Skip to main content
Erschienen in: Virchows Archiv 5/2003

01.11.2003 | Original Article

Disruption of the integrity of human peritoneal mesothelium by interleukin-1β and tumor necrosis factor-α

verfasst von: Sylvia Stadlmann, Ruth Raffeiner, Albert Amberger, Raimund Margreiter, Alain Gustave Zeimet, Burkhardt Abendstein, Patrizia Lucia Moser, Gregor Mikuz, Bernd Klosterhalfen, Felix Albert Offner

Erschienen in: Virchows Archiv | Ausgabe 5/2003

Einloggen, um Zugang zu erhalten

Abstract

Inflammatory and neoplastic disease processes of the abdominal cavity are frequently associated with disruption of the integrity of the peritoneal mesothelium. In the present study, we analyzed the effects of the pro-inflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) on the morphology and expression of adhesion molecules of human peritoneal mesothelial cells (HPMC). Treatment of HPMC with IL-1β and TNF-α resulted in a time- and dose-dependent alteration of the normal cobblestone morphology of the mesothelium with loss of polarization, cellular retraction and exposure of the submesothelial matrix. The effect was already observable after 6 h of treatment and was most pronounced at a dose of 10 ng/ml of IL-1β or TNF-α. These morphological alterations were associated with a significant rearrangement of the expression of mesothelial adhesion molecules as detected by flow cytometry. IL-1β and TNF-α both led to a loss of the expression of the hemidesmosomal integrin subunits α6 (P<0.01 and P<0.001) and β4 (P<0.01) and an increased expression of the integrin subunit α5 (P<0.001 and P<0.01). IL-1β furthermore upregulated the expression of the integrin subunits α1, α2 and the adhesion molecule CD44 while the latter was downregulated by TNF-α. Our data indicate that IL-1β and TNF-α may significantly affect disease processes of the abdominal cavity by their potential to disrupt the mesothelial basal cell-matrix adhesion and, thus, the integrity of the peritoneal mesothelial cell lining.
Literatur
1.
Zurück zum Zitat Alt A, Ohba M, Li L, Gartsbein M, Belanger A, Denning MF, Kuroki T, Yuspa SH, Tennenbaum T (2001) Protein kinase C-delta-mediated phosphorylation of alpha6beta4 is associated with reduced integrin localization to the hemidesmosome and decreased keratinocyte attachment. Cancer Res 61:4591–4598PubMed Alt A, Ohba M, Li L, Gartsbein M, Belanger A, Denning MF, Kuroki T, Yuspa SH, Tennenbaum T (2001) Protein kinase C-delta-mediated phosphorylation of alpha6beta4 is associated with reduced integrin localization to the hemidesmosome and decreased keratinocyte attachment. Cancer Res 61:4591–4598PubMed
2.
Zurück zum Zitat Amberger A, Maczek C, Jurgens G, Michaelis D, Schett G, Trieb K, Eberl T, Jindal S, Xu Q, Wick G (1997) Co-expression of ICAM-1, VCAM-1, ELAM-1 and Hsp60 in human arterial and venous endothelial cells in response to cytokines and oxidized low-density lipoproteins. Cell Stress Chaperones 2:94–103PubMed Amberger A, Maczek C, Jurgens G, Michaelis D, Schett G, Trieb K, Eberl T, Jindal S, Xu Q, Wick G (1997) Co-expression of ICAM-1, VCAM-1, ELAM-1 and Hsp60 in human arterial and venous endothelial cells in response to cytokines and oxidized low-density lipoproteins. Cell Stress Chaperones 2:94–103PubMed
3.
Zurück zum Zitat Andreoli SP, Mallett C, Williams K, McAteer JA, Rothlein R, Doerschuk CM (1994) Mechanisms of polymorphonuclear leukocyte mediated peritoneal mesothelial cell injury. Kidney Int 46:1100–1109PubMed Andreoli SP, Mallett C, Williams K, McAteer JA, Rothlein R, Doerschuk CM (1994) Mechanisms of polymorphonuclear leukocyte mediated peritoneal mesothelial cell injury. Kidney Int 46:1100–1109PubMed
4.
Zurück zum Zitat Bittinger F, Schepp C, Brochhausen C, Lehr HA, Otto M, Kohler H, Skarke C, Walgenbach S, Kirkpatrick CJ (1999) Remodeling of peritoneal-like structures by mesothelial cells: its role in peritoneal healing. J Surg Res 82:28–33CrossRefPubMed Bittinger F, Schepp C, Brochhausen C, Lehr HA, Otto M, Kohler H, Skarke C, Walgenbach S, Kirkpatrick CJ (1999) Remodeling of peritoneal-like structures by mesothelial cells: its role in peritoneal healing. J Surg Res 82:28–33CrossRefPubMed
