No description available.

Interleukin-6 (IL-6), oncostatin M (OSM), leukaemia inhibitory factor (LIF) and cardiotrophin-1 (CT-1) are members of the IL-6-type cytokine family that is characterised by sharing the common receptor subunit gp130. While the involvement of these polypeptides in cell differentiation, cell survival, proliferation, apoptosis, inflammation, haematopoiesis, immune response and acute phase reaction has already been demonstrated, the description of their role in development and progression of cardiac hypertrophy is still rather limited. A model has been postulated that declares the transient expression of IL-6-type cytokines as protective, while a continuous cardiac secretion of these proteins seems to be rather harmful for the heart. Within the first part of the study (results 4.1, 4.2 and 4.3) it was shown that OSM induces hypertrophy of primary neonatal rat cardiomyocytes (NRCM), just as its related cytokines LIF, CT-1 and hIL-6/hsIL-6R (hsIL-6R, human soluble IL-6 receptor). Regarding the hypertrophic potentials the LIFR/gp130 utilising cytokines (hLIF, hOSM and hCT-1) are stronger inducers than the OSMR/gp130 utilising mOSM. Human IL-6/hsIL-6R which signals via a gp130 homodimer has the weakest hypertrophic effect. The thorough analysis of typical signalling pathways initiated by IL-6-type cytokines revealed that STAT3 phosphorylation at Y705 seems to be the most important hypertrophy promoting pathway. In addition and in contrast to published work, we clearly demonstrate that classical IL-6 signalling (upon pure IL-6 treatment) has no hypertrophic effect on cardiomyocytes, because they lack sufficient amounts of the membrane-bound IL-6R. This is also true for neonatal rat cardiac fibroblasts (NRCFB). Since these cells can also influence cardiac hypertrophy, signalling pathways and target genes were additionally examined in NRCFB in response to OSM, LIF and IL-6/sIL-6R. One of the key findings of this thesis is the selective change in expression of cytokines and receptors of the IL-6 family in both cell types upon IL-6-type cytokine stimulation. A striking difference between NRCM and NRCFB is the fact that the target gene induction in NRCM is of similar duration upon mOSM and hIL-6/hsIL-6R treatment, while hIL-6/hsIL-6R is capable of promoting the induction of OSMR and IL-6 significantly longer in NRCFB. By searching for transcription factors or intermediate cytokines which could be responsible for this difference, a strong correlation between increased Il6 transcription and amount of mRNA levels for C/EBPβ and C/EBPδ was observed in response to IL-6/sIL-6R stimulation. Interestingly, mOSM also mediates the induction of C/EBPβ and δ, but the initiation is significantly less efficient than in response to IL-6/sIL-6R. Therefore, we assume that mOSM stimulation fails to reach threshold values required for a prolonged IL-6 secretion. Since we additionally observe a slight IL-6R mRNA upregulation in NRCFB, we assume that the combination of IL-6, LIF, C/EBPβ, C/EBPδ and IL-6R expression might be responsible for the observed different kinetics with which IL-6 and OSM stimulate NRCFB. In addition to the aforementioned proteins, members of the renin-angiotensin system seem to support the IL-6-type cytokine mediated hypertrophy. Since it has already been shown that angiotensin II vice versa induces IL-6 expression in NRCM and NRCFB, this enhanced expression of AT1α and ACE could be of crucial interest for the hypertrophy supporting phenotype. The second part of the presented work dealt with the characterisation of the receptor complexes of rat OSM. The central question of this analysis was, whether rOSM, just like mOSM, only binds the type II (OSMR/gp130) receptor complex or is able to utilise the type II and type I (LIFR/gp130) receptor complex. Using different experimental approaches (knock-down of the OSMR expression