Os mini-implantes ortodônticos vem sendo amplamente utilizados na prática clínica como dispositivos de ancoragem. No entanto, há casos em que ocorre sua perda durante o tratamento. Inúmeros aspectos tem sido analisados com o intuito de detectar as causas do insucesso, porém estas ainda não estão totalmente esclarecidas. Portanto, utilizando-se dois grupos de mini-implantes - com estabilidade (sucesso) e sem estabilidade (falha) -, os objetivos do presente estudo in vivo foram: 1) avaliar a contaminação microbiana, empregando sondas de DNA para 40 espécies de bactérias, por meio da técnica de biologia molecular checkerboard DNA-DNA hybridization; 2) quantificar a endotoxina bacteriana presente nos mini-implantes dos dois grupos por meio do teste Limulus Amebocyte Lysate ; e 3) quantificar as citocinas pró-inflamatórias IL-1&alpha;, IL-6, IL-17 e TNF-&alpha; e proteínas marcadoras da osteoclastogênese (RANK, RANKL e OPG) por meio da técnica real-time polymerase chain reaction. Dezesseis pacientes de ambos os sexos (11-49 anos) em tratamento ortodôntico com aparelho corretivo e mini-implantes foram selecionados, sendo obtidos 19 miniimplantes com estabilidade e 10 mini-implantes sem estabilidade. O tempo médio de permanência na boca foi de 23,8 meses para os mini-implantes estáveis e 6,7 meses para os mini-implantes sem estabilidade. Foram utilizados mini-implantes da marca Neodent, com 1,6mm de diâmetro e com 7,0 ou 9,0 mm de comprimento, colocados na maxila e/ou mandíbula. Todos os mini-implantes foram instalados e removidos pelo mesmo cirurgião. No momento da remoção, foram coletados os miniimplantes e amostras de gengiva ao redor dos mesmos. Os mini-implantes foram processados para a detecção dos micro-organismos e para a quantificação da endotoxina bacteriana. As amostras de gengiva foram processadas para a quantificação das citocinas pró-inflamatórias e proteínas marcadoras da osteoclastogênese. Os resultados obtidos foram analisados por meio do teste nãoparamétrico de soma de postos de Wilcoxon, considerando-se os conglomerados, utilizando o software SAS. O nível de significância adotado foi de 5%. Todas (100%) as 40 espécies de microorganismos foram observadas em ambos os grupos de mini-implantes, com diferentes porcentagens de ocorrência. Não foi possível observar diferença entre os grupos com relação aos complexos microbianos (azul, roxo, amarelo, verde, laranja, vermelho e outras espécies). Também não foi possível observar diferença na quantificação de endotoxina e das citocinas e marcadores da osteoclastogênese (p>0,05), com exceção da IL-6 (p<0,05). Baseado nos resultados obtidos, pode-se concluir que a contaminação microbiana e a quantidade de endotoxina nos mini-implantes, assim como a expressão das citocinas pró-inflamatórias IL-1&alpha;, IL-17 e TNF-&alpha; e dos marcadores da osteoclastogênese RANK, RANKL e OPG no tecido gengival circundante não atuaram como fatores responsáveis pela perda da estabilidade dos mini-implantes e que a maior expressão da citocina próinflamatória IL-6 pode estar diretamente relacionada à perda da estabilidade dos mini-implantes, sugerindo-se estudos adicionais. / Orthodontic mini-implants have been widely used in clinical practice as anchorage devices. However, their loss may occur during the treatment. Several aspects have been investigated to identify the causes of failure, but they are not yet completely elucidated. Therefore, using two groups of miniimplants - stable and unstable/loose - the objectives of this in vivo study were: 1) to evaluate the microbial contamination, using DNA probes for 40 bacterial species by the checkerboard DNA-DNA hybridization biomolecular technique; 2) to quantify the bacterial endotoxin present in both groups of mini-implants by the Limulus Amebocyte Lysate assay; and 3) to quantify the proinflammatory cytokines IL-1&alpha;, IL-6, IL-17 and TNF-&alpha; and the osteoclastogenesis marker proteins (RANK, RANKL and OPG) by real-time polymerase chain reaction technique. Sixteen patients of both sexes (11 to 49 years old) under orthodontic treatment with corrective appliance and mini-implants were selected, obtaining 19 stable mini-implants and 10 unstable/loose mini-implants. The mean time of permanence in the mouth was 23.8 months for stable mini-implants and 6.7 months for unstable/loose mini-implants. The mini-implants (1.6 mm diameter x 7.0 or 9.0 mm long; Neodent) were placed in the maxilla and/or mandible. All mini-implants were placed and removed by the same surgeon. At the moment of removal, the mini-implants and periimplant gingival tissue samples were collected. The mini-implants were processed for detection of microorganisms and quantification of bacterial endotoxin, while the gingival tissue samples were processed for quantification of proinflammatory cytokines and osteoclastogenesis protein markers. The results were analyzed statistically by the nonparametric Wilcoxon rank-sum test, considering the conglomerates, using SAS software. A significance level of 5% was adopted for all analyses. All (100%) 40 microbial species were observed in both groups of mini-implants, with different percentages of occurrence. No differences could be observed between the groups with respect to the microbial complexes (blue, purple, yellow, green, orange, red and other species). There was no significant difference either in the quantification of endotoxin and cytokines and osteoclastogenesis markers (p>0.05), except for IL- 6 (p<0.05). Based on the obtained results, it may be concluded that neither the microbial contamination and amount of endotoxin in mini-implants, nor the expression of proinflammatory cytokines IL-1&alpha;, IL-17 and TNF-&alpha; and osteoclastogenesis markers RANK, RANKL and OPG in the periimplant gingival tissue acted as factors responsible for the loss of stability of the mini-implants, and that the higher expression of the IL-6 proinflammatory cytokine may be directly associated with the loss of stability of the mini-implants, suggesting additional studies.

Made available in DSpace on 2014-08-20T14:31:29Z (GMT). No. of bitstreams: 1 dissertacao_ana_paula_de_lara.pdf: 4627911 bytes, checksum: 887ee69dd56b73509c1a603e3b25aebd (MD5) Previous issue date: 2013-03-08 / Bacillus thuringiensis (Bt) is a Gram-positive bacteria, ubiquitous, facultative anaerobic, and form spores. During sporulation produce a parasporal crystals inclusion. Within these inclusions there are δ-endotoxin proteins well known for its insecticides proprieties. Among them, the Cry (crystal) is wide employed for biological control of plagues. The δ-endotoxin has an advantage of been more specific than chemical insecticides, thus been consider more favorable for the environment. The aim of this study was to obtain the Cry 11Aa recombinant protein of Bacillus thuringiensis var. israelensis in Escherichia coli, active for use in biocontrol. Two expression E. coli strains were tested: BL 21 (DE3) C41 and BL 21 (DE3) Ril. The protein Cry 11Aa was expressed and secreted in a soluble form by the two strains. The expression was demonstrated by Western Blot using anti-histidin monoclonal antibody. The strain BL 21 (DE3) C41 express the protein Cry 11Aa ~3.6 times more than the strain Rill, and showed a biologic efficiency of 95% of mortality for Culex quinquefaciatus larvae. The data obtained in this study suggest that the protein recombinant Cry 11Aa expressed in E. coli has a potential to be used in biological control. / Bacillus thuringiensis (Bt) é uma bactéria Gram-positiva, de ocorrência ubíqua, anaeróbica facultativa, formadora de esporos. Produz cristais, como inclusões parasporal durante a esporulação. Estas inclusões contêm proteínas chamadas de δ-endotoxinas, que são bem conhecidas pelas suas propriedades inseticidas. Dentre elas as toxinas Cry (crystal) são largamente empregadas no controle biológico de pragas. As δ-endotoxinas têm a vantagem de serem mais específicos do que os inseticidas químicos sintéticos, portanto, são considerados como agentes de controles favoráveis ao meio ambiente. O objetivo deste estudo foi a obtenção da proteína Cry 11Aa recombinante de Bacillus thuringiensis var. israelensis em Escherichia coli, ativa, para utilização no controle biológico.Duas cepas de E. coli de expressão foram testadas: BL 21 (DE3) C41 e BL 21 (DE3) Ril. A proteína Cry 11Aa foi expressa e secretada na forma solúvel pelas duas cepas. A expressão foi demonstrada por Western blot utilizando-se anticorpo monoclonal anti-histidina. A cepa BL 21 (DE3) C41 expressou a proteína Cry 11Aa ~3.6 vezes mais que a cepa BL 21 (DE3) Ril, e apresentou, em teste biológico, uma eficácia de 95% de mortalidade sobre larvas de Culex quinquefaciatus. Com os dados obtidos neste trabalho podemos sugerir que a proteína recombinante Cry 11Aa expressa em E. coli é um potencial candidato para ser utilizado no controle biológico.