5.
Zurück zum Zitat Borradori L, Sonnenberg A (1999) Structure and function of hemidesmosomes: more than simple adhesion complexes. J Invest Dermatol 112:411–418 Borradori L, Sonnenberg A (1999) Structure and function of hemidesmosomes: more than simple adhesion complexes. J Invest Dermatol 112:411–418
6.
Zurück zum Zitat Cannistra SA, Kansas GS, Niloff J, DeFranzo B, Kim Y, Ottensmeier C (1993) Binding of ovarian cancer cells to peritoneal mesothelium in vitro is partly mediated by CD44. Cancer Res 53:3830–3838PubMed Cannistra SA, Kansas GS, Niloff J, DeFranzo B, Kim Y, Ottensmeier C (1993) Binding of ovarian cancer cells to peritoneal mesothelium in vitro is partly mediated by CD44. Cancer Res 53:3830–3838PubMed
7.
Zurück zum Zitat Carter D, True L, Otis CN (1997) Serous membranes: histology for pathologists. In: Sternberg SS (ed) Lippincott–Raven, New York, pp 2299–2328 Carter D, True L, Otis CN (1997) Serous membranes: histology for pathologists. In: Sternberg SS (ed) Lippincott–Raven, New York, pp 2299–2328
8.
Zurück zum Zitat Casey RC, Burleson KM, Skubitz KM, Pambuccian SE, Oegema TR Jr, Ruff LE, Skubitz AP (2001) Beta 1-integrins regulate the formation and adhesion of ovarian carcinoma multicellular spheroids. Am J Pathol 159:2071–2080PubMed Casey RC, Burleson KM, Skubitz KM, Pambuccian SE, Oegema TR Jr, Ruff LE, Skubitz AP (2001) Beta 1-integrins regulate the formation and adhesion of ovarian carcinoma multicellular spheroids. Am J Pathol 159:2071–2080PubMed
9.
Zurück zum Zitat Cronauer MV, Stadlmann S, Klocker H, Abendstein B, Eder IE, Rogatsch H, Zeimet AG, Marth C, Offner FA (1999) Basic fibroblast growth factor synthesis by human peritoneal mesothelial cells. Am J Pathol 155:1977–1984PubMed Cronauer MV, Stadlmann S, Klocker H, Abendstein B, Eder IE, Rogatsch H, Zeimet AG, Marth C, Offner FA (1999) Basic fibroblast growth factor synthesis by human peritoneal mesothelial cells. Am J Pathol 155:1977–1984PubMed
10.
Zurück zum Zitat Dowling J, Yu QC, Fuchs E (1996) Beta4 integrin is required for hemidesmosome formation, cell adhesion and cell survival. J Cell Biol 134:559–572PubMed Dowling J, Yu QC, Fuchs E (1996) Beta4 integrin is required for hemidesmosome formation, cell adhesion and cell survival. J Cell Biol 134:559–572PubMed
12.
Zurück zum Zitat Goodison S, Urquidi V, Tarin D (1999). CD44 cell adhesion molecules. Mol Pathol 52:189–196PubMed Goodison S, Urquidi V, Tarin D (1999). CD44 cell adhesion molecules. Mol Pathol 52:189–196PubMed
13.
Zurück zum Zitat Hosono J, Narita T, Kimura N, Sato M, Nakashio T, Kasai Y, Nonami T, Nakao A, Takagi H, Kannagi R (1998) Involvement of adhesion molecules in metastasis of SW1990, human pancreatic cancer cells. J Surg Oncol 67:77–84CrossRefPubMed Hosono J, Narita T, Kimura N, Sato M, Nakashio T, Kasai Y, Nonami T, Nakao A, Takagi H, Kannagi R (1998) Involvement of adhesion molecules in metastasis of SW1990, human pancreatic cancer cells. J Surg Oncol 67:77–84CrossRefPubMed
14.
Zurück zum Zitat Ikubo A, Morisaki T, Katano M, Kitsuki H, Anan K, Uchiyama A, Tanaka M, Torisu M (1995) A possible role of TGF-beta in the formation of malignant effusions. Clin Immunol Immunopathol 77:27–32PubMed Ikubo A, Morisaki T, Katano M, Kitsuki H, Anan K, Uchiyama A, Tanaka M, Torisu M (1995) A possible role of TGF-beta in the formation of malignant effusions. Clin Immunol Immunopathol 77:27–32PubMed
15.
Zurück zum Zitat Klaus A, Margreiter R, Pernthaler H, Klima G, Offner FA (2003) Diffuse mesenterial sclerosis: a characteristic feature of chronic small-bowel allograft rejection. Virchows Arch 442:48–55PubMed Klaus A, Margreiter R, Pernthaler H, Klima G, Offner FA (2003) Diffuse mesenterial sclerosis: a characteristic feature of chronic small-bowel allograft rejection. Virchows Arch 442:48–55PubMed