by RNA interference, blocking of the LIFR by LIF-05, an antagonistic LIF variant, and generation of stably transfected Ba/F3 cells expressing the newly cloned rat OSMR/gp130 or LIFR/gp130 receptor complex) we can clearly show that rat OSM surprisingly utilises both, the type I and type II receptor complex. Therefore it closely mimics the human situation. Furthermore, rOSM displays cross-species activities and stimulates cells of human as well as murine origin. Its signaling capacities closely mimic those of human OSM in cell types of different origin in the way that strong activation of the JAK/STAT, the MAP kinase as well as the PI3K/Akt pathways can be observed. Therefore, the results obtained in the last section of this thesis clearly suggest that rat disease models would allow evaluation of the relevance of OSM for human biology much better than murine models. / Interleukin-6 (IL-6), Oncostatin M (OSM), Leukämie inhibierender Faktor (LIF) und Cardiotrophin-1 (CT-1) sind Mitglieder der IL-6-Typ Zytokin-Familie, welche durch die gemeinsame Nutzung der Rezeptoruntereinheit gp130 charakterisiert ist. Während eine Beteiligung dieser Proteine bei Zelldifferenzierung, Zellüberleben, Proliferation, Apoptose, Entzündung, Hämatopoese, Immunantwort und Akut-Phase-Reaktion bereits gezeigt wurde, ist die Beschreibung ihrer Rolle bei der Entstehung und dem Fortschreiten der kardialen Hypertrophie deutlich limitierter. Es wurde bereits ein Modell postuliert, nach dem die kurzzeitige Expression dieser Zytokine schützend wirkt, während eine andauernde kardiale Sekretion eher schädlich für das Herz zu sein scheint. Im ersten Teil der Arbeit (Ergebnisse 4.1, 4.2 und 4.3) konnte gezeigt werden, dass OSM wie auch seine verwandten Zytokine LIF, CT-1 und hIL-6/hsIL-6R (hsIL-6R, humaner löslicher IL-6 Rezeptor) Hypertrophie-induzierend auf primäre neonatale Ratten-Kardiomyozyten (NRCM) wirkt. Hinsichtlich ihres hypertrophen Potentials sind die Zytokine, welche über LIFR/gp130 signalisieren (hLIF, hOSM und hCT-1), die stärkeren Induktoren im Vergleich zu mOSM, welches den OSMR/gp130 Rezeptorkomplex bindet. Die Stimulation mit humanem IL-6/hsIL-6R hatte hingegen die schwächste hypertrophe Wirkung. Unsere genaue Analyse der typischen IL-6-Typ Zytokin vermittelten Signalwege enthüllte die Phosphorylierung von STAT3 an Y705 als offenkundig wichtigsten hypertrophen Weg. Zusätzlich dazu konnten wir auch zeigen, dass klassisches IL-6 Signalling (ohne sIL-6R) keinen hypertrophen Einfluss auf NRCM hat, da diesen Zellen ausreichende Mengen des membranständigen IL-6R fehlen. Diese Beobachtung steht in klarem Kontrast zu bereits publizierten Arbeiten. In den ebenfalls untersuchten neonatalen Ratten-Kardiofibroblasten (NRCFB) verhält es sich, was den IL-6R angeht, genauso wie in NRCM. Da auch diese Zellen eine kardiale Hypertrophie mit beeinflussen können, wurden in ihnen die gleichen Signalwege und Zielgene nach Stimulation mit OSM, LIF und IL-6/sIL-6R untersucht. Die selektive Expressionsregulation von Zytokinen und Rezeptoren der IL-6-Familie in beiden Zelltypen nach IL-6-Typ Zytokin Stimulation ist hierbei einer unserer wichtigsten Befunde. Ein gravierender Unterschied zwischen NRCM und NRCFB besteht darin, dass die mOSM und hIL-6/hsIL-6R vermittelte Geninduktion in NRCM von vergleichbarer Dauer ist, wohingegen sie sich in NRCFB unterscheidet. Bei der Suche nach Transkriptionsfaktoren oder intermediären Zytokinen, welche für diesen Unterschied verantwortlich sein könnten, beobachteten wir nach IL-6/sIL-6R Stimulation eine deutliche Korrelation zwischen der Il6-Transkription und den mRNA Mengen von C/EBPβ und C/EBPδ. Auch OSM ist in der Lage beide Transkriptionsfaktoren zu induzieren, jedoch viel ineffizienter als IL-6/sIL-6R. Wir vermuten, dass mOSM einen bestimmten Schwellenwert, der für die verlängerte IL-6 Sekretion benötigt wird, nicht erreicht. Da wir zusätzlich