Η λεπτίνη παράγεται από τα κύτταρα του λιπώδους ιστού, καθώς και από άλλους ιστούς συμπεριλαμβανομένων του πλακούντος και ρυθμίζει τη πρόσληψη τροφής, τη κατανάλωση ενέργειας, την αναπαραγωγική διαδικασία και τις ανοσολογικές λειτουργίες. Για τη διερεύνηση του ρόλου της λεπτίνης επί του νεογνικού ανοσολογικού συστήματος μετρήσαμε τα επίπεδα λεπτίνης και κυτταροκινών (INF-γ, TNF-α, IL-2, IL-4, IL-10 και IL-12) στον ορό αίματος ομφαλίου λώρου 481 φυσιολογικών νεογνών τα οποία γεννήθηκαν από υγιείς μητέρες. 317 ήταν νεογνά με ιδανικό βάρος γέννησης για την ηλικία κύησης (AGA) και 164 έφεραν αυξημένο βάρος για την ηλικία κύησης (LGA). Η ενδιάμεση συγκέντρωση λεπτίνης σε ολόκληρο το δείγμα ήταν 11.6 ng/ml. Στο 12% AGA νεογνών, τα επίπεδα λεπτίνης ήταν υψηλότερα του μέσου όρου (ενδιάμεση τιμή 34 ng/ml). Στο 33% των νεογνών αυτών (4% του ολικού δείγματος) τα επίπεδα λεπτίνης κυμαίνονταν μεταξύ 37.5-204 ng/ml, στην ομάδα αυτή βρέθηκαν επίσης υψηλά επίπεδα ιντερφερόνης-γ (μέση τιμή 27.11 pg/ml, διακύμανση 17.5-38.5 pg/ml). Κατόπιν μελετήσαμε εάν η λεπτίνη μπορεί να επηρεάσει τη γονιδιακή έκφραση κυτταροκινών στα Τ κύτταρα και μονοκύτταρα αίματος ομφαλίου λώρου. Η καλλιέργεια των κυττάρων ομφαλίου λώρου (Τ ή μονοκυττάρων) AGA νεογνών, τυχαία επιλεγμένων ή κυττάρων περιφερικού αίματος ενηλίκου, με λεπτίνη είχε σαν αποτέλεσμα τη γονιδιακή έκφραση IL-2, INF-γ και IL-4 από τα κύτταρα του ομφαλίου λώρου, καθώς και από τα Τ κύτταρα του ενηλίκου όπως και την έκφραση IL-10 κυρίως από τα μονοκύτταρα αίματος ομφαλίου λώρου. Σημαντικά υψηλότερη γονιδιακή έκφραση INF-γ παρατηρήθηκε σε Τ κύτταρα ομφαλίου λώρου θήλεος τα οποία καλλιεργήθηκαν με λεπτίνη συγκριτικά με τα Τ κύτταρα ομφαλίου λώρου άρρενος. Συμπερασματικά, η παρουσία υψηλών συγκεντρώσεων λεπτίνης και INF-γ στον ορό αίματος ομφαλίου λώρου φυσιολογικών AGA νεογνών, καθώς και το γεγονός ότι η λεπτίνη μπορεί άμεσα να διεγείρει τη γονιδιακή έκφραση κυτταροκινών σε κύτταρα ομφαλίου λώρου (Τ και μονοκύτταρα) δείχνει ότι τα υψηλά επίπεδα λεπτίνης μπορούν ανεξάρτητα να επηρεάσουν το ανοσολογικό σύστημα των φυσιολογικών νεογνών και να συμβάλλουν στη Th1 διαφοροποίηση της ανοσολογικής απόκρισης. / Leptin is a hormone synthesized by adipocytes and other tissues, including the placenta, and it regulates food intake and energy expenditure, reproductive and immune functions. To investigate the role of leptin in neonatal immunity, we measured serum leptin and cytokine (INF-γ, TNF-α, IL-2, IL-4, IL-10, IL-12) levels in cord blood (cb) of 481 healthy neonates, born to healthy mothers, of which 317 were appropriately grown for gestational age (AGA) and 164 were large for gestational age (LGA). The median serum leptin concentration in the whole sample was 11.6 ng/ml. In 12% AGA neonates, leptin levels were well above average, with a median of 34 ng/ml. In 33% of these neonates (4% of the total sample) leptin levels ranged between 37.5-204 ng/ml; in this group, significantly elevated levels of serum IFN- were also found (mean 27.11 pg/ml, range 17.5-38.5 pg/ml). We then investigated whether leptin can independently influence cytokine gene expression by cb T-cells and monocytes (Mc). Culture of cb T-cells or Mc, isolated from randomly selected AGA neonates or adult peripheral blood mononuclear cells (PBMC), with leptin, resulted in upregulation of IL-2, IFN- and IL-4 gene expression in cb and adult T-cells and IL-10 gene expression mainly in cb-Mc. Significantly higher expression of IFN- occurred in female cb-T-cells cultured with leptin, compared with male cb-T-cells. In conclusion, the concurrent presence of high concentrations in both leptin and INF- in cb of healthy AGA infants, together with the fact that leptin can directly upregulate cytokine gene expression in cb T and Mc cells, indicate that abnormally high leptin levels can independently influence the immune system of healthy newborns, and may mediate gender differences in the development of a Th1 polarized immune response.

