Influence of Short-Term Glucocorticoid Therapy on Regulatory T Cells In Vivo

Background: Pre- and early clinical studies on patients with autoimmune diseases suggested that induction of regulatory T(Treg) cells may contribute to the immunosuppressive effects of glucocorticoids(GCs). Objective: We readdressed the influence of GC therapy on Treg cells in immunocompetent human subjects and naı¨ve mice. Methods: Mice were treated with increasing doses of intravenous dexamethasone followed by oral taper, and Treg cells in spleen and blood were analyzed by FACS. Sixteen patients with sudden hearing loss but without an inflammatory disease received high-dose intravenous prednisolone followed by stepwise dose reduction to low oral prednisolone. Peripheral blood Treg cells were analyzed prior and after a 14 day GC therapy based on different markers. Results: Repeated GC administration to mice for three days dose-dependently decreased the absolute numbers of Treg cells in blood (100 mg dexamethasone/kg body weight: 2.861.86104 cells/ml vs. 336116104 in control mice) and spleen (dexamethasone: 2.861.96105/spleen vs. 956226105/spleen in control mice), which slowly recovered after 14 days taper in spleen but not in blood. The relative frequency of FOXP3+ Treg cells amongst the CD4+ T cells also decreased in a dose dependent manner with the effect being more pronounced in blood than in spleen. The suppressive capacity of Treg cells was unaltered by GC treatment in vitro. In immunocompetent humans, GCs induced mild T cell lymphocytosis. However, it did not change the relative frequency of circulating Treg cells in a relevant manner, although there was some variation depending on the definition of the Treg cells (FOXP3+: 4.061.5% vs 3.461.5%*; AITR+: 0.660.4 vs 0.560.3%, CD127low: 4.061.3 vs 5.063.0%* and CTLA4+: 13.8611.5 vs 15.6612.5%; * p,0.05). Conclusion: Short-term GC therapy does not induce the hitherto supposed increase in circulating Treg cell frequency, neither in immunocompetent humans nor in mice. Thus, it is questionable that the clinical efficacy of GCs is achieved by modulating Treg cell numbers

Characterisation of the pathogenetic-relevant role of SF1 in adrenocortical carcinoma

