene synthesis. The leukotriene antagonist montelukast failed to attenuate PSA, aggravated by asa, suggesting that the pro-anaphylactic effect of asa might be independent of leukotrienes. PGE2 can modulate MC degranulation via EP1-EP4 receptor. Indeed, EP3 and EP4 receptor agonists alleviated anaphylaxis enhanced by asa. Therefore PGE2 might play an important role in the pro-anaphylactic effect of asa. In conclusion, the data demonstrate for the first time that metoprolol and ramipril exacerbate anaphylactic symptoms by a direct increase in MC reactivity. In contrast, asa aggravates anaphylactic reactions by priming MCs through an indirect mechanism. PGE2 is at least partly involved in this process.

Ziel dieser Arbeit war es, sowohl die Auswirkungen einer veränderten Selenversorgung über die Nahrung als auch die Rolle des zentralen Transport- und Speicherproteins für Selen (Selenoprotein P, SepP) auf die intestinale Tumorigenese tierexperimentell zu untersuchen. Eine gestörte SepP-Expression, führte zur Ausbildung größerer Tumore. Durch eine Steigerung der Selenversorgung über die Nahrung eine signifikante Reduktion von Tumoranzahl und Gesamttumorfläche erzielt werden. Hierzu wurde den Tieren ab Tag 21 das Vierfache der empfohlenen Tagesdosis (RDA) für Selen verabreicht. Die Ergebnisse zeigten zudem, dass die Auswirkungen einer verminderten SepP-Expression durch eine nutritive Se-Supplementation kompensiert werden können. Der Verlust eines SepP-Allels war mit einer gesteigerten Infiltration von Mastzellen ins Tumorgewebe und höheren Il6-Spiegeln im Serum assoziiert. Auch waren die Tumore dieser Versuchsgruppen schlechter differenziert. Diese Resultate weisen auf eine modulatorische Wirkung von SepP auf die krebsbedingte Immunantwort hin und unterstreichen eine zentrale Rolle dieses Selenoproteins in Bezug auf anti-kanzerogene Wirkmechanismen von Selen. Die Ergebnisse dieser Arbeit zeigen somit erstmals die Abhängigkeit protektiver Selen-vermittelter Effekte von einer optimalen SepP-Expression und die präventiven Fähigkeiten einer gesteigerten Selenzufuhr zur Kompensation eines nachteiligen Genotyps. Somit können gerade Menschen, die z.B. aufgrund ihrer genetischen Prädisposition ein erhöhtes Darmkrebsrisiko aufweisen von einer gesteigerten präventiven Supplementation profitieren. Dennoch zeigen Vorarbeiten und die Ergebnisse zu den transgenen Versuchstieren, dass es gerade in Bezug auf eine therapeutische Anwendung unabdingbar ist, ein wachstumsförderndes Potential einer solchen Intervention nach erfolgter Tumorinitiation auszuschließen. Hierzu muss in weitergehenden Studien noch eine geeignete Strategie entwickelt und getestet werden. / The aim of this work was to evaluate to which extend the gene expression of the central transport and storage protein for selenium (Selenoprotein P, SepP) is required to mediate health promoting effects and if these effects can be modulated by selenium supplementation. SepP+/--mice were crossed with Apcmin/+-mice to elucidate the potential disadvantage of a decreased SepP-expression. A third mouse strain, expressing human SEPP in liver, was used to study the beneficial effects of additional circulating human SEPP. Two diets with different selenium content were used to obtain better insights into how SepP-expression influences intestinal tumorigenesis. The loss of one SepP-allele resulted in the development of larger tumors. Overall tumor-count and -area could be reduced by increasing nutritional selenium concentrations. Increased tumorigenesis could thus be compensated for raising nutritional Se concentrations. Interestingly, the additional expression of human SEPP did not elicit any cancer-preventive action. An increased number of mast cells was found in tumorous tissue of SepP+/--mice. This was accompanied by a lower differentiation state and higher Il6 concentrations in serum of heterozygous mice. The results indicate that the SepP genotype is modulating the immune response and highlight the central role of SepP in mediating the anti-cancerogenic effects of Se. We are the first to show that protective effects of Se are related to the expression of SepP and that the negative outcome of a reduced expression can be alleviated by raising nutritional Se supply. Individuals with a higher risk for colorectal cancer may thus benefit from supplementation strategies. Nevertheless the data obtained from transgenic mice and the results of previous studies indicate that therapeutic administration of Se should be handled with care. Especially the potential danger of supplemental Se promoting tumor growth in advanced stages should be addressed in further investigations.

Head and neck cancer is a heterogeneous group of tumours, of which certain subgroups such as cancer of the mobile tongue frequently are associated with a relatively poor prognosis due to the high risk of regional failure and mortality rates that haven’t improved in a significant way over the last 3 decades, despite advancements in both diagnostics and treatment. Today we lack means to assess the biological aggressiveness of each individual tumour, which varies largely. Treatment comprises of surgery with additional radiotherapy and medical therapies in more advanced tumours. The focus in this thesis is on molecular biomarker expression in head and neck cancer and especially in association with radiotherapy. Increased knowledge paves the way to a more individualized cancer treatment aiming for better outcome and less overtreatment and sequelae. The aims of this thesis was: To map the effects of radiotherapy in both tumour and adjacent tissue for the possible markers hyaluronan, EGFR and mast cells. To investigate whether the expression of hyaluronan in the epithelium and connective tissue stroma and EGFR in the tumour correlates with the risk for developing cervical metastasis in N0 patients, and to find out whether the 3-year tumour-specific survival rates correlates with the expression of HA in the epithelium and EGFR in the tumour. To establish an animal model for radiation-induced mucositis and to use that model to examine the pattern of invading inflammatory cells. To investigate whether the expression of podoplanin in tongue cancer correlates with the risk for cervical metastasis and to determine whether the total amount of lymph vessels in the diagnostic biopsy has any impact on the clinical outcome. To investigate the differences in the metabolome of tongue cancer cell lines with different radiosensitivity. The most important findings of this thesis were: The expression of EGFR and hyaluronan hade the same pattern of expression in both tumour and adjacent tissues before radiotherapy. The expression of EGFR was increased in the epithelium of the adjacent tissue close to the tumour after radiotherapy. The intensity of the staining of hyaluronan was correlated to the 3-year survival rates in patients with tongue cancer. An experimental model for radiation-induced oral mucositis in rat was established and in this model a temporal pattern of macrophage invasion with two different subtypes of macrophages was found. There were no correlation between the expression of podoplanin in the tumour tissue and the cervical metastasis rate in patients with tongue cancer, but the younger patients were more likely to have a higher expression of podoplanin in their tumour than elder patients. Tongue cancer cell lines with different radiosensitivity respond to irradiation with different patterns of metabolic expressions.

No description available.