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Os mecanismos oxidativos pelos quais macrófagos exercem atividade microbicida permanecem em discussão, e estudos com hospedeiros animais serão essenciais para elucidar tal questão. Nesse trabalho, estudamos os mecanismos microbicidas de macrófagos in vivo comparando parâmetros de infecção nas lesões de camundongos resistentes (C57Bl/6) e suscetíveis (BALB/c) ao protozoário Leishmania amazonensis. A comparação mostrou que o controle da infecção pelos camundongos resistentes é dependente da ativação de macrófagos com expressão da enzima óxido nítrico sintase induzível, síntese de óxido nítrico e extensa nitração e hidroxilação das proteínas dos parasitas dentro dos fagolisossomos dos macrófagos. O principal agente tóxico aos parasitas parece ser derivado do peroxinitrito porque a nitração dos parasitas ocorreu na ausência virtual de células polimorfonucleares e foi acompanhada de hidroxilação. Além disso, tempol um inibidor de reações de nitração mediadas por peroxinitrito, inibiu a nitração de proteínas da lesão e aumentou o número de parasitas nelas presentes. Também, estudos com parasitas em cultura confirmaram que o peroxinitrito é citotóxico aos parasitas enquanto o óxido nítrico é citostático. O camundongo suscetível se mostrou capaz de sintetizar óxido nítrico mas o fez em estágios tardios da infecção e, provavelmente, em resposta a uma infecção secundária por bactérias. Tomados conjuntamente, os resultados indicam que o peroxinitrito e radicais dele derivados são os principais agentes leishmanicidas produzidos por macrófagos in vivo. / Macrophage oxidative microbicidal mechanisms remain debatable and their elucidation is likely to depend on studies with mammalian hosts. To examine macrophage microbicidal mechanisms in vivo, we compared infection parameters in the lesions of resistant (C57Bl/6) and susceptible (BALB/c) mice to the protozoan Leishmania amazonensis. This comparison demonstrated that infection control by resistant mice relied on macrophage activation with inducible nitric oxide synthase expression, nitric oxide synthesis and extensive nitration and hydroxylation of the proteins of the parasites inside macrophage phagolysosomes. The toxic agent to the parasite is likely to be peroxynitrite-derived because parasite nitration occurred in the virtual absence of polymorphonuclear cells and was accompanied by parasite hydroxylation. In addition, tempol, an inhibitor of peroxynitrite-mediated nitrations, inhibited protein nitration of the lesions and increased the number of parasites in them. Also, studies with parasite cultures confmed that peroxynitrite is cytotoxic to the parasites whereas nitric oxide is cytostatic. The susceptible mice were also able to synthesize nitric oxide but only at late infection time and, most likely, in response to a secondary bacterial infection. Taken together, the results indicate that peroxynitrite and derived radicals are the main leishrnanicidal agents produced by macrophages in vivo.

Oxidative stress, caused by increased levels of reactive oxygen species (ROS)and reactive nitrogen species (RNS) and/or a decrease in antioxidant capacity, can result in the oxidation of various bio-molecules, such as proteins, lipids and deoxyribonucleic acid (DNA). These oxidized bio-molecules may contribute to pathologies such as cardiovascular diseases, neurodegenerative disorders and cancer. The Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study was initiated in 2008 to investigate the coping styles and catecholamine metabolic markers of Africans, contributing to their higher sympathetic output and poorer psychosocial wellbeing. This study forms part of the SABPA study, but with a specific aim to investigated lipid and protein oxidation markers in hypertensive Africans versus their normotensive counterparts. Analytical methods for the quantification of specific lipid and protein oxidation markers were optimized and validated. Urine samples from 172 urbanized black South Africans were collected and 3-nitrotyrosine (3NT) and thiobarbituric acid reactive substances (TBARS) were quantified in these samples, using the optimized spectrophotometric and LC-MS/MS methods. Statistical analyses showed that in both males and females, TBARS and 3NTcorrelated with each other. In males, 3NT also correlated with physical activity level (PAL) and C-reactive protein (CRP), while TBARS also correlated with body mass index (BMI). In females 3NT correlated with BMI, while TBARS correlates with PAL. These correlations meant that they could influence the calculations of the true effect of 3NT and TBARS levels between normotensive and hypertensive subjects. After analyses of covariance (ANCOVA) analyses it was determined that the hypertensive male subjects had higher TBARS values than the normotensive male subjects did (p-value = 0.03) and the normotensive female subjects had higher 3NT levels compared to the hypertensive female subjects (p-value = 0.04). These results partially supported the hypothesis that that elevated concentrations of specific urinary lipid and protein oxidation markers will be observed in the hypertensive test subjects compared to their normotensive counterparts. The results also indicated that there were indeed a difference in lipid and protein oxidation between hypertensive and normotensive subject. / Thesis (MSc (Biochemistry))--North-West University, Potchefstroom Campus, 2013

