VEGF is a main driver of tumor angiogenesis, playing an important role not only in the formation of new blood vessels, but also acts as a factor for cell migration, proliferation, survival and apoptosis. Angiogenesis is a universal function shared by most solid tumors and its inhibition was thought to have the potential to work across a broad patient population. Clinical evidence has shown that inhibiting pathological angiogenesis only works in a subset of patients and the identification of those patients is an important step towards personalized cancer care. The first approved antiangiogenic therapy was bevacizumab (Avastin®), a monoclonal antibody targeting VEGF in solid tumors including CRC, BC, NSCLC, RCC and others. In addition to endothelial cells, VEGF receptors are present on a number of different cell types including tumor cells, monocytes and macrophages. The work presented in this thesis looked at the in vitro cellular changes in tumor cells and leukocytes in response to the inhibition of VEGF signaling with the use of bevacizumab. In the initial experiments, VEGF was induced by hypoxia in tumor cells to evaluate changes in survival, proliferation, migration and changes in gene or protein expression. There was a minimal direct response of VEGF inhibition in tumor cells that could be attributed to bevacizumab treatment, with minor variations in some of the cell lines screened but no uniform or specific response noted. MMR deficiency often results in microsatellite instability (MSI) in tumors, as opposed to microsatellite stable (MSS) tumors, and accounts for up to 15% of colorectal carcinomas (CRCs). It has been suggested in clinical data that MMR deficient tumors responded better to bevacizumab regimens, therefore further research used isogenic paired CRC tumor cell lines (MMR deficient and proficient). Furthermore, a DNA damaging agent was added to the treatment regimen, the topoisomerase inhibitor SN-38 (the active metabolite of irinotecan). Inhibiting VEGF using bevacizumab significantly inhibited the ability of MMR deficient tumor cells to form anchor dependent colonies, however conversely, bevacizumab treatment before damaging cells with SN-38, showed a significant increase in colony numbers. Moreover, VEGF inhibition by bevacizumab pretreatment also significantly increased the mutation fraction in MMR deficient cells as measured by transiently transfecting a dinucleotide repeat construct, suggesting VEGF signaling may have an intrinsic role in MMR deficient cells. A number of pathways were analyzed in addition to changes in gene expression profiles resulting in the identification of JNK as a possible VEGF targeted pathway. JUN expression was also reduced in these conditions reinforcing this hypothesis, however the intricate molecular mechanisms remain to be elucidated. In order to remain focused on the clinical application of the findings, it was noted that some cytokines were differentially regulated by bevacizumab between MMR proficient and deficient cells. Treatment regimens employed in vitro attempted to mimic the clinical setting by inducing DNA damage, then allowing cells to recover with or without VEGF using bevacizumab treatment. Inflammatory cytokines, CCL7 and CCL8, were found to have higher expression in the MMR deficient cell line with bevacizumab after DNA damage, therefore the cross talk via tumor derived factors to myeloid cells was analyzed. Gene expression changes in monocytes induced by tumor conditioned media showed CCL18 to be a bevacizumab regulated gene by MMR deficient cells and less so in MMR proficient cells. CCL18 has been described as a prognostic marker in gastric, colorectal and ovarian cancers, however the significance is dependent on tumor type. CCL18 primarily exerts its function on the adaptive immune system to trigger a TH2 response in T cells, but is also described to increase non-specific phagocytosis. The results of this study did show an increase in the phagocytic activity of macrophages in the presence of bevacizumab that was significantly more