Tumore der Nebennieren stellen häufige Tumore dar, welche bei mindestens 3 % der Population über 50-Jähriger vorkommen. Im Gegensatz dazu ist das Nebennierenrindenkarzinom mit einer Inzidenz von 1-2 Einwohner pro Million ein sehr seltener Tumor. Da seine Prognose allerdings ungünstig, und diese maßgeblich davon abhängt wie fortgeschritten der Tumor bei Diagnosestellung ist, ist es wichtig, dass die richtige Diagnose frühzeitig gestellt wird. Bis heute ist kein zuverlässiger immunhistochemischer Nebennierenrindenkarzinom-spezifischer Marker etabliert um das Nebennierenrindenkarzinom von anderen retroperitonealen Tumoren zu differenzieren. Sasano et al. schlug bereits 1995 erstmalig den Transkriptionsfaktor Steroidogenic Factor 1 (SF1) als Marker zur Differenzierung von Nebennierenrinden- und Nicht-Nebennierenrindentumoren vor. Allerdings wurde die diagnostische Wertigkeit bisher nur in sehr kleinen Fallserien mit insgesamt nur 17 Nebennierenrindenkarzinomen untersucht. In der vorliegenden Arbeit wurde die SF1 Protein-Expression bei 163 Nebennierenrindenkarzinomen, 52 Nebennierenrinden-Adenomen, 12 normalen steroidogenen Geweben (6 Nebennieren und 6 Ovare), sowie 73 Nicht-Steroidtumoren immunhistochemisch untersucht. Hierbei zeigte sich, das SF1 bei 158 von 161 evaluierbaren Nebennierenrindenkarzinomen und bei allen Proben von normalen und gutartigen Geweben (n=64) nachweisbar war. Im Gegensatz dazu war keine der 73 Nicht-Steroidgeweben SF1 positiv, so dass die diagnostische Genauigkeit extrem gut ist (Sensitivität: 98.6 %, Spezifität: 100 %, positive und negative predictive value jeweils 100 % und 97.3 %). In einem zweiten Schritt wurde untersucht ob die Protein-Expression von SF1 beim Nebennierenrindenkarzinom auch prognostische Bedeutung hat. Hierbei zeigte sich, dass Patienten mit Tumoren mit starker SF1 Färbung (30 %) ein deutlich schlechteres tumorstadium-adjustiertes Rezidiffreies- und Gesamt-Überleben haben als Patienten mit geringer SF1 Expression (hazard ratio: 2.45). Zusätzlich zu den immunhistochemischen Untersuchungen wurden FISH Analysen durchgeführt. Hierbei zeigte sich allerdings keine signifikante Korrelation zwischen SF1 Gendosis und der SF1 Protein-Expression, so dass zu vermuten ist, dass SF1 maßgeblich auf Transkriptions- und Translationsebene reguliert wird. In einem Versuch diese Frage zu beantworten wurden zwei mutmaßliche SF1 Interaktionspartner, FATE1 und DAX1, genauer immunhistochemisch untersucht. Hierbei wurde deutlich, dass FATE1 bei 62 von 141 evaluierbaren Nebenierenrindenkarzinomen und 12 von 62 normalen und gutartigen Geweben nachweisbar war. Im Gegensatz hierzu waren alle 9 Nicht-Steroidgewebe FATE1 negativ. Dies zeigt, das FATE1 nicht zur Diagnostik nutzbar ist (Sensitivität: 61 %, Spezifität: 100 %, positive und negative predictive value 100 % bzw. 14 %). Die DAX1 Analyse zeigte, dass alle 20 normalen und gutartigen Gewebe eine positive DAX1 Färbereaktion zeigten. Von 126 Nebennierenrindenkarzinomen waren 71 DAX1 positiv. Von den 8 untersuchten Nicht-Steroidgeweben waren 6 DAX1 positiv. Diese Ergebnisse belegen, dass auch DAX1 keine diagnostische Genauigkeit besitzt (Sensitivität: 56 %, Spezifität: 25 %, positive und negative predictive value 92 % bzw. 4 %). Die Untersuchung der prognostischen Fähigkeiten von FATE1 und DAX1 zeigte, dass Patienten mit Tumoren mit starker FATE1 Färbung (39 %) ein schlechteres tumorstadium-adjustiertes Gesamt- aber nicht Rezidiffreies-Überleben haben als Patienten mit niedriger FATE1 Protein-Expression (hazard ratio: 2.01). Weiterhin wurde deutlich, dass DAX1 keine deutlichen prognostischen Fähigkeiten besitzt. Zusammenfassend läßt sich aus der vorliegenden Arbeit folgern, das SF1 aktuell der beste diagnostische Marker zur Diagnose von Tumoren der Nebennierenrinde ist und damit Eingang in die histopathologische Routine-Diagnostik von Nebennierentumoren finden wird. Zusätzlich ist die SF1 Expression ein sehr guter prognostischer Marker beim Nebennierenrindenkarzinom, wobei sich die prognostische Aussage durch zusätzliche Färbung von FATE1 und DAX1 nur unwesentlich verbessern läßt.Adrenal tumors are common tumors which are present in at least 3 % in the human population over their 5th decade. However, adrenocortical carcinoma (ACC) is a rare malignancy which shows an approximate anual incidence of 1-2 per million. Prognosis of ACC is generally poor and depends strongly on the tumor stage. Thus, early and correct diagnosis is important. Until now, no reliable immunohistochemical ACC-specific marker has been established for its differentiation from other retroperitoneal tumors. Already in 1995, Sasano et al. suggested the transcription factor Steroidogenic Factor 1 (SF1) as useful marker for differentiation of adrenocortical and non-adrenocortical tumors. Up to now, SF1's value as diagnostic marker for ACC was investigated only in small series of in a total of 17 samples. In our work, SF1 expression was investigated by immunohistochemistry in 163 ACC, 52 adrenocortical adenomas, 12 normal steroidogenic tissues (6 adrenal glands and 6 ovaries), as well as 73 non-steroidogenic tumors. SF1 protein expression was shown in 158 of a total of 161 evaluable ACC, as well as all normal and benign steroidogenic tissues. In contrast, no SF1 protein was detectable in the non-steroidogenic tumors. Thus, SF1 protein expression is a highly specific diagnostic tool (sensitivity: 98.6 %, specificity: 100 %, positive and negative predictive value: 100 % and 97.3 %, respectively). In a second step, SF1 protein expression was investigated as a prognostic tool in ACC. As shown by us, ACCs presenting strong SF1 immunoreactivity (30 %) showed a strong correlation with overall and recurrence-free patients survival than ACCs presenting low SF1 protein expression (hazard ratio: 2.45). Moreover, FISH analyses were performed which revealed no significant correlation of SF1 gene dosis and SF1 protein expression, suggesting a regulatory mechanism at transcriptional and translational level. To investigate the hypothesis, we investigated two putative interaction partners of SF1, namely FATE1 and DAX1 protein, by immunohistochemistry. FATE1 protein was expressed in 62 of a total of 141 evaluable ACC as well as 12 of a total of 62 normal and benign steroidogenic tissues. In contrast, all non-steroidogenic tissues were FATE1 negative (n=9). Thus, FATE1 is no valuable diagnostic tool (sensitivity: 61 %, specificity: 100 %, positive and negative predictive value: 100 % and 14 %, respectively). DAX1 immunohistochemistry showed that all normal and benign steroidogenic tissues (n=20) were DAX1 positive as well as 71 of a total of 126 ACC samples. Furthermore, 6 out of a total of 8 non-steroidogenic tissues stained DAX1 positive, showing that DAX1 protein is no diagnostic tool (sensitivity: 50 %, specificity: 25 %, positive and negative predictive value: 92 % and 4 %, respectively). Investigation of the prognostic value of FATE1 and DAX1 revealed that patients with tumors characterized by strong FATE1 immunoreactivity (39 %) had a worse outcome in overall but not recurrence-free survival than patients showing low FATE1 expression (hazard ratio: 2.01). DAX1 protein expression has no prognostic value in ACC. In summary, we showed that SF1 is currently the best available diagnostic marker for differentiation of adrenocortical tumors from other retroperitoneal tumors, and that it will be suitable for histopathological diagnostic routine. Furthermore, SF1 expression is a well-suited prognostical tool in adrenocortical carcinoma which is only marginally enhanced by subsequent staining of FATE1 and DAX1 protein

