Von TRAIL, FasL und APRIL, drei Mitgliedern der TNF-Liganden-Familie, ist bekannt, dass Trimerstabilität und Oligomerisierungsstatus maßgeblich das Rezeptoraktivierungspotential dieser Liganden beeinflussen. Für die immunstimulatorischen TNF-Liganden CD27L, CD40L, OX40L, 41BBL und GITRL war hingegen vor der Durchführung dieser Arbeit praktisch nicht bekannt, inwieweit Trimerbildung, Stabilisierung und Oligomerisierung wichtig für deren Aktitvität sind. Dies wurde in dieser Arbeit systematisch untersucht. CD40L besaß bereits als trimeres Molekül eine hohe Aktivität, die durch sekundäre Oligomerisierung nur wenig gesteigert wurde. Die spezifische Aktivität konnte durch Stabilisierung mit Hilfe der Tenascin-C (TNC)-Trimerisierungsdomäne nur geringfügig gesteigert werden. CD27L war als lösliches Flag-markiertes sowie als hexameres Fc-Protein selbst nach Quervernetzen nicht in der Lage, seinen Rezeptor CD27 zu binden und zu aktivieren. Die TNC-stabilisierte trimere Form des CD27L hingegen induzierte nach Oligomerisierung mit einem anti-Flag-Antikörper ein starkes Signal. Trimerer OX40L und trimerer 41BBL konnten nur in oligomerisierter Form ihre Rezeptoren aktivieren, wobei die Aktivität der TNC-stabilisierten Form signifikant stärker ausgeprägt war. GITRL aktivierte seinen Rezeptor bereits als stabilisiertes Trimer und Hexamer, die Aktivität konnte durch Quervernetzen nur gering gesteigert werden. Zusammenfassend kann man sagen, dass CD27L, OX40L und 41BBL zu der Untergruppe der TNF-Ligandenfamilie gehört, für die eine Stabilisierung des trimeren Moleküls und dessen Oligomerisierung nötig sind, um eine starke Rezeptoraktivierung zu ermöglichen. Im Gegensatz dazu zeigten CD40L und GITRL bereits oligomerisierungsunabhängig eine hohe Aktivität. GITRL benötigte allerdings die Stabilisierung des trimeren Moleküls durch die TNC-Domäne, um gute Aktivität zu zeigen. Im Weiteren wurden Antikörperfragment (scFv-)-TNF-Ligand-Fusionsproteine konstruiert und untersucht, die ein Zelloberflächenantigen binden. Eine starke Zelloberflächenantigen-spezifische Aktivierung des jeweiligen Rezeptors konnte für scFv-41BBL und für scFv-OX40L gezeigt werden, wohingegen scFv-CD40L und scFv-GITRL bereits auf antigennegativen Zellen stark aktiv waren. scFv-CD27L war selbst auf antigenpositiven Zellen inaktiv. Verwendet man an Stelle des Antikörperfragments eine extrazelluläre Proteinbindedomäne, z.B. die eines TNF-Rezeptors, erhält man Fusionsproteine, die zum einen eine selektive Aktivierung der TNF-Ligandendomäne und somit die Aktivierung des korrespondierenden Rezeptors auf der Zielzelle ermöglichen, zum anderen aber durch die Bindung an den membranständigen Liganden dessen Aktitvät neutralisieren können. Für CD40-, RANK- und B7-2-FasL konnte der immobilisationabhängige Aktivierungseffekt auf entsprechenden Zelloberflächenmolekül-exprimierenden Zellen gezeigt werden. Anhand von T47D-Zellen, die durch eine autokrine CD40L-CD40-Signalschleife vor Apoptose geschützt sind, konnte gezeigt werden, dass durch die Bindung von CD40-FasL an membranständigen CD40L die CD40L-CD40-Interaktion gestört und gleichzeitig Apoptose verstärkt induziert werden kann. Das Prinzip der antigenabhängigen Aktivierung von TNF-Liganden könnte Anwendung in der Tumortherapie finden, da bei Verwendung entsprechender selektiv exprimierter Marker eine lokale Rezeptoraktivierung erreicht und so Nebenwirkungen minimiert werden können. / Trimer stability and oligomerization status of TRAIL, FasL and APRIL, three members of the TNF ligand family, critically determine their receptor activating potential. However, detailed information for the immunostimmulatory ligands CD27L, CD40L, OX40L, 41BBL and GITRL regarding the importance of trimer formation, stabilization and oligomerization for ligand activity was lacking. These aspects were investigated systematically in this work. CD40L was highly active as a trimeric molecule. Secondary oligomerization and/or stabilization via the tenascin-C (TNC) trimerization domain slightly enhanced its specific activity. As soluble Flag-tagged and as hexameric Fc protein CD27L failed to bind and activate its cognate receptor CD27, even after crosslinking. However, the TNC stabilized form of CD27L induced a strong signal after oligomerization with anti-Flag antibody. Receptor signaling was only activated by oligomerized molecules of trimeric