Refine
Year of publication
- 2018 (204) (remove)
Document Type
- Doctoral Thesis (204) (remove)
Has Fulltext
- yes (204)
Is part of the Bibliography
- no (204)
Keywords
- Lebensqualität (2)
- Spracherwerb (2)
- vascular endothelial cells (2)
- ABCE1 (1)
- ARFI (1)
- Adhärenz (1)
- Afghanistan (1)
- Allosteric inhibition (1)
- Anomalie <Medizin> (1)
- Anwendungsorientierte Forschung (1)
Institute
- Biochemie, Chemie und Pharmazie (44)
- Medizin (39)
- Biowissenschaften (34)
- Physik (21)
- Informatik und Mathematik (17)
- Gesellschaftswissenschaften (8)
- Sprach- und Kulturwissenschaften (8)
- Neuere Philologien (7)
- Biochemie und Chemie (3)
- Kulturwissenschaften (3)
Metabolic engineering can serve to convert microorganisms to
microbial cell factories with the goal of producing various chemicals. Commonly used strategies to modify metabolic pathways include deletions and overexpression of genes, as well as the introduction of heterologous genes or genes which have been optimized for the host organism or for a reaction of interest. Aside from these classic metabolic engineering strategies, researchers have also implemented pathway compartmentalization strategies, which mimic nature’s strategies of colocalizing enzymes for pathway optimization.
In this thesis, classic metabolic engineering strategies were combined with pathway compartmentalization strategies. For pathway compartmentalization, mitochondria and peroxisomes were harnessed, and additionally a new strategy to create artificial subcellular organelles was evaluated. In the latter approach, the so-called Zera peptide was fused to the enzymes of interest. Zera consists of the first 113 amino acids of the plant storage protein γ-Zein (Zea mays). Natively, plant storage proteins accumulate in endoplasmic reticulum (ER)-derived vesicles in plant seeds and serve as an amino acid source for the germinating plant. In this thesis, it was shown that Zera also induces the formation of artificial, ER-derived vesicles in Saccharomyces cerevisiae. Furthermore, it was shown that Zera fusion enzymes remained active, albeit with sometimes reduced activity.
In line with the goal of compartmentalizing pathways in these artificial, Zera-induced vesicles, a new tool was developed to determine the pH in the ER of S. cerevisiae and in the ER-derived vesicles. pHluorin, a pH-sensitive green fluorescent protein (GFP) variant, is commonly used to analyze the cytosolic pH or the pH of subcellular organelles. In this thesis, it was shown that pHluorin has very low fluorescence intensity and pH sensitivity in the ER and in Zera-induced ER-derived vesicles. Therefore, a superfolder variant of pHluorin was developed which allows reliable pH measurements in these compartments and can be used to analyze whether the organellar or vesicular pH suits a pathway of interest....
A necessary requirement for a pharmacological effect is that a drug molecule tightly interacts with its disease relevant target molecule in the patient. Kinases are regulatory, signal transmitting enzymes and are a large protein family that belongs to the most frequent targets of pharmaceutical industry, as deregulation of kinases has been associated with the development of a variety of diseases, including cancer. In drug discovery, equilibrium binding metrics such as the affinity (Ki, KD) or potency (IC50, EC50) are usually applied for the systematic profiling for potent and selective drug candidates. In recent years, dynamic binding parameters, the drugs association (kon) and dissociation (koff) rates for desired primary-targets and undesired off-targets, were discussed to be better predictors than steady-state affinity per se (KD = koff / kon) for the onset and duration of the drug-target complex in the open in vivo environment and thereby for the therapeutic effect and safety of the drug. It is yet unclear whether and when the binding kinetics parameters can influence drug action in the complex context of pharmacokinetics and pharmacodynamics and how the kinetic rate constants can be optimized rationally. One major obstacle for providing proof for the hypothesis that drug binding kinetics is of importance for drug action is the generation of large and comparable binding kinetic datasets.
