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Cancer associated fibroblasts and tumor cells: a diabolic cross-talk driving cancer progression Prof. Dr. rer.nat. Gerhard Unteregger Clinic of Urology Saarland University Medical Center Homburg/Saar - Germany * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 1 Tumor: A never healing wound ?! * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Crosstalk: Not restricted to malignant tissue! * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 3 Crosstalk: Not restricted to malignant tissue! • • • Bell et al., J. Invest. Dermatol. 1983: „The reconstitution of living skin.“ Keratinocytes Mackenzie & Fusenig, J. Invest. Dermatol.,1983: “Regeneration of organized epithelial structure.” Asselineau & Prunieras, Brit. J. Dermatol., 1984: “Reconstruction of simplified skin: control of fabrication.” Air-exposed +/- Ca2+ Collagen I Medium Collagen I gel with fibroblasts * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 4 The complex composition within the prostate tissue ...but the microevironment appears to be a little bit more complex! epithelial cells basal cells luminal cells transit amplifying cells stem cells neuroendocrine cells stroma cells fibroblats myofibroblasts endothelial (progenitor) cells macrophages Extracellular Matrix epithelial – mesenchymal transitions mesenchymal – epithelial transitions mesenchymal – mesenchymal transitions There is a strong communication within this network: = Co-evolution? * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 5 Fibroblasts as Co-factors in Prostate Development and Cancer Fibroblasts are critical determinants in prostatic cancer growth and Dissemination. Chung LW Cancer Metastasis Rev. 1991 Oct; 10(3): 263-74 Stroma and Epithelial cells determine by paracrine interaction normal and malignant development! * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 6 Epithelial cells and Fibroblasts in Prostate Stroma Normal Prostate Gland Basal Cells Invasive Prostate Cancer Especially Basal Cells are in close contact to the stroma compartment * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 7 Receptors enables a permanent dynamic non-diabolic cross-talk * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Cancer associated fibroblasts and tumor cells: a diabolic cross-talk driving cancer progression We focus on Cancer Associated Fibroblasts (CAF) : Are they a specific cell type or only a phenotype? • Where do they come from? • Charcterization by phenotype? • Characterization by function? * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Origins of CAF – some ideas P. Cirri & P. Chiarugi: AmCancRes 2011; 1(4);482-497 * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Origins of CAF – some more ideas Otranto et al. Cell Adesion & Migration 2012: 6:3; 203-219 Changes in the ECM stiffness * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 11 Feed-back-loop enables a co-evolution of CAF and Cancer cells P. Cirri & P. Chiarugi: AmCancRes 2011; 1(4);482-497 ECM-remodelling: Stiffness of ECM = Mechanical stress! * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Niche-to-niche migration of BM and tumor cells. The transit of BM and tumor cells from their respective niches is a multidirectional pathway. Hematopoietic cells are mobilized from the BM niche in response to tumor-secreted chemokines and subsequently home to both the primary tumor microenvironment and peripheral niches. BMDCs homing to the primary tumor niche may remain in an undifferentiated state in the form of HPCs, EPCs, MSCs, or GR-1+ CD11b+ MDSCs; or may differentiate into more specialized cell types including TAMs. Early BMDCs in transit to premetastatic peripheral niches likely possess an undifferentiated status as HPCs or myeloid-precursor cells, and at later stages involve homing of EPCs. Metastasizing tumor cells subsequently travel to peripheral niches occupied by BMDCs. Wels et al. Migratory neighbors and distant invaders: tumor-associated niche cells. GENES DEVELOP. 