Refine
Year of publication
Document Type
- Doctoral Thesis (126)
Has Fulltext
- yes (126)
Is part of the Bibliography
- no (126)
Keywords
- Gentherapie (4)
- Akute lymphatische Leukämie (3)
- AF4 (2)
- Genfallen-Vektoren (2)
- Hämatopoese (2)
- LINE-1 (2)
- Primäre Immundefekte (2)
- Promotor <Genetik> (2)
- Transkriptionsfaktor (2)
- Virologie (2)
Institute
- Biochemie, Chemie und Pharmazie (48)
- Pharmazie (48)
- Biochemie und Chemie (27)
- Medizin (6)
- Biowissenschaften (1)
- Georg-Speyer-Haus (1)
- keine Angabe Institut (1)
Der Hirntumor Glioblastom (GBM) ist aufgrund seines infiltrativen Wachstums, der hohen intra- und intertumoralen Heterogenität, der hohen Therapieresistenz als auch aufgrund der sogenannten gliomartigen Stammzellen sehr schwer zu behandeln und führt fast immer zu Rezidiven. Da es in den letzten Jahrzehnten kaum Fortschritte in der Behandlung des GBMs gab, bis auf die Therapie mit Tumortherapiefeldern, wird weiterhin nach alternativen Zelltodtherapien geforscht, wie zum Beispiel dem Autophagie-abhängigen Zelltod. Der Autophagie-abhängige Zelltod ist durch einen erhöhten autophagischen Flux gekennzeichnet und obwohl die Autophagie, als auch selektive Formen wie die Lysophagie und Mitophagie, normalerweise als überlebensfördernde Mechanismen gelten, konnten viele Studien eine duale Rolle in der Tumorentstehung, -progression und -behandlung aufzeigen, die vor allem vom Tumortyp und stadium abhängt. Um die zugrunde liegenden Mechanismen des durch Medikamente induzierten Autophagie-abhängigen Zelltods im GBM weiter zu entschlüsseln, habe ich in meiner Dissertation verschiedene Substanzen untersucht, die einen Autophagie-abhängigen Zelltod induzieren.
In einer zuvor in unserem Labor durchgeführten Studie konnte gezeigt werden, dass das Antipsychotikum Pimozid (PIMO) und der Opioidrezeptor-Antagonist Loperamid (LOP) einen Autophagie-abhängigen Zelltod in GBM Zellen induzieren können. Darauf aufbauend habe ich die Fähigkeit zur Induktion des Autophagie-abhängigen Zelltods in weiteren Zellmodellen validiert. Dies bestätigte einen erhöhten autophagischen Flux nach PIMO und LOP Behandlung, während der Zelltod als auch der autophagische Flux in Autophagie-defizienten Zellen reduziert war. In weiteren Versuchen konnte ich die Involvierung der LC3-assoziierten Phagozytose (LAP), ein Signalweg der auf die Funktion einiger autophagischer Proteine angewiesen ist, ausschließen. Weiterhin konnte ich eine massive Störung des Cholesterin- und Lipidstoffwechsels beobachten. Unter anderem akkumulierte Cholesterin in den Lysosomen gefolgt von massiven Schäden des lysosomalen Kompartiments und der Permeabiliserung der lysosomalen Membran. Dies trug einerseits zur Aktivierung überlebensfördernder Lysophagie als auch der Zell-schädigenden „Bulk“-Autophagie bei. Letztendlich konnte aber die erhöhte Lysophagie die Zellen nicht vor dem Zelltod retten und die Zellen starben einen Autophagie-abhängigen lysosomalen Zelltod. Da die Eignung von LOP als Therapie für das GBM aufgrund der fehlenden Blut-Hirn-Schranken Permeabilität und von dem Antipsychotikum PIMO aufgrund teils schwerer Nebenwirkungen eingeschränkt ist, habe ich mich im weiteren Verlauf meiner Dissertation mit einer Substanz mit einem anderen Wirkmechanismus beschäftigt.
