PURPOSE: The aim of this study is to examine the healing of intact extraction sockets grafted with leukocyte-platelet rich fibrin (L-PRF) as compared to sockets grafted with freeze-dried bone allograft (FDBA) and a resorbable collagen barrier membrane (RCM). METHODS: This prospective randomized, examiner blinded pilot study included 17 subjects randomized to two treatment groups. Serum total cholesterol, low density lipoprotein (LDL), 25-hydroxyvitamin-D3, and platelet counts were determined preoperatively in all subjects. The experimental arm consisted of 8 posterior tooth-bounded intact extraction sites receiving L-PRF plugs. The control group consisted of 9 posterior tooth-bounded intact extraction sites receiving FDBA and RCM. An acrylic stent was fabricated to take duplicate clinical and CBCT measurements immediately post-extraction and at time of implant placement. A repeat-measures analysis of variance was utilized for statistical analysis. RESULTS: The study failed to detect a clinical or radiographic difference between treatment groups in horizontal or vertical ridge dimension changes. Serum cholesterol, LDL, 25-hydroxyvitamin-D3, and buccal plate thickness had a non-significant effect on outcome measurements, although there was a high prevalence of hyperlidpidemia and hypovitaminosis in the study population. CONCLUSIONS: The alveolar ridge dimension changes in intact posterior extraction sockets may be similar when either L-PRF or FDBA and RCM are utilized as socket grafting material. Although there was a high prevalence of high cholesterol and low 25-hydroxyvitamin-D3 levels in the population, this study failed to detect a significant correlation between preoperative serum levels and postoperative ridge dimension changes.

Os venenos de aranhas do gênero Loxosceles possuem uma ampla gama de atividades em diferentes células, tecidos e sistemas, e é notória a sua capacidade de causar a formação da lesão dermonecrótica. Em um trabalho prévio, relatamos uma intensa trombocitopenia induzida pelo veneno loxoscélico em coelhos. Objetivou-se no presente estudo avaliar primeiramente a interação in vitro entre as plaquetas, humanas e de coelhos, com o veneno de Loxosceles gaucho e seu principal componente, a fração esfingomielinásica. Posteriormente, investigou-se o papel da plaqueta no desenvolvimento da lesão dermonecrótica através de um modelo de trombocitopenia em coelhos. Nos estudos in vitro, os resultados de agregação em plasma rico em plaquetas evidenciou que tanto o veneno total quanto a fração esfingomielinásica induziram um aumento desta resposta nas plaquetas das duas espécies, que foi mais intensa nas plaquetas humanas. Uma vez que em plaquetas lavadas a agregação não foi constatada, confirmou-se a necessidade de componente(s) plasmático(s) para a indução desta resposta. Ainda, os dados de LDH indicaram que o veneno total, nas concentrações aqui utilizadas, não foi capaz de causar à lise plaquetária. Com relação à ativação, o veneno total, foi capaz de aumentar a expressão da LIBS1 nas plaquetas de ambas as espécies e de P-selectina na plaqueta de coelho. Sob as nossas condições experimentais, a fração não promoveu o aumento dos marcadores de ativação. Finalizando os estudos in vitro, o veneno total e a fração provocaram um aumento da adesão nas plaquetas das duas espécies, sendo que a resposta à fração esfingomielinásica mostrou-se dose-dependente. O estudo experimental, por vez, necessitou de uma etapa preliminar para a obtenção de um anticorpo anti-plaqueta, produzido em cabras, que mostrou-se eficaz em induzir um intenso quadro trombocitopênico em coelhos. Análises histopatológicas indicam que a ausência das plaquetas não diminuiu a formação de trombos intravasculares na área da derme sob a ação do veneno. O desenvolvimento da lesão dermonecrótica em coelhos injetados com o veneno loxoscélico mostrou-se mais intenso naqueles depletados de plaquetas do que nos animais com número normal de plaquetas, constatável pelo desenvolvimento de maiores áreas de equimose e das escaras necróticas. Os resultados semelhantes dos níveis plasmáticos do fator