>Magister Scientiae - MSc / Tuberculosis (TB) is a disease that results from infection by Mycobacterium tuberculosis, which is regarded the most common infecting organism. TB has killed countless numbers of people particularly in underdeveloped countries. TB bacteria can remain inactive or in dormant state for years without causing symptoms or spreading to other subjects, but as soon as the immune system of the host becomes weakened, the bacteria become active and infect mainly the lungs along with other parts of body. TB cases are further aggravated by other illnesses that affect the immune system, such as human immune virus (HIV), which is very prevalent in resource-poor countries. Interferon-gamma (IFN-γ) is a TB biomarker that has found to have all the qualities that are needed to help and cure Tuberculosis disease. Early diagnosis and treatment are essential measures for effectively controlling the disease. Traditional microbial culture-based tests are the most common methodologies currently used. Usually, these methods involve cell culture, cell counts, and cell enrichment, but this process is time-consuming and laborious, especially for the slow-growing bacteria like M. tuberculosis. Sputum smear is one of the methods currently used to detect acid fast bacilli (AFB) in clinical specimens or fluorescent staining. It is a cost-effective tool for diagnosing patients with TB and to monitor the progress of treatment especially in developing countries. The traditional method of inoculating solid medium such as Lowerstein-Jensen (L-J) or 7H10/7H11 media is also used currently it is slow and takes 6-8 weeks of incubation to diagnose the infection and further more time to determine the susceptibility patterns. The microscopic observation drug susceptibility (MODS) assay they are also used currently they rely on light microscopy to visualize the characteristic cording morphology of M. tuberculosis in liquid culture. MODS has shorter time to culture positivity (average 8 days) compared with LJ medium (average ~26 days), they are very expensive. The Gen-Probe assay specific for M. tuberculosis complex is a rapid detection that is also used, nucleic acid amplification (NAA) test results can be obtained as fast as in two hours (provided if a positive culture is present); it also has a high sensitivity of 99% and specificity of 99.2%. It holds the disadvantage of needing of positive culture that can take several days. Enzyme-linked immunosorbent assay (ELISA), is a test that uses antibodies and colour change to identify a substance. ELISA is an assay that uses a solid-phase enzyme immunoassay (EIA) to detect the presence of a substance, usually an antigen, in a liquid sample or wet sample. It can be used to detection of Mycobacterium antibodies in tuberculosis. The Amplified Mycobacterium Tuberculosis Direct Test (AMTDT) is used for the detection of M. tuberculosis it enables the amplification and detection of M. tuberculosis rRNA directly from respiratory specimens. The diagnostic methods employing genetechnology based on the amplification of DNA or RNA are expected to improve the speed, sensitivity, and specificity of Mycobacterium tuberculosis detection. TB rapid cultivation detection technique, such as MB/BacT system, BactecMGIT 960 system and flow cytometry. The BACTEC MGIT960 system (Becton Dickinson, Sparks, MD) performs incubation and reading of the tubes continuously inside the machine using a predefined algorithm to interpret the fluorescent signal and giving the results as positive or negative. When performing DST, the BACTEC MGIT960 interprets the results as susceptible or resistant to the antibiotic under study. Results are available within 8 days. A recent meta-analysis of the published studies found high accuracy and high predictive values associated with the use of BACTEC MGIT960. These methods are more sensitive and rapid than the traditional microbial culture-based methods. However, they cannot provide the detection results in real-time and most of these methods are centralized in large stationary laboratories because complex instrumentation and highly qualified technical staff are required. Recently, Food and Drug Administration (FDA) approved two new assays that were introduced. These two assays detect in vitro a specific immune response to M. tuberculosis. These tests are the QuantiFERON-TB Gold In-Tube (Cellestis/Qiagen, Carnegie, Australia) and the T-SPOT.TB assay (Oxford Immunotec, Abingdon, United Kingdom). Both assays use whole blood from