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Systematic reviews represent the core and backbone of evidence-based medicine (EBM) strategies in all fields of medicine. In order to depict a first global sketch of the international efforts in the Cochrane database systematic reviews (CDSR), we analyzed the systematic reviews of the Cochrane database. Our global maps of systematic reviewing offer intriguing structural insights into the world of EBM strategies. They demonstrate that for the CDSR, the UK and Commonwealth countries take the lead position. Since patients, care providers and health systems all over the world benefit from systematic reviewing, institutions in other countries should increase their commitment.
Small-scale phenotypic differentiation along complex stream gradients in a non-native amphipod
(2019)
Background: Selective landscapes in rivers are made up by an array of selective forces that vary from source to downstream regions or between seasons, and local/temporal variation in fitness maxima can result in gradual spatio-temporal variation of phenotypic traits. This study aimed at establishing freshwater amphipods as future model organisms to study adaptive phenotypic diversification (evolutionary divergence and/or adaptive plasticity) along stream gradients.
Methods: We collected Gammarus roeselii from 16 sampling sites in the Rhine catchment during two consecutive seasons (summer and winter). Altogether, we dissected n = 1648 individuals and quantified key parameters related to morphological and life-history diversification, including naturally selected (e.g., gill surface areas) as well as primarily sexually selected traits (e.g., male antennae). Acknowledging the complexity of selective regimes in streams and the interrelated nature of selection factors, we assessed several abiotic (e.g., temperature, flow velocity) and biotic ecological parameters (e.g., conspecific densities, sex ratios) and condensed them into four principal components (PCs).
Results: Generalized least squares models revealed pronounced phenotypic differentiation in most of the traits investigated herein, and components of the stream gradient (PCs) explained parts of the observed differences. Depending on the trait under investigation, phenotypic differentiation could be ascribed to variation in abiotic conditions, anthropogenic disturbance (influx of thermally polluted water), or population parameters. For example, female fecundity showed altitudinal variation and decreased with increasing conspecific densities, while sexual dimorphism in the length of male antennae—used for mate finding and assessment—increased with increasing population densities and towards female-biased sex ratios.
Conclusions: We provide a comprehensive protocol for comparative analyses of intraspecific variation in life history traits in amphipods. Whether the observed phenotypic differentiation over small geographical distances reflects evolutionary divergence or plasticity (or both) remains to be investigated in future studies. Independent of the mechanisms involved, variation in several traits is likely to have consequences for ecosystem functions. For example, leaf-shredding in G. roeselii strongly depends on body size, which varied in dependence of several ecological parameters.
The overarching aim of this doctoral research was to examine and quantify the spatiotemporal variability in the movements of nomadic ungulates to better understand the possible drivers and characteristics of such movements as well as to examine the particular conservation challenges associated with nomadic movements.
Cerebellar ataxias are a group of neurodegenerative disorders primarily affecting the cerebellum. Although causative mutations in several genes have been identified there is currently no cure for ataxias.
The first part of this dissertation is focused on Spinocerebellar ataxia type 2 (SCA2). SCA2 is a dominant ataxia caused by repeat expansion mutations in the ATXN2 gene, which encodes the protein Ataxin2 (ATXN2). A polyglutamine (polyQ) tract consisting of CAG repeats interrupted by CAA was identified at exon 1 of ATXN2. Healthy individuals have between 22 and 23 glutamines, while expansions longer than 33 CAG repeats cause SCA2. The most noticeable symptom that SCA2 patients show is ataxic gait; however, they also show cerebellar dysarthria, dysdiadochokinesia, and ocular dysmetria caused by the progressive cerebellar degeneration.
To model the SCA2 disease, we generated a new mouse model where 100 CAG repeats were introduced in the mouse Atxn2 gene via homologous recombination. The characterization of this mouse model, Atxn2-CAG100-KIN, demonstrated that it reproduces the symptomatology observed in SCA2 patients. These animals showed significant loss of weight over time, brain atrophy, and motor deficits.
