Ovarian cancer is a disease with a high rate of mortality where the need for novel treatments will increase in the near future as older and populous generations reach the age where the cancer is usually diagnosed. Once treated, ovarian cancer tends to recur and display a newfound resistance against the platinum-based chemotherapeutic drugs that are used to treat the disease. Therefore, devising new methods of treatment is of utmost importance. Treatment with oncolytic viruses like LOAd703 offers an alternative treatment option that is more specific, causes immunogenic cell death in tumor cells, can stimulate the patient’s own immune system into fighting the cancer, and also has the potential to induce long term immune memory. In this project, the oncolytic and immunogenic capacity of LOAd703 in three different ovarian cancer cell lines was tested in conjunction with the standard-of-care chemotherapeutical drugs paclitaxel, cisplatin and carboplatin. The chemotherapy did not inhibit the replication, transgene expression or oncolysis of the LOAd703 virus. LOAd703 was able to effectively induce oncolysis in all three cell lines. The oncolytic capacity was generally increased when combined with chemotherapeutics. In cells resistant to chemotherapeutics, combination therapy with LOAd703 increased the killing capacity. While combination therapy proved effective, it did leave behind a small population of tumor cells that appeared to be resistant to both chemotherapy and viral oncolysis but longer culturing times may be tested to evaluate if complete killing will occur or if it is a primary resistance to these treatments in the cell lines. Further, if there is resistance to oncolysis or chemotherapy-mediated killing, employing tumor-immune cell co-cultures or in vivo studies might be necessary in order to assess whether the immunostimulatory effects of LOAd703 will lead to a complete eradication of the remaining tumor cells. The treatments also caused an increase in the expression of certain cell surface markers, like PD-L1 and CD262, which might open the door for future trials combining chemotherapy and LOAd703 with anti-PD-L1 inhibitors or soluble TRAIL.

Acinetobacter är gramnegativa bakterier som orsakar svåra nosokomiala infektioner hos immunkomprometterade och neutropena patienter. Det har rapporterats att den vanligaste smittkällan är sjukhusutrustning såsom andningsinstrument, där kolonisation av acinetobacter observerats. Av den anledningen att acinetobacter är multiresistenta mot olika antibiotikum medför det att en acinetobact infektioner blir svåra att behandla. Syftet med studien var att undersöka vilka acinetobactarter som orsakat bakteremi i Skåne från 2011-2019 samt undersöka vilka antibiotika de är resistenta för. Dessutom undersöktes hur stor andel av bakteremifynden som är resistenta mot betalaktamantibiotika, och vilka arter som är mest resistenta. För att artidentifiera acinetobacterna användes MALDI-TOF som analysinstrumentet. Resistensbestämningen bestämdes med E-test och diskdiffusionsmetoden, där tolv olika antibiotika testades. Resultatet visade att bland de 107 stammarna var A. Iwoffii störst då den utgjorde 31 st. Dessutom visade resultatet att majoriteten av stammarna var känsliga mot de tolv antibiotikasorterna. Bland de resistenta stammarna var de flesta av arten A. Baumannii som tidigare är kända för att vara multidrug-resistant (MDR). / Acinetobacter are gram-negative bacteria that cause severe nosocomial infections in immunocompromised and neutropenic patients. It has been reported that the most common source of infection is hospital equipment such as respiratory instruments, where colonization of acinetobacter has been observed. Due to the fact that acinetobacter is multi-resistant to various antibiotics, it makes an acinetobact infection difficult to treat. The aim of the study is to investigate which acinetobact species caused bacteremia in Skåne from 2011-2019 and to investigate which antibiotics they are resistant to. In addition, the proportion of bacteremia findings that are resistant to beta-lactam antibiotics was examined, and which species are most resistant. MALDI-TOF was used to identify the species of acientobacter. Twelve different antibiotics were tested with E-test and the disc diffusion method. The results showed that among the 107 strains was A. iwoffii the largest acinetobacter species, which corresponds to 31. In addition, the results obtained showed that the majority of the strains were sensitive to the twelve types of antibiotics. Among the resistant strains were the majority of the species A. Baumannii, which are known to be multidrug resistant (MDR).

