CD4+CD25+FoxP3+ regulatory T cells (Treg) possess the capacity to modulate both adaptive and innate immunity. Due to their suppressive nature, Treg cells have been studied and tested in a variety of scenarios in an attempt to ameliorate undesired immune responses. While graft versus host disease (GVHD) has in fact emerged as the first clinical application for human Treg cells (Riley et al. 2009), equally important are issues concerning hematopoietic engraftment and immune reconstitution. Currently, little is known about the effect(s) that regulatory T cells may exert outside the immune system in this context. Based on cytokine effector molecules they can produce we hypothesized that Treg cells could regulate hematopoietic phenomena. The studies portrayed in this dissertation demonstrate that Treg cells can differentially affect the colony forming activity of myeloid and erythroid progenitor cells. In-vitro as well as in-vivo findings demonstrate the ability of Tregs to inhibit and augment the differentiation of primitive and intermediate myeloid (interleukin (IL)-3 driven) and late erythroid (erythropoietin driven) hematopoietic progenitor cells, respectively. The inhibitory and enhancing affects appeared to be mediated by independent pathways, the former requiring cell-cell contact, major histocompatibility complex (MHC) class II expression on marrow cells and involving transforming growth factor beta (TGF-beta), whereas the latter required interleukin (IL)-9 and was not contact dependent. Strikingly, we observed that in addition to regulating hematopoietic activity in normal primary BM cells, Tregs were also capable of suppressing colony forming activity by the myelogenous leukemia cell line NFS-60. Furthermore, studies involving endogenous Treg manipulations in-situ (i.e. depletion of these cells) resulted in elevated overall myeloid colony activity (CFU-IL3) and diminished colony numbers of erythroid precursors (CFU-E) in recipients following BMT. Consistent with these results, it was found that upon co-transplant with limiting numbers of bone marrow cells, exogenously added Treg cells exert in-vivo regulation of myeloid and erythroid CFU activity during the initial weeks post-transplantation. This regulation of hematopoietic activity by freshly generated Tregs upon transplantation led to the elaboration of a second hypothesis; following lethal total body irradiation (TBI) the host microenvironment facilitates regulatory T cell activation/effector function. Substantial evidence has accumulated in support of this hypothesis, for example we demonstrate up-regulation of surface molecules such as GARP and CD150/SLAM, which have been previously reported as indicators of Treg activation following TCR signaling and co-stimulation, occurs in donor (reporter) Treg populations. Acquisition of an activated phenotype and hence of effector/modulatory function is consistent with the previous in-vivo observations, indicating that both recipient and donor Treg cells can influence hematopoietic progenitor cell activity post-transplant. Finally, the present studies may be of great relevance in the emerging field of Treg cell based immunotherapy for prevention and/or treatment of HSCT complications.

Acute myeloid leukemia (AML) is a fatal cancer of the human hematopoietic system characterized by the rapid accumulation of non-functional, immature hematopoietic cells in the bone marrow (BM) and peripheral blood (PB) of affected patients. Limited sources of safe hematopoietic stem/progenitor cells (HSPCs) for transplantation and incomplete mechanistic understandings of disease initiation, progression and maintenance have impeded advances in therapy required for improvement of long-term AML patient survival rates. Toward addressing these unmet clinical needs, the ability to generate induced pluripotent stem cells (iPSCs) from human somatic cells may provide platforms from which to develop patient-specific (autologous) cell-based therapies and disease models. However, the ability to generate iPSCs from human AML patient somatic cells had not been investigated prior to this dissertation. Accordingly, I hypothesized that cellular reprogramming of human AML patient somatic cells to iPSCs is possible and will enable derivation of autologous sources of normal and dysfunctional hematopoietic progenitor cells (HPCs). I first postulated that reprogramming AML patient fibroblasts (AML Fibs) to pluripotency would provide a novel source of normal autologous HPCs. Our findings revealed that AML patient-specific iPSCs devoid of leukemia-associated aberrations found in the matched bone marrow (BM) could be generated from AML Fibs, and demonstrated that this cellular platform allowed for the derivation of healthy HPCs capable of normal differentiation to mature myeloid lineages in vitro. During the tenure of these experiments we also redefined conventional reprogramming methods by discovering that OCT4 transcription factor delivery combined with culture in pluripotent-supportive media was minimally sufficient to induce pluripotency in AML and normal Fibs. Toward capturing and modeling the molecular heterogeneity observed across human AML samples in vitro, we next asked whether reprogramming of AML patient leukemic cells would enable generation of iPSCs and derivative HPCs that recapitulated dysfunctional differentiation features of primary disease. Our results demonstrated that conventional reprogramming conditions were insufficient to induce pluripotency in leukemic cells, but that generation of AML iPSCs could be reproducibly achieved in one AML sample when reprogramming conditions were modified. These AML iPSCs and their derivative HPCs harboured and expressed the leukemia-associated aberration found in the BM leukemic cells and similarly possessed dysfunctional differentiation capacities. Together, this body of works provides the proof of principle that cellular reprogramming can be applied on a personalized basis to generate normal and dysfunctional HPCs from AML patient somatic cells. These foundational findings should motivate additional studies aimed at developing iPSC-based cell therapies and disease models toward improving AML patient quality of life and long-term survival rates. / Thesis / Doctor of Philosophy (PhD)

Background: Receptor tyrosine kinase, c-Kit (CD117) plays a pivotal role in the maintenance and expansion of hematopoietic stem/progenitor cells (HSPCs). Additionally, over-expression and/or mutational activation of c-Kit have been implicated in numerous malignant diseases including acute myeloid leukemia. However, the translational regulation of c-Kit expression remains largely unknown. Methods and results: We demonstrated that loss of Pim1 led to specific down-regulation of c-Kit expression in HSPCs of Pim1(-/-)mice and Pim1(-/-)2(-/-)3(-/-) triple knockout (TKO) mice, and resulted in attenuated ERK and STAT3 signaling in response to stimulation with stem cell factor. Transduction of c-Kit restored the defects in colony forming capacity seen in HSPCs from Pim1 (-/-) and TKO mice. Pharmacologic inhibition and genetic modification studies using human megakaryoblastic leukemia cells confirmed the regulation of c-Kit expression by Pim1 kinase: i.e., Pim1-specific shRNA knockdown down-regulated the expression of c-Kit whereas overexpression of Pim1 up-regulated the expression of c-Kit. Mechanistically, inhibition or knockout of Pim1 kinase did not affect the transcription of c-Kit gene. Pim1 kinase enhanced c-Kit S-35 methionine labeling and increased the incorporation of c-Kit mRNAs into the polysomes and monosomes, demonstrating that Pim1 kinase regulates c-Kit expression at the translational level. Conclusions: Our study provides the first evidence that Pim1 regulates c-Kit gene translation and has important implications in hematopoietic stem cell transplantation and cancer treatment.

