Since September 11, 2001 there has been much commotion regarding the Muslim- American community. Constituting one percent of the U.S population, Muslim- Americans represent a multitude of ethnicities, socioeconomic classes, beliefs, preferences, and behaviors, occupying a multitude of worldviews--those arising from their various religious and cultural heritages and those innate to their American roots. Muslim-Americans’ unique hyphenated-identities, imbued with historical and political significance in the post-9/11 era, makes them vital to understanding the current landscape of minority mental health. While existing literature examines Muslim-Americans perceptions of mental health, focused exploration of Muslim-Americans lived experiences with mental health has been limited. This study investigates Muslim- Americans perceptions of mental health using standard ethnographic methods: in-depth and open-ended interviews, and immersion as participant observer in the research population at a local Islamic center and through community events. The findings suggest that: 1) Muslim-Americans’ interstitial identity, compounded by socio-political and religious-cultural frameworks, shapes their perceptions of and attitudes towards mental health and 2) mainstream American narratives of mental health care and support do not adequately accommodate varying approaches to personhood and well-being.

<p>This thesis describes recombinant proteins that have been generated by rational and combinatorial protein engineering strategies for use in subunit vaccine delivery and tumor targeting.</p><p>In a first series of studies, recombinant methods for incorporating immunogens into an adjuvant formulation, e.g. immunostimulating complexes (iscoms), were evaluated. Protein immunogens, which are not typically immunogenic in themselves, are normally administered with an adjuvant to improve their immunogenicity. To accomplish iscom incorporation of a <i>Toxoplasma gondii</i> surface antigen through hydrophobic interaction, lipids were added either <i>in vivo</i> via <i>E. coli</i> expression, or <i>in vitro</i> via interaction of an introduced hexahistidyl (His6) peptide and a chelating lipid. The possibility of exploiting the strong interaction between biotin and streptavidin was also explored, in order to couple a<i> Neospora caninum</i> surface antigen to iscom matrix, i.e. iscom particles without any antigen. Subsequent analyses confirmed that the immunogens were successfully incorporated into iscoms by the investigated strategies. In addition, immunization of mice with the recombinant Neospora antigen NcSRS2, associated with iscoms through the biotin-streptavidin interaction, induced specific antibodies to native NcSRS2 and reduced clinical symptoms following challenge infection. The systems described in this thesis might offer convenient and efficient methods for incorporating recombinant immunogens into adjuvant formulations that might be considered for the generation of future recombinant subunit vaccines.</p><p>In a second series of studies, Affibody® (affibody) ligands directed to the extracellular domain of human epidermal growth factor receptor 2 (HER2/neu), which is known to be overexpressed in ∼ 20-30% of breast cancers, were isolated by phage display <i>in vitro</i> selection from a combinatorial protein library based on the 58 amino acid residue staphylococcal protein A-derived Z domain. Biosensor analyses demonstrated that one of the variants from the phage selection, denoted His₆-Z_HER2/neu:4, selectively bound with nanomolar affinity (KD ≈ 50 nM) to the extracellular domain of HER2/neu (HER2-ECD) at a different site than the monoclonal antibody trastuzumab. In order to exploit avidity effects, a bivalent affibody ligand was constructed by head-to-tail dimerization, resulting in a 15.6 kDa affibody ligand, termed His₆-(Z_HER2/neu:4)₂, that was shown to have an improved apparent affinity to HER2-ECD (KD ≈ 3 nM) compared to the monovalent affibody. Moreover, radiolabeled monovalent and bivalent affibody ligands showed specific binding in vitro to native HER2/neu molecules expressed in human cancer cells. Biodistribution studies in mice carrying SKOV-3 xenografted tumors revealed that significant amounts of radioactivity were specifically targeted to the tumors <i>in vivo</i>, and the tumors could easily be visualized with a gamma camera. These results suggest that affibody ligands would be interesting candidates for specific tumor targeting in clinical applications, such as <i>in vivo</i> imaging and radiotherapy.</p>

