30 research outputs found

    Untersuchungen zur MembranfluiditÀt als regulatorisches Element der APP-Prozessierung

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    ExtrazellulĂ€re Ablagerungen aus aggregierten Abeta-Peptiden stellen das pathologische Hauptmerkmal der Alzheimer Demenz dar. Schrittweise VerĂ€nderungen der Gleichgewichtsspiegel an Abeta im Gehirn begrĂŒnden den Beginn der Amyloid Kaskaden Hypothese, in deren Folge es zu einer vermehrten Bildung und Aggregation von Abeta kommt. Im Zuge dieser Arbeit wurde im Zellmodell untersucht, welche Faktoren die Aggregation und die Bildung von Abeta initiieren bzw. verstĂ€rken. Etliche Arbeiten deuten darauf hin, dass der Amyloid-Metabolismus eng mit dem zellulĂ€ren Cholesteringehalt verknĂŒpft ist. In den hier verwendeten Modellsystemen bestĂ€tigte sich dieser Befund, da die Reduktion von Cholesterin durch Lovastatin und selektive Inhibitoren der Cholesterinbiosynthese mit einer signifikanten Abnahme der Abeta-Produktion einherging. Der Statin-Effekt konnte dabei nachweislich auf die Cholesterinreduktion bezogen und gegenĂŒber pleitropen Isoprenoid-Effekten abgegrenzt werden, da die Inhibition der Isoprenoid- Transferasen FTase und GGTase zu keiner verminderten Abeta-Sekretion fĂŒhrte. FĂŒr eine mechanistische Analyse wurde die Rolle des freien Cholesterins als determinierender Faktor der MembranfluiditĂ€t untersucht. Die APP-Prozessierung ist in der Membran lokalisiert und unterliegt daher dem Einfluss von Cholesterin als Modulator der physikalisch-chemischen Membraneigenschaften. Die Reduktion von Cholesterin bewirkt eine Zunahme der MembranfluiditĂ€t, wĂ€hrend hohe Cholesterinspiegel zu einer starren Membran fĂŒhren. Beide ZustĂ€nde wurden unabhĂ€ngig vom Cholesteringehalt durch den Membranfluidizer Benzyl-Alkohol und den Membranrigidizer Pluronic F68 simuliert. Die Zunahme der MembranfluiditĂ€t nach der Behandlung mit Benzyl Alkohol resultierte in einer signifikant verminderten Abeta-Sekretion. Pluronic F68 hingegen fĂŒhrte cholesterinunabhĂ€ngig zu einer Abnahme an MembranfluiditĂ€t, die mit einer verstĂ€rkten amyloidogenen APP-Prozessierung einherging. Die Befunde weisen die MembranfluiditĂ€t explizit als regulatorisches Element der Abeta-Produktion aus. Benzyl Alkohol und Pluronic F68 zeigten außerdem eine starke Beeinflussung der Membranorganisation in Bezug auf die Formation von Lipid Rafts als potentielle DomĂ€nen der amyloidogenen APP-Prozessierung. Benzyl Alkohol fĂŒhrte zu einer diffusen Lokalisation von GM-1 und Cholesterin, wĂ€hrend Pluronic F68 eine Kondensation der Raftlipide bewirkte. Abeta selbst interagiert mit der Plasmamembran und stört deren IntegritĂ€t. Eine Reihe von Daten deutet darauf hin, dass Abeta spezifisch an Komponenten der Lipid Rafts bindet. Die vorliegende Arbeit bestĂ€tigt die Kolokalisation von GM-1 und Abeta und belegt, dass die Interaktion zu einer Abnahme der MembranfluiditĂ€t fĂŒhrt. WeiterfĂŒhrend konnte gezeigt werden, dass die Bindung von Abeta zu einer verstĂ€rkten amyloidogenen APP-Prozessierung fĂŒhrt und so einen selbstverstĂ€rkenden Mechanismus der Abeta-Produktion initiiert. Der Effekt konnte in proliferierenden Zellen durch langfristige Inhibition der Abeta-Sekretion rĂŒckgĂ€ngig gemacht werden. Anhand der Ergebnisse wurde ein Modell entworfen, in dem die Aggregation von gebundenem Abeta zu einer Vernetzung von Lipid Rafts fĂŒhrt und so die amyloidogene APP-Prozessierung stimuliert. Die Hypothese wurde mit Hilfe von Antikörperinduzierter Quervernetzung von GM-1 ĂŒberprĂŒft und bestĂ€tigt. Zusammengenommen zeigt die vorliegende Arbeit, dass 1.) die Lovastatin-induzierte Abnahme der Abeta-Sekretion in den verwendeten Zellmodellen auf die Reduktion von Cholesterin, bzw. die daraus resultierende Zunahme der MembranfluiditĂ€t zurĂŒckzufĂŒhren ist, 2.) die MembranfluiditĂ€t unabhĂ€ngig vom Cholesteringehalt Einfluss auf die APP-Prozessierung nimmt, wobei eine fluide Membran die nicht-amyloidogene und eine starre Membran die amyloidogene APP-Prozessierung begĂŒnstigt, 3.) die Vernetzung bzw. Kondensation von Lipid Rafts zu einer verstĂ€rkten amyloidogenen Prozessierung fĂŒhrt und 4.) Abeta selbst durch Bindung an die Membran diesen Zustand bedingt und damit einen Teufelskreislauf initiiert, in dem es die eigene Produktion stimuliert. Damit fĂŒgt die Arbeit dem Puzzle um die Genesis der sporadischen Form der Alzheimer Demenz einige StĂŒcke hinzu und bietet neue Aspekte fĂŒr die therapeutische Intervention der Erkrankung an