Der Eisenchelator und oxidative Phosphorylierungs (OXPHOS) Inhibitor VLX600 wurde zuvor berichtet mitochondriale Dysfunktion und Zelltod in Kolonkarzinomzellen zu induzieren. Allerdings hat meines Wissens nach bisher noch keine Studie die therapeutische Eignung von VLX600 für das GBM untersucht. Hier zeige ich eine neuartige Autophagie-abhängige Zelltod-induzierende Fähigkeit von VLX600 für GBM Zellen, da der Zelltod signifikant in Autophagie-defizienten Zellen aber nicht durch Caspase-Inhibitoren gehemmt wurde und der autophagische Flux erhöht war. Darüber hinaus konnte ich die Hemmung der OXPHOS und die Induktion von mitochondrialem Stress in GBM Zellen bestätigen und weiterhin aufzeigen, dass VLX600 nicht nur die mitochondriale Homöostase stört, sondern auch zu einer BNIP3-BNIP3L-abhängigen Mitophagie führt, die wahrscheinlich durch HIF1A reguliert wird aber keinen erkennbaren Nettoeffekt auf den von VLX600 induzierten Zelltod hat. Demnach induziert VLX600 letale „Bulk“-Autophagie in den hier verwendeten Zellmodellen. Darüber hinaus konnte ich zeigen, dass die Eisenchelatierung durch VLX600 eine große Rolle für den von VLX600-induzierten Zelltod spielt aber auch für die Mitophagie Induktion, Histon Lysin Methylierung und den ribosomalen Stress. Letztendlich ist es wahrscheinlich ein Zusammenspiel all dieser Faktoren, die zur Zelltodinduktion durch VLX600 führen und interessanterweise werden Eisenchelatoren bereits in präklinischen und klinischen Studien für Krebstherapien untersucht. Dabei könnten gewisse metabolische Eigenschaften verschiedener Tumorzellen die Sensitivität von Wirkstoffen, die auf den Metabolismus wirken wie VLX600, beeinflussen was in zukünftigen Studien beachtet werden sollte um den bestmöglichsten Therapieerfolg zu erzielen. Zusammenfassend unterstützt meine Dissertation die duale Rolle der Autophagie, die stark vom jeweiligen Kontext abhängt und befürwortet die weitere Forschung von Substanzen, die einen Autophagie-abhängigen Zelltod induzieren, für das GBM.
As one of the most widespread infectious diseases in the world, it is currently estimated that approximately 296 million people globally are chronically infected with Hepatitis B virus (HBV), the consequences of HBV infection cause more than 620,000 deaths each year. Although safe and effective HBV vaccines have reduced the incidence of new HBV infections in most countries, there are still around 1.5 million new infections each year. HBV remains a major health problem because there is no large-scale effective vaccination strategy in many countries with a high burden of disease, many people with chronic HBV infection are not receiving effective and timely treatment, and a complete cure for chronic infection is still far from being achieved.
Since its discovery, HBV has been identified as an enveloped DNA virus with a diameter of 42 nm. For efficient egress from host cells, HBV is thought to acquire the viral envelope by budding into multivesicular bodies (MVBs) and escape from infected cells via the exosome release pathway. It is clear that HBV hijacks the host vesicle system to complete self-assembly and propagation by interacting with factors that mediate exosome formation. Consequently, the overlap with exosome biogenesis, using MVBs as the release platform, raises the possibility for the release of exosomal HBV particles. Currently, virus containing exosomal vesicles have been described for several viruses. In light of this, this study explored whether intact HBV-virions wrapped in exosomes are released by HBV-producing cells.
First, this study established a robust method for efficient separation of exosomes from HBV virions by a combination of differential ultracentrifugation and iodixanol density gradient centrifugation. Fractionation of the density gradient revealed that two populations of infectious viral particles can be separated from the culture fluids of HBV-producing cells. The population present in the low-density peak co-migrates with the exosome markers. Whereas the population that appeared in the high-density fractions was the classical HBV virions, which are rcDNA-containing nucleocapsids encapsulated by the HBV envelope.
Subsequently, the characterization of this low-density population was performed, namely the highly purified exosome fraction was systematically investigated. Relying on the detergent sensitivity of the exosome membrane and the outer envelope of the HBV virus, disruption of the exosome structure by treatment with limited detergent revealed the presence of HBsAg in the exosomes. At the same time, mild and limited NP-40 treatment of highly purified exosomes and a further combination of density gradient centrifugation resulted in the stepwise release of intact HBV virions and naked capsids from the exosomes generated by HBV-producing cells. This implies the presence of intact HBV particles encapsulated by the host membrane.