16.
Zurück zum Zitat Kutteh WH, Kutteh CC (1992) Quantitation of tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 in the effusions of ovarian epithelial neoplasms. Am J Obstet Gynecol 167:1864–1869PubMed Kutteh WH, Kutteh CC (1992) Quantitation of tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 in the effusions of ovarian epithelial neoplasms. Am J Obstet Gynecol 167:1864–1869PubMed
17.
Zurück zum Zitat Lessan K, Aguiar DJ, Oegema T, Siebenson L, Skubitz AP (1999) CD44 and beta1 integrin mediate ovarian carcinoma cell adhesion to peritoneal mesothelial cells. Am J Pathol 154:1525–1537PubMed Lessan K, Aguiar DJ, Oegema T, Siebenson L, Skubitz AP (1999) CD44 and beta1 integrin mediate ovarian carcinoma cell adhesion to peritoneal mesothelial cells. Am J Pathol 154:1525–1537PubMed
18.
Zurück zum Zitat Li FK, Davenport A, Robson RL, Loetscher P, Rothlein R, Williams JD, Topley N (1998) Leukocyte migration across human peritoneal mesothelial cells is dependent on directed chemokine secretion and ICAM-1 expression. Kidney Int 54:2170–2183CrossRefPubMed Li FK, Davenport A, Robson RL, Loetscher P, Rothlein R, Williams JD, Topley N (1998) Leukocyte migration across human peritoneal mesothelial cells is dependent on directed chemokine secretion and ICAM-1 expression. Kidney Int 54:2170–2183CrossRefPubMed
19.
Zurück zum Zitat Mandl-Weber S, Cohen CD, Haslinger B, Kretzler M, Sitter T (2002) Vascular endothelial growth factor production and regulation in human peritoneal mesothelial cells. Kidney Int 61:570–578CrossRefPubMed Mandl-Weber S, Cohen CD, Haslinger B, Kretzler M, Sitter T (2002) Vascular endothelial growth factor production and regulation in human peritoneal mesothelial cells. Kidney Int 61:570–578CrossRefPubMed
20.
Zurück zum Zitat Margetts PJ, Kolb M, Yu L, Hoff CM, Holmes CJ, Anthony DC, Gauldie J (2002) Inflammatory cytokines, angiogenesis, and fibrosis in the rat peritoneum. Am J Pathol 160:2285–2294PubMed Margetts PJ, Kolb M, Yu L, Hoff CM, Holmes CJ, Anthony DC, Gauldie J (2002) Inflammatory cytokines, angiogenesis, and fibrosis in the rat peritoneum. Am J Pathol 160:2285–2294PubMed
21.
Zurück zum Zitat Nagy JA, Morgan ES, Herzberg KT, Manseau EJ, Dvorak AM, Dvorak HF (1995) Pathogenesis of ascites tumor growth: angiogenesis, vascular remodeling and stroma formation in the peritoneal lining. Cancer Res 55:376–385PubMed Nagy JA, Morgan ES, Herzberg KT, Manseau EJ, Dvorak AM, Dvorak HF (1995) Pathogenesis of ascites tumor growth: angiogenesis, vascular remodeling and stroma formation in the peritoneal lining. Cancer Res 55:376–385PubMed
22.
Zurück zum Zitat Nicoletti I, Migliorati G, Pagliacci MC, Grignani F, Riccardi C (1991) A rapid and simple method for measuring thymocyte apoptosis by propidium iodide staining and flow cytometry. J Immunol Methods 139:271–279PubMed Nicoletti I, Migliorati G, Pagliacci MC, Grignani F, Riccardi C (1991) A rapid and simple method for measuring thymocyte apoptosis by propidium iodide staining and flow cytometry. J Immunol Methods 139:271–279PubMed
23.
Zurück zum Zitat Nishimura S, Chung YS, Yashiro M, Inoue T, Sowa M (1996) CD44H plays an important role in peritoneal dissemination of scirrhous gastric cancer cells. Jpn J Cancer Res 87:1235–1244PubMed Nishimura S, Chung YS, Yashiro M, Inoue T, Sowa M (1996) CD44H plays an important role in peritoneal dissemination of scirrhous gastric cancer cells. Jpn J Cancer Res 87:1235–1244PubMed
24.
Zurück zum Zitat Offner FA, Obrist P, Stadlmann S, Feichtinger H, Klingler P, Herold M, Zwierzina H, Hittmair A, Mikuz G, Abendstein B, Zeimet A, Marth C (1995) IL-6 secretion by human peritoneal mesothelial and ovarian cancer cells. Cytokine 7:542–547CrossRefPubMed Offner FA, Obrist P, Stadlmann S, Feichtinger H, Klingler P, Herold M, Zwierzina H, Hittmair A, Mikuz G, Abendstein B, Zeimet A, Marth C (1995) IL-6 secretion by human peritoneal mesothelial and ovarian cancer cells. Cytokine 7:542–547CrossRefPubMed