de von Willembrand, dos tempos de protrombina e de tromboplastina parcial ativada, assim como dos testes de fagocitose por polimorfonucleares isolados do sangue periférico, entre os coelhos trombocitopênicos e aqueles com contagem normal de plaquetas, evidenciam que não houve alterações expressivas nas células endoteliais, no sistema da coagulação e na capacidade fagocítica via C3b dos polimorfonucleares do sangue periférico. Os presentes resultados mostram que o veneno loxoscélico in vitro é capaz de elicitar em plaquetas humanas e de coelhos as respostas de agregação, de adesão e de ativação. Por fim, as diferenças no desenvolvimento da lesão, constatadas entre o animal trombocitopênico e o animal normal, evidenciam que a plaqueta é um fator importante para controlar a expansão e a gravidade da lesão dermonecrótica induiza em coelhos pelo veneno loxoscélico. / Venoms from Loxosceles spiders exhibit a wide range of activities on different cells, tissues and systems, being specially evident their ability to cause a dermonecrotic lesion. In a previous paper, we showed that Loxosceles gaucho spider venom induces intense thrombocytopenia in rabbits. Thus, in the present study, we firstly aimed to evaluate the in vitro interaction between human and rabbits platelets and L. gaucho venom and its major component, the sphingomyelinase fraction. Secondly, we investigated the platelet role in the dermonecrotic lesion formation using an experimental model of thrombocytopenia in rabbits. Both total venom and its sphingomyelinase fraction stimulated in vitro aggregation per se in platelet-rich plasma from both species, but a more intense response was obtained with human platelets. Taking into consideration that neither total venom nor its sphingomyelinase fraction induced aggregation of washed platelets, it can be deduced that one or more plasma components are necessary to induce this response. Moreover, LDH data indicated that total venom, at least at the concentration levels used in this study, cannot induce platelet lysis. Regarding platelet activation, total venom was able to increase the expression of LIBS1 on both human and rabbit platelet surface and P-selectin on only rabbit platelet surface. However, the sphingomyelinase fraction did not increase the expression of any marker of platelet activation, at least in the experimental conditions used in this study. Another in vitro study showed that both total venom and its sphingomyelinase fraction induce an increase in human and rabbit platelet adhesion, with the sphingomyelinase fraction exhibiting a dose-dependent response. For the study using an animal model of thrombocytopenia, it was necessary to previously produce goat antibodies against rabbit platelets, which showed to be effective to induce an intense thrombocytopenia in rabbits. Histopathological analysis of venom-induced dermic tissue lesion indicated that platelet absence does not decrease the formation of intravascular thrombi in the injured area. Nonetheless, bigger areas of equimosis and necrotic scabs could be observed in the dermonecrotic lesion of rabbits injected with loxoscelic venom and depleted of platelets. In the different groups, plasma levels of von Willembrand factor, prothrombin and activated partial thromboplastin times, and data from phagocytosis tests using polymorphonuclear cells isolated from rabbit periferical blood were similar comparing thrombocitopenic rabbits with those exhibiting normal platelet count; therefore, we can deduce that there is not any expressive alteration in endotelial cells, coagulation system and phagocytic ability of polymorphonuclear leukocytes via their complement receptor C3b. In conclusion, the loxoscelic venom is able to unchain in vitro different mechanisms leading to adhesion, activation and aggregation of both human and rabbit platelets. Furthermore, due to differences in the dermic lesion patterns between thrombocitopenic and normal animals, we can conclude that platelets must play a key role in controlling the expansion and severity of the dermonecrotic lesion induced in rabbits by L. gaucho venom.