the patient and measure the production of interferon gamma after the whole blood is exposed to specific antigens from M. tuberculosis. These tests are based on the knowledge that IFN-γ is a product of an active cell-mediated immune response induced by M. tuberculosis. However, TB detection remains a major obstacle due to several drawbacks of these methods. To date, the number of diagnosis approaches for TB has increased as the disease continues to be a major public health problem worldwide and most conventional detection technologies present difficulties in recognizing the presence of M. tuberculosis, since they are time consuming, do not provide clinically reliable results and significantly lack of sensitivity. This thesis focusedon developing two binary and one ternary-electrochemically quantum dots, all synthesised at room temperature in aqueous media for detecting (IFN-γ). Copper telluride (CuTe) and Zinc telluride (ZnTe) was prepared to check how does the two quantum dot behave individual and also to check on how they behave when they are combined and formed ternary quantum dots (CuZnTe). The electrochemical studies of the binary CuTe quantum dots, ZnTe quantum dots and the ternary CuZnTe core-shell quantum dots reveal that ternary quantum dots were stable and showed a significant enhancement in the conductivity of CuZnTe core-shell solution compared to that of CuTe and ZnTe, all studied in solution. The three different quantum dots were capped with three different capping reagents which are tetraethyl orthosilicate (TEOS), thioglycolic acid (TGA), (3-mercaptopropyl) trimethoxysilane (MPS). In the study, a label-free electrochemical immunosensor for the detection of interferon gamma (IFN-γ) was prepared for the first time using ternary quantum dots. The biosensor consists of water-soluble silica coated Copper Zinc telluride (CuZnTe core-shell) quantum dots conjugated to a gold electrode. The antibody-antigen were then conjugated on the CuZnTe core-shell QD modified gold electrode. Results from synthesis of two different binary quantum dots are also presented in the study and compared to the results of the CuZnTe core-shell QDs. The CuTe quantum dots had a small average size which was confirmed through HRTEM, SAXS and XRD analysis

Das Ubiquitin-Proteasom-System sorgt in eukaryontischen Zellen für einen kontrollierten Abbau von Proteinen. Das 20S Proteasom ist als Multikatalytischer Protease Komplex der zentrale Bestandteil dieses Systems. In der vorliegenden Arbeit konnte gezeigt werden, dass sich gereinigtes 20S Proteasom aus HeLa-Zellen chromatographisch in Subtypen auftrennen lässt, die sich strukturell und in ihrer proteolytischen Aktivität unterscheiden. Nach Induktion der Zellen mit gamma-Interferon (gamma-IFN) werden Immuno-Proteasomen gebildet und es kommt zu einer Veränderung des Subtypen-Musters und der Aktivitäten. Unter dem Einfluss von gamma-IFN bilden sich hauptsächlich Mischkomplexe mit sowohl konstitutiven als auch Immuno-Untereinheiten. Weiterhin konnte gezeigt werden, dass in den Zellkompartimenten Cytoplasma, Zellkern und Microsomen von HeLaS3-Zellen unterschiedliche 20S Proteasom-Subtypen vorkommen. Dies war unter anderem auf eine unterschiedliche Glykosylierung einzelner proteasomaler Untereinheiten zurückzuführen. Die genaue Kenntnis von Struktur und Funktion der 20S Proteasom-Subtypen ist im Hinblick auf neue diagnostische und therapeutische Ansätze in der Humanmedizin von großem Interesse. / The Ubiquitin-proteasome system is responsible for the regulated protein degradation in eucaryotic cells. The 20S proteasome is as a multicatalytic protease the central complex of these system. This study has shown that it is possible to separate 20S proteasome subtypes from HeLa cells by chromatography. 20s proteasome subtypes differ in structure and proteolytic activity. The subtype-pattern and the activity are significantly changed after an induction of the cells with gamma-Interferon (gamma-IFN) under formation of immuno proteasomes. After gamma-IFN induction mainly mixed complexes have been formed with both constitutive and immuno subunits. Further it has been shown that in cell compartements cytoplasm, microsomes and nucleus of HeLaS3 cells different 20S proteasome subtypes are located. Among other things glycosylation of some subunits is responsible for that phenomenon. With regard to new strategies in diagnostic and therapy of human diseases the exactly knowledge of structure and function of the proteasome subtypes is a case of interest.

