@phdthesis{Demeter2024,
  author    = {Demeter, Eran},
  title     = {Retrospektive Untersuchung zur H{\"a}ufigkeit von unerw{\"u}nschten immunvermittelten Ereignissen unter Immuntherapie mit Nivolumab oder Pembrolizumab bei {\"a}lteren und j{\"u}ngeren Patient*innen},
  doi       = {10.25972/OPUS-35258},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-352586},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {ICIs sind inzwischen integrales Therapiemittel vieler Tumoren, selbst in nicht metastasierten Stadien. Das Management von dabei eventuell entstehenden Nebenwirkungen bleibt wichtiger Bestandteil der Therapie vor allem im fortgeschrittenen Alter. Retrospektive Untersuchungen wie unsere tragen dazu bei, das in vielen klinischen Studien unterrepr{\"a}sentierte Patientenkollektiv {\"a}lterer Patienten in den klinischen Alltag sowie in Therapieentscheidungen und -planungen zu integrieren. Der prim{\"a}re Studienendpunkt unserer Arbeit unterst{\"u}tzt wichtige Erkenntnisse anderer Studien, dass irAEs insgesamt unter {\"a}lteren Patienten nicht h{\"a}ufiger auftreten. Zwischen allen drei Altersklassen von ~55, ~70 und ~80 Jahren zeigten sich keine signifikanten Unterschiede im Auftreten von irAEs aller Grade, wobei irAEs Grad III/IV etwas h{\"a}ufiger bei ~80-J{\"a}hrigen auftraten. In unserem Fall stellten wir fest, dass auftretende irAEs im Alter h{\"a}ufiger behandelt wurden, und dass die Immuntherapie h{\"a}ufiger pausiert oder abgebrochen wurde. Zudem war der Anteil an Therapieabbr{\"u}chen unter den {\"a}lteren Patienten wegen bestimmter Ereignisse wie TRAEs und dem Einsatz von Glukokortikoiden h{\"o}her als bei j{\"u}ngeren Patienten. Die Ergebnisse unserer Studie deuten außerdem darauf hin, dass selbst unter Polypharmazie und Multimorbidit{\"a}t irAEs nicht h{\"a}ufiger bei {\"A}lteren auftraten. Ebenso k{\"o}nnen wir die interessante Beobachtung verzeichnen, dass Patienten mit >5 Medikamenten und gleichzeitig >5 Erkrankungen signifikant mehr irAEs Grad III/IV aufwiesen oder mehr Patienten Glukokortikoide verabreicht bekommen haben. Auch der Anteil an Interventionsbedarf oder Therapieabbruch war hier in allen Altersklassen h{\"o}her. Es stellt sich die Frage, inwiefern hohes Alter, Komorbidit{\"a}t und Polypharmazie Risikofaktoren f{\"u}r Interventionsbedarf oder Therapieabbruch in der Immuntherapie sind, und ob ihnen eher besondere Gewichtung als Risikofaktor zukommt als dem Alter selbst.},
  subject      = {Immuntherapie},
  language  = {de}
}
@article{HalfmannCastioniWetzeletal.2024,
  author    = {Halfmann, Marie and Castioni, Noah and Wetzel, Lea and Koopmann, Anne and K{\"o}nig, Sarah and Schmieder, Astrid},
  title     = {Effects of the COVID-19 pandemic on the mental health of medical students and young physicians in Germany: Gender-specific results of an online survey},
  series = {Heliyon},
  volume    = {10},
  journal   = {Heliyon},
  number    = {1},
  issn      = {2405-8440},
  doi       = {10.1016/j.heliyon.2023.e23727},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-350502},
  year      = {2024},
  abstract  = {Background Healthcare workers and medical students faced new challenges during the COVID-19 pandemic. Processes within many hospitals were completely disrupted. In addition, the face to face teaching of medical students was drastically reduced. Those at risk of developing mental health problems appear to be younger health care workers and women. Objective To investigate potential COVID-19 pandemic-related gender differences in psychological distress among medical students and physicians in their first years of practice. Design and setting An anonymous survey was carried out online between December 1, 2021, and March 31, 2022, at the Mannheim Medical Faculty and the W{\"u}rzburg Medical Faculty, Germany, after obtaining informed consent. Primary outcome measures