Neste estudo avaliou-se a ação do gel de Plaquetas e da Glutamina no processo de cicatrização de lesões bucais causadas por mucosite induzida por quimioterapia em ratos Wistar. Foram utilizados 50 animais divididos em 05 grupos: um Grupo A (Gel de Plaquetas), Grupo B (Glutamina tópica), Grupo C (Glutamina gavagem), Grupo D (Glutamina + Gel de plaquetas) e Grupo E (controle +). A partir do 7o dia após a quimioterapia, avaliou-se os graus de mucosite e iniciou-se a aplicação dos medicamentos propostos para cada grupo. O sacrifício dos animais ocorreu em 5 e 10 dias após o início de aplicação dos medicamentos. Foram realizadas as biópsias da mucosa jugal e língua para análise do exame histopatológico onde se avaliou a quantidade de macrófagos, linfócitos e queratinização. Os graus de mucosite desenvolvidos na 1a e 2a fase do experimento apresentaram variação numérica importante, mas sem diferenças estatísticas significantes. Na análise histológica, resultados estatisticamente significativos foram obtidos (Fase 1) para linfócitos em mucosa jugal, onde o grupo B (glutamina) foi maior que o do grupo D (gel de plaquetas + glutamina) (p = 0,032); os linfócitos em língua do grupo A (gel de plaquetas) (p = 0,000) foi superior quando comparado com todos os outros grupos. A queratinização em mucosa jugal no grupo D (Fase 1) apresentou resultados significativamente superiores quando comparada com a queratinização dos demais grupos. A queratinização em língua no grupo D apresentou diferenças estatisticamente significantes (p = 0,000) e maior em relação aos outros grupos. Na fase 2, os macrófagos em língua tiveram resultados significantes entre os grupos A e C (p = 0,031) e A e E (p = 0,006), onde A foi maior. Diante dos resultados encontrados, concluiu-se que os biocurativos utilizados neste estudo promoveram uma maior reação inflamatória no conjuntivo e maior queratinização no epitélio. Entretanto, clinicamente, nas lesões observadas, o tempo de cicatrização foi semelhante em todos os grupos. A dificuldade em induzir uma mucosite mais grave e os cuidados preventivos à morbidade não propiciou a avaliação dos biocurativos em lesões mais extensas, fato este importante para análise mais efetiva da ação dos medicamentos propostos para este estudo. / Among bio-curatives there are those derived from the addition \"in vitro\" of thrombin and calcium gluconate to the platelet rich human plasma that stimulate its degranulation to releasing of growth factors acting on the healing process. Glutamine is the amino acid present in plasma and muscle tissue being considered an important energetic source for the immune system cells. Mucositis is a denomination for the changes that occur in the oral mucosa, mainly due to the cancer treatments. In this study, the action of platelet gel and Glutamine was evaluated in the oral lesions healing process caused by mucositis induced by chemotherapy in Wistar rats. 50 animals divided into 05 groups were used: A Group (Platelet Gel), B Group (Topical glutamine), C Group (Glutamine gavage), D Group (Glutamine + Platelet Gel) and E Group (control +). From the 7th day after chemotherapy, the degree of mucositis was evaluated and the proposed drug application began for each group. The animal sacrifice occurred within 5 to 10 days after the medicine application beginning. Jugal and tongue mucosa biopsies for histopathological examination analysis were carried out which evaluated the macrophages amount, lymphocytes and keratinization. The mucositis degrees developed in the 1st and 2nd phase of the experiment showed important numerical variation, but without meaningful statistical differences. In the histological analysis, statistically meaningful results were obtained (Phase 1) for lymphocytes in the jugal mucosa where the B group (glutamine) was higher than D group (platelet gel + glutamine) (p = 0,032); lymphocytes in tongue in A group (platelet gel) (p = 0,000) was higher when compared to all other groups. Keratinization in the jugal mucosa in D group (Phase 1), showed meaningfully superior results when compared to the keratinization of the other groups. The Keratinization in tongue in D group showed meaningful statistical differences (p = 0,000) and higher compared to the other groups. In phase 2, the macrophages in tongue showed meaningful results between A and C groups (p = 0,031) and A and E (p = 0,006), where A was the highest. Considering the results, it was concluded that bio-curatives used in this study promoted greater inflammatory reaction in the connective and increased keratinization in epithelium. However, clinically, in the observed lesions, the healing time was similar in all groups. The difficulty in inducing a more severe mucositis and the preventive care to morbidity did not propitiate the bio-curatives evaluation in more extensive lesions, an important fact for more effective analysis of proposed medicine action for this study.