La barrière hémo-encéphalique (BHE) est formée des cellules endothéliales microvasculaires cérébrales reliées entre elles par des jonctions serrées. Grâce à sa perméabilité restreinte et sélective, la BHE entrave le passage des molécules et cellules du sang vers le système nerveux central (SNC). Chez les patients atteints de sclérose en plaques (SEP), une maladie inflammatoire du SNC, la rupture de la BHE permet aux cellules immunes actives d'infiltrer le tissu cérébral. Il s'ensuit une réaction inflammatoire excessive au cours de laquelle d'autres leucocytes sont recrutés dans le cerveau et qui culmine par la formation des plaques de démyélinisation caractéristiques de la SEP. On dénote au niveau de ces lésions une présence importante de lymphocytes T CD4⁺ activés et de cytokines pro-inflammatoires propres à une réponse de type TH1, tels l’IFN-γ et l’IL-1. Curieusement cependant, l’inhibition de la voie TH1 n’empêche pas l’apparition de la maladie dans le modèle murin de la SEP et en aggrave même les symptômes. On attribue maintenant aux lymphocytes TH17, nommées en raison de leur capacité à produire de l’IL-17, un rôle clé dans le développement de la maladie. L’objectif de ce travail de thèse visait à caractériser les lymphocytes TH17 chez l’humain et définir leur contribution exacte dans la fragilisation de la BHE, une étape décisive dans la formation des lésions de SEP. Pour ce faire, nous avons mis au point une méthode expérimentale permettant l’expansion in vitro de populations de lymphocytes TH17 à partir de cellules mononuclées du sang de donneurs sains. Nos travaux démontrent que l’IL-23 induit la production d’IL-17, d’IL-22 et de granzyme B par les lymphocytes T CD4⁺CD45RO⁺ mémoires humains et qu’une proportion des cellules exprime de manière concomitante de l’IL-17 et de l’IFN-γ. La fréquence des lymphocytes T CD4⁺ IL17⁺, IL-22⁺ et des doubles positifs IL-17⁺IFN-γ⁺ est significativement plus élevée dans les lignées de lymphocytes TH17 provenant de patientes en poussée que dans celles de contrôles. Nos analyses démontrent que les cellules endothéliales de la BHE expriment de faibles niveaux des récepteurs de l’IL-17 et de l’IL-22 à l’état basal mais que leur présence est accrue dans le cerveau de patients atteints de SEP. L’activation du récepteur de l’IL-17 entraîne une augmentation de la perméabilité de la BHE et une perturbation de l’organisation des protéines de jonction occludine et ZO-1. Finalement, nous démontrons que la migration des lymphocytes TH17 à travers la BHE est régie en grande partie par la molécule d’adhérence ICAM-1 et que les lymphocytes qui co-expriment l’IL-17 et l’IFN-γ sont plus aptes à franchir la BHE que ceux qui produisent uniquement l’une ou l’autre de ces cytokines. Nous retrouvons d’ailleurs des cellules qui expriment simultanément les facteurs de transcription T-bet et RORC, associés respectivement aux lymphocytes TH1 et aux TH17, au sein des infiltrats péri-vasculaires des lésions actives de SEP. Les travaux présentés dans cette thèse auront permis d’affiner nos connaissances sur les mécanismes d’entrée des lymphocytes TH17 dans le SNC et les propriétés délétères des cytokines qu’ils sécrètent, notamment dans l’activation et la déstabilisation de l’endothélium cérébral. / The blood-brain barrier (BBB) plays a crucial role in protecting the central nervous system (CNS) by restricting entry of cells and molecules into the brain. In the CNS disorder multiple sclerosis (MS), breakdown of the BBB allows activated leukocytes to infiltrate the brain parenchyma, leading to the formation of the characteristic demyelinated lesions. For decades, MS was viewed as a TH1-mediated disease, a notion that was largely supported by studies in its animal model and by the abundance of prototypical TH1-associated cytokines within active MS lesions. However, over the years, accumulating evidence has highlighted the involvement of another subset of CD4⁺ T cells that express IL-17, therefore named TH17 lymphocytes, in the pathology of the disease. The goal of the work presented herein was to characterize the human TH17 lymphocyte