OX40L and 41BBL whereas the respective TNC fusion protein showed significant stronger activity. Stabilized GITRL trimers and hexamers already activated their receptor whereas oligomerization of GITRL just slightly enhanced the specific activity. Taken together, CD27L, OX40L and 41BBL belong to a TNF ligand family subgroup which requires oligomerization and stabilization of the trimeric molecule to ensure strong receptor activation. In contrast, CD40L and GITRL already display high oligomerization-independent activity, though the latter needs stabilization by the TNC domain. Furthermore, antibody fragment (scFv)-ligand fusion proteins targeting specific cell surface antigens were designed and analyzed. Strong cell surface antigen-selective TNF receptor activation was achieved for scFv-41BBL and scFv-OX40L whereas scFv-CD40L and scFv-GITRL already induced signaling in the absence of antigen-positive cells. scFv-CD27L lacked activity even on antigen-positive cells. Using an extracellular protein binding domain for example the ligand binding domain of a TNF receptor instead of an antibody fragment resulted in fusion proteins that on the one hand activate the TNF ligand domain and thus the corresponding receptor on target cells and on the other hand neutralize membrane ligand activity by binding. The effect of cell surface immobilization-mediated activation of these fusion proteins on cells expressing the corresponding target molecule was shown here for CD40-, RANK- and B7-2-FasL. The CD40-FasL fusion protein simultaneously blocked CD40L-CD40 interaction and induced strong apoptosis in T47D cells displaying an antiapoptotic autocrine CD40L-CD40 signaling loop. The principle of antigen-dependent activation of TNF ligands could be of use in tumor treatment due to the fact that tumor specific marker targeting leads to locally restricted receptor activation on antigen positive cells, promising a reduction in potential off target effects.

O endotélio reveste a parede vascular e possui função essencial na manutenção da homeostase. A célula endotelial é capaz de perceber estímulos extracelulares, como fatores químicos e mecânicos, transmitir a informação para dentro da célula e regular sua função e fenótipo. Neste sentido, investigamos os mecanismos moleculares associados as células endoteliais em dois contextos importantes de intervenções vasculares 1) nos stents farmacológicos, onde a rapamicina exerce funções antiproliferativas e pró-trombogênicas, e 2) na revascularização cardíaca por ponte de safena, onde o alto estiramento mecânico exerce grande impacto no remodelamento vascular e no fenótipo da célula endotelial. A rapamicina pertence à classe de drogas limus, bastante utilizadas nos stents farmacológicos usados no procedimento de desobstrução vascular. Além de sua função antiproliferativa, exploramos os efeitos deletérios associados a pró-trombogênese. Os dados demonstraram que a rapamicina ativa o receptor de TGF independentemente de seu ligante TGFbeta, promovendo aumento na expressão da PAI-1 (pró-trombogênica), alteração no fenótipo endotelial (Transição endotélio-mesenquimal - EndMT) e na formação de fibras de estresse. Os efeitos observados são dependentes da ativação de Smad2 e independentes da via clássica antiproliferativa por mTOR. Experimentos in vivo mostraram que o tratamento com inibidor do receptor de TGF diminui os efeitos pró-trombogênicos e a expressão de PAI-1 induzidos pela rapamicina em artérias carótidas de camundongos. A ponte de safena é um procedimento bastante utilizado na cirurgia de revascularização cardíaca e a arterialização do segmento venoso submetido ao estresse hemodinâmico arterial resulta em remodelamento vascular, que influencia o sucesso do procedimento. Nossos dados demonstram que a célula endotelial humana de veia safena humana (hSVEC), susceptível as modificações do tipo EndMT induzido quimicamente (estímulo pró-fibrótico e pró-inflamatório), não expressou o mesmo comportamento em resposta ao aumento de estiramento mecânico que ocorre durante a arterialização venosa. Entretanto, detectamos uma pronunciada redução dos filamentos de actina, modulação no padrão de ativação da cofilina e na proporção de actina glomerular (G-actina) entre citoplasma e núcleo, com redução da biodisponibilidade de NO. De modo interessante, demonstramos que a redução no filamento de actina é