No description available.

No description available.

No description available.

Background: Life-prolonging tumour removal surgery is associated with increased metastasis and disease recurrence. Natural Killer (NK) cells are critical for the anti-tumour immune response. Postoperatively, NK cell cytotoxicity and interferon-gamma (IFNγ) production are profoundly suppressed and this dysfunction has been linked to increased metastases/poor patient outcomes. NK cell activity depends on the integration of signals through receptors and can be modulated by soluble factors, including transforming growth factor- beta (TGFβ). The postoperative period is characterized by the expansion of myeloid-derived suppressor cells (sxMDSCs), which inhibit NK cell effector functions. I hypothesize that impaired NK cell IFNγ production is due to altered signaling pathways caused by sxMDSC-derived TGFβ. Methods: Postoperative changes in NK cell receptor expression, receptor-dependent phosphorylation of downstream targets, and rIL-2/12-stimulated IFNγ production were assessed using newly developed whole blood assays utilizing peripheral blood samples from cancer surgery patients. Isolated healthy NK cells were incubated in the presence of healthy/baseline/postoperative day (POD) 1 plasma or isolated sxMDSCs and NK cell phenotype and function were assessed. NK cells were also cultured with plasma in the presence/absence of a TGFβ blocking monoclonal antibody (mAb) or a TGFβ RI small molecule inhibitor (smi). Single-cell RNA-sequencing was performed on six colorectal cancer surgery patients at baseline and on POD1. S6 phosphorylation was used as a proxy for mammalian target of rapamycin complex (mTORC) 1 activity to investigate the mechanism of TGFβ-mediated NK cell dysfunction. Results: Intracellular NK cell IFNγ, activating receptors CD132 (IL-2R), CD212 (IL-12R), NKG2D, and DNAM-1, and the phosphorylation of downstream targets STAT5, STAT4, p38 MAPK, and S6 were significantly reduced on POD1. TGFβ was increased in patient plasma on POD1. The dysfunctional phenotype could be phenocopied in healthy NK cells through the addition of rTGFβ1 or by incubation with POD1 plasma. This dysfunctional phenotype could be prevented with the addition of an anti-TGFβ mAb or a TGFβ RI smi in culture. RNA-sequencing revealed a reduction in transcripts associated with mTOR effector functions, suggesting an impairment in mTOR. S6 phosphorylation was maintained with the addition of TGFβ-specific therapies. The hyporesponsive NK cell phenotype was reproduced upon culture of healthy NK cells with sxMDSCs and sxMDSCs were shown to produce soluble TGFβ in culture. Conclusion: Surgically stressed NK cells display a dysfunctional phenotype, which could be prevented in vitro through the addition of TGFβ-specific blocking therapies. sxMDSCs produced TGFβ and co- incubation induced dysfunction in healthy NK cells. The recovery of impaired S6 phosphorylation with TGFβ-specific therapies suggests that TGFβ is inducing NK cell dysfunction via inhibition of mTORC1 activity. The perioperative period of immunosuppression presents a window of opportunity for novel therapeutics to prevent metastases and cancer recurrence among cancer surgery patients.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Feb. 13, 2009). Includes bibliographical references.

No description available.