This thesis examines the thought, work, and impact of the Scottish medical missionary, Dr Neil Macvicar, as well other personnel connected to the Victoria Hospital at the Lovedale mission in the Eastern Cape. Of special concern for study in medical history, missiology, and relief development studies, this work centres on Macvicar’s modern Western conceptions of Christianity, biomedicine, civilisation, African cosmological understandings, and traditional methods of healing, within the last years of the Cape Colony and the early history of the Union of South Africa. Macvicar was heavily influenced by the scientific advances and thought of his day, which in turn shaped his perceptions and attitudes not only to African worldviews but to his form and expression of Western Christianity and mission work. His efforts to eradicate and replace ‘superstitious’ thought and ‘inadequate’ methods of treatment focussed especially on the training of an African elite, including the first certified black nurses and largely unsuccessful attempts to initiate a scheme for black doctors. In addition, he promoted public health education endeavours; was heavily involved with patient care and treatment; enabled the inception of the South African Health Society; contributed countless articles, pamphlets, reviews, and books – both scholarly and popular; and was a central figure in the formation of the South African Native College (later to become Fort Hare University). As well as Macvicar, this thesis draws upon and exposes the impact of more marginalised medical personnel, such as Jane Waterston, one of the first female physicians in the modern British scheme, and Govan Koboka, a South African medical dispenser. Their work at Lovedale, among others like them in the late 19th century, was the primary approach to Western biomedical treatment offered by the mission, though largely unacknowledged in wider historical studies. This work also reveals how the hospital operated not simply as a place for healing, or indeed of dying, but as a ‘sacred’ or religious space in addition to its role as an educational centre for patients, and place for the training of other missionaries. Finally, elements of hospital-based biomedical practices, such as surgery, are examined and the Influenza Pandemic of 1918-1919 is looked at as a case study of mission community response to catastrophic disease.

No description available.

Cette recherche propose d’étudier l’expérience du cancer de la prostate. Elle a pour objectif de documenter le vécu et la prise en charge de cette maladie à partir d’une sociologie qui entre dans la fabrique des sujets. Dans quelle mesure les hommes atteints d’un cancer de la prostate et leur entourage peuvent-ils produire de nouvelles formes de subjectivités compte tenu de la vulnérabilité à laquelle ils sont exposés ? Pour répondre à cette question, l’enquête repose principalement sur l’articulation d’observations ethnographiques réalisées pendant une durée de cinq mois au sein de quatre hôpitaux publics avec un corpus de 70 entretiens semi-directifs conduits auprès de patient·e·s, de proches et de professionnel·le·s de santé. L’adoption d’un regard socio-historique permet tout d’abord de mettre en évidence le caractère situé des subjectivités et ouvre la voie à une analyse des modes de subjectivation à l’ère de la biomédecine. L’expérience du cancer de la prostate est ensuite décrite à travers une analyse de son imbrication avec les pratiques et les savoirs biomédicaux. Enfin, les bouleversements du cancer de la prostate au-delà des mondes du soin sont également abordés. Outre les apports de cette thèse à la sociologie du cancer et aux études sur les masculinités, la conclusion met la focale sur sa contribution à l’étude du sujet vulnérable. / This research focuses on the experience of prostate cancer. Its aims to document the lived experience and the medical care of this illness from a sociological perspective that enters into the making of subjects. To what extent can men with prostate cancer and relatives produce new forms of subjectivity given the vulnerability they are enduring? To answer this question, the study relies mainly on the articulation of ethnographic observations carried out over a period of five months in four public hospitals with a corpus of 70 semi-directive interviews conducted with patients, relatives and health professionals. Firstly, the adoption of a socio-historical approch allows us to highlight the situated expression of subjectivities and opens the way to an analysis of processes of subjectivation in the age of biomedicine. Secondly, the experience of prostate cancer is described as intertwined with knowledges and practices of biomedicine. Thirdly, the lived experience of prostate cancer in everyday life is analysed. Besides the contributions of this reaserch to the sociology of cancer and masculinities studies, the conclusion focuses on the construction of vulnerable subjects.