A hematopoese tem sido bem descrita em modelos murinos nas últimas décadas, contudo, trabalhos demonstrando os mecanismos da hematopoese em humanos ainda são escassos. A derivação da primeira linhagem de células-tronco embrionárias humanas (CTEhs) em 1998, gerou novas perspectivas tanto para o estudo da hematopoese na tentativa de mimetizar o que ocorre naturalmente durante o desenvolvimento embrionário, quanto para a aplicação clínica das células hematopoéticas obtidas a partir da diferenciação dessas células. Contudo, apesar de inúmeros trabalhos terem demonstradoa obtenção de células hematopoéticas a partir de CTEhs, os protocolos têm gerado quantidades variáveis de células, com baixa eficiência e com propriedades funcionais de células primitivas. Desse modo, este trabalho procurou estabelecer um modelo próprio de diferenciação de CTEhs-H1 em células progenitoras hematopoéticas para que estas pudessem ser melhor caracterizadas e obtidas de forma mais eficiente. Para isto, foi desenvolvido um sistema de diferenciação baseado no co-cultivo da linhagem de CTEh-H1 com fibroblastos de embrião de camundongo (MEFs), em meio de diferenciação suplementado soro fetal bovino (SFB) e citocinas e fatores de crescimento hematopoéticos em baixas concentrações. Como resultado, o desenvolvimento do presente trabalho permitiu o estabelecimento de um método para geração de populações mistas de células enriquecidas em CPHs positivas para o marcador CD45, o qual mostrou ser coexpresso com outros marcadores hematopoéticos (CD31, CD43, CD71 e CD38), e células hematopoéticas maduras positivas para marcadores mielóide-específicos (235a, CD14, CD15, CD16) e com características morfológicas típicas. Foi demonstrado que as células obtidas expressavam genes relativos ao sistema hematopoético (CD45, CD31, runx1, tal1, lmo2, prom1, CD34 e notch1), e possuíam potencial clonogênico in vitro da ordem de 1/574 células plaqueadas. Em adição, corroboramos os achados de que as células hematopoéticas apresentam duas origens distintas: a partir do endotelio hemogênico e a partir de células com propriedades hemangioblásticas independentes do endotélio hemogênico. / Hematopoiesis has been well described in murine models in recent decades, however, studies demonstrating the mechanisms of hematopoiesis in humans are still scarce. The first human embryonic stem cells line (hESCs) derived in 1998, has generated new perspectives about the study of hematopoiesis as in attempting to mimic what naturally occurs during embryonic development, as for clinical application of hematopoietic cells obtained from the differentiation of these cells. However, although numerous studies have shown the production of hematopoietic cells derived from hESCs, the protocols have generated varying quantities of cells with low efficiency and functional properties of primitive stem cells. Thus, this study sought to establish our own model for hESC-H1 differentiation in hematopoietic progenitor cells so that they could be better characterized and obtained more efficiently. For this way, we developed a differentiation system based on co-culture of hESC-H1 line with inactivated mouse embryonic fibroblasts (MEFs) in differentiation medium supplemented with fetal calf serum (FCS) and cytokines and hematopoietic growth factors in low concentrations. As a result, the development of this study allowed the establishment of a method for generation of mixed population of cells enriched in hematopoietic progenitor cells positive for the marker CD45, which proved to be co-expressed with other hematopoietic markers (CD31, CD43, CD71 and CD38), and mature hematopoietic cells positive for myeloid-specific markers (235a, CD14, CD15, CD16) and morphological characteristics typical. It was shown that these cells expressed genes related to the hematopoietic system (CD45, CD31, runx1, TAL1, LMO2, prom1, CD34 and NOTCH1), and had clonogenic potential in vitro of 1/574 plated cells. In addition, we corroborate the findings that hematopoietic cells have two distinct origins: they can arise as from an hemogenic endothelium as from cells with hemangioblastic properties by an hemogenic endothelium-independent way.