apparent in MMR deficient cells. Furthermore, after DNA damage MMR deficient cells treated with bevacizumab released a cytokine mix that induced monocyte migration in a bevacizumab dependent manner, showing a functional response with the combination of MMR deficiency and bevacizumab. In summary, the work in this thesis has shown evidence of immune cell modulation that is specific to MMR deficient tumor cells that may translate into a marker for the administration of bevacizumab in a clinical setting. VEGF ist ein zentraler Regulator der Tumor-Angiogenese, und spielt eine wichtige Rolle nicht nur in der Bildung von neuen Blutgefäßen, sondern ist auch für die Migration, Proliferation, das Überleben und Apoptose von Tumorzellen essentiell. Angiogenese ist eine der universellen Funktionen, welche das Wachstum der meisten soliden Tumoren charakterisiert. Eine der klassischen therapeutischen Ideen wurde auf der Basis entwickelt, dass die spezifische Hemmung der Angiogenese das Potenzial hat in einer breiten Patientenpopulation einen klinischen Effekt zu zeigen. Die klinische Erfahrung und Anwendung hat jedoch gezeigt, dass die Hemmung der pathologischen Angiogenese nur in einem Teil der Patienten einen therapeutischen Nutzen aufweist. Somit stellt die Identifikation derjenigen Patienten, welche von der anti-angiogenen Therapie profitieren, einen wichtiger Schritt zur personalisierten Krebsbehandlung dar. Die erste zugelassene antiangiogene Therapie war Bevacizumab (Avastin®), ein monoklonaler Antikörper gegen VEGF, welcher unter anderem in soliden Tumoren wie CRC, BC, nicht-kleinzelligem Lungenkrebs (NSCLC) und dem Nierenzellkarzinom angewandt wird. VEGF-Rezeptoren befinden sich nicht nur auf Endothelzellen, sondern sind auch auf einer Anzahl von verschiedenen Zelltypen, einschließlich Tumorzellen, Monozyten und Makrophagen nachweisbar. Die in dieser Arbeit vorgestellten Ergebnisse befassen sich mit den zellulären Veränderungen an Tumorzellen und Leukozyten als Reaktion auf die Hemmung der VEGF-Signalkaskade durch Bevacizumab in-vitro. In den Initialen Experimenten wurde VEGF durch Hypoxie in Tumorzellen induziert und Veränderungen der Überlebensrate, der Proliferation, Migration als auch in der Gen- oder Protein-Expression gemessen. Es konnte eine minimale direkte Reaktion der VEGF-Hemmung auf Tumorzellen beobachtet werden, welche auf die Bevacizumab Behandlung zurückgeführt werden könnte. Es zeigten sich aber auch geringfügige Abweichungen in einigen der verwendeten Zellinien, die keine einheitliche Interpretation erlauben oder auf eine uniformelle Reaktion hinweisen würden. Das phänotypische Korrelat einer „Mismatch“ Reparatur (MMR)-Defizienz ist die Mikrosatelliteninstabilität im Gegensatz zu mikrosatellitenstabilen Tumoren und findet sich bei bis zu 15% der kolorektalen Karzinomen (CRC) wieder. Klinischen Daten deuten daraufhin, dass Bevacizumab besser in MMR-defizienten Tumoren wirkt. Daher wurden die weiteren Untersuchungen in gepaarten MMR stabilen und MMR instabilen CRC-Tumorzelllinien (MMR defizient und kompetent) durchgeführt. Weiterhin wurde ein DNA-schädigendes Agens, SN-38, ein Topoisomerase-Inhibitor (der aktive Metabolit von Irinotecan) dem Behandlungsschema zugefügt. Es zeigte sich, dass die Hemmung von VEGF mittels Bevacizumab die Fähigkeit der MMR defizienten Tumorzellen Kolonien zu bilden signifikant inhibiert. Im Gegensatz dazu, hatte die Behandlung von Bevacizumab vor der Zugabe des DNA schädigenden Agens zu einer vermehrten Kolonienzahl geführt. Außerdem erhöhte die Vorbehandlung mit Bevacizumab deutlich die Mutationsrate in MMR-defizienten Zellen, was durch die transiente Transfektion eines Dinukleotid-Repeat-Konstrukts nachgewiesen werden konnte. Dies deutete darauf hin, dass VEGF eine intrinsische Rolle in der Signalkaskade des MMR-Systems haben könnte. Deshalb wurde eine Anzahl von Signalalkaskaden zusätzlich zu Veränderungen von Genexpressionsprofilen untersucht und JNK als mögliche Verbindungsstelle der beiden Signalkaskaden, VEGF und MMR, identifiziert. Diese Hypothese wurde