Diabetes is closely associated with increased oxidative stress, especially originating from the mitochondria. A mechanism to reduce increased mitochondria superoxide production is to reduce the mitochondria membrane potential by releasing protons across the mitochondria membrane. This phenomenon is referred to as mitochondria uncoupling since oxygen is consumed independently of ATP being produced and can be mediated by Uncoupling Proteins (UCPs). However, increased oxygen consumption is potentially detrimental for the kidney since it can cause tissue hypoxia. Therefore, this thesis aimed to investigate the role of mitochondria uncoupling for development of diabetic nephropathy.      UCP-2 was demonstrated to be the only isoform expressed in the kidney, and localized to tubular segments performing the majority of tubular electrolyte transport. Streptozotocin-induced diabetes in rats increased UCP-2 protein expression and correlated to increased non-transport dependent oxygen consumption in isolated proximal tubular cells. These effects were prevented by intense insulin treatment to the diabetic animals demonstrating a pivotal role of hyperglycemia. Importantly, elevated UCP-2 protein expression increased mitochondria uncoupling in mitochondria isolated from diabetic kidneys. Mitochondria uncoupling and altered morphology was also evident in kidneys from db/db-mice, a model of type-2 diabetes, together with proteinuria and glomerular hyperfiltration which are both clinical manifestations of diabetic nephropathy. Treatment with the antioxidant coenzyme Q10 prevented mitochondria uncoupling as well as morphological and functional alterations in these kidneys. Acute knockdown of UCP-2 paradoxically increased mitochondria uncoupling in a mechanism involving the adenosine nucleotide transporter. Increased uncoupling via adenosine nucleotide transporter decreased mitochondria membrane potential and kidney oxidative stress but did not affect glomerular filtration rate, renal blood flow, total kidney oxygen consumption or intrarenal tissue oxygen tension.      The role of increased mitochondria oxygen consumption was investigated by administering the chemical uncoupler dinitrophenol to healthy rats. Importantly, increased mitochondria oxygen consumption resulted in kidney tissue hypoxia, proteinuria and increased staining of the tubular injury marker vimentin, demonstrating a crucial role of increased oxygen consumption per se and the resulting kidney tissue hypoxia for the development of nephropathy.      Taken together, the data presented in this thesis establishes an important role of mitochondria uncoupling for the development of diabetic nephropathy.

Autosomal dominant epidermolytic ichthyosis (EI) is a rare disease characterized by intra-epidermal blistering due to mutations in either of two keratin genes, KRT1 and KRT10, expressed by suprabasal keratinocytes. Autosomal recessive congenital ichthyosis (ARCI) is a non-blistering, hyperkeratotic disease caused by mutations in one of the following genes: ABCA12, ALOX12B, ALOXE3, TGM1, CYP4F22, NIPAL4 and SLC27A4, which are all essential for skin barrier homeostasis. ARCI and EI often respond well to treatment with retinoids, but the mechanism of action is unclear. The aim of this thesis was to increase the knowledge of pathogenic pathways in ichthyosis and to find new explanations to the effect of retinoids. In vitro studies of immortalized keratinocytes from EI patients showed an abnormal keratin aggregation after heat stress, that could be partially inhibited by pre-treatment with all-trans retinoic acid (ATRA) or retinoic acid receptor α-agonists. ATRA treatment also reduced the relative expression of mutated vs wildtype KRT10. The clearance of ATRA in human keratinocytes was found to be mediated by CYP26B1. In skin biopsies from ARCI patients, immunofluorescence analysis of 12R-LOX, eLOX-3, TGM1, ichthyin and FATP4 showed altered expression, not only of the mutated protein, but also of the other proteins. These observations are consistent with a feedback regulatory mechanism by which the loss of one protein results in an up-regulation of other proteins. Furthermore, 12R-LOX, eLOX-3 and TGM1 were intimately co-localized in stratum corneum, as were ichthyin and FATP4, suggesting that the proteins are linked to the same metabolic pathway. When treated with a CYP26 inhibitor known to raise the endogenous ATRA level of the skin, two patients with NIPAL4 mutations, initially exhibiting increased co-localization signals for 12R-LOX and eLOX-3, displayed normalized lipoxygenase expressions and showed clinical improvement. In conclusion, mechanisms are proposed by which pathogenic keratin aggregations in EI and epidermal protein deficiencies in ARCI patients may be mitigated by retinoids. Furthermore, the vivid crosstalk between proteins incriminated in ARCI suggests that these enzymes operate along a common metabolic pathway essential for producing barrier lipids in stratum corneum. Any abrogation of this production may cause barrier failure, hence resulting in a compensatory hyperkeratosis characteristic of congenital ichthyosis.