Oxidative stress, caused by increased levels of reactive oxygen species (ROS)and reactive nitrogen species (RNS) and/or a decrease in antioxidant capacity, can result in the oxidation of various bio-molecules, such as proteins, lipids and deoxyribonucleic acid (DNA). These oxidized bio-molecules may contribute to pathologies such as cardiovascular diseases, neurodegenerative disorders and cancer. The Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study was initiated in 2008 to investigate the coping styles and catecholamine metabolic markers of Africans, contributing to their higher sympathetic output and poorer psychosocial wellbeing. This study forms part of the SABPA study, but with a specific aim to investigated lipid and protein oxidation markers in hypertensive Africans versus their normotensive counterparts. Analytical methods for the quantification of specific lipid and protein oxidation markers were optimized and validated. Urine samples from 172 urbanized black South Africans were collected and 3-nitrotyrosine (3NT) and thiobarbituric acid reactive substances (TBARS) were quantified in these samples, using the optimized spectrophotometric and LC-MS/MS methods. Statistical analyses showed that in both males and females, TBARS and 3NTcorrelated with each other. In males, 3NT also correlated with physical activity level (PAL) and C-reactive protein (CRP), while TBARS also correlated with body mass index (BMI). In females 3NT correlated with BMI, while TBARS correlates with PAL. These correlations meant that they could influence the calculations of the true effect of 3NT and TBARS levels between normotensive and hypertensive subjects. After analyses of covariance (ANCOVA) analyses it was determined that the hypertensive male subjects had higher TBARS values than the normotensive male subjects did (p-value = 0.03) and the normotensive female subjects had higher 3NT levels compared to the hypertensive female subjects (p-value = 0.04). These results partially supported the hypothesis that that elevated concentrations of specific urinary lipid and protein oxidation markers will be observed in the hypertensive test subjects compared to their normotensive counterparts. The results also indicated that there were indeed a difference in lipid and protein oxidation between hypertensive and normotensive subject. / Thesis (MSc (Biochemistry))--North-West University, Potchefstroom Campus, 2013

In this work we developed an electrochemical sensor modified with multi-walled carbon nanotubes and 5-nitroindole (5-NI) for the simultaneous determination of ascorbic (AA) and uric (UA) acids in urine and serum samples and a biosensor based on dsDNA for determination of 3-nitro-L-tyrosine ethyl ester (3NO2TEE), as a biomarker of biological peroxynitration. The polymer of 5-NI was electrogenerated in situ on the carbon nanotubes deposited on glassy carbon electrode (GCE). Thereafter, the aromatic nitro group, present in the molecule, was reduced, generating a hydroxylamine/nitroso redox couple, then used for detection and quantification of the analytes in the biological samples. The electrochemical behavior of the modified electrodes were studied using cyclic voltammetry, differential pulse voltammetry and chronoamperometry, which were used for the detection of the analytes and to obtain the kinetic parameters and the analytical characterization of the platforms. The chronoamperometric studies were performed in order to obtain more information about the redox processes between AA and the sensor, since it proved to be an electrocatalytic process. Thus, by means of graphs and Cottrell equations, it was possible to obtain values for the diffusion coefficient (DAA) and the catalytic constant (kcat) for the AA electrocatalytic oxidation. The values for DAA and kcat, determined for AA were 4.2 x10-6 cm-2 s-1 and 1.1 x 106 M-1 s-1, respectively. The platform for the detection of AA e AU showed good sensitivity and stability in urine and serum samples, with LOD of 1.9 mol L-1 for AA and 2.1 mol L-1 for UA. The analytical performance obtained for the nanostructured platform GCE/MWCNT/poly-5-NID justifies its use as a sensor for the simultaneous determination of AA and UA. Studies of 3NO2TEE in protic media (pH 4.5 acetate buffer and pH 7.4 and 10.0, in phosphate buffer) and in aprotic media (DMF/TBAPF6, 0.1 mol L-1), using Pt and glassy carbon electrodes, were necessary before the construction of the CT-DNA biosensor. The spectrolectrochemistry of 3NO2TEE, held in aprotic media was useful for rationalizing the electrochemical behavior of 3NO2TEE and intermediates generated during the reduction. For the biosensor construction, the amount of dsDNA, the conditioning time for reduction of the analyte, the pH value, on GCE, were optimized. The developed biosensor was used to determine the concentration of 3NO2TEE and showed a linear range from 60 to 320 nmol L-1 and LOD and LOQ of 58 nmol L-1 and 200 nmol L-1, respectively. These results indicate that the prepared sensor and biosensor were effective for the detection of substances with biological interest. (P.S.: some expressions out of formatting) / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Neste trabalho foram desenvolvidos um sensor eletroquímico modificado com nanotubos de carbono de paredes múltiplas (MWCNT) e 5-nitroindol (5-NI) para determinação simultânea dos ácidos ascórbico (AA) e úrico (AU), em amostras de urina e soro, e um biossensor à base de dsDNA para determinação do éster etílico da 3-nitro-L-tirosina (3NO2TEE), como biomarcador de peroxinitração biológica. O trímero do 5-nitroindol foi eletrogerado in situ sobre os nanotubos de carbono depositados em eletrodo de carbono vítreo (ECV). Após esse processo, o grupo nitro aromático, presente na molécula foi reduzido gerando o par redox hidroxilamina/nitroso, utilizado para detecção e quantificação dos analitos presentes nas amostras biológicas. Os comportamentos eletroquímicos dos eletrodos modificados foram estudados, empregando as técnicas de voltametria cíclica, voltametria de pulso diferencial e cronoamperometria, as quais foram