In addition, ATXN2 intermediate expansions have been linked to the pathology of Amyotrophic lateral sclerosis (ALS) as a risk factor. ALS is a fatal neurodegenerative disease where the motor neurons in the brain and spinal cord degenerate. A hallmark of ALS is the presence of TDP43-positive inclusions in neurons and glia. Further studies of post mortem spinal cord samples from SCA2 patients showed severe and widespread neurodegeneration of the central somatosensory system. Therefore, it was of interest to further investigate the pathology affection of this tissue in the Atxn2-CAG100-KIN line and the relationship between ATXN2 and TDP43. The characterization of the spinal cord pathology via protein quantification, transcript quantification, and immunohistochemistry showed a preferential affection of RNA binding proteins (RBP) in the spinal cord rather than the cerebellum. The ALS-linked factors TDP43 and TIA1 showed time-dependent co-aggregation with ATXN2 in spinal cord sections together with an increase of CASP3 levels. Therefore, this mouse model can help develop new therapies and evaluate their effect in differently affected areas.
A transcriptome data set from Atxn2-CAG100-KIN spinal cord samples at the final disease stage of this mouse model showed a strong up-regulation of RNA toxicity-, immune- and lysosome-implicated factors. These data pointed to a pathological reactivation of the synaptic pruning and phagocytosis in microglia. ATXN2-positive aggregates were found in microglia from spinal cord sections of 14-month-old Atxn2-CAG100-KIN via immunohistochemistry. The characterization of microglial response and the potentially deleterious effects of the expanded ATXN2 in this cell type could lead to therapies to improve patients’ living standards or delay the symptoms’ onset.
The second part of this thesis was focused on an autosomal recessive form of cerebellar ataxia, Ataxia Telangiectasia (A-T), with childhood onset. A-T patients show severe cerebellar atrophy manifesting as ataxia when the child starts to walk. The genetic cause of A-T is loss-of-function-mutations in the Ataxia Telangiectasia Mutated gene (ATM). ATM is a kinase involved in DNA damage response, oxidative stress, insulin resistance, autophagy via mTOR signaling, and synaptic function.
Working with proteome data from cerebrospinal fluid of 12 A-T patients and 12 healthy controls, we aimed to define novel biomarkers that would allow following the neurodegeneration in extracellular fluid. Additional validation efforts with ~2-month-old Atm-knock-out (Atm-/-) cerebellar samples helped us to define a scenario were the deficit of vesicle-associated ATM alters the secretion of ApoB, reelin, and glutamate. As extracellular factors, apolipoproteins and their cargo such as vitamin E may be useful for neuroprotective interventions.
ADAM15, which belongs to the family of the disintegrin and metalloproteinases, is a multi-domain transmembrane protein. A strongly upregulated expression of ADAM15 is found in inflamed synovial membranes from articular joints affected by osteoarthritis and especially rheumatoid arthritis (RA). During the chronic inflammatory process in RA the synovial membrane gets hyperplastic, resulting eventually in the formation of a pannus tissue, which can invade into the adjacent cartilage and bone thereby destroying their integrity. Previously, the expression of ADAM15 in fibroblasts of the RA synovial membrane was found to confer a significant anti-apoptotic response upon triggering of the Fas receptor, which resulted in the activation of two survival kinases, focal adhesion kinase (FAK) and Src. The Fas receptor, also named CD95, belongs to the death receptor family of the tumor necrosis factor receptors and stimulation of Fas/CD95 by its ligand FasL results in the execution of apoptotic cell death in synovial membranes of RA patients. However, the occurrence of apoptotic cell death in vivo in RA synovial tissues is considerably low despite the presence of FasL at high concentrations in the chronically inflamed joint. Accordingly, a general apoptosis resistance is a characteristic of RA-synovial fibroblasts that contributes considerably to the formation the hyperplastic aggressive pannus tissue. The objective of this study was to investigate the mechanisms underlying the capability of ADAM15 to transform FasL-mediated death- inducing signals into pro-survival activation of Src and FAK in rheumatoid arthritis fibroblasts (RASFs).
In the present study, the down-regulation of ADAM15 by RNA interference resulted in a significant increase of caspase 3/7 activity upon stimulation of the Fas receptor in RASFs. Likewise, chondrocytes expressing a deletion mutant of ADAM15 (ΔC), lacking the cytoplasmic domain, revealed increased caspase activities upon Fas ligation in comparison to cells transfected with full-length ADAM15, clearly demonstrating the importance of the cytoplasmic domain for an increased apoptosis resistance. Furthermore, activation of the Fas receptor triggered the phosphorylation of Src at Y416, which results in the active conformation of Src, as well as the phosphorylation of FAK at Y576/577 and Y861 – the target tyrosines phosphorylated by Src - in full-length ADAM15-transfected chondrocytes. However, cells transfected with ADAM15 mutant (ΔC) or with vector control did not exhibit any activation of Src and FAK upon Fas ligation. This suggested the presence of an as yet unknown protein interaction mediating the Fas triggered activation of the two kinases.