A hematopoese tem sido bem descrita em modelos murinos nas últimas décadas, contudo, trabalhos demonstrando os mecanismos da hematopoese em humanos ainda são escassos. A derivação da primeira linhagem de células-tronco embrionárias humanas (CTEhs) em 1998, gerou novas perspectivas tanto para o estudo da hematopoese na tentativa de mimetizar o que ocorre naturalmente durante o desenvolvimento embrionário, quanto para a aplicação clínica das células hematopoéticas obtidas a partir da diferenciação dessas células. Contudo, apesar de inúmeros trabalhos terem demonstradoa obtenção de células hematopoéticas a partir de CTEhs, os protocolos têm gerado quantidades variáveis de células, com baixa eficiência e com propriedades funcionais de células primitivas. Desse modo, este trabalho procurou estabelecer um modelo próprio de diferenciação de CTEhs-H1 em células progenitoras hematopoéticas para que estas pudessem ser melhor caracterizadas e obtidas de forma mais eficiente. Para isto, foi desenvolvido um sistema de diferenciação baseado no co-cultivo da linhagem de CTEh-H1 com fibroblastos de embrião de camundongo (MEFs), em meio de diferenciação suplementado soro fetal bovino (SFB) e citocinas e fatores de crescimento hematopoéticos em baixas concentrações. Como resultado, o desenvolvimento do presente trabalho permitiu o estabelecimento de um método para geração de populações mistas de células enriquecidas em CPHs positivas para o marcador CD45, o qual mostrou ser coexpresso com outros marcadores hematopoéticos (CD31, CD43, CD71 e CD38), e células hematopoéticas maduras positivas para marcadores mielóide-específicos (235a, CD14, CD15, CD16) e com características morfológicas típicas. Foi demonstrado que as células obtidas expressavam genes relativos ao sistema hematopoético (CD45, CD31, runx1, tal1, lmo2, prom1, CD34 e notch1), e possuíam potencial clonogênico in vitro da ordem de 1/574 células plaqueadas. Em adição, corroboramos os achados de que as células hematopoéticas apresentam duas origens distintas: a partir do endotelio hemogênico e a partir de células com propriedades hemangioblásticas independentes do endotélio hemogênico. / Hematopoiesis has been well described in murine models in recent decades, however, studies demonstrating the mechanisms of hematopoiesis in humans are still scarce. The first human embryonic stem cells line (hESCs) derived in 1998, has generated new perspectives about the study of hematopoiesis as in attempting to mimic what naturally occurs during embryonic development, as for clinical application of hematopoietic cells obtained from the differentiation of these cells. However, although numerous studies have shown the production of hematopoietic cells derived from hESCs, the protocols have generated varying quantities of cells with low efficiency and functional properties of primitive stem cells. Thus, this study sought to establish our own model for hESC-H1 differentiation in hematopoietic progenitor cells so that they could be better characterized and obtained more efficiently. For this way, we developed a differentiation system based on co-culture of hESC-H1 line with inactivated mouse embryonic fibroblasts (MEFs) in differentiation medium supplemented with fetal calf serum (FCS) and cytokines and hematopoietic growth factors in low concentrations. As a result, the development of this study allowed the establishment of a method for generation of mixed population of cells enriched in hematopoietic progenitor cells positive for the marker CD45, which proved to be co-expressed with other hematopoietic markers (CD31, CD43, CD71 and CD38), and mature hematopoietic cells positive for myeloid-specific markers (235a, CD14, CD15, CD16) and morphological characteristics typical. It was shown that these cells expressed genes related to the hematopoietic system (CD45, CD31, runx1, TAL1, LMO2, prom1, CD34 and NOTCH1), and had clonogenic potential in vitro of 1/574 plated cells. In addition, we corroborate the findings that hematopoietic cells have two distinct origins: they can arise as from an hemogenic endothelium as from cells with hemangioblastic properties by an hemogenic endothelium-independent way.