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Die Pathophysiologie der Bandscheibendegeneration (intervertebral disc degeneration, IVDD) und ihre molekularen Mechanismen sind noch in weiten Teilen unverstanden. Ihre Ursachen und Risikofaktoren sind vielfältig und schließen unter anderem Alter, Geschlecht, Umwelteinflüsse oder mechanische Belastungen mit ein.
Für das der Bandscheibe eng verwandte Knorpelgewebe wurde in aktuellen Studien der Einfluss des Sympathikus bzw. dessen Neurotransmitters Noradrenalin (NE) via adrenerger Rezeptoren (AR) auf die Zellproliferation, die Expression von Molekülen der extrazellulären Matrix und somit auch auf die Degeneration beschrieben. In Bandscheiben wurde bereits das Vorhandensein von sympathischen Nervenendigungen nachgewiesen, allerdings wurde die Expression der Adrenozeptoren hier noch nie untersucht. Das Ziel der vorliegenden Arbeit war also die Analyse der ARs im Gewebe der Bandscheibe und die Evaluation der Korrelation mit der Bandscheibendegeneration.
Das für die Analyse benötigte Gewebe stammt von Patienten, bei welchen eine Wirbelkörperverblockung (Spondylodese) durchgeführt wurde. Im Rahmen dieser Spondylodese wird das Bandscheibengewebe des betroffenen Segmentes entfernt. Der Degenerationsgrad der anonymisierten Proben wurde prä- und intraoperativ bestimmt und im entnommenen Gewebe sowie in isolierten Zellen die Expression aller bekannten ARs mittels reverse transcription polymerase chain reaction (RT-PCR) untersucht. Zum Nachweis der ARs auf Proteinebene wurden einzelne humane Proben auch immunhistochemisch analysiert. Des Weiteren wurde anhand von Wildtyp- und sogenannten SM/J-Mäusen, die eine spontane IVDD entwickeln, die Proteinexpression der ARs und der extrazellulären Matrix (ECM) von gesunden und geschädigten Bandscheiben an histologischen Schnitten verglichen. Schließlich wurde an isolierten und kultivierten humanen Zellen ein Stimulationsversuch mit Noradrenalin durchgeführt, um zu prüfen, ob es nach Aktivierung der ARs zu einer intrazellulären Signalweiterleitung kommt.
In Nativgewebe der humanen Bandscheibe konnte die messenger Ribonukleinsäure (mRNA) von α1a-, α1b-, α2a-, α2b-, α2c-, β1- und β2-ARs nachgewiesen werden. Nach siebentägiger Zellkultur im Monolayer präsentierte sich ein nur dezent abweichendes Genexpressionsmuster. Auf Proteinebene war das Signal des β2-AR nur im Bereich des Annulus fibrosus (AF) detektierbar jedoch nicht im Nucleus pulposus (NP). Selbiges war auch in murinen Schnitten festzustellen, wobei sich bei Wildtype (WT)-Mäusen hauptsächlich im inneren AF β2-positive Zellen fanden, während sich das Signal bei der SM/J-Maus weiter in Richtung des äußeren AF und des NP ausdehnte. α2a-AR und α2c-AR waren hingegen auf Proteinebene nicht nachweisbar. Bei der immunhistochemischen Untersuchung relevanter ECM-Moleküle zeigte sich für Kollagen II, Kollagen XII, cartilage oligomeric matrix protein (COMP) und Decorin (DCN) eine Verteilung, die mit der des β2-AR-Signals korreliert. Der Stimulationsversuch in humaner Zellkultur ergab eine Aktivierung der für die ARs relevanten Proteinkinase A (PKA)- und extracellular signal–regulated kinases (ERK1/2) -Signalwege.
In der vorliegenden Arbeit konnte zum ersten Mal die Existenz und Funktionalität von Adrenozeptoren im Bandscheibengewebe nachgewiesen werden. Unterschiede in der Expression der ARs, kombiniert mit Veränderungen der ECM-Zusammensetzung könnten ein Hinweis auf den Einfluss des Sympathikus bei IVDD sein. Die aktuelle demographische Entwicklung und die sich hieraus ergebende gesundheitsökonomische Belastung machen die Ergründung molekularer Mechanismen der IVDD und die daraus resultierende Entwicklung innovativer Behandlungsmethoden zu Kardinalfragen moderner orthopädischer Grundlagenforschung.
Recent data indicate that reactive oxygen species (ROS) are produced in the nociceptive system during persistent pain and contribute to pain sensitization. Aim of this study was to investigate potential antinociceptive effects of ROS scavengers in different animal models of pain. Intrathecal injection of ROS scavengers 1-Oxyl-2,2,6,6-tetramethyl -4-hydroxypiperidine (TEMPOL) or Phenyl-N-tert-butylnitrone (PBN) significantly inhibited formalin-induced nociceptive behavior in mice, suggesting that ROS released in the spinal cord are involved in nociceptive processing. Formalin-induced nociceptive behavior was also inhibited by intraperitoneal injection of a combination of vitamin C and vitamin E, but not of vitamin C or vitamin E alone. Moreover, the combination of vitamin C and E dose-dependently attenuated mechanical allodynia in the spared nerve injury (SNI) model of neuropathic pain. The SNI-induced mechanical allodynia was also reduced after intrathecal injection of the combination of vitamin C and E, and western blot analyses revealed that vitamin C and E treatment can ameliorate the activation of p38 MAPK in the spinal cord and in DRGs. These data suggest that a combination of vitamin C and E can inhibit the nociceptive behavior in animal models of pain, and points to a role of the spinal cord as an important area of ROS production during nociceptive processing.