Le choc septique est une défaillance circulatoire aiguë déclenchée par un agent infectieux, entraînant des désordres hémodynamiques, métaboliques et viscéraux, en raison notamment de la libération de cytokines proinflammatoires. Le taux de mortalité est élevé (environ 40 %). L’évolution des sepsis sévères est souvent compliquée par des phénomènes thrombotiques qui résultent en partie de l’activation de la coagulation par les agents infectieux, mais aussi de la libération de Neutrophil Extracellular Traps (NETs) par les polynucléaires neutrophiles. Ainsi, chez ces patients, une coagulation intravasculaire disséminée (CIVD) est souvent observée, caractérisée par un état d’équilibre instable, où co-existent un risque thrombotique et un risque hémorragique, dû à la consommation des facteurs de coagulation.Plusieurs études ont suggéré que l’administration d’antithrombine (AT) ou de Protéine C activée diminuait la mortalité, non seulement en diminuant l’activation de la coagulation, mais aussi en ayant des effets cytoprotecteurs et anti-inflammatoires indépendants de leur activité anti-coagulante. Toutefois, leurs effets cytoprotecteurs nécessitent l’administration de doses élevées, responsables d’hémorragies.L’inhibiteur dépendant de la protéine Z (ZPI), appartient à la superfamille des serpines, comme l’AT, mais n’inhibe que les facteurs Xa (FXa) et XIa (FXIa). L’inhibition du FXa est potentialisée par la Protéine Z (PZ), un facteur vitamine K-dépendant, qui circule dans le plasma lié au ZPI. Dans un modèle en sang total, j’ai observé que le ZPI exerce un effet inhibiteur sur la production de cytokines pro-inflammatoires (IL-6 et TNF-α) en réponse au lipopolysaccharide (LPS). A forte concentration (4 fois la concentration physiologique), l’effet anti-inflammatoire (EAI) du ZPI n’est pas modifié par l’ajout de PZ ou d’héparine non fractionnée, qui majorent l’effet anticoagulant du ZPI. De plus, l’EAI persiste avec un variant de ZPI muté sur son site actif (ZPI Y387A), suggérant que le ZPI possède un EAI indépendant de son activité anticoagulante. In vitro, en sang total, le ZPI augmente précocement la production de CCL-5, une chimiokine ayant des propriétés anti-inflammatoires. Ces observations ont été confirmées dans un modèle d’endotoxinémie in vivo, chez la souris, en injectant par voie intra-péritonéale du LPS. Les souris qui avaient reçu simultanément du ZPI recombinant humain ont un taux plasmatique plus faible d’IL-6 et de TNF α que les souris contrôles et un taux plus élevé de CCL-5 dans le lavage péritonéal.De plus, nous avons mis en évidence, en milieu purifié, que l’élastase neutrophile, une enzyme libérée à la surface des NETs induisait plusieurs clivages du ZPI. Le premier clivage se produit au niveau de la boucle réactive du ZPI, qui perd alors son activité inhibitrice sur les FXa et FXIa. La PZ ne protège pas le ZPI de sa dégradation par l’élastase. La dégradation du ZPI induite par les NETs pourrait participer à leurs propriétés procoagulantes.Enfin, en collaboration avec l’équipe du Service de Réanimation du CHU de Strasbourg, nous avons étudié les variations des taux plasmatiques de PZ et ZPI chez 100 patients atteints de sepsis sévère. Dans les premières 24 heures, nous avons observé une diminution du taux de PZ par rapport à une groupe de sujets sains, et à l’inverse, une augmentation d’environ 2,5 fois du taux de ZPI. Ce taux élevé de ZPI persiste à J3 et J7, alors que le taux de PZ augmente. Les variations de PZ ou ZPI ne sont pas prédictifs de la mortalité à 30 jours ni de l’apparition d’une CIVD.Ces résultats suggèrent que des doses élevées de ZPI (4 fois la concentration physiologique) pourraient constituer un traitement adjuvant du choc septique, en diminuant la production de cytokines pro-inflammatoires, avec un risque hémorragique faible, puisque l’inhibition du FXIa a des activités antithrombotiques dépourvues de risque hémorragique. / Septic shock is an acute circulatory failure caused by an infectious agent, resulting in hemodynamic, metabolic and visceral disorders, in particular due to pro-inflammatory cytokines. The mortality rate is high (about 40 %). Progression of severe sepsis is often complicated by thrombotic events, in part because of a direct coagulation activation by bacteria, but also because of Neutrophil Extracellular Traps (NETs) released by polymorphonuclear neutrophils. Disseminated intravascular coagulation (DIC) is frequently present in these patients, characterized by an unstable equilibrium, where thrombotic and bleeding risks coexist, due to the consumption of coagulation factors.Several studies suggested that administration of coagulation inhibitors, such as antithrombin (AT) or activated Protein C, decreased mortality, not only by preventing the activation of coagulation, but also through their cytoprotective and anti-inflammatory effects, independent of their anticoagulant activity. However, the cytoprotective effects require the administration at very high doses, leading to a bleeding tendency.The protein Z-dependent protease inhibitor (ZPI) belongs to the serpin superfamily, as AT, but in contrast to AT, inhibits only factors Xa (FXa) and XIa (FXIa) of coagulation. FXa inhibition by ZPI is potentiated by Protein Z (PZ), a vitamin K-dependent factor, which circulates in plasma in a complex with ZPI. In a whole blood model, I observed that ZPI exerts an inhibitory effect on lipopolysaccharide (LPS)-induced pro-inflammatory cytokines production (IL-6 and TNF-α). At high concentration (4 times physiological concentration), ZPI anti-inflammatory effect (AIE) is not modified by PZ or unfractionned heparin, which increase ZPI anticoagulant activity. Moreover, this AIE is still present using a reactive center loop variant of ZPI (ZPI Y387A), suggesting that the AIE of ZPI is independent of its anticoagulant activity. In vitro, in whole blood, ZPI induced an early increased of CCL-5, a chemokine with anti-inflammatory properties. These data are confirmed in vivo in a murine model of endotoxin shock where LPS is injected intraperitoneally. Simultaneously injection of recombinant human ZPI (rhZPI) with LPS led to lower plasma levels of IL-6 and TNF-α than in control mice, whereas higher CCL-5 levels were observed in peritoneal lavages.In addition, using purified proteins, we have shown that neutrophil elastase, an enzyme which decorates NETs, induces several cleavages of rhZPI. A quick and first cleavage is observed on the reactive centre loop of ZPI, inducing a loss of inhibitory activity towards FXa and FXIa. PZ does not protect ZPI from elastase degradation. ZPI proteolysis induced by NETs could contribute to their procoagulant activity.Lastly, in collaboration with the intensive care unit of Strasbourg Hospital, we studied plasma levels of PZ and ZPI in 100 patients with severe sepsis. During the first 24 hours, there was a significant decrease of plasma PZ levels, compared to levels of healthy subjects, whereas an approximately 2.5 times increase was observed for ZPI levels. These high levels of ZPI were still present at D3 and D7, whereas PZ levels regularly increased. Variations of PZ and ZPI levels were not predictive of the 30-day mortality rate, and not associated with DIC development.These results suggest that elevated concentrations of ZPI (4 times physiological concentration) could be an adjuvant therapy to septic shock, by decreasing pro-inflammatory cytokines production, but devoid of bleeding risk, since FXIa inhibition has antithrombotic activity without inducing haemorrhages.

