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Zusammenfassung Die Alzheimersche Krankheit (AD) ist mit 60% die am häufigsten auftretende Art der Demenz. Weltweit sind ca. 24 Mio. Menschen von der neurodegenerativen Krankheit betroffen, welche sich durch den Verlust der kognitiven Fähigkeiten auszeichnet. Es gibt zwei Ausprägungen der Demenz, zum einen die sporadische Verlaufsform, die bei Menschen in einem Alter ab 65 Jahren auftritt und zum anderen die familiäre Alzheimersche Krankheit (FAD), die schon weitaus jüngere Menschen betrifft und auf genetische Mutationen zurück zu führen ist. Beide Formen der Demenz zeigen den gleichen neuropathologische Phänotyp, der zur Ausbildung von extrazellulären Plaques und intrazellulären Neurofibrillen führt. Durch die Entstehung der Plaques und der Neurofibrillen werden die Verbindungen zwischen den einzelnen Neuronen verringert und die Neuronen sterben ab. Für das Auftreten der FAD sind Mutationen in den Genen des Amyloid Vorläufer Proteins (APP, Substrat) sowie der Aspartatprotease Einheit des γ-Sekretase Komplexes, Presenilin 1 (PS1) oder Presenilin 2 (PS2), verantwortlich. Die γ-Sekretase ist ein membranständiger Komplex bestehend aus den vier Untereinheiten PS1 oder PS2, Nicastrin (Nct), Aph-1 und Pen-2. Um ausreichende Informationen über den γ-Sekretase Komplex bezüglich seiner Interaktionsflächen, seines Katalysemechanismus und seiner Substraterkennung zu erhalten, wäre es hilfreich seine 3 Dimensionale Struktur aufzuklären, wozu große Mengen der sauberen und homogenen Proteine benötigt werden. Die Herstellung von ausreichenden Proteinmengen stellt derzeit aber einen Engpass für die strukturelle und funktionelle Charakterisierung des γ-Sekretase Komplexes in-vitro dar. Alzheimer’s disease (AD) is the most common cause of dementia, which affects 24 million people worldwide. It is a neurodegenerative disorder, which occurs either in its most common form in people over 65 years or in the rare early-onset familial AD (FAD). Responsible for the autosomal dominant FAD are mutations in the genes encoding for the β-amyloid precursor protein (APP) and the two homologues integral membrane proteins Presenilin 1 (PS1) and Presenilin 2 (PS2). The two PSs are major but alternative components of the intramembrane aspartyl protease γ-secretase. Further components are the membrane proteins Nicastrin (Nct), Aph-1 and Pen-2. Production of sufficient amounts of protein samples is still the major bottleneck for the detailed functional and structural in-vitro characterization of the γ-secretase complex. Due to toxicity, stability and targeting problems, the overproduction of MPs in conventional in-vivo systems often has only limited success. Therefore, efficient expression protocols using the cell-free (CF) system were established in this work. After optimization, I was able to produce up to milligram amounts of the single proteins PS1 and PS2, the cleavage products PS1-NTF and PS1-CTF, and Pen-2. The in-vitro produced γ-secretase subunits were further characterized, concerning their purity, secondary fold, thermal stability and homogeneity. Highest purities with over 90% after affinity chromatography could be achieved for PS1-CTF and Pen-2. Reconstitution of PS1, PS1-NTF, PS1-CTF and Pen-2 into E. coli liposomes results in a homogeneously distribution, which gives evidence for a structural folding. This was confirmed by CD spectroscopy of PS1-CTF and Pen-2. The thermal stability of Pen-2 shows a transition at 68°C, whereas PS1-CTF is stable up to 95°C. Both proteins show in addition homogeneous elution profiles investigated by analytical SEC and exhibit a monomeric (Pen-2) or dimeric (PS1-CTF) character analyzed by blue native PAGE. Different methods were performed to get evidence about the assembly of the complex, like pull-down experiments, immunoprecipitation, co-expression of radioactive labeled subunits and titration assays by liquid-state NMR. First hints for an interaction of the CF synthesized proteins could be observed by co-expression. Supplemental, Pen-2 and CTF could be purified in sufficient amounts and to apparent homogeneity that allow structural approaches by X-ray crystallography and liquid-state NMR spectroscopy. First conditions for protein crystals were achieved for Pen-2 and structural investigations of PS1-CTF by liquid-state NMR could be performed after optimization of the expression-, purification- and detergent conditions.
