| 1. |
- Spiegelberg, Diana, 1982-
(författare)
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Towards Personalized Cancer Therapy : New Diagnostic Biomarkers and Radiosensitization Strategies
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on the evaluation of biomarkers for radio-immunodiagnostics and radio-immunotherapy and on radiosensitization strategies after HSP90 inhibition, as a step towards more personalized cancer medicine. There is a need to develop new tracers that target cancer-specific biomarkers to improve diagnostic imaging, as well as to combine treatment strategies to potentiate synergistic effects. Special focus has been on the cell surface molecule CD44 and its oncogenic variants, which were found to exhibit unique expression patterns in head and neck squamous cell carcinoma (HNSCC). The variant CD44v6 seems to be a promising target, because it is overexpressed in this cancer type and is associated with radioresistance. Two new radioconjugates that target CD44v6, namely, the Fab fragment AbD15179 and the bivalent fragment AbD19384, were investigated with regard to specificity, biodistribution and imaging performance. Both conjugates were able to efficiently target CD44v6-positive tumors in vitro and in vivo. PET imaging of CD44v6 with 124I-AbD19384 revealed many advantages compared with the clinical standard 18F-FDG. Furthermore, the efficacy of the novel HSP90 inhibitor AT13387 and its potential use in combination with radiation treatment were evaluated. AT13387 proved to be a potent new cancer drug with favorable pharmacokinetics. Synergistic combination effects at clinically relevant drug and radiation doses are promising for both radiation dose reduction and minimization of side effects, or for an improved therapeutic response. The AT13387 investigation indicated that CD44v6 is not dependent on the molecular chaperone HSP90, and therefore, radio-immunotargeting of CD44v6 in combination with the HSP90 inhibitor AT13387 might potentiate treatment outcomes. However, EGFR expression levels did correlate with HSP90 inhibition, and therefore, molecular imaging of EGFR-positive tumors may be used to assess the treatment response to HSP90 inhibitors.In conclusion, these results demonstrate how tumor targeting with radiolabeled vectors and chemotherapeutic compounds can provide more specific and sensitive diagnostic tools and treatment options, which can lead to customized treatment decisions and a functional diagnosis that provides more precise and safer drug prescribing, as well as a more effective treatment for each patient.
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| 2. |
- Abramenkovs, Andris, 1989-
(författare)
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Induction and repair of clustered DNA damage sites after exposure to ionizing radiation
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The mechanisms that maintain genomic stability safeguard cells from constant DNA damage produced by endogenous and external stressors. Therefore, this thesis aimed to specifically address questions regarding the requirement and involvement of DNA repair proteins in the repair of various types of radiation-induced DNA damage.The first aim was to determine whether the phosphorylation of DNA-PKcs, a major kinase involved in non-homologous end joining pathway, can be utilized to score the DNA double-strand break (DSB) content in cells. DNA-PKcs phosphorylated (pDNA-PKcs) at T2609 was more sensitive to the cellular DSB content than ɣH2AX, as analyzed by flow cytometry. Further, pDNA-PKcs at T2609 could discriminate between DSB repair-compromised and normal cells, confirming that the pDNA-PKcs can be used as a DSB repair marker. In paper II, the DSB repair was assessed in cells with reduced levels of DNA-PKcs. The reduction in DNA-PKcs resulted in decreased cell survival and unaffected DSB repair. These results clearly indicate that DNA-PKcs plays an additional role in promoting cell survival in addition to its function in DSB repair.The second part of the thesis focused on the characterization of complex DNA damage. DNA damage was investigated after exposure to α-particles originating from Ra-223. The Ra-223 treatment induced a nonrandom DSB distribution consistent with damage induced by high-linear energy transfer radiation. The exposure to Ra-223 significantly reduced cell survival in monolayers and 3D cell structures. The last paper unraveled the fate of heat-sensitive clustered DNA damage site (HSCS) repair in cells. HSCS repair was independent of DSB repair, and these lesions did not contribute to the generation of additional DSBs during repair. Prolonged heating of DNA at relatively low temperatures induced structural changes in the DNA that contributed to the production of DNA artifacts.In conclusion, these results demonstrate that DNA-PKcs can be used to monitor DSB repair in cells after exposure to ionizing radiation. However, the functions of DNA-PKcs are not limited to DSB repair, as it can promote cell survival through other mechanisms. The complexity of the DNA damage produced by high-LET radiation is a major contributor to cell death. However, not all clusters produced in irradiated cells are converted into DSBs during repair.