The presence of exosome-encapsulated HBV particles was consequently also verified by suppressing the morphogenesis of MVBs or exosomes. Impairment of MVB- or exosome-generation with small molecule inhibitors has significantly inhibited the release of host membrane-encapsulated HBV particles as well. Likewise, silencing of exosome-related proteins caused a diminution of exosome output, which compromised the budding efficiency of wrapped HBV.
Moreover, electron microscopy images of ultra-thin sections combined with immunogold staining visualized the hidden virus in the exosomal structure. Additionally, the presence of LHBs on the surface of exosomes derived from HBV-expressing cells was also observed.
As expected, these exosomal membrane-wrapped HBV particles can spread productive infection in differentiated HepaRG cells. In HBV-susceptible cells, as LHBs on the membrane surface, this type of exosomal HBV appeared to be uptaken in an NTCP receptor-dependent manner.
Taken together these data indicate that a fraction of intact HBV virions can be released as exosomes. This reveals a so far not described release pathway for HBV. Exosomes hijacked by HBV act as a transporter impacting the dissemination of the virus.
The impact of 2-desaza-annomontine on processes of inflammation and its resolution in leukocytes
(2024)
This present study investigated the effects of the b-carboline derivative C81, also called 2-desaza-annomontine, on the inflammatory response and resolution processes in vivo and in vitro. The study focused on leukocytes and on the elucidation of the underlying pharmacological mode of action. C81 potently reduced the inflammatory response in an imiquimod-induced psoriasis mouse model and additionally resolved the inflammation more quickly. In a CNV model, C81 significantly decreased the microglial infiltration in the inflamed laser lesion in vivo. In vitro experiments revealed that C81 inhibits the migration of macrophages and leukocyte-endothelial cell interaction by reducing the activation of integrins on leukocytes, in particular LFA-1, without affecting the total protein level on the cell surface.
Further experiments revealed that C81 inhibited the expression of EPAC-1, required for Rap1 activation. Consequently, C81 reduced the LPS/PMA-induced Rap1 activity, which is responsible for integrin activation. Moreover, C81 potently reduced the LPS-induced formation of pro-inflammatory mediators, including cytokines and eicosanoids, in macrophages. The C81-derived inhibition of eicosanoid release was surprisingly potent, probably due to the C81-evoked inhibition of cPLA2 expression, resulting in less liberated arachidonic acid, the precursor for eicosanoids. At the same time, C81 only delayed COX-2 expression, but completely diminished LPS-induced mPGES-1 expression. In addition to the potent anti-inflammatory effects in vitro, C81-derived impact was complemented with promising pro-resolving effects. Hence, C81 significantly induced neutrophil apoptosis without affecting the cell viability of other leukocytes, such as macrophages. Accordingly, the caspase 3 activity in neutrophils increased upon C81 treatment. The underlying mechanism altered by C81 was the expression of the anti-apoptotic mediator Mcl-1, which is required for the survival of neutrophils, but not macrophages. Furthermore, neutrophils treated with C81 were significantly better efferocytosed by macrophages. Analyzes of the pharmacological mode of action of C81 revealed DYRK1B as the key target kinase in inflammatory processes in leukocytes. Of note, experiments with pharmacological inhibition of DYRK1B by C81 or the ‘selective’ DYRK1B inhibitor AZ-DYRK1B-33, could not completely exclude the involvement of the CLKs and other DYRKs. Therefore, DYRK1B knockdown and overexpression experiments were conducted to elucidate the impact of DYRK1B alone. Pharmacological inhibition of DYRK1B and DYRK1B knockdown phenocopied the inhibitory effect of C81 on leukocyte adhesion. In parallel, DYRK1B overexpression mitigated the C81-evoked effect, supporting the hypothesis that C81 inhibits DYRK1B to mediate its effects on leukocytes. Furthermore, DYRK1B inhibition and DYRK1B knockdown resulted in depletion of STAT3 phosphorylation. In addition, C81-evoked STAT3 inhibition was again mitigated by DYRK1B overexpression, suggesting a link or even an interaction between DYRK1B and STAT3. Indeed, direct interaction between DYRK1B and STAT3 was confirmed by a NanoBRET