Bio-ontologies and Linked Data have become integral part of biological and biomedical knowledge bases with over 500 of them and millions of triples. Such knowledge bases are primarily developed for information retrieval, query processing, data integration, standardization, and provision. Developing machine learning methods which can exploit the background knowledge in such resources for predictive analysis and novel discovery in the biomedical domain has become essential. In this dissertation, we present novel approaches which utilize the plethora of data sets made available as bio-ontologies and Linked Data in a single uni ed framework as knowledge graphs. We utilize representation learning with knowledge graphs and introduce generic models for addressing and tackling computational problems of major implications to human health, such as predicting disease-gene associations and drug repurposing. We also show that our methods can compensate for incomplete information in public databases and can smoothly facilitate integration with biomedical literature for similar prediction tasks. Furthermore, we demonstrate that our methods can learn and extract features that outperform relevant methods, which rely on manually crafted features and laborious features engineering and pre-processing. Finally, we present a systematic evaluation of knowledge graph representation learning methods and demonstrate their potential applications for data analytics in biomedicine.

Patient-specific induced pluripotent stem cells (iPSCs) emerged as a promising cell source for disease modeling and drug screening as well as a virtually unlimited source for restorative therapy. The thesis deals with three major topics to help realizing biomedical applications with neural stem cells. To enable the generation of transgene-free iPSCs, alternatives to retroviral reprogramming were developed. Hence, the adaptation and evaluation of reprogramming using excisable lentiviral constructs, Sendai virus (SeV) and synthetic mRNA-based methods was assessed in the first part of this thesis. hiPSCs exhibit the pluripotency markers OCT4, SSEA-4, TRA1-60 which were confirmed by immunofluorescence and flow cytometry. Besides, the potential to differentiate in cell types of all three germ layers was detected, confirming pluripotent identity of proliferating colonies resulting from various reprogramming strategies. However, major differences such as high efficiency with SeV in contrast to a relatively low efficiency with mRNA in regard to passage number and the phenotype of starting fibroblasts were observed. Furthermore, a prolonged clone- and passage-dependent residual presence of viral RNA genes was identified in SeV-iPSCs for up to 23 passages using RT-PCR underlining the importance of careful monitoring of clone selection. In contrast, viral-free reprogramming by synthetic mRNA represents a fully non-integrative approach but requires further refinement to be efficiently applicable to all fibroblasts. The second part of this thesis deals with the establishment of a rapid monolayer approach to differentiate neural progenitor cells from iPSCs. To achieve this, a two-step protocol was developed allowing first the formation of a stable, primitive NPC line within 7 days which was expanded for 2-3 passages. In a second step, a subsequent adaptation to conditions yielding neural rosette-like NPCs followed. Both neural lines were demonstrated to be expandable, cryopreservable and negative for the pluripotency marker OCT4. Furthermore, a neural precursor identity including SOX1, SOX2, PAX6, Nestin was confirmed by immunofluorescence and quantitative RT-PCR. Moreover, the differentiation resulted in TUJ1-positive neurons and GFAP-positive astrocytes. Nonetheless, the outcome of glial differentiation from primitive NSCs remained low, whereas FGF/EGF-NPCs were efficiently differentiated into GFAP-positive astrocytes which were implicated in a cellular model of the blood brain barrier. The third and major objective of this study was to generate human early neural progenitor cells from fetal brain tissue with a wide neural differentiation capacity. Therefore, a defined medium composition