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| 3. |
- Bajinskis, Ainars, 1973-
(författare)
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Studies of DNA repair strategies in response to complex DNA damages
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aim of this thesis was to study the role of the indirect actions of γ-rays and α-particles on the complexity of primary DNA damages and the repair fidelity of major DNA repair pathways: non-homologous end joining (NHEJ), homologous recombination repair (HRR) and base excision repair (BER). The complexity of radiation-induced damages increases and the proximity between damages decreases with increasing LET due to formation of ionization clusters along the particle track. The complexity of damages formed can be modified by the free radical scavenger dimethyl sulfoxide (DMSO). In addition, the effects of low doses of low dose rate γ-radiation on cellular response in terms of differentiation were investigated.Paper I investigates the role of the indirect effect of radiation on repair fidelity of HRR, NHEJ and BER when damages of different complexity were induced by radiation or by potassium bromate. We found that potassium bromate induces complex DNA damages through processing of base modifications and that the indirect effect of radiation has a high impact on the NHEJ pathway. Results in paper II confirmed our conclusions in paper I that the indirect effect from both γ-rays and α-particles has an impact on all three repair pathways studied and NHEJ benefits the most when the indirect effect of radiation is removed.In paper III we investigated the effects of low dose/dose rate γ-radiation on the developmental process of neural cells by using cell models for neurons and astrocytes. Our results suggest that low dose/dose rate γ-radiation attenuates differentiation and down-regulates proteins involved in the differentiation process of neural cells by an epigenetic rather than cytotoxic mechanism.
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| 4. |
- Pour Khavari, Ali
(författare)
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Oxidized nucleotides as a predictor of radiation sensitivity
- 2018
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The direct and indirect effects of IR can lead to DNA damage and activation of DNA repair. The indirect effects of ionizing radiation mediated by reactive oxygen species (ROS) which produced through radiolysis of water and if not taken care of by the antioxidant system, can also give rise to oxidative stress. ROS can affect the DNA or RNA directly or indirectly. Directly by causing damage to the DNA/RNA bases present in their structures. Indirectly by causing modifications of the dNTPs and rNTPs which later become incorporated into DNA or RNA. The presence of modified base in RNA seems to be less important as in a cell several thousand RNA transcripts of a gene are available. However, under severe oxidative stress, biological effects of oxidized rNTP or damaged RNA can become important. In the dNTP, one such modification is 8-oxo-dGTP, which can be incorporated in front of an A or a C and lead to mutation during replication. In our previous studies we have shown a correlation between serum/urinary 8-oxo-dG levels and individual radiosensitivity in breast and head and neck cancer patients receiving radiotherapy. We have also shown that a protein called MTH1 hydrolyses 8-oxo-dGTP to 8-oxo-dGMP. 8-Oxo-dGMP becomes dephosphorylated to 8-oxo-dG which can then excrete from the cells to the extracellular milieu. In our recent publication, included in the thesis, we aimed to investigate whether the oxidative stress marker, 8-oxo-dG, is a predictor of tumor response. We used modified ELISA, originally developed at Stockholm University, with a two-step filtration to analyze 8-oxo-dG in serum. The relationship between 8-oxo-dG levels and tumour response was studied in esophageal and gastric cancer patients who received radiotherapy and chemotherapy. In the radiotherapy and the merged radiotherapy and chemotherapy groups, the background levels of serum 8-oxo-dG were significantly lower in responder than in non-responder patients and the increments after treatment were greater. In comparison with patients whose serum 8-oxo-dG levels decrease after treatment, patients with increasing levels had a longer median “progression-free survival”. The results suggest that serum levels of 8-oxo-dG or oxidative stress response in general may potentially be used to predict the sensitivity and outcome of radiotherapy and chemotherapy of upper gastrointestinal tumours. Since the patient cohort is small more investigation is needed to validate the results.In