Molecular oxygen (O2) is essential for numerous metabolic processes. Not surprisingly, hypoxia and the resulting adaptations play a pivotal role in pathophysiology, e.g., in cancer or in inflammatory diseases. Of note, myeloid cells are known to accumulate in hypoxic regions such as tumor cores or rheumatoid arthritis joints and may contribute to disease progression. While most studies so far concentrated on transcriptional adaptation by the hypoxia-inducible factors (HIF) 1 and 2 under short term hypoxia, prolonged oxygen deprivation and alternative post-transcriptional regulation are rather poorly investigated.
Consequently, the aim of the study was to generate a comprehensive overview of mRNA de novo synthesis and degradation and its contribution to total mRNA changes in monocytic cells in the course of hypoxia.
To this end, I used thiol-linked alkylation for the metabolic sequencing of RNA (SLAM-Seq) to characterize RNA dynamics under hypoxia. Specifically, I labeled monocytic THP-1 cells under normoxia (N), acute hypoxia (AH; 8 h 1% O2), or chronic hypoxia (CH; 72 h 1% O2) with 4-thiouridine (4sU), which allows for transcriptome-wide identification of de novo synthesized mRNAs and estimation of their half-lives. Total mRNA expression analyses revealed that most changes occurred under CH. Considering that HIF accumulation and resulting transcriptional regulation was shown to decline again under CH, I further analyzed the impact of RNA stability on gene expression. I observed a global reduction in RNA half-lives under hypoxia, indicative for the attenuation of energy-consuming protein synthesis upon oxygen deprivation. Moreover, I observed a subgroup of hypoxic destabilized transcripts with resulting decreased mRNA expression under CH, which consisted of 59 nuclear-encoded mitochondrial mRNAs. This might prevent futile production of new mitochondria under conditions, where mitochondria are even actively degraded to prevent production of detrimental reactive oxygen species.
While stability-regulated transcripts were mainly destabilized under hypoxia, the vast majority of differentially de novo synthesized transcripts were upregulated.
Functional analyses revealed not only hypoxia, but also cholesterol homeostasis and inflammatory response as top enriched terms, corroborating findings on total mRNA level. Focusing on hypoxia-altered cholesterol metabolism, I observed an 9 accumulation of early and a decrease in late cholesterol precursors, which are separated by several oxygen-dependent enzymatic steps. Although total cholesterol levels were only slightly reduced, my data indicate locally lowered endoplasmic reticulum (ER) cholesterol levels under hypoxia, which cause feedback activation of the ER cholesterol-sensing transcription factor sterol regulatory element-binding protein 2 (SREBP2) and induction of cholesterol biosynthesis enzymes. Interestingly, a broad range of interferon-stimulated genes (ISGs), mainly known for their antiviral function, was also induced under hypoxia with similar kinetics as SREBP2 targets, suggesting an immunometabolic crosstalk. While the availability of certain cholesterol biosynthesis intermediates as well as a direct involvement of SREBP2 seemed rather unlikely to cause hypoxic ISG induction, changes in intracellular cholesterol distribution appeared crucial for the hypoxic induction of chemokine-ISGs. Mechanistically, I found that MyD88-dependent toll-like receptor 4 (TLR4) signaling contributes to enhanced hypoxic ISG induction, likely sensitized by changes in cholesterol dynamics. Importantly, hypoxia amplified induction of chemokine-ISGs in monocytes upon treatment with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) spike protein via TLR4 similarly as after addition of infectious virus, which might contribute to systemic inflammation in hypoxemic patients with severe coronavirus disease-2019 (COVID-19).
Taken together, I comprehensively analyzed RNA dynamics in hypoxic monocytes. Specifically, I identified RNA stability as a modulating mechanism to limit production of mitochondria under oxygen-restricted conditions. Moreover, I characterized the immunometabolic crosstalk between disturbed cholesterol homeostasis and spontaneous induction of interferon (IFN)-signaling in hypoxic monocytes, which might contribute to systemic inflammation in severe cases of COVID-19.
Hypoxie und Stickstoffmonoxid (NO) sind wichtige Mediatoren von akuten und chronischen Erkrankungen sowie auch von Tumoren. Makrophagen spielen eine zentrale Rolle bei der Eliminierung von Pathogenen aber auch bei der Induktion, Entwicklung und Metastasierung von Tumoren. Wenn Makrophagen in verletztes Gewebe, einen Entzündungsherd oder in einen Tumor einwandern, sind sie einem Umfeld ausgesetzt, das durch Hypoxie und die Produktion von NO und ROS erheblichen Stress auf die Zellen ausübt. Dieser Zellstress wirkt sich auf das Redoxgleichgewicht und damit auf die Signaltransduktion der Zellen aus. Im ersten Teil meiner Arbeit wurde mittels einer Micoarray-Analyse die Interaktion von hypoxischen und NO-vermittelten Signalen in Makrophagen und deren Bedeutung für die Zellen im entzündlichen Umfeld ermittelt. In RAW 264.7 Makrophagen wurden 196 Gene als Hypoxie-reguliert 85 Gene als DETA-NO-reguliert identifiziert. Die Mehrzahl der Gene (292) wurde jedoch von einer Kombination aus Hypoxie und DETA-NO reguliert und lediglich 14 Gene wurden in allen drei Ansätzen identifiziert. Aus der Gruppe der durch Hypoxie-und DETA-NO-regulierten