Antibiotics are one of the greatest discoveries in medicine, and emerged resistances have become a global threat. It is theorized that a big part of the antibiotic resistance genes come from the environment, and wastewater treatment plants and hospitals are considered a great breeding ground for the spread of these. The aim of this project is to analyse the microbiome and resistome of the wastewater of Uppsala and to evaluate the efficiency in the elimination of antibiotic resistance genes and bacteria. Samples from the University Hospital and the influents, sand filter and effluent of the Wastewater Treatment Plant were collected, DNA was extracted and sequenced to be analysed through metagenomics to explore them taxonomically and looking for resistance genes. Bacteria were also isolated, and their resistances were analysed. Taxonomical differences became noticeable in Order, Family, Genus and Species, with an increase of diversity in the Effluent samples. A total of 233 resistance genes were found in all the samples. There was a clear reduction in the number of resistance genes in the Effluent samples. However, there was an important number of genes carried in these and some prevail through all the path. Within all the isolates collected, from a total of 11, three E. coli isolates, one C. freundii and one E. cloacae presented resistances. Our study shows that the effluent of the wastewater treatment plant of Uppsala is potentially causing a negative impact on the environment, flushing out water not completely free of antibiotic resistance genes and resistant bacteria.

The human gut microbiome is a complex ecosystem with hundreds of species interacting with each other and the host. One function of the microbiome is to break down undigested nutrients into smaller nutrients, sometimes available for uptake by the host. The digestion of such macromolecules can involve several species where one feeds on another’s byproducts, forming a large cross-feeding network. The method of digital evolution can be of great aid in studying such complex ecosystems by creating models of the studied system. In this study, the digital evolution software Avida was used to study the effects of perturbations in the system on byproduct cross-feeding chain length. Intense perturbations were found to shorten the chain lengths in general whereas weaker perturbations had either a small or no effect. When perturbations ceased, most byproduct chains displayed recovery to lengths similar to the preperturbation lengths. This indicates that byproduct chain lengths may be kept short by common ecological mechanisms alone, explaining why very long chains are rarely observed while still theoretically possible.

Resistensbestämningar som genererar ett kvantitativt MIC-värde är värdefullt för att kunna välja adekvat antibiotikabehandling. Referensmetoden för MIC-bestämning är mikrobuljongspädning där kommersiella antibiotikapaneler underlättar handhavandet av metoden på kliniska laboratorier. Syftet med studien var att verifiera mikrobuljongspädning med Sensititre™-panelerna SEMSE7 och SEMST7 avsedda för grampositiva kocker, genom att jämföra erhållet resultat med tidigare uppmätta referensvärden av MIC samt SIR-kategorier. Mikrobuljongspädning utfördes med SEMSE7-panel och MH-buljong för Staphylococcus spp. (n=21) och Enterococcus spp. (n=13) samt med SEMST7-panel och MH-F buljong för Streptococcus pneumoniae (n=20). Avläsning av MIC utfördes samt tolkades enligt SIR-systemet. Resultaten jämfördes mot kända referensvärden tidigare uppmätta med mikrobuljongspädning. Isolat analyserade med SEMSE7-panel och SEMST7-panel erhöll en överensstämmelse av MIC på 88,2% respektive 96,7%. Motsvarande kategorisk överensstämmelse av SIR var 92,5% respektive 92,6%. Resultatet visar att Sensititre™-panelen SEMST7 är godkänd i verifieringen av mikrobuljongspädning med god överensstämmelse med referensvärden av MIC samt SIR-kategorier. Vidare bedöms att fortsatt verifiering krävs av SEMSE7-panelen eftersom ej tillfredställande överenstämmelse med referensvärden av MIC erhölls, trots god överenstämmelse av SIR-kategorier. Studien visar att SEMST7-panelen kan implementeras för Streptococcus pneumoniae i den kliniska verksamheten på mikrobiologilaboratoriet, Jönköping. / Antimicrobial susceptibility testing methods generating a quantitative MIC are valuable for choosing adequate antibiotic treatment. Broth microdilution is the reference method for MIC determination and commercial panels with antibiotics facilitate the procedure in clinical laboratories. The aim of the study was to verify broth microdilution with the Sensititre™ panels SEMSE7 and SEMST7 designed for gram-positive cocci, by comparing results with previously measured reference values of MIC and SIR. Broth microdilution was performed using the SEMSE7 panel with MH broth for Staphylococcus spp. (n=21) and Enterococcus spp. (n=13), and using the SEMST7 panel with MH-F broth for Streptococcus pneumoniae (n=20). Reading MIC endpoints was performed and interpreted according to SIR system. Isolates analysed with the SEMSE7 and SEMST7 panel obtained essential agreement of 88,2% and 96,7%, and categorical agreement of 92,5% and 92,6% respectively. In conclusion, the Sensititre™ panel SEMST7 is approved in the verification of broth microdilution with satisfactory essential agreement and categorical agreement. Furthermore, it is considered that further verification is required for the SEMSE7 panel as unsatisfactory essential agreement was obtained, despite satisfactory categorical agreement. The study shows that the SEMST7 panel can be implemented for Streptococcus pneumoniae in the clinical practice at the microbiology laboratory, Jönköping.