específica para a célula endotelial venosa, não sendo observado em células endoteliais de origem arterial de aorta e coronária. Em conjunto, os dados mostram que 1) efeitos pró-trombogênicos associados a rapamicina são mediados por ativação do receptor de TGF independente do seu ligante e da atividade antiproliferativa da droga e 2) a adaptação da célula endotelial venosa ao estiramento mecânico envolve modulação da síntese/degradação de filamentos de actina e redução na biodisponibilidade de NO. Estes novos elementos sobre o mecanismo de transdução de estímulos químicos e físicos pelo endotélio poderão ser explorados terapeuticamente para modular a plasticidade endotelial em disfunções cardiovasculares / Endothelium is the inner layer in vascular wall and displays an essential role in the maintenance of cardiovascular homeostasis. Endothelial cell senses the extracellular stimuli, such as chemical and mechanical factors, transduce and process these signals to regulate cell function and phenotype. Here, we investigated molecular underpinning of the endothelial cells under two important scenarios: 1) in drug-eluting stents, where rapamycin exerts antiproliferative and undesirable prothrombogenic functions, and 2) in vein graft bypass surgery, where increased stretch modulates vascular remodeling and endothelial cell phenotype. Rapamycin belongs to the class of limus drugs and is widely used in drug eluting stents (DES) to vascular restenosis. In addition to its antiproliferative function, we explore the deleterious effects associated with prothrombogenesis. Our data demonstrated that rapamycin activates TGF receptor independent of its ligand TGFbeta, in concert with promotion of PAI-1 expression (prothrombogenic), changes in endothelial phenotype (Endothelial to Mesenchymal Transition - EndMT) and stress fibers induction. These effects are Smad2 dependent and independent of the classical antiproliferative mTOR pathway of rapamycin. Our in vivo experiments showed that TGF receptor inhibitor treatment decreases prothrombogenic effects and PAI-1 expression induced by rapamycin in mice carotid arteries. Saphenous vein is widely used in coronary artery bypass surgery (CABG) and the vein arterialization remodeling in response to the increased stress influences graft patency. Our data demonstrated that human saphenous vein endothelial cell (hSVEC) is susceptible to chemically induced endothelial-to-mesenchymal transition (EndMT) by pro-fibrotic and pro-inflammatory stimuli. On the other hand, physical stimulus associated with high stretch failed to induce EndMT. However, we detected a pronounced decrease of actin filaments, modulation of the cofilin activation, changes in the proportion of glomerular actin (G-actin) between cytoplasm and nucleus, and reduction of NO bioavailability. Interestingly, the reduction of actin fibers by high stretch is specific to venous endothelial cell since arterial endothelial cells from aorta, and coronary artery failed to display the response. Altogether, our data show that 1) the thrombogenic effects of rapamycin are mediated by TGF receptor activation independent of its ligand and independent of the antiproliferative pathway of the drug, and 2) the adaptation of venous endothelial cell to mechanical stretch involves synthesis/degradation of actin filaments and reduced NO bioavailability. These new elements on signal transduction of endothelial cells in response to chemical and physical stimuli may be therapeutically explored to modulate endothelial plasticity in cardiovascular disorders

Die Studie beinhaltet eine biochemisch-molekularbiologische Analyse des 20S-Proteasoms und seiner Aktivierung durch Proteine der PA28-Familie. Das 20S-Proteasom ist die zentrale Epitop-prozessierende cytosolisch-nukleäre Protease des MHC-Klasse-I-Antigenpräsentationsweges. In Mikroglia, wie auch in anderen Zellen, unterliegt das Proteasom einer Interferon-g-(IFN-g)-vermittelten strukturellen Plastizität, d.h. einer Substitution der Untereinheiten der Aktiven Zentren. Durch diesen Austauschmechanismus werden proteolytische Schnittpräferenzen modifiziert, was für die Hierarchie von cytotoxischen T-Zellantworten von Bedeutung ist. Lipopolysaccharide (LPS) bewirken in Mikroglia ebenfalls Veränderungen der proteasomalen Zusammensetzung des 20S-Komplexes und seines PA700-Aktivators. Dies ist ein Hinweis auf