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Die Aufdeckung krankheitsbedingter Unterschiede und die Identifizierung neuer Biomarker sind essenziell für Diagnose und Behandlung verschiedener Erkrankungen. Unterschiede zwischen Erkrankungen können u.a. durch Analyse des Lipidprofils aufgedeckt werden, da dieses eng mit dem Phänotyp verknüpft ist. Ein unvoreingenommenes Screening gewährt einen umfassenderen Einblick in den metabolischen Zustand als eine gezielte Untersuchung weniger Analyten und kann neue Hypothesen generieren. Deshalb wurde im Rahmen dieser Arbeit eine Screening-Methode zur untargeted Untersuchung des Lipidoms in biologischen Proben entwickelt. Durch die Kombination aus Umkehrphasenchromatographie und hochauflösender Massenspektrometrie mit datenabhängiger Aufnahme von MS/MS-Spektren konnten in Humanplasma 440 Lipide aus mehr als 15 Lipidklassen identifiziert werden. Die mehrstufige Identifizierung der Analyten, basierend auf der exakten Masse ±5 ppm, der Isotopenverteilung, der MS/MS-Fragmentierungsmuster in beiden Ionisationsmodi sowie der chromatographischen Auftrennung von Isomeren und Isobaren, erfolgte mit hoher Selektivität. Mit der vorgestellten Methode können sowohl Lipidklassen als auch einzelne Lipide relativ zu den internen Standards quantifiziert werden.
Der Probendurchsatz wurde erhöht, um den Einsatz der Methode im Rahmen größerer klinischer Studien zu ermöglichen und vorhandene Ressourcen effizient einzusetzen. Dabei wurden die Inkubationszeiten während der Flüssig-Flüssig-Extraktion mit MTBE:Methanol deutlich reduziert und die Handhabung vereinfacht bei gleichbleibend hoher Wiederfindung. Der hohe Probendurchsatz wird weiter unterstützt durch die kurze chromatographische Laufzeit von 17 min pro Ionisationsmodus. Die Auswertung der Ergebnisse ist der heikelste und zeitintensivste Schritt bei der Entwicklung und Anwendung von Screening-Methoden, deshalb wurde der Arbeitsablauf zur univariaten Analyse durch Entwicklung von R Skripten vereinfacht und beschleunigt.
Die Qualität und Reproduzierbarkeit der Ergebnisse sind essenziell. Aus diesem Grund wurde die Qualität der entwickelten Methode, angelehnt an den strikten Vorgaben der FDA und EMA zur Validierung von quantitativen Methoden, sichergestellt, obwohl eine Methodenüberprüfung im Bereich von untargeted Methoden nicht verbreitet ist. Die Reproduzierbarkeit der relativen Lipidkonzentrationen konnte z.B. durch die Messung von Kontrollplasmaproben über einen Zeitraum von 10 Monaten gezeigt werden. Außerdem wurde die Linearität der Verdünnung von Plasmaproben bestätigt und eine Verschleppung in darauffolgende Proben ausgeschlossen. Die Stabilität der Proben muss in jeder Messphase inklusive der Präanalytik durch geeignete Untersuchungen und Maßnahmen sichergestellt werden. Anhand einer Studie zur präanalytischen Stabilität humaner Blutproben konnte ein Protokoll zur Probennahme und -vorbereitung für weitere klinische Studien erarbeitet werden. Die Stabilität des Lipidoms in Vollblut und Plasma konnte durch den Einsatz von Natriumfluorid/Citrat als Antikoagulans verbessert werden. Auch die Stabilität der Proben während der Lipidextraktion und Messung konnte gezeigt werden. Es wurden 16 verschiedene Probenarten analysiert, darunter Plasmaproben, verschiedene Mausgewebe und Zellpellets.
Mit der entwickelten Methode wurden die Unterschiede im Lipidprofil im Plasma und Gewebe von Mäusen mit einer akuten Entzündung durch LPS bzw. Zymosan-Injektion aufgedeckt. Dabei wurden die Ether-Phosphatidylcholine als potenzielle Entzündungsmarker identifiziert. Die entwickelte Methode wurde außerdem erfolgreich im Rahmen anderer Arbeiten für die Untersuchung verschiedener Erkrankungen angewendet.