noch eine schwache Zunahme der IL-6R mRNA in NRCFB beobachten konnten, gehen wir davon aus, dass die Expression von IL-6, LIF, C/EBPβ, C/EBPδ und IL-6R für die unterschiedlichen Kinetiken, mit denen IL-6 und OSM NRCFB stimulieren, verantwortlich sein dürfte. Es scheinen auch Mitglieder des Renin-Angiotensin-Systems die IL-6-Typ Zytokin vermittelte Hypertrophie zu unterstützen. Da schon gezeigt wurde, dass Angiotensin II reziprok die IL-6 Expression induziert, könnte diese verstärkte Synthese von AT1α und ACE von größter Bedeutung für den Hypertrophie-unterstützenden Phänotyp sein. Der zweite Teil der Arbeit (4.4) beschäftigte sich mit der Charakterisierung der Rezeptorkomplexe des Ratten-OSM. Die zentrale Frage hierbei bestand darin, ob rOSM wie mOSM nur den Typ II (OSMR/gp130) Rezeptorkomplex bindet, oder wie das hOSM sowohl den Typ II als auch den Typ I (LIFR/gp130) Rezeptorkomplex benutzen kann. Mit Hilfe unterschiedlicher experimenteller Strategien (knock-down der OSMR Expression durch RNA-Interferenz, LIFR-Blockade durch antagonistisches LIF-05, und die Generierung von stabil transfizierten Ba/F3-Zellen, welche die hierzu klonierten OSMR/gp130 oder LIFR/gp130 Rezeptorkomplexe der Ratte exprimieren) konnten wir eindeutig zeigen, dass Ratten-OSM überraschenderweise beide Rezeptorkomplexe benutzt. In dieser Hinsicht verhält sich es sich wie das humane Homolog. Des Weiteren besitzt Ratten-OSM Kreuz-Spezies-Aktivität und stimuliert humane und murine Zellen. Das Signal-Potential von rOSM ist dem von humanem OSM auf Zellen unterschiedlichen Ursprungs sehr ähnlich. Das Zytokin ist befähigt JAK/STAT, MAP Kinase und PI3K/Akt Signalwege potent zu aktivieren. Deshalb deuten die Daten des zweiten Teils dieser Arbeit darauf hin, dass Krankheitsmodelle in Ratten die Evaluierung der Relevanz des OSM für die humane Biologie deutlich besser widerspiegeln würden als murine Modelle.

Die Nicht-alkoholische Fettlebererkrankung (NAFLD) ist eine der häufigsten chronischen Lebererkrankungen der westlichen Welt. Die Pathogenese der Erkrankung ist noch nicht vollständig erforscht und wirksame medikamentöse Therapien sind bisher nicht zugelassen. Wachsende Evidenz zeigt, dass das Interleukin-6-Typ-Zytokin Oncostatin M (OSM) eine wichtige Rolle in der Pathogenese der NAFLD spielt. Die japanische Arbeitsgruppe um Komori et al. zeigte an OSM-Rezeptor-β-defizienten (Osmr-KO-) Mäusen sowie durch OSM-Behandlung von genetisch und ernährungsbedingt adipösen Mäusen, dass OSM vor einer hepatischen Steatose und metabolischer Komorbidität schützen kann. Andere Publikationen suggerieren, dass OSM an NAFLD-Entwicklung und -Progression beteiligt ist, indem es die Expression von Genen der β-Oxidation und Very-Low-Density-Lipoprotein (VLDL-) Sekretion reprimiert und die Expression profibrogenetischer Gene fördert. Low-Density-Lipoprotein-Rezeptor-defiziente- (Ldlr-KO-) Mäuse sind seit Langem als Atherosklerose-Modell etabliert und wurden zuletzt auch als physiologisches Modell für NAFLD identifiziert. Um die Rolle von OSM in der NAFLD-Pathogenese zu beleuchten, wurden Osmr-KO-Mäuse auf Wildtyp- (WT-) und Ldlr-KO-Hintergrund untersucht, die über 12 Wochen eine fett- und cholesterinreiche Western Diet erhielten und anschließend für die Organentnahme geopfert wurden. Im Vorfeld dieser Arbeit wurden Körpergewicht, Blutglukose, Serum-Cholesterin und Lebergewicht der Tiere gemessen. Hierbei zeigte sich ein erhöhtes Körpergewicht, unveränderte Blutglukose, erhöhtes Serum-Cholesterin sowie ein erhöhtes Lebergewicht in Osmr-KO- gegenüber WT-Mäusen. Andersherum waren Körpergewicht, Blutglukose, Serum-Cholesterin und Lebergewicht in Ldlr-Osmr-KO- gegenüber Ldlr-KO-Mäusen vermindert. Im Rahmen der vorliegenden Arbeit erfolgte die histologische Untersuchung des Lebergewebes, die Messung von Serum-Triglyzeriden und Fettsäuren sowie die Untersuchung der hepatischen Genexpression. An kultivierten