utilizadas para a detecção dos analitos e para obtenção dos parâmetros cinéticos e caracterização analítica da plataforma. Os estudos cronoamperométricos foram realizados com o objetivo de obter maiores informações dos processos redox entre AA e o sensor, uma vez que este demonstrou ser um processo eletrocatalítico. Assim, por meio de gráficos e equações de Cottrell, foi possível obter os valores para o coeficiente de difusão (DAA) e a constante catalítica (kcat) da reação para o AA. Os valores do DAA e de kcat, determinados para AA, foram de 4,2 x10-6 cm-2 s-1 e 1,1 x 106 M-1 s-1, respectivamente. O método desenvolvido de detecção de AA e AU apresentou boa sensibilidade e estabilidade em amostras de urina e soro, com limite de detecção (LD) de 1,9 mol L-1 para AA e 2,1 mol L-1 para AU. A partir do desempenho analítico obtido da plataforma nanoestruturada ECV/MWCNT/poli-5-NID, justifica-se a sua utilização deste como sensor para a determinação simultânea de AA e AU. Antes da construção do biossensor de DNA, para nitroaromáticos de importância biológica, foi necessária a realização dos estudos da 3NO2TEE, em meios prótico: tampão acetato pH 4,5 e tampão fosfato pH 7,4 e 10,0 e, em meio aprótico (DMF/ TBAPF6, 0,1 mol L-1), utilizando eletrodo de Pt e carbono vítreo, como eletrodos de trabalho. A espectroeletroquímica de 3NO2TEE, realizada em meio aprótico, foi útil para racionalizar o comportamento eletroquímico de 3NO2TEE e de seus intermediários gerados durante a redução. Para a construção do biossensor, sobre o eletrodo de carbono vítreo, foram otimizados: concentração de dsDNA, tempo de condicionamento para a redução do nitrocomposto, valor de pH. O biossensor ECV/dsDNA apresentou faixa linear de 60 - 320 nmol L-1 e LD e LQ (limite de quantificação) encontrados foram 58 nmol L-1 e 200 nmol L-1. Estes resultados indicaram que o sensor e o biossensor foram produzidos e aplicados de forma eficaz para detecção de substâncias de interesse biológico. (obs.: algumas expressões fora da formatação)

Os mecanismos oxidativos pelos quais macrófagos exercem atividade microbicida permanecem em discussão, e estudos com hospedeiros animais serão essenciais para elucidar tal questão. Nesse trabalho, estudamos os mecanismos microbicidas de macrófagos in vivo comparando parâmetros de infecção nas lesões de camundongos resistentes (C57Bl/6) e suscetíveis (BALB/c) ao protozoário Leishmania amazonensis. A comparação mostrou que o controle da infecção pelos camundongos resistentes é dependente da ativação de macrófagos com expressão da enzima óxido nítrico sintase induzível, síntese de óxido nítrico e extensa nitração e hidroxilação das proteínas dos parasitas dentro dos fagolisossomos dos macrófagos. O principal agente tóxico aos parasitas parece ser derivado do peroxinitrito porque a nitração dos parasitas ocorreu na ausência virtual de células polimorfonucleares e foi acompanhada de hidroxilação. Além disso, tempol um inibidor de reações de nitração mediadas por peroxinitrito, inibiu a nitração de proteínas da lesão e aumentou o número de parasitas nelas presentes. Também, estudos com parasitas em cultura confirmaram que o peroxinitrito é citotóxico aos parasitas enquanto o óxido nítrico é citostático. O camundongo suscetível se mostrou capaz de sintetizar óxido nítrico mas o fez em estágios tardios da infecção e, provavelmente, em resposta a uma infecção secundária por bactérias. Tomados conjuntamente, os resultados indicam que o peroxinitrito e radicais dele derivados são os principais agentes leishmanicidas produzidos por macrófagos in vivo. / Macrophage oxidative microbicidal mechanisms remain debatable and their elucidation is likely to depend on studies with mammalian hosts. To examine macrophage microbicidal mechanisms in vivo, we compared infection parameters in the lesions of resistant (C57Bl/6) and susceptible (BALB/c) mice to the protozoan Leishmania amazonensis. This comparison demonstrated that infection control by resistant mice relied on macrophage activation with inducible nitric oxide synthase expression, nitric oxide synthesis and extensive nitration and hydroxylation of the proteins of the parasites inside macrophage phagolysosomes. The toxic agent to the parasite is likely to be peroxynitrite-derived because parasite nitration occurred in the virtual absence of polymorphonuclear cells and was accompanied by parasite hydroxylation. In addition, tempol, an inhibitor of peroxynitrite-mediated nitrations, inhibited protein nitration of the lesions and increased the number of parasites in them. Also, studies with parasite cultures confmed that peroxynitrite is cytotoxic to the parasites whereas nitric oxide is cytostatic. The susceptible mice were also able to synthesize nitric oxide but only at late infection time and, most likely, in response to a secondary bacterial infection. Taken together, the results indicate that peroxynitrite and derived radicals are the main leishrnanicidal agents produced by macrophages in vivo.