our ongoing project we investigate cytoplasmic extracts from organs of irradiated mice; liver and brain. In this project we are trying to establish working protocols to measure the nucleotide pool imbalance and modifications arising from IR-induced ROS. We look at the possibilities of finding additional nucleotide pool modifications that can be used as stress biomarkers e.g. modified adenosines and other markers. We are establishing an HPLC method for detecting these modifications. Our results so far are that we can quantify the rNTPs, however the dNTPs are more difficult to detect in the cytoplasm isolated from organs. Our results also indicate a trend that inosine levels increase while adenosine decreases by irradiation of mice. For our future studies inosine and adenosine are interesting to investigate. Also the proteins involved in the DNA damage and repair and oxidative stress pathways will be investigated in the liver and brain of irradiated mice.
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| 5. |
- Pour Khavari, Ali, 1985-
(författare)
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Role of oxidative stress response in radiosensitivity
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The quality of the ionizing radiation (IR) can be described in terms of its nature, photons or particles, and their corresponding energies. The energy is classified in terms of High or Low linear energy transfer that will produce a different distribution of DNA damage and other molecules in the cell either by direct action or indirect action. Indirect action leads to the production of reactive oxygen species (ROS) modifying nucleotides in DNA or free dNTPs. 8-oxo-dGTP is formed through ROS endogenously when there is an imbalance between the antioxidants defence systems and the production of ROS levels in favour of ROS, leading to an oxidative stress condition. Organisms, organs, and cell types show different degrees of radiosensitivity, and this thesis aimed to investigate the underlying mechanisms of IR induced oxidative stress and its relation with radiosensitivity.In previous studies, we identified proteins involved in radiation response with a focus on low dose radiation response. Cell models were established in which the expression of some protein/s was downregulated by knocking down/out using CRISPR/Cas9 or shRNA technology. The knockdown or knockout cells were exposed to different doses at low dose rates (LDR) or high dose rate (HDR) to investigate the role of these genes/proteins for survival (radiosensitivity), mutation induction, stress response, differentiation, etc. and they were subjected to further studies in this thesis.Publication I, cell lines with hMTH1, and MYH knockdown were established and exposed to 0.5 and 1 Gy administered at different dose rates. We found that LDR induces significantly increased levels of extracellular 8-oxo-dG compared to HDR. We also found that hMTH1 and MYH play together an important role in the protection of cells against ROS-induced mutagenicity.Publication II, the role of NRF2 was investigated for the radiosensitivity of glioblastoma cancer stem cells (CSCs). The neutrosphere cells from the U87MG cell line were irradiated with three different radiation qualities. The results show that cells exposed to LDR produce significantly higher levels of extracellular 8-oxo-dG compared to HDR and carbon ion irradiated cells. Lower proliferation, self-renewal, and neurosphere formation were observed in both LDR and HDR irradiated NRF2-knockdown cells as compared with the wild type. The results show that NRF2 plays an important role in the radiosensitivity of neurosphere cells isolated from the U87MG cell line.Publication III, we examined the relation between 8-oxo-dG levels and the outcome of radiotherapy and chemotherapy in gastrointestinal cancer patients. The results showed that patients with improved treatment outcomes (responders), had lower levels of the stress marker extracellular 8-oxo-dG before the start of the treatment and the levels were increased 2 weeks after completing the treatment.Publication IV, mice were whole-body irradiated with different doses administered at LDR and HDR. Three hours or three weeks after exposure, the immune cell populations in the spleens were phenotyped. The effects of dose, dose rate, and time after exposure and interaction between them were investigated to check which of the factors had the main effect on the change of immune cell populations. The results indicate that there was a pro-inflammatory short-term effect at high doses for both HDR and LDR. The results also indicate a pro-inflammatory effect of low doses of radiation three weeks after exposure.