2008 * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Fibroblasts as Co-factors in Prostate Development and Cancer Microenvironment as a pivotal co-factor was described a lot of years ago… Reconstituted basement membrane promotes morphological and functional differentiation of primary human prostatic epithelial cells. Fong CJ et al. Prostate 1991; 19(3):221-35 Acceleration of Human Prostate Cancer Growth in Vivo by Factors Produced by Prostate and Bone Fibroblasts. Gleave M et al. Cancer Research 1991; 51: 3733-3761 Growth of an androgen-sensitive human prostate cancer cell line, LNCaP, in nude mice. Lim et al. Prostate 1993; 22(2): 109-118 Regulation of prostate-specific antigen gene expression in LNCaP human prostatic carcinoma cells by growth, dihydrotestosterone, and extracellular matrix. Guo Y et al. Prostate 1994; 24(1):1-10 Prostate epithelial differentiation is dictated by its surrounding stroma. Chung LW and Davies R. Mol Biol Rep. 1996; 23(1):13-19 * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 14 Cancer associated fibroblasts and tumor cells: a diabolic cross-talk driving cancer progression Cancer Associated Fibroblasts (CAF) : Where do they come from? • • • • • Resident within the tumor/organ Phenotypic switch into Myofibroblasts EMT and MMT contribute to phenotypical changes Circulating cells of different origin will contribute,too Disclosure of the nature and origin remains a challenge * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Cancer associated fibroblasts and tumor cells: a diabolic cross-talk driving cancer progression We focus on Cancer Associated Fibroblasts (CAF) : Are they a specific cell type or only a phenotype? • Where do they come from? • Charcterization by phenotype • Characterization by function? * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* „Phenotypic Characterization of CAF´S“ D Wever O. et al. Int. J. Cancer 2008;129: 2229-2231 A Challenge! * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 17 Fibroblasts as Co-factors in Prostate Development and Cancer Strategies to disclose phenotype and function! “Cancer –associated-Fibroblasts CAF”: Are they really defined? How they are defined? How they are prepared? Distance beetwen tumor-epithelial cells: 50-100-200-500μm ? • By isolation of “fibroblasts ” from TUR (normal) and Prostatectomy (CAF) using digestion (SH Lang, M. Stower and NJ Maitland, Br.J. Cancer (2000) 82(4), 990-997 • Immortalization of NAF and CAF by hTERT N. Paland et al. Mol Canc Res (2009) 7(8), 1212-1223 • Embryonic rat urogenital sinus mesenchyme (UGM) K. Ishii et al. Endocrine-Related Cancer (2009) 16, 415-428 • NAF and CAF from BPH and Prostatectomy using digestion – activated by TGF-ß E. Giannoni et al. CancRes (2010) 70(17), 6945-6956 • Isolation of CAF and NAF and outgrowth as explants using selective media and coatings D.Peehl and R. Sellers Prostate (2000) 45, 115-123 • Isolation from explants and characterization by IC (Vimentin, SMC, CD90) J.A. Tuxhorn ClinCancRes (2002) 8, 2912 -2923 • Isolation from histological examined regions*, digestion, centrifugation, MACS and FACS analysis! L.E. Pascal et al. BMC Cancer (2009) 9, 317 * parallel sections were examined additionally! Conclusions: Most NAF/CAF were not comprehensively characterized * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 18 Strategies to disclose the role of “Cancer associated fibroblasts” in tumor development and progression: Fibroblasts as Modulators in Primary Cell Cultures of Prostatic Carcinoma Selection toward diploid cells in prostatic carcinoma derived cell cultures. Ketter R. et al. Prostate 1996; 28(6): 365-71. A new serial transfer explant cell culture system for human prostatic cancer tissues preventing selection toward diploid cells. Zwergel Th. et al. Cancer Genet. Cytogenet. 1998; 101 (1): 16-22 Origin of our „CAF“ used in these experiments: Selection of outgrowing cells from patients specimens after Prostatectomy: Examination by an experienced Pathologist and by parallel histological analysis – * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 19 Strategies to disclose the role of “Cancer associated fibroblasts” in tumor development and progression The most important question considering the experimental design: Different strategies for NAF/CAF preparation Isolation of stroma by LCM Isolation of living cells* Only descriptive Alignment to Histology Contamination Heterogeneous Selection Functional analysis Changes in gene expression Genetic modification Really „CAF?“ But: Really „CAF?“ * Stability of phenotype and function in vitro? * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 20 Strategies to disclose the role of “Cancer associated fibroblasts” in tumor development and progression Recovery of epithelial cells and fibroblasts w/o digestion by selective outgrowth using coating and specific media Primary cell culture forming a monolayer Epithelial cells Primary cell culture forming a monolayer CAF/ NAF fibroblasts Particle * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 21 „Phenotypic Characterization of CAF´S“ * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 22 miRNA-pattern as markers for CAF? Microarray analysis; comparison of microRNA expressionpatterns of fibroblasts from invasive tumour, normal urothelial tissue fibroblasts and foreskin fibroblasts as control. Red high regulation; green low Regulation.