Introdução: Poucos estudos avaliaram marcadores inflamatórios associados à nitração da placa aterosclerótica no prognóstico da doença arterial coronariana (DAC). Assim, o objetivo deste estudo é analisar a influência dos níveis de atividade da mieloperoxidase (MPO) e nitrotirosina (NT) na sobrevida em curto e longo prazo, em uma coorte prospectiva de síndrome coronariana aguda (SCA), Estratégia de Registro de Síndrome Coronariana Aguda (estudo ERICO). Métodos: Avaliou-se a influência da atividade da MPO e dos níveis de NT, ambos dosados até 10 dias após a síndrome coronariana aguda (SCA), em relação à mortalidade em até 4 anos de seguimento. A atividade da MPO e os níveis de NT, coletados durante a fase aguda e subaguda do início dos sintomas da síndrome coronariana aguda (SCA) (infarto do miocárdio (IAM) com supra e sem supra do segmento ST e angina instável), foram avaliados em 342 pacientes. Em 180 dias, 1 ano, 2 anos e 4 anos foram calculadas as taxas de letalidade geral, assim como as curvas de sobrevivência de Kaplan-Meier e os modelos de regressão logística de Cox com respectivas razões de risco (RR) cumulativas (intervalo de confiança de 95%; IC 95%), de acordo os tercis de atividade da MPO e de NT para mortalidade (geral, cardiovascular e por IAM fatal). As RR cumulativas para atividade da MPO e NT foram calculadas sem ajuste, ajustadas por idade e sexo e com ajuste adicional para tabagismo, diabetes, hipertensão e níveis de colesterol LDL e HDL. Resultados: No geral, o valor mediano para a atividade da MPO foi de 29,6 mU / ml (variação: 1,8 a 282,1 mU / ml) e NT foi de 208,33 nmol / L (variação: 3,09 a 1.500,00 nmol / L), independentemente do subtipo de SCA. Durante o seguimento de 4 anos, observamos 55 (16,1%) óbitos. A taxa de sobrevida global foi de 287 (83,9%) (tempo mediano de sobrevida foi 1.517, IIQ: 1.1391.904 dias). A atividade de MPO e os níveis de NT não se associaram com as taxas de letalidade e nem de sobrevivência (mortalidade geral, cardiovascular e por IAM fatal) pelas RR de 180 dias até 4 anos de seguimento. Conclusões: A atividade da MPO, assim como, os níveis de NT não foram preditores de morte após SCA em curto e longo prazo no estudo ERICO / Introduction: Few studies have evaluated inflammatory markers associated with atherosclerotic plaque nitration in the prognosis of coronary artery disease (CAD). Thus, the objective of this study is to analyze the influence of levels of myeloperoxidase (MPO) activity and nitrotyrosine (NT) on short- and long-term survival in a prospective cohort of acute coronary syndrome (ACS), Coronary Syndrome Registry Strategy Acute (ERICO study). Methods: The influence of MPO activity and NT levels, both dosed up to 10 days after acute coronary syndrome (ACS), was evaluated in relation to mortality up to 4 years of follow-up. The MPO activity and NT levels, collected during the acute and subacute phase of the onset of ACS symptoms (myocardial infarction (MI) with supra and non-ST-segment elevation and unstable angina), were evaluated in 342 patients. Overall, case-fatality rates, as well as, Kaplan-Meier survival curves and Cox logistic regression models with cumulative hazard ratios (HR) were calculated for 180 days, 1 year, 2 years and 4 years (range (95% confidence interval, 95% CI), according to tertiles of MPO and NT activity for mortality (overall, cardiovascular and fatal MI). Cumulative RRs for MPO and NT activity were calculated as crude, age and sex-adjusted, and with additional adjustment for smoking, diabetes, hypertension, and LDL and HDLcholesterol levels. Results: Overall, the median value for MPO activity was 29.6 mU / ml (range: 1.8 to 282.1 mU / ml) and NT of 208.33 nmol / L (range: 3, 09 to 1,500.00 nmol / L), regardless of the subtype of ACS. During the 4-year follow-up, we observed 55 (16.1%) deaths. The overall survival rate was 287 (83.9%) (median survival time was 1,517, IQR: 1,139-1,904 days). MPO activity and NT levels were nor associated with case-fatality neither survival rates (overall, cardiovascular and fatal MI mortality ) by HRs from 180 days to 4 years of follow-up. Conclusions: MPO activity, as well as, NT levels were not predictors of short- and long-term mortality after ACS in the ERICO study

Rupture of atherosclerotic plaque is one of the primary causes of death due to cardiovascular disease. The factors directing plaque progression to instability are poorly understood. It is well-known that arteries respond to changes in mechanical stress by remodeling, and that remodeling is mediated by the inflammatory response. Studies have shown that both mechanical stress and markers of inflammation are increased in the fibrous cap and shoulder regions of plaque, where rupture most often occurs. In this study we hypothesized that there are spatial relationships between the local mechanical environment and expression of markers of inflammation in atherosclerosis, and that these relationships are plaque-progression dependent. To test these hypotheses, we analyzed cross-sections at intervals along the length of human coronary atherosclerotic arteries. For each cross-section, a heterogeneous finite element model was developed to determine the spatial distribution of stress. In addition, novel techniques for quantifying inflammatory markers at high spatial resolution were used to determine the distributions of inflammatory markers. The distributions of stress and five markers of inflammation activated NF-kB, macrophages, MMP-1, nitrotyrosine, and microvessels - were then compared to determine whether spatial relationships exists. We demonstrated that the probability of activated NF-kB expression increases monotonically with increasing stress in all stages of plaque progression. This indicates that the relationship between mechanical stress and NF-kB activation is a player throughout the disease process. We found that the relationship between mechanical stress and macrophages is highly dependent on the state of plaque progression. In intermediate stages of progression macrophages increase with moderate stress but drop off again at very high stresses, while in the advanced stage macrophages continue to increase monotonically with stress. We found that MMP1 increases with stress in stages of progression where active remodeling is occurring, but decreases with stress in mature stable plaque. We found no relationship between mechanical stress and nitrotyrosine expression or microvessels. Taken together, these results support the role of mechanical stress in instigating and maintaining the inflammatory response, and help explain how mechanical input is able to direct the complex biological changes involved in remodeling.