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| 6. |
- Gustafsson, Ann-Sofie, 1982-
(författare)
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Radiation response in human cells : DNA damage formation, repair and signaling
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Ionizing radiation induces a range of different DNA lesions. In terms of mutation frequency and mammalian cell survival, the most critical of these lesions is the DNA double-strand break (DSB). DSB left unrepaired or mis-repaired may result in chromosomal aberrations that can lead to permanent genetic changes or cell death. The complexity of the DNA damage and the capacity to repair the DSB will determine the fate of the cell. This thesis focuses on the DNA damage formation, repair and signaling after irradiation of human cells.Radiation with high linear energy transfer (LET) produces clustered damaged sites in the DNA that are difficult for the cell to repair. Within these clustered sites, non-DSB lesions are formed that can be converted into a DSB and add to the damage complexity and affect DSB repair and the measurement. Heat-labile sites in DNA are converted into DSB at elevated temperatures. We show that heat-released DSB are formed post-irradiation with high-LET ions and increase the initial yield of DSB by 30%-40%, which is similar to yields induced by low-LET radiation.DNA-PKcs, a central player in non-homologous end-joining (NHEJ), the major mammalian DSB repair pathway, has been found to be both up- and downregulated in different tumor types. In Paper II we show that low levels of DNA-PKcs lead to extreme radiosensitivity but, surprisingly, had no effect on the DSB repair. However, the fraction of cells in G2/M phase increased two-fold in cells with low levels of DNA-PKcs. The study continued in Paper IV, where cells were synchronized to unmask potential roles of DNA-PKcs in specific cell cycle phases. Irradiation of DNA-PKcs suppressed cells in the G1/S phase caused a delay in cell cycle progression and an increase in accumulation of G2 cells. Further, these cells showed defects in DNA repair, where a significant amount of 53BP1 foci remained after 72 h. This further strengthens the hypothesis that DNA-PKcs has a role in regulation of mitotic progression.Several cellular signaling pathways are initiated in response to radiation. One of these downstream signaling proteins is AKT. We identified an interaction between DNA-PKcs and AKT. Knockouts of both AKT1 and AKT2 impaired DSB rejoining after radiation and low levels of DNA-PKcs increased radiosensitivity and decreased DNA repair further.
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| 7. |
- Häggblad Sahlberg, Sara, 1980-
(författare)
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Colorectal cancer and radiation response : The role of EGFR, AKT and cancer stem cell markers
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The primary treatment for colorectal cancer is surgery. Radiotherapy and chemotherapy, sometimes combined, are also frequently used to diminish recurrence risk. In response to radiation exposure, several cellular signaling cascades are activated to repair DNA breaks, prevent apoptosis and to keep the cells proliferating. Several proteins in the radiation response and cell survival pathways are potential targets to enhance the effects of radiation. The epidermal growth factor receptor (EGFR), which is frequently upregulated in colorectal cancer and exhibits a radiation protective function, is an attractive target for treatment. EGFR is activated by radiation which in turn activates numerous signaling pathways such as the PI3 kinase/AKT cascade, the RAS/RAF/ERK pathway and STAT leading to tumor cell proliferation. EGFR is also believed to interact with proteins in the DNA repair process, such as DNA-PKcs and MRE11. The cytotoxic effect of an affibody molecule (ZEGFR:1907)2, with high affinity to EGFR, in combination with radiation produced a small, but significant, reduction in survival in a KRAS mutated cell line. However, not in the BRAF mutated cell line. The next step was therefore to target proteins downstream of EGFR such as AKT. There was an interaction between AKT and the DNA repair proteins DNA-PKcs and MRE11 and both AKT1 and AKT2 were involved in the radiation response. The knockout of both AKT isoforms impaired the DNA double strand break rejoining after radiation and suppression of DNA-PKcs increased the radiations sensitivity and decreased the DNA repair further. The AKT isoforms also affected the expression of cancer stem cell markers CD133 and CD44 which are associated with the formation of metastasis as well as radiation and drug resistance. The CD133 expression was associated with AKT1 but not AKT2, whereas the CD44 expression was influenced by the presence of either AKT1 or AKT2. AKT was also involved in cell migration, cell-adhesion and metabolism. Overall, these results illustrate the complexity in response to radiation and drugs in cells with different mutations and the need for combining inhibitors against several targets such as EGFR, AKT, DNA-PKcs, CD133 or CD44.