The subject of this thesis was to study two intestinal barriers to oral drug bioavailability, drug efflux proteins of the ABC-transporter family, and in particular ABCB1/P-glycoprotein (Pgp), and the drug metabolizing enzyme cytochrome P450 (CYP) 3A4. At the onset of this thesis, similarities between CYP3A4 and Pgp in terms of their tissue distribution and gene regulation, along with overlapping substrate specificities, had generated the hypothesis that CYP3A4 and Pgp may have a complementary function and thus form a coordinated intestinal barrier to drug absorption and gut wall metabolism. In the first part of this thesis, a cell culture model of the intestinal epithelium that expressed both functional Pgp and CYP3A4 was developed. This model was then used to investigate the steroselective drug efflux and metabolism of R/S-verapamil. In summary, the results indicated that the two barriers in the cell culture model were in agreement with those in the human intestine. Both ABC-transporters and CYPs are regulated by drugs that interact with nuclear receptors. However, while the regulation of CYPs is quite well understood, less is known about how repeated drug administration regulates the most abundantly expressed ABC-transporters. Therefore, in the second part of this thesis, the effects of repeated drug administration on the gene regulation of four ABC-transporters and CYP3A4 were studied in intestinal epithelial cell lines in vitro and in the perfused human jejunum in vivo. The in vitro studies revealed that the ABC-transporters are induced by drugs that interact with slightly different sets of nuclear receptors. The in vivo study showed that repeated oral administration of St John’s wort decreased the bioavailability of verapamil, predominantly by induction of intestinal CYP3A4. This part of the thesis provides new information about the regulation of ABC-transporters, shows that the intestinal metabolism is the most significant barrier to oral bioavailability of verapamil and provides evidence for a clinically significant interaction between verapamil and St John’s wort in vivo.

Morphologic and metabolic change is a known property of the adult brain. A number of behavioural tasks alter local cerebral blood flow and glucose utilisation. The expression of the glucose transporter 1 (GLUT1), which allows the entry of glucose to the brain, also has been shown to change in response to long-lasting neuronal activation. However, little is known about the effect of acute neuronal activation on GLUT1 expression. Using immunohistochemistry and Western blot, we investigated cerebral GLUT1 expression and vasculature density in mice undergoing a 48-hour voluntary wheel running period. The results showed that the striatum was the main region where GLUT1 protein was up-regulated: There was a trend for GLUT1 expression and blood vessels density to be associated with the distance run during the experiment. These results indicate that short-term increased neuronal activation is associated with rapid changes in glucose transport and possibly vascular remodelling.

A limited understanding of iron uptake mechanisms is available for Streptococcus pyogenes, a hemolytic human pathogen capable of using a variety of hemoproteins in addition to ferric and ferrous iron. This study characterizes the transporters of iron-complexes siuADBG (for streptococcal iron uptake) and siaABC (for streptococcal iron acquisition). These ABC-type transporters are encoded by iron regulated operons and their protein products are homologous to components of heme and siderophore transporters found in both Gram-positive and Gram-negative bacteria. Mutants of the membrane permeases siuG and siaB were constructed and characterized. Mutations in both transporters demonstrated growth reduction in comparison to the parent strain when grown in complex medium containing iron in the form of hemoglobin. The addition of heme to the growth medium inhibited ferric uptake by the wild-type while the addition of protoporphyrin IX did not, suggesting that heme utilization as an iron source is responsible for the inhibition of ferric accumulation. Inactivation of siuG reduced the ability of heme to inhibit ferric incorporation by the cells. Inactivation of siaB in addition to siuG had a cumulative effect, indicating that both siu and sia transporters are involved in heme utilization. We also demonstrated that purified rSiaA, the surface receptor of SiaABC, binds heme and hemoglobin in vitro, and we propose a mechanism of heme binding by SiaA. Studies in a zebrafish infection model revealed that the siuG mutant was attenuated in producing disease. While the siaB mutant also presented virulence attenuation, infection by this mutant was characterized by an increase in the host inflammatory response. These observations show that iron acquisition is important for S. pyogenes virulence. We propose that the SiaABC and SiuADBG, together with the multi-metal transporter MtsABC, are involved in iron acquisition from different iron sources present in the human body, thus contributing to the survival and pathogenesis of S. pyogenes.