In der vorliegenden Arbeit wird demnach eine schnelle, reproduzierbare und vor allem selektive LC-MS-Screening-Methode vorgestellt, die Veränderungen des Lipidstoffwechsels aufdecken und potenzielle Biomarker identifizieren kann.
An overexpression of the E3 ubiquitin ligase TRIM25 is implicated in several human cancers and frequently correlates with a poor prognosis and occurrence of therapy resistance in patients. Previous studies of our group have identified the mRNA encoding the pro-apoptotic caspase-2 as a direct target of the ubiquitous RNA binding protein human antigen R (HuR). The constitutive HuR binding observed in colon carcinoma cells negatively interferes with the translation of caspase-2 mainly through binding to the 5' untranslated region (UTR) of caspase-2 and thereby confers an increased survival of tumor cells. The main objective of this thesis was to unravel novel regulatory proteins critically involved in the control of caspase-2 translation and their impact on therapeutic drug resistance of human colon carcinoma cells. By employing RNA affinity chromatography in combination with mass-spectrometry, among several putative caspase-2 mRNA binding proteins, we have identified the tripartite motif-containing protein 25 (TRIM25) as novel caspase-2 translation regulatory protein in colon carcinoma cells. The constitutive TRIM25 binding to caspase-2 mRNA in two different human colorectal carcinoma cell lines was validated by ribonucleoprotein (RNP)-immunoprecipitation (RIP)-RT-PCR assay and by means of biotin-labeled RNA-pull-down assay. Since caspase-2 is a caspase which is particularly involved in the DNA-damage-induced apoptosis, I tested the functional relevance of negative caspase-2 regulation by TRIM25 for chemotherapeutic drug-induced cell death of different adenocarcinoma cells by RNA interference (RNAi)- mediated loss-of-function and gain-of-function approaches. In the first part of the thesis, I could demonstrate that transient silencing of TRIM25 caused a significant increase in caspase-2 protein levels without affecting the amount of corresponding mRNAs. Mechanistically, the TRIM25 silencing-triggered increase in caspase-2 was totally impaired by cycloheximide, indicating that the stimulatory effects on caspase-2 levels depend on protein synthesis. This finding was corroborated by RNP/polysomal fractionation, which revealed that the transient knockdown of TRIM25 caused a significant redistribution of caspase-2 transcripts from the fraction of RNP particles to that from translationally active polyribosomes.
The second part of my thesis aimed at the elucidation of the functional consequences of the negative caspase-2 regulation by TRIM25 for enhanced tumor cell survival. Thereby, I found that the siRNA-mediated knockdown of TRIM25 caused a significant increase in the chemotherapeutic drug-induced cleavage of caspase-3 and to elevations in cytoplasmic cytochrome c levels implicating that TRIM25 depletion did mainly affect the intrinsic apoptotic pathway. Concordantly, the ectopic expression of TRIM25 caused a reduction in caspase-2 protein levels, concomitant with an attenuated sensitivity of tumor cells to doxorubicin.
To test the functional impact of caspase-2 in the TRIM25 depletion-dependent sensitization to drug-induced apoptosis, I employed a siRNA-mediated knockdown of caspase-2. Interestingly, the strong induction of caspase-3 and -7 cleavage after doxorubicin treatment was fully impaired after the additional knockdown of caspase-2, indicating the sensitizing effects by TRIM25 knockdown depend on caspase-2.
Data from this thesis identified the TRIM25 as a novel RNA-binding protein of caspase-2 mRNA, which negatively interferes with the translation of caspase-2 and which functionally contributes to chemotherapeutic drug resistance of colon carcinoma cells. Interfering with the negative TRIM25-caspase-2 axis may represent a promising therapeutic avenue for sensitizing colorectal cancers to conventional anti-tumor therapies.