zusätzlich unterstützt durch die Tatsache, dass die JUN Expression unter diesen experimentellen Bedingungen reduziert war. Die Aufklärung der komplexen molekularen Mechanismen der potentiellen Interaktion bleibt zukünftigen Untersuchungen vorbehalten. In Hinblick auf die klinische Konsequenz der erhaltenen Ergebnisse war es auffällig, dass einige Zytokine durch Bevacizumab in den MMR defizienten Zellen im Gegensatz zu den MMR kompetenten Zellen unterschiedlich reguliert wurden. Die in-vitro verwendeten Behandlungsschemata waren den klinisch zur Anwendung kommenden Protokollen nachempfunden. Zuerst wurde ein DNA-Schaden gesetzt, und den Zellen ermöglicht, sich mit oder ohne Bevacizumab zu erholen. Es konnte gezeigt werden, dass die inflammatorischen Zytokine CCL7 und CCL8 eine höhere Expression in der MMR-defiziente Zelllinie in Kombination mit Bevacizumab aufweisen. Daher wurde ein möglicher Crosstalk zwischen von Tumorzellen sezernierten Faktoren und myeloischen Zellen weiter verfolgt. Veränderungen der Genexpression in Monozyten durch Tumorzell- konditionierte Medien zeigte CCL18 als ein Bevacizumab reguliertes Gen in MMR-defizienten Zellen, aber nicht in MMR kompetenten Zellen. CCL18 übt seine Funktion primär im adaptiven Immunsystems aus um eine TH2-Antwort in T-Zellen auszulösen Ausserdem wird eine Erhöhung der nicht-spezifische Phagozytose als weitere Funktion beschrieben. CCL18 wurde bereits als prognostischer Marker in Magen-, Dickdarm- und Eierstockkrebsarten beschrieben; die klinische Bedeutung ist jedoch abhängig von Tumortyp. Die Ergebnisse dieser Arbeit zeigen, dass eine Erhöhung der phagozytischen Aktivität von Makrophagen in Gegenwart von Bevacizumab wesentlich deutlicher in MMR-defizienten Zellen ausgeprägt war. Weiterhin wurde gefunden, dass nach DNA-Schädigung in Bevacizumab behandelten MMR-defizienten Zellen Zytokine freigesetzt werden, welche eine Monozytenmigration in einer Bevacizumab-abhängigen Weise induzieren. Dies weist auf eine funktionelle Interaktion von MMR-Defizienz und Bevacizumab hin. Zusätzlich zeigen die Ergebnisse dieser Arbeit eine Immunzellmodulation, die spezifisch für Mismatch-Reparatur defiziente Tumorzellen ist und in der klinischen Praxis als Marker für die Verabreichung von Bevacizumab verwendet werden könnte. / VEGF ist ein zentraler Regulator der Tumor-Angiogenese, und spielt eine wichtige Rolle nicht nur in der Bildung von neuen Blutgefäßen, sondern ist auch für die Migration, Proliferation, das Überleben und Apoptose von Tumorzellen essentiell. Angiogenese ist eine der universellen Funktionen, welche das Wachstum der meisten soliden Tumoren charakterisiert. Eine der klassischen therapeutischen Ideen wurde auf der Basis entwickelt, dass die spezifische Hemmung der Angiogenese das Potenzial hat in einer breiten Patientenpopulation einen klinischen Effekt zu zeigen. Die klinische Erfahrung und Anwendung hat jedoch gezeigt, dass die Hemmung der pathologischen Angiogenese nur in einem Teil der Patienten einen therapeutischen Nutzen aufweist. Somit stellt die Identifikation derjenigen Patienten, welche von der anti-angiogenen Therapie profitieren, einen wichtiger Schritt zur personalisierten Krebsbehandlung dar. Die erste zugelassene antiangiogene Therapie war Bevacizumab (Avastin®), ein monoklonaler Antikörper gegen VEGF, welcher unter anderem in soliden Tumoren wie CRC, BC, nicht-kleinzelligem Lungenkrebs (NSCLC) und dem Nierenzellkarzinom angewandt wird. VEGF-Rezeptoren befinden sich nicht nur auf Endothelzellen, sondern sind auch auf einer Anzahl von verschiedenen Zelltypen, einschließlich Tumorzellen, Monozyten und Makrophagen nachweisbar. Die in dieser Arbeit vorgestellten Ergebnisse befassen sich mit den zellulären Veränderungen an Tumorzellen und Leukozyten als Reaktion auf die Hemmung der VEGF-Signalkaskade durch Bevacizumab in-vitro. In den Initialen Experimenten wurde VEGF durch Hypoxie in Tumorzellen induziert und Veränderungen der Überlebensrate, der Proliferation, Migration als auch in der Gen- oder Protein-Expression gemessen. Es konnte eine minimale