Diabetes has caused many deaths worldwide but can be combated at least partially by diet and physical activity. The gut microbiome shows correlation with both type 1 and type 2 diabetes, has modulatory effects on the immune system and implicates brain functions through the gut-brain axis, in part by microbial metabolites. Diet has long been known to impact the microbiome but exercise has gained interest within the last decade, with studies mostly done on rodents and athletes with somewhat positive results on its modulation of the microbiome. This literature study aims to evaluate whether exercise can influence the microbiome for healthy, prediabetic, and diabetic cohorts and what this might mean for host health. The database PubMed was searched for articles in January 2021 and inclusion criteria yielded 7 articles for review. These differed in methods, cohorts, and exercise interventions, and therefore cannot grant any strong evidence but indicate along with previous research that exercise affects the microbiome, with slight differences in responses depending on the individual’s current state and exercising methods. / Diabetes har orsakat många dödsfall världen över men kan bekämpas åtminstone delvis med hjälp av diet och fysisk aktivitet. Tarmens mikrobiom har visats korrelera med både typ 1 och typ 2 diabetes, har reglerande effekter på immunsystemet och inverkar på hjärnfunktioner genom tarm-hjärna-axeln, delvis via metaboliter från mikroberna. Det har länge varit känt att mat kan påverka mikrobiomet, men träning har också väckt intresse över det senaste årtiondet med studier som fokuserat mest på möss och atleter med någorlunda positiva resultat för dess förändring av mikrobiomet. Denna litteraturstudie syftar till att undersöka om träning kan ha effekt på mikrobiomet hos såväl friska människor som prediabetiker och diabetiker, och vad detta kan betyda för hälsan. En litteratursökning gjordes i databasen PubMed i januari 2021 som efter sortering enligt inkluderande kriterier gav 7 artiklar för granskning. Dessa använde olika metoder, undersökta grupper och träningsupplägg, vilket försvårar jämförelser men indikerar i linje med tidigare forskning att träning påverkar mikrobiomet, med en del skillnader i resultat beroende på individens status och träningsupplägg.

Abstract Background: Gastroenteritis is a common infection and the leading cause of morbidity worldwide and is mostly caused by viruses. Outbreaks appear in both developed and developing countries and result in large economic costs. Rapid detection is important for appropriate treatment, control and to prevent the spread of infection.  Objective: Evaluation and performance comparison between the BioFire®FilmArray® Torch System gastrointestinal panel and the Molecular BD MAXTMenteric viral panel to indicate a multiplex method for viral gastroenteritis diagnostic in a routine laboratory setting.  Material and methods: In this study, 58 different samples were used which consisted of selected stool specimens from patients who were tested and treated for gastroenteritis infection at Uppsala Academic Hospital and Norrlands University Hospital in Umeå during 2018-2021, samples from Quality control for molecular diagnostics viral gastroenteritis EQA pilot study during 2018-2019 and cultivated strains of different adenovirus species from 2018. All samples were analyzed with both systems for comparison of detected pathogens.  Results: Sensitivity and specificity values were 95% and 100% respectively for the BioFire®FilmArray®Torch System and 100% and 93.3% for the BD MAXTMSystem.   Conclusions: Bothsystems are rapid and adequate diagnostic tools. The BioFire®FilmArray®Torch System with greater coverage has the ability of detecting more pathogens and is more promising particularly in the occasional infection circumstance. The BD MAXTMSystem demonstrated almost the same results and seems to be a better option in times of an outbreak when the numbers of patients are significantly higher.