Transkripte zeigte Sesn2 als Peroxiredoxin (Prdx) Reparatur-Protein eine signifikant höhere Induktion durch DETA-NO im Vergleich zur Hypoxie. Mit Hilfe von HIF-1α-/- Maus-Peritonealmakrophagen wurde Sesn2 als sowohl Hypoxie- und NO-reguliertes HIF-1α Zielgen identifiziert. Eine Vorinkubation der RAW 264.7 Zellen mit DETA-NO reduzierte die Bildung von überoxidiertem, inaktivem Prdx durch H2O2. Die Reduktion an überoxidiertem Prdx durch eine Vorinkubation mit DETA-NO konnte mittels eines siRNA knockdowns auf Sesn2 zurückgeführt und Sesn2 als Prdx-Reduktase etabliert werden. Diese Ergebnisse zeigen, dass eine Vorinkubation von Makrophagen mit NO die Akkumulation von Sesn2 HIF-1α-abhängig induziert und somit Prdxs vor einer Überoxidierung durch ROS schützt. Die Aktivierung von HIF-1α durch Hypoxie oder NO kann somit die Vitalität von Zellen in einem entzündlichen Mikroumfeld verbessern. Im zweiten Teil meiner Arbeit wurde mittels konditioneller knockouts von HIF-2α und HIF-2α in myeloiden Zellen deren Auswirkung auf die Tumorentwicklung im PyMT Tumormodell untersucht. Die Tumorbelastung der Tiere zeigte in Folge der myeloiden knockouts von 1α und HIF-2α nur eine leichte Tendenz zu geringerer Tumorbelastung. Im Gegensatz zum myeloiden HIF-2α knockout beschleunigte der knockout von HIF-1α die Tumorinzidenz in PyMT Mäusen verlangsamte jedoch die Tumorentwicklung. Zusätzlich führte der myeloide knockout von HIF-1α und HIF-2α zu verstärkter Tumorhypoxie. Dies konnte auf eine Beeinträchtigung der Tumorangiogenese in den Tumorkernzonen zurückgeführt werden, wobei die Angiogenese durch das Fehlen von myeloidem HIF-1α am stärksten beeinträchtigt wurde. Während der Entstehung eines Tumors und dessen Progression werden die Tumorumgebung, das sogenannte Stroma, und der Tumor selbst von unterschiedlichen Immunzellen infiltriert. Der myeloide knockout von HIF-1α hatte erheblichen Einfluss auf die Immunzellverteilung im Tumorgewebe. Es wanderten weniger Makrophagen und B Zellen in den Tumor ein, wohingegen die Zahl von CD4+ T Helfer Zellen signifikant erhöht war. Zusätzlich wurde die Reifung der Dendritischen Zellen (DCs) durch den myeloiden knockout von HIF-1α erheblich beeinträchtigt. Der myeloide knockout von HIF-2α resultierte lediglich in einer verminderten Zahl an B Zellen und T Zellen im Tumorgewebe. Wildtyp und HIF-2α-/- Makrophagen, die hypoxische Tumorareale infiltrierten wiesen eine erhöhte Akkumulation von HIF-1α Protein auf. Makrophagen mit einem knockout von HIF-1α zeigten daraus folgend keine Akkumulation des HIF-1α Proteins in hypoxischen Tumorarealen. Darüber hinaus wurde Ym1 in allen Makrophagen-Genotypen im Tumorgewebe gleichstark exprimiert, wohingegen die Expression von iNOS im Tumorgewebe durch den myeloiden knockout von HIF-1α und HIF-2α verringert war. Die kolokalisierte Expression von iNOS und Ym1 in den Tumor-assoziierten Makrophagen deutet auf eine sowohl pro- als auch anti-inflammatorische Aktivierung der Makrophagen im Tumor hin. Die Ergebnisse der Immunzellverteilung von Makrophagen, unreifen DCs, CD4+ T Helfer Zellen sowie auch die verminderte iNOS-Expression weisen jedoch auf ein eher anti-inflammatorisches Tumormileu der PyMT+/-/HIF-1α -/- Tiere hin. Dies zeigt, dass HIF-1α in Makrophagen an der Entstehung eines inflammatorischen Tumormileus beteiligt ist.
Die Therapie des critical size defects stellt eine große Herausforderung der Medizin dar. Die Knochendefekte können beispielsweise in Folge von Tumorresektionen, Knochenheilungsstörungen oder nach Frakturen entstehen. Den aktuellen Goldstandard in der Therapie großer Knochendefekte stellt die Transplantation von autologem Knochenmaterial dar. Die Entnahme des Materials aus dem Beckenkamm ist allerdings mit Nachteilen wie der Entnahmemorbididät verbunden. Alternativ können Tissue-Engineering Techniken eingesetzt werden, bei denen Zellen mit regenerativem Potential mit Knochenersatzmaterialien und Wachstumsfaktoren kombiniert werden, um eine Defektheilung zu erzielen. Der Einsatz von bone marrow mononuclear cells (BMC) mit einem osteokonduktiven Gerüst wie b-TCP hat sich als geeignetes Therapiekonzept bewiesen. Einen weiteren Ansatz stellt die Verwendung von autologen Blutkonzentraten wie beispielsweise des platelet rich fibrin (PRF) dar. Das PRF kann innerhalb weniger Minuten aus patienteneigenem Blut mittels Zentrifugation hergestellt und direkt angewandt werden. Durch seine charakteristische dreidimensionale Fibrinmatrix dient das PRF als Reservoir für Wachstums- und Regenerationsfaktoren.
Die Kombination von BMC mit PRF könnte also durch die gesteigerte Konzentration an Zytokinen und Wachstumsfaktoren wie VEGF und TGF-b zu einer Unterstützung der regenerativen Wirkung der BMC führen. Ziel dieser Arbeit war es daher, den Effekt von PRF auf BMC in vitro zu analysieren.
In Anlehnung an das low speed centrifugation concept wurden zwei verschiedene PRF-Matrices hergestellt. Diese wurden entweder mit mittlerer relativer Zentrifugalbeschleunigung (RCF) (208g) oder mit geringer RCF (60g) zentrifugiert. Um eine geeignete Konzentration des PRF zur Kombination mit den BMC zu finden, wurde im Vorfeld eine Dosisfindungskurve erstellt. Zu diesem Zweck wurde der Einfluss ansteigender PRF-Konzentrationen auf die metabolische Aktivität der BMC nach 7 Tagen Inkubation analysiert. Wir konnten einen Trend zu erhöhten Werten bei einer Konzentration von 10% des PRF beobachten. Die metabolische Aktivität der BMC wurde durch höhere PRF-Konzentrationen nicht weiter gesteigert.