Zellen der humanen Hepatom-Zelllinie HepG2 wurde eine mögliche Regulation der CYP7A1-Genexpression durch OSM untersucht. CYP7A1 ist als Schrittmacherenzym der Gallensäuresynthese an der hepatischen Cholesterin-Clearance beteiligt. Osmr-KO-Mäuse zeigten gegenüber WT-Mäusen histologisch eine verstärkte hepatische Steatose. Bei der Untersuchung der mRNA-Expression von Genen mit Beteiligung an der hepatischen Lipidhomöostase zeigte sich eine Minderexpression von Ldlr in Osmr-KO-Mäusen. Weiterhin zeigte sich eine etwas geringere Expression von Cyp7a1 in Osmr-KO-Mäusen. Die Expression aller anderen untersuchten Gene, die an Fettsäuresynthese, Cholesterintransport und –metabolismus beteiligt sind, lieferten keine Erklärung für eine erhöhte hepatische Lipidakkumulation in Osmr-KO-Mäusen. Ldlr-Osmr-KO-Mäuse hatten gegenüber Ldlr-KO-Mäusen eine geringer ausgeprägte hepatische Steatose. Die mRNA-Expression von Genen der Fettsäuresynthese, der Cholesterinbiosynthese und des Cholesterintransports waren in Ldlr-Osmr-KO- gegenüber Ldlr-KO-Mäusen nicht wesentlich verändert. Allerdings fiel eine deutliche Hochregulation von Cyp7a1 in Ldlr-Osmr-KO-Mäusen auf. Darüber hinaus war Osm in Ldlr-KO-Mäusen gegenüber WT-Mäusen stärker exprimiert. Um eine Regulation von CYP7A1 durch OSM nachzuweisen, wurde die Genexpression in HepG2-Zellen nach Stimulation mit OSM untersucht. Hierbei zeigte sich, dass OSM die mRNA-Expression von CYP7A1 supprimierte. Dieser Effekt war durch die Zugabe von Inhibitoren der Januskinasen (JAK), Mitogen Activated Protein Kinase/ERK-Kinase (MEK) und Extracellular-signal Regulated Kinase ½ (ERK1/2) reversibel. Die CYP7A1-Suppression durch OSM ging mit einer verminderten Expression des Transkriptionsfaktor-Gens HNF4A einher. Osmr-KO-Mäuse zeigten gegenüber WT-Mäusen nach 12 Wochen Western Diet verstärkte Adipositas, Dyslipidämie sowie eine hepatische Steatose. Die Analyse der hepatischen mRNA-Expression legt nahe, dass die Minderexpression von Ldlr in Osmr-KO-Mäusen im Vergleich zu WT-Mäusen zur Verstärkung der Dyslipidämie und hepatischen Steatose beigetragen hat. Weiterhin kann die geringere Expression von Cyp7a1 in Osmr-KO-Mäusen durch daraus resultierende Akkumulation von Cholesterin zur erhöhten hepatischen Lipidakkumulation in diesen Mäusen beigetragen haben. Ldlr-KO-Mäuse zeigten nach 12 Wochen Western Diet ebenfalls eine hepatische Steatose. Diese war in Ldlr-Osmr-KO-Mäusen gegenüber Ldlr-KO-Mäusen geringer ausgeprägt. Die erhöhte Expression von Cyp7a1 in Ldlr-Osmr-KO-Mäusen kann die Verbesserung von hepatischer Lipidakkumulation und Dyslipidämie durch erhöhte Cholesterinmetabolisierung zu Gallensäuren erklären. Übereinstimmend mit der Cyp7a1-Regulation in LDLR-defizienten Mäusen zeigte sich in vitro, dass OSM die Expression von CYP7A1 in HepG2-Zellen vermindert und sich so negativ auf die hepatische Lipidhomöostase auswirken kann. Insgesamt implizieren diese Ergebnisse eine divergierende Rolle von OSM bei der Entwicklung einer hepatischen Steatose abhängig vom genetischen Hintergrund. OSM scheint bei WT-Mäusen für die Erhaltung der metabolischen Gesundheit wichtig zu sein. Bei Ldlr-KO-Mäusen hingegen scheint OSM die Entwicklung von Adipositas, Dyslipidämie und hepatischer Steatose zu fördern. Die differenzielle Rolle in WT- und Ldlr-KO-Mäusen könnte durch unterschiedliche Osm-Expressionsspiegel zustande kommen: Während basale OSMRβ-Signaltransduktion durch geringe OSM-Spiegel in WT-Mäusen für die Lipidhomöostase essenziell zu sein scheint, könnte erhöhte oder prolongierte OSMRβ-Signaltransduktion durch höhere OSM-Spiegel in Ldlr-KO-Mäusen das Fortschreiten der hepatischen Steatose fördern. Dies stellt OSM als mögliches NAFLD-Therapeutikum in Frage. Um die Hypothese zu überprüfen, dass OSM abhängig von der Höhe und Kinetik der Spiegel günstige oder ungünstige Effekte auf die NAFLD-Entwicklung hat, sollte in zukünftigen