including small molecules and growth factors capable of modulation of crucial signaling pathways orchestrating early human development such as SHH and FGF was assessed. Indeed, specific culture conditions containing TGFβ inhibitor SB431542, SHH agonist Purmorphamine, GSK3β inhibitor CHIR99021 and basic FGF, but no EGF enabled robust formation of early neuroepithelial progenitor (eNEP) colonies displaying a homogeneous morphology and a high proliferation rate. Moreover, primary eNEPs exhibit a relatively high clonogenicity of more than 23 % and can be monoclonally expanded for more than 45 passages carrying a normal karyotype. Characterization by immunofluorescence, flow cytometry and quantitative RT-PCR revealed a distinct NPC profile including SOX1, PAX6, Nestin and SOX2 and Prominin. Furthermore, primary eNEPs show NOTCH and HES5 activation in combination with non-polarized morphology, indicative of an early neuroepithelial identity. Microarray analysis unraveled SOX11, BRN2 and other HES-genes as characteristic upregulated genes. Interestingly, eNEPs were detected to display ventral midbrain/hindbrain regional identity. The validation of yielded cell types upon differentiation indicates a strong neurogenic potential with more than 90 % of TUJ1-positive neurons. Moreover, astrocytes marked by GFAP and putative myelin structures indicating oligodendrocytes were identified. Electrophysiological recordings revealed functionally active neurons and immunofluorescence indicate GABAergic, glutamatergic, dopaminergic and serotonergic subtypes. Additionally, putative physiological synapse formation was observed by the presence of Synapsin and PSD-95 as well as by ultrastructural examination. Notably, rare neurons stained positive for the peripheral neuronal marker Peripherin suggesting the potential of eNEPS to give rise to cells of neural tube and neural crest origin. By the application of specific differentiation protocols an increase of TH-positive neurons or neural crest-derivatives such as putative A- and C-sensory neurons and mesenchymal cells was identified. Taken together, primary eNEPs might help to elucidate mechanisms of early human neurodevelopment and will serve as a novel source for cell replacement and further biomedical applications. / Patientenspezifische induziert pluripotente Zellen (iPSZ) haben sich als eine vielversprechende Möglichkeit erwiesen Zellen zu gewinnen, die für Krankheitsmodellierung, Arzneimitteltests und Zellersatztherapie in Frage kommen. In dieser Arbeit wurden drei wichtige Fragestellungen adressiert, die für potenzielle biomedizinische Anwendungen von neuralen Stammzellen von großem Interesse sind. Um die Generierung von transgenfreien iPSZ zu ermöglichen, wurden Alternativen zur retroviralen Reprogrammierung entwickelt. Im ersten Teil dieser Arbeit wurden Reprogrammierungsmethoden, die auf deletierbaren, lentiviralen Konstrukten oder nichtintegrativen Verfahren wie Sendaivirus (SeV)-Transduktion und Transfektion synthetischer mRNA basieren, adaptiert und evaluiert. Die daraus resultierenden iPSZ exprimieren die Pluripotenzmarker OCT4, SSEA-4 und TRA1-60. Weiterhin wurde das Potenzial in Zelltypen aller drei Keimblätter zu differenzieren nachgewiesen. Dadurch konnte die pluripotente Identität der proliferativen Kolonien bestätigt werden. Beim Vergleich der angewandten Methoden fielen, bezüglich der generierten iPSZ-Linien, sowohl qualitative als auch quantitative Unterschiede auf. Bei der Verwendung von SeV-Partikeln wurde eine hohe Reprogrammierungseffizienz festgestellt. Bei der Transfektion von mRNAs hingegen war die Reprogrammierungseffizienz deutlich niedriger. Diese war darüber hinaus abhängig von der Passage und dem Genotyp der Ausgangsfibroblasten. Des Weiteren konnte eine klon- und passagenabhängige Präsenz viraler Gene in SeV-iPSZ bis zu 23 Passagen lang beobachtet werden, während bei der mRNA-Transfektion keine Spuren der genetischen Manipulation zurückblieben. Dies verdeutlicht die Bedeutung einer sorgfältigen Qualitätskontrolle bei der Klonselektion im Falle der SeV-iPSZ. Im Gegensatz dazu stellt die Reprogrammierung durch Transfektion synthetischer mRNAs eine völlig