Tesis por compendio / [ES] Esta tesis doctoral titulada "Nanopartículas de sílice mesoporosas funcionalizadas con puertas moleculares para aplicaciones biomédicas" está centrada en el diseño y la síntesis de nuevos nanosistemas sensores y terapéuticos con aplicaciones en el campo clínico y medioambiental. En la introducción de esta tesis (capítulo uno) se presenta una visión general de conceptos básicos de nanotecnología, química supramolecular, nanopartículas de sílice mesoporosa y de puertas moleculares. A continuación, se presentan los objetivos generales y específicos que se van a desarrollar en los capítulos experimentales siguientes. En el tercer capítulo se presenta el diseño, síntesis y caracterización de un nanodispositivo para la detección de endotoxina en medios acuosos. El nanodispositivo está basado en nanopartículas de sílice mesoporosa con los poros cargados con rodamina B y su superficie externa funcionalizada con grupos carboxilato. Los poros se bloquean, para evitar la liberación de la rodamina B, con polimixina B, un péptido con carga positiva. En presencia de la endotoxina, la polimixina B es desplazada de la superficie de las nanopartículas y se activa la liberación de la rodamina B del interior de los poros a la disolución. Esta liberación genera un aumento significativo de la fluorescencia en la disolución permitiendo la detección de la endotoxina. La respuesta obtenida con el nanodispositivo es muy selectiva ya que otras especies como el arabinogalactan, el ß-(1,3)-D-glucano, la pectina, el EDTA, la glucosa, el GTP y el polvo no son capaces de inducir la apertura de los poros y la liberación de la rodamina B. Además, el nanodispositivo presenta un límite de detección para la endotoxina en el rango picomolar. En el cuarto capítulo se describe un nanodispositivo, basado en nanopartículas de sílice mesoporosa cargadas con rodamina B y tapadas con curcumina, que se emplea para la detección selectiva de seroalbúmina humana (HSA) mediante medidas de fluorescencia. En este nanodispositivo, de nuevo, la presencia de HSA es capaz de desplazar la curcumina de la superficie de las nanopartículas permitiendo la liberación controlada de la rodamina B. El nanodispositivo preparado presentó una respuesta muy selectiva hacia la HSA con un límite de detección tan bajo como 0.1 mg/mL en PBS (pH 7.4)-acetonitrilo 95:5 v/v. El capítulo cinco está centrado en la preparación de un nanodispositivo para la liberación sinérgica del antibiótico linezolida en presencia de bacterias Gram negativas. Este nanomaterial está basado en el empleo de nanopartículas de sílice mesoporosa (como soporte inorgánico) con los poros cargados con linezolida y con la superficie externa funcionalizada con el antibiótico disruptor de membrana polimixina B (mediante interacciones electrostáticas). Cuando estas nanopartículas entran en contacto con bacterias Gram negativas el lipopolisacárido (LPS) de sus membrabas induce el desplazamiento de la polimixina B que actúa eficientemente como permeador y permite la liberación de la linezolida. La liberación simultánea de linezolida y la polimixina B en forma de nanoformulación inducen una reducción significativa de los valores del IC50 para bacterias cuando se compara con los valores obtenidos empleando de forma individual ambas especies. El capítulo sexto está dedicado a la discusión de los resultados experimentales descritos en los capítulos tres, cuatro y cinco. Finalmente, el capítulo siete de esta tesis doctoral, presenta las conclusiones generales que se derivan del trabajo experimental realizado. También se presentan las perspectivas futuras en el campo de las aplicaciones biomédicas de las nanopartículas de sílice mesoporosa con puertas moleculares. Esperamos que los resultados que se presentan en esta tesis doctoral puedan abrir nuevas oportunidades de investigación en el desarrollo de nuevos nanodispositivos inteligentes que puedan actuar como agentes antimicrobianos. / [CAT] Aquesta tesi doctoral titulada "Nanopartícules de sílice mesoporoses funcionalitzades amb portes moleculars per a aplicacions biomèdiques" està centrada en el disseny i la síntesi de nous nanosistemes sensors i terapèutics amb aplicacions en el camp clínic i mediambientals. En la introducció d'aquesta tesi (capítol un) es presenta una visió general de conceptes bàsics de nanotecnologia, química supramolecular, nanopartícules de sílice mesoporosa i de portes moleculars. A continuació, es presenten els objectius generals i específics que es desenvoluparan en els capítols experimentals següents. En el tercer capítol es presenta el disseny, síntesi i caracterització d'un nanodispositiu per a la detecció d'endotoxina en mitjans aquosos. El nanodispositiu està basat en nanopartícules de sílice mesoporosa amb els porus carregats amb rodamina B i la seua superfície externa funcionalitzada amb grups carboxilat. Els porus es bloquegen, per a evitar l'alliberament de la rodamina B, amb polimixina B, un pèptid amb càrrega positiva. En presència de l'endotoxina, la polimixina B és desplaçada de la superfície de les nanopartícules i s'activa l'alliberament de la rodamina B de l'interior dels porus a la dissolució. Aquest alliberament genera un augment significatiu de la fluorescència en la dissolució permetent la detecció de l'endotoxina. La resposta obtinguda amb el nanodispositiu és molt selectiva ja que altres espècies com l'arabinogalactan, el ß-(1,3)-D-glucà, la pectina, l'EDTA, la glucosa, el GTP i la pols no són capaços d'induir l'obertura dels porus i l'alliberament de la rodamina B. A més, el nanodispositiu presenta un límit de detecció per a l'endotoxina en el rang picomolar. En el quart capítol es descriu un nanodispositiu, basat en nanopartícules de sílice mesoporosa carregades amb rodamina B i tapades amb curcumina, que s'empra per a la detecció selectiva de seroalbúmina humana (HSA) mitjançant mesures de fluorescència. En aquest nanodispositiu, de nou, la presència de HSA és capaç de desplaçar la curcumina de la superfície de les nanopartícules permetent l'alliberament controlat de la rodamina B. El nanodispositiu preparat va presentar una resposta molt selectiva cap a la HSA amb un límit de detecció tan baix com 0.1 mg/ml en PBS (pH 7.4)-acetonitril 95:5 v/v. El capítol cinc està centrat en la preparació d'un nanodispositiu per a l'alliberament sinèrgic de l'antibiòtic linezolida en presència de bacteris Gram negatives. Aquest nanomaterial està basat en l'ús de nanopartícules de sílice mesoporosa (com a suport inorgànic) amb els porus carregats amb linezolida i amb la superfície externa funcionalitzada amb l'antibiòtic disruptor de membrana polimixina B (mitjançant interaccions electroestàtiques). Quan aquestes nanopartícules entren en contacte amb bacteris Gram negatives el lipopolisacàrid (*LPS) de les seues membranes indueix el desplaçament de la polimixina B que actua eficientment com permeador i permet l'alliberament de la linezolida. L'alliberament simultani de linezolida i la polimixina B en forma de nanoformulació indueixen una reducció significativa dels valors de l'IC50 per a bacteris quan es compara amb els valors obtinguts emprant de manera individual totes dues espècies. El capítol sisé està dedicat a la discussió dels resultats experimentals descrits en els capítols tres, quatre i cinc. Finalment, el capítol set d'aquesta tesi doctoral, presenta les conclusions generals que es deriven del treball experimental realitzat. També es presenten les perspectives futures en el camp de les aplicacions biomèdiques de les nanopartícules