Tumour necrosis factor stimulated gene 6 (TSG-6) is a protein present in a range of tissues and is produced by a wide range of cell types in response to a number of inflammatory stimuli, where this protein is thought to mediate protection against excessive inflammation. TSG-6 is expressed in response to inflammation and has been implicated as an endogenous protector of tissues, e.g. in the context of inflammatory arthritis. TSG-6 has also been shown to reduce inflammatory damage in animal models of both myocardial infarction and corneal injury. Our earlier studies demonstrated that TSG-6 is a potent inhibitor of neutrophil migration, which likely contributes to these protective activities. Here we investigated the effect of TSG-6 on CXCL8-mediated pro-inflammatory processes. The interaction of TSG-6 with CXCL8, and how this influences the binding of CXCL8 to heparin, was investigated using solid-phase assays and surface plasmon resonance (SPR). The ability of this interaction to inhibit the interaction between CXCL8 and one of its receptors CXCR2 was investigated using murine pre-B cells expressing this receptor, in flow cytometry experiments. The effects of TSG-6 on CXCL8's pro-inflammatory activities were assessed using a neutrophil cell line (differentiated HL60 cells) in a trans-endothelial migration assay and gelatin zymography to measure secretion of MMPs by the endothelial cell (EC) line EA.hy 926. TSG-6 expression in EA.hy 926 and HL-60 cells was assessed using qRT-PCR, immunofluorescence and western blotting of cell lysates and culture media. We have shown that TSG-6 binds to CXCL8 via its Link module domain (Link_TSG6) and inhibits the interaction of CXCL8 with heparin. Analysis of culture media from EA.hy 926 cells revealed that both full-length TSG-6 and Link_TSG6 abolished CXCL8-mediated up-regulation of MMP-2 secretion. In transmigration assays, TSG-6 and Link_TSG6 were found to inhibit CXCL8-induced migration of neutrophils across an EC monolayer and also inhibited the interaction between CXCL8 and CXCR2; this effect was enhanced in mutants of Link_TSG6 with reduced heparin-binding functions. Very limited TSG-6 expression was observed in EA.hy 926 and HL-60 cells, where stimulation with pro-inflammatory mediators had little effect on expression. Here we have shown that TSG-6 binds directly to CXCL8 and inhibits its interaction with heparin, its interaction with CXCR2 and its enhancement of MMP-2 secretion by ECs; these effects are mediated via the Link module of TSG-6. Furthermore, Link_TSG6 inhibits trans-endothelial migration of neutrophils in a dose dependent manner; this could be due in part to reduced association of CXCL8 with EC glycosaminoglycans or with its receptors on neutrophils, thereby limiting its pro-migratory activity. Inhibition of MMP production by ECs could also limit neutrophil trans-migration as well as tissue damage and angiogenesis. Thus, the modulation of CXCL8 activity represents one way in which TSG-6 might protect tissues from the damaging effects of inflammation.

Ischaemic stroke occurs as a result of a blockage in one of the brain’s arteries, leading to neuronal injury and death. Although stroke is a major cause of death and disability, there is no widely available treatment. Inflammation occurs in the brain and in the periphery following stroke, and both contribute to the ischaemic damage. Leukocytes such as neutrophils are key mediators of brain damage and inflammation, particularly in the presence of systemic inflammatory challenges such as interleukin-1 (IL-1). Tumor necrosis factor-stimulated gene 6 (TSG-6) is a potent inhibitor of neutrophil migration, and also modulates the immune response by dampening expression of cytokines and stabilising the extra-cellular matrix (ECM). Mesenchymal stem cells (MSCs) have shown immunomodulatory actions in many inflammatory conditions, and their benefit has often been attributed to the production of TSG-6. This work aimed to evaluate the potential of TSG-6 and TSG-6-expressing MSCs as therapies in cerebral ischaemia, and to investigate the expression profile of endogenous TSG-6 in response to stroke. Mice were subjected to middle cerebral artery occlusion (MCAo) followed by reperfusion. We investigated whether IL-1-induced acute brain injury after stroke is reversed by TSG-6, and long-term recovery was evaluated in mice treated with TSG-6 or MSCs. Functional outcomes were assessed, and brains were sectioned and