die Rolle des Proteasoms auch bei der Prozessierung von Antigenen des endolysosomalen Antigenpräsentationsweges. Die Modulation der Zusammensetzung des 20S-Proteasoms in Mikroglia durch IFN-g und LPS ist ein weiterer Beleg für die Rolle der Mikroglia bei der zellulären Immunantwort im Zentralnervensystem. Funktionen des Proteasoms in der MHC-Klasse-I-Antigenpräsentation werden durch den Proteasomaktivator PA28 optimiert. Die PA28-Proteinfamilie besteht aus den Proteinen PA28a, PA28b und PA28g. Diese Studie trägt - basierend auf kinetischen Modellierungen, Mutagenese- und Protein-Protein-Interaktionsstudien und Untersuchungen zur MHC-Klasse-I-Antigen-präsentation in PA28-Transfektanten - zur funktionellen Neubewertung dieser drei Proteine bei. Die drei PA28-Proteine sind autonome Aktivatoren des Proteasoms. Heteromere PA28ab-Komplexe verursachen eine stärkere Aktivierung des Proteasoms als die homomeren PA28a-oder PA28b-Komplexe. Das PA28g-Protein ist in vitro ein schwacher Aktivator verschiedener proteasomaler Peptidaseaktivitäten, der dennoch in unserem in vivo-Modell eine verbesserte MHC-Klasse-I-Antigenpräsentation bewirkt. Kinetische Argumente sprechen für Funktionen der PA28a und PA28b-Proteine als Translokasen für Peptidsubstate und -produkte des Proteasoms. Anhand des HBx-Proteins des Hepatitis B-Virus wird die Möglichkeit illustriert, das vorgestellte Modell zur Analyse viraler Faktoren anzuwenden, die mit der Aktivierung des Proteasoms durch PA28 interferieren. / The 20S proteasome is the proteolytic core complex of the main cytoplasmic and nuclear protein degradation system. One of the numerous functions assigned to the 20S proteasome is the generation of antigenic peptides from intracellular proteins. MHC class I surface presentation of antigenic peptides is one key event of the cellular immune response. The presented study was aimed on the biochemical and molecular-biological analysis of the 20S proteasome and its activation by regulatory proteins of the PA28 family. In the brain, microglial cells are the major antigen presenting cells and they respond sensitive to pathologic events. Cultured mouse microglia was used as a model to study the correlation between microglial activation parameters and structural plasticity of the 20S/26S proteasome. In response to interferon-g , constitutive active site subunits were replaced by inducible subunits as described for other cellular systems. These replacements result in altered proteolytic cleavage preferences, indicating that activated microglia adapts its proteasomal subunit composition to the requirements of an optimized MHC class I epitope processing. Since lipopolysaccharide (LPS), a glycolipid of bacterial pathogens, also alters proteasome subunit composition of the 20S proteasome and its activator PA700, a function of microglial proteasome in processing of antigens of the endolysosomal pathway has been postulated. The modulation of the 20S proteasome subunit composition indicates that microglia is part of the cellular immune response in the central nervous system. The proteasome activator PA28 has been reported to optimize MHC class I antigen presentation. The PA28 protein family is composed of three proteins: PA28a, PA28b and PA28b. Based on kinetic modelling approaches, mutagenesis of activator proteins, protein-protein interaction studies and investigation of MHC class I antigen presentation in PA28-transfected cell lines a evaluation of functions of these three proteins has been performed. In vitro investigations revealed that the recombinant PA28 proteins are activators of peptidase activities of the proteasome. Heteromeric PA28ab complexes are stronger activators than homomeric PA28a o PA28b complexes. Recombinant PA28g is a weak activator of several peptidase activities. Nevertheless, in PA28g transfected B8-fibroblasts preliminary results indicate an improved MHC class I presentation. Based on kinetic evidence, a model has been presented indicating that PA28a and PA28b proteins act as peptide translocases, performing the import of substrates or the export of products into the catalytic chamber of the 20S proteasome. Finally, as examplified with the HBx protein of Hepatitis B virus, the opportunity is presented to use an in vitro reconstitution system of proteasomal activation to examine viral proteins interfering with proteasomal activation.