assay. Importantly, in vitro experiments demonstrated, that C81 did not affect LPS recognition mechanisms, investigated by TLR-4 and CD14 expression, and other important inflammatory signaling pathways. Although C81 inhibited the regeneration of IkBa, this had no effect on the translocation of the NFkB subunit p65. Furthermore, C81 did not alter the activation of MAPK pathways, including p38, JNK and ERK. As a result, the focus was on the potent inhibition of LPS-nduced STAT3 activation mediated by DYRK1B, which was shown to be IL-6 independent. Indeed, direct STAT3 inhibition by Stattic phenocopied all tested C81-derived effects on leukocytes, including migration, adhesion, pro-inflammatory cytokine expression, eicosanoid formation and cell type specific induction of neutrophil apoptosis. The underlying mechanisms altered by Stattic in terms of migration/adhesion and lipid mediator formation were the same as for C81. STAT3 inhibition led to decreased EPAC1 expression and accordingly to reduced Rap1 activation. In addition, inhibited STAT3 phosphorylation resulted in reduced cPLA2 expression and also in attenuated mPGES-1 expression.
Finally, the C81-derived depleted Mcl-1 expression was linked to reduced STAT3 inhibition. As C81 abolished STAT3 phosphorylation, less STAT3 was translocated into the nucleus upon LPS stimulation and less STAT3 enrichment at the MCL1 promoter was observed, leading to reduced gene expression and consequently protein levels.
In summary, using the natural product-derived compound C81, the DYRK1B/STAT3 axis was identified as a novel key regulator of inflammatory processes in human leukocytes. This present study revealed that interfering with the DYRK1B-STAT3 signaling can address essential cell functions including leukocyte extravasation, pro-inflammatory mediator release, neutrophil apoptosis and efferocytosis (Figure 1). Furthermore, two different mouse models demonstrated the in vivo relevance of this signaling axis and highlight DYRK1B as an important kinase modulating inflammation and resolution.
In this research project we aimed to generate genetically modified megakaryocytes and platelets, by targeting protein expression to their secretory alpha-granules to delivery ectopic or therapeutic proteins, to be stored and kept there until an external stimulus triggers platelet activation and platelet secretion takes place. During platelet activation, the therapeutic proteins would then be released to the extracellular space, either as a soluble protein or exposed as a transmembrane protein on the cell surface of platelets. For long-term approaches, genetic modifications must be introduced at the hematopoietic stem cell level.
AIMS: As first approach, we aimed to characterize the lineage-specificity of expression of six different promoter fragments in lentiviral vectors: the murine platelet factor 4 (mPf4) 1222 bp (-1074 to +148), human glycoprotein Ib alpha (hGP1BA) 595 bp (-265 to +330), a short and a longer fragment of the human glycoprotein 6 (hGP6 / hGP6s) 351 bp (-322 to +29) / 726 bp (-697 to +29), as well the human glycoprotein 9 (GP9) promoter 794 bp (-782 to -12). These promoter fragments were included as internal cellular promoters in self-inactivating lentiviral vectors (SIN), using an enhanced green fluorescent protein (eGFP) as gene reporter. GFP detection was evaluated in vitro (in transduced non-megakaryocitc blood cell progenitors and in-vitro differentiated megakaryocytes) and in vivo (Bone marrow cells, blood cells and spleen cells). For targeting of proteins to the secretory alpha granules of megakaryocytes and platelets, we followed two strategies: A) The sorting signal of the cytokine RANTES was fused N-terminally to the destabilized GFP, d2eGFP (RANTES. d2eGFP), to deliver the protein into the granules as soluble cargo. B) The transmembrane granular targeting sequence of P-selectin (the transmembrane domain and cytoplasmic tail (referred as TDCT) was fused to d2eGFP or the B domain deleted codon optimized human coagulation Factor VIII cDNA (referred as BDcohFVIII_TDCT or FVIII_TDCT), to deliver the protein into the membrane of alpha granules. These two strategies were tested in-vitro, from transduced differentiated megakaryocytes in liquid cultures, and in-vivo, by analysis of genetically modified platelets by means of Laser Scanning Confocal Microscopy (LSM) in colocalization analysis (performed at the single cell level) and fluorescence intensity analysis.
