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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
41

Inflammation-Dependent Regulation of Hepatocellular Carcinoma Tumor Progression

Markowitz, Geoffrey Joseph January 2015 (has links)
<p>Liver cancer is a devastating disease that is the 5th most common cancer in men, 7th most common cancer in women, and the 3rd leading cause of cancer-related mortality. This disease arises from multiple etiological factors, including hepatitis viruses, environmental toxins, alcohol abuse, and metabolic syndrome, which induce a state of chronic inflammation. This diseased liver tissue background is a drastically different microenvironment from the healthy liver, especially with regards to immune cell prevalence and presence of mediators of immune function. It has been well-established that this altered tissue background contributes significantly to the tumorigenic process, yet its effects on the progression of the disease are more poorly understood. </p><p>To better understand the consequences of liver disease on tumor growth and the interplay with its microenvironment, we first utilized two standard methods of fibrosis induction and orthotopic implantation of tumors into the inflamed and fibrotic liver to mimic the liver condition in human HCC patients, and examined the immune infiltrate. Compared to non-diseased controls, tumor growth is significantly enhanced under fibrotic conditions. The immune cells that infiltrated the tumors are also drastically different, with decreased proportions of natural killer cells but greatly increased numbers of immune-suppressive CD11b+ Gr1hi myeloid cells in both models of fibrosis. In addition, there are model-specific differences: increased proportions of CD11b+ myeloid cells and CD4+ CD25+ T-cells are found in tumors in the bile duct ligation model but not in the carbon tetrachloride model. Importantly, the skewed immune infiltration into the tumor, while having some commonalities with the non-tumor tissue, had several distinct, tumor-specific populations. Induction of fibrosis also alters the cytokine production of implanted tumor cells, which could have far-reaching consequences on the immune infiltrate and its functionality. Taken together, this work demonstrates that the combination of fibrosis induction with orthotopic tumor implantation results in a markedly different tumor microenvironment and tumor growth kinetics. </p><p>Appreciating that the altered immune microenvironment dramatically shifts tumor progression, we sought to further explore the effects of individual inflammatory mediators on the development of the disease. Interleukin 18 (IL-18) is an inflammatory cytokine that is markedly increased in the circulation of patients with HCC correlated with poor prognosis. However, the precise role for IL-18 in HCC remains unclear, with reports presenting both pro- and anti-tumorigenic activities. To answer this question definitively, we interrogated in more detail the expression profiles of IL-18 in tissue specimens from HCC patients and conducted experimentation using multiple clinically relevant mouse models to explore the functional role of this cytokine in the context of HCC. Our results indicate that IL-18 exerts a tumor-suppressive effect mediated in large part by alterations in survival and functionality of T-lymphocytes which infiltrated the tumor microenvironment. This tumor-suppressive effect is however dependent upon the inflammatory milieu: In the absence of an inflammatory environment, whether from a chemical carcinogenesis model or a fibrosis induction model, loss of IL-18 signaling does not affect tumor growth. This effect is also stage-dependent. Taken together, our findings establish a tumor-suppressive role for IL-18 in established HCC and provide a mechanistic explanation for the complex relationship between its expression pattern and HCC prognosis. </p><p>In summary, this work demonstrates a dramatic shift in the microenvironment of developing HCC tumors in the presence of chronic inflammatory stimuli. This microenvironment, which more accurately models the situation in which tumors develop and progress in patients, alters the presence and functionality of many immune mediators. In particular, IL-18 signaling is a powerful mediator of tumor progression, however observation of its functionality is dependent on an inflammatory context. This work provides new insight into the complex processes underlying HCC tumor progression, and emphasizes the necessity for more accurate modeling of HCC progression in mice which takes into account the drastic changes in the tissue caused by chronic liver disease.</p> / Dissertation
42