In order to identify this mechanism, the application of signal transduction inhibitors interfering with Calcium signaling either by inhibiting calmodulin with trifluoperazine (TFP) or the Calcium release-activated channel (CRAC/Orai1) with BTP-2 efficiently inhibited the phosphorylation of FAK and Src, revealing a role of calmodulin, the major Ca2+ sensor in cells, in ADAM15-dependent and Fas-elicited activation of the two survival kinases. Also, a direct Ca2+ -dependent binding of calmodulin to ADAM15 could be demonstrated by pull-down assays using calmodulin-conjugated sepharose and by protein binding assays using the recombinant cytoplasmic domain of ADAM15 and calmodulin.
Furthermore, it could be demonstrated in living synovial fibroblasts by double immunofluorescence stainings that triggering the Fas receptor by its ligand FasL or a Fas-activating antibody resulted in the recruitment of calmodulin to ADAM15 as well as to the Fas receptor in patch-like structures at the cell membrane. Simultaneously, Src associated with calmodulin was shown to become engaged in an ADAM15 complex, also containing cytoplasmic-bound FAK, by co-immunoprecipitations.
Additional studies were performed to analyze the efficacy of TFP and BTP-2 on apoptosis induction in synovial fibroblasts from 10 RA patients. Using caspase 3/7 and annexin V stainings for determining apoptosis, it could be shown that both inhibitors did not possess any apoptosis inducing capacity. However, when co-incubated with FasL both compounds synergistically enhanced apoptosis rates in the RASFs. Moreover, an additional silencing of ADAM15 revealed a further significant rise in apoptosis rates upon incubation with FasL/TFP or FasL/BTP-2, providing unequivocal evidence for an involvement of ADAM15 in facilitating apoptosis resistance in RASFs.
Taken together, these results demonstrate that ADAM15 provides a scaffold for the formation of calmodulin-dependent pro-survival signaling complexes upon CRAC/Orai1 coactivation by Fas ligation, which provides a new potential therapeutic target to break the apoptosis resistance in RASFs that critically contributes to joint destruction in RA.
Hintergrund
Das intrahepatische cholangiozelluläre Karzinom ist ein seltener, hoch aggressiver Tumor2, der zu den cholangiozellulären Karzinomen gehört1 und sich mit einem Fünfjahresüberleben von lediglich 18% durch seine ungünstige Prognose auszeichnet. Bei weltweit steigender Inzidenz und Mortalität stellt die radikale Resektion zum jetzigen Zeitpunkt die einzige kurative Behandlungsoption dar. Aufgrund der niedrigen Fallzahlen und uneinheitlichen Klassifikationen, ist der internationale Studienvergleich erschwert und die Frage nach Prognosefaktoren noch nicht abschließend geklärt.
Ziele
Ziel der Studie war es, Prognosefaktoren anhand von patienten-, tumor- und therapiespezifischen Charakteristika zu detektieren, um eine prognoseadjustierte Therapieentscheidung zu erleichtern und Ausblick hinsichtlich des Gesamtüberlebens geben zu können.
Methoden
Es handelt sich um eine retrospektive unizentrische Kohortenstudie aus der Klinik für Allgemein- und Viszeralchirurgie des Universitätsklinikums Frankfurt am Main. Eingeschlossen in die Analyse wurden 69 erwachsene Patienten mit intrahepatischem cholangiozellulärem Karzinom, die im Zeitraum von Juni 2001 und August 2013 in kurativer Absicht eine Operation als Primärtherapie erhielten.
Um den Einfluss auf das Gesamtüberleben festzustellen, wurden 48 Variablen zunächst mittels univariater Cox-Regressionsanalyse auf ihre Signifikanz getestet. Im Anschluss erfolgte eine multivariate Cox-Regressionsanalyse um Zusammenhangs-, bzw. Abhängigkeitsstrukturen zwischen den Variablen zu erkennen.
Ergebnisse
In der univariaten Cox-Regressionsanalyse ergaben sich, was die prätherapeutischen Symptome betrifft, Hinweise darauf, dass das Vorhandensein von Ikterus (p=,047), Nachtschweiß (p=,026) und Schmerzen (p=,023) die Prognose signifikant verschlechtern könnte, ebenso ein erhöhtes CEA (p=,021).