Streptococcus pneumoniae est la cause principale de pneumonies, otites, méningites et septicémies. La transformation génétique naturelle constitue l’élément clé de son adaptation aux changements environnementaux. Elle s’effectue par intégration d’ADN d’origine externe dans le chromosome de la bactérie, et a lieu pendant un état physiologique particulier appelé compétence.Mon travail de thèse a consisté à étudier les acteurs principaux de la régulation de la compétence (ComD, ComE) et les protéines impliquées dans la prise en charge, le traitement de l’ADN transformant et la recombinaison (DprA, RecA). J’ai notamment résolu la structure du facteur de transcription ComE par cristallographie aux rayons X, et réalisé une étude fonctionnelle de sa fixation sur un de ses promoteurs. Les résultats obtenus ont permis de proposer un mécanisme selon lequel la dimérisation induite par la phosphorylation de ComE, couplée à sa fixation sur la séquence promotrice d’ADN, provoquerait une courbure de l’ADN. Cette courbure permettrait la fixation de l’ARN polymérase, activant ainsi la transcription des gènes nécessaires à la mise en place de la compétence. / Streptococcus pneumoniae is the leading cause of community-acquired infections worldwide. The natural genetic transformation is the key to its adaptation to environmental changes. It takes place with the integration in its chromosome of exogenous DNA, during a physiological state called competence.During my thesis I have focused on the main actors of competence regulation (ComD, ComE) and on proteins involved in exogenous DNA processing and recombination (DprA, RecA). In particular, I have solved the structure of the transcriptional activator ComE by X-ray crystallography, and carried out a functional study of its binding to its promoter. The results obtained allowed us to propose a mechanism regarding the transcriptional activation by ComE of the genes necessary for the set up of the competence : the phosphorylation-induced dimerization, coupled to the binding of ComE to its DNA promoter, would curve the DNA and allow the binding of the RNA polymerase.

Orientador: Alessandro Lia Mondelli / Resumo: Introdução: O Acidente Vascular Cerebral (AVC) é uma das principais causas de morte e sequelas neurológicas no mundo. O reconhecimento precoce e a pré-notificação hospitalar por serviços de atendimento pré-hospitalar têm sido relacionados com o aumento nas taxas de tratamento adequado. Sendo assim, a American Heart Association e a European Stroke Organisation recomendam o uso de escalas de avaliação pelas equipes do atendimento pré-hospitalar. Objetivo: Traduzir para o idioma português do Brasil, realizar a adaptação transcultural das escalas Cincinnati Prehospital Stroke Scale e Los Angeles Prehospital Stroke Screen e avaliar a confiabilidade e validade na população brasileira. Material e Métodos: Trata-se de um estudo metodológico, transversal e prospectivo realizado em 2 etapas: a primeira constituída pelos processos de tradução e adaptação transcultural das escalas e a segunda pela aplicação das mesmas, que ocorreu entre julho de 2016 e dezembro de 2017. Resultados e Discussão: A Cincinnati Prehospital Stroke Scale ficou denominada de “Escala de Avaliação pré-hospitalar do AVC – Cincinnati”. Os resultados mostraram um Coeficiente de alpha de Cronbach foi de 0,39 e uma alta confiabilidade interobservador do instrumento final, evidenciada pelo alto valor do índice de Kappa, principalmente nos itens “queda do braço” e “fala” que obtiveram o valor máximo. A escala apresentou acurácia de 93% (IC 95% 87,76, – 98,24%), sensibilidade de 92,42% (IC 95%, 86,03 – 98,80% / VPP = 71,7... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Strokes are one of the leading causes of death and neurological disability in the world. Early recognition and prehospital notification may increase rates of thrombolysis with recombinant tissue plasminogen activator (rt-PA). Therefore, the American Heart Association and the European Stroke Organization recommend the use of assessment scales by prehospital care teams. Objective: To translate the Cincinnati Prehospital Stroke Scale (CPSS) and the Los Angeles Prehospital Stroke Screen to Portuguese, make a cross-cultural adaptation to Brazilian culture, and validate and verify its reliability in a Brazilian population. Material and Methods: This was a cross-sectional and prospective methodological study carried out in two stages: the first one consisted