direkte Reaktion der VEGF-Hemmung auf Tumorzellen beobachtet werden, welche auf die Bevacizumab Behandlung zurückgeführt werden könnte. Es zeigten sich aber auch geringfügige Abweichungen in einigen der verwendeten Zellinien, die keine einheitliche Interpretation erlauben oder auf eine uniformelle Reaktion hinweisen würden. Das phänotypische Korrelat einer „Mismatch“ Reparatur (MMR)-Defizienz ist die Mikrosatelliteninstabilität im Gegensatz zu mikrosatellitenstabilen Tumoren und findet sich bei bis zu 15% der kolorektalen Karzinomen (CRC) wieder. Klinischen Daten deuten daraufhin, dass Bevacizumab besser in MMR-defizienten Tumoren wirkt. Daher wurden die weiteren Untersuchungen in gepaarten MMR stabilen und MMR instabilen CRC-Tumorzelllinien (MMR defizient und kompetent) durchgeführt. Weiterhin wurde ein DNA-schädigendes Agens, SN-38, ein Topoisomerase-Inhibitor (der aktive Metabolit von Irinotecan) dem Behandlungsschema zugefügt. Es zeigte sich, dass die Hemmung von VEGF mittels Bevacizumab die Fähigkeit der MMR defizienten Tumorzellen Kolonien zu bilden signifikant inhibiert. Im Gegensatz dazu, hatte die Behandlung von Bevacizumab vor der Zugabe des DNA schädigenden Agens zu einer vermehrten Kolonienzahl geführt. Außerdem erhöhte die Vorbehandlung mit Bevacizumab deutlich die Mutationsrate in MMR-defizienten Zellen, was durch die transiente Transfektion eines Dinukleotid-Repeat-Konstrukts nachgewiesen werden konnte. Dies deutete darauf hin, dass VEGF eine intrinsische Rolle in der Signalkaskade des MMR-Systems haben könnte. Deshalb wurde eine Anzahl von Signalalkaskaden zusätzlich zu Veränderungen von Genexpressionsprofilen untersucht und JNK als mögliche Verbindungsstelle der beiden Signalkaskaden, VEGF und MMR, identifiziert. Diese Hypothese wurde zusätzlich unterstützt durch die Tatsache, dass die JUN Expression unter diesen experimentellen Bedingungen reduziert war. Die Aufklärung der komplexen molekularen Mechanismen der potentiellen Interaktion bleibt zukünftigen Untersuchungen vorbehalten. In Hinblick auf die klinische Konsequenz der erhaltenen Ergebnisse war es auffällig, dass einige Zytokine durch Bevacizumab in den MMR defizienten Zellen im Gegensatz zu den MMR kompetenten Zellen unterschiedlich reguliert wurden. Die in-vitro verwendeten Behandlungsschemata waren den klinisch zur Anwendung kommenden Protokollen nachempfunden. Zuerst wurde ein DNA-Schaden gesetzt, und den Zellen ermöglicht, sich mit oder ohne Bevacizumab zu erholen. Es konnte gezeigt werden, dass die inflammatorischen Zytokine CCL7 und CCL8 eine höhere Expression in der MMR-defiziente Zelllinie in Kombination mit Bevacizumab aufweisen. Daher wurde ein möglicher Crosstalk zwischen von Tumorzellen sezernierten Faktoren und myeloischen Zellen weiter verfolgt. Veränderungen der Genexpression in Monozyten durch Tumorzell- konditionierte Medien zeigte CCL18 als ein Bevacizumab reguliertes Gen in MMR-defizienten Zellen, aber nicht in MMR kompetenten Zellen. CCL18 übt seine Funktion primär im adaptiven Immunsystems aus um eine TH2-Antwort in T-Zellen auszulösen Ausserdem wird eine Erhöhung der nicht-spezifische Phagozytose als weitere Funktion beschrieben. CCL18 wurde bereits als prognostischer Marker in Magen-, Dickdarm- und Eierstockkrebsarten beschrieben; die klinische Bedeutung ist jedoch abhängig von Tumortyp. Die Ergebnisse dieser Arbeit zeigen, dass eine Erhöhung der phagozytischen Aktivität von Makrophagen in Gegenwart von Bevacizumab wesentlich deutlicher in MMR-defizienten Zellen ausgeprägt war. Weiterhin wurde gefunden, dass nach DNA-Schädigung in Bevacizumab behandelten MMR-defizienten Zellen Zytokine freigesetzt werden, welche eine Monozytenmigration in einer Bevacizumab-abhängigen Weise induzieren. Dies weist auf eine funktionelle Interaktion von MMR-Defizienz und Bevacizumab hin. Zusätzlich zeigen die Ergebnisse dieser Arbeit eine Immunzellmodulation, die spezifisch für Mismatch-Reparatur defiziente Tumorzellen ist und in der klinischen Praxis als Marker für die Verabreichung von Bevacizumab verwendet werden könnte.