stained for analysis of lesion volume, haemorrhagic transformation, blood-brain barrier (BBB) disruption and neutrophil infiltration. The expression profile of TSG-6 was evaluated in mice allowed to recover for 4h, 24h, 3, 5 or 7 days. TSG-6 expression was determined by quantitative PCR and immunohistochemistry. Treatment with TSG-6 reduced IL-1-induced neutrophil infiltration into the striatum, and led to decreased BBB disruption and haemorrhagic transformation at 24h. Treatment with TSG-6 in the absence of a systemic inflammatory challenge had no significant effect on lesion volume, BBB disruption or haemorrhagic transformation after 7 days reperfusion, however thalamic neutrophil infiltration was significantly reduced. Treatment with human MSCs had no significant effect on behavioural or histological outcomes, however a heightened inflammatory response in MSC-treated mice suggested rejection of the cells by the murine immune system. TSG-6 expression peaked in the ischaemic hemisphere at 5 days post-reperfusion, and was associated with astrocytes in the glial scar surrounding the infarcted tissue. TSG-6 might be a promising therapy for the treatment of stroke in the presence of systemic inflammation. TSG-6-expressing MSCs might provide a broader therapeutic potential, and further work should optimise experimental conditions to prevent rejection of the cells. Expression of TSG-6 within the glial scar suggests a potential role in repair and recovery following ischaemic stroke. Modulating the peripheral immune response remains an attractive and accessible therapeutic target for the treatment of cerebral ischaemia.

The chondroitin sulphate proteoglycan (CSPG) versican forms complexes with hyaluronan (HA), which are essential in a range of functions including cellular proliferation and migration. Four isoforms of versican result from alternative splicing. Furthermore, biological roles have been identified for the proteolytic cleavage product of versican which contains the N-terminal G1 hyaluronan binding domain. All of these versican forms have different tightly regulated tissue expression profiles. Consequently, impaired regulation is associated with a number of disease pathologies. For example the largest variants (V0/V1) have been shown to be negative indicators of disease outcome in a number of malignant cancers and are a marker of disease progression in atherosclerosis. Interestingly, the smaller versican isoform V3 which lacks CS chains has been demonstrated to have the potential to reverse disease associated phenotypes. The motivation for carrying out the work in this thesis was to try and gain a better understanding of how versican functions on a molecular scale. In this regard, the first aim was to investigate the structure of the hyaluronan binding region of versican using a construct called VG1. The structure of VG1 was analysed in the presence and absence of hyaluronan oligomers. This revealed an insight into the multi-modular structure of the versican hyaluronan binding region and demonstrated that on binding to HA, VG1 under goes a conformational change. Furthermore, the interaction between VG1 and longer lengths of hyaluronan (pHA) was investigated. This demonstrated that when VG1 binds to pHA it is does so with positive cooperativity, packing very close to neighbouring VG1 molecules along a chain of HA. One consequence of this interaction was to reorganise pHA into a helical conformation, an organisation that was confirmed by a number of solution phase techniques. The effect of this reorganisation of pHA by VG1 on HA/CD44 interactions was also assessed. Previously the interaction between CD44 (a cell surface hyaluronan receptor) and long chains of HA (>30 kDa) was shown to be irreversible; however we demonstrate that VG1 can reverse this. Furthermore, a TSG-6 enhanced CD44/interaction was also completely reversed by the addition of VG1. This provides an indication that a functional hierarchy of hyaluronan binding proteins may exist which could have important implications in understanding the function of hyaluronan complexes. Currently, we do not know whether intact versican molecules could interact with HA in the same way as VG1. However, preliminary data suggests that the CS-containing variants (i.e. V0, V1 and V2) would not, whereas V3 and versican fragments could. This work provides an exciting mechanistic insight into the function of versican variants and their breakdown products.