ATP binding cassette (ABC) transporters constitute one of the largest families of transport proteins. The occurrence of multidrug resistance (MDR) in human cancer cells has been correlated with the over expression of human ABC, P-glycoprotein (Pgp). Streptomyces peucetius produces two anticancer agents, doxorubicin and daunorubicin, that belong to the anthracycline family of antibiotics. The organism is self-resistant to the potent effects of the antibiotics it produces due to the action of an efflux pump, DrrAB. Both Pgp and DrrAB carry out similar functions, but in two different cell types. An understanding of the bacterial drug transporter DrrAB is thus expected to help in obtaining a better understanding of the function and evolution of the multidrug transporter P-glycoprotein. In DrrAB, the catalytic and membrane domains are present on separate subunits, DrrA and DrrB respectively. How the catalytic ATP-binding domains and the membrane domains in transporters interact with each other, or how energy is transduced between them, is not well understood. We introduced several single cysteine substitutions in DrrB and then by using a cysteine to amine hetero-bifunctional cross-linker showed that DrrA interacts predominantly with the N-terminal cytoplasmic tail of DrrB. Within this region of DrrB, we also identified a sequence with similarities to the EAA motif found in importers of the ABC family of proteins, thus leading to the proposal that the EAA or the EAA-like motif may be involved in forming a generalized interface between the ABC and the TMD of both uptake and export systems. By using a combination of approaches, including point mutations and disulfide cross-linking analysis, we show here that the Q-loop region of DrrA plays an important role in dimerization of DrrA as well as in interactions with DrrB. Furthermore, we also show that the interaction of the Q-loop with the N-terminus of DrrB is involved in transmitting conformational changes between DrrA and DrrB. The scope of the present study further extends into identifying the factors involved in the biogenesis of the DrrAB pump. We have identified two accessory proteins namely, FtsH and GroEL that may be involved in proper folding and assembly of the transporter.

Morphologic and metabolic change is a known property of the adult brain. A number of behavioural tasks alter local cerebral blood flow and glucose utilisation. The expression of the glucose transporter 1 (GLUT1), which allows the entry of glucose to the brain, also has been shown to change in response to long-lasting neuronal activation. However, little is known about the effect of acute neuronal activation on GLUT1 expression. Using immunohistochemistry and Western blot, we investigated cerebral GLUT1 expression and vasculature density in mice undergoing a 48-hour voluntary wheel running period. The results showed that the striatum was the main region where GLUT1 protein was up-regulated: There was a trend for GLUT1 expression and blood vessels density to be associated with the distance run during the experiment. These results indicate that short-term increased neuronal activation is associated with rapid changes in glucose transport and possibly vascular remodelling.

Syfte: Att ur ett intensivvårds- och röntgensjuksköterskeperspektivbeskriva och jämföra upplevelser och erfarenheter av att utföra CT-hjärna på enneurointensivvårdsavdelning. Metod: En deskriptiv intervjustudie medkvalitativ design användes, där åtta sjuksköterskor inom professionernaröntgen- och intensivvård deltog. Resultat:Intensivvårdssjuksköterskorna såg fram emot att apparaten skulle börja användaspå avdelningen, medan röntgensjuksköterskorna upplevde en frustration över attför lite tid och resurser avsatts för att kunna utföra undersökningen påavdelningen på ett bra sätt.  Intensivvårdssjuksköterskornaupplevde en tidsbesparing att kunna utföra undersökningen på avdelningen medanröntgensjuksköterskornas uppfattning var att man hann undersöka färre patientertotalt under samma tid. Resultatet visar också att sjuksköterskorna i bådagrupperna är medvetna om riskerna med intrahospitala transporter och ansermöjligheterna att utföra CT-hjärna på avdelningen som fördelaktigt förpatienten ur säkerhetssynpunkt. Slutsats:Noggrann planering, väl utarbetade rutiner och involvering av berörd personalär nödvändiga åtgärder för att skapa förutsättningar för ett gott arbetsklimatmellan arbetsgrupper. God kommunikation och förståelse för varandrasansvarsområden är förutsättningar för en trygg arbetsmiljö vilket iförlängningen ger en god och säker vård för patienten.  Sökord: Mobil CT, intrahospitalatransporter, neurointensivvård, sjuksköterska, röntgensjuksköterska, erfarenhet. / Objective: From an intensive care and radiology nursing perspective describe andcompare the experiences of performing CT brain on a neurological intensive careunit. Method: A descriptivequalitative interview, in which eight nurses in the professions radiology andcritical care participated. Results: Intensivecare nurses were looking forward to when the unit would start to be used in thedepartment, while radiology nurses experienced a frustration that not enoughtime and resources were allocated to carry out the examination in thedepartment in a good way. Intensive care nurses experienced a time save toperform the examination in the department while the radiology nurses felt thatthey had time to examine fewer patients in total during the same time. Theresults also show that nurses in both groups are well aware of the risksintrahospital transport constitute and consider the possibility to perform CTbrain in the ICU as very beneficial for the patient safety. Conclusion: Careful planning,well-developed procedures and the involvement of the personnel are necessarysteps to create conditions for a good working atmosphere between the teams.  Goodcommunication and understanding of each other’s responsibilities areprerequisites for a safe working environment which ultimately provides a goodand safe care for the patient. Keywords: Mobile CT, intrahospital transport, neuro-intensivecare, nurse, radiographer, experience.