Aufgrund dieser Ergebnisse wurde für die nachfolgenden Experimente eine Konzentration von 10% der PRF-Aufbereitungen und der Serum-Kontrolle eingesetzt.
Zur Charakterisierung der beiden PRF-Aufbereitungen wurde der Gehalt an Wachstumsfaktoren im Vergleich zu humanem Serum untersucht. Es zeigten sich signifikant gesteigerte Konzentrationen von Insulin-like Growth Factor-1 (IGF-1), soluble Intercellular Adhesion Molecule-1 (sICAM-1) und Transforming Growth Factor-b (TGF-b) in dem PRF. Bezüglich des Vascular Endothelial Growth Factor (VEGF)-Gehaltes ließ sich allerdings kein Unterschied zwischen humanem Serum und den PRF-Matrices darstellen.
Der Effekt des PRF low-RCF und PRF medium-RCF auf die Viabilität der BMC wurde anhand der metabolischen Aktivität nach 2, 7 und 14 Tagen Inkubation untersucht. Als Kontrollgruppe diente hierbei der Zusatz von humanem Serum. Die metabolische Aktivität der BMC zeigte sich an Tag 14 in allen Gruppen signifikant gesteigert.
Außerdem konnten wir zeigen, dass der Zusatz von PRF zu BMC zu einer statistisch signifikant erhöhten Genexpression der Matrix-Metalloproteasen (MMP) -2, -7 und - 9 im Vergleich zur Serum-Kontrollgruppe führt.
In unseren Versuchen konnte nachgewiesen werden, dass die apoptotische Aktivität der BMC durch Kombination mit PRF nicht negativ beeinflusst wird. Zusammenfassend lässt sich sagen, dass sich PRF-Matrices als geeignete allogene oder autologe Quelle von Wachstums- und Regenerationsfaktoren nutzen lassen. Sie besitzen damit die Kapazität, Zellen wie die BMC zu stimulieren und zu aktivieren. Unsere Studie zeigt, dass der Zusatz von PRF für BMC-gestützte Therapien förderlich sein könnte. Dies muss jedoch in geeigneten Tiermodellen überprüft werden.
Disturbances in lipid metabolism are responsible for many chronic disorders, such as type 2 diabetes and atherosclerosis. Regulation of lipid metabolism occurs by activated transcription factors peroxisome proliferator-activated receptor δ (PPARδ) and liver X receptor α (LXRα) mediating transcription of different target genes involved in regulation of fatty acid uptake and oxidation or cellular cholesterol homeostasis. This is especially relevant for the macrophages, since pathways regulated by PPARδ and LXRα affect foam cell formation, a process driving the progression of atherosclerotic lesion. AMP-activated protein kinase (AMPK) plays a central role in energy homeostasis in every type of eukaryotic cell, but its role in human macrophages, particularly with regard to lipid metabolism, is not precisely defined yet. Thus, I investigated the impact of AMPK activity on PPARδ and LXRα and the expression of their target genes involved in fatty acid oxidation (FAO) and cholesterol metabolism.
As PPARδ has been described as a potential target for prevention and treatment of several disorders and AMPK as interesting drug target for diabetes and metabolic syndrome, the aim of the first part of my studies was to investigate their interaction in primary human macrophages. Completing the first challenge successfully, I was able to establish a lentiviral transduction system for constitutively active AMPK (consisting of a truncated catalytic AMPKα1 subunit bearing an activating T198D mutation) in primary human macrophages.
Using genome-wide microarray analysis of gene expression, I demonstrate FAO as the strongest affected pathway during combined AMPKα1 overexpression and PPARδ activation.
The most influenced genes were validated by quantitative PCR as well as by Western analysis. I found that AMPK increases the expression of FAO-associated genes targeted by PPARδ. Corroborating the results obtained using AMPKα1 overexpression, PPARδ target gene expression was increased not only by PPARδ agonist GW501516, but also by pharmacological allosteric AMPK activator A-769662. Additional enhancement of target gene mRNA expression was achieved upon co-activation of PPARδ and AMPK. Silencing PPARδ expression increased basal expression of target genes, confirming the repressive nature of ligand-free PPARδ, abolishing the increased target gene expression upon AMPK or PPARδ activation. Measurements of triglyceride contents of human macrophages incubated with VLDL following PPARδ activation demonstrated a reduction of intracellular triglyceride accumulation in cells, which may reflect the enhancement of fat catabolism.
In the second part of my studies, I concentrated on the regulation of cholesterol transporter ATP-binding cassette transporter A1 (ABCA1) expression by AMPK. ABCA1 facilitates
cholesterol efflux from macrophages thus, preventing atherosclerosis progression. For the first time, AMPK implication in the regulation of the ABCA1 pathway could be presented. Both AMPK overexpression and activation lead to significantly increased ABCA1 expression, whereas AMPKα1 knock-down strongly reduced this effect. Besides, I was able to prove an enhanced activity of ABCA1 during AMPK activation in human THP-1 macrophages by measuring cholesterol efflux into apolipoprotein AI-containing medium.
Previous findings showed regulation of ABCA1 by LXRα. I confirmed these results by silencing experiments indicating an essential role of LXRα in ABCA1 regulation pathway.
Here, ABCA1 mRNA as well as protein expression were positively mediated by LXRα. LXRα activation elevated ABCA1 levels, whereas its silencing down-regulated this effect.
