Influenza is a contagious respiratory disease that has caused at least four pandemics and countless epidemics since the 20th century, impacted millions of people worldwide and the global economy. To date, the predominant influenza species circulating in humans are influenza A and B. Influenza may cause serious illness in all age groups but individuals such as the newborns and senior population whose immune systems are compromised are at higher risk for severe disease. Interestingly, during the outbreak of pandemic 2009 H1N1 (H1N1pdm), it was found that the elderly had the lowest hospitalization rate and an increased proportion of healthy adults developed severe disease. Furthermore, several clinical studies have demonstrated that most H1N1pdm infected children experienced mild to moderate illness and led to the least mortality. The difference of disease outcome in age groups between different influenza infections may be due to several factors, which include differing pathogenicity between the viruses, differential immune status and composition among the age groups, and pre-existing immunity from previous encounter(s) with a similar virus. Since the human clinical data are often complicated by secondary factors such as co-morbidities, I used the ferret model to address these questions. I first compared the clinical and pathological patterns among the pandemic and seasonal influenza strains and found H1N1pdm caused the most severe illness to healthy ferrets. Importantly, the disease severity did not correlate with viral burden but immunopathology. To study the age effect, I found that H1N1pdm infected young ferrets with mild clinical symptoms developed specialized ectopic lymphoid structures and a distinct cytokine expression profile in the lungs, which were absent in adult ferrets with severe illness. I also examined antigenic change in historical H1N1s and anti-H1 responses to explain the pre-existing immunity of H1N1pdm found in the elderly. However, low similarity was found between historical H1N1s and H1N1pdm. Lastly, I conducted a detailed influenza B comparative study. I observed the pathogenic B strain was capable to cause lower respiratory tract infection and pathology like the influenza A viruses. Overall, this thesis provides novel insights for developing therapeutic and prophylactic strategies against influenza infection.

Influenza is a contagious respiratory disease that has caused at least four pandemics and countless epidemics since the 20th century, impacted millions of people worldwide and the global economy. To date, the predominant influenza species circulating in humans are influenza A and B. Influenza may cause serious illness in all age groups but individuals such as the newborns and senior population whose immune systems are compromised are at higher risk for severe disease. Interestingly, during the outbreak of pandemic 2009 H1N1 (H1N1pdm), it was found that the elderly had the lowest hospitalization rate and an increased proportion of healthy adults developed severe disease. Furthermore, several clinical studies have demonstrated that most H1N1pdm infected children experienced mild to moderate illness and led to the least mortality. The difference of disease outcome in age groups between different influenza infections may be due to several factors, which include differing pathogenicity between the viruses, differential immune status and composition among the age groups, and pre-existing immunity from previous encounter(s) with a similar virus. Since the human clinical data are often complicated by secondary factors such as co-morbidities, I used the ferret model to address these questions. I first compared the clinical and pathological patterns among the pandemic and seasonal influenza strains and found H1N1pdm caused the most severe illness to healthy ferrets. Importantly, the disease severity did not correlate with viral burden but immunopathology. To study the age effect, I found that H1N1pdm infected young ferrets with mild clinical symptoms developed specialized ectopic lymphoid structures and a distinct cytokine expression profile in the lungs, which were absent in adult ferrets with severe illness. I also examined antigenic change in historical H1N1s and anti-H1 responses to explain the pre-existing immunity of H1N1pdm found in the elderly. However, low similarity was found between historical H1N1s and H1N1pdm. Lastly, I conducted a detailed influenza B comparative study. I observed the pathogenic B strain was capable to cause lower respiratory tract infection and pathology like the influenza A viruses. Overall, this thesis provides novel insights for developing therapeutic and prophylactic strategies against influenza infection.

