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Biomedical subjects

Uwe Koch

Publications and source records attributed to Uwe Koch.

49 records · Page 3Linked to original sources

[Medical psychology in Germany--a discipline between continuity and change].

In 2002 a survey of institutes of Medical Psychology was accomplished in order to describe the situation of the subject. As regards the content the survey referred to five scopes: structural conditions, teachings, research, health care as well as general questions about the situation of the discipline. All 35 addressed departments and institutes of Medical Psychology in Germany took part in the situation analyses of the subject and responded to a questionnaire. The results indicate strengths and weaknesses of the current situation of the discipline and will be discussed in terms of research, teaching, and clinical work.

Data Collection↗

In vitro selection and characterization of hepatitis C virus serine protease variants resistant to an active-site peptide inhibitor.

The hepatitis C virus (HCV) serine protease is necessary for viral replication and represents a valid target for developing new therapies for HCV infection. Potent and selective inhibitors of this enzyme have been identified and shown to inhibit HCV replication in tissue culture. The optimization of these inhibitors for clinical development would greatly benefit from in vitro systems for the identification and the study of resistant variants. We report the use HCV subgenomic replicons to isolate and characterize mutants resistant to a protease inhibitor. Taking advantage of the replicons' ability to transduce resistance to neomycin, we selected replicons with decreased sensitivity to the inhibitor by culturing the host cells in the presence of the inhibitor and neomycin. The selected replicons replicated to the same extent as those in parental cells. Sequence analysis followed by transfection of replicons containing isolated mutations revealed that resistance was mediated by amino acid substitutions in the protease. These results were confirmed by in vitro experiments with mutant enzymes and by modeling the inhibitor in the three-dimensional structure of the protease.

Binding Sites↗

Recent developments in the discovery of hepatitis C virus serine protease inhibitors--towards a new class of antiviral agents?

Hepatitis C virus (HCV) infection is an epidemic disease and a significant worldwide health problem. Despite impressive improvements in the efficacy of the standard, interferon-based therapies, at present, the virus can not be eradicated in the majority of infected individuals. The last decade has witnessed a burst in our understanding of the molecular biology of HCV infection and lead to the identification of essential features of the viral genome that are being targeted for the development of specific antiviral agents. The non-structural protein 3 of the HCV genome harbours a serine protease domain that is essential for viral replication. This enzyme has been studied in great detail and the wealth of structural and functional data are presently nurturing drug development efforts. The peculiar active site structure of the enzyme imposes considerable obstacles to the development of small molecule inhibitors. However, the combination of creativity with the powerful tools of modern drug discovery has led to impressive progress in this field over the past few years and, as a result, the first compounds are now entering clinical trials.

Animals↗

Capped dipeptide alpha-ketoacid inhibitors of the HCV NS3 protease.

The N-terminal aminoacid of alpha-ketotripeptide inhibitors of the hepatitis C virus NS3 protease can be replaced with an alpha-hydroxy acid, leading to capped dipeptide inhibitors such as 20 with an IC(50) value of 3.0 microM. The importance of the lipophilic side chain interactions at S3 of the protease and the requirement of the capping residue with R configuration have been explained by molecular modeling studies.

Binding Sites↗

Classification of proteins based on the properties of the ligand-binding site: the case of adenine-binding proteins.

Comparative analysis of protein binding sites for similar ligands yields information about conserved interactions, relevant for ligand affinity, and variable interactions, which are important for specificity. The pattern of variability can indicate new targets for a pharmacologically validated class of compounds binding to a similar site. A particularly vast group of therapeutically interesting proteins using the same or similar substrates are those that bind adenine-containing ligands. Drug development is focusing on compounds occupying the adenine-binding site and their specificity is an issue of paramount importance. We use a simple scheme to characterize and classify the adenine-binding sites in terms of their intermolecular interactions, and show that this classification does not necessarily correspond to protein classifications based on either sequence or structural similarity. We find that only a limited number of the different hydrogen bond patterns possible for adenine-binding is used, which can be utilized as an effective classification scheme. Closely related protein families usually share similar hydrogen patterns, whereas non-polar interactions are less well conserved. Our classification scheme can be used to select groups of proteins with a similar ligand-binding site, thus facilitating the definition of the properties that can be exploited to design specific inhibitors.

Adenine↗

Prime site binding inhibitors of a serine protease: NS3/4A of hepatitis C virus.

Serine proteases are the most studied class of proteolytic enzymes and a primary target for drug discovery. Despite the large number of inhibitors developed so far, very few make contact with the prime site of the enzyme, which constitutes an almost untapped opportunity for drug design. In the course of our studies on the serine protease NS3/4A of hepatitis C virus (HCV), we found that this enzyme is an excellent example of both the opportunities and the challenges of such design. We had previously reported on two classes of peptide inhibitors of the enzyme: (a) product inhibitors, which include the P(6)-P(1) region of the substrate and derive much of their binding energy from binding of their C-terminal carboxylate in the active site, and (b) decapeptide inhibitors, which span the S(6)-S(4)' subsites of the enzyme, whose P(2)'-P(4)' tripeptide fragment crucially contributes to potency. Here we report on further work, which combined the key binding elements of the two series and led to the development of inhibitors binding exclusively to the prime site of NS3/4A. We prepared a small combinatorial library of tripeptides, capped with a variety of constrained and unconstrained diacids. The SAR was derived from multiple analogues of the initial micromolar lead. Binding of the inhibitor(s) to the enzyme was further characterized by circular dichroism, site-directed mutagenesis, a probe displacement assay, and NMR to unequivocally prove that, according to our design, the bound inhibitor(s) occupies (occupy) the S' subsite and the active site of the protease. In addition, on the basis of the information collected, the tripeptide series was evolved toward reduced peptide character, reduced molecular weight, and higher potency. Beyond their interest as HCV antivirals, these compounds represent the first example of prime site inhibitors of a serine protease. We further suggest that the design of an inhibitor with an analogous binding mode may be possible for other serine proteases.