Strategisk rörlighet är ett begrepp som används frekvent i dagens moderna insatsförsvar.Men vad är strategisk rörlighet egentligen? Räcker det att införskaffa modernatransportflyg för att insatsförband ska ha strategisk rörlighet? Denna uppsats har till syfteatt visa på att strategisk rörlighet är ett komplext begrepp. Ämnet är angripet med ensystemvetenskaplig teorianknytning och genomförs som en kvalitativ deskriptiv metod.Den teknik som används för insamling av data är litteratursökning. Det är trefrågeställningar som behandlas: Är Sverige som nation i behov av förmågan och/ellerfunktionen strategisk rörlighet, Vad är strategisk rörlighet samt Finns det någon skillnadmellan funktionen och förmågan strategisk rörlighet och i så fall vad består den i?Strategisk rörlighet visar sig vara ett komplext begrepp som täcker ett stort område alltifrånvilka transportresurser som behövs, till att enheter behöver vara interoperabla för att intebara kunna transporteras utan för att kunna verka tillsammans med andra länders enheter.Resultatet är att Sverige är i behov av förmågan strategisk rörlighet, att strategisk rörlighetär ett system av transportkapaciteter, materiel och utrustning samt personal och kompetens,att strategisk rörlighet är en förmåga och inte en funktion. / Strategic mobility is a conception that is frequently used in today’s modernwarfare. But what is strategic mobility really? Is it enough to buy moderntransport aircraft to have strategic mobility? This essay has the purpose ofshowing that strategic mobility is a complex conception. The subject has beendealt with using a systems scientific theory and a qualitative descriptivemethod has been employed. The technique for collecting information wasstudying literature. These are the questions that have been considered: IsSweden, as a nation, in need of the capability or the function known asstrategic mobility? What is strategic mobility and is there a difference betweenthe capability and the function of strategic mobility and in that case, what isthis difference?Strategic mobility appears to be a complex conception that covers a big area;everything from what transport capacities are required to what units need to beinteroperable, not only for transportation but also for the cooperation with othercountries’ units.The conclusion is, that Sweden is in need of strategic mobility capability, thatstrategic mobility is a system of transport abilities, materiel and equipment,personnel and know-how and finally, that strategic mobility is a capability andnot a function.. / Avdelning: ALB - Slutet Mag 3 C-upps.Hylla: Upps. ChP 02-04

Both deficiency and toxicity of the essential micronutrient boron (B) lead to reduced crop yield in agriculture. However, our understanding of the molecular responses of plants under B stresses to tackle the yield loss is limited. Therefore, in the present study, transcriptional alterations in sensitive and tolerant barley cultivars under B deficiency and toxicity were investigated in order to reveal the molecular responses. Transcriptomes were monitored at seedling stage by global expression profiling using oligonucleotide microarrays. In the context of the study, we have determined that response to B toxicity in barley involved jasmonic acid and various components of biotic stress responses. Examination of expression profiles indicated that B toxicity and deficiency resulted in significant global changes in the transcriptomes of leaf and root tissues, respectively. Inter-varietal comparison of sensitive and tolerant genotypes of barley revealed that a combinatorial effect of transcription factors on regulation could alter the gene expression patterns in tolerant cultivar and provide B toxicity tolerance. Furthermore, mechanisms of vacuolar sorting or efflux by transporters and aquaporins might be contributing to the tolerance to B stresses in barley according to the results of this study. Additionally, we have identified and cloned the HvBor1a gene encoding a putative B transporter in barley using candidate gene approach and functionally characterized its roles in the tolerance to B stresses. The full length coding sequence and also the non-coding regions of the gene were identified. It was demonstrated that the protein product of HvBor1a was localized to the plasma membrane and it displayed B transporter activity. High transcript abundances in leaf tissues of barley suggested a role for HvBor1a in re-distribution of B within the plant tissues. Interestingly, examination of last intron of HvBor1a has led to the identification of an alternatively spliced variant in certain cultivars of barley. Furthermore, interval mapping and positional cloning was performed to locate the HvBor1a on 3H B tolerance QTL and a novel CAPS marker was developed to narrow the genetic distances at the locus. As a conclusion, this work presents, for the first time, the transcriptome profiling of a member of Triticeae under B toxicity and deficiency. The data generated should enlighten succeeding studies to unravel molecular mechanisms and signaling networks of tolerance to B stresses especially in crops like barley and wheat. The results of the study will provide novel tools and genes for conventional and biotechnological approaches for the reduction of yield loss due to B toxicity or deficiency.