Interestingly, ABCA1 was found to be regulated only by LXRα and not through LXRα. At the same time, knock-down of PPARδ, -γ or -δ, which may be also involved in the regulation of LXR/ABCA1 axis, did not influence the activation of ABCA1 expression by an AMPK activator. To confirm that LXRE on Abca1 promoter is essential for ABCA1 regulation, I performed luciferase reporter assay using constructs based on Abca1 promoter with or without LXRE mutation. Mutation of LXRE abolished reporter activity, whereas AMPK activation increased luciferase activity of wild-type LXRE construct. Furthermore, I demonstrate AMPK-dependent LXRα binding to the LXRE site of Abca1 promoter using the method of chromatin immunoprecipitation. AMPK activation significantly increased, whereas silencing of AMPK significantly attenuated LXRα binding, indicating AMPK as one of the most important regulators of ABCA1 expression.
In summary, I provided an evidence for AMPK involvement into lipid and cholesterol metabolism in human macrophages showing the regulation of PPARδ and LXRα target genes. The understanding of AMPK and PPARδ interaction allows the development of new approaches for treatment of metabolic syndrome and related diseases. Increased FAO during the activation of both proteins may exhibit better therapeutic benefit. On the other hand, I have shown the impact of AMPK activation on ABCA1 via LXRα up-regulation leading to increased cholesterol efflux in human macrophages for the first time. These findings thus may impact future improving of anti-atherosclerosis therapies.
Tumor development usually follows predictable paths where tumor cells acquire common characteristics and features known as the hallmarks of cancer. Recently, additional characteristics have been added to these hallmarks since solid tumors are composed of a very heterogeneous population of transformed, formerly normal tissue cells and stromal cells, e.g. immune cells and fibroblasts. Compelling evidence suggests that stromal cells and tumor cells maintain a symbiotic relationship to build up the tumor microenvironment and to fuel tumor growth. In cancer therapies, common features of tumors such as unrestricted cell growth, suppression of immunological responses, and the ability to form new blood vessels (angiogenesis) have emerged as the main targets of interest. The lipid mediator prostaglandin E2 (PGE2) is known to promote all these features and thus, is connected to cancer progression in general. Its synthesis is triggered in response to stress factors or during inflammation. Inducible PGE2 production relies on the enzymes cyclooxygenase 2 (COX-2) and microsomal prostanglandin E synthase 1 (mPGES-1), which are simultaneously expressed in response to a variety of different stimuli and are functionally coupled. Inhibition of COX-2 with non-steroidal antiinflammatory drugs (NSAIDs) for cancer treatment is, however, limited by cardiovascular risks, since selective COX-2 inhibition disrupts the prostacyclin/thromboxane balance. Therefore targeting mPGES-1 downstream of COX-2 for PGE2 inhibition was evaluated in this work in different steps of carcinogenesis. Knockdown of mPGES-1 in DU145 prostate cancer cells revealed that the mPGES-1 status did not affect growth of monolayer tumor cells, but significantly impaired 3D growth of multi-cellular tumor spheroids (MCTS). Spheroid formation induced COX-2 in DU145 and other prostate cancer spheroids. High levels of PGE2 were detected in supernatants of DU145 MCTS as opposed to monolayer DU145 cells. Pharmacological inhibition of COX-2 and mPGES-1 confirmed the pivotal role of PGE2 for DU145 MCTS growth. Besides promoting spheroid growth, MCTS-derived PGE2 also inhibited cytotoxic T lymphocyte (CTL) activation. When investigating the mechanisms of COX-2 induction during spheroid formation, the typical tumor microenvironmental factors such as glucose deprivation, hypoxia or tumor cell apoptosis failed to enhance COX-2. Interestingly, when interfering with apoptosis in DU145 spheroids, the pan-caspase inhibitor Z-VAD-FMK triggered a Summary 12 shift towards necrosis, thus enhancing COX-2 expression. Coculturing viable DU145 monolayer cells with isolated heat-shocked-treated necrotic DU145 cells, but not with necrotic cell supernatants, induced COX-2 and PGE2, confirming the impact of necrosis for MCTS growth and CTL inhibition. As mentioned, in vivo tumors are very heterogenous mixtures of tumor cells and stromal cells e.g. immune cells. Hence, the interaction of the immune system with tumors was investigated in further experiments. When coculturing MCF-7 breast cancer spheroids with human peripheral blood mononuclear cells (PBMCs), only low levels of PGE2 were detected, since MCF-7 cells did not upregulate COX-2 during spheroid formation and did not induce PGE2 production by PBMCs. Under inflammatory conditions, by adding the toll-like receptor 4 (TLR4) agonist lipopolysaccharide (LPS) to cocultures, PGE2 production was triggered, spheroid sizes were reduced, and numbers of high levels of granzyme B expressing (GrBhi) CTLs were increased, while CD80 expression by tumor-associated phagocytes was also elevated. Inhibition of CD80 but not CD86 diminished numbers of GrBhi CTLs and attenuated spheroid lysis. To determine the role of ctivation-induced PGE2 production, use of the COX-2 inhibitor celecoxib and the experimental mPGES-1 inhibitor C3 further increased CD80 expression. Addition of PGE2, the prostaglandin E2 (EP2) receptor agonist butaprost, and the phosphodiesterase 4 (PDE4) inhibitor rolipram reduced LPS/C3-triggered CD80 expression, confirming the impact of COX- 2/mPGES-1-derived PGE2 on shaping phagocyte phenotypes in an EP2/cAMP-dependent manner. In a spontaneous breast cancer model (MMTV-PyMT), mPGES-1-deficiency significantly delayed tumor growth in mice, confirming an overall protumorigenic role of mPGES-1 in breast cancer development in vivo. However in tumors of mPGES-1-/- mice, tumor-infiltrating phagocytes expressed low levels of CD80 similar to their wildtype counterparts. These data suggest that the immunosuppressive microenvironment does not allow for immunostimulatory effects by mPGES-1 inhibition without an activating stimulus. Evidences in this study recommend the application of mPGES-1 inhibitors for treating cancer diseases, since mPGES-1 promotes tumor growth in multiple steps of carcinogenesis, ranging from well-characterized effects of tumor cell growth to immune suppression of CTL activity and phagocyte polarization. Regarding the latter, blunting PGE2 during immune activation may limit the tumor-favoring features of inflammation and improve the efficiency of TLR4 based immune therapies.