Bei der Bestrahlung von Kopf-Hals-Tumoren tritt die orale Mukositis als wichtigste und dosislimitierende frühe Nebenwirkung auf. Verschiedene prophylaktische und therapeutische Maßnahmen wurden untersucht, jedoch konnte bisher keine Methode in der klinischen Routine etabliert werden. Ein neuer Ansatz ist die Verwendung des Cholesterinsynthese-hemmers Lovastatin. Für diesen Wirkstoff konnte in vorhergehenden Untersuchungen ein mukoprotektiver Effekt nachgewiesen werden. In der vorliegenden Arbeit wurde der Zusammenhang zwischen diesem schleimhaut-schützenden Effekt und der Expression von induzierbarer Stickstoffmonoxid-Synthase (iNOS), Nitrotyrosin (NT) und CD105 betrachtet. Das Enzym iNOS ist an Entzündungsreaktionen beteiligt; NT stellt ein Folgeprodukt des durch iNOS gebildeten Stickstoffmonoxids dar. CD105 wird von aktivierten Monozyten und Makrophagen exprimiert. Ausgangsmaterial für die vorliegende Studie waren 174 Präparate aus dem vorangegangenen Tierversuch. In diesem wurde bei Mäusen eine fraktionierte Schnauzenbestrahlung zum Teil mit einer Lovastatingabe kombiniert. Zusätzlich wurden Tiere alleinig mit Lovastatin behandelt. Für diesen Versuch wurden Mäuse des Stammes C3H/Neu verwendet. Die Bestrahlung erfolgte mit 5 x 3 Gy über zwei Wochen. Lovastatin wurde in einer Dosis von 16 mg/kg oral verabreicht. Gegenstand der aktuellen Untersuchung war - neben der allgemeinen histologischen Charakterisierung - die immunhistochemische Darstellung von iNOS, NT und CD105 im Epithel der Zungenunterseite sowie im subepithelialen Gewebe. Ausgewertet wurden die Gesamtzellzahl im Epithel, die Zahl iNOS- und NT-positiver Zellkerne in Germinativ- und funktioneller Schicht sowie jeweils die Farbintensität der positiven Epithelzellen. In der L. propria und L. muscularis wurden die CD105-, iNOS-, und NT-positiven Makrophagen sowie die weiteren iNOS- und NT-positiven Immunzellen erfasst und ihre Farbintensität bestimmt. Weiterhin wurde die Homogenität und Intensität der Expression von iNOS im Endothel bewertet. Die Auswertung umfasst die deskriptive Darstellung der Werteverläufe dieser Parameter. Aufgrund der geringen Anzahl von drei Versuchstieren je Tag und Gruppe wurde auf die Berechnung der statistischen Signifikanz der Ergebnisse verzichtet. Die Gesamtzellzahl im Zungenepithel zeigte bei Bestrahlung eine deutliche Reduktion auf 65 % des Ausgangswertes. Mit Beendigung der Behandlung war eine entsprechende Erholung zu sehen. Die alleinige Lovastatinbehandlung bewirkte dagegen eine Steigerung der Gesamtzell-zahl auf ca. 110 %. Während iNOS sowohl im unbehandelten als auch im behandelten Epithelgewebe nachweisbar war, war NT im unbehandelten Epithel kaum vorhanden. Die Ausgangswerte betrugen 22 % iNOS-positive Kerne in der Germinativschicht und 8 % in der funktionellen Schicht, sowie 2 % und 1 % für die NT-Färbung. In der Germinativschicht waren sowohl bei alleiniger Bestrahlung als auch bei alleiniger Lovastatintherapie 30 - 50 % der Zell-kerne iNOS-positiv. Bei zweiwöchiger Kombinationstherapie lagen die Werte teils darunter; bei Lovastatingabe ab Tag 7 lagen sie vornehmlich in dem oberen Bereich. In der funktionellen Schicht spiegelten sich diese Verteilungsmuster wider, allerdings lag die Anzahl positiver Kerne insgesamt überwiegend unter 30 %. Die Zahl NT-positiver Zellkerne stieg in beiden Schichten infolge der Bestrahlung auf ca. 50 - 60 %. Unter alleiniger Lovastatintherapie lag sie unter 30 %. Die zweiwöchige Kombination zeigte ebenfalls eine Tendenz zum niederen Bereich. Bei Lovastatingabe ab Tag 7 lagen die Werte geringgradig vermehrt im höheren Bereich. Die Anfärbung der Makrophagen gegen CD105 verdeutlichte bei allen Gruppen eine Reduktion der Makrophagenzahl auf ca. 50 % des Ausgangswertes. Auch die Zahl iNOS-positiver Makrophagen reduzierte sich in allen Behandlungsgruppen einheitlich auf unter 80 % der Norm. Die Zahl NT-positiver Makrophagen lag näher am Ausgangswert. Im Gegensatz dazu waren die restlichen Immunzellen unter Behandlung vermehrt iNOS-positiv. Die Werte lagen häufig weit oberhalb des Referenzbereichs. Dabei zeigte im Vergleich die alleinige Bestrahlung die niedrigsten Werte mit maximal 136 % der Norm. Bei der Färbung gegen NT konnten nur bei alleiniger Lovastatinverabreichung konstant Werte oberhalb des Ausgangswertes festgestellt werden. Innerhalb der Untersuchungen konnte das Endothel nur mit iNOS-AK auswertbar angefärbt werden. Es zeigte in allen Gruppen eine durchgängig homogene Färbung. Die Farbintensität war mittelmäßig und wurde in allen Behandlungsgruppen zum Ende des Untersuchungszeitraums kräftiger. Als Resultat dieser Arbeit ist festzuhalten, dass bei allen vier Behandlungsvarianten iNOS und NT in hohem Maße in der Germinativschicht des Epithels exprimiert wurden. In der funktionellen Schicht war die Expression von iNOS schwächer, während die NT-expression nahezu gleich blieb. Damit muss NT eine längere Halbwertszeit haben. Des Weiteren waren nicht alle aktivierten (CD105-positiven) Makrophagen iNOS-positiv und wiederum produzierte iNOS nicht in allen Zellen NT. Dies wurde auch durch die deutlich höhere Zahl iNOS-positiver Immunzellen in den Ll. propriae und musculares deutlich. Die biochemischen Abläufe, durch welche Lovastatin zur Reduktion der radiogenen Mucositis enoralis führt, bleiben daher weiterhin zu erforschen. In der durchgeführten Untersuchung zeigte sich kein eindeutiger Hinweis auf einen Zusammenhang mit dem iNOS-NT-Signaltransduktionsweg.:Abkürzungsverzeichnis VIII 1 Einleitung 1 2 Literaturübersicht 3 2.1 Bedeutung von Tumorerkrankungen bei Mensch und Tier 3 2.2 Kopf-Hals-Tumoren 4 2.2.1 Tumorvorkommen beim Menschen 4 2.2.2 Tumorvorkommen bei Hund