Extracellular Matrix as a Key Mediator of Mammary Tumor Cell Normalization

Bischof, Ashley Gibbs 08 June 2015 (has links)
Some epithelial cancers can be induced to revert to quiescent differentiated tissues when combined with embryonic mesenchyme; however, the mechanism of this induction is unknown. This dissertation is based on the hypothesis that because extracellular matrix (ECM) plays a critical role during organ development in the embryo, it also may mediate the differentiation-inducing effects of embryonic mesenchyme on cancer cells. To test this hypothesis, I first optimized methods to isolate ECMs from whole tissues or cultured cells, and to repopulate them with cultured cells, using embryonic tooth as a model system. In Chapter 2, I describe these studies and use them to demonstrate that embryonic ECM is sufficient to regulate odontogenic signaling, cell fate decisions and histodifferentiation during normal tooth development. In Chapter 3, I adapt these methods to show that culture of breast cancer cells with ECM derived from embryonic mammary mesenchyme decreases tumor cell proliferation, and stimulates differentiation, including formation of hollow acini and ducts as well as enhanced expression of estrogen receptor-alpha and decreased migration. Further, when the inductive ECMs were injected into fast-growing breast tumors in mice, they significantly inhibited cancer expansion. Critically, the differentiation observed with ECM was the same as that observed in co-culture with mammary mesenchyme cells, showing that ECM is playing a dominant role in tumor cell normalization. In Chapter 4, I then set out to determine the mechanism by which embryonic ECM normalizes tumor cells, I analyzed the contributions of bound cytokines, ECM composition and mechanics. Western blot analysis revealed several bound growth factors, which remained following decellularization; however, removal of these growth factors using high salt washes had no effect on ECM-mediated normalization of tumors. Further, using proteomics analysis I identified eleven ECM proteins present only within inductive ECMs and by testing these proteins in 3D culture, I found three proteins -- collagen III, biglycan and SPARC -- that increased lumen formation to a similar extent as embryonic ECM. These data confirm that mesenchyme-induced tumor cell normalization is mediated by the insoluble ECM, and reveal the identity of some of the inductive molecules responsible for these effects.
43

Ο ρόλος του μικροπεριβάλλοντος στην ανάπτυξη, διήθηση και μετάσταση των νεοπλασμάτων

Τζελέπη, Βασιλική 30 July 2007 (has links)
Ο καρκίνος αποτελεί μια από τις μεγαλύτερες μάστιγες της σύγχρονης ζωής. Η ιστολογική εξέταση των νεοπλασμάτων (τόσο στις πρωτοπαθείς εστίες όσο και στις δευτεροπαθείς εναποθέσεις) αποκαλύπτει ότι οι όγκοι αποτελούν ένα ετερογενές σύνολο άμορφων και έμμορφων στοιχείων. Η νεοπλασματική μάζα εκτός από τα καρκινικά κύτταρα, περιλαμβάνει ποικίλα κύτταρα (ινοβλάστες, κύτταρα αγγείων, μακροφάγα, φλεγμονώδη κύτταρα, λιποκύτταρα) και στοιχεία της εξωκυτταρίου ουσίας (κολλαγόνο, ελαστικές ίνες, πρωτεΐνες της εξωκυττάριας ουσίας) τα οποία στη μεγάλη πλειοψηφία τους προσελκύονται, άμεσα ή έμμεσα, από τα κακοήθη κύτταρα. Τα κύτταρα του καρκινικού μικροπεριβάλλοντος δεν αποτελούν αδρανείς παρατηρητές της καρκινικής διεργασίας αλλά συμμετέχουν ενεργά σε αυτή καθώς αυξάνουν τον πολλαπλασιασμό, καταστέλλουν την απόπτωση, ευνοούν την επιβίωση, διευκολύνουν τη μετανάστευση και εξασφαλίζουν την επαρκή θρέψη και οξυγόνωση των καρκινικών κυττάρων. Επιπλέον προστατεύουν τα καρκινικά κύτταρα από το ανοσοποιητικό σύστημα του ξενιστή. Η μελέτη των ποικίλων αλληλεπιδράσεων που αναπτύσσονται στο καρκινικό μικροπεριβάλλον ανάμεσα στα καρκινικά κύτταρα και τα στοιχεία του ξενιστή αποκαλύπτει καινούργιους θεραπευτικούς στόχους στην αντικαρκινική θεραπεία και βοηθάει στην κατανόηση του μηχανισμού των μεταστάσεων, δημιουργώντας την ελπίδα της αποτελεσματικότερης αντιμετώπισης του καρκίνου. Στην παρούσα εργασία γίνεται μια συνολική αναφορά της συμμετοχής όλων των στοιχείων του καρκινικού μικροπεριβάλλοντος στη νεοπλασματική εξεργασία. Επίσης καταβάλλεται προσπάθεια να τονιστούν οι σύνθετες αλληλεπιδράσεις ανάμεσα στα καρκινικά κύτταρα και το μικροπεριβάλλον. / Cancer is a devastating disease. Histologic examination of neoplasms (in the primary sites and their metastases as well) reveals that tumors are composed of a heterogeneous population of cells (fibroblast, vascular cells, macrophages, inflammatory cells, lipocytes) and extracellular matrix proteins (ECM) (collagen, elastin fibers, other ECM proteins). Recruitment of non-neoplastic tissue (stromal cells and ECM) to the tumor microenvironment is mostly mediated, directly or indirectly, by the malignant cells. Stromal cells are not quiescent bystanders of the neoplastic process. Instead they have an active role since they promote the proliferation, growth and migration of the tumor cells, inhibit their apoptosis and support tumor supply of oxygen and nourishment. In addition, stromal cells and ECM network protect cancer cells from the host defense. Research on the evolving crosstalk between the different cell types and ECM molecules within the tumor mass can disclose new therapeutic targets and help elucidate the pathogenetic mechanisms underlying metastasis, thus leading to a more effective anticancer therapy. This study discusses the potential role of the different stromal compartments in cancer initiation and progression and emphasizes the complex crosstalk between cancer cells and their microenvironment.
44