Slack (sequence like a Ca2+ -activated K + channel; also termed Slo2.2, Kcnt1, or KNa 1.1) is a Na+ -activated K + channel that is highly expressed in the peripheral and central nervous system. Previous studies have shown that Slack is enriched in the isolectin B4binding, non-peptidergic subpopulation of C-fiber sensory neurons and that Slack controls the sensory input in neuropathic pain. Recent single-cell RNA-sequencing studies suggested that Slack is highly co-expressed with transient receptor potential (TRP) ankyrin 1 (TRPA1) in sensory neurons. By using in situ hybridization and immunostaining we confirmed that Slack is highly co-localized with TRPA1 in sensory neurons, but only to a minor extent with TRP vanilloid 1. Mice lacking Slack globally or conditionally in sensory neurons (SNS-Slack─/─ ), but not mice lacking Slack conditionally in neurons of the spinal dorsal horn (Lbx1-Slack─/─ ), displayed increased pain behavior after intraplantar injection of the TRPA1 activator allyl isothiocyanate. Patch-clamp recordings with cultured primary neurons and in a HEK-293 cell line transfected with TRPA1 and Slack revealed that Slack-dependent K + currents are modulated in a TRPA1-dependent manner. Taken together, these findings highlight Slack as a modulator of TRPA1-mediated activation of sensory neurons.
Furthermore, we investigated the contribution of Slack in the spinal dorsal horn to pain processing. Lbx1-Slack ─/─ mice demonstrated normal basal pain sensitivity and Complete Freund’s Adjuvant-induced inflammatory pain. Interestingly, we observed a significantly increased spared nerve injury (SNI)-induced neuropathic pain hypersensitivity in Lbx1-Slack ─/─ mutants compared to control littermates. Moreover, we tested the effects of pharmacological Slack activation in the SNI model. Systemic and intrathecal, but not intraplantar administration of the Slack opener loxapine significantly alleviated SNI-induced hypersensitivity in control mice, but only slightly in Lbx1Slack ─/─ mice, further supporting the inhibitory function of Slack in spinal dorsal horn neurons in neuropathic pain processing.
Altogether, our data suggest that Slack in sensory neurons controls TRPA1-induced pain, whereas Slack in spinal dorsal horn neurons inhibits peripheral nerve injury induced neuropathic pain. These data provide further insights into the molecular mechanisms of pain sensation.
Bioactive small molecules are used in many research areas as important tools to uncover biological pathways, interpret phenotypic changes, deconvolute protein functions and explore new therapeutic strategies in disease relevant cellular model systems. To unlock the full potential of these small molecules and to ensure reliability of results obtained in cellular assays, it is crucial to understand the properties of these small molecules. These properties encompass their activity and potency on their designated target(s), their selectivity towards unintended off-targets and their phenotypic effects in a cellular system. Approved drugs often engage with multiple targets, which can be beneficial for some applications such as treatment of cancer where several pathways need to be inhibited for treatment efficacy. However, targeting multiple key proteins in diverse pathways also increases the possibility for unspecific or unwanted side effects. For many drugs the entire target space that they modulate is not known. This makes it difficult to use these drugs for target deconvolution or functional assays with the aim to understand the underlying biological processes. In contrast to drugs, for mechanistic studies, a good alternative are chemical tool compounds so called chemical probes that are usually exclusively selective as well as chemogenomic compounds, that inhibit several targets but have narrow selectivity profiles. Because they are mechanistic tools, chemical tool compounds must meet stringent quality criteria and they are therefore well characterized in terms of their potency, selectivity and cellular on-target activity. To ensure that an observed phenotypic effect caused by a compound can be attributed to the described target(s), it is essential to study also properties of chemical tools leading to unspecific cellular effects. There are a variety of unspecific effects that can be caused by physiochemical compound properties that can interfere with phenotypic assays as well as functional compound evaluations. One of these effects is low solubility causing toxicity or intrinsic fluorescence potentially interfering with assay readouts. But unanticipated cellular responses can also arise from unspecific binding, accumulation in cellular compartments or damage caused to organelles such as mitochondria or the cytoskeleton that can result in the induction of diverse forms of cell death.