The aim of this thesis was the comprehensive analysis of the binding kinetic and affinity parameters of a diverse spectrum of 270 small-molecule kinase inhibitors against a panel of pharmacologically relevant kinases to study the role played by binding kinetics for drug discovery: The generated dataset was utilized to assess the effect of chemical properties on drug binding kinetics, and to evaluate the impact of kinetic rate constants on the success of compounds in the drug discovery pipeline.
Large scale profiling was made possible by a recently developed “kinetic Probe Competition Assay” (kPCA), whose evaluation is based on Motulsky’s and Mahan’s “kinetics of competitive binding” theory. Monte Carlo analyses performed in this dissertation widened the theoretical knowledge of this theory, provided new insights into its limitations and allowed to derive recommendations about how to best design assays. It was demonstrated that kPCA is indeed high-throughput compatible and that it is comparable to other biochemical and biophysical assay formats in terms of precision and accuracy.
Multivariable linear regression for the description of the determined kinase inhibitors’ target binding characteristics (kon or koff or KD) using molecular properties and/or particular kinase-inhibitor interactions as descriptors supported the assumption that molecular properties of compounds might affect binding kinetics, generated new hypothesis about molecular determinants influencing binding kinetic parameters and provided a rational basis for following structure-kinetic relationship studies. Remarkably, the binding kinetic rate constants were better described by the established models than binding affinities.
Interestingly, the systematic, quantitative analysis of kinase inhibitors’ target binding kinetics indicated that a slow dissociation rate for the main target is a feature which is more frequently observed in inhibitors that reached approval or late stage clinical testing than in earlier phases of clinical development. In addition, it was demonstrated that binding kinetics of kinase inhibitors is a better predictor for the time course of target engagement in cells as compared to affinity per se. Furthermore, in some study cases simulations using a standard pharmacokinetics model and a modified model considering the inhibitors binding kinetics lead to different in vivo kinase occupancy time profiles. It was illustrated by simulations how the concept of kinetic selectivity can be applied to turn an unselective compound in equilibrium conditions into a more selective compound in the open in vivo situation, where the thermodynamic equilibrium of drug-target binding is not necessarily reached.
Thus the generated data and models provide evidence for the importance of binding kinetics in drug discovery and represent a valuable resource for future studies in this field.
Das Ziel dieser Dissertation war es die biologische Rolle der Ubiquitinierung und die Bedeutung für Alterungsprozesse im filamentösen Ascomyceten Podospora anserina zu untersuchen. Folgende Ergebnisse wurden dabei erzielt:
1. Ubiquitinierte Proteine wurden nachgewiesen und die Deubiquitinierung von Proteinen konnte durch den Einsatz der Inhibitoren Urea, PR-619 und PIC erfolgreich inhibiert werden, was die Anwesenheit aktiver Deubiquitinasen in P. anserina beweist. Zudem wurden erstmalig ubiquitinierte Proteine in P. anserina unter den zur Aufreinigung
gewählten Bedingungen über die Technik der LC-MS/MS identifiziert.
2. Insgesamt wurden 1745 ubiquitinierte Proteine in P. anserina identifiziert, was ca. 16,4 % des gesamten Proteoms darstellt. Somit wurde erstmalig das Ubiquitinom des Ascomyceten P. anserina charakterisiert, welches Proteine aus allen zellulären Kompartimenten enthält.
3. Die erste im Rahmen dieser Arbeit durchgeführte umfassende Studie altersabhängiger Veränderungen im Ubiquitinom eines Organismus zeigt eine Herabregulation der Ubiquitinierung im Alter in der gesamten Zelle. Dem gegenüber steigt die Ubiquitinierung an den Mitochondrien leicht an und unterstreicht die Rolle einer mitochondrialen Qualitätskontrolle durch diesen Prozess.
4. Die Untersuchung der am Ubiquitinierungsprozess beteiligten E3-Ligase PaMUS10 zeigt, dass es sich bei Mus10 um ein essentielles Gen in P. anserina handelt, da die Deletion zu starken mitochondrialen Beeinträchtigungen und dem sofortigen Absterben des Organismus direkt nach der Keimung führt.