Experimenten der Einfluss kurz- und langfristiger Behandlung von WT-Mäusen mit OSM unterschiedlicher Konzentrationen auf die Entwicklung einer hepatischen Steatose untersucht werden. / Non-alcoholic fatty liver disease (NAFLD) is among the most common chronic liver diseases in Western societies. Pathogenetic mechanisms are not fully elucidated and to date there is no approved drug therapy available. There is mounting evidence that the Interleukin-6-type-cytokine Oncostatin M (OSM) plays a crucial role in the pathogenesis of NAFLD. The Japanese working group of Komori et al. had shown that OSM has favorable effects on metabolism und protects against hepatic steatosis using OSM-receptor-β-deficient (Osmr-KO-) mice as well as OSM treatment of genetically or diet-induced obese mice. Other publications suggest that OSM contributes to the pathogenesis and progression of NAFLD by reducing the expression of genes involved in β-oxidation and Very-Low-Density-Lipoprotein (VLDL) secretion and inducing the expression of genes involved in fibrogenesis. Recently Low-Density-Lipoprotein-Receptor-deficient (Ldlr-KO-) mice, which are a well-established model for atherosclerosis, have also been considered a physiological model for NAFLD. To further investigate the role of OSM in NAFLD pathogenesis Osmr-KO mice on either wild type- (WT-) or Ldlr-KO-background were fed a high-fat and high-cholesterol Western diet for 12 weeks and were then sacrificed for tissue collection. Prior to the present thesis body weight, blood glucose levels, serum cholesterol and liver weight of the mice were measured. Osmr-KO mice showed increased body weight, serum cholesterol levels and liver weight compared to WT mice, whereas blood glucose levels did not differ. On the contrary, Ldlr-Osmr-KO mice showed decreased values in all parameters compared to Ldlr-KO mice, including body weight, blood glucose levels, serum cholesterol levels and liver weight. In the present thesis a histological examination of the liver tissue was made, serum levels of triglycerides and fatty acids were measured, and hepatic gene expression was analyzed. In cultured cells of the human hepatoma cell line HepG2 a potential regulation of CYP7A1 gene expression by OSM was examined. CYP7A1 is the rate limiting enzyme of bile acid synthesis and is therefore involved in hepatic cholesterol clearance. Osmr-KO mice showed enhanced hepatic steatosis compared to WT mice. Examination of gene expression involved in hepatic lipid homeostasis revealed reduced Ldlr expression levels in Osmr-KO mice. Furthermore, a slightly decreased Cyp7a1 expression was observed. The expression of other genes involved in fatty acid synthesis, cholesterol transport and cholesterol metabolism did not explain the enhanced hepatic lipid accumulation in Osmr-KO mice. In Ldlr-Osmr-KO mice hepatic steatosis was reduced compared to Ldlr-KO mice. The expression of genes involved in fatty acid synthesis, cholesterol synthesis and cholesterol transport was not considerably altered in Ldlr-Osmr-KO compared to Ldlr-KO mice. However, Cyp7a1 was markedly upregulated in Ldlr-Osmr-KO mice. In addition, Osm expression was increased in Ldlr-KO mice compared to WT mice. To prove the regulation of CYP7A1 by OSM, gene expression was determined in OSM-treated HepG2 cells. The results show that OSM attenuated CYP7A1 expression. This effect was reversed by the addition of inhibitors of either januskinases (JAK), mitogen-activated protein kinase/ERK-kinase (MEK) or extracellular-signal regulated kinase 1/2 (ERK1/2). CYP7A1-suppression by OSM was accompanied by reduced expression levels of the transcription factor gene HNF4A. After 12 weeks of Western diet Osmr-KO mice showed enhanced obesity, dyslipidemia and hepatic steatosis compared to WT mice. Determination of hepatic gene expression suggests that decreased expression of Ldlr in Osmr-KO mice compared to WT mice