Die Expansion des renalen Tubulointerstitiums aufgrund einer Akkumulation zellulärer Bestandteile und extrazellulärer Matrix ist eine charakteristische Eigenschaft der chronischen Nierenerkrankung (CKD) und führt zu einer Progression der Erkrankung in Richtung eines terminalen Nierenversagens. Die Fibroblasten Proliferation und ihre Transformation hin zum sekretorischen Myofibroblasten-Phänotyp stellen hierbei Schlüsselereignisse dar. Signalprozesse, die zur Induktion der Myofibroblasten führen, werden aktiv beforscht um anti-fibrotische Therapieansätze zu identifizieren. Das anti-inflammatorische Protein Annexin A1 und sein Rezeptor Formyl-Peptid Rezeptor 2 (FPR2) wurden in verschiedenen Organsystemen mit der Regulation von Fibroblastenaktivität in Verbindung gebracht, jedoch wurden ihre Expression und Funktion bei renalen fibrotischen Erkrankungen bisher nicht untersucht. Ziel der aktuellen Studie war daher die Untersuchung der renalen Annexin A1- und FPR2-Expression in einem Tiermodell des chronischen Nierenversagens, sowie die Charakterisierung der funktionellen Rolle von Annexin A1 in der Regulation des Fibroblasten Phänotyps und ihrer Syntheseleistung. Dazu wurden neugeborene Sprague-Dawley Ratten in den ersten zwei Wochen ihres Lebens entweder mit Vehikel oder mit einem Angiotensin II Typ I Rezeptor Antagonisten behandelt und ohne weitere Intervention bis zu einem Alter von 11 Monaten (CKD Ratten) gehalten. Die Regulation und Lokalisation von Annexin A1 und FPR2 wurden mit Hilfe von Real-Time PCR und Immunhistochemie erfasst. Annexin A1- und FPR2-exprimierende Zellen wurden weiter durch Doppelimmunfluoreszenzfärbungen charakterisiert. Gefärbt wurde mit Antikörpern gegen endotheliale Zellen (rat endothelial cell antigen), Makrophagen (CD 68), Fibroblasten (CD73) und Myofibroblasten (alpha-smooth muscle actin (α-sma)). Zellkulturstudien wurden an immortalisierten renalen kortikalen Fibroblasten aus Wildtyp- und Annexin A1-defizienten Mäusen, sowie an etablierten humanen und murinen renalen Fibrolasten durchgeführt. Eine Überexpression von Annexin A1 wurde durch eine stabile Transfektion erreicht. Die Expression von Annexin A1, α-sma und Kollagen 1α1 wurde durch Real-Time PCR, Western Blot und Immuhistochemie erfasst. Die Sekretion des Annexin A1 Proteins wurde nach TCA-Fällung des Zellkulturüberstandes im Western Blot untersucht. Wie zu erwarten zeigten die CKD Ratten eine geringere Anzahl an Nephronen mit deutlicher glomerulären Hypertrophie. Der tubulointerstitielle Raum war durch fibrilläres Kollagen, aktivierte Fibroblasten und inflammatorische Zellen expandiert. Parallel dazu war die mRNA Expression von Annexin A1 und Transforming growth factor beta (TGF-β) signifikant erhöht. Die Annexin A1-Lokalisation mittels Doppelimmunfluorsezenz identifizierte eine große Anzahl von CD73-positiven kortikalen Fibroblasten und eine Subpopulation von Makrophagen als Annexin A1-positiv. Die Annexin A1-Menge in Myofibroblasten und renalen Endothelien war gering. FPR2 konnte in der Mehrzahl der renalen Fibroblasten, in Myofibroblasten, in einer Subpopulation von Makrophagen und in renalen Epithelzellen nachgewiesen werden. Eine Behandlung der murinen Fibroblasten mit dem pro-fibrotischen Zytokin TGF-β führte zu einem parallelen Anstieg der α-sma-, Kollagen 1α1- und Annexin A1-Biosynthese und zu einer gesteigerten Sekretion von Annexin A1. Eine Überexpression von Annexin A1 in murinen Fibroblasten reduzierte das Ausmaß der TGF-β induzierten α-sma- und Kollagen 1α1-Biosynthese. Fibroblasten aus Annexin A1-defizienten Mäusen zeigten einen starken Myofibroblasten-Phänotyp mit einer gesteigerten Expression an α-sma und Kollagen 1α1. Der Einsatz eines Peptidantagonisten des FPR2 (WRW4) resultierte in einer Stimulation der α-sma-Biosynthese, was die Vermutung nahe legte, dass Annexin A1 FPR2-vermittelt anti-fibrotische Effekte hat. Zusammenfassend zeigen diese Ergebnisse, dass renale kortikale Fibroblasten eine Hauptquelle des Annexin A1 im renalen Interstitium und einen Ansatzpunkt für Annexin A1-Signalwege in der Niere darstellen. Das Annexin A1/FPR2-System könnte daher eine wichtige Rolle in der