5. Zur weiteren Untersuchung von PaMus10 wurde erstmalig und vollständig ein Hygromycin-basiertes „Knockdown“-System in P. anserina etabliert, was die detaillierte Untersuchung eines essentiellen Gens in diesem Organismus ermöglichte. Durch dessen Einsatz konnte eine reduzierte Fertilität, eine verkürzte Lebensspanne sowie Veränderungen der mitochondrialen Morphologie und Funktion als direkte Folge einer PaMus10-Herabregulation nachgewiesen werden.
6. PaMUS10 ist vorwiegend cytosolisch lokalisiert wird aber unter oxidativem Stress oder in gealterten Kulturen an die Mitochondrien rekrutiert, was einen vergleichbaren Mechanismus zur menschlichen E3-Ligase PARKIN darstellt.
7. Der Verlust von PaMUS10 verursacht ein Präseneszenzsyndrom und führt zum vorzeitigen Absterben des Organismus, wohingegen die zusätzliche Expression von PaMus10::Gfp offenbar positive Effekte nach sich zieht, da hier eine deutliche Verlängerung der Lebensspanne beobachtet wurde.
8. Der Vergleich der beiden Ubiquitinome von ∆PaMus10/PaMus10 und Wthph1/2 zeigt eine massive Reduzierung der globalen Ubiquitinierung, welche offenbar durch das Fehlen von PaMUS10 ausgelöst wird und damit dessen Funktion als E3-Ligase untermauert.
9. Im Rahmen der hier durchgeführten Substratanalyse wurden insgesamt 131 Proteine identifiziert, von denen ca. 20 % dem Mitochondrium zugeordnet werden können. Aufgrund der diversen biologischen Prozesse und Funktionen dieser Substrate ist PaMUS10 sowohl in die Ubiquitinierung cytosolischer als auch mitochondrialer Proteine involviert und greift womöglich sogar als zentraler Schalter in die gesamte zelluläre Homöostase ein.
Aufgrund der nicht unerheblichen Zahl der identifizierten ubiquitinierten Proteine (Ubiquitinom) und den fatalen Auswirkungen, die der Verlust einer E3-Ligase in diesem Organismus nach sich zieht, lässt sich folgende grundlegende Erkenntnis formulieren:
Die Ubiquitinierung spielt in P. anserina eine bedeutende Rolle zur Aufrechterhaltung zellulärer Prozesse insbesondere der mitochondrialen Homöostase und beeinflusst dadurch positiv die Entwicklung und Alterung in diesem Organismus.
My study examined MMA training, and thereby the ‘back region’ of MMA, where the ‘everyday life’ of MMA takes place. I enquired into how MMA training corresponds with MMA’s self-description, namely the somehow self-contradicting notion that MMA fights would be dangerous combative goings-on of approximately real fighting, but that MMA fighters would be able to approach these incalculable and uncontrolla-ble combative dangers as calculable and controllable risks.235 Conducting an ethnog-raphy in which I focused on the combination of participation and observation, I stud-ied how the specific interaction organisations of the three core training practices of MMA training provide the training students with specific combative experiences and how they thereby construct the social reality that is MMA training....