population and define their contribution to the disruption of the BBB and leukocyte infiltration into the CNS, both important early events in the formation of MS lesions. To do so, we developed and optimized a method to successfully generate human TH17 lines in vitro from peripheral blood mononuclear cells of healthy donors. We demonstrate that in response to IL-23, human memory CD4⁺CD45RO⁺ but not naïve CD4⁺CD45RA⁺ T lymphocytes produce IL-17, IL-22, and granzyme B, with a subset of cells simultaneously expressing IL-17 and IFN-γ. Interestingly, we measure a significant increase in the percentage of T CD4⁺ IL17⁺, of IL-22⁺, and of IL-17⁺IFN-γ⁺ dual producers in TH17 cell lines expanded from the peripheral blood of acutely relapsing MS women as compared to those generated from healthy controls and remitting MS patients. We show that both IL-17 and IL-22 receptors are upregulated on BBB endothelial cells in situ during inflammation and that IL-17 enhances BBB permeability by disrupting the integrity of tight junction proteins occludin and ZO-1. Finally, we provide evidence that TH17 lymphocytes transmigrate efficiently across human brain endothelial cells via the adhesion molecule ICAM-1 and show that IL-17⁺IFN-γ⁺ double producers have an increased propensity to do so. Accordingly, we detect lymphocytes that display immunoreactivity against both the TH1- and TH17-associated transcription factors T-bet and RORC within perivascular infiltrates of active MS lesions. The work presented in this thesis has refined our understanding of the mechanisms that drive TH17 lymphocyte recruitment into the CNS and shed light on the deleterious effect of TH17-secreted cytokines, specifically in the activation and breakdown of the BBB.

Das human pathogene Varicella-Zoster Virus (VZV) gehört zur Familie der Herpesviren und ist weltweit verbreitet. Die Primärinfektion verursacht Varicellen, welche durch einen bläschenartigen Hautausschlag charakterisiert ist. Im Anschluss daran etabliert VZV eine lebenslange Latenz und verursacht nach Reaktivierung Herpes Zoster. Seit 2004 ist der Lebendimpfstoff aus attenuierten Virionen des VZV-Stammes V-Oka in Deutschland empfohlen. Im Gegensatz zur Infektion mit zirkulierenden virulenten VZV Stämmen tritt nach Verimpfung des Vakzin-Stammes V-Oka kein Exanthem auf. Die Haut ist der Hauptreplikationsort von VZV und immunologische Unterschiede zwischen virulentem VZV und dem Vakzin-Stamm treten hier am deutlichsten auf. In der vorliegenden Arbeit konnte eine neue Immunevasionsstrategie virulenter VZV Stämme aufgedeckt werden, welche erklären könnte, wie virulente VZV Stämme frühe antivirale Immunantworten umgehen. In Hautläsionen von Herpes Zoster Patienten konnte eine massive Infiltration von myeloiden inflammatorischen Dendritischen Zellen beobachtet werden. In vitro Studien mit Monozyten abgeleiteten Dendritischen Zellen (DC), welche inflammatorische DC repräsentieren, zeigten, eine signifikant erhöhte Expression von CD1c Molekülen nach Infektion mit dem Vakzin-Stamm, sowie virulentem VZV. Funktionelle Untersuchungen mit intraepithelialen CD1c-restringierten gamma delta T Zellen zeigten, dass DC nach Infektion mit dem Vakzin-Stamm phänotypisch und funktionell reiften und somit die T Zellen zur IFN-gamma Sekretion stimulierten. Im Gegensatz dazu wurde die funktionelle Reifung von DC, die mit virulentem VZV infiziert waren, geblockt. Folglich wurde kein bioaktives IL-12 sezerniert, welches als entscheidendes Cytokin zum Aufbau einer antiviralen T-Helfer 1 Immunantwort beiträgt. Darüber hinaus konnte gezeigt werden, dass virulentes VZV die Signalkaskade des Toll-like Rezeptors 2 (TLR2) in DC inhibiert und somit die IL-12 Produktion verhindert. / Varicella-zoster virus (VZV) which belongs to the family of herpesviruses is restricted to humans and distributed worldwide. Primary infection of VZV causes chickenpox characterized by a disseminated rash. Thereafter, VZV establishes a lifelong latency and can be reactivated to cause herpes zoster. Since 2004 the attenuated strain V-Oka of VZV was licensed for Germany to immunize