Bezüglich intraoperativer Merkmale, ließ sich außerdem ein signifikanter Zusammenhang zwischen Prognose und intraoperativem EK-Bedarf (p=,006) sowie der Anlage einer biliodigestiven Anastomose (p=,007) vermuten. Davon abgesehen konnten auch postoperative Komplikationen, wie die Galleleckage (p=,015), die schwerste eingetretene Komplikation, klassifiziert nach Dindo-Clavien (p=,001) und ein hoher CCI-Wert (p=,000) mit dem Gesamtüberleben in Verbindung gebracht werden, ebenso das Vorhandensein von Fernmetastasen (p=,015).
In der multivariaten Cox-Regressions-Analyse konnten Schmerzen, Nachtschweiß, die Anlage einer biliodigestiven Anastomose, eine postoperative Galleleckage, die schwerste Komplikation nach Dindo-Clavien und ein hoher CCI-Wert als störungsfreie, signifikante Prognosefaktoren mit unabhängigem Einfluss auf das Gesamtüberleben gewertet werden.
Schlussfolgerung
Limitiert wird die Übertragung unserer Studienergebnisse durch die relativ geringe Fallzahl. Dennoch konnten wir zeigen, dass es bestimmte Risikogruppen gibt, die nach Resektion in kurativer Intention eine schlechtere Prognose hinsichtlich des Gesamtüberlebens haben, sodass auf jene Patienten vermehrt geachtet werden sollte.
An essential part of the animal survival strategy comprises the ability to control body movement and coordinate long-term navigational strategies, in order to maintain locomotion towards a nutrition source and stay in its vicinity. In the nematode Caenorhabditis elegans (C. elegans) this function is carried out by neuronal circuits, that vary their activity in response to diverse environmental condition.
This comprises different classes of neurons, acting together in a sensory, signaling and modulatory system to control body posture and induce behavioral responses. For this reason, one particular goal in the field of neuroscience research is to elucidate the mechanisms of how neuronal circuits integrate multiple sensory cues to navigate the environment. Aim of this study was to analyze the function of a neuronal network comprising the interneurons AVK, as well as the identification of signaling molecules, controlling body posture during food related locomotory behavior. This should be achieved by establishing optogenetic approaches, which provide a non inversive and temporally precise control of neuronal activity and drives the activation or silencing of individual neurons, to alter the neuronal basis of behavior. Animals exposed to food perform a dwelling-like behavior, characterized by a slowing of locomotion with a reduced crawling distance and an irregular movement, accompanied by a high frequency of pauses, reversals and directional changes. Upon food-removal, they initiate a local-search behavior with the same behavioral characteristics, but with a more pronounced sinusoidal movement. After a prolonged period of unsuccessful food finding, animals exhibited long runs with reduced pauses, reversals and turnings, increasing their maximal covered distance, indicated as dispersal behavior. Acute photoinhibition of AVK neurons, mediated by cell-specific expression of halorhodopsin (NpHR) caused the animals to perform a dwelling-like locomotory state with increased bending angles, as seen during local-search behavior. Thus, food-induced behavioral effects are mimicked by the optogenetic manipulation of AVK interneurons.
In this study, signaling molecules were ascertained by cell specific mRNA profiling of AVK neurons, mediating these behavioral responses. It was able to demonstrate, that flp-1, coding for a FMRFamidelike neuropeptide, is one of the genes with the highest distribution in AVK. In the absence of food, AVK neurons continuously release the FMRFamide-like neuropeptide FLP-1 to inhibit a subset of target motoneurons, leading the animals to maintain a low body curvature to promote dispersing behavior.
Conversely, if AVK was inhibited by NpHR or the presence of food, less FLP-1 was secreted to the body fluid, indicated by reduced intracellular fluorescence levels of mCherry-tagged FLP-1 proteins in the scavenger cells. The search of a FLP-1 receptor was successful by in vitro investigation on G protein-coupled receptors (GPCRs) and neuropeptide ligands, revealing NPR-6 to be activated by FLP-1 neuropeptides, but with a low potency. Expression pattern of the NPR-6 receptor indicated receptor localization in in the VC ventral cord and SMB head motoneurons, as well as in a subset of other neurons required for chemosensation and feeding. AVK interneurons are highly coupled to SMB head motoneurons, forming electrical synapses composed of the gap junction protein subunits UNC-7 and UNC-9. Elimination of SMB or gap junction genes using cell ablation and RNA interference, respectively, phenocopied effects of AVK inhibition on bending angles. Furthermore, this study was able to demonstrate that these neurons get inhibited during FLP-1 transmission to the NPR-6 receptor, which was required to mediate AVK effects on crawling behavior. Consequently, photoinhibition of AVK caused disinhibition of VC and SMB neurons, in order to enhance sinusoidal movement and to induce a local-search related locomotory behavior.