* *Specific protein and miRNA patterns characterise tumour-associated fibroblasts in bladder cancer Astrid Enkelmann … Kerstin Junker J Cancer Res Clin Oncol (2011) 137:751–759 * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* The long way from normal prostate development to CRPC Changes in the behavior, function and localisation of Prostate Epithelial (Cancer) Cells are under control of T/DHT and AR (and several other factors) and triggered by the environment. Differentiation Proliferation Invasion Survival* Extravasation (vessel) Organrestricted PrCa Association w. Macrophages Embolies 2nd Tumor+ (bone) Attachment Proliferation Stem cells? AR+ Invasion MMP`s MET *as circulating tumor cells + Metastasis Detachment Migration MMP`s EMT * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 24 Co-cultivation systems (6-24 well systems) Cells are cultivated in the membrane insert (top) and/or bottom of a corresponding plate Sekretom cell type 1 membrane cell type 1 cell type 2 cell type 2 Sekretom Important: Not easy to discriminate the origin of secretom! Functional analysis is more convenient Standard assays (e.g. WST) can be adapted Microscopic examination difficult * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 25 Verification of CAF-mediated functions Co-culture as one tool to proof CAF-TC crosstalk Lang&Maitland Lang +/- conditioned Medium LNCaP Stroma PC-3 bPS+/tPS CI-Gel Stroma enhances Proliferation of Tumor cells (XTT) * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* *Norman Maitland attending our annual AuF Meeting - Berlin 2012 Changes from “normal” to “activated” fibroblasts by Genom Function Influence on Production of Proliferation Migration Invasion EMT AR-Activation Stemness Cytokines SDF Growth factors = Secretome Genotyping - Epigenetic – Phenotype CGH Methylation * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* SMA 27 Crosstalk within a tumor region * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 28 Changes from “normal” to “activated” fibroblasts Lang&Maitland (2000) Function PETMembrane 0.4µm +/- conditioned Medium LNCaP Stroma (fibroblasts) influence of normal and cancer-associated fibroblasts on the Influence on Differential growth of human epithelial cells in an in vitro cocultivation model of prostate cancer. Proliferation Paland N, et al. Mol Cancer Res. 2009 7(8) Migration Invasion EMT AR-Activation Bhowmick NA, Hayward SW. Cancer Res. 2011 71(4): Altered TGF-β signaling in a subpopulation of human stromal cells promotes prostatic carcinogenesis. Franco OE, Jiang M, Strand DW, Peacock J, Fernandez S, Jackson RS 2nd, Revelo MP, The Gene Expression Program of Prostate Fibroblast Senescence Modulates Neoplastic Epithelial Cell Proliferation trough Paracrine Mechanisms. : Bavikl et al. Cancer Res. 2006 66(2) * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 29 Changes from “normal” to “activated” fibroblasts Tumor samples (Prostatectomy) PET-Insert Medium Membrane 8 µm Function Matrigel Tumor Spheroids Compan.plate Matrigel Collagen I Collagen I Fibroblasts (CAF) Replaced by SDF1 Influence on Proliferation Migration Invasion CAFas attractant EMT AR-Activation Same using SDF1 30 * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* Mechanisms of invasion: Movement and enyzm activities Function Prostate Stromal Cell-Derived Hepatocyte Growth Factor Induces invasion of Prostate Cancer Cell Line DU-145 through Tumor-Stromal Interaction. K. Nishimura et al. Prostate 1999; 41. Stromal-epithelial interactions influence prostate cancer cell invasion by altering the Balance of metallopeptidase expression. LA Dawson et al. Br J Cancer 2004; 90. Influence on Proliferationn Migration Invasion EMT AR-Activation Regulation of migration of primary prostate epithelial cells by secreted factors from prostate stromal cells. X. You et al. Experimental Cell Res. 2003; 288. Stromal myofibroblasts are drivers of invasive cancer growth. O. De Wever et al. Int J Cancer 2008; 123. Estrogens Promote Invasion of Prostate Cancer Cells in a Paracrine Manner through Up-Regulation of Matrix Metalloproteinase 2 in Prostatic Stromal Cells. L.Yu et al. Endocrinology 2011; 152. * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 31 EMT = Epithelial-Mesenchymal-Transition Temporary shift in differentiation allowing enhanced mobility * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 32 Crosstalk's between Tumor cells and Microenvironment Considering the “Secretome” +ECM! O.E. Franco et al. (2010): Cancer associated fibroblasts in cancer pathogenesis. SemCell&DevelopBiol * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 33 Fibroblast derived Factors inducing EMT* TGF-ß oxidative stress HIF-1α ROS Wnt//ß-Cat KGF HGF * Acquisition of metastatic and aggressive phenotypes: Mesenchymal morphology Resistance to drugs , stress and anoikis Enhanced migratory and invasive properties Inhibition of senescence Immunosuppression Metastasis Update: Human Prostate Carcinoma Invasion via Tubulogenesis. Nagle RB, Cress AE. Prostate Cancer. 