Nach einer Gewebeschädigung stellt die Entzündungsreaktion den ersten essentiellen Schritt für die Wundheilung dar, deren anschließendes Auflösen den Übergang zur Phase der Gewebeneubildung einleitet. Voraussetzung für diesen Ablauf ist die Herunterregulierung der Aktivität proinflammatorischer M1-Makrophagen (M1-Ma) sowie die Induktion antiinflammatorischer M2-Makrophagen (M2-Ma). Zwischen diesen beiden Phänotypen steht ein breites Spektrum unterschiedlich aktivierter Ma, die in der Wundheilung aktiv sind. Die Auslöser für diesen wichtigen Übergang sind dabei weitgehend unbekannt. Es ist in in vitro Versuchen beschrieben, dass entzündlich aktivierte humane dermale Fibroblasten (dFb) die inflammatorische Aktivität von M1-Ma reduzieren und zusätzlich die Polarisierung von inflammatorisch aktivierten Monozyten zu M2-Ma fördern. Diese Effekte vermitteln sie über die Freisetzung immunmodulierender Mediatoren, insbesondere von TSG-6 und PGE2, einem Produkt der Cyclooxygenase 2 (COX 2). Bisher wurden diese Faktoren noch nicht im zeitlichen Verlauf der Entzündungsreaktion während der Wundheilung in einem in vivo Tiermodell untersucht. In dieser Arbeit konnte festgestellt werden, dass in dem angewendeten murinen in vivo Wundheilungsmodell die initiale Entzündungsreaktion nach 24 Stunden ihren Höhepunkt erreicht. Synchron dazu konnte erstmals gezeigt werden, dass das Auftreten von TSG-6 und COX-2 ebenfalls die höchste Expression am 1. Tag nach der Wundsetzung aufzeigt. In der Analyse der aufgetrennten Zellschichten der Haut wurde nachgewiesen, dass COX-2 in der epidermalen und dermalen Schicht exprimiert wird. Die Synthese von TSG-6 hingegen ist auf die Zellen in der dermalen Schicht beschränkt. Die Isolierung und Untersuchung von dFb aus dem restlichen Zellverband des Wundgewebes bestätigte dFb als Quelle für die TSG-6 Synthese. In einem weiteren Versuchsansatz mit entzündlich aktivierten humanen Keratinozyten wurde gezeigt, dass sie kein TSG-6 bilden können. Somit stellen die gewonnenen Erkenntnisse die Grundlagen zukünftiger Untersuchungen zum funktionalen Ablauf der Wundheilung dar, in welchem die dermalen Fibroblasten als zentrale Schlüsselrolle im Entzündungsgeschehen betrachtet werden müssen. Daraus können sich neue therapeutische Ansätze zur Modulation einer gestörten Wundheilung ergeben.:1 Einleitung 1.1 Aufbau und Funktion der Haut 1.2 Wundheilung 1.2.1 Phasen der Wundheilung 1.2.1 Bedeutung der Makrophagen in der Wundheilung 1.3 Beeinflussung der Entzündungsauflösung 1.4 Einfluss von dFb auf die Ma-Differenzierung 1.5 Aufgabenstellung 2 Materialien und Methoden 2.1 Materialien 2.1.1 Maus 2.1.2 Geräte und Verbrauchsmaterialien 2.1.3 Software 2.1.4 Chemikalien und molekularbiologische Reagenzien 2.1.5 Antikörper und Primer 2.2 Methoden 2.2.1 Zellkultur 2.2.2 In vivo Wundheilungsmodell 2.2.3 Aufbereitung der Gewebeproben 2.2.3.1 Gesamtwundgewebe 2.2.3.2 Auftrennung der dermalen und epidermalen Schicht 2.2.3.3 Isolierung von dermalen Fibroblasten aus Wund- und Hautbiopsien 2.2.4 Histologische Analyse 2.2.5 Zellzahlbestimmung 2.2.6 Durchflusszytometrie 2.2.7 Genexpressionsanalysen 2.2.7.1 RNA- Isolierung/Konzentrations- und Reinheitsbestimmung 2.2.7.2 Herstellung von cDNA 2.2.7.3 Quantitative Echtzeit-PCR 2.2.8 Proteinbiochemische Analysen 2.2.8.1 Proteingewinnung aus Zellkulturen 2.2.8.2 Proteinisolation aus den Wund- und Hautbiopsien 2.2.8.3 Immunoassays 2.2.8.4 Analytische Auswertung der Proteinmessungen aus den Wund- und Hautbiopsien 2.2.9 Statistische Auswertung 3 Ergebnisse 3.1 Charakterisierung der Entzündungsphase 3.1.1 Wundverschluss 3.1.2 Zeitliche Expression proinflammatorischer Mediatoren 3.1.3 Zeitliche Expression antiinflammatorischer Mediatoren 3.2 Zeitliche Expression von TSG-6 und COX-2 und deren Produkte in der Gesamtwunde 3.3 Bestimmung des Ursprungs von TSG-6 und COX-2 in der Wundheilung 3.3.1 Auftrennung des Wundgewebes in