und Katze 4 2.2.3 Symptome beim Kleintier 5 2.2.4 Behandlungsmethoden 5 2.2.4.1 Chirurgie 5 2.2.4.2 Chemotherapie 5 2.2.4.3 Radiotherapie 6 2.2.4.4 Radiochemotherapie 7 2.2.5 Nebenwirkungen der Tumorbehandlung 7 2.2.5.1 Nebenwirkungen der Chemotherapie 7 2.2.5.2 Nebenwirkungen der Radiotherapie 8 2.3 Mucositis enoralis 8 2.3.1 Aufbau von Zunge und Zungenepithel 8 2.3.2 Pathogenese und zeitlicher Verlauf der radiogenen oralen Mukositis 10 2.3.2.1 Stadien der Mukositis und klinisches Erscheinungsbild 10 2.3.2.2 Reaktionskette der Strahlenwirkung 11 2.3.3 Einteilung des Schweregrades der Mukositis 12 2.3.3.1 Einteilung für die Humanmedizin 12 2.3.3.2 Einteilung für die Veterinärmedizin 13 2.3.4 Aktuelle Herangehensweise an die radiogene orale Mukositis 13 2.4 Lovastatin 14 2.4.1 Struktur und Anwendung 14 2.4.2 Weitere Wirkmechanismen von Statinen 14 2.4.2.1 Die apoptotische Wirkung der Statine 15 2.4.3 Eigenschaften im Tiereinsatz 15 2.5 Induzierbare Stickstoffmonoxid-Synthase und Nitrotyrosin 16 2.5.1 Die NOS und Nitrotyrosinbildung 16 2.5.2 Vorkommen von iNOS und Nitrotyrosin 17 3 Zielstellung der Arbeit 19 4 Material und Methoden 20 4.1 Versuchstiere 20 4.2 Perkutane Schnauzenbestrahlung 20 4.3 Applikation von Lovastatin 22 4.4 Versuchsprotokoll 22 4.5 Histologische Aufbereitung 23 4.5.1 Antikörper 23 4.5.1.1 Induzierbare Stickstoffmonoxid-Synthase (iNOS) 23 4.5.1.2 Nitrotyrosin 23 4.5.1.3 CD105 ... 23 4.5.1.4 Kontroll-Antikörper 23 4.5.2 Färbeprotokolle 24 4.5.2.1 iNOS und CD105 24 4.5.2.2 Nitrotyrosin 26 4.5.2.3 Optimierung der Konzentration der primären Antikörper 27 4.5.3 Histologische Auswertung 29 4.5.3.1 Epithel .. 29 4.5.3.2 L. propria und L. muscularis 30 4.5.3.3 Endothel 31 4.6 Analyse 31 5 Ergebnisse 32 5.1 Zellzahlen im Epithel 32 5.1.1 Kontrollgruppe 32 5.1.2 Alleinige Bestrahlung 32 5.1.3 Alleinige Lovastatinbehandlung 33 5.1.4 Bestrahlung und Lovastatingabe von Tag 0 bis 14 34 5.1.5 Bestrahlung und Lovastatingabe von Tag 7 bis 14 34 5.2 Expression von iNOS 36 5.2.1 Kontrollgruppe 36 5.2.2 Alleinige Bestrahlung 36 5.2.3 Alleinige Lovastatingabe 38 5.2.4 Bestrahlung und Lovastatingabe von Tag 0 bis 14 41 5.2.5 Bestrahlung und Lovastatingabe von Tag 7 bis 14 43 5.3 Expression von Nitrotyrosin 45 5.3.1 Kontrollgruppe 45 5.3.2 Alleinige Bestrahlung 45 5.3.3 Alleinige Lovastatinbehandlung 47 5.3.4 Bestrahlung und Lovastatingabe von Tag 0 bis 14 49 5.3.5 Bestrahlung und Lovastatingabe von Tag 7 bis 14 51 5.4 Expression von CD105 54 5.4.1 Alleinige Bestrahlung 54 5.4.2 Alleinige Lovastatinbehandlung 54 5.4.3 Bestrahlung und Lovastatingabe von Tag 0 bis 14 55 5.4.4 Bestrahlung und Lovastatingabe von Tag 7 bis 14 55 6 Diskussion 57 6.1 Klinischer Hintergrund 57 6.2 Tiermodelle für die radiogene orale Mukositis 58 6.2.1 Maus 58 6.2.2 Ratte 58 6.2.3 Hamster 58 6.3 Eigenschaften des unbehandelten Zungengewebes 59 6.3.1 Epithel der Zungenunterseite 59 6.3.1.1 Zellzahl . .59 6.3.1.2 Nachweis von iNOS 59 6.3.1.3 Nachweis von Nitrotyrosin 60 6.3.2 Immunzellen in der L. propria und L. muscularis 60 6.3.2.1 Nachweis von iNOS 60 6.3.2.2 Nachweis von Nitrotyrosin 60 6.3.2.3 Nachweis von CD105 60 6.3.3 Endothelien der L. propria und L. muscularis 60 6.4 Veränderungen bei konventioneller fraktionierter Bestrahlung 61 6.4.1 Epithel der Zungenunterseite 61 6.4.1.1 Zellzahl . 61 6.4.1.2 Nachweis von iNOS 61 6.4.1.3 Nachweis von Nitrotyrosin 62 6.4.2 Immunzellen in der L. propria und L. muscularis 62 6.4.2.1 Nachweis von iNOS 62 6.4.2.2 Nachweis von Nitrotyrosin 62 6.4.2.3 Nachweis von CD105 63 6.4.3 Endothelien der L. propria und L. muscularis 63 6.5 Veränderungen bei alleiniger Lovastatinbehandlung 63 6.5.1 Epithel der Zungenunterseite 63 6.5.1.1 Zellzahl . 63 6.5.1.2 Nachweis von iNOS 63 6.5.1.3 Nachweis von Nitrotyrosin 64 6.5.2 Immunzellen in der L. propria und L. muscularis 64 6.5.2.1 Nachweis von iNOS 64 6.5.2.2 Nachweis von Nitrotyrosin 64 6.5.2.3 Nachweis von CD105 64 6.5.3 Endothelien der L. propria und L. muscularis 65 6.6 Veränderungen bei fraktionierter Bestrahlung mit zusätzlicher Lovastatinbehandlung über 2 Wochen 65 6.6.1 Epithel der Zungenunterseite 65 6.6.1.1 Zellzahl . 65 6.6.1.2 Nachweis von iNOS 65 6.6.1.3 Nachweis von Nitrotyrosin 66 6.6.2 Immunzellen in den L. propria und L. muscularis 66 6.6.2.1 Nachweis von iNOS 66 6.6.2.2 Nachweis von Nitrotyrosin 67 6.6.2.3 Nachweis von CD105 67 6.6.3 Endothelien der L. propria und L. muscularis 67 6.7 Veränderungen bei fraktionierter Bestrahlung mit zusätzlicher Lovastatinbehandlung ab Tag 7 68 6.7.1 Epithel der Zungenunterseite 68 6.7.1.1 Zellzahl . 68 6.7.1.2 Nachweis von iNOS 68 6.7.1.3 Nachweis von Nitrotyrosin 68 6.7.2 Immunzellen in der L. propria und L. muscularis 69 6.7.2.1 Nachweis von iNOS 69 6.7.2.2 Nachweis von Nitrotyrosin 69 6.7.2.3 Nachweis von CD105 69 6.7.3 Endothelien der L. propria und L. muscularis 70 6.8 Zusammenfassende Einschätzung der Ergebnisse 70 7 Ausblick 72 8 Zusammenfassung 73 9 Summary 75 10 Abbildungsverzeichnis 77 11 Tabellenverzeichnis 80 12 Literatur 81 13 Anhang 92 14 Danksagung 100 / During radiation of head-and-neck-cancer oral mucositis is the most important and dose-limiting early side effect. Different preventive and theoretical procedures were investigated, but so far there has been no method established in clinical routine. A new approach is the application of the cholesterol synthesis inhibitor lovastatin. Previous investigtions proved a mucoprotective effect of this agent. In this investigation the correlation between this mucoprotective effect and the expression of inducible nitric oxide synthase (iNOS), nitrotyrosine (NT) and CD105 was observed. The enzyme iNOS takes part in inflammtory reactions; NT is a secondary product of the nitric oxide produced by iNOS. CD105 is expressed by activated monocytes and