contributes to dyslipidemia and hepatic steatosis. Furthermore, the decreased expression of Cyp7a1 in Osmr-KO mice may contribute to cholesterol accumulation and accordingly to hepatic lipid accumulation in these mice. Ldlr-KO mice also showed hepatic steatosis after 12 weeks of Western diet. In comparison, hepatic steatosis was markedly reduced in Ldlr-Osmr-KO mice. Increased expression levels of Cyp7a1 and hence enhanced metabolization of cholesterol to bile acids in Ldlr-Osmr-KO mice can explain improved hepatic lipid accumulation and dyslipidemia in these mice compared to Ldlr-KO mice. Consistent with the discovered Cyp7a1 regulation in LDLR-deficient mice, OSM decreased the expression of CYP7A1 in HepG2 cells and therefore may have detrimental effects on hepatic lipid homeostasis. Altogether the results implicate a diverging role of OSM in the pathogenesis of hepatic steatosis depending on the genetic background. In WT mice OSM seems to convey protective effects on lipid homeostasis, whereas in Ldlr-KO mice OSM seems to promote the development of obesity, dyslipidemia and hepatic steatosis. The differential role of OSM in WT and Ldlr-KO mice might be caused by diverging Osm expression levels: Basal OSMRβ signal transduction caused by low OSM levels seems to be essential for lipid homeostasis, whereas enhanced or prolonged OSMRβ signal transduction caused by higher OSM levels might foster the progression of hepatic steatosis. These findings question OSM as a putative therapeutic agent for NAFLD. To test the hypothesis that OSM has beneficial or detrimental effects on NAFLD pathogenesis depending on OSM levels and kinetics, future studies should examine the effect of short- and long-term administration of OSM in different concentrations on the development of hepatic steatosis in WT mice.

Hohenheim, Univ., Diss., 2008.

Axonal degeneration is a major pathological feature of the central nervous system (CNS) inflammatory demyelinating disease multiple sclerosis (MS). This axonal degeneration has major consequences, as functional axonal regeneration in the CNS is largely absent. Cumulative axonal degeneration is the likely cause of the majority of progressive MS-related disability, and therefore, the need for novel neuroprotective therapies for MS exists. Experimental autoimmune encephalomyelitis (EAE), an animal model of MS pathology, also produces axonal injury. In particular, the optic nerve and spinal cord are key sites of neuroinflammation in mouse EAE. By utilizing this model, the short term and long term effects of the putative neuroprotective cytokine, leukaemia inhibitory factor (LIF), were investigated in the optic nerve and spinal cord utilising a number of outcome measures of axonal dysfunction. These included MRI measures of water diffusivity along (ADC ||) and across (ADC┴) the optic nerves, serum levels of phosphorylated neurofilament heavy chain subunit (pNF-H) and histological morphometric measures. LIF treatment reduced EAE grade and pNF-H plasma levels, decreased ADC┴, but had no effect on ADC ||, axon counts or inflammatory infiltration. / In contrast, genetic deletion of LIF and its sister cytokine ciliary neurotrophic factor (CNTF), not only increased EAE grade and pNF-H levels, but also decreased optic nerve ADC|| and optic nerve and spinal cord axon densities. After reviewing current literature, we hypothesize that the target cell for endogenously upregulated LIF in EAE may be the neuron or axon, whereas the target cell for exogenously administered therapeutic LIF may be another cell type, possibly infiltrating macrophages and activated microglial cells. LIF antagonist treatment did not have any affect on EAE grade, pNF-H levels or MRI parameters. This lack of effect may be due to the inability of the LIF antagonist to enter the CNS, supporting the hypothesis that endogenous LIF has a centrally acting mechanism.