"February 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 171-209). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Neste estudo avaliou-se a ação do gel de Plaquetas e da Glutamina no processo de cicatrização de lesões bucais causadas por mucosite induzida por quimioterapia em ratos Wistar. Foram utilizados 50 animais divididos em 05 grupos: um Grupo A (Gel de Plaquetas), Grupo B (Glutamina tópica), Grupo C (Glutamina gavagem), Grupo D (Glutamina + Gel de plaquetas) e Grupo E (controle +). A partir do 7o dia após a quimioterapia, avaliou-se os graus de mucosite e iniciou-se a aplicação dos medicamentos propostos para cada grupo. O sacrifício dos animais ocorreu em 5 e 10 dias após o início de aplicação dos medicamentos. Foram realizadas as biópsias da mucosa jugal e língua para análise do exame histopatológico onde se avaliou a quantidade de macrófagos, linfócitos e queratinização. Os graus de mucosite desenvolvidos na 1a e 2a fase do experimento apresentaram variação numérica importante, mas sem diferenças estatísticas significantes. Na análise histológica, resultados estatisticamente significativos foram obtidos (Fase 1) para linfócitos em mucosa jugal, onde o grupo B (glutamina) foi maior que o do grupo D (gel de plaquetas + glutamina) (p = 0,032); os linfócitos em língua do grupo A (gel de plaquetas) (p = 0,000) foi superior quando comparado com todos os outros grupos. A queratinização em mucosa jugal no grupo D (Fase 1) apresentou resultados significativamente superiores quando comparada com a queratinização dos demais grupos. A queratinização em língua no grupo D apresentou diferenças estatisticamente significantes (p = 0,000) e maior em relação aos outros grupos. Na fase 2, os macrófagos em língua tiveram resultados significantes entre os grupos A e C (p = 0,031) e A e E (p = 0,006), onde A foi maior. Diante dos resultados encontrados, concluiu-se que os biocurativos utilizados neste estudo promoveram uma maior reação inflamatória no conjuntivo e maior queratinização no epitélio. Entretanto, clinicamente, nas lesões observadas, o tempo de cicatrização foi semelhante em todos os grupos. A dificuldade em induzir uma mucosite mais grave e os cuidados preventivos à morbidade não propiciou a avaliação dos biocurativos em lesões mais extensas, fato este importante para análise mais efetiva da ação dos medicamentos propostos para este estudo. / Among bio-curatives there are those derived from the addition \"in vitro\" of thrombin and calcium gluconate to the platelet rich human plasma that stimulate its degranulation to releasing of growth factors acting on the healing process. Glutamine is the amino acid present in plasma and muscle tissue being considered an important energetic source for the immune system cells. Mucositis is a denomination for the changes that occur in the oral mucosa, mainly due to the cancer treatments. In this study, the action of platelet gel and Glutamine was evaluated in the oral lesions healing process caused by mucositis induced by chemotherapy in Wistar rats. 50 animals divided into 05 groups were used: A Group (Platelet Gel), B Group (Topical glutamine), C Group (Glutamine gavage), D Group (Glutamine + Platelet Gel) and E Group (control +). From the 7th day after chemotherapy, the degree of mucositis was evaluated and the proposed drug application began for each group. The animal sacrifice occurred within 5 to 10 days after the medicine application beginning. Jugal and tongue mucosa biopsies for histopathological examination analysis were carried out which evaluated the macrophages amount, lymphocytes and keratinization. The mucositis degrees developed in the 1st and 2nd phase of the experiment showed important numerical variation, but without meaningful statistical differences. In the histological analysis, statistically meaningful results were obtained (Phase 1) for lymphocytes in the jugal mucosa where the B group (glutamine) was higher than D group (platelet gel + glutamine) (p = 0,032); lymphocytes in tongue in A group (platelet gel) (p = 0,000) was higher when compared to all other groups. Keratinization in the jugal mucosa in D group (Phase 1), showed meaningfully superior results when compared to the keratinization of the other groups. The Keratinization in tongue in D group showed meaningful statistical differences (p = 0,000) and higher compared to the other groups. In phase 2, the macrophages in tongue showed meaningful results between A and C groups (p = 0,031) and A and E (p = 0,006), where A was the highest. Considering the results, it was concluded that bio-curatives used in this study promoted greater inflammatory reaction in the connective and increased keratinization in epithelium. However, clinically, in the observed lesions, the healing time was similar in all groups. The difficulty in inducing a more severe mucositis and the preventive care to morbidity did not propitiate the bio-curatives evaluation in more extensive lesions, an important fact for more effective analysis of proposed medicine action for this study.