nicht-integrative Strategie dar, erfordert allerdings weitere Verfeinerung um das Verfahren effizient und vor allem für alle Fibroblastenpräparationen anwendbar zu machen. Der zweite Teil der Arbeit behandelt die Etablierung eines schnellen, adhärenten Protokolls, um neurale Vorläuferpopulation aus iPSZ zu differenzieren. Um dies zu erreichen, wurde ein zweiphasiges Protokoll entwickelt, welches zunächst die Generierung einer primitiven neuralen Vorläuferzellpopulation innerhalb von 7 Tagen erlaubt. In einem zweiten Schritt erfolgte die Adaptierung an Kulturbedingungen, die eine neurale, rosettenähnliche Zellpopulation induzieren. Beide neuralen Zellpopulationen konnten weiter expandiert und eingefroren werden und waren negativ für den Pluripotenz-assoziierten Transkriptionsfaktor OCT4. Darüber hinaus konnte die neurale Vorläuferidentität mittels positiver Expression von SOX1, SOX2, PAX6 und Nestin bestätigt werden. Eine weitere Differenzierung dieser Zellen resultierte in TUJ1-positiven Neuronen und GFAP-positiven Astrozyten, die die Verwendung der Zellpopulation beispielsweise in einem zellulären Modell der Blut-Hirn-Schranke erlaubten. Das Hauptprojekt dieser Dissertation war es, frühe humane neurale Vorläuferzellen aus fetalem Hirngewebe zu isolieren und in Kultur zu stabilisieren. Diese Population sollte eine breite Differenzierungskapazität aufweisen. Zu diesem Zweck wurde eine chemisch definierte Medienzusammensetzung gewählt, die zusätzlich pharmakologisch wirksame Verbindungen und Wachstumsfaktoren beinhaltet. Hierdurch konnten Signaltransduktionswege wie zum Beispiel der Sonic-Hedgehog- (SHH) oder FGF-Signalweg, die bei der frühen neuralen Entwicklung eine bedeutende Rolle spielen, moduliert werden. In der Tat ermöglichten spezifische Kultivierungsbedingungen, die den TGFβ-Inhibitor SB431542, den SHH-Agonisten Purmorphamin, den GSK3β-Inhibitor CHIR99021 und basisches FGF, jedoch kein EGF enthielten, die robuste Bildung einer früheren neuroepithelialen Vorläuferpopulation (eNEP). Die so stabilisierten Kolonien wiesen eine homogene Morphologie und eine hohe Proliferationsrate auf. Außerdem zeigten sie eine hohe Klonogenitätsrate von 23%, die es ermöglichte monoklonale Zelllinien zu isolieren und für mehr als 45 Passagen zu expandieren. Dabei blieb ein normaler Karyotyp erhalten. Die Zellen zeigten ein eindeutiges neurales Profil, gekennzeichnet durch SOX1, PAX6, Nestin, SOX2 und Prominin-Expression. Weiterhin wiesen eNEPs NOTCH und HES5-Aktivierung in Kombination mit nicht-polarisierter Morphologie auf, was auf eine frühe neuropitheliale Identität hinweist. Eine Microarray-Analyse demonstrierte weiterhin SOX11, BRN2 und einige HES-Gene als charakteristisch hochregulierte Gene. Interessanterweise zeigen eNEPs eine regionale Identität, die auf eine Mittelhirn/Hinterhirn-Regionalisierung hinweist. Die Validierung ungerichtet ausdifferenzierter Zelltypen offenbarte mit einem Kulturanteil von 90% TUJ1-positiven Neuronen ein stark neurogenes Potenzial. Zusätzlich konnten GFAPpositive Astrozyten sowie mögliche Myelinstrukturen, die auf Oligodendrozyten hinweisen, nachgewiesen werden. Elektrophysiologische Aufzeichnungen deuten auf funktionell aktive Neurone hin und Immunofluoreszenzfärbungen zeigten GABAerge, glutamaterge, dopaminerge und serotonerge neuronale Subtypen. Außerdem wurden mittels Immunfluoreszenzanalyse Synapsin- und PSD-95- positive synaptische Strukturen nachgewiesen. Ultrastrukturelle Analysen mittels Transmissionselektronenmikroskopie bestätigten das Ergebnis. Hervorzuheben ist, dass einige Neurone positiv für den peripheren Neuronenmarker Peripherin gefärbt wurden, was darauf hinweist, dass eNEPs das Potenzial besitzen, in Zellen der Neuralleiste zu differenzieren. Durch die Verwendung von spezifischen Differenzierungsprotokollen konnte das Vorkommen TH-positiver und auch möglicher A- und C-sensorischer Fasern, sowie mesenchymaler Zellen nachgewiesen werden. Zusammenfassend lässt sich sagen, dass primäre eNEPs dazu beitragen könnten, die frühe humane Gehirnentwicklung zu verstehen. Darüber hinaus stellen eNEPs eine potentielle zelluläre Quelle für Zellersatztherapien und weitere biomedizinische Anwendungen dar.