Peripheral nerve trauma is a common cause of considerable functional morbidity, and healthcare expenditure. Particularly in the ~15% of injuries unsuitable for primary repair, standard clinical management results in inadequate sensory restitution in the majority of cases, despite the rigorous application of complex microsurgical techniques. This can largely be explained by the failure of surgical management to adequately address the neurobiological hurdles to optimal regeneration. Most significant of these is the extensive sensory neuronal death that follows injury, and which is accompanied by a reduction in the regenerative potential of axotomised neurons, and in the supportive capacity of the Schwann cell population if nerve repair is delayed. The present study aimed to accurately delineate the timecourse of neuronal death, in order to identify a therapeutic window during which clinically applicable neuroprotective strategies might be adopted. It then proceeded to investigate means to increase the regenerative capacity of chronically axotomised neurons, and to augment the Schwann cells’ ability to promote that regenerative effort. Unilateral sciatic nerve transection in the rat was the model used, initially assessing neuronal death within the L4&5 dorsal root ganglia by a combination of morphology, TdT uptake nick-end labelling (TUNEL), and statistically unbiased estimation of neuronal loss using the stereological optical disector technique. Having identified 2 weeks, and 2 months post-axotomy as the most biologically relevant timepoints to study, the effect upon neuronal death of systemic treatment with acetyl-L-carnitine (ALCAR 10, or 50mg/kg/day) or N-acetyl-cysteine (NAC 30, or 150mg/kg/day) was determined. A model of secondary nerve repair was then adopted; either 2 or 4 months after unilateral sciatic nerve division, 1cm gap repairs were performed using either reversed isografts, or poly-3-hydroxybutyrate (PHB) conduits containing an alginate-fibronectin hydrogel. Six weeks later nerve regeneration and the Schwann cell population were quantified by digital image analysis of frozen section immunohistochemistry. Sensory neuronal death begins within 24 hours of injury, but takes 1 week to translate into significant neuronal loss. The rate of neuronal death peaks 2 weeks after injury, and neuronal loss is essentially complete by 2 months post-axotomy. Nerve repair is incompletely neuroprotective, but the earlier it is performed the greater the benefit. Two clinically safe pharmaceutical agents, ALCAR & NAC, were found to virtually eliminate sensory neuronal death after peripheral nerve transection. ALCAR also enhanced nerve regeneration independently of its neuroprotective role. Plain PHB conduits were found to be technically simple to use, and supported some regeneration, but were not adequate in themselves. Leukaemia inhibitory factor enhanced nerve regeneration, though cultured autologous Schwann cells (SC’s) were somewhat more effective. Both were relatively more efficacious after a 4 month delay in nerve repair. The most profuse regeneration was found with recombinant glial growth factor (rhGGF-2) in repairs performed 2 months after axotomy, with results that were arguably better than were obtained with nerve grafts. A similar conclusion can be drawn from the result found using both rhGGF-2 and SC’s in PHB conduits 4 months after axotomy. In summary, these findings reinforce the significance of sensory neuronal death in peripheral nerve trauma, and the possibility of its` limitation by early nerve repair. Two agents for the adjuvant therapy of such injuries were identified, that can virtually eliminate neuronal death, and enhance regeneration. Elements in the creation of a bioartificial nerve conduit to replace, or surpass autologous nerve graft for secondary nerve repair are presented.