macrophages. The source material for this study were 174 preparations from previous animal examinations. In this investigation a daily fractionated radiation of the snout was partly combined with lovastatin applications. In addition some mice were treated with lovastatin only. For this research mice of the line C3H/Neu were used. Radiation was performed with 5 x 3Gy over two weeks. Lovastatin was used at an oral dose of 16mg/kg. The matter of the research was - next to general histological characterisation - the immunohistochemical exposure of iNOS, NT and CD105 in the epithelial layer of the undersurface of the tongue and in the subepithelial tissue. The total cell count in the epithelium, the number of iNOS- and NT-positive nuclei in the germinal and the functional layer, as well as the intensity of the staining were evaluated. In the l. propria and l. muscularis CD105-, iNOS-, and NT-positive macrophages and other iNOS- and NT-positive immune cells were identified and the intensity of their staining was determined. Furthermore the homogeneity and intensity of the expression of iNOS in the endothelium were rated. The analysis contains the descriptive presentation of the value patterns of these parameters. Because of the small number of three test animals per day and group the statistical significance of the results was not determined. In consequence of radiotherapy the total cell count in the epithelium decreased to 65% of origin. Recovery was visible after termination of the treatment. With lovastatin medication only, the cell count increased to approximately 110%. While iNOS was present in the untreated as well as in the treated tissue, NT was hardly visible in the untreated one. The basic values were 22% of iNOS-positive nuclei in the germinal layer and 8% in the functional layer, and 2% and 1% for the NT-staining. Both, sole radiation and sole lovastatin therapy, showed 30-50% iNOS-positive nuclei in the germinal layer. With combined therapy for two weeks the values were partially lower, with lovastatin treatment from day 7 they were in the upper range. This group distribution was reflected in the functional layer, although altogether the quantity of positive nuclei was mostly under 30%. Due to radiation the number of NT-positive nuclei increased to 50-60% in both layers. With sole lovastatin therapy it was under 30%. Combined therapy over two weeks showed a tendency to the lower range too. With lovastatin treatment from day 7 the values were situated a little bit more in the upper range. The macrophage staining against CD105 revealed a reduction of macrophage cell count to approximately 50% of origin in all groups. Likewise the number of iNOS-positive macrophages decreased in all groups consistently to less than 80% of normal. The number of NT-positive macrophages was closer to the origin. In contrast to this, the other immunocompetent cells were increasingly iNOS-positive under treatment. Often values were high above the reference range. In comparison sole radiation therapy showed the lowest values with a maximum of 136% of normal. Regarding the staining against NT only sole lovastatin treatment showed values constantly above origin. Within this study the only evaluable staining for the endothelium was with iNOS-antibody. It showed a constant homogeneous staining in all groups. The intensity of the staining was moderate and increased in all treatment groups towards the end of the examination. Therefore it can be concluded that under treatment iNOS and NT were both highly expressed in the germinal layer. In the functional layer the expression of iNOS was reduced whereas the expression of NT remained about the same. So NT must have a longer half-life. In addition not all activated (CD105-positive) macrophages were also iNOS-positive and again iNOS did not produce NT in all cells. This was also proven by the distinct higher number of iNOS-positive immunocompetent cells in the ll. propriae and musculares. Therefore the biochemical processes, because of which lovastatin leads to the reduction of the radiogenic mucositis enoralis, remain to be investigated. During the present investigation there was no distinct hint for a correlation with the iNOS-NT-pathway.:Abkürzungsverzeichnis VIII 1 Einleitung 1 2 Literaturübersicht 3 2.1 Bedeutung von Tumorerkrankungen bei Mensch und Tier 3 2.2 Kopf-Hals-Tumoren 4 2.2.1 Tumorvorkommen beim Menschen 4 2.2.2 Tumorvorkommen bei Hund und Katze 4 2.2.3 Symptome beim Kleintier 5 2.2.4 Behandlungsmethoden 5 2.2.4.1 Chirurgie 5 2.2.4.2 Chemotherapie 5 2.2.4.3 Radiotherapie 6 2.2.4.4 Radiochemotherapie 7 2.2.5 Nebenwirkungen der Tumorbehandlung 7 2.2.5.1 Nebenwirkungen der Chemotherapie 7 2.2.5.2 Nebenwirkungen der Radiotherapie 8 2.3 Mucositis enoralis 8 2.3.1 Aufbau von Zunge und Zungenepithel 8 2.3.2 Pathogenese und zeitlicher Verlauf der radiogenen oralen Mukositis 10 2.3.2.1 Stadien der Mukositis und klinisches Erscheinungsbild 10 2.3.2.2 Reaktionskette der Strahlenwirkung 11 2.3.3 Einteilung des Schweregrades der Mukositis 12 2.3.3.1 Einteilung für die Humanmedizin 12 2.3.3.2 Einteilung für die Veterinärmedizin 13 2.3.4 Aktuelle Herangehensweise an die radiogene orale Mukositis 13 2.4 Lovastatin 14 2.4.1 Struktur und Anwendung 14 2.4.2 Weitere Wirkmechanismen von Statinen 14 2.4.2.1 Die apoptotische Wirkung der Statine 15 2.4.3 Eigenschaften im Tiereinsatz 15 2.5 Induzierbare Stickstoffmonoxid-Synthase und Nitrotyrosin 16 2.5.1 Die NOS und Nitrotyrosinbildung 16 2.5.2 Vorkommen von iNOS und Nitrotyrosin 17 3 Zielstellung der Arbeit 19 4 Material und Methoden 20 4.1 Versuchstiere 20 4.2 Perkutane Schnauzenbestrahlung 20 4.3 Applikation von Lovastatin 22 4.4 Versuchsprotokoll 22 4.5 Histologische Aufbereitung 23 4.5.1 Antikörper 23 4.5.1.1 Induzierbare Stickstoffmonoxid-Synthase (iNOS) 23 4.5.1.2 Nitrotyrosin 23 4.5.1.3 CD105 ... 