Protein biosynthesis is a conserved process, essential for life. Proteins are assembled from single amino acids according to their genetic blueprint in the form of a messenger ribonucleic acid (mRNA). Peptide bond formation is catalyzed by ancient ribonucleic acid (RNA) residues within the supramolecular ribosomal complex, which is organized in two dynamic subunits (Ramakrishnan, 2014). Each subunit comprises large ribosomal RNA (rRNA) molecules and several dozens of peripheral proteins. mRNA translation has been divided into three phases, namely translation initiation, elongation and termination in biochemistry textbooks. During initiation, the ribosomal subunits assemble into a functional ribosome on an activated mRNA and acquire the first transfer RNA (tRNA), an adapter between the start codon on the mRNA and the N-terminal methionine of the protein (Hinnebusch and Lorsch, 2012). During elongation, the ribosome translocates along the mRNA exposing one codon after the other, and amino acids are delivered to the ribosome by the respective tRNAs, and attached to the nascent polypeptide chain. During termination, the polypeptide is released and the ribosome remains loaded with mRNA and tRNA at the end of the open reading frame for the translated gene (Hellen, 2018). Bacterial ribosomes are subsequently recycled by a specific ribosome recycling factor and the small ribosomal subunit is simultaneously consigned to initiation factors for a next round of translation – rendering bacterial translation as a cyclic process with an additional ribosome recycling phase. However, the process of ribosome recycling remained enigmatic in Eukarya and Archaea until the simultaneous discovery of the twin-ATPase ABCE1 as the major ribosome recycling factor. Strikingly, ABCE1 has initially been shown to participate in translation initiation (Nürenberg and Tampé, 2013). Thus, closing the translation cycle by revealing the detailed molecular mechanism of ABCE1 and its role for translation initiation are the two goals of this research.
Beyond the plenitude of well-studied translational GTPases, ABCE1 is the only essential factor energized by ATP, delivering the energy for ribosome splitting via two nucleotide-binding sites. Here, I define how allosterically coupled ATP binding and hydrolysis events in ABCE1 empower ribosome recycling. ATP occlusion in the low-turnover control site II promotes formation of the pre-splitting complex and facilitates ATP engagement in the high-turnover site I, which in turn drives the structural re- organization required for ribosome splitting. ATP hydrolysis and ensuing release of ABCE1 from the small subunit terminate the post-splitting complex. Thus, ABCE1 runs through an allosterically coupled cycle of closure and opening at both sites consistent with a processive clamp model. This study delineates the inner mechanics of ABCE1 and reveals why various ABCE1 mutants lead to defects in cell homeostasis, growth, and differentiation (Nürenberg-Goloub et al., 2018).
Additionally, a high-resolution cryo-electron microscopy (EM) structure of the archaeal post-splitting complex was obtained, revealing a central macromolecular assembly at the crossover of ribosome recycling and translation initiation. Conserved interactions between ABCE1 and the small ribosomal subunit resemble the eukaryotic complex (Heuer et al., 2017). The conformational state of ABCE1 at the post-splitting complex confirms the molecular mechanism of ribosome recycling uncovered in this study. Moving further along the reaction coordinate of cellular translation, I reconstitute the complete archaeal translation initiation pathway and show that essential archaeal initiation factors are recruited to the post-splitting complex by biochemical methods and cryo-EM structures at intermediate resolution. Thus, the archaeal translation cycle is closed, following its bacterial model and paving the way for a deeper understanding of protein biosynthesis.
Die Arbeit thematisiert weibliche Beiträge der graphischen Gattung der humorvollen und satirischen Zeichnung im "Golden Age" der Karikatur in Großbritannien. Ausgehend von den Begünstigungen und relativen Freiheiten weiblicher Bildproduktion in der vorviktorianischen Zeit, setzt die Untersuchung die zeichnerische Aktivität von Frauen in den Kontext von weiblicher "curiosity" und weiblichem "wit" in der Wahrnehmung neuer Interessenlagen der Aufklärung.
Object recognition is such an everyday task it seems almost mundane. We look at the spaces around us and name things seemingly effortlessly. Yet understanding how the process of object recognition unfolds is a great challenge to vision science. Models derived from abstract stimuli have little predictive power for the way people explore "naturalistic" scenes and the objects in them. Naturalistic here refers to unaltered photographs of real scenes. This thesis therefore focusses on the process of recognition of the objects in such naturalistic scenes. People can, for instance, find objects in scenes much more efficiently than models derived from abstract stimuli would predict. To explain this kind of behavior, we describe scenes not solely in terms of physical characteristics (colors, contrasts, lines, orientations, etc.) but by the meaning of the whole scene (kitchen, street, bathroom, etc.) and of the objects within the scene (oven, fire hydrant, soap, etc.). Object recognition now refers to the process of the visual system assigning meaning to the object.