were changes in anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS), and changes in participants' current quality of life using the WHO Quality of Life BREF. Results The results show wave-like courses for perceived anxiety and burden overlapping with the course of the COVID-19 incidence. In comparison to men, women showed a significant higher increase in HADS (p = 0.005) and a reduced life quality (p = 0.007) after COVID-19. Both sexes showed different frequencies of the factors influencing quality of life, with the presence of a previous mental illness and mean anxiety having a significant higher negative impact in women. Conclusion Future and young female physicians reported a disproportionate higher burden during COVID-19 compared to their male colleges. These observations suggest an increased need for support and prevention efforts especially in this vulnerable population.},
  language  = {en}
}
@phdthesis{Roth2023,
  author    = {Roth, Nadine},
  title     = {Hyperhidrose bei Acne inversa},
  doi       = {10.25972/OPUS-30577},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-305779},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Trotz der urspr{\"u}nglichen Bezeichnung der Acne inversa als "hidrosad{\´e}nite phlegmoneuse", die eine inflammatorische Fehlfunktion der apokrinen Schweißdr{\"u}sen impliziert, geriet die Rolle der Schweißdr{\"u}sen hinsichtlich der Pathogenese der AI in Vergessenheit. Ziel dieser Studie war die Evaluierung der Rolle der Schweißdr{\"u}sen im Hinblick auf die f{\"u}r die AI charakteristischen proinflammatorischen Mediatoren. Zu diesem Zweck wurden gravimetrische Schweißmessungen, Multiplex-Zytokin-Assays von Schweißproben, sowie immunfluoreszenzoptische Zytokin-/Chemokin-Untersuchungen von l{\"a}sionaler AI-Haut durchgef{\"u}hrt. Die gravimetrische Untersuchung von 17 AI-Patienten zeigte, dass AI nicht mit Hyperhidrose assoziiert ist. Allerdings scheinen sich AI-Patienten durch ihr Schwitzen im Vergleich zu einer gesunden Kontrollgruppe subjektiv st{\"a}rker beeintr{\"a}chtigt zu f{\"u}hlen. Unsere Daten zeigen eine komplexe proinflammatorische Signatur im AI-Schweiß, die durch eine signifikant erh{\"o}hte Konzentration von Monozyten-Chemoattraktant-Protein-1 (MCP-1), Interleukin-8 (CXCL8) und Interferon-γ gekennzeichnet ist. Passend dazu konnten wir eine erh{\"o}hte Expression dieser Mediatoren in apokrinen Schweißdr{\"u}sen l{\"a}sionaler AI-Haut nachweisen. Diese Ergebnisse werfen ein neues Licht auf die proinflammatorische Kapazit{\"a}t apokriner Schweißdr{\"u}sen bei AI, was zu einem {\"U}berdenken der Rolle der Schweißdr{\"u}sen im Hinblick auf die Pathogenese der AI f{\"u}hren kann.},
  subject      = {Hidradenitis suppurativa},
  language  = {de}
}
@phdthesis{Wendlinger2023,
  author    = {Wendlinger, Simone Alice},
  title     = {Function of Peripheral Blood Eosinophils in Melanoma},
  publisher = {Cancers (Basel)},
  doi       = {10.25972/OPUS-30119},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-301194},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Despite accounting for only a small proportion of all skin cancers, malignant melanoma displays a serious health risk with increasing incidence and high mortality rate. Fortunately, advances in the treatment of malignant melanoma now prolong survival and enhance response and treatment efficacy. Established biomarkers help evaluate disease progression and facilitate choosing appropriate and individual treatment options. However, the need for easily accessible and reliable biomarkers is rising to predict patient-specific clinical outcome. Eosinophil infiltration into the tumor and high peripheral eosinophil counts prior and during treatment have been associated with better response in patients for various cancer entities, including melanoma. An analysis of a heterogeneous study cohort reported