Im Folgenden werden einige Facetten dieses weiten Feldes [der Synästhesie] herausgegriffen, nämlich das der Farblichtmusik und der Verbindung von Ton und Bild zwischen 1920 und 1930 mittels apparativer Verschaltungen. Hierzu werden zwei technische Anordnungen gegenübergestellt, die eine Ton-Bild-Wandlung auf eine Weise vornahmen, die radikaler als die damals weit verbreiteten Lichtorgeln vorging, indem sie nicht nur metaphorisch mit der gleichschwingenden Kraft von Tönen und Bildern agierten, sondern diese zum Gegenstand medientechnischer Anordnungen machten. Die eine dieser Apparaturen wurde im Kontext der Kunst entwickelt und stammt von Raoul Hausmann, während die andere von dem Fernmeldetechniker Fritz Winckel realisiert wurde. Indem Hausmann und Winckel die Zuordnung von Tönen und Bildern nicht assoziativ realisierten wie die meisten Lichtorgeln dieser Zeit, sondern die Ton- und Bildquellen mit analoger Technik direkt verschalteten, riefen sie umso mehr den Vergleich mit der durch Menschen wahrgenommenen Synästhesie auf, weshalb zu Beginn auf diese etwas breiter eingegangen werden muss. Hier ist zu fragen, was geschieht, wenn Synästhesie zu einem künstlerischen Konzept wird und welche Rhetoriken von Kunstschaffen in den 1920er Jahren daran gebunden waren. Es soll deutlich werden, dass die vom Menschen wahrgenommene Synästhesie in ihrer körperlichen Grundlage sowie in ihrem ästhetischen Empfinden nicht mehr als eine Metapher für ihr medientechnisches Pendant sein konnte. Synästhetische Wahrnehmung und verschaltete Medien bringen jeweils ihre eigenen ästhetischen Reiche hervor. Andererseits boten die unscharfen und vielschichtigen Konzepte der Synästhesie zahlreiche Anregungen für Künstler, schufen Raum für eine Synthese der Künste und waren der Anstoß für neue künstlerische Ausdrucksformen mittels Medientechnik und damit eine frühe Form der Medienkunst.
Trotz der Relevanz des Themas Suizidalität und gut bekannter Risikofaktoren gibt es bisher keine deutsche Leitlinie zur Suizidalität im Erwachsenenalter. In diesem Beitrag werden zunächst die Geschichte und die Hintergründe der Arbeit mit Leitlinien beschrieben. Der aktuelle Stand der Leitlinien für psychische Erkrankungen in Deutschland wird dargestellt und auf suizidpräventive Inhalte hin untersucht. Die Notwendigkeit evidenzbasierter Suizidprävention und einer spezifischen Leitlinie zur Suizidprävention bei Erwachsenen wird diskutiert.
Nur durch gezielte Suizidpräventionsstrategien und Interventionen für die jeweiligen Risikogruppen und unter Beachtung von Alters- und Geschlechtsspezifität kann für alle Betroffenen eine flächendeckende, gut erreichbare, bedarfs- und versorgungsgerechte, finanzierbare sowie nachhaltige medizinische Versorgung auf einem hohen Niveau sichergestellt werden. Dies gilt für den ambulanten und den stationären Bereich sowie für deren Schnittstellen. Bei Suizidalität handelt es sich um ein diagnoseübergreifendes, in unterschiedlichen Versorgungskontexten auftretendes Syndrom mit komplexem Behandlungsbedarf, weshalb intersektorale und multiprofessionelle Aspekte in einer entsprechenden Leitlinie besonders zu adressieren sind. Wissenschaftliche Evidenz und interdisziplinärer Konsens unter Expertinnen und Experten zum Umgang mit suizidalem Verhalten in der medizinischen Versorgung können dazu beitragen, Morbidität und Mortalität im Zusammenhang mit Suizidalität zu reduzieren. Im August 2021 wurde die Finanzierung einer S3-Leitlinie „Umgang mit Suizidalität“ vom Innovationsfonds des Gemeinsamen Bundesausschusses bewilligt.
Objective: To evaluate prognostic factors in pediatric patients with gonadal germ cell tumors (GCT). Methods: Patients <18 years with ovarian and testicular GCT (respectively OGCT and TGCT) were prospectively registered according to the guidelines of MAKEI 96. After resection of the primary tumor, patients staged ≥II received risk-stratified cisplatin-based combination chemotherapy. Patients were analyzed in respect to age (six age groups divided into 3-year intervals), histology, stage, and therapy. The primary end point was overall survival. Results: Between January 1996 and March 2016, the following patients were registered: 1047 OGCT, of those, 630 had ovarian teratoma (OTER) and 417 had malignant OGCT (MOGCT); and 418 TGCT, of those, 106 had testicular teratoma (TTER) and 312 had malignant TGCT (MTGCT). Only in MTGCT, older age correlated with a higher proportion of advanced tumors. All 736 teratomas and 240/415 stage I malignant gonadal GCT underwent surgery and close observation alone. In case of watchful waiting, the progression rate of OGCT was higher than that of TGCT. However, death from disease was reported in 8/417 (1.9%) MOGCT and 8/312 (2.6%) MTGCT irrespective of adjuvant chemotherapy and repeated surgery. Conclusions: The different pathogenesis and histogenesis of gonadal GCT reflects sex- and age-specific patterns that define clinically relevant risk groups. Therefore, gender and age should be considered in further research on the biology and clinical practice of pediatric gonadal GCT.