de sílice mesoporosa amb portes moleculars. Esperem que els resultats que es presenten en aquesta tesi doctoral puguen obrir noves oportunitats d'investigació en el desenvolupament de nous nanodispositius intel·ligents que puguen actuar com a agents antimicrobians / [EN] This PhD thesis entitled "Gated mesoporous silica nanoparticles for biomedical applications" is focused on the design and synthesis of novel nanodevices for sensing and therapeutic applications in clinical and environmental fields. The first introductory chapter presented an overview of the different concepts related to nanotechnology, supramolecular chemistry, mesoporous silica nanoparticles (MSNs), and molecular gates. Next, the general and specific objectives of this PhD thesis, that are addressed in the different experimental chapters, are presented. The third chapter presented the design, synthesis, and characterization of a nanodevice for endotoxin detection in aqueous environments. The prepared nanodevice is based on mesoporous silica nanoparticles loaded rhodamine B and with its external surface functionalized with carboxylates. Pores are finally capped upon addition of cationic polymyxin B peptide. In the presence of endotoxin, polymyxin B is detached from the surface of the nanoparticles with subsequent rhodamine B release from the inner of the pores to the solution. This release generated a marked emission enhancement in solution which allow endotoxin detection. The obtained response was highly selective to endotoxin because other interfering agents such as arabinogalactan, ß-(1,3)-D-glucan, pectin, EDTA, glucose, GTP and dust were unable to induce pore opening and rhodamine B release. Besides, the system detects endotoxin with a limit of detection in the picomolar range. The fourth chapter presented a nanodevice, based on mesoporous silica nanoparticles loaded with rhodamine B and capped with anionic curcumin, which is used for the selective and sensitive fluorogenic detection of human serum albumin (HSA). Again, in the presence of HSA, curcumin was detached from nanoparticles surface allowing rhodamine B release. Prepared nanodevice showed a highly selective response toward HSA with a limit of detection for HSA as low as 0.1 mg/mL in PBS (pH 7.4)-acetonitrile 95:5 v/v. Chapter five focus on the design and synthesis of a nanodevice for the synergic release of linezolid antibiotic in the presence of Gram-negative bacteria. This nanodevice is based on the use of mesoporous silica nanoparticles (as inorganic support) with the pores loaded with linezolid and capped with the membrane disruptor polymyxin B through electrostatic interactions. When these particles enter in contact with Gram-negative bacterium, lipopolysaccharide (LPS) present in the cell membrane induces the detachment of polymyxin B, which acts as membrane permeator, from the nanodevice allowing linezolid release. Simultaneous release of linezolid and polymyxin B as a nanoformulation induced a marked reduction in the IC50 values for bacteria when compared to the values obtained using free linezolid and polymyxin B alone. The sixth chapter is devoted to the discussion of the experimental results described in the previous chapters. Finally, the seventh chapter of this PhD thesis, presented the main conclusions, derived from the experimental work, and future perspectives in the field of gated mesoporous silica nanoparticles for biomedical applications. We hope that the results achieved in this PhD thesis will open new research opportunities to develop advanced smart nanodevices as antimicrobial drugs / Otri, I. (2023). Gated Mesoporous Silica Nanoparticles for Biomedical Applications [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/194710 / Compendio

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Die Störung der intestinalen Mikrozirkulation gilt als ein kardinaler Mechanismus für die Entwicklung des Multiorganversagens bei Sepsis. Da das Intestinum für mikrozirkulatorische Studien klinisch kaum zugänglich ist, wurden die Auswirkungen einer Therapie mit den antioxidativen Substanzen Oxypurinol und U-74389G (Lazaroid) bzw. den vasoaktiven Substanzen Iloprost (Prostacyclin-Analogon) und Dopexamin auf die intestinale Mikrozirkulation und die systemische Mediatorfreisetzung in einem Tiermodell mit moderater und hoher Endotoxin-Belastung untersucht. Die intravitalmikroskopische Untersuchung der Kapillarperfusion in der Muskularisschicht bei Endotoxinämie erbrachte eine Verbesserung durch Oxypurinol- und Dopexamingabe. Die Perfusion der Mukosa konnte vor allem durch eine Iloprostapplikation gesteigert werden. Die Endotoxin-induzierte, intestinale Leukozytenadhärenz wurde insbesondere durch die Behandlung mit den antioxidativen Substanzen vermindert. Beide therapeutischen Optionen bewirkten eine ca. 60 %ige Reduktion der initialen Tumornekrosefaktor-alpha-Freisetzung in der Versuchsreihe mit der niedrigeren Endotoxin-Dosis. Parallel dazu konnte anhand von Malondialdehyd-Analysen gezeigt werden, dass Oxypurinol und U-74389G wirksam die intestinale, Radikal-induzierte Lipidperoxidation verringerten. Der intestinale mikrovaskuläre Blutfluss konnte durch beide vasoaktiven Substanzen - sowohl bei moderater als auch bei erhöhter Endotoxin-Dosierung - signifikant gesteigert werden. Die Ergebnisse beider Teilstudien bestätigten, dass sowohl reaktive Sauerstoffspezies als auch eine inadäquate Perfusion in der Mikrozirkulation wesentliche pathogenetische Faktoren bei Endotoxinämie bzw. Sepsis darstellen und entsprechende Therapieformen indiziert und effektiv sind. Eine kombinierte Gabe beider Substanzklassen erscheint daher sinnvoll und sollte in weiteren tierexperimentellen und klinischen Studien evaluiert werden. / The disturbance of the intestinal microcirculation is regarded as a pivotal mechanism in the development of multiorgan failure related to sepsis. Since the intestine is clinically not accessible for microcirculatory studies, the effects of a therapy with the antioxidants oxypurinol and U-74389G (lazaroid) as well as the vasoactive substances iloprost (a prostacyclin analogue) and dopexamine on the intestinal microcirculation and the systemic mediator release was studied in an animal model with moderate and high endotoxin challenge. The intravital microscopic examination of the capillary perfusion in the muscularis layer of the intestine during endotoxemia revealed an improvement by administration of oxypurinol and dopexamine. The perfusion of the mucosa could be increased by iloprost administration. The amount of the endotoxin induced, intestinal leukocyte adherence was especially decreased by the treatment with the antioxidants. Both therapeutic options caused a 60 % reduction in the initial tumor necrosis factor-alpha-release in the experiments with the lower endotoxin dose. Malondialdehyde analyses showed that oxypurinol and U-74389G reduced effectively the intestinal, radical-induced lipid peroxidation. The intestinal microvascular blood flow could be significantly increased by both vasoactive substances - as well as with moderately than also with elevated endotoxin-dosage. The results of the study confirmed that both reactive oxygen-species as well as an inadequate perfusion in the microcirculation represent essential pathogenetic factors during endotoxemia as well as sepsis and index corresponding therapy-forms and participates effective. A combined offering both substance-classes appears therefore meaningfully and should be evaluated in further experimental and clinical studies.