high serum ECP levels in non-responders. Hence, eosinophil frequency and serum ECP as a soluble eosinophil-secreted mediator were suggested as prognostic biomarkers in melanoma. We examined whether melanoma patients treated with first-line targeted therapy could also benefit from the effects of eosinophils. In total, 243 blood and serum samples from patients with advanced melanoma were prospectively and retrospectively collected before and after drug initiation. To link eosinophil function to improved clinical outcome, soluble serum markers and peripheral blood counts were used for correlative studies using a homogeneous study cohort. In addition, functional and phenotypical characterizations provided insights into the expression profile and activity of freshly isolated eosinophils, including comparisons between patients and healthy donors. Our data showed a significant correlation between high pre-treatment blood eosinophil counts and improved response to targeted therapy and by trend to combinatorial immunotherapy in patients with metastatic melanoma. In accordance with previous studies our results links eosinophil blood counts to better response in melanoma patients. High pre-treatment ECP serum concentration correlated with response to immunotherapy but not to targeted therapy. Eosinophils from healthy donors and patients showed functional and phenotypical similarities. Functional assays revealed a strong cytotoxic potential of blood eosinophils towards melanoma cells in vitro, inducing apoptosis and necrosis. In addition, in vitro cytotoxicity was an active process of peripheral eosinophils and melanoma cells with bidirectional features and required close cell-cell interaction. The extent of cytotoxicity was dose-dependent and showed susceptibility to changes in physical factors like adherence. Importantly, we provide evidence of an additive tumoricidal function of eosinophils and combinatorial targeted therapy in vitro. In summary, we give valuable insights into the complex and treatment-dependent role of eosinophils in melanoma. As a result, our data support the suggestion of eosinophils and their secreted mediators as potential prognostic biomarkers. It will take additional studies to examine the molecular mechanisms that underlie our findings.},
  subject      = {Melanom},
  language  = {en}
}
@article{WobserGoebeler2023,
  author    = {Wobser, Marion and Goebeler, Matthias},
  title     = {Special Issue "Cutaneous Lymphomas"},
  series = {Cancers},
  volume    = {15},
  journal   = {Cancers},
  number    = {5},
  issn      = {2072-6694},
  doi       = {10.3390/cancers15051481},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304180},
  year      = {2023},
  abstract  = {No abstract available},
  language  = {en}
}
@article{HoubenCelikdemirKervarrecetal.2023,
  author    = {Houben, Roland and Celikdemir, B{\"u}ke and Kervarrec, Thibault and Schrama, David},
  title     = {Merkel cell polyomavirus: infection, genome, transcripts and its role in development of Merkel cell carcinoma},
  series = {Cancers},
  volume    = {15},
  journal   = {Cancers},
  number    = {2},
  issn      = {2072-6694},
  doi       = {10.3390/cancers15020444},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-305021},
  year      = {2023},
  abstract  = {The best characterized polyomavirus family member, i.e., simian virus 40 (SV40), can cause different tumors in hamsters and can transform murine and human cells in vitro. Hence, the SV40 contamination of millions of polio vaccine doses administered from 1955-1963 raised fears that this may cause increased tumor incidence in the vaccinated population. This is, however, not the case. Indeed, up to now, the only polyomavirus family member known to be the most important cause of a specific human tumor entity is Merkel cell polyomavirus (MCPyV) in Merkel cell carcinoma (MCC). MCC is a highly deadly form of skin cancer for which the cellular origin is still uncertain, and which appears as two clinically very similar but molecularly highly different variants. While approximately 80\% of cases are found to be associated with MCPyV the remaining MCCs carry a high mutational load. Here, we present an overview of the multitude of molecular functions described for the MCPyV encoded oncoproteins and non-coding RNAs, present the available MCC mouse models and discuss the increasing evidence that both, virus-negative and -positive MCC constitute epithelial tumors.},
  language  = {en}
}
@article{MarquardtHartrampfKollmannsbergeretal.2023,
  author    = {Marquardt, Andr{\´e} and Hartrampf, Philipp and Kollmannsberger, Philip and Solimando, Antonio G. and Meierjohann, Svenja and K{\"u}bler, Hubert and Bargou, Ralf and Schilling, Bastian and Serfling, Sebastian E. and Buck, Andreas and Werner, Rudolf A. and Lapa, Constantin and Krebs, Markus},
  title     = {Predicting microenvironment in CXCR4- and FAP-positive solid tumors — a pan-cancer machine learning workflow for theranostic target structures},
  series = {Cancers},
  volume    = {15},
  journal   = {Cancers},
  number    = {2},
  issn      = {2072-6694},
  doi       = {10.3390/cancers15020392},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-305036},
  year      = {2023},
  abstract  = {(1) Background: C-X-C Motif Chemokine Receptor 4 (CXCR4) and Fibroblast Activation Protein Alpha (FAP) are promising theranostic targets. However, it is unclear whether CXCR4 and FAP positivity mark distinct microenvironments, especially in solid tumors. (2) Methods: Using Random Forest (RF) analysis, we searched for entity-independent mRNA and microRNA signatures related to CXCR4 and FAP overexpression in our pan-cancer cohort from The Cancer Genome Atlas (TCGA) database — representing n = 9242 specimens from 29 tumor entities. CXCR4- and FAP-positive samples were assessed via StringDB cluster analysis, EnrichR, Metascape, and Gene Set Enrichment Analysis (GSEA). Findings were validated via correlation analyses in n = 1541 tumor samples. TIMER2.0 analyzed the association of CXCR4 / FAP expression and infiltration levels of immune-related cells. (3) Results: We identified entity-independent CXCR4 and FAP gene signatures representative for the majority of solid cancers. While CXCR4 positivity marked an immune-related microenvironment, FAP overexpression highlighted an angiogenesis-associated niche. TIMER2.0 analysis confirmed characteristic infiltration levels of CD8+ cells for CXCR4-positive tumors and endothelial cells for FAP-positive tumors. (4) Conclusions: CXCR4- and FAP-directed PET imaging could provide a non-invasive decision aid for entity-agnostic treatment of microenvironment in solid malignancies. Moreover, this machine learning workflow can easily be transferred towards other theranostic targets.},
  language  = {en}
}
@phdthesis{Jonas2023,
  author    = {Jonas, Wenzel Till},
  title     = {Komparative Analyse des Einflusses zielgerichteter Therapeutika auf den immunologischen Ph{\"a}notyp im BRAF-V600-mutierten Melanom},
  doi       = {10.25972/OPUS-32323},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323239},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Die Einf{\"u}hrung von zielgerichteter Therapie und Immuntherapie hat die Behandlungsm{\"o}glichkeiten des Melanoms revolutioniert. Jedoch profitieren viele Patienten nicht langfristig von diesen Therapien. Derzeit werden klinische Studien durchgef{\"u}hrt, die zielgerichtete Therapie und Immuntherapie miteinander kombinieren. In dieser Arbeit wurden in vitro Untersuchungen an den drei BRAF-V600E-mutieren Melanomzelllinien UACC 257, Malme 3M und Sk-Mel 5 unter kombinierter MAPK-Inhibitortherapie durchgef{\"u}hrt. Es wurden die aus der klinischen Routine bekannten