25.
Zurück zum Zitat Offner FA, Feichtinger H, Stadlmann S, Obrist P, Marth C, Klingler P, Grage B, Schmahl M, Knabbe C (1996) Transforming growth factor-β synthesis by human peritoneal mesothelial cells. Induction by interleukin-1. Am J Pathol 148:1679–1688PubMed Offner FA, Feichtinger H, Stadlmann S, Obrist P, Marth C, Klingler P, Grage B, Schmahl M, Knabbe C (1996) Transforming growth factor-β synthesis by human peritoneal mesothelial cells. Induction by interleukin-1. Am J Pathol 148:1679–1688PubMed
26.
Zurück zum Zitat Propst T, Propst A, Herold M, Schauer G, Judmaier G, Braunsteiner H, Stoffler G, Vogel W (1993) Spontaneous bacterial peritonitis is associated with high levels of interleukin-6 and its secondary mediators in ascitic fluid. Eur J Clin Invest 23:832–836PubMed Propst T, Propst A, Herold M, Schauer G, Judmaier G, Braunsteiner H, Stoffler G, Vogel W (1993) Spontaneous bacterial peritonitis is associated with high levels of interleukin-6 and its secondary mediators in ascitic fluid. Eur J Clin Invest 23:832–836PubMed
27.
Zurück zum Zitat Runyon BA, Hillebrand DJ (1998) Surgical peritonitis and other diseases of the peritoneum, mesentery, momentum, and diaphragm. In: Feldman M, Scharschmidt BF, Sleisenger MH (eds) Gastrointestinal and liver disease. Pathophysiology, diagnosis, management. Saunders, Philadelphia, pp 2035–2046 Runyon BA, Hillebrand DJ (1998) Surgical peritonitis and other diseases of the peritoneum, mesentery, momentum, and diaphragm. In: Feldman M, Scharschmidt BF, Sleisenger MH (eds) Gastrointestinal and liver disease. Pathophysiology, diagnosis, management. Saunders, Philadelphia, pp 2035–2046
28.
Zurück zum Zitat Ruoslahti E, Vaheri A (1997). Cell-to-cell contact and extracellular matrix. Curr Opin Cell Biol 9:605–607CrossRefPubMed Ruoslahti E, Vaheri A (1997). Cell-to-cell contact and extracellular matrix. Curr Opin Cell Biol 9:605–607CrossRefPubMed
29.
Zurück zum Zitat Sachs L (1997) Angewandte statistik. In: Sachs L (ed) Anwendung statistischer methoden. Springer, Berlin Heidelberg New York, pp 335–337 Sachs L (1997) Angewandte statistik. In: Sachs L (ed) Anwendung statistischer methoden. Springer, Berlin Heidelberg New York, pp 335–337
30.
Zurück zum Zitat Skubitz AP, Bast RCJr, Wayner EA, Letourneau PC, Wilke MS (1996) Expression of alpha 6 and beta 4 integrins in serous ovarian carcinoma correlates with expression of the basement membrane protein laminin. Am J Pathol 148:1445–1461PubMed Skubitz AP, Bast RCJr, Wayner EA, Letourneau PC, Wilke MS (1996) Expression of alpha 6 and beta 4 integrins in serous ovarian carcinoma correlates with expression of the basement membrane protein laminin. Am J Pathol 148:1445–1461PubMed
31.
Zurück zum Zitat Sriram PS, Mohammed KA, Nasreen N, Hardwick J, Van Horn R, Sanders K, Antony VB (2002) Adherence of ovarian cancer cells induces pleural mesothelial cell (PMC) permeability. Oncol Res 13:79–85PubMed Sriram PS, Mohammed KA, Nasreen N, Hardwick J, Van Horn R, Sanders K, Antony VB (2002) Adherence of ovarian cancer cells induces pleural mesothelial cell (PMC) permeability. Oncol Res 13:79–85PubMed
32.
Zurück zum Zitat Strobel T, Cannistra SA (1999) Beta1-integrins partly mediate binding of ovarian cancer cells to peritoneal mesothelium in vitro. Gynecol Oncol 73:362–367CrossRefPubMed Strobel T, Cannistra SA (1999) Beta1-integrins partly mediate binding of ovarian cancer cells to peritoneal mesothelium in vitro. Gynecol Oncol 73:362–367CrossRefPubMed
33.
Zurück zum Zitat Tietze L, Borntraeger J, Klosterhalfen B, Amo-Takyi B, Handt S, Gunther K, Merkelbach-Bruse S (1999) Expression and function of beta(1) and beta(3) integrins of human mesothelial cells in vitro. Exp Mol Pathol 66:131–139CrossRefPubMed Tietze L, Borntraeger J, Klosterhalfen B, Amo-Takyi B, Handt S, Gunther K, Merkelbach-Bruse S (1999) Expression and function of beta(1) and beta(3) integrins of human mesothelial cells in vitro. Exp Mol Pathol 66:131–139CrossRefPubMed