Charakteristisch für Perlcellulose als Regenerat vom Typ Cellulose II sind sphärisch geformte, poröse Partikel mit einer hohen spezifischen Oberfläche und einer guten Bioverträglichkeit. Aufgrund ihrer Eigenschaften sind diese Cellulosemikropartikel besonders gut für medizinische Anwendungen geeignet. Im Mittelpunkt der Arbeit standen Herstellung, Charakterisierung und Modifizierung von Perlcellulosen mit Partikelgrößen von etwa 1 bis10 µm. Im Rahmen der Arbeit wurden zunächst sieben technische Cellulose-2,5-acetate mit vergleichbaren molekularen Eigenschaften auf ihre Eignung zur Herstellung von Perlcellulose nach dem in EP0750007 beschriebenen Acetatverfahren untersucht. Dabei erfolgte der Vergleich verschiedener Eigenschaften. Aus allen untersuchten Celluloseacetaten können Perlcellulosen synthetisiert werden. Als besonders geeignet erwies sich ein Produkt mit einer Molmasse von über 100.000, einem Verhältnis der Molmasse zur numerischen Molmasse von etwa 1,5 und einer guten Löslichkeit in Ethylacetat / Methanol (100:17,5). Die hergestellte Perlcellulose hat eine geringe Partikelgröße und eine relativ enge Größenverteilung. Damit erfüllt dieses Cellulose-2,5-acetat alle Anforderungen für die Synthese von Perlcellulose. Der entscheidende Verfahrensschritt zur Herstellung von Perlcellulose ist das Dispergieren der Emulsion mittels Inline-Ultraturrax. Die Partikelgrößenverteilung hängt im Wesentlichen von den Bedingungen während des Dispergierens ab. Im Rahmen der Arbeit gelang die reproduzierbare Herstellung von Cellulosemicrospheres mit einer Partikelgröße unter 5 µm. Für die Herstellung von Cellulosemikropartikeln mit definierten Eigenschaften ist neben den Synthesebedingungen auch die Charakterisierung der Perlcellulosen von entscheidender Bedeutung. Dafür wurden zunächst etablierte Verfahren verwendet (Partikelgrößenmessung, REM und Quecksilberporosimetrie). Parallel dazu erfolgte die Entwicklung bzw. Einführung neuer Methoden. Im Vordergrund stand die Untersuchung des Sedimentationsverhaltens der Perlcellulosen durch analytisches Zentrifugieren. Davon ausgehend konnte ein Verfahren zur Berechnung der Porosität aus dem Sedimentationsvolumen entwickelt werden. Zum Nachweis der kompletten Deacetylierung der Proben wurde die Ramanspektroskopie genutzt. Durch die Anwendung vorhandener und die Entwicklung neuer Methoden wird die genaue Einstellung von Eigenschaften der Perlcellulosen (z. B. Partikelgröße und deren Verteilung, Morphologie sowie Porosität) ermöglicht und deren Reproduzierbarkeit gewährleistet. Weitere Versuche hatten die Entwicklung von Endotoxinadsorbermaterial auf Basis von Perlcellulose und Polymyxin-B-sulfat (PMB) zum Ziel. Die Kopplung des PMB erfolgte meist nach Aktivierung der Proben mit Epichlorhydrin. Zunächst wurde die eingesetzte Epichlorhydrinmenge variiert, um das Optimum für die Aktivierung der Perlcellulosen zu finden. Weiterhin wurden unterschiedliche Mengen PMB angebunden und die Anbindung an nicht aktivierte Proben untersucht. Die Planung aller Versuche erfolgte jeweils nach Auswertung der an der Donau-Universität Krems durchgeführten Limulus- Amöbocyten- Lysat (LAL)-Tests. Mittels dieser Batchtests wurde die Wirksamkeit des Endotoxinadsorbermaterials sowohl im Vergleich zu unbehandeltem Blutplasma und als auch zu kommerziell erhältlichen Adsorbern auf Polystyrenbasis getestet. Endotoxinadsorber, die bei diesen Tests besonders gut bewertet wurden, konnten in einem up-scale- Versuch erstmals in größeren Mengen synthetisiert werden. Auch die direkte Herstellung von Endotoxinadsorbermaterial aus Perlcelluloseacetat konnte realisiert werden. Bei diesem neu entwickelten Verfahren erfolgen Deacetylierung und Aktivierung in einem Schritt. Damit kann die Herstellung vereinfacht werden. Zur Gewährleistung der Erstfehlersicherheit in extrakorporalen Blutreinigungssystemen sollen magnetisierte Perlcellulosepartikel als bioverträgliche Marker eingesetzt werden. Versuche zur Magnetisierung von Cellulosemikropartikeln während des Herstellungsprozesses zeigten, dass die Einbindung von Magnetit bei Erhalt der sphärischen Partikelstruktur prinzipiell auch auf diesem homogenen Syntheseweg möglich ist.:1. EINLEITUNG 3 2. THEORETISCHE GRUNDLAGEN 5 2.1 CELLULOSE 5 2.1.1 Molekulare Struktur 7 2.1.2 Morphologische Struktur 9 2.1.3 Polymorphie 9 2.1.3.1 Native Cellulose 11 2.1.3.2 Weitere Cellulosemodifikationen 12 2.1.3.3 Umwandlung von Cellulose I in Cellulose II 13 2.1.4 Aktivierung 15 2.2 CELLULOSEACETAT 17 2.2.1 Herstellung 17 2.2.1.1 Technische Herstellung 18 2.2.1.2 Homogene Herstellungsmethoden 19 2.2.2 Eigenschaften und Charakterisierung 20 2.2.3 Verwendung 21 2.3 PERLCELLULOSE 22 2.3.1 Herstellung 23 2.3.1.1 Sprühverfahren 23 2.3.1.2 Suspensionsverfahren 24 2.3.1.3 Acetatverfahren 24 2.3.2 Charakterisierung 26 2.3.2.1 Partikelgröße und Partikelgrößenverteilung 26 2.3.2.2 Porosität 27 2.2.2.3 Quellwert 28 2.3.2.4 Weitere Methoden 28 2.3.3 Verwendung 30 2.3.3.1 Perlcellulose als Adsorbermaterial 30 2.3.3.2 Adsorption von Endotoxinen 31 2.3.4 Magnetisierung 36 2.3.4.1 Einsatz und Herstellung magnetischer Partikel 36 2.3.4.2 Einbindung von Magnetit in Perlcellulose 39 3. HERSTELLUNG VON PERLCELLULOSE 41 3.1 CELLULOSEACETAT ALS AUSGANGSSTOFF FÜR DIE SYNTHESE VON PERLCELLULOSE 41 3.1.1 Charakterisierung von Celluloseacetaten 41 3.1.1.1 Löslichkeit 41 3.1.1.2 Trübungsmessungen 42 3.1.1.3 Molmassenverteilung 44 3.1.1.4 Verteilung der Substituenten 45 3.1.1.5 Bestimmung des Substitutionsgrades mittels NMR und SEC 46 3.1.2 Einfluss der Celluloseacetate auf die Eigenschaften der Perlcellulose 47 3.1.2.1 Herstellung der Perlcellulosen 47 3.1.2.2 Messung der Partikelgröße 48 3.1.2.3 Charakterisierung der Perlcellulosen mittels Rasterelektronenmikroskopie 49 3.1.3 Schlussfolgerungen 51 3.2 HERSTELLUNG VON PERLCELLULOSE MIT DEFINIERTEN EIGENSCHAFTEN 52 3.2.1 Bildung der Celluloseperlen 52 3.2.2 Dispergieren im Inline- Ultraturrax 54 3.2.2.1 Einfluss der Drehzahl 54 3.2.2.2 Mehrfaches Dispergieren 56 3.2.2.3 Geschwindigkeit der Schlauchpumpe 58 3.2.2.4 Vergleich der Ergebnisse 59 3.2.3 Zusammensetzung der Emulsion 60 3.2.3.1 Salzgehalt 61 3.2.3.2 Methylcellulosekonzentration 62 3.2.3.3 Ethylacetatkonzentration 63 3.2.3.4 Tensidgehalt 65 3.2.3.5 Gleichzeitige Veränderung mehrerer chemischen Parameter 66 3.2.4 Aufbereitung des Perlcelluloseacetats 68 3.2.4.1 Abrotieren der Lösungsmittel 68 3.2.4.2 Reinigung und Deacetylierung 69 3.2.5 Standardbedingungen 69 4. CHARAKTERISIERUNG VON PERLCELLULOSEN 70 4.1 PARTIKELGRÖßENMESSUNG 70 4.2 RASTERELEKTRONENMIKROSKOPIE 70 4.3 