Os venenos de aranhas do gênero Loxosceles possuem uma ampla gama de atividades em diferentes células, tecidos e sistemas, e é notória a sua capacidade de causar a formação da lesão dermonecrótica. Em um trabalho prévio, relatamos uma intensa trombocitopenia induzida pelo veneno loxoscélico em coelhos. Objetivou-se no presente estudo avaliar primeiramente a interação in vitro entre as plaquetas, humanas e de coelhos, com o veneno de Loxosceles gaucho e seu principal componente, a fração esfingomielinásica. Posteriormente, investigou-se o papel da plaqueta no desenvolvimento da lesão dermonecrótica através de um modelo de trombocitopenia em coelhos. Nos estudos in vitro, os resultados de agregação em plasma rico em plaquetas evidenciou que tanto o veneno total quanto a fração esfingomielinásica induziram um aumento desta resposta nas plaquetas das duas espécies, que foi mais intensa nas plaquetas humanas. Uma vez que em plaquetas lavadas a agregação não foi constatada, confirmou-se a necessidade de componente(s) plasmático(s) para a indução desta resposta. Ainda, os dados de LDH indicaram que o veneno total, nas concentrações aqui utilizadas, não foi capaz de causar à lise plaquetária. Com relação à ativação, o veneno total, foi capaz de aumentar a expressão da LIBS1 nas plaquetas de ambas as espécies e de P-selectina na plaqueta de coelho. Sob as nossas condições experimentais, a fração não promoveu o aumento dos marcadores de ativação. Finalizando os estudos in vitro, o veneno total e a fração provocaram um aumento da adesão nas plaquetas das duas espécies, sendo que a resposta à fração esfingomielinásica mostrou-se dose-dependente. O estudo experimental, por vez, necessitou de uma etapa preliminar para a obtenção de um anticorpo anti-plaqueta, produzido em cabras, que mostrou-se eficaz em induzir um intenso quadro trombocitopênico em coelhos. Análises histopatológicas indicam que a ausência das plaquetas não diminuiu a formação de trombos intravasculares na área da derme sob a ação do veneno. O desenvolvimento da lesão dermonecrótica em coelhos injetados com o veneno loxoscélico mostrou-se mais intenso naqueles depletados de plaquetas do que nos animais com número normal de plaquetas, constatável pelo desenvolvimento de maiores áreas de equimose e das escaras necróticas. Os resultados semelhantes dos níveis plasmáticos do fator de von Willembrand, dos tempos de protrombina e de tromboplastina parcial ativada, assim como dos testes de fagocitose por polimorfonucleares isolados do sangue periférico, entre os coelhos trombocitopênicos e aqueles com contagem normal de plaquetas, evidenciam que não houve alterações expressivas nas células endoteliais, no sistema da coagulação e na capacidade fagocítica via C3b dos polimorfonucleares do sangue periférico. Os presentes resultados mostram que o veneno loxoscélico in vitro é capaz de elicitar em plaquetas humanas e de coelhos as respostas de agregação, de adesão e de ativação. Por fim, as diferenças no desenvolvimento da lesão, constatadas entre o animal trombocitopênico e o animal normal, evidenciam que a plaqueta é um fator importante para controlar a expansão e a gravidade da lesão dermonecrótica induiza em coelhos pelo veneno loxoscélico. / Venoms from Loxosceles spiders exhibit a wide range of activities on different cells, tissues and systems, being specially evident their ability to cause a dermonecrotic lesion. In a previous paper, we showed that Loxosceles gaucho spider venom induces intense thrombocytopenia in rabbits. Thus, in the present study, we firstly aimed to evaluate the in vitro interaction between human and rabbits platelets and L. gaucho venom and its major component, the sphingomyelinase fraction. Secondly, we investigated the platelet role in the dermonecrotic lesion formation using an experimental model of thrombocytopenia in rabbits. Both total venom and its sphingomyelinase fraction stimulated in vitro aggregation per se in platelet-rich plasma from both species, but a more intense response was obtained with human platelets. Taking into consideration that neither total venom nor its sphingomyelinase fraction induced aggregation of washed platelets, it can be deduced that one or more plasma components are necessary to induce this response. Moreover, LDH data indicated that total venom, at least at the concentration levels used in this study, cannot induce platelet lysis. Regarding platelet activation, total venom was able to increase the expression of LIBS1 on both human and rabbit platelet surface and P-selectin on only rabbit platelet surface. However, the sphingomyelinase fraction did not increase the expression of any marker of platelet activation, at least in the experimental conditions used in this study. Another in vitro study showed that both total venom and its sphingomyelinase fraction induce an increase in human and rabbit platelet adhesion, with the sphingomyelinase fraction exhibiting a dose-dependent response. For the study using an animal model of thrombocytopenia, it was necessary to previously produce goat antibodies against rabbit platelets, which showed to be effective to induce an intense thrombocytopenia in rabbits. Histopathological analysis of venom-induced dermic tissue lesion indicated that platelet absence does not decrease the formation of intravascular thrombi in the injured area. Nonetheless, bigger areas of equimosis and necrotic scabs could be observed in the dermonecrotic lesion of rabbits injected with loxoscelic venom and depleted of platelets. In the different groups, plasma levels of von Willembrand factor, prothrombin and activated partial thromboplastin times, and data from phagocytosis tests using polymorphonuclear cells isolated from rabbit periferical blood were similar comparing thrombocitopenic rabbits with those exhibiting normal platelet count; therefore, we can deduce that there is not any expressive alteration in endotelial cells, coagulation system and phagocytic ability of polymorphonuclear leukocytes via their complement receptor C3b. In conclusion, the loxoscelic venom is able to unchain in vitro different mechanisms leading to adhesion, activation and aggregation of both human and rabbit platelets. Furthermore, due to differences in the dermic lesion patterns between thrombocitopenic and normal animals, we can conclude that platelets must play a key role in controlling the expansion and severity of the dermonecrotic lesion induced in rabbits by L. gaucho venom.