In this study, we investigated the influence of a variety of small molecules on distinct cell states, by establishing and validating high-content imaging assays, which we called Multiplex assay. This assay portfolio enabled us to detect different cellular responses using diverse fluorescent reporters, such as the influence of a compound on cell viability, induction of cell death programs and modulation of the cell cycle. Additionally, general compound properties such as precipitation and intrinsic fluorescence were simultaneously detected. The assay is adaptable to assess other cellular properties of interest, such as mitochondrial health, changes in cytoskeletal morphology or phospholipidosis. A significant advantage of the assay is that we are using live cells, so we can capture dynamic cellular changes and fluctuations that can be crucial for the understanding of cellular responses.
Ceramide synthase (CerS) is the enzyme responsible for the de novo synthesis of ceramide. In this process, the different CerS isoforms are substrate-specific and produce ceramides of different chain lengths. Ceramides form the backbone for other sphingolipids and are enriched in membrane microdomains called lipid rafts. Lipid rafts are important signaling platforms for many transmembrane proteins, but can also act as bioactive lipids. Depending on the chain length, the effects on signaling pathways can vary. The aim of this work was to further investigate the chain length-specific effects by CerS4 on the progression of inflammatory colon cancer. To understand the tissue-specific effects of CerS4 deficiency on the progression of acute colitis and colitis-associated cancer (CAC), CerS4 knockout models were used. Disease progression of wild-type CerS4 (WT) was compared with that of mice with global CerS4 knockout (CerS4 KO) and mice in which CerS4 deficiency was restricted to T cells (CerS4 LCK/Cre) or intestinal cells (CerS4 Vil/Cre). Acute colitis was induced with sodium dextran sulfate (DSS), whereas azoxymethane (AOM)/DSS combinations were used to induce CAC in mice. The results showed a different disease progression depending on the specific knockout. While CerS4 KO mice were sensitive to DSS. AOM/DSS treatment was lethal for these mice, indicating an important role of CerS4 in other tissues. CerS4 Vil/Cre mice were protected from tumor formation. In contrast, CerS4 LCK/Cre mice experienced increased tumor formation and pan-inflammation. The mechanism behind this is due to the absence of cytotoxic T cells and the increase of regulatory T cells in the CerS4 LCK/Cre mice, demonstrating that CerS4 is critical for T cell function and development. To understand the role of CerS in humans, organoids were prepared from patients and the CerS profile in the different organoids was elucidated. This work provides, for the first time, insights into the CerS profile in human organoids and demonstrates a link between differentiation markers and stem cell markers with CerS. In addition, the role of CerS4 was investigated in vitro using three different colon cell lines-Caco-2 cells, HCT116 cells, and HCT15 cells. Hypoxia induced downregulation of CerS4 in all cell lines. Using the luciferase promoter assay, hypoxia-induced downregulation could already be detected at the promoter. Downregulation of CerS4 and CerS5 in Caco-2 cells and HCT116 cells resulted in different metabolic changes and mitochondrial dynamics after hypoxia. In conclusion, the results show that the role of CerS4 depends on the tissue cell type and stage of colorectal carcinoma, which complicates the consideration of CerS4 as a target in patients.
Hintergrund: Die Komplexität einer medikamentösen Behandlung steigt mit der Anzahl der Medikamente, der Einzeldosen und der Darreichungsformen und bedroht dadurch die Adhärenz der Patienten. Patienten mit Multimorbidität benötigen oft flexible, individualisierte Behandlungsschemata. Häufige Medikationsänderungen im Verlauf der Behandlung können jedoch die Komplexität einer Therapie weiter erhöhen.
Ziel: Das Ziel der vorliegenden Arbeit war es daher, Medikationsveränderungen bei älteren Patienten mit Multimorbidität und Multimedikation in der hausärztlichen Praxis zu beschreiben und deren Abhängigkeit von soziodemographischen und weiteren Merkmalen zu untersuchen. Zudem sollten die Medikationsveränderungen in den Daten der cluster-randomisierten kontrollierten PRIMUM-Studie (Priorisierung der MUltimedication in Multimorbidity) analysiert werden, um Effekte der komplexen PRIMUM-Intervention zu untersuchen und damit einen Beitrag zur Prozessevaluation zu leisten.