Head and neck squamous cell carcinomas (HNSCC) remain a significant cause of morbidity worldwide, with approximately 550,000 new cases diagnosed each year. The main etiological factors include smoking and alcohol consumption. The incidence of non-oropharyngeal HNSCC is gradually decreasing while the incidence of squamous cell oropharyngeal carcinoma (OPSCC) is still on the rise. This increasing incidence can be most likely attributed to an increasing prevalence of human papillomavirus (HPV) infection. From the clinical point of view the most significant fact is that patients with HPV positive OPSCC have better prognosis. HNSCC is linked to an alteration in the immune system. Only a limited number of studies have correlated both the immunological parameters and HPV status with patient prognosis. Therefore, we focused on the research of the immunological profile of patients with HNSCC of viral and non-viral etiology. In our study, 110 patients with HNSCC were enrolled. They were divided into HPV-positive and HPV-negative groups based on the expression of HPV 16 E6 mRNA detected in the tumor tissue. Basic lymphocyte subpopulations (CD3+, CD4+ CD25+ Treg, CD4+ CD25+ FoxP3 Treg, CD4+, CD8+, CD19, and CD3- CD16+ CD56+ cells) were determined by flow cytometry in the peripheral blood (PB). We observed...

Head and neck squamous cell carcinomas (HNSCC) remain a significant cause of morbidity worldwide, with approximately 550,000 new cases diagnosed each year. The main etiological factors include smoking and alcohol consumption. The incidence of non-oropharyngeal HNSCC is gradually decreasing while the incidence of squamous cell oropharyngeal carcinoma (OPSCC) is still on the rise. This increasing incidence can be most likely attributed to an increasing prevalence of human papillomavirus (HPV) infection. From the clinical point of view the most significant fact is that patients with HPV positive OPSCC have better prognosis. HNSCC is linked to an alteration in the immune system. Only a limited number of studies have correlated both the immunological parameters and HPV status with patient prognosis. Therefore, we focused on the research of the immunological profile of patients with HNSCC of viral and non-viral etiology. In our study, 110 patients with HNSCC were enrolled. They were divided into HPV-positive and HPV-negative groups based on the expression of HPV 16 E6 mRNA detected in the tumor tissue. Basic lymphocyte subpopulations (CD3+, CD4+ CD25+ Treg, CD4+ CD25+ FoxP3 Treg, CD4+, CD8+, CD19, and CD3- CD16+ CD56+ cells) were determined by flow cytometry in the peripheral blood (PB). We observed...

In der vorliegenden Arbeit wurde der zelluläre Immunstatus von 17 Patienten mit Erstdiagnose eines soliden gastrointestinalen Tumors vor und nach intravenöser Applikation von drei Zyklen einer konventionellen Polychemotherapie untersucht. Verglichen wurde zu Beginn der Therapie mit einer Kontrollgruppe, bestehend aus 21 nicht onkologisch vorerkrankten Probanden. Zur Messung der individuellen T-Zellvermittelten Immunantwort auf Einzelzellebene wird auf die Methode des IFN-γ-ELISPOT-Assays zurückgegriffen. Die zentrale Frage war, ob die Applikation einer Polychemotherapie einen messbaren Effekt auf die Immunantwort des einzelnen Individuums hat. Zudem sollte untersucht werden, ob generelle Unterschiede zwischen Patienten mit einer unbehandelten Tumorerkrankung und gesunden Probanden bzw. allgemein internistisch erkrankten Patienten zu erkennen sind. In Zusammenschau der Ergebnisse sind trotz überwiegend unveränderter T-Zell-Antwort auf die meisten der eingesetzten Antigene einige statistisch signifikante Unterschiede festzuhalten. So zeigte die Gruppe der Tumorpatienten vor Applikation der Chemotherapie im Vergleich zur Kontrollgruppe eine signifikant erhöhte Spotintensität und einen höheren Stimulationsindex [A] in Bezug auf das Tuberkulose-Antigen CFP-10. Diese Veränderungen waren nach Applikation der Chemotherapie nicht mehr nachzuweisen. Des Weiteren ergaben sich bei den Tumorpatienten vor und nach Chemotherapie signifikante Veränderungen der T-Zell-Antwort bezüglich des Antigens Tetanus-Toxoid. Nach Applikation von 3 Zyklen Chemotherapie kam es zu einer Verminderung des Stimulationsindex [A]. Es wird daher die Vermutung nahe gelegt, dass sich gerade in Bezug auf bakterielle Infektionen die T-Zell-Antwort der Tumorpatienten signifikant ändert. Die klinische Relevanz müsste jedoch anhand gezielter Messung auf spezifische bakterielle Antigene in größer angelegten Studien überprüft werden.