2011;2011:249290. Epub 2011 Jun 21. Department of Pathology, The Arizona Cancer Center, The University of Arizona, Tucson, AZ 85724, USA. Abstract This paper proposes that human prostate carcinoma primarily invades as a cohesive cell collective through a mechanism similar to embryonic tubulogenesis, instead of the popular epithelial-mesenchymal transformation (EMT) model. Evidence supporting a tubulogenesis model is presented, along with suggestions for additional research. Additionally, observations documenting cell adhesion molecule changes in tissue and stromal components are reviewed, allowing for comparisons between the current branching morphogenesis models and the tubulogenesis model. Finally, the implications of this model on prevailing views of therapeutic and diagnostic strategies for aggressive prostatic disease are considered. * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 34 What is the best technology to characterize the environment completely? Proteomic analysis of primary colon cancer-associated fibroblasts using the SELDI-ProteinChip platform. Z. Wang et al. Biomedicine & Biotechnology. 2012 13(3). FAP only weak expressed SMA overexpressed in 4/6 samples 3 “new” proteins: FMRFamide related peptides, ILG-II, Thyß-4-like protein Identification of stromally expressed molecules in the prostate by tag-profiling of cancer-associated fibroblasts, normal fibroblasts and fetal prostate. B Orr1 et al. Oncogene (2012) 31, 671 transcripts enriched in CAF`s (organogenesis) 356 transcripts decreased as compared to NAF´s (cell cycle associated) Restriction to secreted/membrane bound proteins: ASPN, CAV1, CFH, CTSK, DCN, FBLN1, FHL1, FN, NKTR, OGN, PARVA, S100A6, SPARC, STC1 and ZEB1 Specific and variable expression only in prostate cancer and fetal prostate fibroblasts * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 35 mRNA Array analysis* of matches pairs of NAF/CAF MAP3K1 SCARB1 S10010 *Cooperation with M. Caraglia/G. Vitale * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 36 mRNA Array analysis* of matches pairs of NAF/CAF Fold change upregulated MAP3K1 RNY3 SCARB1 PHLDB2 MAGT1 NBPF11 1,816 1,719 1,565 1,510 1,456 1,237 Fold change downregulated S100A10 SNAPC2 1,589 1.541 MAP3K1 (MEKK1) Associated with focal adhesion Overexpression in pancreatic cancer cells Depletion by siRNA inhibits invasion and migration Tranmitting signals for ECM homeostasis and epithelial cell migration Regulates detachment of migrating fibroblasts Less data available from prostate cancer SCARB1(SRB1) Membrane bound protein receptor for HDL Facilitates influx of Cholesterol into the cells Increased expression in AR-independent cells Enables the synthesis of DHT from Cholesterol Expression involved in CRPC S100A10 Plasminogen receptor Present on the cell surface as heterotetramer Plasmin activates Marix-Metallo-Proteinases Essential for Tumor-promoting macrophages into tumor sites Increased expression in CRPC * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 37 Changes in gene expression following/responsible for EMT EMT Signature Cancer Stem Cell Phenotype induced by CAF`s E-Cadherin-Vimentin-Notch-1-PDFG-D-NF-kB-ZEB1 Only Notch-1 overexpressed in bone metastasis Variable expression and differences between ITF and center of the tumor CAVE: EMT is a transient process and cells can re-differentiate by MET! Sox2, Nanog, Oct4, Lin 28B, Notch1 increased miR-200 decrased Re-expression of miR-200 inhibits prostate spheres forming Re-expression of miR-200 reduces Notch1 and Lin28B expression Molecular signature of epithelial-mesenchymal transitions (EMT) in human prostate cancer bone metastasis. S. Sethi et al. Am J Transl Res 2011, 3(1). Histological sections Epithelial to Mesenchymal Transition is Mechanistically linked with Stem Cell Signatures in Prostate Cancer Cells. D. Kong et al PLoS one 2010; 5(8. PC-3 cell line * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 38 The long way from normal prostate development to CRPC Changes in the behavior, function and localisation of Prostate Epithelial (Cancer) Cells under the Control of T/DHT and AR (and several other factors) and triggered by the environment Differentiation Proliferation Invasion