of the translation and crosscultural adaptation of the original scale and the second involved the application of the final instrument, which occurred between July 2016 and December 2017. Results and discussion: The final version of the Cincinnati Prehospital Stroke Scale was called the “Escala de Avaliação pré-hospitalar do AVC – Cincinnati”. The results showed Cronbach's alpha was 0,39 and a high interobserver reliability of the final instrument, evidenced by the high value of the Kappa index, especially in the items "arm drop" and "speech," which exhibited the maximum values. The scale showed accuracy of 93% (95% CI 87.76 - 98.24%), sensitivity of 92.42% (CI 95% 86.03 - 98.80% / PPV = 71.76) and specificity of 4%... (Complete abstract click electronic access below) / Doutor

<p>UVOD: Akutni ishemijski moždani udar (AIMU) je poremećaj moždane funkcije nastao usled vaskularnih o&scaron;tećenja, uzrokovane okluzijom ili embolijom krvnog suda. Za razliku od standardnog CT pregleda endokranijuma, CT perfuzija (CTP) je napredna dijagnostička procedura koja može u prvim satima od početka simptoma AIMU pružiti precizne informacije o lokalizaciji i veličini infarkta mozga, a u okviru infarkta, razlikovati srž i ishemijsku penumbru. Samim tim, CTP predstavlja svojevrsnu pomoć u selekciji pacijenata za intravensku primenu rekombinantnog tkivnog plazminogen aktivatora (rtPA). CILJ RADA: Cilj istraživanja je bio da se primenom CTP ispita koliko iznosi: optimalna veličina srži, zatim minimalni i optimalan odnos penumbre i srži infarkta pogodnih za primenu rtPA, maligni profil srži infarkta koji je nepogodan za primenu rtPA i % simptomatske hemoragije kao komplikacije nakon rtPA. MATERIJAL I METODE: Istraživanje je obavljeno u Specijalnoj bolnici &bdquo;Sveti Sava&ldquo; u Beogradu kao petogodi&scaron;nja retrospektivna studija. Studija je obuhvatila ukupno 130 pacijenata sa AIMU kod kojih je primenjena CTP. Eksperimentalnu grupu je sačinjavalo 100 pacijenata kojima je aplikovana rtPA, a kontrolnu grupu 30 pacijenata, koji nisu primili rtPA. Svim ispitanicima su načinjeni: standardni CT pregled glave i CT perfuzija odmah nakon prijema i kontrolni standardni CT pregled endokranijuma 24 h nakon prijema u bolnicu. Pregledi su obavljeni sa 16-slajsnom MSCT aparatu, pri čemu je pokrivenost CTP iznosila 2 cm. &bdquo;Mismatch&ldquo; postoji ukoliko je perfuziona lezija na CBF mapi veća od perfuzionog deficita na CBV mapi (srţ infarkta). REZULTATI: Rezultati studije su pokazali da pacijenti oboleli od AIMU sa mismatchom manjim od 20% nisu imali koristi od primenjene rtPA, a pacijenti sa 20% i vi&scaron;e mismatch-om su imali ili umeren ili značajan neurolo&scaron;ki oporavak. Optimalni mismatch, kojim se postiže visoka uspe&scaron;nost nakon rtPA je iznosio ˃ 101% penumbre. Pacijenti sa povr&scaron;inom perfuzionog deficita na CBV mapi manjom od 1175 mm2 su imali bolji neurolo&scaron;ki oporavak, u odnosu na pacijente savećim lezijama, a samim tim su bili pogodni za primenu rtPA. Perfuzioni deficit na CBV mapi veći od 3000 mm2 (60ml) je predstavljao maligni profil infarkta, usled povećanog rizika od nastanka simptomatske hemoragije i smrtnog ishoda. Simptomatska hemoragija u eksperimentalnoj grupi je iznosila svega 3%, &scaron;to predstavlja nizak procenat komplikacija nakon reperfuzione terapije. ZAKLJUČAK: CT perfuzija je urgentna i brza tehnika, koja nam daje jedinstvene informacije o AIMU, pomaže u dono&scaron;enju odluke o terapijskom pristupu i može poslužiti kao surogat biomarker u predikciji kliničkog ishoda.</p> / <p>INTRODUCTION: Acute ischemic stroke (AIS) is functional brain disorder, which is happened due to vascular damaged, caused by vessel occlusion or embolism. Unlike to noncontrast brain CT, CT perfusion (CTP) is advanced diagnostic procedure, which could give accurate information about localization and extent of AIS in the first hours of symptom onset, and also differentiate infarct cor and ischemic penumbra. Thus, CTP helps in selection patients for administration intravenous recombinant tissue plasminogen activator (rtPA) AIM: The aims of study were to estimate: the size of optimal infarct cor, minimal and optimal ratio between penumbra and infarct core which is suitable for rtPA, malignant profile of infarct core which is not suitable for rtPA and percentage of symptomatic intracerebral hemorrhage as compli-cation after rtPA using CTP. MATERIAL AND METHODS: The investigation was performed in Stroke