Kontrolle des Fibroblasten Phänotyp und der Fibroblasten Aktivität spielen und daher einen neuen Ansatz für die anti-fibrotischen pharmakologischen Strategien in der Behandlung des CKD darstellen. / Expansion of the renal tubulointerstitium due to an accumulation of cellular constituents and extracellular matrix is a characteristic feature of chronic kidney disease (CKD) and leads to the progression towards renal failure. Fibroblast proliferation and transformation to the secretory myofibroblast phenotype present key events herein. The signaling process which leads to the generation of myofibroblasts is actively investigated to identify targets for antifibrotic therapeutic strategies. The antiinflammatory protein annexin A1 and its receptor formyl peptide receptor 2 (FPR2) have been implicated in the regulation of fibroblasts from various organs but the expression and function of the two products in renal fibrotic disease have not been elucidated so far. Aim of the present study was therefore to investigate the renal expression of annexin A1 and FPR2 in an animal model of chronic kidney disease and to characterize the role of annexin A1 in the regulation of fibroblast phenotype and synthetic activity. To this end, newborn Sprague-Dawley rats were treated either with vehicle or with an angiotensin II type I receptor antagonist during the first two weeks of their life and kept without further intervention until the age of 11 month (CKD rats). Regulation and localization of annexin A1 and FPR2 were studied using real-time PCR and immunohistochemistry. Annexin A1 and FPR2 expressing cells were further characterized by double labeling immunofluorescence with markers for endothelial cells (rat endothelial cell antigen), macrophages (CD68), fibroblasts (CD73), and myofibroblasts (alpha-smooth muscle actin (α-sma)). Cell culture studies were conducted in immortalized renal cortical fibroblast derived from wildtype and from annexin A1-deficient mice as well as in established cell lines of human and murine renal fibroblasts. Overexpression of annexin A1 was achieved by stable transfection. Expression of annexin A1, α-sma and collagen 1α1 was determined using real-time PCR, Western blotting and immunohistochemistry. Secretion of annexin A1 was studied using trichloroacetic acid protein precipitation of cell culture supernatants and Western blotting. As expected, CKD rats had an overall lower number of nephrons with a marked glomerular hypertrophy. The tubulointerstitial space was expanded due to an accumulation of fibrillar collagens, activated fibroblasts and inflammatory cells. In parallel, mRNA expression for Annexin A1 and transforming growth factor beta (TGF-β) was significantly increased. Double labeling immunofluorescence localization of annexin A1 demonstrated a high abundance in CD73 positive cortical interstitial fibroblasts and in a subset of CD68 immunoreactive macrophages. The abundance in myofibroblasts and renal endothelia was low. FPR2 was found in the majority of renal fibroblasts, myofibroblasts, a subset of macrophages, and in renal endothelial cells. Treatment of cultured murine fibroblasts with the profibrotic cytokine TGF-β resulted in a parallel induction of α-sma-, collagen 1α1- and annexin A1 biosynthesis. In addition, annexin A1 secretion was markedly increased. Overexpression of annexin A1 in murine fibroblasts reduced TGF β-induced α-sma- and collagen 1α1-biosynthesis. Fibroblasts derived from annexin A1-deficient mice showed a strong myofibroblast phenotype with increased expression of both, α-sma-, and collagen 1α1. Application of a peptide antagonist of FPR2 receptor (WRW4) caused a stimulation of α-sma biosynthesis thus suggesting a role of FPR2 in the antifibrotic effects of annexin A1. In conclusion, these results identify renal cortical interstitial fibroblasts as major source and as a target for annexin A1 signalling in the kidney. The annexin A1/FPR2 signalling system may therefore play an important role in the control of fibroblast phenotype and activity and may therefore provide a novel target for antifibrotic pharmacological strategies in the treatment of CKD.

