Effects of antidepressants on K_2P-channels in neuronal and cardiac cells

Die vorliegende Arbeit beschäftigte sich mit der Wirkung von Antidepressiva auf K2P-Kanäle. Sie stellen wie spannungsabhängige Ca2+, Na+ und K+-Kanäle als neuronale Ionenkanäle aufgrund ihrer Expressionsmuster und physiologischen Eigenschaften potentielle Zielproteine für Antidepressiva dar. Darum werden K2P-Kanäle in heterologen Expressionssystemen von klinisch verabreichten Antidepressiva inhibiert. Die K2P-Kanäle TREK-1, TASK-1 und THIK-1 zeigten sich in dieser Arbeit alle sensitiv auf das Antidepressivum Fluoxetin, welches die Kaliumströme der Kanäle unterschiedlich stark inhibierte. Hierbei lieferten die vorliegenden Untersuchungen den Nachweis, dass TREK-1 auf Fluoxetin am meisten, THIK-1 am wenigsten sensitiv reagiert. Der humane TREK-1 wird durch Fluoxetin in den Expressionssystemen Oozyten und HEK-Zellen zu fast 80% inhibiert, wobei bei der humanen Zelllinie nur ein Zehntel der vorher eingesetzten Antidepressivakonzentration für die gleiche Inhibition des Auswärtsstroms notwendig war. Die vorliegende Arbeit weist Inhibitionen des Kanals bei einer Fluoxetinkonzentration von 1 µM nach, was der Serumkonzentration von depressiven Patienten entspricht. Zudem wird TREK-1 durch die Antidepressiva Maprotilin, Mirtazapin, Citalopram, Doxepin und Venlafaxin inhibiert, wobei letzteres kaum eine Wirkung zeigt. Alle verwendeten Antidepressiva nutzen die gleichen Angriffspunkte am Kanalprotein, da es bei einer Koapplikation mit einem weiteren Antidepressivum oder Benzodiazepin zu keiner Inhibitionsverstärkung kommt. Die Interaktion zwischen Antidepressivum und Kanalprotein verläuft mit großer Wahrscheinlichkeit direkt und ohne „second-messenger-Wege“. Hierbei konnten die porenformende Region und der C-Terminus des Kanals als Interaktionspartner ausgeschlossen werden. Der Mechanismus der alternativen Translations-Initiaton generiert zwei unterschiedliche Proteinprodukte aus einem TREK-1 Transkript, eine lange Version des Proteins mit 426 Aminosäuren und zusätzlich eine kurze Version mit 374 Aminosäuren, welcher die ersten 52 N-terminalen Aminosäuren fehlen. Die Fluoxetin-Sensitivität von TREK-1 [N52] verringert sich um 70%. Dies verdeutlicht, dass die ersten 52 Aminosäuren essentiell zur TREK-1 Interaktion mit Antidepressiva beitragen.The study at hand is about the effect of antidepressants on K2P-channels. As neuronal ion-channels like voltage-gated Ca2+, Na+ and K+-channels, the K2P-channels constitute a potential target for antidepressants because of their tissue expression and physiological characteristics. Clinically prescribed antidepressants inhibit the K2P-channels in heterologous expression systems for that reason. In our experiments the K2P-channels TREK-1, TASK-1 and THIK-1 were sensitive to the antidepressant Fluoxetine, which inhibited the potassium current in different ways. The study provides evidence that TREK-1 reacts to Fluoxetine most sensitively whereas THIK-1 reacts least. The humane TREK-1 is inhibited up to 80% by Fluoxetine in expression systems oocytes and HEK-cells, in which only a tenth of the antidepressant concentration induced the same current inhibition. Our experiments showed already a channel block already at 1 µM Fluoxetine concentration, which is conform to the antidepressant serum concentration of depressive patients. Furthermore TREK-1 is inhibited by the antidepressants Maprotiline, Mirtazapine, Citalopram, Doxepin and Venlafaxine, whereas the last one showed least effects. The used antidepressants occupy the same targets at the channel protein, because a coapplication with a further antidepressant or benzodiazepine didn´t increase the maximum channel block. The interaction between antidepressant and channel protein is working directly without second messenger pathway. The pore forming region and the C-terminus of the channels could be excluded as interaction partner. Alternative translation initiation (ATI) generates two different protein products from a single transcript of TREK-1, a long version of the protein with 426 amino acids and in addition a short version with 374 amino acids, lacking the first 52 amino acids at the N-terminus. The sensitivity of TREK-1[N52] to fluoxetine declined by 70% indicating that the first 52 amino acids essentially contribute to the interaction of TREK-1 with the antidepressant

Pediatric ALL relapses after allo-SCT show high individuality, clonal dynamics, selective pressure, and druggable targets

Survival of patients with pediatric acute lymphoblastic leukemia (ALL) after allogeneic hematopoietic stem cell transplantation (allo-SCT) is mainly compromised by leukemia relapse, carrying dismal prognosis. As novel individualized therapeutic approaches are urgently needed, we performed whole-exome sequencing of leukemic blasts of 10 children with post-allo-SCT relapses with the aim of thoroughly characterizing the mutational landscape and identifying druggable mutations. We found that post-allo-SCT ALL relapses display highly diverse and mostly patient-individual genetic lesions. Moreover, mutational cluster analysis showed substantial clonal dynamics during leukemia progression from initial diagnosis to relapse after allo-SCT. Only very few alterations stayed constant over time. This dynamic clonality was exemplified by the detection of thiopurine resistance-mediating mutations in the nucleotidase NT5C2 in 3 patients' first relapses, which disappeared in the post-allo-SCT relapses on relief of selective pressure of maintenance chemotherapy. Moreover, we identified TP53 mutations in 4 of 10 patients after allo-SCT, reflecting acquired chemoresistance associated with selective pressure of prior antineoplastic treatment. Finally, in 9 of 10 children's post-allo-SCT relapse, we found alterations in genes for which targeted therapies with novel agents are readily available. We could show efficient targeting of leukemic blasts by APR-246 in 2 patients carrying TP53 mutations. Our findings shed light on the genetic basis of post-allo-SCT relapse and may pave the way for unraveling novel therapeutic strategies in this challenging situation

Childhood cancer predisposition syndromes-A concise review and recommendations by the Cancer Predisposition Working Group of the Society for Pediatric Oncology and Hematology

Heritable predisposition is an important cause of cancer in children and adolescents. Although a large number of cancer predisposition genes and their associated syndromes and malignancies have already been described, it appears likely that there are more pediatric cancer patients in whom heritable cancer predisposition syndromes have yet to be recognized. In a consensus meeting in the beginning of 2016, we convened experts in Human Genetics and Pediatric Hematology/Oncology to review the available data, to categorize the large amount of information, and to develop recommendations regarding when a cancer predisposition syndrome should be suspected in a young oncology patient. This review summarizes the current knowledge of cancer predisposition syndromes in pediatric oncology and provides essential information on clinical situations in which a childhood cancer predisposition syndrome should be suspected