While TGF-β is able to regulate miRNA expression in numerous cell types, TGF-β-dependent changes in the miRNA profile of CD8+ T cells had not been studied before. Considering that TGF-β suppresses CD8+ T cell effector functions in numerous ways, we wondered whether induction of immune-regulatory miRNAs could add to the known transcriptional effects of TGF-β on immune effector molecules. In this study, we used miRNA arrays, deep sequencing and qRT-PCR to identify miRNAs that are modulated by TGF-β in human CD8+ T cells. Having found that the TGF-β-dependent downregulation of NKG2D surface expression in NK cells and CD8+ T cells does not go along with a corresponding reduction in mRNA levels, this pathway appeared to be a possible target of TGF-β-inducible miRNAs. However, this hypothesis could not be confirmed by miRNA reporter assays. Instead, we observed that DAP10 transcription is suppressed by TGF-β which in turn negatively affects NKG2D surface expression. In spite of promising preliminary experiments, technical difficulties associated with the transfection of primary NK cells and NK cell lines unfortunately precluded the final proof of this hypothesis. Instead, we focused on the TGF-β-induced changes in the miRNome of CD8+ T cells and confirmed the induction of the miR-23a cluster members, namely miR-23a, miR-27a and miR-24 by three different techniques. Searching for potential targets of these miRNAs which could contribute to the immunosuppressive action of TGF-β in T cells, we identified and confirmed a previously unknown regulation of IFN-γ mRNA by miR-27a and miR-24. Newly generated miRNA reporter constructs further revealed that LAMP1 mRNA is a target of miR-23a. Upon modulation of the miR-23a cluster in CD8+ T cells by the respective miRNA antagomirs and mimics, significant changes in IFN-γ expression confirmed the functional relevance of our findings. Effects on CD107a/LAMP1 expression were, in contrast, rather minimal. Still, overexpression of the miR-23a cluster attenuated the cytotoxic activity of antigen-specific CD8+ T cells. Taken together, these functional data reveal that the miR-23a cluster not only is induced by TGF-β, but also exerts a suppressive effect on CD8+ T-cell effector functions, even in the absence of TGF-β signaling. / Obwohl bekannt war, dass TGF- die miRNA Expression in zahlreichen Zelltypen moduliert, waren TGF- abhängige Veränderung des miRNA Profils in CD8+ T Zellen noch nicht untersucht worden. Da TGF-β die Effektorfunktionen von CD8+ T Zellen aber in vielfältiger Weise inhibiert, fragten wir uns, ob die transkriptionellen Effekte, die TGF-β bekanntermaßen auf Immuneffektormoleküle ausübt, noch durch die Induktion immunregulatorischer miRNAs ergänzt werden. Daher nutzten wir miRNA Arrays, Genomsequenzierungstechniken und Echtzeit-PCR um miRNAs zu identifizieren, welche in humane CD8+ T Zellen von TGF- moduliert werden. Die Beobachtung, dass die TGF--abhängige Herunterregulation der NKG2D Oberflächenexpression in Natürlichen Killerzellen und CD8+ T Zellen nicht mit einer entsprechenden Verringerung der mRNA Menge einhergeht, ließ zudem vermuten, dass dieser Signalweg über miRNAs reguliert werden könnte. Nach verschiedenen miRNA Reporterassays musste diese Hpothese jedoch verworfen werden. Stattdessen zeigte sich, dass TGF- die Transkription von DAP10 inhibiert was wiederum die Oberflächenexpression von NKG2D limitieren sollte. Trotz viel versprechender initialer Experimente scheiterte der letzgültige Beweis dieser Hypothese aber an der ungenügenden Transfizierbarkeit von primären NK Zellen sowie von NK Zelllinien. Daher konzentrierten wir uns im Weiteren auf die durch TGF- induzierten Veränderungen im miRNom von CD8+ T Zellen und konnten mit drei verschiedenen Techniken die Induktion des miR-23a Clusters (mit den einzelnen miRNAs miR-23a, miR-27a und miR-24) bestätigen. Auf der Suche nach potentiellen immunregulatorisch relevanten Zielgenen dieser miRNAs konnten wir erstmals eine Regulation von IFN- durch miR-27a und miR-24 nachweisen. Zu diesem Zweck generierte miRNA Reporterkonstrukte zeigten zudem, dass LAMP1 durch miR-23a reguliert wird. Nach Modulation des miR-23a Clusters durch die entsprechenden miRNA Antagomir und Surrogat-Konstrukte konnten wir auch in CD8+ T Zellen signifikante Veränderungen der IFN-γ Expression nachweisen und somit die funktionelle Relevanz unserer Befunde bestätigen. Die Effekte auf die Expression von CD107a/LAMP1 waren hingegen nur minimal. Trotzdem führte die Überexpression des miR-23a Clusters zu einer Verringerung der zytotoxischen Aktivität von antigenspezifischen CD8+ T Zellen. Zusammen genommen belegen diese funktionellen Untersuchungen, dass das miRNA-23a Cluster, welches durch TGF-β induziert wird, zur Hemung der Effektorfunktionen in CD8+ T Zellen beiträgt, und zwar sowohl in Gegenwart als auch in Abwesenheit von TGF-β.

Peripheral nerve damage affects hundreds of thousands of people every year. This study tested the effectiveness of using lysophosphatidylcholine (LPC) in combination with nerve growth factor (NGF) to increase the healing rate of damaged left sciatic nerves in female rats. The rats were randomly divided into eight groups: Sham, Right Sciatic, Crush, LPC, LPC-NGF, Crush- LPC, Crush-NGF, and Crush-LPC-NGF. The healing of the nerves was measured by monitoring gait, electrophysiological parameters (compound muscle action potential amplitudes and nerve conductance velocities) and morphological parameters (total fascicular area, total myelinated fiber counts, fiber densities, fiber diameters, and g-ratio). Gait and electrophysiological parameters were measured three times a week. Morphological parameters were measured at three weeks and at six weeks. The LPC and LPC-NGF groups were not statistically different from the controls (Sham and Right Sciatic) at either of the morphological time points but were statistically different from the controls for the first three weeks for the electrophysiological parameters and gait. The LPC-NGF group did not differ from the LPC group at any time point for any of the parameters. Crush, Crush-LPC, Crush-NGF, and Crush-LPC-NGF groups statistically differed from the controls at week 3 for all parameters and only in the electrophysiological parameters at week 6. Crush-LPC, Crush-NGF, and Crush-LPC-NGF did not differ from each other or from the Crush group. The combination of LPC and NGF did not prove to be an effective treatment for peripheral nerve damage. Future work is recommended to test multiple injections of LPC and NGF.