Decellularized Aortic Scaffold Alleviates H2O2-Induced Inflammation and Apoptosis in CD34+ Progenitor Cells While Driving Neovasculogenesis

Bone marrow-derived stem/progenitor cells have been utilized for cardiac or vascular repair after ischemic injury, but they are subject to apoptosis and immune rejection in the ischemic site. Multiple scaffolds were used as delivery tools to transplant stem/progenitor cells; however, these scaffolds did not show intrinsically antiapoptotic or anti-inflammatory properties. Decellularized aortic scaffolds that facilitate cell delivery and tissue repair were prepared by removing cells of patient-derived aortic tissues. Scanning electron microscopy (SEM) showed cells attached well to the scaffold after culturing for 5 days. Live/dead staining showed most seeded cells survived at day 7 on a decellularized aortic scaffold. Ki67 staining demonstrated that decellularized aortic scaffold promoted proliferation of bone marrow-derived CD34+ progenitor cells. Apoptosis of CD34+ progenitor cells induced by H2O2 at high concentration was significantly alleviated in the presence of decellularized aortic scaffolds, demonstrating a protective effect against oxidative stress-induced apoptosis. Furthermore, decellularized aortic scaffolds significantly reduced the expression of proinflammatory cytokines (IL-8, GM-CSF, MIP-1β, GRO-α, Entoxin, and GRO) concurrently with an increase in anti-inflammatory cytokines (IL-2 and TGF-β) released from CD34+ progenitor cells when exposed to H2O2 at low concentration. Finally, neovascularization was observed by H&E and immunohistochemical staining 14 days after the decellularized aortic scaffolds were subcutaneously implanted in nude mice. This preclinical study demonstrates that the use of a decellularized aortic scaffold possessing antiapoptotic and anti-inflammatory properties may represent a promising strategy for cardiovascular repair after ischemic injury