The relationship between objects in a naturalistic scene is far from random. Objects do not typically float in mid-air and cannot take up the same physical space. Moreover, certain scenes typically contain certain objects. A fire hydrant in the kitchen would seem like an anomaly to the average observer. These "rules" can be described as the "grammar" of the scene. Scene grammar is involved in multiple aspects of scene- and object perception. There is, for instance, evidence that overall scene category influences identification of individual objects. Typically, experiments that directly target object recognition do not involve eye movements and studies that involve eye movements are not directly aimed at object recognition, but at gaze allocation. But eye movements are abundant in everyday life, they happen roughly 4 times per second. Here we therefore present two studies that use eye movements to investigate when object recognition takes place while people move their eyes from object to object in a scene. The third study is aimed at the application of novel methods for analyzing data from combined eye movement and neurophysiology (EEG) measurements.
One way to study object perception is to violate the grammar of a scene by placing an object in a scene it does not typically occur in and measuring how long people look at the so-called semantic inconsistency, compared to an object that one would expect in the given scene. Typically, people look at semantic inconsistencies longer and more often, signaling that it requires extra processing. In Study 1 we make use of this behavior to ask whether object recognition still happens when it is not necessary for the task. We designed a search task that made it unnecessary to register object identities. Still, participants looked at the inconsistent objects longer than consistent objects, signaling they did indeed process object and scene identities. Interestingly, the inconsistent objects were not remembered better than the consistent ones. We conclude that object and scene identities (their semantics) are processed in an obligatory fashion; when people are involved in a task that does not require it. In Study 2, we investigate more closely when the first signs of object semantic processing are visible while people make eye movements.
Although the finding that semantic inconsistencies are looked at longer and more often has been replicated often, many of these replications look at gaze duration over a whole trial. The question when during a trial differences between consistencies occur, has yielded mixed results. Some studies only report effects of semantic consistency that accumulate over whole trials, whereas others report influences already on the duration of the very first fixations on inconsistent objects. In study 2 we argue that prior studies reporting first fixation duration may have suffered from methodological shortcomings, such as low trial- and sample sizes, in addition to the use of non-robust statistics and data descriptions. We show that a subset of fixations may be influenced more than others (as is indicated by more skewed fixation duration distributions). Further analyses show that the relationship between the effect of object semantics on fixation durations and its effect on oft replicated cumulative measures is not straightforward (fixation duration distributions do not predict dwell effects) but the effect on both measures may be related in a different way. Possibly, the processing of object meaning unfolds over multiple fixations, only when one fixation does not suffice. However, it would be very valuable to be able to study how processing continues, after a fixation ends.
Study 3 aims to make such a measure possible by combining EEG recordings with eye tracking measurements. Difficulties in analyzing eye tracking–EEG data exist because neural responses vary with different eye movements characteristics. Moreover, fixations follow one another in short succession, causing neural responses to each fixation to overlap in time. These issues make the well-established approach of averaging single trial EEG data into ERPs problematic. As an alternative, we propose the use of multiple regression, explicitly modelling both temporal overlap and eye movement parameters. In Study 3 we show that such a method successfully estimates the influence of covariates it is meant to control for. Moreover, we discuss and explore what additional covariates may be modeled and in what way, in order to obtain confound-free estimates of EEG differences between conditions. One important finding is that stimulus properties of physically variable stimuli such as complex scenes, can influence EEG signals and deserve close consideration during experimental design or modelling efforts. Overall, the method compares favorably to averaging methods.
From the studies in this thesis, we directly learn that object recognition is a process that happens in an obligatory fashion, when the task does not require it. We also learn that only a subset of first fixations to objects are affected by the processing of object meaning and its fit to its surroundings. Comparison between first fixation and first dwell effects suggest that, in active vision, object semantics processing sometimes unfolds over multiple fixations. And finally, we learn that regression-based methods for combined eye tracking-EEG analysis provide a plausible way forward for investigating how object recognition unfolds in active vision.