hospital &bdquo;Sveti Sava&rdquo; in Belgrade as five years retrospective study. Study included 130 patients with AIS with performed CT perfusion. One hundred patients from experimental group were treated with rtPA and thirty patients from control group were not treated with rtPA. All patients underwent baseline noncontrast CT of brain, CT perfusion and control 24 hours follow-up noncontrast brain CT. Examinations were done on 16-slice MSCT and CTP covered an area of 20 mm of brain tissue. &bdquo;Mismatch &ldquo;was defined as a perfusion lesion (CBF lesion) larger than the core lesion (CBV). RESULTS: Results of study showed that the patients with AIS and mismatch less than 20%, had no benefit from rtPA, but patients with &ge; 20% of mismatch had good or excellent clinical outcome. Optimal mismatch, which provided favorable response after rtPA, was ˃101% of penumbra. Patients with cor perfusion lesion (CBV) less than 1175 mm2, are suitable for rtPAand had better clinical outcome, then the patients with larger lesions. Perfusion cor lesions (CBV) larger than 3000 mm2 (60ml) was malignantprofile, because of high risk of symptomatic intracerebral hemorrhage and mortality. Symptomatic hemorrhage in experimental group was only 3%, as a low percentage of complications after reperfusion therapy.<br />CONCLUSION: CTP is emergency and rapid technique, which provides unique information about AIS, helps with clinical decision making and could be surrogate biomarker in prediction of clinical outcome.</p>

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Os objetivos deste estudo foram avaliar o efeito do aparelho de avanço mandibular (Twin block - TB) no volume das vias aéreas superiores, por meio de tomografia computadorizada cone beam (CBCT); analisar, por meio da polissonografia, as mudanças no índice de apneia e hipopneia (IAH) e índice de apneia por hora de sono (IA), saturação de oxi-hemoglobina e eficiência do sono; e correlacionar o volume na CBCT e as polissonografias. Dezesseis pacientes portadores de apneia obstrutiva do sono, idade média de 47,06 anos, participaram deste estudo prospectivo, com acompanhamento médio de 7 meses. Foram feitas polissonografias iniciais (T1) e de acompanhamento (T2) com o TB em posição, e CBCT sem e com TB em posição. A segmentação e obtenção dos volumes das vias aéreas superiores foram realizadas e utilizados os testes t de Student pareado, de Wilcoxon e o índice de correlação de Spearman, com 5% de significância. Os resultados das polissonografias mostraram diferenças estatisticamente significativas entre T1 e T2 apenas para IAH (p<0,05). Houve aumento do volume da via aérea superior com TB quando comparado com o volume sem TB (p<0,05). Foi possível estabelecer-se correlação positiva entre volume da via aérea superior sem TB e IAH e IA em T1 (p<0,05), mas não houve correlação entre o volume da via aérea com TB e índices polissonográficos em T2. Pode-se concluir que, houve aumento de volume da via aérea superior com o TB e houve redução do IAH em T2 porém, sem correlação entre estes dados. / The aim of this study were to evaluate the effect of a mandibular advancement device (Twin Block TB) in the upper airway volume, with cone beam computed tomography (CBCT); to analyze, by polysomnographys, changes in apnea and hipopnea index per hour (AHI), apnea index per hour of sleep (AI), oxyhemoglobin saturation and sleep efficiency; and correlate changes in volume in CBCT and the results of polysomnography. Sixteen OSA patients, mean age of 47.07 years, participated in this prospective study, with follow up of 7 months. Initial polysomnography (T1) and follow up polysomnography (T2) were taken with TB in position, and CBCT with and without TB were taken. Upper airway segmentations and volumes were performed and were evaluated by the Student t test, the Wilcoxon test, and Spearman correlation, with 5% significance level. The results of the polysomnographs showed statistically significant differences between T1 and T2, only for AHI (p<0.05). There was an increased airway volume with TB in position when compared to volume without TB (p<0.05). A positive correlation between upper airway volume without TB and T1 AHI and AI was established (p<0.05), but there was no correlation between upper airway volume with TB and T2 polysomnography indexes. In conclusion, there was an increase in volume of the upper airway with the TB and reduction of AHI in T2 but without correlation with these data.