children against VZV infection. In contrast to infection by circulating virulent VZV strains, vaccination with V-Oka remains asymptomatic. The skin is the major replication site of VZV and immunological differences between virulent VZV and the vaccine should become most apparent within this immune organ. In summary, this study discovered a new immune evasion strategy of virulent VZV strains which might explain how virulent VZV strains overcome innate antiviral responses. A strong infiltration of myeloid-derived inflammatory DCs has been detected in skin lesions of herpes zoster patients. In vitro studies with monocyte-derived dendritic cells (DCs), reflecting inflammatory DCs, showed that they were efficiently infected by both, the vaccine and a virulent VZV strain. Intriguingly, a significant upregulation of CD1c molecules on VZV-infected DCs was observed. Functional investigations using intraepithelial CD1c-restricted gamma delta T cells revealed that DCs infected with the vaccine virus were fully instructed to mature, thereby promoting IFN-gamma secretion of gamma-delta T cells. In striking contrast, DCs infected with virulent VZV strains were efficiently blocked to mature functionally. In detail, they did not secrete bioactive IL-12 which is an instrumental cytokine for generation of antiviral T helper 1 responses. Moreover, virulent VZV blocked Toll-like receptor 2 (TLR2) signaling in DCs thereby preventing production of bioactive IL-12 which in turn inhibited IFN-gamma secretion by gamma-delta T cells.

Nitric oxide (NO) is an important biological molecule within the body, which over production of this molecule in response to different stimulations can cause various inflammatory diseases. Over production of this molecule is caused by the induction of the inducible nitric oxide synthase (iNOS) enzyme. This enzyme uses L-arginine as a substrate and therefore the presence and transport of this amino acid into the cells can be a key factor in regulating NO over production. Different signalling mechanisms have been implicated in the regulation of this pathway and one of which involves the Mitogen Activated Protein Kinases (MAPK). This family of proteins respond to inflammatory conditions and may mediate effects induced by inflammatory mediators. Of the MAPKs, the role of the c-Jun-N-terminal kinase (JNK) pathway in the induction of iNOS is still controversial. JNK and its downstream target, the transcription factor Activator Protein-1 (AP-1), have shown contradictory effects on iNOS induction leading to controversies over their role in regulating iNOS expression in different cell systems or with various stimuli. The studies described in this thesis have determined the role of JNK/AP-1 on iNOS expression, NO production, L-arginine uptake and also on the transporters responsible for L-arginine transport into the cells. The studies were carried out in two different cell types: rat aortic smooth muscle cells (RASMCs) and J774 macrophages which are both critically associated with the over production of NO in vascular inflammatory disease states. The first approach was to block the expression of the inducible L-arginine-NO pathway using SP600125 and JNK Inhibitor VIII which are both pharmacological inhibitors of JNK. The results from these studies showed that the pharmacological intervention was without effect in RASMCs, but inhibited iNOS, NO and L-arginine transport in J774 macrophages. In contrast, the molecular approach employed using two dominant negative constructs of AP-1 (TAM-67 and a-Fos) revealed a different profile of effects in RASMCs, where a-Fos caused an induction in iNOS and NO while TAM-67 had an inhibitory effect on iNOS, NO, L-arginine transport and CAT-2B mRNA expression. The latter was unaffected in RASMCs but suppressed in J774 macrophages by SP600125. Examination of JNK isoforms expression showed the presence of JNK1 and 2 in both cell systems. Moreover, stimulation with LPS/IFN- or LPS alone resulted in JNK phosphorylation which did not reveal any difference between smooth muscle cells and macrophages. In contrast, expression and