Simultaneous Optical and MR Imaging of Tissue Within Implanted Window Chamber: System Development and Application in Measuring Vascular Permeability

Shayegan Salek, Mir Farrokh January 2013 (has links)
Simultaneous optical imaging and MRI of a dorsal skin-fold window chamber mouse model is investigated as a novel methodology to study the tumor microenvironment. Simultaneous imaging with two modalities allows for cross-validation of results, integration of the capabilities of the two modalities in one study and mitigation of invasive factors, such as surgery and anesthesia, in an in-vivo experiment. To make this investigation possible, three optical imaging systems were developed that operated inside the MRI scanner. One of the developed systems was applied to estimate vascular kinetic parameters of tumors in a dorsal skin-fold window chamber mouse model with simultaneous optical and MRI imaging. The target of imaging was a molecular agent that was dual labeled with both optical and MRI contrast agents. The labeling of the molecular agent, characteristics of the developed optical systems, the methodologies of measuring vascular kinetic parameters using optical imaging and MRI data, and the obtained results are described and illustrated.
45

Untangling Intercellular Communication Using Optical Manipulation in 3D Models of Tumor Microenvironment

Orsinger, Gabriel V. January 2014 (has links)
The tumor microenvironment is a tangled web of multiple cell types, extracellular matrix components, and a multitude of cell signaling pathways frequently contribute to poor outcomes, which make cancer the second leading killer in the United States. A better understanding of how these constituents interact will inevitably facilitate development of novel cancer therapeutics and diagnostics. To advance scientific discovery towards this goal, innovative experimental techniques are required. In this dissertation, new research methods for probing cell communication at a single to multi cell level within 3D models of the tumor microenvironment are presented. Optical trapping, composite nanocapsules (i.e., gold-coated liposomes), and 3D cell culture models were the foundation for the development of these research tools. The first aim of this dissertation was to optimize our ability to optically manipulate gold-coated liposomes for the purpose of delivering molecular content to cells. The second aim was to apply optical manipulation of gold-coated liposomes to quantitatively deliver signaling molecules into a single cell to activate communication. The third aim was to develop a 3D model of the tumor microenvironment and demonstrate cell communication within this physiologically accurate architecture. The basis for this work was gold-coated liposomes' strong plasmon resonance with visible to near infrared (NIR) wavelengths of light, which enabled photo-thermal conversion and optical trapping. To identify preferred conditions for optical manipulation of gold-coated liposomes for delivering content into cells, gold-coated liposomes made with different dielectric properties were optically trapped under various laser modulation schemes and thoroughly characterized, enabled by high speed (kHz) imaging. Application of this technique was realized by precise delivery of molecular agents into a single cell (i.e., optical injection). As a demonstration of optical injection, the NIR trapping beam was utilized to propel gold-coated liposomes encapsulating inositol trisphosphate (IP3) into a single cell to initiate calcium (Ca²⁺) signaling. In another method for intracellular delivery, cells were preloaded with similar gold-coated liposomes, internalized by macropinocytosis, and then exposed to on-resonant laser light to trigger on-demand release of IP3 to activate Ca²⁺ signaling. Lastly, a 3D cell culture model of ovarian cancer microenvironment was developed as a platform for interrogating cell signaling. The in vitro model comprised human ovarian cancerous epithelial cells grown upon a collagen and human fibroblast stroma recapitulating architecture of human tissue. Gold-coated liposomes encapsulating signaling molecules, optical manipulation, and a 3D model of ovarian cancer, a trio of versatile experimental tools opens new opportunities for studying the tumor microenvironment.
46