Protein kinases are targets for drug development. Dysregulation of kinase activity leads to various diseases, e.g. cancer, inflammation, diabetes. Human polo-like kinase 1 (Plk1), a serine/threonine kinase, is a cancer-relevant gene and a potential drug target which attracts increasing attention in the field of cancer therapy. Plk1 is a key player in mitosis and modulates entry into mitosis and the spindle checkpoint at the meta-/anaphase transition. Plk1 overexpression is observed in various human tumors, and it is a negative prognostic factor for cancer patients. The same catalytical mechanism and the same co-substrate (ATP) lead to the problem of inhibitor selectivity. A strategy to solve this problem is represented by targeting the inactive conformation of kinases. Kinases undergo conformational changes between active and inactive conformation and thus an additional hydrophobic pocket is created in the inactive conformation where the surrounding amino acids are less conserved. A "homology model" of the inactive conformation of Plk1 was constructed, as the crystal structure in its inactive conformation is unknown. A crystal structure of Aurora A kinase served as template structure. With this homology model a receptor-based pharmacophore search was performed using SYBYL7.3 software. The raw hits were filtered using physico-chemical properties. The resulting hits were docked using Gold3.2 software, and 13 candidates for biological testing were manually selected. Three compounds of the 13 tested exhibit anti-proliferative effects in HeLa cancer cells. The most potent inhibitor, SBE13, was further tested in various other cancer cell lines of different origins and displayed EC50 values between 12 microM and 39 microM. Cancer cells incubated with SBE13 showed induction of apoptosis, detected by PARP (Poly-Adenosyl-Ribose-Polymerase) cleavage, caspase 9 activation and DAPI staining of apoptotic nuclei.
Poster presentation at 5th German Conference on Cheminformatics: 23. CIC-Workshop Goslar, Germany. 8-10 November 2009 Protein kinases are important targets for drug development. The almost identical protein folding of kinases and the common co-substrate ATP leads to the problem of inhibitor selectivity. Type II inhibitors, targeting the inactive conformation of kinases, occupy a hydrophobic pocket with less conserved surrounding amino acids. Human polo-like kinase 1 (Plk1) represents a promising target for approaches to identify new therapeutic agents. Plk1 belongs to a family of highly conserved serine/threonine kinases, and is a key player in mitosis, where it modulates the spindle checkpoint at metaphase/anaphase transition. Plk1 is over-expressed in all today analyzed human tumors of different origin and serves as a negative prognostic marker in cancer patients. The newly identified inhibitor, SBE13, a vanillin derivative, targets Plk1 in its inactive conformation. This leads to selectivity within the Plk family and towards Aurora A. This selectivity can be explained by docking studies of SBE13 into the binding pocket of homology models of Plk1, Plk2 and Plk3 in their inactive conformation. SBE13 showed anti-proliferative effects in cancer cell lines of different origins with EC50 values between 5 microM and 39 microM and induced apoptosis. Increasing concentrations of SBE13 result in increasing amounts of cells in G2/M phase 13 hours after double thymidin block of HeLa cells. The kinase activity of Plk1 was inhibited with an IC50 of 200 pM. Taken together, we could show that carefully designed structure-based virtual screening is well-suited to identify selective type II kinase inhibitors targeting Plk1 as potential anti-cancer therapeutics.
Aim: It can be challenging to distinguish COVID-19 in children from other common infections. We set out to determine the rate at which children consulting a primary care paediatrician with an acute infection are infected with SARS-CoV-2 and to compare distinct findings. Method: In seven out-patient clinics, children aged 0–13 years with any new respiratory or gastrointestinal symptoms and presumed infection were invited to be tested for SARS-CoV-2. Factors that were correlated with testing positive were determined. Samples were collected from 25 January 2021 to 01 April 2021. Results: Seven hundred and eighty-three children participated in the study (median age 3 years and 0 months, range 1 month to 12 years and 11 months). Three hundred and fifty-eight were female (45.7%). SARS-CoV-2 RNA was detected in 19 (2.4%). The most common symptoms in children with as well as without detectable SARS-CoV-2 RNA were rhinitis, fever and cough. Known recent exposure to a case of COVID-19 was significantly correlated with testing positive, but symptoms or clinical findings were not. Conclusion: COVID-19 among the children with symptoms of an acute infection was uncommon, and the clinical presentation did not differ significantly between children with and without evidence of an infection with SARS-CoV-2.
Aim: It can be challenging to distinguish COVID-19 in children from other common infections. We set out to determine the rate at which children consulting a primary care paediatrician with an acute infection are infected with SARS-CoV-2 and to compare distinct findings. Method: In seven out-patient clinics, children aged 0–13 years with any new respiratory or gastrointestinal symptoms and presumed infection were invited to be tested for SARS-CoV-2. Factors that were correlated with testing positive were determined. Samples were collected from 25 January 2021 to 01 April 2021. Results: Seven hundred and eighty-three children participated in the study (median age 3 years and 0 months, range 1 month to 12 years and 11 months). Three hundred and fifty-eight were female (45.7%). SARS-CoV-2 RNA was detected in 19 (2.4%). The most common symptoms in children with as well as without detectable SARS-CoV-2 RNA were rhinitis, fever and cough. Known recent exposure to a case of COVID-19 was significantly correlated with testing positive, but symptoms or clinical findings were not. Conclusion: COVID-19 among the children with symptoms of an acute infection was uncommon, and the clinical presentation did not differ significantly between children with and without evidence of an infection with SARS-CoV-2.