Epidermis und Dermis 3.3.1.1 Charakterisierung der Schichten 3.3.1.2 Nachweis von TSG-6 und COX-2 3.3.2 Isolierung von dFb aus dem Wundrand 3.3.2.1 Charakterisierung der separierten Zellfraktionen 3.3.2.2 Nachweis von TSG-6 und COX-2 3.4 Humanes Modell: in vitro Kultur hudFb und huKC 3.4.1 Nachweis von TSG-6 und COX-2 und deren Produkte 4 Diskussion 5 Zusammenfassung der Arbeit 6 Literaturverzeichnis A Appendix A1 Erklärung über die eigenständige Abfassung der Arbeit A2 Erklärung über die Vorbehaltlichkeit der Verfahrenseröffnung zur Verleihung des Titels Dr. med. A3 Publikationen A4 Danksagung

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Tumour necrosis factor-stimulated gene-6 (TSG-6) is a protein expressed in a wide range of cell types and tissues, predominantly in response to inflammatory stimuli. The expression of TSG-6 is believed to be associated with the protection of tissues from the damaging effects of inflammation. In animal models treatment with TSG-6 protein has been found to reduce inflammatory damage in myocardial infarction, corneal injury and arthritis. Endogenous TSG-6 production has been suggested to play a protective role in inflammatory arthritis and has been implicated in bone homeostasis. The expression of TSG-6 is also essential in the process of cumulus matrix formation that occurs around the oocyte in the periovulatory period and is necessary for successful ovulation and fertilisation. In many cases the mechanism underlying a particular TSG-6 function is not fully understood. TSG-6 has numerous binding partners including the serum glycoprotein inter-alpha-inhibitor (IαI), the growth factor bone morphogenetic protein-2 (BMP-2) and the extracellular matrix protein fibronectin, as well as glycosaminoglycans (GAGs) such as hyaluronan and heparan sulphate (HS). The TSG-6 protein is mostly composed of contiguous Link and CUB domains, with the majority of ligand binding sites identified within the Link module. The CUB domain of TSG-6 has been less extensively studied. Here biophysical techniques have been used to investigate the TSG-6 interactome including both the Link module and CUB domain. Intrinsic fluorescence spectroscopy was used to establish the metal-ion binding properties of the CUB domain, which was established to have a high affinity Ca2+-binding site. Using surface plasmon resonance (SPR), a novel metal-ion dependent interaction was found for the CUB domain of TSG-6 and the heavy chains (HCs) of IαI. Investigation using mutants of both the CUB domain of TSG-6 and HC of IαI established that the metal-ion binding sites within each protein are involved in the interaction. SPR analysis was also used to define the affinities and binding sites for TSG-6 interactions with fibronectin and BMP-2. High affinity interactions between TSG-6 ligands were also revealed (e.g. BMP-2 and HC, fibronectin and HC) and their binding sites defined. The discovery of the novel interactions between these TSG-6 ligands suggests crosstalk within the TSG-6 interactome, with the potential for ternary complex formation or indeed hierarchical orders of binding. Thus work was undertaken to develop a passivated lipid bilayer platform for use with surface sensitive techniques. This platform was used to investigate the hierarchy of protein and GAG interactions using quartz crystal microbalance with dissipation monitoring (QCM-D) and dual polarisation interferometry (DPI). The investigation revealed a novel role for the Link module of TSG-6 in heparin condensation, potentially via protein dimerisation and/or oligomerisation which could affect heparin/HS functions within the extracellular matrix (ECM). Thus the biophysical analysis of TSG-6 presented here has identified novel interactions and functions of TSG-6 which may provide mechanisms for the protective functioning of TSG-6 in inflammation and its ECM structuring role in ovulation.