The present study aimed to assess the tissue response to the SYMBIOS® resorbable collagen membrane SR, which is derived from bovine Achilles tendon, and compare it to the physiological wound healing of a sham operation as a control.
An ex vivo analysis was performed using injectable platelet-rich fibrin (i-PRF), that is gained by the centrifugation of human venous blood and contains fibrin, leukocytes and platelets, to elucidate the membrane permeability and interactions with human cells and plasma proteins. In the in vivo study, a subcutaneous implantation model was established in Wistar rats to evaluate the cellular reactions for up to 30 days after membrane implantation. Histochemical, immunohistochemical and histomorphometric analyses were performed to assess the cellular inflammatory response, vascularization pattern and cell infiltration capacity.
In the ex vivo study, i-PRF components including fibrin, leukocytes and platelets penetrated the membrane after just 15 minutes. Within the observation period, the cellular reaction in the early phase, which included the first 3 days, produced only mononuclear cells. From 10 to 30 days , the formation of multinucleated giant cells (MNGCs) was induced by the collagen membrane. CD-68 positive cells (macrophages) occurred in a high number on day 3, and the number decreased over time up to day 30. Along with the reduction in the number of CD-68 positive cells, the number of MNGCs increased significantly. The presence of MNGCs was accompanied by significantly increased vascularization within the central region of the membrane, and only mononuclear cells (MNCs) did not produce vascularization. In contrast, the accumulated MNGCs were located on the membrane surface. The control group reflected the physiological process of wound healing, as MNGCs did not form over the 30 day period, and a significantly lower level of vascularization was observed compared with the test group.
This finding showed dynamic changes in the cellular reaction, which indicated a relationship between macrophage fusion and MNGC formation, and vascularization of the collagen membrane is circumstantial evidence of a reaction to a foreign body. However, the collagen membrane was able to maintain its structure and integrity over time, showing no signs of premature breakdown and disintegration due to the specific porosity of its membrane structure.
Therefore, we questioned whether the biomaterial-induced formation of MNGCs should be accepted as a biomaterial-induced cellular reaction that is able to restore vascularization or as an adverse reaction. Therefore, extensive preclinical and clinical studies are needed to investigate the type of MNGCs that form in response to the membrane material studied here.
Cancer is one of the leading causes of death across all countries and its diagnosis still yields fear for the affected patient. Although treatment of cancer has made marvelous progress compared to the agents available thirty years ago, a cure for cancer, however, is still a distant prospect. Modern therapy still is a burden for many patients due to heavy side effects. With the development of agents targeting specific molecular targets on cancer cells, a new field of cancer therapy was opened and a small success story in the history of cancer began.
Aurora kinases represent a relatively new target in cancer therapy. The kinase is a essential part of mitosis and cell cycle progression and its overexpression has been shown to be related to many kinds of malignancies. Allosteric inhibition of a kinase is an increasing pre-clinical approach not yet established in the treatment of patients. In this thesis, we combine allostery with another innovative approach that is drug repurposing. If repurposed, a drug can be permitted to fast track drug admission to clinical trials.
I set up a screening of 1280 FDA approved drugs to identify small molecule compounds that affect the binding of Aurora kinase A and its main physiologic binding partner, TPX2. Further, I characterized the positive hits in vitro for their capabilities to displace TPX2 from Aurora A, to inhibit Aurora kinase activity, to thermally stabilize the protein and performed assays to determine their dissociation constant. Last but not least, I tested the compounds in cells for their effect on the cell viability and cell cycle via flow cytometry. Comparing the hit-compounds with controls I found that ATP-competitive AurA inhibitor MLN 8237 strongly displaces the interaction of Aurora A with TPX2.
Summarized, we identified eight hit compounds allosterically affecting Aurora A, but no compound proved to be active in all assays. Just one compound, PS 731, identified in another screening performed by our group and further characterized in this thesis remains interesting, especially when put in context with recent publications released in the time between the start of experiments for this thesis and its finalization.