Der VEGF-neutralisierende Antikörper Bevacizumab ist ein wichtiger Bestandteil der modernen Tumortherapie. Auch in der Glioblastom Therapie wird Bevacizumab eingesetzt, da in klinischen Studien eine Verlängerung des progressionsfreien Überlebens beobachtet wurde. Leider entwickeln sich schnell Resistenzen und das Gesamtüberleben konnte durch Bevacizumab in der Erstlinientherapie von Glioblastomen nicht verlängert werden.
Die genaue Wirkungsweise von Bevacizumab und somit auch die Resistenzentwicklung sind nur teilweise bekannt. Es wird vermutet, dass es durch Gefäßveränderungen zu einer Mangelsituation und zu Hypoxie kommt. Einige Studien deuten darauf hin, dass es neben der Wiedererlangung einer VEGF-unabhängigen Gefäßversorgung auch zu Resistenz gegen das durch Bevacizumab hervorgerufene, von Sauerstoffmangel gekennzeichnete Mikromilieu kommt. So konnte gezeigt werden, dass Bevacizumab-resistente Tumoren einen stark glykolytischen, sauerstoff-unabhängigen Zellmetabolismus aufweisen und vermehrt Laktat produzieren. Darüber hinaus wurde in Folge der Bevacizumab-Behandlung eine Fehlfunktion von Mitochondrien beobachtet. Unklar ist noch, ob die beschriebenen metabolischen Veränderungen ein Epiphänomen der Nährstoffmangelsituation sind oder ob sie kausal mit der Resistenzentwicklung in Zusammenhang stehen.
In der vorliegenden Arbeit sollte deshalb geprüft werden, ob die metabolische Umstellung hin zu einem glykolytischen, anaeroben Phänotyp eine hinreichende Bedingung zur Entwicklung einer Hypoxie- und Bevacizumabresistenz darstellt.
Hierzu wurden Glioblastomzellen (LNT229) derart verändert, dass sie keine oxidative Phosphorylierung durchführen konnten und rein auf die glykolytische Energiegewinnung angewiesen waren (rho0-Zellen). Diese Veränderung führte in-vitro zu einer Hypoxieresistenz der Zellen. Außerdem waren rho0-Zellen empfindlicher gegenüber Glukoseentzug und einer Behandlung mit dem Glykolyse-Inhibitor 2-Deoxyglucose (2DG). Des Weiteren waren im Mausmodell intrakranielle rho0-Tumorxenografts resistent gegenüber Bevacizumab. Diese Resistenz konnte durch zusätzliche Therapie mit 2DG wieder aufgehoben werden.
Somit konnte in der vorliegenden Arbeit gezeigt werden, dass die Hemmung der oxidativen Phosphorylierung zu einem glykolytischen Phänotyp führt, der hinreichend ist, um eine Hypoxieresistenz und in Folge dessen eine Bevacizumabresistenz in Glioblastomzellen zu verursachen. Dies lässt einen kausalen Zusammenhang zwischen bereits in anderen Studien beschriebenen metabolischen Veränderungen und einer Bevacizumabresistenz in Tumoren vermuten. Der zelluläre Glukosestoffwechsel ist damit ein vielversprechender therapeutischer Angriffspunkt zur Vermeidung und Überwindung einer Bevacizumabresistenz.
In the absence of apparent mutations, alteration of gene expression patterns represents the key mechanism by which normal cells evolve to cancer cells.
Gene expression is tightly regulated by posttranscriptional processes. Within this context, RNA-binding proteins (RBPs) represent fundamental factors, since they control mechanisms, such as mRNA-stabilization, -translation and -degradation. Human antigen R (HuR) was among the first RBPs that have been directly associated to carcinogenesis. HuR modulates the stability and translation of mRNAs which encode proteins facilitating various ‘hallmarks of cancer’, namely proliferation, evasion of growth suppression, angiogenesis, cell death resistance, invasion and metastasis. Furthermore, it is well established that tumor-promoting inflammation contributes to tumorigenesis. In this process, monocytes are attracted to the site of the tumor and educated towards a tumor-promoting macrophage phenotype. While HuR has been extensively studied in various tumor cell types, little is known about HuR in hepatocellular carcinoma (HCC). Thus, the aim of my work was to characterize the contribution of HuR to the development of cancer characteristics in HCC. I was particularly interested to investigate if HuR facilitates tumor-promoting inflammation, since a role for HuR has not been described in this context. To this end, I depleted HuR in HepG2 cells (HuR k/d) and used a co-culture model of HepG2 tumor spheroids and infiltrating monocytes to study the impact of HuR on the tumor microenvironment. I could show that depletion of HuR resulted in the reduction of cell numbers. Additionally, the expression of proliferation marker KI-67 and proto-oncogene c-Myc was reduced, supporting a proliferative role of HuR. Furthermore, exposure to cytotoxic staurosporine elevated apoptosis in HuR k/d cells compared to control cells. Concomitantly, the expression of the anti-apoptotic mediator B-cell lymphoma protein-2 (Bcl-2) was markedly reduced in the HuR k/d cells, pointing to an involvement of HuR in cell survival processes.