Osteoarthritis (OA) is a debilitating condition affecting over 21 million persons in the United States. This number is expected to rise in the coming decades. Treatment approaches for OA focus on symptom modifying measures (i.e., pain relief) as disease modifying interventions do not currently exist. However, some of the interventions used to alleviate the symptoms of OA are also thought to have disease-modifying benefits. Two such non-surgical interventions for OA are intra-articular hyaluronan (HA) injections and physical exercise. In order to effectively study their effects in human OA, animal models that are amenable for studying intervention outcomes are needed. The research focused on developing and characterizing a progressive non-surgical model of knee OA in adult mice. This model was used to firstly, examine the capacity of intra-articular HA injections to prevent knee joint degeneration, and secondly to examine the capacity of moderate exercise to prevent onset and progression of joint degeneration. Intra-articular injections of TGF--β1 into murine knees produce synovial hyperplasia, osteophyte formation, and fibrotic changes on cartilage surfaces and joint capsules. However, additional exposure of the joints to high intensity treadmill running (biomechanical overuse) results in more widespread and focal OA-like cartilage erosions of both the tibial and femoral surfaces, similar to that described for the pathological appearance of late human knee OA. Taken together, these data support that synovitis and soft-tissue activation in early OA joints may precede and/or accelerate the process cartilage degeneration characteristic of progressive and late stage osteoarthritis. Intra-articular injections of high molecular weight HA one day following TGF--β1 injections resulted in decreased synovial hyperplasia, minimized osteophyte formation, and significantly decreased severity of cartilage lesions. A four week, alternate day, low intensity aerobic treadmill running program prior to TGF--β1 injections and overuse also resulted in decreased severity of cartilage lesions.

No description available.

Platelet-derived microparticles, released as a result of platelet activation, promote coagulation through the surface exposure of phosphatidylserine, acting as the catalytic site for the conversion of prothrombin to thrombin by the activated coagulation factors X and V. Although elevated numbers of circulating platelet-derived microparticles can be detected in a number of clinical disorders, the methods for the detection of these microparticles are far from standardised. In addition, recent reports have also speculated that not all microparticles may expose phosphatidylserine, demonstrating that the binding of Annexin V, a phosphatidylserine-specific binding protein, is not detectable on a population of microparticles. The initial stage of this thesis was to establish a flow cytometric method for the detection and enumeration of microparticles based on their capacity to bind Annexin V and to utilise this assay to investigate a number of the issues that have limited assay standardisation. The assay could be performed on either stimulated or unstimulated plasma or whole blood samples. Interestingly, plasma microparticle counts were significantly higher than whole blood microparticle counts. The effects of centrifugation alone could not be attributed as the sole source of this discrepancy. The antigenic characteristics of platelet-derived microparticles were also investigated, with platelet-derived microparticles demonstrated to express the platelet glycoproteins CD31, CD41a, CD42a and CD61. Platelet-derived microparticles also expressed CD42b, and this expression was significantly decreased when compared to their progenitor platelets. The expression of the platelet activation markers CD62p, CD63, CD40L and PAC-1 was dependent upon the sample milieu, suggesting that the centrifugation conditions required to generate platelet-poor plasma may lead to artefactual increases in the expression of platelet activation markers. An investigation of the role of the GpIIb/IIIa complex on the formation of platelet-derived microparticles was also performed. A monoclonal antibody to the GpIIb/IIIa complex (Abciximab) significantly inhibited in vitro collagen-stimulated platelet-derived microparticle formation. Interestingly, platelets obtained from two subjects with impaired GpIIb/IIIa activation, demonstrated normal microparticle formation following collagen stimulation, suggesting that the presence of GpIIb/IIIa complex, but not its activation, is required for collagen-induced microparticle formation. A novel mechanism for microparticle formation was also investigated, with platelet-derived microparticles demonstrated to form in response to the sclerosing agents sodium-tetradecyl sulphate and polidocanol. Interestingly, the removal of plasma proteins by the washing of platelets left platelets more susceptible to sclerosant-induced microparticle formation, suggesting that plasma proteins may protect platelets from microparticle formation. The procoagulant activity of platelet-derived microparticles was also investigated using a novel coagulation assay (XACT) specific for the procoagulant phospholipid. An evaluation of this assay demonstrated a significant correlation between Annexin V binding microparticle counts and procoagulant activity in both whole blood and plasma samples. There was more procoagulant activity in whole blood samples than in plasma samples, suggesting that the procoagulant phospholipid activity