QUECKSILBERPOROSIMETRIE 71 4.4 SEDIMENTATIONSVERHALTEN 73 4.4.1 Sedimentationsgeschwindigkeit 73 4.4.2 Berechnung der mittleren Teilchengröße 79 4.4.3 Sedimentationsvolumen 82 4.5 BESTIMMUNG DER POROSITÄT AUS DEM SEDIMENTATIONSVOLUMEN 83 4.5.1 Porositätsuntersuchungen an einer analytischen Multiprobenzentrifuge 83 4.5.2 Porositätsuntersuchungen an einer Laborzentrifuge 84 4.5.3 Vergleich der ermittelten Porositätswerte 85 4.6 RAMANSPEKTROSKOPIE 87 5. PERLCELLULOSE ALS ENDOTOXINADSORBERMATERIAL 88 5.1 ENTWICKLUNG VON ENDOXINADSORBERN AUF BASIS VON PERLCELLULOSE 88 5.1.1 Aktivierung von Perlcellulose 88 5.1.2 Anbindung von Polymyxin-B-Sulfat 90 5.2 CHARAKTERISIERUNG UND OPTIMIERUNG DES ENDOTOXINADSORBERMATERIALS 90 5.3 UP- SCALE- VERSUCH 96 5.4 WEITERE VERSUCHE MIT PERLCELLULOSE 98 5.5 ANBINDUNG VON PMB AN PERLCELLULOSEACETAT 102 5.6 BEWERTUNG UND AUSBLICK 107 6. MAGNETISCHE MARKERPARTIKEL AUF BASIS VON PERLCELLULOSE 109 6.1 HOMOGENE EINBINDUNG VON MAGNETIT IN PERLCELLULOSE 109 6.1.1 Auswahl des Dispergiergerätes 111 6.1.2 Optimierung der BUT- Drehzahl und der Dispergierzeit 112 6.1.3. Versuche mit Methylcellulose als Schutzkolloid 120 6.2 CHARAKTERISIERUNG DER MAGNETISIERTEN PERLCELLULOSEPARTIKEL 122 6.2.1 Partikelgröße 122 6.2.2 Rasterelektronenmikroskopie 124 6.2.3 Energiedispersive Röntgenmikroanalyse 126 6.2.4 Bestimmung des Eisengehaltes mittels AAS 128 6.2.5 Magnetische Messungen 129 6.3 BEWERTUNG DER BISHERIGEN ERGEBNISSE 130 7. ZUSAMMENFASSUNG UND AUSBLICK 132 8. EXPERIMENTELLES 135 8.1 CHEMIKALIEN 135 8.2 METHODISCHES 135 8.3 PRÄPARATIONSVORSCHRIFTEN UND ARBEITSANLEITUNGEN 136 8.3.1 Herstellen der Ausgangslösungen 136 8.3.2 Herstellung der Perlcellulosen 137 8.3.2.1 Herstellung des Perlcelluloseacetates 137 8.3.2.2 Deacetylierung des Perlcelluloseacetates 138 8.3.3 Aktivierung von Perlcellulosen 138 8.3.4 Herstellung von Endotoxinadsorbermaterial 138 8.3.5 Magnetitanbindung 139 LITERATUR 140 ABKÜRZUNGSVERZEICHNIS 152 ABBILDUNGSVERZEICHNIS 154 TABELLENVERZEICHNIS 158 / Bead cellulose is regenerated cellulose II characterized by spherically shaped, porous particles with a high specific surface and a good biocompatibility. Because of their properties these cellulose microspheres are especially suited for medical applications. The focus of this work was the synthesis, characterization and modification of bead cellulose with particle sizes between 1 to 10 µm. In the frame of this work seven technical cellulose-2.5-acetates were investigated with regard to their suitability for making bead cellulose according to the process described in EP0750007. These cellulose acetates have comparable molecular characteristics. Different properties were compared. Bead celluloses can be synthesized from all investigated cellulose acetates. A product with a molecular weight of more than 100,000 and with a ratio between molecular weight and numeric molecular weight of about 1.5 is special suited. This cellulose-2.5-acetate has a good solubility in ethyl acetate / methanol (100:17.5). The bead cellulose made from it has a low particle size and a relative narrow size distribution. Thus this cellulose acetate complies with the requirements for making bead cellulose. The most important process step for making bead cellulose is the dispersing of the emulsion using an inline-ultraturrax. The distribution of particle size depends mainly on the conditions during dispersing. A reproducible synthesis of cellulose microspheres with a particle size range below 5 µm was successfully achieved. In addition to determining conditions for manufacturing bead cellulose the characterization of the microspheres is essential to obtain bead cellulose with well defined properties. At first well-established methods of characterization were used (particle size measurement, SEM and mercury porosimetry). In parallel new methods were developed and implemented. The main focus was the investigation of sedimentation behaviour of bead cellulose using analytical centrifugation. Based on this knowledge of the sedimentation volume a new method to calculate the porosity was designed. Raman spectroscopy was used for detecting the complete deacetylation of the samples. By using well-established and newly developed methods properties of bead cellulose such as particle size and distribution, morphology and porosity can be accurately adjusted. In this way the reproducible synthesis of cellulose microspheres can be ensured. The aim of further experiments was to develop an endotoxin adsorber material based on a coupling of bead cellulose with Polymyxin B sulfate (PMB). The coupling with PMB was carried out after activation of the samples by using epichlorohydrin. At first the added epichlorohydrin amount was diversified in order to find the optimum for the activation of bead cellulose. Later the coupling of different amounts of PMB took place and the linking of PMB to non activated samples was investigated too. The planning of all experiments occurred after evaluation of Limulus amebocyte lysate (LAL) tests at Danube-University Krems. Using these batch tests the effectiveness of the endotoxin adsorber material was tested compared to untreated blood plasma as well as commercial available adsorbers based on polystyrene. Endotoxin adsorbers showing the best adsorption rate were then synthesized for the first time in larger quantities. Also the direct synthesis of endotoxin adsorber material based on bead cellulose acetate could be realized. Using this newly developed method, deacetylation and activation occur during the same step. This means manufacturing process can be simplified. Using magnetized bead cellulose as biocompatible marker particles is planned to achieve first fault safety in case of a membrane rupture during extracorporeal blood purification. Initial tests have shown that the magnetization of cellulose microspheres is possible during the manufacturing process. The incorporation of magnetite can be realized while keeping the spherical shape of the particles using this homogenous synthesis pathway.:1. EINLEITUNG 3 2. THEORETISCHE GRUNDLAGEN 5 2.1 CELLULOSE 5 2.1.1 Molekulare Struktur 7 2.1.2 Morphologische Struktur 9 2.1.3 Polymorphie 9 2.1.3.1 Native Cellulose 11 2.1.3.2 Weitere Cellulosemodifikationen 12 2.1.3.3 Umwandlung von Cellulose I in Cellulose II 13 2.1.4 Aktivierung 15 2.2 CELLULOSEACETAT 17 2.2.1 Herstellung 17 2.2.1.1 Technische Herstellung 18 2.2.1.2 Homogene Herstellungsmethoden 19 2.2.2 Eigenschaften und Charakterisierung 20 2.2.3 Verwendung 21 2.3 PERLCELLULOSE 22 2.3.1 Herstellung 23 2.3.1.1 Sprühverfahren 