c-kit+AT2R+ Bone Marrow Mononuclear Cell Subset Is a Superior Subset for Cardiac Protection after Myocardial Infarction

Although the bone marrow mononuclear cell (BMMNC) is known as an ideal cell type for cell-based therapy for MI treatment, the effective subpopulation still remains unknown. Our study aimed at identifying the optimal subset of BMMNCs suited for cardiac regeneration. In this study, we observed that MI led to (i) a significant increase of the c-kit+AT2R+ BMMNC subpopulation in mice and (ii) a modest increase of AT2R+ BMMNCs in humans. c-kit+AT2R+ and c-kit+AT2R− BMMNC subpopulations were obtained from mice after MI. Then, we cocultured cardiac H9C2 cells with c-kit+AT2R+, c-kit+AT2R−, and unfractionated BMMNCs; finally, we found that the c-kit+AT2R+ subset is superior to the c-kit+AT2R− subset in improving cardiomyocyte protection in vitro. Of note, c-kit+AT2R+ BMMNCs showed a more robust migration capacity than c-kit+AT2R− and unfractionated BMMNCs in vitro and in vivo. Additionally, compared to c-kit+AT2R− and unfractionated BMMNCs, intravenous transplantation of c-kit+AT2R+ BMMNC resulted in smaller infarct size and lower levels of inflammatory reactions in heart tissue, leading to a higher global heart function improvement. In conclusion, our results indicate that the c-kit+AT2R+ BMMNC subpopulation exerts a protective effect against MI and shows promising therapeutic possibilities with regard to the treatment of ischemic heart disease

Estrogen Receptor α and β in Mouse: Adipose-Derived Stem Cell Proliferation, Migration, and Brown Adipogenesis In Vitro

Background/Aims: Adipose-derived stem cells (ASCs) belong to mesenchymal stem cells and may play a potential role as seeding cells in stem cell transplantation. To be able to exploit stem cells as therapeutic tool, their defects in some important cellular functions, such as low survival rate and cellular activity, should be considered. This is especially the case for stem cells that are intended for transplantation. Of note, stem cell responses to hormones should be considered since estrogen is known to play a critical role in stem cell behavior. However, different impacts of the estrogen receptor (ER) types α and β have not been fully determined in ASC function. In this study, we investigated effects of ERα and ERβ on ASC proliferation, migration, as well as in adipogenesis. Methods: ASCs obtained from mice were cultured with 100nM ERα or ERβ agonist PPT and DPN, respectively. The ERα and ERβ antagonist ICI 182,780 (100nM) was used as control. Results: Compared to ERβ, ERα appears more potent in improving ASC proliferation and migration. Investigation of adipogenesis revealed that ERβ played a significant role in suppressing ASC-mediated brown tissue adipogenesis which is in contrast to ERα. These results correlated with reduced mRNA expression of UCP-1, PGC-1α and PPAR-γ. Conclusions: ERα plays a more critical role in promoting ASC proliferation and migration while ERβ is more potent in suppressing ASC brown adipose tissue differentiation mediated by decreased UCP-1, PGC-1α and PPAR-γ expression

Lymphocyte counts and percentages in the blood and spleen of mice before and after GC therapy <i>in vivo</i>.

<p>* =  as subpopulation of CD4⁺CD25^high cells.</p><p>‡ =  % out of CD4⁺ cells ± SD.</p