was also associated with erythrocytes or leukocytes. To further investigate this phenomenon, a whole blood flow cytometric assay was developed to assess Annexin V binding to erythrocytes, leukocytes, platelets and microparticles. This assay demonstrated that a large proportion of Annexin V binding (51.0%) was associated with erythrocytes. Interestingly, a proportion of the Annexin V binding erythrocytes (24.5%) and leukocytes (78.8%) were also associated with platelet CD61 antigen, suggesting that they also bound a platelet or platelet-derived microparticle. The effect of sample anticoagulant on microparticle procoagulant activity was investigated. Microparticle counts were most stable in EDTA anticoagulated samples, but were stable in sodium citrate for up to 15 minutes following sample collection. The procoagulant activity of microparticles was significantly inhibited by EDTA in collagen-stimulated platelet-rich plasma samples, when compared to sodium citrate anticoagulated samples. Although the initial method used to investigate microparticles was based upon their ability to bind Annexin V, it was consistently observed that a large proportion of events in the size region of a microparticle were Annexin V negative. An investigation was therefore commenced into the procoagulant activity of microparticles based on their capacity to bind Annexin V. The presence of Annexin V negative microparticles was confirmed by flow cytometry and the proportion of microparticles that bound Annexin V was dependent upon type of agonist used to stimulate microparticle formation. Varying the assay constituents (calcium concentration / Annexin V concentration / buffer type) did not alter the proportion of Annexin V binding microparticles. When compared to Annexin V positive microparticles, Annexin V negative microparticles expressed significantly higher levels of CD42b on their surface, but possessed significantly decreased expressions of CD62p, and CD63. A significant correlation between the percentage of Annexin V binding and XACT procoagulant activity was found (p=0.03). Furthermore, Annexin V binding inhibited greater than 98% of procoagulant phospholipid activity, suggesting that Annexin V binding was a true reflection of procoagulant activity. Microparticles could be sorted using either a flow cytometric or magnetic sorting strategy. By electron microscopy, Annexin V negative events isolated following magnetic sorting were vesicular structures and not small platelets or the remnants of activated platelets. In summary, this thesis has demonstrated the ability of the flow cytometer and XACT assays to detect microparticles and their procoagulant activity. It has also shown that the use of Annexin V to detect microparticles may warrant further investigation.

Includes bibliography (leaves 191-219). Examines the levels of insulin-like growth factor and the presence of IGF binding proteins in human wound fluid. Tests the potency of IGF-1 and 2 analogues in in vitro models of fibroblast activity and their effect on healing in normal and diabetic rodent wounds. Shows that IGF-1, IGF-2 and their binding proteins are present in fluid from a partial thickness cutaneous wound; that the binding proteins negatively modulate the activity of insulin-like growth factors in vitro, but that the IGFs do not necessarily show enhanced activity in vivo at the wound site if binding protein affinity is decreased. Discusses possible roles of these binding proteins in wound repair.

Evidence from various sources suggests that schizophrenia may result from altered brain development. The adult olfactory epithelium provides an available 'window' on neuronal development because new neurons are formed there throughout life. This thesis set out to test the neurodevelopmental hypothesis of psychotic disease. Two cell-based models, skin fibroblast and olfactory mucosa culture, were employed to investigate this hypothesis. In order to first demonstrate the utility of olfactory mucosa culture as a model of neurodevelopment, and to allow the candidate to gain proficiency in the culture of this tissue, an investigation of the mitogenic and differentiating properties of insulin-like growth factor-I within this system was undertaken. Insulin-like growth factor-I has multiple effects within the developing nervous system but its role in neurogenesis in the adult nervous system is less clear. The adult olfactory mucosa is a site of continuing neurogenesis that expresses insulin-like growth factor-I, its receptor, and its binding proteins. The action of insulin-like growth factor-I was assayed in several serum-free culture systems combined with bromodeoxyuridine labelling of proliferating cells and immunochemistry for specific cell types. Once proficiency in olfactory mucosa culture was gained, this model was applied to biopsied olfactory mucosa from schizophrenia and bipolar disorder patients in order to test the developmental parameters of adhesion, cell proliferation, and cell death in a neural tissue. It was previously shown that olfactory cultures from individuals with schizophrenia had increased cell proliferation and attached less frequently than cultures from healthy controls suggesting disrupted neurogenesis. An aim of this study was to replicate those observations in individuals with schizophrenia and and extend them to individuals with bipolar disorder. After completion of the cell and tissue culture assays, microarray analysis of these cell-based models was used to reveal gene expression differences present between patients and healthy