<p>Inhibitors belonging to the serpin (serine protease inhibitor) family control proteases involved in various physiological processes. All serpins have a common tertiary structure based on the dominant b-sheet A, but they have different inhibitory specificity. The specificity of a serpin is determined by the Pl-Pl’ peptide bond acting as a bait for the target protease which is made up of an exposed reactive centre loop (RCL). The serpin plasminogen activator inhibitor type-1 (PAI-1) is the main physiological inhibitor of urokinase-type and tissue-type plasminogen activators (uPA and tPA, respectively). Elevated plasma levels of PAI-l have been correlated with a higher risk of deep venous thrombosis, and PAI-1 is a risk factor for recurrent myocardial infarction. Furthermore, PAI-1 has a role in cell migration and has been suggested to regulate tumor growth and angiogenesis. PAI-1 is unique among the serpins in that it can spontaneously and rapidly convert into its latent form. This involves full insertion of the RCL into b-sheet A. </p><p>There were two partially overlapping goals for this thesis. The first was to use latent PAI-1 as model for development of a fluorescence-based method, Donor-Donor Energy Migration for intramolecular distance measurements. The second goal was to use DDEM, together with other biochemical methods, to reveal the structure of the PAI-1/uPA complex, the conformation of the RCL in active PAI-1, and molecular determinants responsible for the conversion of PAI-1 from the active to the latent form.</p><p>The use of molecular genetics for introduction of fluorescent molecules enables the use of DDEM to determine intramolecular distances in a variety of proteins. This approach can be applied to examin the overall molecular dimensions of proteins and to investigate structural changes upon interactions with specific target molecules. In this work, the accuracy of the DDEM method has been evaluated by experiments with the latent PAI-1 for which X-ray structure is known. Our data show that distances approximating the Förster radius (57±1 Å) obtained by DDEM are in good agreement (within 5.5 Å) with the distances obtained by X-ray crystallography.</p><p>The molecular details of the inhibitory mechanism of serpins and the structure of the serpin/protease complex have remained unclear. To obtain the structural insights required to discriminate between different models of serpin inhibition, we used fluorescence spectroscopy and cross-linking techniques to map sites of PAI-1/uPA interaction, and distance measurement by DDEM to triangulate the position of the uPA in the complex. The data have demonstrated clearly that in the covalent PAI-1/uPA complex, the uPA is located at the distal end of the PAI-1 molecule relative to the initial docking site. This indicates that serpin inhibition involves reactive center cleavage followed by full loop insertion, whereby the covalently linked protease is translocated from one pole of the inhibitor to the opposite one. </p><p>To search for molecular determinants that could be responsible for conversion of PAI-1 to the latent form, we studied the conformation of the RCL in active PAI-1 in solution. Intramolecular distance measurements by DDEM, the newly a developed method based on probe quenching and biochemical methods revealed that the RCL in PAI-1 is located much closer to the core of PAI-1 than has been suggested by the recently resolved X-ray structures of stable PAI-1 mutants, and it can be partially inserted. This possibly explains for the ability of PAI-1 to convert spontaneously to its latent form. </p>