34.
Zurück zum Zitat Topley N (1995) The cytokine network controlling peritoneal inflammation. Perit Dial Int 15:35–40 Topley N (1995) The cytokine network controlling peritoneal inflammation. Perit Dial Int 15:35–40
35.
Zurück zum Zitat Topley N, Joerres A, Luttmann W, Petersen MM, Lang J, Thierauch KH, Muller C, Coles GA, Davies M, Williams JD (1993) Human peritoneal mesothelial cells synthesize interleukin-6: induction by IL-1β and TNFα. Kidney Int 43:226–233 Topley N, Joerres A, Luttmann W, Petersen MM, Lang J, Thierauch KH, Muller C, Coles GA, Davies M, Williams JD (1993) Human peritoneal mesothelial cells synthesize interleukin-6: induction by IL-1β and TNFα. Kidney Int 43:226–233
36.
Zurück zum Zitat Topley N, Brown Z, Joerres A, Westwick J, Davies M, Coles GA, Williams JD (1993) Human peritoneal mesothelial cells synthesize interleukin-8: synergistic induction by interleukin-1 beta and tumor necrosis factor-alpha. Am J Pathol 142:1876–1886 Topley N, Brown Z, Joerres A, Westwick J, Davies M, Coles GA, Williams JD (1993) Human peritoneal mesothelial cells synthesize interleukin-8: synergistic induction by interleukin-1 beta and tumor necrosis factor-alpha. Am J Pathol 142:1876–1886
37.
Zurück zum Zitat Van Rossen ME, Hofland LJ, van den Tol MP, van Koetsveld PM, Jeekel J, Marquet RL, van Eijck CH (2001) Effect of inflammatory cytokines and growth factors on tumour cell adhesion to the peritoneum. J Pathol 193:530–537CrossRefPubMed Van Rossen ME, Hofland LJ, van den Tol MP, van Koetsveld PM, Jeekel J, Marquet RL, van Eijck CH (2001) Effect of inflammatory cytokines and growth factors on tumour cell adhesion to the peritoneum. J Pathol 193:530–537CrossRefPubMed
38.
Zurück zum Zitat Volz J, Volz-Koster S, Kanis S, Klee D, Ahlert C, Melchert F (2000) Modulation of tumor-induced lethality after pneumoperitoneum in a mouse model. Cancer 89:262–266CrossRefPubMed Volz J, Volz-Koster S, Kanis S, Klee D, Ahlert C, Melchert F (2000) Modulation of tumor-induced lethality after pneumoperitoneum in a mouse model. Cancer 89:262–266CrossRefPubMed
39.
Zurück zum Zitat Whitaker D, Papadimitriou J (1985) Mesothelial healing: morphological and kinetic investigations. J Pathol 145:159–175PubMed Whitaker D, Papadimitriou J (1985) Mesothelial healing: morphological and kinetic investigations. J Pathol 145:159–175PubMed
40.
Zurück zum Zitat Witz CA, Montoya-Rodriguez IA, Miller DM, Schneider BG, Schenken RS (1998) Mesothelium expression of integrins in vivo and in vitro. J Soc Gynecol Invest 5:87–93CrossRef Witz CA, Montoya-Rodriguez IA, Miller DM, Schneider BG, Schenken RS (1998) Mesothelium expression of integrins in vivo and in vitro. J Soc Gynecol Invest 5:87–93CrossRef
41.
Zurück zum Zitat Zeimet AG, Widschwendter M, Knabbe C, Fuchs D, Herold M, Muller-Holzner E, Daxenbichler G, Offner FA, Dapunt O, Marth C (1998) Ascitic interleukin-12 is an independent prognostic factor in ovarian cancer. J Clin Oncol 16:1861–1868PubMed Zeimet AG, Widschwendter M, Knabbe C, Fuchs D, Herold M, Muller-Holzner E, Daxenbichler G, Offner FA, Dapunt O, Marth C (1998) Ascitic interleukin-12 is an independent prognostic factor in ovarian cancer. J Clin Oncol 16:1861–1868PubMed
Metadaten
Titel
Disruption of the integrity of human peritoneal mesothelium by interleukin-1β and tumor necrosis factor-α
verfasst von
Sylvia Stadlmann
Ruth Raffeiner
Albert Amberger
Raimund Margreiter
Alain Gustave Zeimet
Burkhardt Abendstein
Patrizia Lucia Moser
Gregor Mikuz
Bernd Klosterhalfen
Felix Albert Offner
Publikationsdatum
01.11.2003
Verlag
Springer-Verlag
Erschienen in
Virchows Archiv / Ausgabe 5/2003
Print ISSN: 0945-6317
Elektronische ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-003-0867-2