Introduction: Immune therapy plays a larger role in cancer treatment these days, but in order to find new therapies and improve already existing ones, more knowledge about the immune system is needed. The peripheral blood contains many different cell types, some extensively studied, some less well-known. By using multicolor flow cytometry, the immune status of an individual can be displayed in relatively short time. Aim: The aim of this study was to develop a multicolor flow cytometry method in order to examine the distribution of 31 cell types, with a focus on immune regulatory cells, in peripheral blood in healthy donors, as well as examine the impact of cryopreservation on the different subsets. Methods: After isolating the mononuclear cells from peripheral blood using Ficoll separation, each sample (n = 19) were analyzed with three flow cytometry panels. The remaining cells were cryopreserved in -190°C and later thawed and analyzed the same way as the fresh samples were. Results: The cell distribution in fresh samples were mostly consistent with other studies. While the percentage of many cell types remained unchanged after thawing, the total percentage of T helper cells and some subsets were decreased in frozen samples, leading to a decrease in total T cells. Furthermore, the percentage of total monocytes were increased and the distribution of monocyte subsets were altered in frozen samples, among others. Conclusion: This study confirms the results of other studies of the human immune system and provides valuable knowledge about the impact of cryopreservation.

In der vorliegenden Arbeit wurde der zelluläre Immunstatus von 17 Patienten mit Erstdiagnose eines soliden gastrointestinalen Tumors vor und nach intravenöser Applikation von drei Zyklen einer konventionellen Polychemotherapie untersucht. Verglichen wurde zu Beginn der Therapie mit einer Kontrollgruppe, bestehend aus 21 nicht onkologisch vorerkrankten Probanden. Zur Messung der individuellen T-Zellvermittelten Immunantwort auf Einzelzellebene wird auf die Methode des IFN-γ-ELISPOT-Assays zurückgegriffen. Die zentrale Frage war, ob die Applikation einer Polychemotherapie einen messbaren Effekt auf die Immunantwort des einzelnen Individuums hat. Zudem sollte untersucht werden, ob generelle Unterschiede zwischen Patienten mit einer unbehandelten Tumorerkrankung und gesunden Probanden bzw. allgemein internistisch erkrankten Patienten zu erkennen sind. In Zusammenschau der Ergebnisse sind trotz überwiegend unveränderter T-Zell-Antwort auf die meisten der eingesetzten Antigene einige statistisch signifikante Unterschiede festzuhalten. So zeigte die Gruppe der Tumorpatienten vor Applikation der Chemotherapie im Vergleich zur Kontrollgruppe eine signifikant erhöhte Spotintensität und einen höheren Stimulationsindex [A] in Bezug auf das Tuberkulose-Antigen CFP-10. Diese Veränderungen waren nach Applikation der Chemotherapie nicht mehr nachzuweisen. Des Weiteren ergaben sich bei den Tumorpatienten vor und nach Chemotherapie signifikante Veränderungen der T-Zell-Antwort bezüglich des Antigens Tetanus-Toxoid. Nach Applikation von 3 Zyklen Chemotherapie kam es zu einer Verminderung des Stimulationsindex [A]. Es wird daher die Vermutung nahe gelegt, dass sich gerade in Bezug auf bakterielle Infektionen die T-Zell-Antwort der Tumorpatienten signifikant ändert. Die klinische Relevanz müsste jedoch anhand gezielter Messung auf spezifische bakterielle Antigene in größer angelegten Studien überprüft werden.