Survival* Extravasation Organrestricted PrCa Invasion MMP`s MET 2nd Tumor+ Attachment Proliferation Stem cells? AR+ Association w. Macrophages Embolies Detachment Migration *as circulating tumor cells MMP`s + Metastasis EMT * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 39 Contribution of CAF to AR-mediated gene regulation: CAF express AR at low levels T/DHT mediated activation of these AR contributes to AR activities AR activation occurs by synthesis of T/DHT from DHEA T/DHT independent growth factor promote prostate cancer cells growth *Prostate stromal cells and LNCaP cells coordinately activate the AR through synthesis of testosterone and DHT from dehydroepiandrosterone DHEA. A.Mizokami et al. Endocrine-related cancer 2009; 16. Co-culture of CAF with LNCaP cells – Quantification of androgens by LC-ESI-MS/S RT-PCR of 3ß-HSD and 17ß-HSD Enzymes (HSD = Hydroxysteroid-Dehydrogenase Effects of Androgen Receptor and Androgen on Gene Expression in Prostate Stromal Fibroblasts and Paracrine Signaling to Prostate Cancer Cells. M.J. Tanner et al. PLoS one 2011, 6(1). WPMY-1 transfected to express AR at levels like LNCaP +/-DHT changes gene expression profile (like TGF-ß, Hedgehog, Wnt and MAP Kinase) Conditioned medium from DHT/WPMY.1 increases growth of LNCaP cells * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 40 Strategies to disclose the role of “Cancer associated fibroblasts” in tumor development and progression and for a comprehensive characterization! Changes from “normal” to “activated” fibroblasts by Genom Function Influence on Proliferation Migration Invasion EMT AR-Activation Production of Cytokines SDF Growth factors Genotyping Epigenetic Transcription Phenotype CGH Methylation Senescence Co-Evolution * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* RNA miRNA SMA FAP PDFRß CD90 41 Molecular genetic comparison of cancer and non-cancer-associated fibroblasts in prostate cancer* Epigenetic modifications in Fibroblasts Global hypomethylation of genomic DNA in cancer-associated myofibroblasts. Jiang L, Gonda TA, Gamble MV, Salas M, Seshan V, Tu S, Twaddell WS, Hegyi P, Lazar G, Steele I, Varro A, Wang TC, Tycko B Cancer Res. 2008 Dec 1;68(23):9900-8. Specific age-associated DNA methylation changes in human dermal fibroblasts. Koch CM, Suschek CV, Lin Q, Bork S, Goergens M, Joussen S, Pallua N, Ho AD, Zenke M, Wagner W; PLoS One. 2011 Feb 8;6(2):e16679. Comparison 23 vs 60 years old donors! Hypermethylation in the aged group! No significant changes during subcultivation! * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 42 Molecular genetic comparison of cancer and non-cancer-associated fibroblasts in prostate cancer* Conclusion and Future Trends Secretome by Proteomics Tumor cell ECM CAF/NAF CAF/TC crosstalk highly complex and dynamic Co-Evolution of CAF/TC CAF characterisation difficult Comprehensive characterisation of “Secretome” New and better models required Hormone metabolism in CAF unclear Contribution of CAF to CRPC likely? Secretome by Hormones/Metabolites * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 43 Viability of prostate cancer cell lines after ZOL-application * Cooperation with Prof. Dr. M. Caraglia & Dr. G. De Rosa Comparison between flat and 3D cell cultures* 120 100 80 60 40 Free ZOL [20 µM] PGNP_ZOL [20 µM] NP_ ZOL [20 µM] 20 ph er es ro s et e om os H H at ph er es 0 Fl Absorption in % compared to control PC-3 Cell culture system * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 44 Molecular genetic comparison of cancer and non-cancer-associated fibroblasts in prostate cancer* Gravity contributes to the Fibroblast-Tumor Cell Interaction in-vitro! Three-dimensional co-culture models to study prostate cancer growth, progression, and metastasis to bone Ruoxiang Wang, a, Jianchun Xua, Lisa Juliettec, Agapito Castillejac, John Loveb, Shian-Ying Sunga, Haiyen E. Zhaua, Thomas J. Goodwinb, Leland W.K. Chunga a Department of Urology, Molecular Urology and Therapeutics Program, Emory University School of Medicine, Atlanta, GA 30322, USA b NASA Johnson Space Center, Houston, TX 77058, USA c Wyle Laboratories, Houston, Columbia 1st Fev 2003 harbouring Co-Cultivation Experiments on board * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 45 Thanks to the audience! Thanks to all which contributes to our results: Helga Angeli Eva Schmidt Volker Jung Kerstin Junker Michele Caraglia Giovanni Vitale * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 46 Aber auch die Bewegung spielt eine Rolle! HUVEC cultivated onto/into flow-chambers (IBIDI 24 h w/o Flow 24 h + 48 h + 159p6 161p1 * Molecular Cell- and Tumour Biology * Summer 2013 * Naples* 47