Patients with cystic fibrosis who are infected with the pathogen Pseudomonas aeruginosa have shown favorable responses to the drug azithromycin (AZM). This drug works in an anti-inflammatory capacity, improving clinical outcomes and improving quality of life in this population. The drug has also been shown to affect macrophage polarization by shifting these cells away from an inflammatory phenotype toward an alternatively activated anti-inflammatory phenotype. The full impact of this phenotypic change is not well understood in the context of the response to P. aeruginosa infection, or the overall immune response in cystic fibrosis. To understand how the AZM-polarized macrophage affects other types of cells, we utilized a co-culture in vitro system, with macrophages and fibroblasts incubating together. In this system, we determined that AZM causes upregulation of the pro-fibrotic mediator transforming growth factor-β as well as the extracellular matrix (ECM) protein fibronectin. The mediator of ECM turnover, matrix metalloproteinase (MMP)-9 was upregulated in this system as well. In an in vivo model of P. aeruginosa infection, MMP- 9 and fibronectin were increased in the bronchoalveolar lavage 7 days post-infection in mice that were treated with AZM. This was accompanied by a decrease in damage to the lung tissue, determine by histological examination. To determine if these changes would continue in human subjects with cystic fibrosis, a clinical study was done in this population. Subjects with AZM treatment had decreased TGF-β levels, but no differences in MMP-9 or fibronectin. Interestingly, correlations between certain fibrotic mediators and inflammatory cytokines, specifically interleukin -1β, were different in subjects with AZM treatment compared to subjects without AZM therapy. Together, these data indicate that AZM alters the fibrotic response from the macrophages, as well as the interaction of the inflammatory response and fibrosis development.

Bladder pain syndrome (BPS)/interstitial cystitis (IC) is a chronic pain disorder characterized by at least six weeks of lower urinary tract symptoms and unpleasant sensations (pain, pressure and discomfort) thought to be related to the urinary bladder and not meeting exclusion criteria. While the etiology is not known, BPS/IC may involve a "vicious circle" of uroepithelial dysfunction, inflammation and peripheral and central sensitization. We propose that the urinary bladder inflammatory insult partly mediates voiding dysfunction and visceral neurogenic pain characteristic of BPS/IC. Several studies from our laboratory have already demonstrated the role(s) of cytokines and their downstream targets in the functional alterations in micturition reflex pathways following chemically (cyclophosphamide, CYP)-induced cystitis. More recently, the pleiotropic protein, TGF-β, has been implicated in the pathogenesis of CYP-induced cystitis. TGF-β is activated locally at the initial site of injury by protease-dependent or protease-independent mechanisms to initiate a proinflammatory milieu. Depending on its contextual cues, TGF-β may then aid in resolving the primary immune response and support tissue repair. Though TGF-β is necessary to maintain normal immunological function, its aberrant expression and activation may have detrimental effects on responding tissues and cell types. A sustained increase in peripheral TGF-β reactivity, such as what may be observed in chronic inflammatory bladder conditions, may influence bladder afferent excitability to amplify nociceptive transmission and CNS input. The subsequent sensitization of peripheral afferent nociceptors at the level of the DRG or urothelium may promote spinal cord "wind-up" and cascade into visceral hyperalgesia and allodynia. In the first aim of this dissertation we investigated the functional profile of TGF-β isoforms and receptor (TβR) variants in the normal and inflamed (CYP-induced cystitis) urinary bladder with qRT-PCR, ELISA, IHC and in vivo cystometry. Our studies determined (i) the involvement of TGF-β in lower urinary tract neuroplasticity following urinary bladder inflammation, (ii) a functional role for TGF-β signaling in the afferent limb of the micturition reflex and (iii) urinary bladder TβR-1 as a viable target to reduce voiding frequency with cystitis. In the second aim of this dissertation we investigated the sensory components of the urinary bladder that may underlie the pathophysiology of aberrant TGF-β activation with bladder-pelvic nerve electrophysiology and luciferin-luciferase assays for ATP measurement. Our studies determined that TGF-β1 increased bladder afferent nerve excitability by stimulating ATP release from the urothelium via vesicular exocytosis mechanisms with minimal contribution from pannexin-1 channels. Furthermore, blocking aberrant TGF-β signaling in CYP-induced cystitis with TβR-1 inhibition decreased afferent nerve excitability with an equivalent decrease in ATP release. Taken together, these results establish a causal link between an inflammatory mediator, TGF-β, and intrinsic signaling mechanisms of the urothelium that may contribute to the altered sensory processing of bladder filling to facilitate increased voiding frequency. The distinct interactions of multiple mediators underscore the challenges for single target therapies and support the development of combinatory therapeutics for bladder dysfunction. Ultimately, these studies have increased our understanding of functional disorders and visceral pain and have the potential to improve the health of those suffering from inflammation-associated bladder syndromes.