Methoden: In der vorliegenden Arbeit wurden Daten der PRIMUM-Studie, die in 72 Allgemeinpraxen durchgeführt wurde, retrospektiv analysiert. Dazu wurde ein Algorithmus entwickelt, der die Wirkstoffe, die Wirkstärke, die Dosierung und die Darreichungsform zur Beurteilung von Änderungen an der von Ärzten berichteten Medikationsdaten während zweier Intervalle (Basiswert bis sechs Monate: Δ1; sechs bis neun Monate: Δ2) untersucht. Diese Veränderungen wurden auf Verordnungs- und Patientenebene deskriptiv sowie auf die Assoziation zu soziodemographischen und Versorgungsmerkmalen uni- und multivariat analysiert und auf Interventionswirkungen überprüft.
Ergebnisse: Von 502 Patienten (im Durchschnitt 72 Jahre, 52% weiblich) beendeten 464 die Studie. Medikationsveränderungen traten bei 98,6% der Patienten auf. Die maximale Anzahl an Medikationsänderungen pro Patient betrug 21 in Δ1 und 20 in Δ2. Die Gesamtzahl der Medikamente pro Patient blieb dabei weitgehend konstant und betrug im Median zu allen drei Messzeitpunkten 8 (IQR an T0 und IQR an T1: 6-9 und IQR an T2: 6-10). Änderungen bezogen auf den Wirkstoff während Δ1 und Δ2 traten bei 414 (82,5%) und 338 (67,3%) Patienten auf, Dosierungsänderungen bei 372 (74,1%) und 296 (59,2%) und in der Wirkstärke bei 158 (31,5%) bzw. 138 (27,5%). Die Darreichungsform wurde bei 79 (16%) der Patienten sowohl in Δ1 als auch in Δ2 geändert. Simvastatin, Ramipril, Metformin und Aspirin waren am häufigsten von Veränderungen betroffen. Am häufigsten verordnet waren ASS, Metoprolol und Bisoprolol sowie Simvastatin. Medikationsänderungen traten häufiger nach vorhergehenden Aufenthalten im Krankenhaus auf und Dosisreduktion war bei männlichen Patienten häufiger zu verzeichnen. In der Interventionsgruppe waren Medikationsänderungen um 19% wahrscheinlicher. Insbesondere waren Dosisreduktionen und das Ansetzen von neuen Medikamenten in der Interventionsgruppe signifikant häufiger.
Schlussfolgerungen: Bei älteren Patienten mit Multimedikation und Multimorbidität wurden die Therapiepläne häufig geändert. Auf Verordnungsebene ist dies hauptsächlich auf Absetzen und Dosisanpassungen zurückzuführen, gefolgt von Ansetzen und Wiederansetzen von Medikamenten. Dies kann die (longitudinale) Komplexität der Medikation für Patienten erhöhen und ggf. nachteilige Folgen für Therapieadhärenz und Arzneimitteltherapiesicherheit haben. Zudem wird deutlich, dass die medikamentöse Verordnungsqualität in querschnittlichen Erhebungen nicht zuverlässig beurteilt werden kann. In der PRIMUM-Studie wurden häufiger Änderungen in der Interventions- gegenüber der Kontrollgruppe vorgenommen - hauptsächlich das Ansetzen neuer Medikamente und Dosisreduktion. Damit konnten Effekte der komplexen Intervention gezeigt werden, die im Einklang mit den Zielen der Intervention zur Optimierung von Multimedikation steht.
Neuropathic pain, a form of chronic pain, is a steadily rising health problem due to health costs and increasing numbers of patients. Neuropathic pain conditions arise upon metabolic disorders, infections, chemotherapeutic treatment, trauma or nerve injury. Especially nerve injury induced neuropathic pain is characterized by spontaneous or ongoing pain due to neuroimmune interactions. Thereby, inflammatory mediators, released by the injured nerve, recruit to and activate immune cells at the site of injury. Those mediators further activate transient receptor potential vanilloid 1 (TRPV1), a known channel involved in pain perception, or bind to G-protein coupled receptors (GPCR) in peripheral nerve endings. The following activated second messenger signaling pathways lead to sensitization of TRPV1. One of those GPCRs is G2A.