A successful therapy for colorectal cancer (CRC), one of the most common malignancies worldwide, requires the greatest possible research effort. Of critical importance is an understanding of the relevant intracellular networks of signaling cascades, their activation, and the resulting cellular changes that are a prerequisite for a more successful CRC therapy. Vascular endothelial growth factor (VEGF) and the appropriate VEGF receptors represent molecular targets that have already been successfully implemented in the clinic (i.e. using monoclonal antibodies, tyrosine kinase inhibitors). However, for platelet derived growth factor (PDGF) and the relevant PDGF receptors, there are currently no clinically approved molecular therapeutics available. However, there are preliminary data to show that PDGF and its associated signaling pathways play an important role in CRC progression. In particular, the PI3K/Akt/mTOR pathway is emerging as an important intracellular partner of PDGF with which to control proliferation, migration, and angiogenesis in tumor cells. Therefore it was the objective of this work to investigate the multifactorial influence of PDGF on proliferation and metabolism, depending on CRC mutation status. The intention was to identify new therapeutic targets for future cancer therapy through analyses of PDGF-induced intracellular changes. For this purpose two human colorectal cancer cell lines were analyzed at gene and/or protein level for components of the PI3K/Akt/mTOR and MAPK signaling pathway, c-Myc, p53, and HIF1α (hypoxia-inducible-factor 1α). Changes in proliferation and metabolism, either during stimulation with PDGF and/or PI3K/Akt/mTOR inhibition, were also investigated. Experiments conducted at protein level during PDGF stimulation and/or PI3K/Akt/mTOR inhibition revealed changes in signaling pathways and crosstalk. The influence of the tumor suppressors (retinoblastoma, Rb), oncogenes (c-Myc, p53mut), and HIF1α during stimulation with PDGF, and their interactions in the tumor cell with respect to proliferation and glycolysis warrant further examination in terms of clinical treatment options. Investigations at the gene level of ex vivo samples (UICC I-IV) complete the study with regards to the clinical relevance of PDGF. PDGF stimulation increases tumor cell proliferation in HT29 cells via the PI3K/Akt/mTOR pathway rather than the MAPK pathway. However, if the PI3K/Akt/mTOR pathway is pharmacologically blocked, PDGF stimulation is mediated by inhibitory crosstalk through the MAPK pathway. Further analyses revealed that specific Akt inhibition impedes tumor cell growth, while PI3K inhibition had little effect on proliferation. Inhibitory crosstalk was found to be responsible for these different effects. Careful intervention strategies are therefore required if future therapies intend to make use of these specific signaling pathways. One aim of future research should be to gain a better understanding of the crosstalk between these signaling pathways. In this fashion, “over-inhibition” of the signal pathways, which would result in additional clinical side effects for patients, could be prevented. In late stage UICC, more mutation events occur, with tumorigenicity promoted by an increased mutation rate. Given that PDGF is increasingly expressed in the late UICC stages, our data would indicate that PDGF's effects are amplified with increasing malignancy. The activating effect of PDGF on the PI3K/Akt/mTOR pathway and subsequent changes in the activity of p53mut, Rb, c-Myc, and HIF1α, lead to an unfavorable prognosis for colon cancer patients. PDGF acts on colon cancer cells in an Akt-activating, glycolysis-dependent manner. PDGF increases glycolysis and the ability of CRC cells to adjust their energy metabolism. These activities should be taken as possible starting points with which to design therapeutic interventions for CRC therapy. PDGF, as another representative of the growth factor family, seems to play a similar role to VEGF in CRC. The data from this study underline the importance of the PDGF - PI3K/Akt/mTOR pathway-axis and its potential as a possible target in colorectal cancer. Thus