Accordingly, a pro-survival function of HuR was also observed in tumor spheroids, since HuR k/d spheroids exhibited a larger necrotic core region at earlier time points and showed elevated numbers of dead cells compared to control (Ctr.) spheroids. Interestingly, HuR k/d spheroids isplayed reduced numbers of infiltrated macrophages, suggesting that HuR contributes to a tumor-promoting, inflammatory microenvironment by recruiting monocytes/macrophages to the tumor site. Aiming at identifying HuR-regulated factors responsible for the recruitment of monocytes, I found reduced levels of the chemokine interleukin 8 (IL-8) in supernatants of HuR k/d spheroids, supporting a critical involvement of HuR in the chemoattraction of monocytes. Analyzing supernatants of co-cultures of macrophages and HuR k/d or Ctr. spheroids revealed additional differences in chemokine secretion patterns. Interestingly, protein levels of many chemokines were elevated in co-cultures of HuR k/d spheroids compared to control co-cultures. Albeit enhanced chemokine secretion was observed, less monocytes are recruited into HuR k/d spheroids, further underlining the necessity of HuR in cancer related monocyte/macrophage attraction and infiltration. Differences between chemokine profiles of mono- and co-cultured spheroids could be attributable to changes in spheroid-derived chemokines as a result of the crosstalk with the immune cells. Provided the chemokines originate from monocytes/macrophages, the different secretion patterns suggest that HuR contributes to the modulation of the functional phenotype of infiltrated macrophages, since the tumorenvironment is critically involved in the shaping of macrophage phenotypes. Regions of low-oxygen (hypoxia) represent another critical feature of tumors. Therefore, I next analyzed the impact of HuR on the hypoxic response. Loss of HuR attenuated hypoxia-inducible factor (HIF) 2α expression after exposure to hypoxia, while HIF-1α protein levels remained unaltered. Considering previous results of our group, showing that HIF-2α depletion (HIF-2α k/d) resulted in the enhanced expression of HIF-1α protein, I aimed to determine the involvement of HuR in the compensatory upregulation of HIF-1α protein in HIF-2α k/d cells. I could demonstrate that not only total HuR protein levels, but specifically cytoplasmic HuR was elevated in HIF-2α depleted cells pointing to enhanced HuR activity. Silencing HuR in HIF-2α deficient cells attenuated enhanced HIF-1α protein expression, thus confirming a direct role of HuR in the compensatory upregulation of HIF-1α. This as also reflected on HIF-1α target gene expression. I further investigated the mechanism underlying the compensatory HIF-1α expression in HIF-2α deficient cells. Analyzing HIF-1α mRNA expression, I excluded enhanced HIF1-α transcription and stability to account for elevated HIF-1α expression in HIF-2α k/d cells. HIF-1α promoter activity assays confirmed the mRNA data. Furthermore, HIF-1α protein half-life was not elevated in HIF-2α k/d cells compared to control cells, indicating that HIF-1α protein stability is not altered in HIF-2α k/d cells. Analysis of the association of HIF-1α with the translational machinery using polysomal fractionation finally revealed an increased istribution of HIF-1α mRNA in the heavier polysomal fractions in HIF-2α k/d cells compared to control cells. Since augmented ribosome occupancy is an indicator for more efficient translation, I propose enhanced HIF-1α translation as underlying principle of the compensatory increase in HIF-1α protein levels in HIF-2α k/d cells. In summary, my results demonstrate that HuR is critical for the development of cancer characteristics in HCC. Future work analyzing the impact of HuR on tumor-promoting inflammation, specifically macrophage attraction and activation could provide new trategies to inhibit macrophage-driven tumor progression. Furthermore, I provide evidence that HuR contributes to the hypoxic response by regulating the expression of HIF-1α and HIF-2α. Targeting single HIF-isoforms for tumor therapy should be carefully considered, because of their compensatory regulation when one α-subunit is depleted. Thus, therapeutic strategies targeting factors such as HuR that control both α-subunits and at the same time prevent compensation might be more promising.
The tumor suppressor programmed cell death 4 (Pdcd4) exerts its function by inhibiting protein translation initiation. Specifically, it displaces the scaffold protein eukaryotic initiation factor 4G (eIF4G) from its binding to the eukaryotic initiation factor 4A (eIF4A). Thereby, Pdcd4 inhibits the helicase activity of eIF4A, which is necessary for the unwinding of highly structured 5’ untranslated regions (UTRs) of messenger RNAs (mRNAs) often found in oncogenes like c-myc to make them accessible for the translation machinery and subsequent protein production. Overexpression of Pdcd4 inhibits tumorigenesis in vitro and in vivo and inversely, Pdcd4 knockout mice show enhanced tumor formation. In line, Pdcd4 is lost in various tumor types and proposed as prognostic factor in colon carcinomas. Unlike most other tumor suppressors that are rendered nonfunctional by mutations (e.g., p53), Pdcd4 loss is not attributable to mutational inactivation. It is regulated via translational repression by microRNAs and increased degradation of the protein under tumor promoting, inflammatory conditions and mitogens. Specifically, proteasomal degradation of Pdcd4 is controlled by p70 S6 Kinase (p70S6K)-mediated phosphorylation in its degron sequence (serines 67, 71 and 76). Stimulation of the PI3K-AKT-mTOR pathway by growth factors, hormones and cytokines initiates p70S6K activity. Phosphorylated Pdcd4 is subsequently recognized by the E3 ubiquitin ligase beta-transducin repeats-containing protein (β-TrCP) and marked with a polyubiquitin tail to be detected by the 26S proteasome for degradation. β-TrCP represents the substrate specific recognition subunit of the ubiquitin ligase complex responsible for protein-protein interaction with Pdcd4 as substrate for ubiquitin transfer and subsequent proteasomal disassembly.
