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The thyroid gland is of crucial importance in human metabolism. Its main secretion products, L-thyroxine (T4) and 3,3’,5-triiodo-L-thyronine (T3), are essential for proper development of multiple tissues and organs as well as for their functioning in the adult organism. The secretion of thyroid hormones (TH) is stimulated by thyrotropin (TSH) released from the pituitary gland. This tight connection between both hormones is of crucial importance for the clinical diagnosis of thyroid dysfunction. During the last two decades the concept of TH action developed to increased complexity. However, most of the recent advances in the field of TH research are based either on cell culture, tissue or animal models or stem from studies investigating specific hypotheses in humans. Thus, experimental approaches for the comprehensive, hypothesis-free characterization of metabolic effects of classical and non-classical TH in human are urgently needed. This holds true in particular for the TH derivative 3,5-diiodothyronine (3,5-T2). It was described to alleviate the typical detrimental metabolic consequences of a high-fat diet and even reversed hepatic steatosis. To replicate these experimental findings from rodents in humans, comprehensive data from the population-based Study of Health in Pomerania (SHIP) was analyzed in the present work. Based on a euthyroid, diabetes-free SHIP-subsample (N=761), non-linear associations between the serum concentrations of 3,5-T2 and glucose as well as TSH were detected. In contrast, no significant 3,5-T2 associations with several anthropometric markers or blood lipid parameters were observed, partially questioning the transferability of the beneficial metabolic 3,5-T2 effects reported for pharmacological intervention studies on rodents to humans. Recent advances in technological development now allow for the use of high-throughput spectrometric platforms to characterize the small molecule content (metabolome) of blood and urine samples. The detected metabolome constituents can be associated with any relevant parameters of interest, thereby extending the scope of classical association studies. Therefore, in the second part of the present thesis, the metabolic fingerprints of FT4, TSH as well as the ratio log(TSH)/FT4 as markers of thyroid function were profiled. Strong differences between the metabolic fingerprints of FT4 and TSH were observed, partially alleviated by the log(TSH)/FT4 ratio. These findings not only emphasize the high diagnostic value of the combined evaluation of TSH and FT4 in the assessment of thyroid function but additionally argue for a holistic approach in the diagnosis of thyroid function. More moderate endogenous effects of 3,5-T2 were evaluated by comparing its urinary metabolic fingerprint with that of the classical TH. A number of associations became apparent, indicating a function of endogenous 3,5-T2 in intermediary metabolism. Besides partially confirming associations with respect to the presented findings in animal studies, the strongest 3,5-T2-association was observed with trigonelline, a metabolite described earlier to exhibit similar beneficial effects as 3,5-T2 on glucose metabolism when used as a pharmacological agent in animal studies. An association towards hippurate indicated a partial overlap with the metabolic profile of TSH and hence consolidated results from the first two projects in the sense of a thyromimetic role of 3,5-T2 in the feedback regulation of TH. The diagnosis of thyroid disorders based on the classical markers TSH and FT4 suffers from restricted sensitivity in the subclinical range as both parameters have broad reference ranges in the general population. Therefore, in an approach to detect novel peripheral biomarkers of thyroid function, sixteen healthy young men were challenged with 250 µg of levothyroxine (L-T4) over a period of eight weeks in the fourth project presented here as part of this thesis. Monitoring of the volunteers over a period of sixteen weeks allowed delineation of the metabolic shifts first towards thyrotoxicosis and later in the context of the restoration of euthyroidism. The use of mass spectrometry for the comprehensive characterization of the metabolite as well as the protein content of samples taken at the different time points revealed profound molecular alterations, despite the lack of any clinical symptoms in the volunteers. Molecular signatures of thyrotoxicosis indicated increased energy expenditure, pronounced defense against systemic oxidative stress, a general drop in apolipoproteins, as well as increased abundances of proteins related to the coagulation cascade and the complement system. Good and robust classification of the thyroid state independent of TSH and FT4 was achieved using random forest analysis with a subset of fifteen metabolites and proteins, indicating new options in the individualized diagnosis of thyroid disorders.
In vitro and in vivo analyses of mono- and mixed-species biofilms formed by microbial pathogens
(2022)
Microbial biofilms can be defined as multicellular clusters of microorganisms embedded in a self-produced extracellular matrix (ECM), which is primarily composed of polymeric biomolecules. Biofilms represent one of the most severe burdens in both industry and healthcare worldwide, causing billions of dollars of treatment costs annually because biofilms are inherently difficult to prevent, treat, and eradicate. In health care settings, patients suffering from cystic fibrosis, or patients with medical implants are highly susceptible to biofilm infections. Once a biofilm is formed, it is almost impossible to quantitatively eradicate it by mechanical, enzymatical, chemical, or antimicrobial treatment. Often the only remaining option to fully eradicate the biofilm is removing of the infected implant or body part. The primary reasons for the inherent resistance of biofilms against all forms of antimicrobial treatment are (I) a reduced metabolic activity of biofilm-embedded cells climaxing in the presence of metabolic inactive persister cells, as well as (II) the protective nature of the biofilm matrix acting as a (diffusion) barrier against antimicrobials and the host immune system. Consequently, there is an urgent need to better understand microbial biofilms from a structural and (patho-) physiological point of view in order to be able to develop new treatment strategies.
Therefore, the aims of this study were to investigate fundamental physiological properties of different clinically relevant single and multi-species biofilms, both in vitro and in vivo. Furthermore, the effectiveness of a novel treatment strategy using cold atmospheric pressure plasma was evaluated in vitro to treat biofilms of the pathogenic fungus C. albicans.
In article I, the intracellular and ECM protein inventory of Staphylococcus aureus during in vitro biofilm growth in a flow reactor was analyzed by liquid-chromatography coupled to tandem mass-spectrometry (LC-MS/MS) analysis combined with metabolic footprint analysis. This analysis showed that anaerobiosis within biofilms releases organic acids lowering the ECM pH. This, in turn, leads to protonation of alkaline proteins – mostly ribosomal proteins originating from cell lysis as well as actively secreted virulence factors – resulting in a positive net charge of these proteins. As a consequence, these proteins accumulate within the ECM and form an electrostatic network with negatively charged cell surfaces, eDNA, and metabolites contributing to the overall biofilm stability.
In article II, the in vivo metaproteome of the multi-species biofilm community in cystic fibrosis sputum was investigated. To this end, an innovative protocol was developed allowing the enrichment of microbial cells, the extraction of proteins from a small amount of cystic fibrosis sputum, and subsequent metaproteome analysis. This protocol also allows 16S sequencing, metabolic footprint analysis, and microscopy of the same sample to complement the metaproteome data. Applying this protocol, we were able to significantly enhance microbial protein coverage providing first insights into important physiological pathways during CF lung infection. A key finding was that the arginine deaminase pathway as well as microbial proteases play a so far underappreciated role in CF pathophysiology.
In articles III and IV, a novel treatment strategy for biofilms formed by the important fungal pathogen Candida albicans was evaluated in vitro. Biofilms were treated with two different sources of nonthermal plasma (with the Nonthermal Plasma Jet “kINPen09” as well as with the Microwave-induced plasma torch “MiniMIP”) and the effect on growth, survival, and viability was assessed by counting colony-forming units (CFU), by cell proliferation assays, as well as by live/dead staining combined with fluorescence microscopy, confocal laser scanning microscopy, (CLSM) and atomic force microscopy (AFM). These tests revealed that biofilms were effectively inactivated mostly on the bottom side of biofilms, indicating a great potential of these two plasma sources to fight biofilms.