23 2.3.1.2 Suspensionsverfahren 24 2.3.1.3 Acetatverfahren 24 2.3.2 Charakterisierung 26 2.3.2.1 Partikelgröße und Partikelgrößenverteilung 26 2.3.2.2 Porosität 27 2.2.2.3 Quellwert 28 2.3.2.4 Weitere Methoden 28 2.3.3 Verwendung 30 2.3.3.1 Perlcellulose als Adsorbermaterial 30 2.3.3.2 Adsorption von Endotoxinen 31 2.3.4 Magnetisierung 36 2.3.4.1 Einsatz und Herstellung magnetischer Partikel 36 2.3.4.2 Einbindung von Magnetit in Perlcellulose 39 3. HERSTELLUNG VON PERLCELLULOSE 41 3.1 CELLULOSEACETAT ALS AUSGANGSSTOFF FÜR DIE SYNTHESE VON PERLCELLULOSE 41 3.1.1 Charakterisierung von Celluloseacetaten 41 3.1.1.1 Löslichkeit 41 3.1.1.2 Trübungsmessungen 42 3.1.1.3 Molmassenverteilung 44 3.1.1.4 Verteilung der Substituenten 45 3.1.1.5 Bestimmung des Substitutionsgrades mittels NMR und SEC 46 3.1.2 Einfluss der Celluloseacetate auf die Eigenschaften der Perlcellulose 47 3.1.2.1 Herstellung der Perlcellulosen 47 3.1.2.2 Messung der Partikelgröße 48 3.1.2.3 Charakterisierung der Perlcellulosen mittels Rasterelektronenmikroskopie 49 3.1.3 Schlussfolgerungen 51 3.2 HERSTELLUNG VON PERLCELLULOSE MIT DEFINIERTEN EIGENSCHAFTEN 52 3.2.1 Bildung der Celluloseperlen 52 3.2.2 Dispergieren im Inline- Ultraturrax 54 3.2.2.1 Einfluss der Drehzahl 54 3.2.2.2 Mehrfaches Dispergieren 56 3.2.2.3 Geschwindigkeit der Schlauchpumpe 58 3.2.2.4 Vergleich der Ergebnisse 59 3.2.3 Zusammensetzung der Emulsion 60 3.2.3.1 Salzgehalt 61 3.2.3.2 Methylcellulosekonzentration 62 3.2.3.3 Ethylacetatkonzentration 63 3.2.3.4 Tensidgehalt 65 3.2.3.5 Gleichzeitige Veränderung mehrerer chemischen Parameter 66 3.2.4 Aufbereitung des Perlcelluloseacetats 68 3.2.4.1 Abrotieren der Lösungsmittel 68 3.2.4.2 Reinigung und Deacetylierung 69 3.2.5 Standardbedingungen 69 4. CHARAKTERISIERUNG VON PERLCELLULOSEN 70 4.1 PARTIKELGRÖßENMESSUNG 70 4.2 RASTERELEKTRONENMIKROSKOPIE 70 4.3 QUECKSILBERPOROSIMETRIE 71 4.4 SEDIMENTATIONSVERHALTEN 73 4.4.1 Sedimentationsgeschwindigkeit 73 4.4.2 Berechnung der mittleren Teilchengröße 79 4.4.3 Sedimentationsvolumen 82 4.5 BESTIMMUNG DER POROSITÄT AUS DEM SEDIMENTATIONSVOLUMEN 83 4.5.1 Porositätsuntersuchungen an einer analytischen Multiprobenzentrifuge 83 4.5.2 Porositätsuntersuchungen an einer Laborzentrifuge 84 4.5.3 Vergleich der ermittelten Porositätswerte 85 4.6 RAMANSPEKTROSKOPIE 87 5. PERLCELLULOSE ALS ENDOTOXINADSORBERMATERIAL 88 5.1 ENTWICKLUNG VON ENDOXINADSORBERN AUF BASIS VON PERLCELLULOSE 88 5.1.1 Aktivierung von Perlcellulose 88 5.1.2 Anbindung von Polymyxin-B-Sulfat 90 5.2 CHARAKTERISIERUNG UND OPTIMIERUNG DES ENDOTOXINADSORBERMATERIALS 90 5.3 UP- SCALE- VERSUCH 96 5.4 WEITERE VERSUCHE MIT PERLCELLULOSE 98 5.5 ANBINDUNG VON PMB AN PERLCELLULOSEACETAT 102 5.6 BEWERTUNG UND AUSBLICK 107 6. MAGNETISCHE MARKERPARTIKEL AUF BASIS VON PERLCELLULOSE 109 6.1 HOMOGENE EINBINDUNG VON MAGNETIT IN PERLCELLULOSE 109 6.1.1 Auswahl des Dispergiergerätes 111 6.1.2 Optimierung der BUT- Drehzahl und der Dispergierzeit 112 6.1.3. Versuche mit Methylcellulose als Schutzkolloid 120 6.2 CHARAKTERISIERUNG DER MAGNETISIERTEN PERLCELLULOSEPARTIKEL 122 6.2.1 Partikelgröße 122 6.2.2 Rasterelektronenmikroskopie 124 6.2.3 Energiedispersive Röntgenmikroanalyse 126 6.2.4 Bestimmung des Eisengehaltes mittels AAS 128 6.2.5 Magnetische Messungen 129 6.3 BEWERTUNG DER BISHERIGEN ERGEBNISSE 130 7. ZUSAMMENFASSUNG UND AUSBLICK 132 8. EXPERIMENTELLES 135 8.1 CHEMIKALIEN 135 8.2 METHODISCHES 135 8.3 PRÄPARATIONSVORSCHRIFTEN UND ARBEITSANLEITUNGEN 136 8.3.1 Herstellen der Ausgangslösungen 136 8.3.2 Herstellung der Perlcellulosen 137 8.3.2.1 Herstellung des Perlcelluloseacetates 137 8.3.2.2 Deacetylierung des Perlcelluloseacetates 138 8.3.3 Aktivierung von Perlcellulosen 138 8.3.4 Herstellung von Endotoxinadsorbermaterial 138 8.3.5 Magnetitanbindung 139 LITERATUR 140 ABKÜRZUNGSVERZEICHNIS 152 ABBILDUNGSVERZEICHNIS 154 TABELLENVERZEICHNIS 158

Haemophilus parainfluenzae (Hp) and H. influenzae (Hi) are closely related members of the Pasteurellaceae family and are common commensal bacteria of the human nasopharynx. Whilst Hi is frequently implicated in meningitis, otitis media and respiratory tract infections, reports of pathogenic behaviour by Hp are very rare. Lipopolysaccharide (LPS) is a key component of the Gram negative cell wall, and its structure influences the ability of Haemophilus to interact with the host and evade immune clearance. A better understanding of the differences in LPS structure between Hi and Hp could help to ascertain which parts of the molecule are important for commensal and pathogenic behaviour. Hi LPS comprises lipid A, a conserved oligosaccharide inner core, and an oligosaccharide outer core that differs between strains. The latter is partly phase variable by the slipped strand mispairing during replication of DNA repeat tracts within several LPS biosynthesis genes. Very little was known about LPS in Hp so we investigated its biosynthesis and structure in a panel of 20 Hp carriage isolates. Using PCR, DNA sequencing and Southern analysis we demonstrated that Hp possesses homologues of the Hi lipid A and inner core LPS synthesis genes and a few of the genes for outer core synthesis; however, homologues of the Hi phase variable outer core genes were largely absent and did not contain repeat tracts. The results of immunoblotting and collaborative structural analysis were consistent with this data. Phosphocholine, a phase variable Hi LPS epitope that has been implicated in otitis media, was found to be absent in Hp LPS due to the lack of four genes required for its biosynthesis and incorporation. The introduction of these genes into Hp led to the phase variable addition of phosphocholine to the LPS, indicating that there is no fundamental reason why Hp could not use a similar mechanism of variation to Hi if it was advantageous to do so. SDS-PAGE data suggested the presence of O-antigens (repeated chains of sugars) in many of the Hp strains, an unusual feature for Haemophilus, and all of the strains were found to contain a potential O-antigen synthesis locus. Each locus encodes homologues of several glycosyltransferases in addition to either the Wzy polymerase- or ABC transporter-dependent mechanisms of O-antigen synthesis and transport. Comparisons of wild type and isogenic mutant strains showed that the O-antigen enhances resistance to complement-mediated killing and appears to affect adhesion to epithelial cells in vitro. Hp is a successful commensal organism but lacks the flexibility of adapting its LPS using repeat-mediated phase variation, potentially limiting its range of host niches.