PDGF represents an attractive therapeutic target, besides the VEGF/EGFR-based therapies already used in CRC. / Die erfolgreiche Therapie von Darmkrebs, eine der häufigsten malignen Erkrankungen weltweit, erfordert den größtmöglichen Forschungsaufwand. Von entscheidender Bedeutung ist das Verständnis der maßgeblichen intrazellulären Vernetzungen der Signalkaskaden, deren Aktivierung und die daraus resultierenden zellulären Veränderungen als Vorrausetzung einer erfolgreicheren Darmkrebstherapie. Der Vascular Endothelial Growth Factor (VEGF) und die entsprechenden VEGF Rezeptoren stellen molekulare Ziele dar, die im Kolorektalkarzinom bereits erfolgreich in die Klinik implementiert wurden (wie zum Beispiel monoklonale Antikörper oder Tyrosinkinaseinhibitoren). Für den Wachstumsfaktor Platelet Derived Growth Factor (PDGF) und den entsprechenden PDGF Rezeptoren stehen jedoch noch keine klinisch zugelassenen molekularen Therapeutika zu Verfügung. Allerdings zeigen erste Daten, dass PDGF und seine zugehörigen Signalwege auch eine wichtige Rolle in der Tumorprogression spielen. Insbesondere der PI3K/Akt/mTOR Signalweg kristallisiert sich als wichtiger intrazellulärer Partner von PDGF heraus, um die Proliferation, Migration und Angiogenese in Tumorzellen zu steuern. Deshalb war es Ziel dieser Arbeit, den multifaktoriellen Einfluss von PDGF auf die Proliferation und den Metabolismus, abhängig vom Mutationsstatus, im CRC näher zu untersuchen. Neue therapeutische Angriffsziele für eine zukünftige Tumortherapie sollen durch Analyse der PDGF-bedingten intrazellulären Veränderungen gefunden werden. Hierfür wurden zwei humane Kolorektalkarzinom Zelllinien auf Gen- und/oder Proteinebene auf Komponenten des PI3K/Akt/mTOR- und des MAPK-Signalwegs, auf c-Myc, p53 und HIF1α (Hypoxia-inducible-factor 1α) analysiert. Ferner wurden Änderungen der Proliferation und des Metabolismus jeweils unter Stimulation mit PDGF bzw. PI3K/Akt/mTOR Inhibition untersucht. Durchgeführte Proteinuntersuchungen unter PDGF Stimulation bzw. PI3K/Akt/mTOR Inhibition offenbarten Veränderungen in den Signalwegen und des Crosstalks. Auch die Beeinflussung der Tumor Suppressoren (Retinoblastoma, Rb), Onkogenen (c-Myc, p53mut) und HIF1α unter PDGF Stimulation und deren Zusammenspiel in der Tumorzelle hinsichtlich Proliferation und Glykolyse rechtfertigen im Hinblick auf klinische Therapiemöglichkeiten weitere Untersuchungen. Die Genuntersuchung von ex vivo Gewebeproben (UICC I-IV) komplettieren die Untersuchung unter Beachtung der klinischen Relevanz von PDGF. Die PDGF Stimulation steigert die Tumorzellproliferation in den HT29 Kolonkarzinom Zellen über den PI3K/Akt/mTOR Signalweg anstatt über den MAPK Signalweg. Allerdings wird die Stimulation mit PDGF durch den inhibitorischen Crosstalk über den MAPK Signalweg vermittelt, sollte der PI3K/Akt/mTOR Signalweg durch pharmakologische Inhibition blockiert sein. Die weitergehende Analyse hat gezeigt, dass eine spezifische Akt Inhibition das Tumorzellwachstum hemmt, während eine PI3K Inhibition kaum Einfluss auf die Proliferation besitzt. Der inhibitorische Crosstalk ist für diese unterschiedlichen Effekte verantwortlich. Sorgfältige Interventionsstrategien sind daher erforderlich, wenn man diese spezifischen Signalwege zukünftig therapeutisch ausnutzen möchte. Daher sollte ein besseres Verständnis der Crosstalks zwischen diesen Signalwegen Ziel zukünftiger Forschung sein. Auf diese Weise könnte auch eine „Über-Inhibition“ der Signalwege verhindert werden, die zusätzliche klinische Nebenwirkungen für die Patienten zur Folge hätte. In den späten UICC Stadien treten vermehrt Mutationen auf, die die Kanzerogenität mit steigender Mutationsrate fördert. Angesichts der Tatsache, dass PDGF in den späten UICC Stadien verstärkt exprimiert wird, deuten unsere Daten darauf hin, dass die Effekte von PDGF die erhöhte Malignität verstärken. Der aktivierende Effekt von PDGF auf den PI3K/Akt/mTOR Signalweg und nachfolgende Aktivitätsänderungen von p53mut, Rb, c-Myc und HIF1α führen zu einem ungünstigen Verlauf bei Patienten mit Kolorektalkarzinom. PDGF wirkt auf Darmkrebszellen in einer Akt- aktivierenden, Glykolyse-abhängigen Art