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| 8. |
- Karlsson, Karin, 1977-
(författare)
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Role of Non-Homologous End-Joining in Repair of Radiation-Induced DNA Double-Strand Breaks
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Efficient and correct repair of DNA damage, especially DNA double-strand breaks (DSBs), is vital for the survival of individual cells and organisms. Defects in the DNA repair may lead to cell death or genomic instability and development of cancer. The repair of DSBs in cell lines with different DSB rejoining capabilities was studied after exposure to ionising radiation. A new cell lysis protocol performed at 0ºC, which prevents the inclusion of non-true DSBs in the quantification of DSBs by pulsed-field gel electrophoresis (PFGE), was developed. Results showed that when the standard protocol at 50ºC was used, 30-40% of the initial yield of DSBs corresponds to artifactual DSBs. The lesions transformed to DSBs during incubation at 50ºC were repaired within 60-90 minutes in vivo and the repair was independent of DNA-PK, XRCC1 and PARP-1.Non-homologous end-joining (NHEJ) is the major DSB repair pathway in mammalian cells. We show that DSBs are processed into long single-stranded DNA (ssDNA) ends after ≥1 h of repair in NHEJ deficient cells. The ssDNA was formed outside of the G1 phase of the cell cycle and only in the absence of the NHEJ proteins DNA-PK and DNA Ligase IV/XRCC4. The generation of ssDNA had great influence on the quantification of DSBs by PFGE. The standard protocol caused hybridisation of the ssDNA ends, resulting in overestimation of the DSB repair capability in NHEJ deficient cells.DSBs were also quantified by detection of phosphorylated H2AX (γ-H2AX) foci. A large number of γ-H2AX foci still remaining after 21 h of repair in an NHEJ deficient cell line confirmed the low repair capability determined by PFGE. Furthermore, in normal cells difficulty in repairing clustered breaks was observed as a large fraction of γ-H2AX foci remaining 24 h after irradiation with high-LET ions.