Cardiovascular diseases are among the leading causes of death worldwide and particularly in the developed World. The search for new therapeutic approaches for improving the functions of the damaged heart is therefore a critical endeavour. Myocardial infarction, which can lead to heart failure, is associated with irreversible loss of functional cardiomyocytes. The loss of cardiomyocytes poses a major difficulty for treating the damaged heart since terminally differentiated cardiomyocytes have very limited regeneration potential. Currently, the only effective treatment for severe heart failure is heart transplantation but this option is limited by the acute shortage of donor hearts. The high incidence of heart diseases and the scarcity donor hearts underline the urgent need to find alternative therapeutic approaches for treating cardiovascular diseases. Pluripotent embryonic stem (ES) cells can differentiate into functional cardiomyocytes. Therefore the engraftment of ES cell-derived functional cardiomyocytes or cardiac progenitor cells into the damaged heart to regenerate healthy myocardial tissues may be used to treat damaged hearts. Stem cell-based therapy therefore holds a great potential as a very attractive alternative to heart transplant for treating heart failure and other cardiovascular diseases. A major obstacle to the realisation of stem cell-based therapy is the lack of donor cells and this in turn is due to the fact that, currently, the molecular mechanisms or the regulatory signal transduction mechanisms that are responsible for mediating ES cell differentiation into cardiomyocytes are not well understood. Overcoming this huge scientific challenge is absolutely necessary before the use of stem cell-derived cardiomyocytes to treat the damaged heart can become a reality. Therefore the aim of this thesis was to investigate the signal transduction pathways that are involved in the differentiation of stem cells into cardiomyocytes. The first objective was the establishment and use of cardiomyocyte differentiation models using H9c2 cells and P19 stem cells to accomplish the specific objectives of the thesis. The specific objectives of the thesis were, the investigation of the roles of (i) nitric oxide (ii) protein kinase C (PKC), (iii) p38 mitogen-activated protein kinase (p38 MAPK) (vi) phosphoinositide 3-kinase (PI3K) and (vi) nuclear factor-kappa B (NF-kB) signalling pathways in the differentiation of stem cells to cardiomyocytes and, more importantly, to identify where possible any points of convergence and potential cross-talk between pathways that may be critical for differentiation to occur. P19 cells were routinely cultured in alpha minimal essential medium (α-MEM) supplemented with 100 units/ml penicillin /100 μg/ml streptomycin and 10% foetal bovine serum (FBS). P19 cell differentiation was initiated by culturing the cells in microbiological plates in medium containing 0.8 % DMSO to form embryoid bodies (EB). This was followed by transfer of EBs to cell culture grade dishes after four days. H9c2 cells were cultured in Dulbecco’s Modified Eagle’s medium (DMEM) supplemented with 10% FBS. Differentiation was initiated by incubating the cells in medium containing 1% FBS. In both models, when drugs were employed, they were added to cells for one hour prior to initiating differentiation. Cell monolayers were monitored daily over a period of 12 or 14 days. H9c2 cells were monitored for morphological changes and P19 cells were monitored for beating cardiomyocytes. Lysates were generated in parallel for western blot analysis of changes in cardiac myosin heavy chain (MHC), ventricular myosin chain light chain 1(MLC-1v) or troponin I (cTnI) using specific monoclonal antibodies. H9c2 cells cultured in 1% serum underwent differentiation as shown by the timedependent formation of myotubes, accompanied by a parallel increase in expression of both MHC and MLC-1v. These changes were however not apparent until 4 to 6 days after growth arrest and increased with time, reaching a peak at day 12 to 14. P19 stem cells cultured in DMSO containing medium differentiated as shown by the timedependent appearance of beating cardiomyocytes and this was accompanied by the expression of cTnI. The differentiation of both P19 stem cells and H9c2 into cardiomyocytes was blocked by the PI3K inhibitor LY294002, PKC inhibitor BIM-I and the p38 MAPK inhibitor SB2035800. However when LY294002, BIM-I or SB2035800 were added after the initiation of DMSO-induced P19 stem cell differentiation, each inhibitor failed to block the cell differentiation into beating cardiomyocytes. The NF-kB activation inhibitor, CAPE, blocked H9c2 cell differentiation into cardiomyocytes. Fast nitric oxide releasing donors (SIN-1 and NOC-5) markedly delayed the onset of differentiation of H9c2 cells into cardiomyocytes while slow nitric oxide releasing donors (SNAP and NOC-18) were less effective in delaying the onset of differentiation or long term differentiation of H9c2 cells into cardiomyocytes. Akt (protein kinase B) is the key downstream target of PI3K. Our cross-talk data also showed that PKC inhibition and p38 MAPK inhibition respectively enhanced and reduced the activation of Akt, as determined by the phosphorylation of Akt at serine residue 473. In conclusion, PKC, PI3K, p38 MAPK and NF-kB are relevant for the differentiation of stem cells into cardiomyocytes. Our data also show that the PKC, PI3K and p38 MAPK signalling pathways are activated as very early events during the differentiation of stem cells into cardiomyocytes. Our data also suggest that PKC may negatively regulate Akt activation while p38 MAPK inhibition inhibits Akt activation. Our fast NO releasing donor data suggest that nitric oxide may negatively regulate H9c2 cell differentiation.