Die Rolle der residenten monozytären Zellen sowie Tumorzell-spezifischer Faktoren bei der Metastasierung des Mammakarzinoms / The role of monocytic cells and tumor cell-specific factors during breast cancer metastasis

Rietkötter, Eva 17 October 2012 (has links)
Das Auftreten von Metastasen ist die Haupttodesursache bei Krebspatienten und kennzeichnet den Wendepunkt jeder Tumorerkrankung, nach dem eine Heilung nur noch in Ausnahmefällen erfolgen kann. Eine wesentliche neue Erkenntnis in der Erforschung innovativer Therapieansätze zur Prävention der Metastasierung war, dass eingewanderte Immunzellen nicht nur die ersten Schritte der Tumorprogression fördern, sondern auch im Prozess der Metastasierung von Bedeutung sind. In diesem Zusammenhang konnten vor allem die Makrophagen als Vermittler der Migration und Invasion von Tumorzellen und deren Kolonisation in einem entfernten Organ identifiziert werden. Bisphosphonate (BPs) sind bekanntermaßen sehr potente Inhibitoren von Makrophagen. Dennoch erklärt die Mehrzahl der Studien ihre Tumor hemmenden Eigenschaften mit direkten Effekten auf z.B. Migrations- und Invasionseigenschaften der Tumorzellen und berücksichtigt nicht die Auswirkungen auf das Tumorstroma. Diese Arbeit zeigt, dass Makrophagen sehr viel sensitiver gegenüber dem stickstoffhaltigen BP Zoledronat (ZA) sind als Mammakarzinom-Zelllinien. Weiterhin wird verdeutlicht, dass die Makrophagen-induzierte Invasion sowie die Mikroglia-assistierte Kolonisation von MCF-7 im Hirngewebe durch ZA gehemmt werden, während die Migrations- und Invasionseigenschaften der Tumorzellen nicht beeinflusst werden. Für einen weiteren Makrophageninhibitor, einen CSF-1 Antikörper (5A1), wird in dieser Arbeit gezeigt, dass er die Depletion von Knochenmarksmakrophagen (BMDMs) induziert, jedoch keine Auswirkung auf die Viabilität von Mikroglia hat. Während 5A1 die Mikroglia-induzierte Invasion von MCF-7 wenig hemmt, induziert er eine starke Hemmung der BMDM-induzierten Invasion. Neben den benignen Zellen des Tumorstromas können auch Eigenschaften der Tumorzellen die Metastasierung induzieren. So konnte vor einiger Zeit der Transkriptionsfaktor LEF1 als Faktor der zerebralen Metastasierung des Lungenadenokarzinoms identifiziert werden. Diese Arbeit verdeutlicht, dass die Expression von LEF1 in einer Subgruppe zerebraler Metastasen nachgewiesen werden kann und ebenfalls charakteristisch für invasive Mammakarzinom-Zelllinien ist. Während die Überexpression von LEF1 in der wenig invasiven MCF-7 keinen Einfluss auf die Proliferation, die Migration oder die Sensitivität gegenüber Chemotherapie oder Bestrahlung hat, steigert sie die Invasivität der Zellen und induziert die Angiogenese im Tumor. Diese Effekte sind unabhängig von der direkten Bindung des Transkriptionsfaktors an die DNA und scheinen durch einen β-Catenin-unabhängigen Mechanismus zu erfolgen.
47