The first part of the present work aimed at identifying novel stabilizers of the tumor suppressor Pdcd4 in a high throughput screen (HTS). As assay design, a fragment of Pdcd4 from amino acid 39 to 91, containing the phosphorylation sensitive degron sequence, was fused to a luciferase reporter gene construct. Stable expression of this Pdcd4(39-91)luciferase (Pdcd4(39-91)luc) fusion protein in HEK 293 cells served as read-out for the Pdcd4 protein amount to be detected in a high throughput compatible cell-based assay. Loss of Pdcd4(39-91)luc was induced by treatment with 12-O-
tetradecanoylphorbol-13-acetate (TPA), a phorbolester, which activates the PI3K signaling cascade leading to degradation of Pdcd4. The cut-off for hit definition was set at >50% activity in rescuing the Pdcd4(39-91)luc signal from TPA-induced degradation. Activity was calculated relative to the difference of DMSO- and TPA-treated cells (ΔDMSO-TPA = RLUDMSO-RLUTPA). Initial screening of a protein kinase inhibitor library (PKI) revealed hit substances expected to show Pdcd4 stabilizing activity by inhibition of kinases involved in Pdcd4 downregulation, e.g., the mTOR inhibitor rapamycin, the PI3K inhibitors wortmannin and LY294002 and the PKC inhibitors GF 109203X and Ro 31-8220.
The Molecular Targets Laboratory (MTL) of the National Cancer Institute (NCI) in Frederick, USA, hosts one of the largest collections of crude natural product extracts as well as a big substance libraries from pure synthetic sources. Screening of over 15 000 pure compounds and over 135 000 natural product extracts identified 46 pure and 42 extract hits as Pdcd4 stabilizers. For nine synthetic and six natural product derived compounds (after bioassay-guided fractionation), dose-dependent activities for recovering the TPA-induced Pdcd4(39-91)luc loss defined IC50s in the low micromolar range. Most importantly, these compounds were confirmed to stabilize endogenous Pdcd4 protein levels from forced degradation as well. This result proved the assay design to be highly representative for endogenous cellular mechanisms regulating Pdcd4 protein stability. The next step was to stratify the hit substances according to their likely mechanism of action to be located either up- or downstream of the p70S6K-mediated phosphorylation of Pdcd4. Therefore, phosphorylation of S6, as proto-typical p70S6K target, was analyzed and uncovered two natural derived compounds to influence p70S6K activity. Four substances did not affect p70S6K phosphorylation activity and were therefore considered to stabilize Pdcd4 by acting downstream, i.e. on the β-TrCP-mediated proteasomal degradation.
In the second part of this work, one of these compounds, namely the sesquiterpene lactone erioflorin, isolated by bioassay-guided fraction from the active extract of Eriophyllum lanatum, Asteraceae, was further characterized in detail with respect to its molecular mechanism of action. Erioflorin dose-dependently protected both Pdcd4(39-91)luc and endogenous Pdcd4 protein from TPA-induced degradation with IC50s of 1.28 and 2.64 μM, respectively. Pdcd4 stabilizing activity was maximal at 5 μM erioflorin. Up to this concentration, erioflorin was verified not to inhibit p70S6K activity. In addition, it was observed that erioflorin rescued Pdcd4(39-91)luc from both, wild type and constitutively active p70S6K-mediated downregulation. Only wild type p70S6K was inhibitable by the mTOR inhibitor rapamycin which served as an upstream acting control. To study the next section of Pdcd4 regulation, i.e. recognition by the E3 ubiquitin ligase β-TrCP, Pdcd4(39-91)luc and endogenous Pdcd4 were immunoprecipitated from whole cell extracts with the corresponding antibodies. In this key experiment, treatment with TPA increased overexpressed β-TrCP binding to both and this coimmunoprecipitation could be strongly reduced by erioflorin treatment. This result strongly pointed to an inhibitory mechanism of the β-TrCP specific binding to Pdcd4 by erioflorin. In addition, erioflorin disrupted the binding of in vitro transcribed/translated β-TrCP to Pdcd4 in an in vitro interaction assay to exclude nonspecific intracellular signals. Furthermore, polyubiquitination of Pdcd4 was decreased by erioflorin treatment as well. To clarify questions regarding specificity of erioflorin for the E3 ubiquitin ligase β-TrCP, stability of another important β-TrCP target was explored, i.e. the tumor suppressor inhibitor of kappa B alpha (IκBα). Indeed, the tumor necrosis factor alpha (TNFα)-mediated loss of IκBα could be prevented by erioflorin cotreatment. On the other hand, the E3 ubiquitin ligase von Hippel Lindau protein (pVHL) was left unaffected as its target hypoxia inducible factor 1 alpha (HIF-1α) could not be stabilized from oxygen-dependent degradation by erioflorin treatment. These results argued strongly for erioflorin being a specific inhibitor of β-TrCP-mediated protein degradation. Functional consequences of erioflorin treatment were investigated by observing its influence on the transcriptional activities of the transformation marker activator protein 1 (AP-1, an indirect downstream target of Pdcd4) and nuclear factor κB (NF-κB which is directly inhibited by IκBα). Indeed, erioflorin showed significant inhibition of AP-1 and NF-κB reporter constructs at 5 μM, a concentration for which an impact on cell viability was excluded. Finally to characterize the significance of erioflorin in a cell-based tumorigenesis assay, the highly invasive colon carcinoma cell line RKO was tested in a two dimensional migration assay. Erioflorin was discovered to significantly lower cell migration in a wound closure assay.
In conclusion, development of a high throughput compatible cell-based reporter assay successfully identified novel substances from pure synthetic and natural product derived background as potent stabilizers of the tumor suppressor Pdcd4. In addition, this work aimed at elucidating the detailed mechanism of action of the sesquiterpene lactone erioflorin from Eriophyllum lanatum, Asteraceae. Erioflorin was discovered to inhibit the E3 ubiquitin ligase β-TrCP, thereby preventing protein degradation of tumor suppressors like Pdcd4 and IκBα. This may offer the possibility to more specifically target protein degradation and generate less adverse side effects by blocking a particular E3 ubiquitin ligase compared to general proteasome inhibition.