Kombinationen aus BRAF- und MEK-Inhibitor - Vemurafenib und Cobimetinib, Dabrafenib und Trametinib sowie Encorafenib und Binimetinib - verwendet. Es wurde untersucht, ob obige zielgerichtete Therapeutika einen Effekt auf immunologische Marker im Melanom haben und ob sich eine der Kombinationen in ihrer Wirkung signifikant von den {\"u}brigen unterscheidet. Mittels MTS-Assay und Zellzyklusanalysen konnte eine konzentrationsabh{\"a}ngige Wirkung der Inhibitoren gezeigt und in ihrer Wirkung vergleichbare Inhibitorkonzentrationen eingestellt werden. Unter kombinierter MAPK-Inhibitortherapie zeigte sich ein begrenzter Effekt auf die theoretische Immunogenit{\"a}t des Melanoms. So konnte eine erh{\"o}hte MHC-I-Expression (+14 \%) und eine verminderte PD-L1-Expression (-24 \%) gezeigt werden. Die gew{\"a}hlten Dosen an Inhibitoren induzierten keinen ER-Stress. Ebenso konnte keine Ekto-Calreticulin-Expression auf lebenden Zellen nachgewiesen werden. Zwischen den drei Inhibitorkombinationen zeigten sich keine signifikanten Unterschiede. Die in dieser Arbeit gezeigten begrenzten immunologischen Effekte unter kombinierter MAPK-Inhibitortherapie legen nahe, dass eine Kombination mit Immuntherapie in Teilen synergistisch wirken k{\"o}nnte. Hier sind die Ergebnisse weiterer Studien abzuwarten, die zielgerichtete und Immuntherapie miteinander kombinieren, um ein tiefgreifenderes Verst{\"a}ndnis bzgl. etwaiger Synergien zu generieren. Da zwischen den Inhibitorkombinationen keine signifikanten Unterschiede hinsichtlich ihrer Wirkung auf die Immunogenit{\"a}t des Melanoms gefunden wurden, ist anzunehmen, dass sie sich grunds{\"a}tzlich alle gleichermaßen f{\"u}r eine Kombination mit einer Immuntherapie eignen. Die gezeigte MHC-I-Erh{\"o}hung trat bereits bei geringen Inhibitorkonzentrationen auf. M{\"o}glicherweise gen{\"u}gt bei einer Kombination mit Immuntherapie bereits eine niedrige Dosis der zielgerichteten Therapie, um die Immuntherapie zu boostern. Um die Frage nach einer m{\"o}glichen Kombinationstherapie fortw{\"a}hrend zu analysieren, sollten zus{\"a}tzliche Aspekte der Immunogenit{\"a}t unter kombinierter MAPK-Inhibitortherapie untersucht und die Inhibitortitration zum Vergleich der zielgerichteten Therapeutika weiter pr{\"a}zisiert werden.},
  subject      = {Melanom},
  language  = {de}
}
@article{HoubenAlimovaSarmaetal.2023,
  author    = {Houben, Roland and Alimova, Pamela and Sarma, Bhavishya and Hesbacher, Sonja and Schulte, Carolin and Sarosi, Eva-Maria and Adam, Christian and Kervarrec, Thibault and Schrama, David},
  title     = {4-[(5-methyl-1H-pyrazol-3-yl)amino]-2H-phenyl-1-phthalazinone inhibits MCPyV T antigen expression in Merkel cell carcinoma independent of Aurora kinase A},
  series = {Cancers},
  volume    = {15},
  journal   = {Cancers},
  number    = {9},
  issn      = {2072-6694},
  doi       = {10.3390/cancers15092542},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-313547},
  year      = {2023},
  abstract  = {Merkel cell carcinoma (MCC) is frequently caused by the Merkel cell polyomavirus (MCPyV), and MCPyV-positive tumor cells depend on expression of the virus-encoded T antigens (TA). Here, we identify 4-[(5-methyl-1H-pyrazol-3-yl)amino]-2H-phenyl-1-phthalazinone (PHT) — a reported inhibitor of Aurora kinase A — as a compound inhibiting growth of MCC cells by repressing noncoding control region (NCCR)-controlled TA transcription. Surprisingly, we find that TA repression is not caused by inhibition of Aurora kinase A. However, we demonstrate that β-catenin — a transcription factor repressed by active glycogen synthase kinase 3 (GSK3) — is activated by PHT, suggesting that PHT bears a hitherto unreported inhibitory activity against GSK3, a kinase known to function in promoting TA transcription. Indeed, applying an in vitro kinase assay, we demonstrate that PHT directly targets GSK3. Finally, we demonstrate that PHT exhibits in vivo antitumor activity in an MCC xenograft mouse model, suggesting a potential use in future therapeutic settings for MCC.},