Die Tuberkulose ist eine der bedeutendsten Infektionskrankheiten weltweit. In Deutschland spielt sie eine untergeordnete Rolle und betrifft hauptsächlich Risikogruppen. Bisher wurde noch keine mehrere Jahre umfassende Arbeit zur Epidemiologie der Tuberkulose anhand molekularbiologischer Faktoren in einer deutschen Stadt veröffentlicht. In dieser Arbeit wurden mittels 24-loci MIRU-VNTR und Spoligotypisierung die Mykobakterienstämme von Patienten in Frankfurt am Main aus dem Zeitraum von 2008 bis 2016 genetisch typisiert und aus Fällen mit übereinstimmendem DNA-Fingerabdruck bestehende molekulare Cluster identifiziert, um in Zusammenschau mit epidemiologischen Patientendaten die Übertragungswege in Frankfurt am Main besser zu verstehen. Dabei wurden mittels logistischer Regression Risikofaktoren für Clusterzugehörigkeit identifiziert, einzelne Cluster auf epidemiologische Plausibilität hin untersucht und die Bedeutung der Tuberkulose vor dem Hintergrund zunehmender Migration beschrieben.
Insgesamt wurden im Studienzeitraum 61 molekulare Cluster identifiziert. Der Clusteranteil (28,6%) und der Anteil rezenter Übertragung (18,7%) lagen in der Größenordnung anderer Niedriginzidenzländer. Es dominierten kleine Cluster, nur vereinzelt kam es zu Infektionsketten mit mehr als 3 Fällen. Obwohl 81% der Patienten aus dem Ausland stammten und nur 19% aus Deutschland, hatten Migranten ein signifikant niedrigeres Risiko, einem Cluster anzugehören als Deutsche. Unter den Clustern bestanden 42,6% sowohl aus Patienten deutscher als auch Patienten nichtdeutscher Herkunft. Im Ausland geborene Patienten in gemischten Clustern lebten zum Diagnosezeitpunkt durchschnittlich bereits 10 Jahre in Deutschland und stammten mehrheitlich aus europäischen Ländern. Eine TB-Übertragung von kürzlich eingewanderten Patienten auf einheimische Bürger fand in begrenztem Umfang statt, begründet aber keine Ängste vor einer erhöhten Gefährdung der in Deutschland geborenen Bevölkerung im Hinblick auf die Tuberkulose in Frankfurt am Main.
Nur 9,8% der molekularen Cluster konnten epidemiologisch bestätigt werden. Infektionswege, die über das familiäre Umfeld oder bestimmte Risikomilieus (Drogen, Obdachlosigkeit) hinausgehen, ließen sich anamnestisch nur schwer erfassen. Männer, in Deutschland geborene Personen und iv-drogenabhängige Personen wiesen ein erhöhtes Risiko auf, sich vor Ort mit Tuberkulose zu infizieren oder die Erkrankung auf andere zu übertragen. Dies trifft vermutlich auch auf andere deutsche Großstädte zu und betont die Notwendigkeit einer Integration von iv-Drogenabhängigen in die medizinische Regelversorgung und die Bedeutung einer Zusammenarbeit von öffentlichem Gesundheitsdienst und entsprechenden Hilfseinrichtungen.
Es ist von einer Überschätzung des Clusteranteils mittels 24-loci MIRU-VNTR auszugehen, weshalb für zukünftige Arbeiten die feinere Typisierung und somit eine zuverlässigere Identifikation von Clustern mittels Whole Genome Sequencing wünschenswert ist. Für die bundesweite Verbesserung der TB-Kontrolle ist weiterhin eine enge Zusammenarbeit zwischen den Gesundheitsämtern erforderlich. Um zu untersuchen, wie sich die TB-Epidemiologie von Frankfurt am Main im bundesweiten Vergleich darstellt, sind ähnlich angelegte Arbeiten aus anderen deutschen Großstädten notwendig.