RESULTS: GFP expression in blood cells from transplanted mice was significantly higher in platelets, with a smaller background promoter activity in leukocytes and erythrocytes. The highest expression was observed from the mPf4-vector, followed by hGP1BA, hGP6 and hGP6s vectors, identifying the hGP6 vectors as the most restricted to the megakaryocyte and platelet lineage. Analysis in bone marrow cells showed that hGP6-vectors have the lowest activity in the hematopoietic stem and progenitor cells (HSPC) with less than 10% of GFP positive stem cells. Surprisingly, the mPf4 and hGP1BA vectors were both highly active in the HSPC, in a range of 20 to 70% of GFP-positive cells. Polyploidization in later stages of MK-maturation of in-vitro Mks differentiated from Mpl-/- lineage marker negative cells were recovered after gene transfer of the thrombopoietin receptor Mpl, under the control of MK-specific vectors in differentiated into MKs. These results were corroborated in in-vivo analysis, where Mpl-/- mice transplanted with lin-BM cells transduced with the mPf4.Mpl and hGP6.Mpl vectors, showed significantly elevated platelet counts compared to control mice transplanted with a GFP-encoding control vector (PGK-GFP). In the Fluorescent intensity and colocalization analysis of transduced megakaryocytes with the targeting vectors, we observed a significant difference in the GFP targeting compared with those MK transduced with the non-targeting vectors. The median of the WCC values observed from the RANTES.d2eGFP targeting vector was 0.8 (80 % of colocalization) with P-selectin stained granules, and 0.7 (70%) with von Willebrand Factor stained granules. In the case of the non-targeting vector SFFV.d2eGFP the median of the WCC observed were <0.3 (30%) both in P-selectin and von Willebrand Factor stained granules. We observed as well that the GFP signal of MK transduced with the P-selectin.d2eGFP fusion overlapped the signals emitted by P-selectin and von Willebrand factor stained granules, not just in LSM-digitalized images but in the fluorescens intensity analysis as well, indicating a clear signal of GFP colocalization. Likewise, an evident signal overlap between the targeted FVIII (FVIII_TDCT) with the P-selectin / von Willebrand marker was observed. Colocalization and fluorescens intensity analysis performed on activated platelets from transplanted mice with the targeting vectors, corroborated what was previously observed in in-vitro megakaryocytes. The genetic modification of megakaryocyte and platelets will allow in the furture, not just the development of new generation of cells with advanced functions, but it will help us to elucidate new mechanisms and pathways of important cellular processes, by modifying cell function and cell interactions.
Ataxia Telangiectasia (A-T) is a rare monogenetic, autosomal recessive disorder with an incidence of 1 in 40,000-100,000 live births caused by mutations in the ataxia telangiectasia mutated (ATM) gene. The encoded serine/threonine protein kinase (ATM) plays a major role in DNA damage response as well as apoptosis, cell cycle regulation, cell survival, oxidative stress response and genomic stability. Biallelic mutations result in partial or complete loss of ATM expression and/or ATM protein activity. A-T is a disease characterized by progressive cerebellar degeneration, telangiectasia, immunodeficiency (impaired B- and T-cell development), recurrent sinopulmonary infections, radiation sensitivity, premature aging, and a predisposition to cancer. Life expectancy of these patients is highly compromised, with only around 50% expected to reach 20 years of age. Malignancies and pulmonary diseases are the two main causes of death. There is currently no therapy available for A-T patients. There are symptomatic treatments available (e.g. immunoglobulin replacement therapy, therapy with antioxidants, and the administration of growth hormone or glucocorticoids as anti- inflammatory hormones) and in some patients, allogeneic hematopoietic stem cell transplantations from matched donors were performed with improved disease outcome. Unfortunately, suitable donors are not available for most patients. An autologous hematopoietic stem cell (HSC)-directed gene therapy approach is a promising alternative, since no matching donor is needed. The patient’s own cells are used, modified ex-vivo (e.g. delivering a healthy copy of the gene with viral vectors or directly correcting the mutation with gene editing). Afterwards, modified HSCs are given back to the patient thereby repopulating the bone marrow and re-establishing the whole blood system. The aim of this project was to develop a gene transfer tool for Atm.