Thereby, FLP-1 neuropeptide transmission is the preferred used signaling pathway over direct gap junction coupling. Additional neuropeptides and receptors were identified to be essential downstream to AVK neurons to mediate effects on body curvature and locomotory behavior as well. The high-potency FRPR-7 receptor was shown to mediate FLP-1 peptide effects on undulatory motion during swimming in a liquid environment, rather than crawling locomotion on a solid surface. This result suggests that the receptor NPR-6 is required for FLP-1 peptide effects on bending and crawling locomotion, whereas conversely the receptor FRPR-7 is addressed by FLP-1 peptides to exclusively regulate swimming behavior. The FRPR-7 receptor is expressed in the AIM and NSM motoneurons, which are suggested to be the primary neuronal candidates mediating swimming behavior. Furthermore, this study provides evidence, that FRPR-7 acts in the DVC interneuron to control spontaneous reversal behavior, most probably by inhibitory FLP-1 signaling from the AVK neurons. Among other neuropeptides, the FMRFamide-like peptide FLP-26 binds with higher affinity to NPR-6 receptors than FLP-1 peptides. FLP-26 peptides are expressed in the SMB motoneurons, where they are able to further potentiate FLP-1 inhibitory effects by simultaneous binding to NPR-6.
...
Rhabdomyosarcoma (RMS) is the most frequent pediatric soft-tissue sarcoma comprising two major subtypes – the alveolar and the embryonal rhabdomyosarcoma. The current therapeutic regime is multimodal including surgery, radiation and chemotherapy with cytostatic drugs. Although the prognosis for RMS patients has steadily improved to a 5-year overall survival rate of 70% for ERMS and 50% for ARMS, prognosis for subgroups with primary metastases or relapsed patients is still less than 25%, highlighting the need for development of new therapies for these subgroups. Since cancer cells are addicted to their cancer promoting transcriptional program, remodeling transcription by targeting bromodomain and extraterminal (BET) proteins has emerged as compelling anticancer strategy. However, in many cancer types BET inhibition was proved cytostatic but not cytotoxic emphasizing the need for combination protocols.
In this study we identify a novel synergistic interaction of the BET inhibitor JQ1 with p110α-isoform-specific Phosphoinositid-3-Kinase (PI3K) inhibitor BYL719 (Alpelisib) to induce mitochondrial apoptosis and global reallocation of BRD4 to chromatin. At first, we showed that JQ1 single treatment had cytostatic effects at nanomolar concentrations and inhibited MYC and Hedgehog (Hh) signaling in RMS known to promote proliferation of RMS. However, JQ1 single treatment barely induced cell death in RMS cells even at concentrations of up to 20 µM (< 20% cell death). Thus, we next tested combination approaches to elicit cell death. Since we previously identified synergistic cell death induction of Hh inhibition and PI3K inhibition in RMS cells we tested JQ1 in combination with the pan-PI3K/mTOR inhibitor PI-103 and the p110α-isoform-specific PI3K inhibitor BYL719. In addition, we tested JQ1 in combination with distinct HDAC inhibitors namely JNJ-26481585, SAHA (Vorinostat), MS-275 (Entinostat) and LBH-589 (Panobinostat) since the synergistic interaction of BET and HDAC inhibition has previously been described for other tumor entities.