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13464号 / 論医博第2251号 / 新制||医||1055(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 金子 新, 教授 江藤 浩之, 教授 髙折 晃史 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

<p>Megakaryocyte cultures are a strong tool for the in vitro investigation of platelet production in platelet disorders. Peripheral blood derived hematopoietic progenitor cells (PB-HPCs) are the most accessible source of HPCs with high potential to produce mature megakaryocytes in vitro; however, they are present in low numbers making peripheral blood an inefficient source. Additionally, a megakaryocyte culture with an optimized thrombopoietin (TPO) concentration is required which can reliably allow the investigation of suppressive effects of antibodies/plasma from immune thrombocytopenia (ITP) patients. In this study, we developed a megakaryocyte culture with the utilization of human PB-HPCs in an efficient fashion resulting in the production of high purity megakaryocytes in a TPO-dependent manner.</p> <p>The mononuclear fraction was collected from 180 mL of peripheral whole blood and CD34+ cells were isolated by a positive selection yielding the average of 5.5 x 105 ± 2.5 x 105 CD34+ cells (n = 18). Using 96-well tissue-culture plates and seeding 10,000 CD34+ cells/well, the average of 13 experiments in triplicate can be set up utilizing isolated CD34+ in an efficient manner. Capitalizing on a TPO dose-dependent megakaryocyte production experiment, 20 ng/mL was established as the TPO concentration which resulted in the production of mature megakaryocytes without reaching the plateau in megakaryopoiesis response. On day 11 of culture, the expression of megakaryocytic lineage (CD41/61+) and maturation (CD41/61+CD42+) markers peaked at 90.65% and 76.10%. In conclusion, this culture system has broad application for investigation of platelet disorders and drug discovery which can be accessible to all researchers.</p> / Master of Science (MSc)

Η ακτινοθεραπεία αποτελεί μέρος της θεραπείας πολλών αιματολογικών κακοηθών νοσημάτων επηρεάζοντας τον αριθμό και την λειτουργικότητα των προγονικών αιμοποιητικών κυττάρων CD34+ Το DNA των κυττάρων αποτελεί το βασικότερο και ίσως καλύτερα μελετημένο μόριο-στόχο της ακτινοβολίας. Ο μηχανισμός που προκαλεί βλάβη στο DNA είναι άμεσος αλλά και έμμεσος. Η άμεση επίδραση και βλάβη της ακτινοβολίας στο DNA αφορά στην απευθείας δράση της στο μόριο του DNA που είναι δυνατόν να οδηγήσει σε αντικατάσταση ή απώλειας μιας βάσης, αλλαγές στην τεταρτοταγή δομή του DNA και κατά συνέπεια στις αλληλεπιδράσεις του με άλλα μόρια του κυττάρου (cross links), σπασίματα της διπλής έλικας DSB (Double Strand Breaks) ή της μίας μόνο εκ των δύο αλυσίδων SSB (Single Strand Breaks), σημειακές μεταλλάξεις ή απώλεια τμήματος των χρωμοσωμάτων. Ο έμμεσος μηχανισμός δράσης της ακτινοβολίας στο DNA αφορά την δημιουργία ελευθέρων ριζών από την αλληλεπίδραση της ακτινοβολίας με τα μόρια του νερού, ενδοκυττάρια και εξωκυττάρια από τη μία αλλά και από την απευθείας βλάβη του μιτοχονδρίου που αποτελεί κύρια ενδοκυττάρια πηγή ελευθέρων ριζών. Οι παραγόμενες ελεύθερες ρίζες με τη σειρά τους προκαλούν απευθείας βλάβη στο μόριο του DNA, με αποτέλεσμα την πυροδότηση ενός φαυλού κύκλου ενδοκυττάριας παραγωγής ελευθέρων ριζών και πρόκλησης βλαβών στο μόριο του DNA. Σκοπός της παρούσας εργασίας ήταν