Background & aims. DNA methylation induced tumor suppressor gene silencing plays an important role in carcinogenesis. By using methylation-sensitive representational difference analysis, we identified paired box gene 5 (PAX5) being methylated in human cancer. PAX5 locates at human chromosome 9p13.2 and encodes a 391 amino acids transcription factor. However, the role of PAX5 in gastric cancer is still unclear. Hence, we analyzed its epigenetic inactivation, biological functions, and clinical implications in gastric cancer. / Conclusions. Our results demonstrated that PAX5 promoter methylation directly mediates its transcriptional silence and commonly occurs in gastric cancer. PAX5 gene can act as a functional tumor suppressor in gastric carcinogenesis by playing an important role in suppression of cell proliferation, migration, invasion, and induction of cell apoptosis. Detection of methylated PAX5 may be utilized as a biomarker for the prognosis of gastric cancer patients. / Methods. Methylation status of PAX5 promoter in gastric cancer cell lines and clinical samples was evaluated by methylation specific polymerase chain reaction (MSP) and bisulfite genomic sequencing (BGS). The effects of PAX5 re-expression in cancer cell lines were determined in proliferation, cell cycle, apoptosis, migration and invasion assays. Its in vivo tumorigenicity was investigated by injecting cancer cells with PAX5 expression vector subcutaneously into the dorsal flank of nude mice. Chromosome Immunoprecipitation (ChIP) and cDNA expression array were performed to reveal the molecular mechanism of the biological function of PAX5. / Results. PAX5 was silenced or down-regulated in seven out of eight of gastric cancer cell lines examined. A significant down-regulation was also detected in paired gastric tumors compared with their adjacent non-cancer tissues (n = 18, P = 0.0196). In contrast, PAX5 is broadly expressed in all kinds of normal adult and fetal tissues. The gene expression of PAX5 in the gastric cancer cell line is closely linked to the promoter hypermethylation status. In addition, the expression levels could be restored by exposure to demethylating agents 5-aza-21-deoxycytidine. Re-expression of PAX5 in AGS, BGC823 and HCT116 cancer cells reduced colony formation (P &lt; 0.01) and cell viability (P &lt; 0.05), arrested cell cycle in G0/G1 phase (P = 0.0055), induced cell apoptosis (P &lt; 0.05), repressed cell migration and invasion (P = 0.0218) in vitro. It also inhibited tumor growth in nude mice (P &lt; 0.05). The molecular basis of its function were investigated by cDNA expression array and demonstrated that ectopic expression of PAX5 up-regulated tumor suppressor gene P53, anti-proliferation gene P21, pro-apoptosis gene BAX, anti-invasion gene MTSS1 and TIMP1; and down-regulated anti-apoptosis gene BCL2, cell cycle regulator cyclinD1, migration related gene MET and MMP1. ChIP assay indicated that P53 and MET are direct transcriptional target of PAX5. Moreover, PAX5 hypermethylation was detected in 90% (145 of 161) of primary gastric cancers compared with 16% (3 of 19) of non-cancer tissues (P &lt; 0.0001). After a median follow-up period of 15.4 months, multivariate analysis revealed that gastric cancer patients with PAX5 methylation had a significant poor overall survival compared with the unmethylated cases (P = 0.0201). / Li, Xiaoxing. / Advisers: Hsiang Fu Kung; Jun Yu. / Source: Dissertation Abstracts International, Volume: 72-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 134-159). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Cell-free protein synthesis (CFPS) is a powerful protein expression platform where protein synthesis machinery is borrowed from living organisms. Target proteins are synthesized in a reaction tube together with cell extract, amino acids, energy source, and DNA. This reaction is versatile, and dynamic optimizations of the reaction conditions can be performed. The "œopen" nature of CFPS makes it a compelling candidate for many technologies and applications. This dissertation reports new and innovative applications of CFPS including 1) enzyme encapsulation in a virus-like particle, 2) detection of endocrine disrupting chemicals in the presence of blood and urine, and 3) expression of a multi-disulfide bond therapeutic protein. Two major limitations of enzymes are their instability and recycling difficulty. To overcome these limitations, we report the first enzyme encapsulation in the CFPS by immobilizing in a virus-like particle using an RNA aptamer. This technique allows simple and fast enzyme production and encapsulation We demonstrate, for the first time, the Rapid Adaptable Portable In vitro Detection biosensor platform (RAPID) for detecting endocrine disrupting chemicals (EDCs) in human blood and urine samples. Current living cell-based assays can take a week to detect EDCs, but RAPID requires only 2 hours. It utilizes the versatile nature of CFPS for biosensor protein complex production and EDC detection. Biotherapeutic protein expression in E. coli suffers from inclusion body formation, insolubility, and mis-folding. Since CFPS is not restricted by a cell wall, dynamic optimization can take place during the protein synthesis process. We report the first expression of full-length tissue plasminogen activator (tPA) using CFPS. These research works demonstrate the powerful and versatile nature of the CFPS.

Thesis (M.Sc. (Nutrition))--North-West University, Potchefstroom Campus, 2007.