Interestingly the synergism of cell death induction of JQ1/BYL719 co-treatment is superior to the synergism of JQ1 with pan-PI3K/mTOR inhibitor PI-103 or the tested HDAC inhibitors as confirmed by calculation of combination index. To investigate the molecular mechanisms underlying the synergy of JQ1/BYL719 co-treatment, we performed RNA-Seq and BRD4 ChIP-Seq experiments. RNA-Seq exhibited, that JQ1/BYL719 co-treatment shifted the overall balance of BCL-2 family gene expression towards apoptosis and increased gene expression of proapoptotic BMF, BCL2L11 (BIM) and PMAIP1 (NOXA) while decreasing gene expression of antiapoptotic BCL2L1 (BCL xL). These changes were verified by qRT-PCR and Western blot. Notably, BRD4 is phosphorylated upon JQ1/BYL719 co-treatment and globally reallocates BRD4 to chromatin. This BRD4 reallocation includes enrichment of BRD4 at the super-enhancer site of BMF, at the super-enhancer, typical enhancer and promoter regions of BCL2L11 (BIM) and at the PMAIP1 (NOXA) promoter, while JQ1 alone, as expected, reduces global chromatin binding of BRD4. Integration of RNA-Seq and BRD4 ChIP-Seq data underlines the transcriptional relevance of reallocated BRD4 upon JQ1/BYL719 co-treatment. Immunopreciptation studies showed, that RMS cells are initially primed to undergo mitochondrial apoptosis since BIM is constitutively bound to antiapoptotic BCL-2, BCL xL and MCL-1. JQ1/BYL719 co-treatment increased BIM expression and its neutralization of antiapoptotic BCL-2, BCL-xL and MCL-1 thereby rebalancing the ratio of pro- and antiapoptotic BCL-2 proteins in favor of apoptosis. This promotes activation of BAK and BAX resulting in caspase-dependent apoptosis. The functional relevance of proapoptotic re-balancing for the execution of JQ1/BYL719-mediated apoptosis was confirmed by individual silencing of BMF, BIM, NOXA or overexpression of BCL-2 or MCL-1, which all significantly rescued JQ1/BYL719-induced cell death. Execution of cell death by mitochondrial caspase-dependent apoptosis was veryfied by individual knockdown of BAK and BAX or caspase inhibitor N-Benzyloxycarbonyl-Val-Ala-Asp(O-Me) fluoromethylketone (zVAD.fmk), which all significantly rescued JQ1/BYL719-induced cell death.
In summary, combined BET and PI3Kα inhibition cooperatively induces mitochondrial apoptosis by proapoptotic re-balancing of BCL-2 family proteins accompanied by reallocation of BRD4 to transcriptional regulatory elements of BH3-only proteins.
The Compressed Baryonic Matter experiment (CBM) at FAIR and the NA61/SHINE experiment at CERN SPS aim to study the area of the QCD phase diagram at high net baryon densities and moderate temperatures using heavy-ion collisions. The FAIR and SPS accelerators cover energy ranges 2-11 and 13-150 GeV per nucleon respectively in laboratory frame for heavy ions up to Au and Pb. One of the key observables to study the properties of a matter created in such collisions is an anisotropic transverse flow of particles.
In this work, the performance of the CBM experiment for anisotropic flow measurements is studied with Monte-Carlo simulations using gold ions at SIS-100 energies employing different heavy-ion event generators. Also, procedures for centrality estimation and charged hadron identification are described and corresponding frameworks are developed.
The measurement of the reaction plane angle is performed with Projectile Spectator Detector (PSD), which is a hadron calorimeter located at a very forward angle. To prevent radiation damage by the high-intensity ion beam, the PSD has a hole in the center to let the beam pass through. Various combinations of CBM detector subsystems are used to investigate the possible systematic biases in flow and centrality measurements. Effects of detector azimuthal non uniformity and the PSD beam hole size on physics performance are studied. The resulting performance of CBM for flow measurements is demonstrated for identified charged hadron anisotropic flow as a function of rapidity and transverse momentum in different centrality classes.
The measurement techniques developed for CBM were also validated with the experimental data recently collected by the NA61/SHINE experiment at CERN SPS for Pb+Pb collisions at the beam momenta 30A GeV/c. Compared to the existing data from the NA49 experiment at the CERN SPS, the new data allows for a more precise measurement of anisotropic flow harmonics. The fixed target setup of NA61/SHINE also allows extending flow measurements available from the STAR at the RHIC beam energy scan (BES) program to a wide rapidity range up to the forward region where the projectile nucleon spectators appear. In this thesis, an analysis of the anisotropic flow harmonics in Pb+Pb collisions at beam momenta 30A GeV/c collected by the NA61/SHINE experiment in the year 2016 is presented. Flow coefficients are measured relative to the spectator plane estimated with the Projectile Spectators Detector (PSD). The flow coefficients are obtained as a function of rapidity and transverse momentum in different classes of collision centrality. The results are compared with the corresponding NA49 data and the measurements from the RHIC BES program.