η μελέτη της δράσης χαμηλών και υψηλότερων δόσεων ακτινοβολίας (1, 2 και 5Gy) σε προγονικά αιμοποιητικά κύτταρα CD34+ προερχόμενα από αίμα ομφαλίου λώρου φυσιολογικών νεογνών, και ο πιθανός προστατευτικός μηχανισμός που ενεργοποιείται από την παρουσία του ινσουλινικού αυξητικού παράγοντα IGF-1. Η προκαλούμενη από την ακτινοβολία ενδοκυττάρια παραγωγή ενεργών μορφών οξυγόνου μελετήθηκε παρουσία ή απουσία του IGF-1, 30 λεπτά και 24 ώρες μετά την ακτινοβόληση με χρήση κυτταρομετρίας ροής. Η έκφραση του αντιοξειδωτικού ενζύμου MnSOD εκτιμήθηκε ποσοτικά με την τεχνική της ανοσοαποτύπωσης και ποιοτικά μέσω ανοσοφθορισμού. Η προκαλούμενη από την ακτινοβολία απόπτωση και η δράση του υπό μελέτη αυξητικού παράγοντα εκτιμήθηκε με τις ακόλουθες τεχνικές: • Διπλή χρώση των κυττάρων με Αννεξίνη και Ιωδιούχο προπίδιο και ανάλυση με κυτταρομετρία ροής • Ανάλυση DNA σε γέλη αγαρόζης • Εκτίμηση σε επίπεδο mRNA και πρωτεΐνης του λόγου των μορίων BCL-2 και BAX • Εκτίμηση της έκφρασης του μορίου κασπάση -9, με τη μέθοδο του ανοσοφθορισμού Εκτιμήθηκε επίσης ο πολλαπλασιασμός και η κλωνογόνος ικανότητα των προγονικών αιμοποιητικών κυττάρων. Η ενδοκυττάρια παραγωγή της ρίζας του υπεροξειδίου παρουσίασε αύξηση 30 λεπτά και 24 ώρες μετά την ακτινοβόληση, και η παρουσία του IGF-1 ανέτρεψε το φαινόμενο αυτό, μειώνοντας και επιστρέφοντας τα ενδοκυττάρια επίπεδα του ανιόντος του υπεροξειδίου στα επίπεδα του δείγματος ελέγχου. Αμέσως μετά την ακτινοβόληση των κυττάρων τα ενδοκυττάρια επίπεδα του υπεροξειδίου του υδρογόνου ανευρέθηκαν υψηλά σε σύγκριση με τα αυθόρμητα ενδογενή επίπεδα μη ακτινοβολημένων κυττάρων για όλες τις δόσεις ακτινοβολίας, όμως στον όψιμο χρόνο μελέτης, των 24 ωρών, παρέμειναν σχεδόν σταθερά, παρουσιάζοντας τάση μείωσης, χωρίς όμως να σημειώνονται στατιστικά σημαντικές διαφορές. Είκοσι τέσσερεις ώρες μετά την ακτινοβόληση τα επίπεδα του αντιοξειδωτικού ενζύμου MnSOD αυξήθηκαν, και η παρουσία του IGF-1 οδήγησε σε περαιτέρω αύξηση της έκφρασης του. Ο IGF-1 ανέστειλε την ενεργοποίηση του μιτοχονδριακού μηχανισμού απόπτωσης ρυθμίζοντας σε μοριακό και κυτταρικό επίπεδο την έκφραση των BCL-2, ΒΑΧ και του λόγου BCL-2/BAX, και μειώνοντας την έκφραση του προαποπτωτικού μορίου κασπάση-9. Θετική ήταν και η δράση του IGF-1 στον πολλαπλασιασμό και στην ικανότητα αποδοτικής αιμοποίησης των προγονικών αιμοποιητικών κυττάρων, ενισχύοντας την ικανότητα πολλαπλασιασμού των ακτινοβολημένων κυττάρων αλλά και την κλωνογόνο ικανότητα τους ως προς τον σχηματισμό BFU-e και CFU-GM αποικιών. Συνοψίζοντας, μπορούμε να υποστηρίξουμε ότι ο IGF-1 συμμετέχει στη διατήρηση της οξειδοαναγωγικής ομοιόστασης του ενδοκυττάριου περιβάλλοντος των προγονικών αιμοποιητικών κυττάρων μειώνοντας τα ενδοκυττάρια επίπεδα των παραγόμενων ενεργών μορφών οξυγόνου. Μέσω θετικής ρύθμισης του αντιοξειδωτικού μηχανισμού MNSOD και συμμετέχοντας προστατευτικά στο μιτοχονδριακό καταρράκτη της απόπτωσης οδηγεί σε προστασία των ακτινοβολημένων αιμοποιητικών κυττάρων επιτρέποντας τους να διατηρήσουν την λειτουργικότητα τους και την ικανότητα αιμοποίησης. / Radiation exerts direct as well as indirect effects on DNA through the generation of reactive oxygen species (ROS). Irradiated hematopoietic progenitor cells (HPCs) experience DNA strand breaks, favoring genetic instability, due to ROS generation. Our aim was to study the effect of a range of radiation doses in HPCs and the possible protective mechanisms activated by insulin-like growth factor-1 (IGF-1). ROS generation was evaluated, in the presence or absence of IGF-1 in liquid cultures of human HPCs-CD34+ irradiated with 1-, 2- and 5-Gy X-rays, using a flow cytometry assay. Manganese superoxide dismutase (MnSOD) expression was studied by western blot analysis and visualized by an immunofluorescence assay. Apoptosis was estimated using the following assays: Annexin-V assay, DNA degradation assay, BCL-2/BAX mRNA and protein levels and caspase-9 protein immunofluorescence visualization. Viability and clonogenic potential were studied in irradiated HPCs. The generation of superoxide anion radicals at an early and a late time point was increased. This linear increase was reversed by the IGF-1 presence, restoring O.