Background: Tendinosis is a painful chronic, degenerative condition characterized by objective changes in the tissue structure of a tendon. Hallmark features in tendinosis tendons include increased number of cells (hypercellularity), extracellular matrix (ECM) degradation and disorganized collagen. The progression of these pathological changes seen in tendinosis is neither well characterized nor fully understood. Studies have suggested that there are biochemical and mechanical elements involved in tendinosis. From a biochemical perspective, studies have shown that the tendon cells, tenocytes, produce a number of neuronal signal substances/neuromodulators, such as substance P (SP) and acetylcholine (ACh), traditionally thought to be confined to the nervous system. Furthermore, it has been shown that the expression of these neuromodulators is elevated in tendinosis tendons as compared to normal healthy tendons. Interestingly, studies on other tissue types have revealed that both SP and ACh can induce tissue changes seen in tendinosis, such as hypercellularity and collagen disorganization. From a mechanical angle, it has been suggested that overload of tendons, including extensive strain on the primary tendon cells (tenocytes), causes the degenerative processes associated with tendinosis. In vivo studies have shown that in overloaded tendons, the presence of neuromodulators is elevated, not least SP, which also precedes the development of the tissue changes seen in tendinosis. This further supports the importance of combining biochemical factors and mechanical factors in the pathogenesis of tendinosis. Hypotheses: In this thesis project, we hypothesize: 1) that neuromodulators, such as SP and ACh when stimulating their preferred receptors, the neurokinin 1 (NK-1 R) and muscarinic receptors (mAChRs), respectively, can cause increased tenocyte proliferation; 2) that the effects of SP and ACh on tenocyte proliferation converge mechanistically via a shared signalling pathway; 3) that mechanical loading of tenocytes results in increased production of SP by the tenocytes; and 4) that SP enhances collagen remodelling by tenocytes via NK-1 R. Model system: In vitro studies offer insight into the function of healthy tendon matrix and the etiology of tendinopathy. Using a cell culture model of human primary tendon cells, highly controlled experiments were performed in this thesis project to study a subset of biological and mechanical parameters that are implicated in tendinosis. The FlexCell® Tension System was used to study the influence of mechanical loading on tenocytes. As well, a collagen gel contraction assay was used to examine the intrinsic ability of tenocytes to reorganise type I collagen matrices under the influence of the neuromodulator SP. Results: The studies showed that exogenous administration of SP and ACh results in increased tenocyte proliferation that is mediated via activation of the ERK1/2 mitogenic pathway when the preferred receptors of SP and ACh, the NK-1 R and mAChRs, respectively, are stimulated. Furthermore, the studies resulted in the novel finding that SP and ACh both converge mechanistically via transforming growth factor (TGF)-β1 and that a negative feedback mechanism is present in which TGF-β1 downregulates the expression of mAChRs and NK-1 R. The studies also showed that SP can increase collagen remodelling and upregulate expression of genes related to tendinosis. Finally, it was established that tenocytes are mechanoresponsive by showing that cyclic mechanical loading increases the expression of SP by human tenocytes. Conclusions: This thesis work concludes that stimulation of NK-1 R and mAChRs results in proliferation of human tenocytes, which both involve the ERK1/2 signalling pathway. It also shows that SP and ACh converge mechanistically via TGF-β1 in their contribution to tenocyte proliferation. The role of hypercellularity in tendinosis tissue is unknown. Possibly, it has different roles at different stages of the disease. The findings also show that SP increases collagen remodelling, suggesting that increased SP not only results in hypercellularity but also contributes to the collagen morphology in tendinosis.