23 4.5.1.4 Kontroll-Antikörper 23 4.5.2 Färbeprotokolle 24 4.5.2.1 iNOS und CD105 24 4.5.2.2 Nitrotyrosin 26 4.5.2.3 Optimierung der Konzentration der primären Antikörper 27 4.5.3 Histologische Auswertung 29 4.5.3.1 Epithel .. 29 4.5.3.2 L. propria und L. muscularis 30 4.5.3.3 Endothel 31 4.6 Analyse 31 5 Ergebnisse 32 5.1 Zellzahlen im Epithel 32 5.1.1 Kontrollgruppe 32 5.1.2 Alleinige Bestrahlung 32 5.1.3 Alleinige Lovastatinbehandlung 33 5.1.4 Bestrahlung und Lovastatingabe von Tag 0 bis 14 34 5.1.5 Bestrahlung und Lovastatingabe von Tag 7 bis 14 34 5.2 Expression von iNOS 36 5.2.1 Kontrollgruppe 36 5.2.2 Alleinige Bestrahlung 36 5.2.3 Alleinige Lovastatingabe 38 5.2.4 Bestrahlung und Lovastatingabe von Tag 0 bis 14 41 5.2.5 Bestrahlung und Lovastatingabe von Tag 7 bis 14 43 5.3 Expression von Nitrotyrosin 45 5.3.1 Kontrollgruppe 45 5.3.2 Alleinige Bestrahlung 45 5.3.3 Alleinige Lovastatinbehandlung 47 5.3.4 Bestrahlung und Lovastatingabe von Tag 0 bis 14 49 5.3.5 Bestrahlung und Lovastatingabe von Tag 7 bis 14 51 5.4 Expression von CD105 54 5.4.1 Alleinige Bestrahlung 54 5.4.2 Alleinige Lovastatinbehandlung 54 5.4.3 Bestrahlung und Lovastatingabe von Tag 0 bis 14 55 5.4.4 Bestrahlung und Lovastatingabe von Tag 7 bis 14 55 6 Diskussion 57 6.1 Klinischer Hintergrund 57 6.2 Tiermodelle für die radiogene orale Mukositis 58 6.2.1 Maus 58 6.2.2 Ratte 58 6.2.3 Hamster 58 6.3 Eigenschaften des unbehandelten Zungengewebes 59 6.3.1 Epithel der Zungenunterseite 59 6.3.1.1 Zellzahl . .59 6.3.1.2 Nachweis von iNOS 59 6.3.1.3 Nachweis von Nitrotyrosin 60 6.3.2 Immunzellen in der L. propria und L. muscularis 60 6.3.2.1 Nachweis von iNOS 60 6.3.2.2 Nachweis von Nitrotyrosin 60 6.3.2.3 Nachweis von CD105 60 6.3.3 Endothelien der L. propria und L. muscularis 60 6.4 Veränderungen bei konventioneller fraktionierter Bestrahlung 61 6.4.1 Epithel der Zungenunterseite 61 6.4.1.1 Zellzahl . 61 6.4.1.2 Nachweis von iNOS 61 6.4.1.3 Nachweis von Nitrotyrosin 62 6.4.2 Immunzellen in der L. propria und L. muscularis 62 6.4.2.1 Nachweis von iNOS 62 6.4.2.2 Nachweis von Nitrotyrosin 62 6.4.2.3 Nachweis von CD105 63 6.4.3 Endothelien der L. propria und L. muscularis 63 6.5 Veränderungen bei alleiniger Lovastatinbehandlung 63 6.5.1 Epithel der Zungenunterseite 63 6.5.1.1 Zellzahl . 63 6.5.1.2 Nachweis von iNOS 63 6.5.1.3 Nachweis von Nitrotyrosin 64 6.5.2 Immunzellen in der L. propria und L. muscularis 64 6.5.2.1 Nachweis von iNOS 64 6.5.2.2 Nachweis von Nitrotyrosin 64 6.5.2.3 Nachweis von CD105 64 6.5.3 Endothelien der L. propria und L. muscularis 65 6.6 Veränderungen bei fraktionierter Bestrahlung mit zusätzlicher Lovastatinbehandlung über 2 Wochen 65 6.6.1 Epithel der Zungenunterseite 65 6.6.1.1 Zellzahl . 65 6.6.1.2 Nachweis von iNOS 65 6.6.1.3 Nachweis von Nitrotyrosin 66 6.6.2 Immunzellen in den L. propria und L. muscularis 66 6.6.2.1 Nachweis von iNOS 66 6.6.2.2 Nachweis von Nitrotyrosin 67 6.6.2.3 Nachweis von CD105 67 6.6.3 Endothelien der L. propria und L. muscularis 67 6.7 Veränderungen bei fraktionierter Bestrahlung mit zusätzlicher Lovastatinbehandlung ab Tag 7 68 6.7.1 Epithel der Zungenunterseite 68 6.7.1.1 Zellzahl . 68 6.7.1.2 Nachweis von iNOS 68 6.7.1.3 Nachweis von Nitrotyrosin 68 6.7.2 Immunzellen in der L. propria und L. muscularis 69 6.7.2.1 Nachweis von iNOS 69 6.7.2.2 Nachweis von Nitrotyrosin 69 6.7.2.3 Nachweis von CD105 69 6.7.3 Endothelien der L. propria und L. muscularis 70 6.8 Zusammenfassende Einschätzung der Ergebnisse 70 7 Ausblick 72 8 Zusammenfassung 73 9 Summary 75 10 Abbildungsverzeichnis 77 11 Tabellenverzeichnis 80 12 Literatur 81 13 Anhang 92 14 Danksagung 100

Protein nitration is considered as a marker of reactive nitrogen species formation. Heme oxygenases (HOs) are important for the defence against oxidative stress. We evaluated the involvement of the neuronal (nNOS), the endothelial (eNOS), and the inducible (iNOS) in nitrotyrosine formation and localitzation, and both the expression and funcional significance (HO inhibition and contractility studies) of HOs in sepsis-induced muscle contractile dysfunction. Sepsis was elicited by injecting rats and transgenic mice deficient in either nNOS, eNOS, or iNOS isoforms with E.Coli lipolysaccharide (LPS). Nitrotyrosine formation and HO expressions were assessed by immunoblotting. Oxidative stress was assessed measuring protein oxidation, lipid peroxidation, and muscle glutathione. We conclude that protein tyrosine nitration occurs in normal muscles, and sepsis-mediated increase in nitrotyrosine formation is limited to the mitochondria and membrane muscle fractions. The iNOS isoform is mostly involved in nitrotyrosine formation. HOs protect normal and septic muscles from the deleterious effects of oxidants. / En un model de sepsi de disfunció diafragmàtica, s´ha avaluat el paper de les sintetases de l'òxid nítric (NOS) en la formació i localitzacio de 3-nitrotirosina, i l´expressió i significat biològic de les hemo oxigenases (HOs) (inhibidor de les HOs i estudis de contractilitat) davant l' estrès oxidatiu. La sepsi s'induí mitjançant injecció de 20 mg/kg del lipolisacàrid (LPS) d´Escherichia Coli a rates, i a ratolins deficients en les NOS induïble (iNOS), neuronal (nNOS) i endotelial (eNOS). Les proteïnes nitrificades i les HOs es van detectar amb anticossos específics. L' estrès oxidatiu s' avaluà mitjançant l' oxidació proteica, la peroxidació lipídica i el glutation muscular. Concloem que hi han proteïnes nitrificades en el múscul normal i aquestes s'incrementen durant la sepsi en les fraccions mitocondrial i membranar. L'isoforma iNOS és majorment responsable de la formació de nitrotirosina. Les HOs protegirien el múscul normal i sèptic dels efectes deleteris dels oxidants.