<p>Poly(A) polymerase (PAP) is the enzyme catalyzing the synthesis of the adenine tail to the 3’-end of mRNA. This A-tail is present on the majority of the primary RNA transcripts of protein-coding genes, and is important for mRNA stability, export to the cytoplasm and translation. Therefore, PAP is a key regulator of eukaryotic gene expression. This thesis describes the heterogeneity of PAP and the functional significance of multiple isoforms of PAP. </p><p>PAP exists in many different isoforms generated by three different mechanisms, gene duplication, alternative mRNA processing and post-translational modification. In HeLa cell extracts three different forms of PAP being 90, 100 and 106 kDa in size have been detected, where the 106 kDa isoform is a phosphorylated version of the 100 kDa species. It is shown that the N-terminal region of PAP contains a region required for catalysis, while the C-terminal end is important for the interaction with the cleavage and polyadenylation specificity factor (CPSF). Interestingly, it was found that also the extreme N-terminal end is important for the interaction with CPSF. This region is post-translationally modified by phosphorylation. Five alternatively spliced forms of PAP mRNAs are encoded by the PAPOLA gene while one unique species is encoded by the PAPOLG gene. The analysis showed that the exact structure of the alternatively spliced C-terminal end of PAP played an important role for catalytic efficiency. Thus, the C-terminal end contains a region important for modulating the catalytic efficiency of PAP.</p><p>Aminoglycoside antibiotics inhibit PAP activity, most likely by displacement of catalytically important divalent metal ions. Data shows that different aminoglycosides inhibit PAP activity by different mechanisms suggesting that the binding sites for the different aminoglycosides do not completely overlap. It is concluded that aminoglycosides interfere with enzymes important for housekeeping functions in mammalian cell, which may explain some of the toxic side effects caused by aminoglycoside antibiotics in clinical practice.</p>

<p>Conventional cancer treatment based on radiotherapy or chemotherapy affects all dividing cells. By directing the therapy specifically to the tumor cells, normal cells can be spared. Tumor targeting molecules carrying a cytotoxic moiety is then an attractive approach. </p><p>In this thesis, an affibody molecule with high affinity for the protein HER-2, that is strongly associated with aggressive forms of breast cancer, was selected. After radiolabeling with ¹²⁵I, the affibody molecule, in monovalent and bivalent form, was tested <i>in vitro</i> in HER-2 overexpressing tumor cells and in transplanted tumors in mice. </p><p>It was shown that the HER-2 targeting affibody molecule bound its target in a specific manner, both <i>in vitro</i> and <i>in vivo</i>. The small size of the affibody molecule resulted in fast clearance through the kidneys. An impressive tumor-to-blood ratio of 10 eight hours post injection was achieved and the tumors could easily be visualized in a gamma camera. </p><p>The biologic effects of the bivalent affibody molecule and a monovalent affinity maturated version was measured and compared with the effects of the monoclonal antibody trastuzumab. It was found that although all molecules target the same protein, the effects differed greatly.</p><p>The affibody molecule was also labeled with the alpha-emitting radionuclide ²¹¹At. Specific decrease in survival was seen in HER-2 overexpressing cells receiving the ²¹¹At labeled affibody molecule. The sensitivity to the treatment differed between cell lines, probably as a result of differences between the cell lines in internalization and nuclear size. The ²¹¹At labeled affibody molecules were also tested <i>in vivo</i>, where stability of the ²¹¹At label was a problem. To circumvent this problem, more stable conjugation chemistry was tested, as well as strategies to prevent uptake of released ²¹¹At by normal organs.</p><p>This thesis describes the selection and optimization of affibody molecules for medical use for the first time.</p>