activation of AP-1 subunits revealed differences between the two cell systems. Activation of cells with LPS and IFN- (RASMCs) or LPS alone (J774 macrophages) resulted in changes in the activated status of the different AP-1 subunit which was different for the two cell systems. In both cell types c-Jun, JunD and Fra-1 were increased and in macrophages, FosB activity was also enhanced. Inhibition of JNK with SP600125 caused down-regulation in c-Jun in both cell types. Interestingly this down-regulation was in parallel with increases in the subunits JunB, JunD, c-Fos and Fra-1 in RASMCs or JunB and Fra-1 in J774 macrophages. Since, SP600125 was able to exert inhibitory effects in the latter cell type but not in RASMCs, it is possible that the compensatory up-regulation of certain AP-1 subunits in the smooth muscle cells may compensate for c-Jun inhibition thereby preventing suppression of iNOS expression. This notion clearly needs to be confirmed but it is potentially likely that hetero-dimers formed between JunB, JunD, c-Fos and Fra-1 could sustain gene transcription in the absence of c-Jun. The precise dimer required has not been addressed but unlikely to exclusively involve JunB and Fra-1 as these are up-regulated in macrophages but did not sustain iNOS, NO or induced L-arginine transport in the presence of SP600125. To further support the argument above, the dominant negatives caused varied effects on the activation of the different subunits. a-Fos down-regulated c-Jun, c-Fos, FosB, Fra-1 whereas TAM-67 reduced c-Jun and c-Fos but marginally induced Fra-1 activity. Associated with these changes was an up-regulation of iNOS-NO by a-Fos and inhibition by TAM-67. Taken together, the data proposes a complex mechanism(s) that regulate the expression of the inducible L-arginine-NO pathway in different cell systems and the complexity may reflect diverse intracellular changes that may be different in each cell type and not always be apparent using one experimental approach especially where this is pharmacological. Moreover, these findings strongly suggest exercising caution when interpreting pure pharmacological findings in cell-based systems particularly where these are inconsistent or contradictory.

Background: Pembrolizumab and cetuximab are antibodies under investigation in head and neck squamous cell carcinoma (HNSCC) either as single agents or combined with cisplatin and other chemotherapeutic drugs, e.g., 5-fluorouracil and/or docetaxel. However, also the combination of both antibodies may have potential in recurrent/ metastatic (R/M) HNSCC, in particular in cisplatin-resistant or -refractory cases or patients with comorbid disease, e.g. patients with impaired renal function. Methods: To clarify potential benefit that may result from such combination, we used the FLAVINO assay, a short-time ex vivo assay to compare responsiveness of HNSCC to pembrolizumab, cetuximab and both combined regarding colony formation of epithelial cells of biopsy-derived tumor samples and their cytokine production within three days either without or with stimulation with 10 ng/mL interferon gamma (IFN-g). Vascular endothelial growth factor A (VEGF), monocyte chemoattractant protein 1 (MCP-1 or CCL2), interleukin 6 (IL-6), IL-8, IFN-g, and interferon gamma-induced protein 10 (IP-10 or CXCL10) in supernatants were measured by ELISA. Results: We detected huge heterogeneity in response to cetuximab, pembrolizumab and both combined with and without IFN-g stimulation. Moreover, we detected a link between IFN-g induced IP-10 release and improved outcome in those HNSCC patients who were capable to respond to IFN-g and pembrolizumab, cetuximab and both combined with a further increase in IP-10 production. We derived an “IP-10 score” that independent from clinical characteristics of HNSCC patients and therapy regimens applied was able to predict their outcome. Conclusions: The heterogeneity in the ex vivo response of cetuximab, pembrolizumab and both combined with and without IFN-g stimulation identifies subgroups of HNSCC patients with deviating OS.

No description available.