Indiana University-Purdue University Indianapolis (IUPUI) / The extracellular matrix (ECM) provides a structural and signaling platform for cells that comprise various organs, playing a critical role in tissue maintenance, injury, and repair. Hyaluronan (also known as hyaluronic acid, HA) is a ubiquitous ECM polysaccharide consisting of a repeating disaccharide backbone that can be covalently modified by the heavy chains (HC) of the serum protein inter-alpha-inhibitor (IαI) during inflammation. Known as the only covalent modification of HA, the HC linking of HA is exclusively mediated by the inflammation-induced secreted enzyme TNFα-stimulated gene-6 (TSG-6). Mice deficient for HC-HA formation, due to the lack of either TSG-6 or IαI, display reduced survival during systemic lipopolysaccharide (LPS)-induced endotoxic shock and its associated acute lung injury. We therefore hypothesized that HC-HA should play an important protective role against acute lung injury induced by intratracheal LPS or Pseudomonas aeruginosa (PA) gram-negative bacteria. We also identified that lung instillation of LPS or PA caused rapid induction of lung parenchymal HC-HA that was largely cleared during resolution of injury, indicative of a high rate of HA turnover and remodeling during reversible lung injury. However, using TSG-6 knockout mice, we determined that HC-HA exerted minimal protective effects against intratracheal LPS or PA-induced acute lung injury. To better address the differential roles of HC-HA during systemic versus localized intratracheal exposure to LPS, we characterized and compared the induction of HC-HA in plasma and lung in these two models. While lung parenchymal HC-HA formed in both injury models, intravascular HC-HA and TSG-6 were exclusively induced during systemic LPS exposure and were associated with improved outcomes, including decreased number of circulating neutrophils and plasma TNFα levels. Our results suggest that LPS induces HC-HA formation in various tissues depending on the route of exposure and that the specific intravascular induction of HCHA during systemic LPS exposure may have a protective role during endotoxic shock.

Indiana University-Purdue University Indianapolis (IUPUI). / Tumor necrosis factor-induced protein 6 (TSG-6) has been shown to mitigate inflammation. Its presence in the secretome of adipose stem / stromal cells (ASC) and its role in activities of ASC have been overlooked. This thesis described for the first time the release of TSG-6 from ASC, and its modulation by endothelial cells. It also revealed that protection of endothelial barrier function was a novel mechanism underlying the anti-inflammatory activity of both ASC and TSG-6. Moreover, TSG-6 was found to inhibit mitogen-activated lymphocyte proliferation, extending the understanding of its pleiotropic effects on major cell populations involved in inflammation. Next, enzyme-linked immunosorbent assays (ELISA) were established to quantify secretion of TSG-6 from human and murine ASC. To study the importance of TSG-6 to specific activities of ASC, TSG-6 was knocked down in human ASC by siRNA. Murine ASC from TSG-6-/- mice were isolated and the down-regulation of TSG-6 was verified by ELISA. The subsequent attempt to determine the efficacy of ASC in ameliorating ischemic limb necrosis and the role of TSG-6, however, was hampered by the highly variable ischemic tissue necrosis in the BALB/c mouse strain. Afterwards in a mouse model of cigarette smoking (CS), in which inflammation also plays an important role, it was observed, for the first time, that 3-day CS exposure caused an acute functional exhaustion and cell cycle arrest of hematopoietic progenitor cells; and that 7-week CS exposure led to marked depletion of phenotypic bone marrow stem and progenitor cells (HSPC). Moreover, a dynamic crosstalk between human ASC and murine host inflammatory signals was described, and specifically TSG-6 was identified as a necessary and sufficient mediator accounting for the activity of the ASC secretome to ameliorate CS-induced myelotoxicity. These results implicate TSG-6 as a key mediator for activities of ASC in mitigation of inflammation and protection of HSPC from the myelotoxicity of cigarette smoke. They also prompt the notion that ASC and TSG-6 might potentially play therapeutic roles in other scenarios involving myelotoxicity.