controls. Microarray analysis is a complicated technique and the limited amounts of RNA that can be extracted from a single nasal biopsy further compounds this issue. In order to obtain enough material for microarray hybridization RNA samples underwent antisense amplification. Therefore, with the aim of allowing the candidate to gain proficiency in both these techniques prior to microarray analysis of olfactory biopsies from patients with schizophrenia and bipolar disorder, a pilot microarray study of cultured skin fibroblasts from schizophrenia patients and healthy controls was performed. The present findings show that insulin-like growth factor-I and its receptor were expressed by globose basal cells (the neuronal precursor), by neurons and by olfactory ensheathing cells, the special glia of the olfactory nerve. Insulin-like growth factor-I reduced the numbers of proliferating neuronal precursors, induced their differentiation into neurons, and promoted morphological differentiation of neurons. In contrast, this growth factor was mitogenic for olfactory ensheathing cells. The evidence suggests that insulin-like growth factor-I is an autocrine/paracrine signal that induces neuronal precursors to differentiate into olfactory sensory neurons and induces olfactory ensheathing cells to proliferate and that olfactory mucosa culture is valuable in modelling neurodevelopmental processes. When the olfactory musoca culture model was applied to patients with psychosis, a two-fold increase in proliferation of neural cells was found in schizophrenia compared to controls and bipolars. In bipolar cultures there was a 3-fold increase in cell death compared to controls and schizophrenia. Microarray analysis of cultured skin fibroblasts revealed differential expression of over 1000 genes between patients and controls. Inspection of the significant data showed alterations to gene expression between groups in the cell cycle, oxidative phosphorylation, TCA cycle and oxidative stress pathways. Gene expression in each of these pathways was predominately decreased in schizophrenia. Quantitative PCR analysis of selected differentially expressed genes involved with cell cycle regulation validated the increased expression of vitamin D receptor, and decreased expression of proliferating cell nuclear antigen and DEAD (Asp-GIu-Ala-Asp) box polypeptide 5 in skin fibroblasts from patients with schizophrenia. Microarray analysis of biopsied olfactory mucosa showed 146 and 139 differentially expressed genes in schizophrenia and bipolar disorder respectively, compared to controls. Consistent with increased mitosis in schizophrenia biopsy cultures three genes that function to positively influence cell cycle had increased expression. In the bipolar disorder group a dysregulation of the phosphatidylinositolsignalling pathway was seen; five genes that either directly function within or interact with this pathway had decreased expression. There is speculation that the therapeutic effect of psychotropic drugs acting upon this pathway in bipolar disorder involves reduction of neuronal cell death. Increased mitosis of neural cells has now been observed in two separate groups of schizophrenic patients indicating a robust finding. The use of fibroblast and olfactory mucosal tissue can be used to study biological and genetic aspects of neurodevelopment in living humans both with and without psychotic disease. Biopsied olfactory mucosa provides benefits over the use of autopsied material for study of psychotic disease because post-mortem duration and agonal factors that lead to tissue, protein and nucleic acid degradation are not an issue. This study provides evidence for a neurodevelopmental aetiology of schizophrenia and bipolar disorder acting at the level of cell cycle control. Subtle changes in the timing of cell cycle regulation could account for the brain pathologies observed in these diseases. Olfactory mucosa culture is a valuable model of neurodevelopmental processes.

Includes bibliography (leaves 191-219). / Copy 2 lacks some pages. / x, 219 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the levels of insulin-like growth factor and the presence of IGF binding proteins in human wound fluid. Tests the potency of IGF-1 and 2 analogues in in vitro models of fibroblast activity and their effect on healing in normal and diabetic rodent wounds. Shows that IGF-1, IGF-2 and their binding proteins are present in fluid from a partial thickness cutaneous wound; that the binding proteins negatively modulate the activity of insulin-like growth factors in vitro, but that the IGFs do not necessarily show enhanced activity in vivo at the wound site if binding protein affinity is decreased. Discusses possible roles of these binding proteins in wound repair. / Thesis (M.D.)--Dept. of Surgery, University of Adelaide, 2001?

Addenda held in pocket pasted onto back end paper. / Bibliography: leaves 137-165. / xvi, 165 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / This thesis involves the retrospective investigation of the insulin-like growth factors and their binding proteins in the serum of children with chronic renal failure (CRF) and transplantation, before and after treatment with recombinant human growth hormone (rhGH). IGF-IGFBP complexes in pooled serum from prepubertal and pubertal children of both sexes with CRF and renal transplantation, before and after treatment with rhGH, are analysed by fast protein liquid chromatography under neutral conditions. / Thesis (M.D.)--University of Adelaide, Dept. of Paediatrics, 1997?