Antibiotics are essential drugs in modern medicine. After consumption antibiotics are excreted in unmetabolized form in the urine and reach our sewage treatment plants (STP). STP are not able to degrade all antibiotics leading to release of antibiotics into the aquatic environment. Aquatic animals are thus continuously exposed to antibiotics. This study involved assessment of the toxicity of eight antibiotics previously detected in the river Fyrisån, Uppsala, Sweden, in developing zebrafish (Danio rerio) embryos up to day six of age. The experiments included assessment of embryonal toxicity for the individual antibiotics as well as mixtures of all antibiotics.  The mixtures were based on previously measured concentrations in river Fyrisån and tested in increasing concentrations up to 1000-times higher concentrations. In the toxicity assessment different lethal and sublethal endpoints were observed, such as early movements, heart rate, hatching time and length. These experiments were followed by behaviour study observing the swimming activity during alternating dark-light alternations. Lastly, a bioaccumulation study was performed on mixtures of antibiotics to determine if these antibiotics were bioaccumulative in zebrafish embryos. The results showed that these eight antibiotics, individually and as a mixture did not affect any of the endpoints. As for bioaccumulation, none of the eight antibiotics were bioaccumulating in zebrafish embryos. These antibiotics seem to be non-toxic during fish embryonal development. However, the results cannot determine the long-term effects of antibiotic exposure and thus further studies are needed to assess the potential toxicity of environmentally present antibiotics to fish.

As drivers of biogeochemical cycles and nutrient recycling, such as carbon turnover, the microbial community is essential in sustaining functioning ecosystems. Together with the metazoan community, the microbial community constitute the majority of all life in the benthos. Environmental change in biotic and abiotic factors may influence the dynamics of these communities, for example through a sorting or driving effect on the community structure through assembly processes. Environmental change, e.g. change in dissolved oxygen concentration, salinity and temperature, can directly or indirectly affect community composition. How, in what way, and to what extent, benthic bacterial and meiofaunal community composition in the eutrophied, brackish benthic environments, in the Baltic Sea sub-basin the Baltic Proper, respond to environmental change is understudied, both at local and seascape scale. This thesis aimed to study and understand the effects of environmental variation on the diversity and biogeographic patterns of Baltic Sea sediment bacterial and meiofaunal communities. A further aim was to understand the links between the different community levels by studying the interaction between meiofaunal- and macrofaunal communities in relation to environmental variation. Community diversity was analysed along a latitudinal transect of national environmental monitoring stations in the Baltic Proper using a framework of metapopulation and metacommunity theory. The analyses were based on environmental genomics, with high-throughput sequencing, bioinformatics and statistics. The total community genome was analysed using phylogenetic marker gene fragments as a proxy for taxonomic diversity, to investigate diversity, community structure and dynamics. Salinity and oxygen were found to be the main abiotic environmental drivers of benthic community composition and alpha- and beta-diversity patterns. Furthermore, macrofauna-meiofauna interactions were significantly more complex in higher salinity environments. Results also showed that both enhanced environmental gradients and dispersal following a major inflow of saline and oxygenated water from the Atlantic Ocean, influenced the composition of sediment bacterial communities at the seascape scale of the Baltic Sea, as shown by a reduced beta-diversity and increased alpha-diversity, and the development of a significant distance-decay of community similarity. This study also identified strong metapopulation dynamics of the benthic sediment bacterial communities with many satellite and a few core taxa. The outcomes from this study contribute to the understanding of how environmental variation and environmental change relate to changes in Baltic Sea benthic community diversity and composition, and important factors and processes governing community dynamics.

Coronaviruses have caused three large outbreaks in the past century. The most recent one, also still ongoing, is represented by the SARS-CoV-2/Covid-19 pandemic. Efforts have been taken to develop efficient vaccines and antivirals and one of the major virus-based targets in drug development is represented by the main protease of these viruses. Main proteases are proteins (cysteine hydrolases) with high level of conservation among different coronaviruses and have an important role in the virus life cycle. Due to the need of developing broad-spectrum antivirals against Coronaviruses, this study aimed to set up a CPE-based assay for testing compounds against the main protease of human coronavirus 229E. An optimized TCID50 protocol was established by using MRC-5 cells, at a density of 1x104 cells/ml with a 3h incubation prior infection with a concentration of 10-1 of HCoV-229E. The cell viability was assessed through MTT assay. Using reference compounds, with previously demonstrated antiviral potency against the main protease of different coronaviruses (GC-376, Nirmatrelvir), the efficiency of the conceived assay was validated (GC-376 EC50 = 1.24 μM; Nirmatrelvir Ec50= 0.72 μM). Compound 19 was proved to also be active against the main protease of HCoV-229E (EC50 = 0.22 μM), and together with previous findings, it was concluded that this compound has a broad-spectrum activity. Newly developed compounds MP17 and MP19 were also demonstrated to be efficient against HCoV-229E. As a future perspective, further investigations of these compounds should take place for the identification of EC50 values.