The overall aim of this thesis was to investigate the role of G2A in nerve-injury induced neuropathic pain. For this, the common mouse model of nerve-injury induced neuropathic pain, the spared-nerve injury, was used. As measurements with dynamic plantar aesthesiometer showed, G2A-deficiency leads to reduced mechanical hypersensitivity. Upon analysis with FACS, ELISA and Luminex a reduced number of macrophages and neutrophils at the injured nerve, as well as less inflammatory mediators (TNFα, IL-6, VEGF) in G2A-deficient animals was observed. In dorsal root ganglia (DRGs) there was only a reduced number of macrophages and less IL-12 observed in G2A-deficient animals. Additionally, in wild-type mice, G2A agonist 9-HODE was elevated at the injured nerve, as a LC-MS/MS analysis showed.
To investigate the underlying pathways of G2A-9-HODE signaling, a proteom screen was performed. This screen revealed upregulation of multiple proteins involved in migration in wild-type macrophages. Additionally, Ca-Imaging and transwell migration assays showed that the G2A antagonist G2A11, had desensitizing effects on DRG neurons and inhibited macrophage migration.
Overall, the results suggest that loss of G2A has dual effects. On the one hand loss of G2A is antinociceptive. On the other hand, G2A-deficiency leads to reduced inflammation, suggesting G2A as promising target in treatment of neuropathic pain. Here, an antagonist had inhibitory effects on the migration and the sensitization.
Redox homeostasis must be kept in balance for an intact redox signaling, which is necessary to control neuronal pathways such as growth cone pathfinding, synaptic plasticity and transmission (Oswald, Garnham, Sweeney, & Landgraf, 2018).
Nucleoredoxin (NXN) is an oxidoreductase and thioredoxin-like protein holding two conserved cysteine residues in its structure (Funato & Miki, 2007), which are essential for its redox-regulating functionality. The function of NXN in neurons is still less well studied. But the expression of NXN in neurons, which was confirmed through analyzing adult NXN-LacZ reporter mice, suggested a dominant functional role in neuronal pathways. Initial experiments revealed calcium-calmodulin-dependent kinase 2 a (Camk2a) as a potential interaction partner through a Yeast-2-Hybrid screen (not shown) which is the major protein to induce synaptic plasticity during neuronal activity. Therefore, neuronal expression of NXN and the potential interaction with Camk2a prompted us to investigate deeper into the neuronal pathway. The goal of this work was to confirm the interaction of Camk2a and NXN with further experiments and to characterize behavior of mice carrying a neuronal NXN deletion. To achieve a pan-neuronal depletion of NXN expression in our mouse model, we used the Cre/loxP system with a NestinCre driver. We did not achieve the expected complete deletion of NXN due to unknown compensatory mechanisms. Nevertheless, the partial deletion of NXN in our transgenic mouse model prevented embryonic lethality as occurring in complete NXN knockout mice (Funato et al., 2010). The interaction of Camk2a and NXN was confirmed through proximity ligation assay (PLA) and immunofluorescence staining of primary cortical neurons.
Investigations of the functional interaction revealed a lower redox-sensitivity of Camk2a activity in NXN-deficient brain samples. Additionally, the respiratory activity was significantly reduced in mitochondria of NXN deficient mouse brain pointing to possible dysfunctional mitochondria which is also observed in various neurodegenerative diseases, e.g.: Alzheimer, Parkinson, and Huntington disease (Norat et al., 2020). Unexpectedly, behavioral studies revealed only a subtle effect of the pan-neuronal NXN-deficiency. Significant differences between genotypes were found at the reduction of exploratory behavior and a reduced motivation for the voluntary wheel running in NesNXN-/- mice, which is normally seen as a joyful and rewarding activity. The observed behavior of NesNXN-/- mice potentially results from interaction mechanisms of NXN with Camk2a, as well as decreased oxidation of
Camk2a and further unidentified target proteins of NXN.