Weitere Artikel der Ausgabe 5/2003

Virchows Archiv 5/2003 Zur Ausgabe

Neu im Fachgebiet Pathologie

Molekularpathologische Untersuchungen im Wandel der Zeit

Open Access Biomarker Leitthema

Um auch an kleinen Gewebeproben zuverlässige und reproduzierbare Ergebnisse zu gewährleisten ist eine strenge Qualitätskontrolle in jedem Schritt des Arbeitsablaufs erforderlich. Eine nicht ordnungsgemäße Prüfung oder Behandlung des …

Vergleichende Pathologie in der onkologischen Forschung

Pathologie Leitthema

Die vergleichende experimentelle Pathologie („comparative experimental pathology“) ist ein Fachbereich an der Schnittstelle von Human- und Veterinärmedizin. Sie widmet sich der vergleichenden Erforschung von Gemeinsamkeiten und Unterschieden von …

Gastrointestinale Stromatumoren

Open Access GIST CME-Artikel

Gastrointestinale Stromatumoren (GIST) stellen seit über 20 Jahren ein Paradigma für die zielgerichtete Therapie mit Tyrosinkinaseinhibitoren dar. Eine elementare Voraussetzung für eine mögliche neoadjuvante oder adjuvante Behandlung bei …

Personalisierte Medizin in der Onkologie

Aufgrund des erheblichen technologischen Fortschritts in der molekularen und genetischen Diagnostik sowie zunehmender Erkenntnisse über die molekulare Pathogenese von Krankheiten hat in den letzten zwei Jahrzehnten ein grundlegender …