- generation at the levels of the innate production as manifested in control non irradiated samples. The hydrogen peroxide generation was increased at early time point but at late time point was stable. IGF-1 presence further enhanced the radiation-induced increase of MnSOD at 24 h post irradiation. IGF 1 inhibited the mitochondria- mediated pathway of apoptosis by regulating the m-RNA and protein expression of BAX, BCL-2 and the BCL-2/BAX ratio and by decreasing caspase-9 protein expression. IGF-1 presence in culture media of irradiated cells restored the clonogenic capacity and the viability of HPCs as well. In conclusion, our data support that IGF-1 anticipates oxidative microenvironment of HPCs by reducing the oxidative stress in intracellular environment due to a range of doses of radiation. IGF-1 succeeds to eliminate free radicals by favoring scavenger’s mechanisms and by regulating elements responsible for the mitochondrial pathway of apoptosis, allowing the sustained clonogenic capacity of hematopoietic progenitor cells.

No description available.

Mit der vorliegenden Habilitationsschrift habe ich den Versuch unternommen, die beiden Themenkomplexe meiner bisherigen wissenschaftlichen Tätigkeit als Beispiele für die Rolle von Modellen in der klinischen Forschung zu verwenden. Den Ansto§ dazu gaben Diskrepanzen, die mir in der Auseinandersetzung mit eigenen Ergebnissen und Beobachtungen im Umfeld dieser Themenkomplexe aufgefallen sind: der Rolle kontaminierender Tumorzellen in der Hochdosistherapie maligner Tumoren einerseits und dem Enzym Dipeptidylpeptidase IV (DPP IV) andererseits. Die beobachteten Diskrepanzen sind Ausdruck konkurrierender pathophysiologischer oder therapeutischer Modelle, und die Präferenz eines bestimmten Modells scheint nicht rein rational erklärbar. Welche Faktoren tragen jedoch zur Entscheidung für oder gegen ein bestimmtes Modell bei? Ich möchte den Umgang mit wissenschaftlichen Modellen anhand der genannten Themenkomplexe aus meiner Sicht erörtern. Anschlie§end soll ein Entwurf skizziert werden, in dem die der Entscheidung für oder gegen ein therapeutisches Modell zugrundeliegende Motivationslage besser verständlich wird und die Intentionalität klinischer Forschung auf den Patienten hin berücksichtigt. / In the thesis presented here, I have taken the challenge to use the topics of my scientific work to discuss the role that models appear to exert in clinical science. This decision arose from discrepancies that became evident in the comparative assessment of my own studies in relation with the surrounding scientific context: the role of tumor cells contaminating peripheral blood or progenitor cell harvests as part of a high-dose chemotherapy regimen on the one hand, and the enzyme dipeptidyl peptidase IV (DPP IV) on the other. The observed discrepancies appear to result from competing pathophysiological or therapeutic models, and the preference or rejection of one model apparently cannot be explained solely by rational factors. I will discuss the application of models in the context of the topics which my scientific work has been focusing on, and I will develop a draft proposal which will render the individual motivational status underlying the decision in favor of or against a distinct model easier to understand, with attention to the intentionality of clinical research towards the patient.