  language  = {en}
}
@phdthesis{Fusi2023,
  author    = {Fusi, Lorenza},
  title     = {Crosstalk between the MEK5/ERK5 and PKB/FoxO pathways: underlying mechanism and its relevance for vasoprotection and tumorigenesis},
  doi       = {10.25972/OPUS-29676},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-296769},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Forkhead box O transcription factors are a family of proteins involved in cellular processes downstream of the Insulin-PI3K-PKB pathway. In response to extra- or intracellular stresses, for example starvation or oxidative stress, FoxOs are required to direct cell cycle progression and apoptosis. In endothelial cells, they induce apoptosis, and their deregulation is linked to diseases involving the insulin pathway, such as diabetes. FoxOs also exhibit a complex role in tumour transformation: here their main function is to suppress tumorigenesis. In both physiological and cancer contexts, FoxO activation leads to the transcription of some general targets, such as p27kip1 or IGFBP1. The FoxOs can also induce tissue-specific genes, as ANGPT2 and BIM in the endothelium. In endothelial cells, another pathway with a pivotal function is the MEK5/ERK5 MAPK signalling way. Its activation promotes cell survival and proliferation in stressful conditions, e.g., when blood vessels are exposed to the shear forces exerted by the blood stream. Furthermore, recent data described ERK5 as a kinase directing tumour resistance upon therapy-induced stress. Comparing their reported roles in various tumours and in the endothelium, FoxO proteins and the MEK5/ERK5 MAPK cascade appear to exert opposite functions. First non-published data confirmed the hypothesis that FoxO factors are subject to a negative modulation by the MEK5/ERK5 pathway. Hence, one goal of this PhD project was to further characterise this crosstalk at molecular level. The major mechanism of FoxO regulation is the balance among several post translational modifications, such as phosphorylation, acetylation, and ubiquitination. Most importantly, the PKB dependent phosphorylation of FoxOs negatively controls their activity, and it is critical for their subcellular localization. Therefore, the regulation of FoxO localization as mechanism of ERK5 dependent suppression was studied, but the results presented in this thesis argue against this hypothesis. However, additional experiments are required to explore the impact of ERK5 activity on FoxO post-translational modifications. FoxO activity can also be modulated by the interaction with other proteins, which in turn could explain general- and tissue-specific gene expression. Thus, another objective of this work was to investigate FoxO3-interactome in endothelial cells and the impact of MEK5/ERK5 activation on it. As published in (Fusi et al. 2022) and presented here, this analysis unveiled TRRAP as new FoxO bound protein in several cell types. Moreover, the interaction did not rely on the capacity of the FoxOs to bind their consensus DNA sequences at the promoter of target genes. Functional data demonstrated that TRRAP is required for FoxO-dependent gene transcription in endothelial and osteosarcoma cells. In addition, TRRAP expression in the endothelium is important for FoxO induced apoptosis. In summary, the interaction between FoxO factors and TRRAP revealed a new regulatory mechanism of FoxO-dependent gene transcription. It remains to be analysed whether the MEK5/ERK5 cascade may exert its suppressive effect on FoxO activity by interfering with their binding to TRRAP and whether such a mechanism may be relevant for tumorigenesis.},
  subject      = {Endothel},
  language  = {en}
}