In the first part of this project, retroviral vectors containing the full-length murine Atm cDNA were generated. Gene transfer of Atm with retroviral vectors is challenging, as the Atm cDNA is 9.1 kb in size reaching the packaging capacity of retroviral vectors. Although the foamy viral vector is described to have superior abilities to transfer large sequences, produced titers of the foamy viral Atm vectors were low and transductions of Atm-deficient fibroblasts were inefficient. In contrast, gene transfer of Atm with gammaretroviral and lentiviral vectors was possible, and because lentiviral vectors harboring the full-length Atm coding sequence were produced with the highest viral titers, this vector was used to transduce Atm-deficient fibroblasts. Following transduction, ATM protein levels were restored (40 - 50% of wild-type level). In addition, transduced cells showed increased levels of phosphorylated ATM downstream substrates (γH2AX, pKap1 and p-p53) after irradiation, demonstrating functional reconstitution. However, efficient transduction of murine lineage marker negative cells, the target cells for an Atm gene therapy approach, was not possible and viability of these cells was highly compromised after transduction.
Therefore, a dual vector system was developed in the second part of the project to circumvent the packaging limit of retroviral vectors. Protein halves were fused with split inteins which catalyze their self-excision followed by the formation of a full-length protein in a process called protein trans-splicing. The split Atm cDNA was delivered with lentiviral vectors and sufficient viral titers were achieved for efficient double transduction of Atm-deficient fibroblasts. Whereas the reconstitution of full-length ATM protein was low in cells transduced with vectors containing Npu split inteins, the use of Rma split inteins showed superior reconstitution. When comparing reconstitution levels with two different split sites within the ATM protein, no major differences were observed. Because a proof of ATM functionality could not be shown with these vector pairs, the F2A site used to co-deliver a marker gene was replaced by an IRES element. After transduction with split intein Atm vectors containing IRES elements, the level of ATM protein reached only 10% of the wild-type level. Nevertheless, an increased amount of pKap1 and p-p53 was detected demonstrating a functional kinase activity of reconstituted ATM protein. Furthermore, a partial repair of cell cycle defects in Atm-deficient fibroblasts was demonstrated.
In parallel to the development of a gene transfer tool for Atm, preliminary experiments were performed in Atm-deficient mice to create optimal transplantation conditions for gene-corrected HSCs that could be performed in the future. Because Atm-deficient mice are highly sensitive to irradiation, conventional conditioning regimes (e.g. total body irradiation or myeloablative conditioning with chemotherapeutics) cannot be used prior to HSC transplantation. Therefore, Atm-deficient mice were pretreated with different conditioning regimens and subsequently received a bone marrow transplantation. Mice that did not receive preconditioning prior to transplantation showed no chimerism in peripheral blood, bone marrow or spleen samples, indicating that preconditioning of mice is required for donor cell engraftment. A non-myeloablative conditioning regimen with cyclophosphamide and immunosuppressive CD4 and CD8 antibodies and the application of a mobilizing agent (Plerixafor) one hour before transplantation showed the highest chimerism in recipient mice. None of the mice developed a thymic tumor, and lymphoid-biased differentiation of the donor cells was observed, as chimerism was highest in T cells in the blood, bone marrow and spleen. In addition, chimerism was higher in lymphoid progenitor cells than in myeloid progenitors. Blood counts (white blood cell and lymphocyte counts) were normal 20 weeks after transplantation (comparable to wild-type mice), making this preconditioning regime suitable for Atm-deficient mice.
Taken together, this data paves the way for using split intein-based lentiviral vectors for Atm delivery in preclinical models and opens new possibilities for developing gene therapy for A-T patients.
Rearrangements des MLL Gens sind für 5-10% aller akuten Leukämien, biphenotypischen Leukämien und myelodysplastischen Syndrome im Kindes- und Erwachsenenalter verantwortlich. 5-10% dieser MLL Aberrationen sind wiederum therapiebedingt.