Conclusively, function of NXN was revealed as a non-essential redox modulator of Camk2a in neurons. The behavioral phenotype of NesNXN-/- mice is probably compensated through unknown mechanisms. Redox signaling of Camk2a in neurons is regulated through various components such as TXN or GSH, which can backup each other (Branco et al., 2017; Ren et al., 2017). NXN is an additional but not essential regulator.
The scope of this thesis is to elaborate on the use cases of the EEG in pain research. It has been submitted as a cumulative dissertation, meaning that the main part of this thesis has been previously published in international peer-reviewed journals. The first part of this thesis begins with an introduction which describes the general methodoligcal considerations and theoretical background information that is needed to perform pain research using the EEG. Then, I will give a summary of the results of all three studies and the subsequently published manuscripts. The discussion will give an outlook on two ongoing projects and elaborate how the methodology that has been compiled throughout my time as a PhD student can be further applied to scientific problems in pain research. I will conclude with the possibilities and the limitations of the EEG in pain research. The second part of this thesis consists of three publications that cover three individual studies, of which I am the lead/first author. These publications describe different use cases for the EEG in pain research. The first publication lays out the methodological backbone of this thesis, analyzing the exact EEG parameters that are needed to achieve the results in the following projects. Then, I present two additional studies. The first study describes the usefulness of pain-related evoked signatures after standardized noxious stimulation in the EEG in patients undergoing general anesthesia. The second study outlines differences in the pain processing of elite endurance athletes versus a normally active control group. Furthermore, it outlines how the function of the endogenous pain modulatory system can be measured in the EEG using CPM. All studys are discussed individually as per the journal guidelines.
In Vorarbeiten wurde gezeigt, dass der Kaliumkanal Slack an der Verarbeitung neuropathischer Schmerzen funktionell beteiligt ist und dass das klassische Neuroleptikum Loxapin Slack-abhängig neuropathisches Schmerzverhalten im Mausmodell lindert (Lu et al. 2015).
Ausgehend von Loxapin als Leitstruktur wurden in der vorliegenden Arbeit im FluxOR™ Kaliumkanal-Assay an Slack-transfizierten HEK-Zellen insgesamt 68 neue Loxapin-Derivate gescreent. Hierbei wurden 23 Substanzen mit Slack-aktivierenden Eigenschaften identifiziert, von denen VHP93, VH408 und VH425 weiter in vivo untersucht wurden. Dabei zeigten Mäuse nach systemischer Gabe von VHP93 ein reduziertes Verhalten in einem Modell für neuropathische Schmerzen. Dem gegenüber wurde durch VH408 das Verhalten im neuropathischen Schmerzmodell nicht beeinflusst.
Des Weiteren konnte in dieser Arbeit gezeigt werden, dass durch eine Slack-Aktivierung nicht nur neuropathisches Schmerzverhalten gehemmt wird, sondern auch die Kratzreaktionen im Chloroquin-Modell des Histamin-unabhängigen Juckreizes reduziert werden können.
Neben Slack wurde in dieser Arbeit auch die Gewebsexpression und funktionelle Bedeutung des eng mit Slack verwandten Kaliumkanals Slick charakterisiert. Expressionsanalysen ergaben, dass Slick überwiegend in dünn myelinisierten A-delta-Fasern und inhibitorischen Interneuronen im Dorsalhorn des Rückenmarks lokalisiert ist. Tierexperimentelle Untersuchungen zeigten, dass Slick-Knockout-Mäuse ein erhöhtes Schmerzverhalten nach thermischer Stimulation aufwiesen. Außerdem wurde bei Slick-Knockout-Mäusen in der späten Phase des Capsaicin- und Formalin-Tests ein signifikant erhöhtes Leckverhalten verzeichnet. Die Ergebnisse dieser Arbeit liefern somit Hinweise auf eine funktionelle Beteiligung von Slick bei der Detektion von Hitzeschmerzen und bei der TRPV1- und TRPA1-vermittelten Schmerzantwort. Zusammengefasst zeigen diese Daten, dass Slick vorrangig an der Verarbeitung thermischer und chemischer Noxen beteiligt ist und dabei eine antinozizeptive Funktion ausübt.