Profiling and Targeting Microenvironment-Induced Changes in the Cancer Epigenome

Skowronski, Karolina 26 June 2012 (has links)
The tumor microenvironment consists of multiple cells types, including endothelial cells that line the tumor vasculature. Tumor vasculature is often abnormal and results in development of tissue ischemia, another contributing factor to the tumor microenvironment. Previous studies have demonstrated that ischemia influences epigenetic programming, but the mechanisms remained unclear and required further investigation. First, we profiled DNA methyltransferase (DNMT) expression and activity in human colorectal cancer cells (HCT116) under hypoxia or hypoglycaemia (mimicking ischemia). We found that DNMT1 and DNMT3b were significantly downregulated by hypoxia and hypoglycaemia, and DNMT3a was downregulated by hypoglycaemia. However, DNMT1 downregulation was p53-dependent. To examine if the changes in DNMT expression and activity translated to changes in DNA methylation patterns, we used bisulfite sequencing and examined the promoter region of p16. Hypoglycaemia significantly demethylated this region in both p53 wild-type and p53-null cells. Next, we used a genome-wide approach to discover what additional genes are hypomethylated by ischemia. Methylated DNA was immunoprecipitated and analysed with an Affymetrix promoter array, in parallel with an expression array. Ingenuity pathway analysis software revealed that a significant proportion of genes which were hypomethylated and upregulated were involved in cellular movement, including PLAUR and CYR61. We believe that hypoxia and hypoglycaemia may be driving changes in DNA methylation through dysregulation of DNMTs, resulting in cells acquiring a more mobile phenotype in ischemic regions. DNMT and histone deacetylase inhibitors are commonly used in research and some cancer therapies. Modifying epigenetic patterning with these inhibitors has been widely studied in cancer cells, but only briefly explored in the tumor’s vascular endothelium. We profiled the effect of these inhibitors on endothelial cell (EC) behaviour, and tested if combining them with a targeted anti-angiogenic therapy would augment the inhibition of angiogenesis. When the DNMT inhibitor 5-aza-2’-deoxycytidine was combined with sunitinib, inhibition of EC proliferation was enhanced compared to treatment with sunitinib alone. EC migration was also inhibited by the combination of these two inhibitors, but not in an additive manner. These studies have improved our understanding of how altering epigenetic patterning with ischemia and therapeutic inhibitors can influence colorectal cancer and endothelial cell behaviour. / Canadian Cancer Society Research Institute. The Cancer Research Society.
48

Lactate Metabolism in Cancer Cell Lines

Kennedy, Kelly Marie January 2013 (has links)
<p>Pathophysiologic lactate accumulation is characteristic of solid tumors and has been associated with metastases and poor overall survival in cancer patients. In recent years, there has been a resurgence of interest in tumor lactate metabolism. In the past, our group has shown that lactate can be used as a fuel in some cancer cell lines; however, survival responses to exogenous lactate alone are not well-described. We hypothesized that lactate utilization and cellular responses to exogenous lactate were varied and dynamic, dependent upon factors such as lactate concentration, duration of lactate exposure, and of expression of the lactate transporter, monocarboxylate transporter 1 (MCT1). We hypothesized that pharmacological inhibition of MCT1 with a small molecule, competitive MCT1 inhibitor, &#945;-cyano-4-hydroxycinnamic acid (CHC), could elicit cancer cell death in high lactate conditions typical of that seen in breast cancer. </p><p>My work focused on defining: 1. Lactate levels in locally advanced breast cancer (LABC); 2. Lactate uptake and catabolism in a variety of cancer cell lines; 3. The effect of exogenous lactate on cancer cell survival; 4. Whether the lactate-transporters, MCT1 and MCT4 can be used as markers of cycling hypoxia. </p><p>Lactate levels in LABC biopsies were assessed ex vivo by bioluminescence. NMR techniques were employed extensively to determine metabolites generated from 13C-labeled lactate. Cell viability in response to extracellular lactate ( ± glucose and ± CHC) was measured with Annexin V / 7-AAD staining to assess acute survival responses and clonogenic assays to evaluate long-term colony forming ability after lactate treatment. MCT1 and MCT4 protein expression was evaluated in cancer cell lines with Western blots after exposure to chronic or cycling hypoxia. Immunofluorescence was employed to assess MCT1 and MCT4 expression in head and neck cancer biopsies, and the expression patterns of the transporters were correlated to areas of hypoxia, as indicated by hypoxia marker EF5. </p><p>Lactate concentrations in LABC biopsied ranged from 0 - 12.3 µmol/g of tissue. The LABC dataset was too small to derive statistical power to test if lactate accumulation in LABC biopsies was associated with poor patient outcome or other clinical parameters of known prognostic significance. All cell lines tested (normal and cancer) showed uptake and metabolism of labeled lactate, with dominant generation of alanine and glutamate; however, relative rates and the diversity of metabolites generated was different among cell lines. MCF7 cells showed greater overall lactate uptake (mean = 18mM) over five days than MDA-MB-231 cells (mean = 5.5mM). CHC treatment effectively prevented lactate uptake in cancer cells when lactate concentrations were &#8804;20mM. </p><p>Cell survival was dependent upon lactate concentration and glucose availability. Acute responses to exogenous lactate did not reflect the long-term consequences of lactate exposure. Acutely, HMEC and R3230Ac cells were tolerant of all lactate concentrations tested (0-40mM) regardless of presence or absence of glucose. MCF7 and MDA-MB-231 cells were tolerant of lactate within the concentration ranges seen in biopsies. Cytotoxicity was seen after 24 hr incubation with 40mM lactate (-glucose), but this concentration is three times higher than any measurement made in human biopsies of LABC. Similarly, HMEC and MCF7 cells showed significantly decreased colony formation in response to 40mM exogenous lactate (+ glucose) while R3230Ac and MDA-MB-231 cells showed no impairment in colony-forming abilities with any lactate concentration (+ glucose). 5mM CHC significantly increased cell death responses independent of lactate treatment, indicating off-target effects at high concentrations. </p><p>MCT1 was found to be expressed in a majority of the cell lines tested, except for MDA-MB-231 cells. Cancer cells exposed to exogenous lactate showed upregulation of MCT1 but not MCT4. Chronic hypoxia resulted in an increase in protein expression of MCT4 but a decrease in MCT1 expression in cancer cell lines. The time course of regulation of protein levels of each transporter suggested the possibility of expression of both transporters during cycling hypoxia. When cancer cells were exposed to cycling hypoxia, both transporters showed upregulation. In head and neck tumor biopsies, MCT1 expression was significantly positively correlated to aerobic tumor regions and inversely correlated to hypoxic tumor regions. </p><p>Cancer cell responses to exogenous lactate were not uniform. Some cell lines demonstrated a lactate-tolerant and/or a lactate-consuming phenotype while other cell lines demonstrated lactate-intolerant and/or non-lactate-consuming phenotype. My work indicates that exogenous lactate was well-tolerated at clinically relevant concentrations , especially in the presence of glucose. Evidence of glutamate metabolism from lactate indicated that exogenous lactate partially progresses through the TCA cycle, suggesting that lactate may be utilized for fuel. The cell death elicited from 5mM CHC treatment was not dependent upon presence of lactate, indicating that manipulation of lactate metabolism may not be the best option for targeting cancer metabolism. When attempting to manipulate lactate metabolism in tumors, microenvironmental factors, such as hypoxia and glucose, must be taken into account in order to ensure a predictable and favorable outcome. Together, these results illustrate the importance of characterizing tumor metabolism before therapeutic intervention.</p> / Dissertation
49