Empregando a técnica de biologia molecular Checkerboard DNA-DNA Hybridization e o teste Limulus Amebocyte Lysate, os objetivos do presente estudo clínico randomizado in vivo foram avaliar, em bráquetes ortodônticos metálicos: 1) A presença de 16 espécies de microrganismos periodontopatogênicos Gram-negativos pertencentes aos complexos laranja e vermelho, por meio de sondas de DNA; 2) A quantidade de endotoxina bacteriana presente; e 3) A eficácia da utilização do gluconato de clorexidina a 0,12%, sob a forma de bochechos, na redução da contaminação pelas 16 espécies de microrganismos periodontopatogênicos Gram-negativos e na redução da quantidade de endotoxina bacteriana. Participaram do estudo 33 pacientes de 11 a 33 anos de idade, em tratamento com aparelho ortodôntico fixo, nos quais foram colocados randomicamente 3 bráquetes metálicos novos nos pré-molares. Os pacientes do Grupo Controle (n=17) fizeram 2 bochechos semanais com solução placebo, durante 30 dias. Os pacientes do Grupo Experimental (n=16) fizeram bochechos com solução à base de gluconato de clorexidina a 0,12% (Periogard®), da mesma forma que o grupo Controle. Decorridos 30 dias, os 3 bráquetes foram removidos de cada paciente e processados para a detecção dos microrganismos, pela técnica Checkerboard DNA-DNA Hybridization, e para a quantificação da endotoxina bacteriana por meio do teste Limulus Amebocyte Lysate. Os resultados obtidos foram analisados por meio dos testes não-paramétricos de Kruskal-Wallis, Mann-Whitney e pós-teste de Dunn, utilizando os softwares SAS e Graphpad Prism. O nível de significância adotado foi de 5%. De acordo com os resultados obtidos, observou-se que todos os bráquetes dos pacientes do Grupo Controle encontravam-se densamente contaminados pelos microrganismos avaliados. Nesse grupo, as espécies bacterianas do complexo laranja apresentaram-se em maiores quantidades, em relação às espécies do complexo vermelho (p<0,01). A mediana da quantidade de endotoxina para este grupo foi de 0,6673 EU/ml. Quando comparado ao grupo Controle, observou-se que o número total de microrganismos no grupo Experimental foi estatisticamente menor, com mediana de 29.150.000 no grupo Controle e de 13.130.000 no grupo Experimental (p=0,01). Quando os microrganismos foram avaliados por complexos, foi observada diferença estatisticamente significante entre os grupos Controle e Experimental para o complexo laranja (p=0,04), com contagens menores de bactérias após os bochechos com clorexidina. Por outro lado, observou-se que a quantidade de endotoxina no grupo Experimental foi maior, com mediana de 1,2199 EU/ml (p=0,02). Concluiu-se que os bochechos com solução de gluconato de clorexidina a 0,12% podem ser úteis, na prática clínica, com a finalidade de reduzir os níveis de microrganismos periodontopatogênicos Gram-negativos, em pacientes portadores de aparelhos ortodônticos fixos. No entanto, em função do aumento da quantidade de endotoxina bacteriana após o uso dos bochechos com clorexidina, estudos adicionais são necessários com a finalidade de desenvolver procedimentos clínicos ou agentes antimicrobianos que tenham ação sobre a endotoxina presente nos bráquetes metálicos. / Using the biomolecular technique Checkerboard DNA-DNA Hybridization and the Limulus Amebocyte Lysate (LAL) assay, the purposes of the present randomized clinical study were to evaluate in orthodontic metallic brackets: 1) The presence of 16 Gram-negative periodontopathogenic microbial species of the orange and red complexes by using DNA probes; 2) The amount of bacterial endotoxin; and 3) The efficacy of 0.12% chlorhexidine gluconate mouthwashes in reducing the contamination by the evaluated microbial species and the amount of bacterial endotoxin. Thirty-three 11-33-year-old patients undergoing orthodontic treatment with fixed appliances were enrolled in the study and all subjects had 3 new metallic brackets bonded to different premolars in a randomized manner. The patients in the Control group (n=17) were instructed to use a placebo mouthwash twice a week, while those in the Experimental group (n=16) were instructed to use a 0.12% chlorhexidine gluconate mouthwash (Periogard®) in the same way. After 30 days, the 3 brackets were removed from each patient and processed for detection of the microorganisms by the Checkerboard DNADNA hybridization technique, and for quantification of bacterial endotoxin by the LAL assay. The data were analyzed statistically by the non-parametric Mann-Whitney, Kruskal-Wallis and Dunn\'s post tests using SAS and GraphPad Prism softwares. A significance level of 5% was set for all analyses. The brackets of the patients in the Control group were densely contaminated by the evaluated microbial species. In this group, the number of bacterial species of the orange complex was larger compared to the number of bacterial species of the red complex (p<0.01). The median of the amount of bacterial endotoxin for this group was 0.6673 EU/ml. The Experimental group had a significantly smaller number of microorganisms than the Control group (median 13,130,000 versus 29,150,000; p=0.01). When the microorganisms were analyzed by complex, there was statistically significant difference between the Control and Experimental groups for the orange complex (p=0.04) with smaller counts of bacteria after use of chlorhexidine oral rinses. On the other hand, there was a greater amount of bacterial endotoxin in the Experimental (median of 1,2199 EU/ml; p=0.02). In conclusion, 0.12% chlorhexidine oral rinse can be useful in the clinical practice to reduce the levels of Gram-negative periodontopathogenic microorganisms in patients with fixed orthodontic appliances. Considering the increase in the amount of bacterial endotoxin after use of chlorhexidine oral rinses, further research is necessary to develop clinical procedures or antimicrobial agents with action against the endotoxin in the metallic brackets