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| 9. |
- Lindgren, Theres
(författare)
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Optimizing experimental radioimmunotherapy : investigating the different mechanisms behind radiation induced cell deaths
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background. Radiation therapy is an important treatment regimen for malignant disease. Radiation therapy uses ionizing radiation to induce DNA damage in tumor cells in order to kill them. Tumor cells are more sensitive than normal cells, since they have an increased proliferation rate and often lack the ability to properly repair the induced damage. Radiation can be delivered by an external source outside the body, by brachytherapy delivered inside the patient near the tumor, or systemically by injection into the blood stream. When delivered systemically, the radiation is administered as radioisotope alone or conjugated to antibodies targeting tumor antigens (radioimmunotherapy). Radiotherapy (RT) usually is administered using high doses, causing necrotic cell death. Low doses of radiation (by RT or RIT) have been observed to induce different types of cell deaths, like apoptosis, mitotic catastrophe or senescence.Aims. We wanted to elucidate the molecular and cellular events responsible for the induction of cell death in cells of different origin and p53 status. We also wanted to identify the kinetics behind gene expression alterations induced in response to irradiation and correlate these to cell death specific molecular and cellular events. In the end this research aims to identify key regulators of the main radiation induced cell death modalities in order to improve our understanding and potentially use this knowledge to increase treatment efficacy of radiation therapy.Methods. Four different cell lines were used in these studies to elucidate the role of p53 status cell origin in radiation induced cell death. HeLa Hep2 tumor cells have been used previously in our group in several RIT and RT studies. During these studies we observed morphological alterations in shrinking tumors that were typical for mitotic catastrophe. This led to studies on the underlying mechanisms causing these aberrations. Isogenic solid tumor cell lines HCT116 p53 +/+ and HCT116 p53 -/- were included to further elucidate the role of p53, and also to study senescence, one of the main outcomes in irradiated tumor cells. MOLT-4 was finally included to compare these finding to classical apoptosis. Gene expression analysis was done using Illumina bead chip arrays, and pathway analysis was performed using MetaCore (Thomson Reuters).Results. In paper I, II, and III, transient G2/M arrests were observed in HeLa Hep2 and HCT116 p53 -/- cells following irradiation. The lack of p53 in these cells caused checkpoint adaptation due to an unscheduled accumulation of genes promoting mitosis. Anaphase bridges were observedivin HeLa Hep2 cells, as a consequence of premature mitotic entry with unrepaired DNA damage. Centrosome amplification, as well as deregulation of genes involved in centrosome amplification and clustering was observed in both cell lines. We observed changes in expression of several genes responsible for maintaining the spindle assembly checkpoint (SAC) arrest. A prolonged SAC arrest has been shown to be important for execution of mitotic catastrophe. SAC activation was followed by mitotic slippage and a subsequent failure of cytokinesis. We observed multipolar mitoses (both cell lines), multiple- and micronuclei (HeLa Hep2, paper I), and an increased frequency of tetraploid cells (HeLa Hep2 and HCT116 p53 -/- cells). A fraction of HeLa Hep2 cells also displayed apoptotic features, including caspase activation and DNA fragmentation (paper I). These findings indicate that mitotic catastrophe and the activation of a delayed type of apoptosis are involved in cell death following RIT.HCT116 p53 +/+ cells induced both G1 and G2 arrest following irradiation (paper III). Gene expression analysis revealed significantly decreased expression of genes responsible for cell cycle progression (pronounced decrease compared to HeLa Hep2 and HCT116 p53 -/-), especially mitotic genes. The prolonged arrest transitioned into senescence starting 3 days following irradiation and peaked after 7 days. Several genes associated with SASP were upregulated in the same time frame as senescence was induced, further supporting the fact that senescence is the main radiation induced response in HCT116 p53 +/+ cells.MOLT-4 cells, similar to HCT116 p53 +/+ cells, induced both G1 and G2 arrests in response to irradiation (paper IV). Morphological studies revealed apoptotic features like shrunken cells with condensed DNA. Caspase assays showed increased activity of caspases -3, -8, and -9. Gene expression analysis confirmed an increased expression of genes important for both extrinsic (FAS and TRAIL) and intrinsic (BAX) apoptosis. Furthermore, changed expression also included genes involved in cell cycle checkpoints and their regulation and genes important for T-cell activation/proliferation.Conclusions. RIT is successfully used to treat lymphoma, but treatment of solid tumors with RIT is still difficult. This thesis elucidates cellular alterations characteristic for the 3 main radiation death modalities, i.e. mitotic catastrophe, senescence and apoptosis. Furthermore, cell death specific traits are correlated to alterations in gene expression. Treatment efficacy can potentially be improved by finding key cell death mediators to inhibit in combination with radiation.
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| 10. |
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