und Weise. PDGF steigert die Glykolyse und die Fähigkeit der kolorektalen Karzinomzellen, ihren Energiemetabolismus unter PDGF Stimulation anzupassen. Diese Aktivitäten sollten als mögliche therapeutisch nutzbare Ausgangspunkte verwendet werden, um Therapieansätze für das kolorektale Karzinom zu entwerfen. PDGF, als weiterer Vertreter aus der Familie der Wachstumsfaktoren, scheint eine vergleichbare Rolle wie VEGF im kolorektalen Karzinom zu spielen. Die Daten dieser Studie unterstreichen die Wichtigkeit der PDGF - PI3K/Akt/mTOR Signalwegsachse und deren Potential für ein mögliches Angriffsziel im kolorektalen Karzinom. PDGF stellt somit ein interessantes therapeutisches Ziel neben der bereits genutzten VEGF/EGFR – basierten Therapie im kolorektalen Karzinom dar.

Copies of author's previously published articles inserted. / Includes bibliographical references. / xiii, 231, [145] leaves, [2] leaves of plates : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Aims to analyse the interactions and to identify synergism occurring between the combinations of adrenaline with ADP and 5-HT with ADP ; and to identify the intraplatelet mechanism involved in signalling the initiation of the enhanced aggregation response. / Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical and Experimental Pharmacology, 1995?

<p> </p><p><strong>Conclusion:</strong>Medical treatment may have a role in platelet count after transfusion. Since the TACSI platelets passed the quality requirements, and the vast majority of patients platelet count increased after TACSI platelet transfusion, the TACSI platelets will replace the old method to produce platelets at the Uppsala University hospital.</p><p> </p><p> </p><p><strong>Methods:</strong> A new approach that pools 8 buffy coats (TACSI platelets) that were separated into 2 units instead of 4-6 buffy coats pooled to 1 unit was investigated in this study. After the platelets were extracted from the buffy coats their quality was controlled and subsequently the platelet product was evaluated in 96 patients.</p><p> </p><p><strong>Results:</strong> The results showed that 80 % of the platelet units passed the European quality requirements. Further, the platelet count was increased in most patients that received TACSI platelets.</p><p><strong> Conclusion:</strong> Medical treatment may have a role in platelet count after transfusion. Since the TACSI platelets passed the quality requirements, and the vast majority of patients platelet count increased after TACSI platelet transfusion, the TACSI platelets will replace the old method to produce platelets at the Uppsala University hospital.</p><p> </p><p> </p><p> </p>

Human platelets are constantly regulated by activating and inhibitory effectors. Thrombin,the most potent platelet agonist, induces signaling through the protease-activated receptors(PARs) 1 and 4 which in turn convey their signal by coupling to G-proteins. Nitric oxide (NO)is a potent platelet inhibitor continuously formed by the endothelium exerting its effect byincreasing cGMP through activation of soluble guanylyl cyclase (sGC). The purpose of thiswork has been to investigate how NO would affect platelets already activated by PARagonists.To examine the different contributions of the PAR1- and PAR4-signals, the selectiveagonist peptides SFLLRN and AYPGKF-NH2 were utilized. Aggregation, Ca2+-mobilization andphosphorylation of threonine 696 in myosin phosphatase target subunit 1 (MYPT1) wereanalyzed. Intriguingly PAR1-, but not PAR4-, agonist provoked aggregation was rapidlyreversed upon NO exposure. PAR-agonist induced Ca2+-mobilization was markedly reducedafter exposure to NO, however this Ca2+-suppression did not cause the disaggregation ofPAR1-agonist evoked platelet aggregation. The reversal of aggregation was suspected to becaused by a cGMP-mediated inhibition of the Rho-kinase/ROCK-signaling pathway. This wassupported by Westen blot analysis where a marked decrease of MYPT1 phosphorylationcompared to basal levels could be observed. In conclusion, NO was found to reverse humanplatelet aggregation evoked by PAR1-activation by inhibition of a Rho-kinase/ROCK-signalingpathway.