    The impact of participation restrictions on everyday life in long-term colorectal cancer survivors in the EnCoRe study:A mixed-method study

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    Purpose: Knowledge about long-term colorectal cancer (CRC) or treatment related health and functioning problems and on its impact on participation of CRC survivors in domestic life and in society is limited. We aimed to explore the nature and impact of cancer (treatment) related participation restrictions on everyday life of long-term CRC survivors, their current satisfaction with participation, and associations of health and functioning problems with participation satisfaction, using the International Classification of Functioning, Disability and Health (ICF) to comprehensively study participation.Method: Mixed-method study in 2-10 years post-diagnosis stage I-III CRC survivors (n = 151) from the cross-sectional part of the EnCoRe study. Participation restrictions were explored by semi-structured interviews in a subsample reporting participation restrictions (n = 10). Role functioning (SF36-Health Survey), fatigue (Checklist Individual Strength), and peripheral neuropathy symptoms (EORTC QLQ-CIPN20) were assessed in all participants and associations with self-reported participation satisfaction were analyzed by multivariable logistic regression models.Results: 19% of CRC survivors reported dissatisfaction with participation. Participation restrictions were reported for interpersonal relationships, work/employment, and social/civic life. CRC survivors reporting better physical and emotional role functioning were significantly less likely to be dissatisfied with their participation, whereas survivors reporting higher levels of fatigue or more peripheral neuropathy symptoms were more likely to be dissatisfied with participation.Conclusions: Colorectal cancer (treatment) related health and functioning problems negatively impacts the ability of nearly 1 in 5 long-term CRC survivors to participate in everyday life situations and their satisfaction with participation. Follow-up care needs to be able to identify and address these problems.</p

    Measuring the association of objective and perceived neighborhood environment with physical activity in older adults: challenges and implications from a systematic review

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    BACKGROUND: A supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence. METHODS: A systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≄ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided. RESULTS: Of the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified. CONCLUSIONS: The strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored

    Aangepast preventiebeleid bij patiënten met hyposplenie of asplenie

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    The Dutch guideline for the preventions of infections in persons with (functional) hypo- or asplenie has been revised, recommending adjustments for the use of vaccinations and antibiotics. The spleen has an important function in the defence against infections. Around 1,000 splenectomies are performed in the Netherlands every year. Three different groups of patients are distinguished: (a) persons with a partially or completely removed spleen after surgery or embolization; (b) persons with congenital asplenia; and (c) a heterogeneous group of patients, who may have functional hyposplenie or asplenia due to an underlying condition or specific treatments. Patients with asplenia have an increased risk of severe infections by encapsulated bacteria, including in particular Streptococcus pneumoniae, but also Haemophilus influenzae type b and Neisseria meningitides may lead to an increased risk S.pneumoniae causes up to 90% of the infections, which makes it the most important infectious agent in patients with asplenia. A number of preventive measures are recommended to prevent infections in patients with hypo- or asplenie, including the use of vaccinations and antibiotics and patient counselling

    CD2AP/CIN85 balance determines receptor tyrosine kinase signaling response in podocytes

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    Defects in podocyte signaling are the basis of many inherited glomerular diseases leading to glomerulosclerosis. CD2-associated protein (CD2AP) is highly expressed in podocytes and is considered to play an important role in the maintenance of the glomerular slit diaphragm. Mice deficient for CD2AP (CD2AP(-/-)) appear normal at birth but develop a rapid onset nephrotic syndrome at 3 weeks of age. We demonstrate that impaired intracellular signaling with subsequent podocyte damage is the reason for this delayed podocyte injury in CD2AP(-/-) mice. We document that CD2AP deficiency in podocytes leads to diminished signal initiation and termination of signaling pathways mediated by receptor tyrosine kinases (RTKs). In addition, we demonstrate that CIN85, a paralog of CD2AP, is involved in termination of RTK signaling in podocytes. CIN85 protein expression is increased in CD2AP(-/-) podocytes in vitro. Stimulation of CD2AP(-/-) podocytes with various growth factors, including insulin-like growth factor 1, vascular endothelial growth factor, and fibroblast growth factor, resulted in a significantly decreased phosphatidylinositol 3-kinase/AKT and ERK signaling response. Moreover, increased CIN85 protein is detectable in podocytes in diseased CD2AP(-/-) mice, leading to decreased base-line activation of ERK and decreased phosphorylation after growth factor stimulation in vivo. Because repression of CIN85 protein leads to a restored RTK signaling response, our results support an important role of CD2AP/CIN85 protein balance in the normal signaling response of podocytes
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