Die 43 heute schon bekannten Partnergene und die mindestens 36 noch nicht identifizierten Partnergene stellen dabei ein großes Problem für die MLL-Diagnostik dar, denn nach der zytogenetischen Analyse werden nur die am häufigsten auftretenden Partnergene MLLT2, MLLT3, MLLT1, MLLT4, ELL, und MLLT10 über RT-PCR untersucht. Dagegen werden die nicht so häufig auftretenden oder unbekannten Partnergene von einer weiteren Untersuchung ausgeschlossen.
Wenn auch alle MLL Translokationen mit einer Hochrisiko-Leukämie in Verbindung gebracht werden, bestimmt jedoch das Partnergen den Verlauf der Leukämie mit günstiger oder schlechter Prognose. Deshalb ist eine schnelle Identifizierung des Partnergens wichtig, um somit einer optimalen Behandlung beginnen zu können.
Aus diesem Grund ist eine universelle Diagnostik-Methode entwickelt worden, die es ermöglicht, alle MLL Rearrangements innerhalb der MLL Bruchpunktsregion zu ermitteln, auch wenn das Partnergen noch nicht bekannt ist. Diese Methode beruht auf der inversen Long Range PCR (LDI-PCR), einer Methode zur Amplifizierung von unbekannten DNA Sequenzen (Partnergen), die von bekannten DNA Sequenzen (MLL Gen) flankiert werden.
Mit dieser universellen Diagnostik-Methode konnten 340 Patienten aus 15 unterschiedlichen europäischen Diagnostikzentren erfolgreich untersucht werden. Die 340 Patienten setzen sich aus 238 Kindern und 102 Erwachsenen zusammen. Bei 157 Patienten (66 Kinder und 91 Erwachsene) konnte über eine Voruntersuchung ein MLL Rearrangement festgestellt werde. 183 Patienten (172 Kinder und 11 Erwachsene) sind vorher nicht auf eine MLL Aberration hin untersucht worden. Insgesamt konnten mit dieser Methode 144 Patienten mit mindestens einem MLL Rearrangement identifiziert werden. Bei diesen Rearrangements handelte es sich in den meisten Fällen um reziproke balancierte Translokationen, aber es konnten mit dieser Methode auch Deletionen, Inversionen, Insertionen und eine Tandem-Duplikation (MLL-PTD) identifiziert werden. Von den 172 vorher nicht untersuchten pädiatrischen Patienten konnten 11 (ca. 6%) mit einer MLL Aberration identifiziert werden. Dies entspricht in etwa der in der Literatur beschriebenen Häufigkeit von 10%. 12 (8%) der schon voruntersuchten Patienten konnten mit dieser Methode nicht verifiziert werden. Diese Fälle sollten weiter untersucht werden, um die Methode dieser Problematik entsprechend zu optimieren.
Während dieser Arbeit konnten auch die 6 neuen Partnergene ACACA, ARHGEF17, SMAP1, SELB und TIRAP (DCPS) identifiziert werden. Damit steigt die Zahl der charakterisierten Partnergene von 43 auf 49.
Diese Ergebnisse zeigen, dass sich diese Methode sehr gut für die Identifizierung von bekannten und unbekannten Partnergenen des MLL Gens eignet. In Verbindung mit der Split-Signal FISH Technik kann diese Methode sehr gut für eine Routinediagnostik und einen hohen Durchsatz an Proben herangezogen werden. Ein langfristiges Ziel wird die Analyse des MLL Rekombinoms sein, denn mindestens 36 Partnergene (40%) warten noch auf ihre Identifizierung.
Darüber hinaus können die patientenspezifischen chromosomalen Fusionssequenzen für das Monitoren von leukämischen Zellen über quantitative PCR Methoden herangezogen werden. Diese genomischen MRD Marker können dann in den einzelnen Zentren genutzt werden und dazu beitragen, dass in Zukunft die Therapieprotokolle und der Therapieerfolg verbessert werden. Erste Studien sind mit Hilfe der von uns generierten molekularen Marker bereits an zwei Zentren durchgeführt worden.