Extracellular vesicles as mediators of intercellular communication in human breast cancer progression

Menck, Kerstin 31 March 2014 (has links)
No description available.
50

CD40L Gene Therapy for Solid Tumors

Liljenfeldt, Lina January 2014 (has links)
Adenoviral CD40L gene therapy (AdCD40L) is a strong inducer of anti-tumor immune responses via its activation of dendritic cells (DCs). Activated DCs can in turn activate T cells, which are key players in an efficient anti-tumor response. This thesis includes three papers that focus on different aspects of AdCD40L gene therapy. In the first paper, the infiltration of suppressive CD11b+Gr-1+ cells in orthotopic MB49 bladder tumors was investigated and found to be significantly reduced while activated T cells were increased when the tumors had been treated with local AdCD40L gene therapy. Further, AdCD40L could tilt the cells in the tumor microenvironment in favor of an efficient anti-tumor immunity (M1 macrophages and activated T cells) instead of an immunosuppressive environment (CD11b+Gr-1int/low myeloid cells and M2 macrophages). Immunotherapy combined with chemotherapy has shown promising results, and the second paper investigates the combination of AdCD40L gene therapy together with the chemotherapeutic drug 5-Fluorouracil (5-FU). A synergistic effect of the combination treatment on orthotopic MB49 bladder tumors could be demonstrated. The combination therapy resulted in decreased tumor growth, increased survival and systemic MB49-specific immunity, whereas AdCD40L or 5-FU therapy alone had a poor effect on tumor growth. Efficient AdCD40L therapy is dependent on high transduction efficiency in both cancer cells and cells present in the tumor microenvironment. In an attempt to enhance the transduction efficiency, and thereby the therapeutic efficacy, a modified adenovirus was developed for paper three. This modified Ad5PTDf35(mCD40L) could, in comparison with the unmodified Ad5(mCD40L), demonstrate increased transduction capacity of a variety of murine cells. Further, the ability of antigen presenting cells (APCs) to present antigens to T cells was improved after transduction with Ad5PTDf35(mCD40L).

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