Amino Acid Sequence↗

Evolution, synthesis and SAR of tripeptide alpha-ketoacid inhibitors of the hepatitis C virus NS3/NS4A serine protease.

N-terminal truncation of the hexapeptide ketoacid 1 gave rise to potent tripeptide inhibitors of the hepatitis C virus NS3 protease/NS4A cofactor complex. Optimization of these tripeptides led to ketoacid 30 with an IC50 of 0.38 microM. The SAR of these tripeptides is discussed in the light of the recently published crystal structures of a ternary tripetide/NS3/NS4A complexes.

Carboxylic Acids↗

[Willingness to donate organs - Strategies to influence attitude].

While organ shortage remains one of the major problems in the treatment of many terminally ill patients with more than 13 000 patients currently on the waiting list in Germany, surveys are showing positive attitude towards organ donation in the general population. In this paper, several possible explanations for this apparent contradiction are discussed. Considering the fact that organ donation is supported by a vast majority in the general population while the donation rate remains considerably low, the significance of mass media campaigns to support donation is re-evaluated. Empirical studies have shown that the support for organ donation can hardly be further increased by campaigns. However, it has been shown that involvement with the topic may be increased significantly. This may play an important role because high involvement seems to be associated with actual behavior (e.g. signing a donor card). Since the donation rate is influenced by a whole array of factors, we argue that it may only be increased by using an "orchestra" of coordinated strategies. Such an orchestra is outlined and the role of mass media campaigns discussed within such a concept.

Attitude↗

[Inpatient psychotherapeutic health care services in northern Germany--Results of an expertise].

In Germany health care services for patients with psychosomatic disorders are characterized by three specific features: A large amount of inpatient facilities, which have been developed outside psychiatric institutions and which are mainly rehabilitation clinics instead of acute clinics. We have tried to analyze whether (1) there is a sufficient number of inpatient facilities in Northern Germany, whether (2) the treatment of psychosomatic disorders should be conducted in large-scale outpatient clinics or in minor departments of community hospitals and (3) to what extent therapy should preferably be offered in acute rather than in rehabilitative settings. By means of different methodological approaches our analysis shows (1) a need for more facilities for the treatment of patients with psychosomatic disorders than legally established by the government, (2) the necessity to differentially allocate patients to appropriate clinics and (3) to encourage clinics to develop or to expand those therapeutic elements which aim more at rehabilitative or acute care.

Data Collection↗

[Treatment goals as an instrument of quality management in psychosomatic rehabilitation].

The present article outlines the development of a system of categories of treatment goals in psychosomatic rehabilitation. As a first step a content analysis of 242 letters of discharge was carried out. In order to give a systematic describe of the thus extracted goals a system of categories was developed. Which was then in a second step used as the basis for detailed discussions by psychosomatic rehabilitation experts aimed at revising and optimizing the system of categories. This developed classification of treatment goals--owning to the possibility in principle of operationalization--will provide the conditions for further strategies within the context of evaluation and measures of quality assurance.

Humans↗

Assessing different classification methods for virtual screening.

How well do different classification methods perform in selecting the ligands of a protein target out of large compound collections not used to train the model? Support vector machines, random forest, artificial neural networks, k-nearest-neighbor classification with genetic-algorithm-optimized feature selection, trend vectors, naïve Bayesian classification, and decision tree were used to divide databases into molecules predicted to be active and those predicted to be inactive. Training and predicted activities were treated as binary. The database was generated for the ligands of five different biological targets which have been the object of intense drug discovery efforts: HIV-reverse transcriptase, COX2, dihydrofolate reductase, estrogen receptor, and thrombin. We report significant differences in the performance of the methods independent of the biological target and compound class. Different methods can have different applications; some provide particularly high enrichment, others are strong in retrieving the maximum number of actives. We also show that these methods do surprisingly well in predicting recently published ligands of a target on the basis of initial leads and that a combination of the results of different methods in certain cases can improve results compared to the most consistent method.

Algorithms↗

[Differential group experiences of cognitive-behavioral and psychodynamic group psychotherapy].

Research concerning the question, whether and to what extent cognitive-behavioral (CB) and psychodynamic (PD) therapy consist of differing process components under clinical representative conditions, is relevant especially for a valid interpretation of comparative outcome research, for identifying differential beneficial factors of psychotherapy and for a systematic indication for, respectively assignment of, patients to the two treatments. In this study it is investigated whether PD and CB differ concerning the realisation of factors of group experience, respectively of beneficial group elements (e. g. cohesion, catharsis, learning by feedback). For this purpose, in a naturalistic design, a stratified sample (N = 36) of 104 videotaped sessions (PD groups, interactional CB groups and indicative CB groups; N = 171 patients with a broad spectrum of F-diagnoses of ICD-10, especially F3/F4) were rated by observers using the Kieler-Gruppenpsychotherapie-Prozess-Skala (KGPPS). Analyses of variance and a priori Helmert-contrasts reveal differences between PD and CB with at least medium effect sizes in 12 of the 16 factors of group experience. However, differences also were found between the two CB group treatments (9 factors of group experience with differences with large effect sizes). The results suggest that the different treatment approaches foster different qualities and quantities of group experience and that the latter seems not to evolve from the group context "per se" (i. e. by the plurality of the group).

Adult↗