@techreport{OPUS4-35963,
  title     = {Platelets - Molecular, cellular and systemic functions in health and disease},
  editor    = {Nieswandt, Bernhard},
  organization    = {Collaborative Research Centre/Transregio 240},
  doi       = {10.25972/OPUS-35963},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-359636},
  pages     = {25},
  year      = {2024},
  abstract  = {Besides their central role in haemostasis and thrombosis, platelets are increasingly recognised as versatile effector cells in inflammation, the innate and adaptive immune response, extracellular matrix reorganisation and fibrosis, maintenance of barrier and organ integrity, and host response to pathogens. These platelet functions, referred to as thrombo-inflammation and immunothrombosis, have gained major attention in the COVID-19 pandemic, where patients develop an inflammatory disease state with severe and life-threatening thromboembolic complications. In the CRC/TR 240, a highly interdisciplinary team of basic, translational and clinical scientists explored these emerging roles of platelets with the aim to develop novel treatment concepts for cardiovascular disorders and beyond. We have i) unravelled mechanisms leading to life-threatening thromboembolic complica-tions following vaccination against SARS-CoV-2 with adenoviral vector-based vaccines, ii) identified unrecognised functions of platelet receptors and their regulation, offering new potential targets for pharmacological intervention and iii) developed new methodology to study the biology of megakar-yocytes (MKs), the precursor cells of platelets in the bone marrow, which lay the foundation for the modulation of platelet biogenesis and function. The projects of the CRC/TR 240 built on the unique expertise of our research network and focussed on the following complementary fields: (A) Cell bi-ology of megakaryocytes and platelets and (B) Platelets as regulators and effectors in disease. To achieve this aim, we followed a comprehensive approach starting out from in vitro systems and animal models to clinical research with large prospective patient cohorts and data-/biobanking. Despite the comparably short funding period the CRC/TR 240 discovered basic new mechanisms of platelet biogenesis, signal transduction and effector function and identified potential MK/platelet-specific molecular targets for diagnosis and therapy of thrombotic, haemorrhagic and thrombo-inflammatory disease states.},
  subject      = {Thrombozyt},
  language  = {en}
}
@article{SchosseeVeitGitteletal.2022,
  author    = {Schossee, Nadine and Veit, Gabriele and Gittel, Julia and Viebahn, Johannes and Niklaus, Marius and Klingler, Philipp and {\"U}{\c{c}}eyler, Nurcan and Klinker, Erdwine and Kobsar, Anna and Boeck, Markus and Koessler, Juergen},
  title     = {Profile of the single-use, multiple-pass protein A adsorber column in immunoadsorption},
  series = {Vox Sanguinis},
  volume    = {117},
  journal   = {Vox Sanguinis},
  number    = {3},
  doi       = {10.1111/vox.13205},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259689},
  pages     = {393-398},
  year      = {2022},
  abstract  = {Background and Objectives Immunoadsorptions (IA) are used to remove autoantibodies from the plasma in autoimmune disorders. In this study, we evaluated the effects of a single-use, recombinant staphylococcal protein A-based immunoadsorber on blood composition of the patient. Materials and Methods In a cohort of patients with myasthenia gravis or stiff-person syndrome, essential parameters of blood cell count, coagulation, clinical chemistry or plasma proteins and immunoglobulins (Ig) were measured before and after IA (n = 11). Results In average, IA reduced the levels of total IgG, IgG1, IgG2 and IgG4 by approximately 60\%, the acetylcholine receptor autoantibody levels by more than 70\%. IgG3, IgA or IgM were diminished to a lower extent. In contrast to fibrinogen or other coagulation factors, the column markedly removed vitamin K-dependent coagulation factors II, VII, IX and X by approximately 40\%-70\%. Accordingly, international normalized ratio and activated partial thromboplastin time were increased after IA by 59.1\% and 32.7\%, respectively. Coagulation tests almost returned to baseline values within 24 h. Blood cell count, electrolytes, total protein or albumin were not essentially affected. No clinical events occurred. Conclusion The single-use, multiple-pass protein A adsorber column is highly efficient to remove IgG1, IgG2 and IgG4 or specific acetylcholine receptor autoantibodies from the plasma. Coagulation parameters should be monitored, since the column has the capacity to largely reduce vitamin K-dependent factors.},
  language  = {en}
}
@article{MeybohmStraubFuellenbachetal.2020,
  author    = {Meybohm, Patrick and Straub, Niels and F{\"u}llenbach, Christoph and Judd, Leonie and Kleiner{\"u}schkamp, Adina and Taeuber, Isabel and Zacharowski, Kai and Choorapoikayil, Suma},
  title     = {Health economics of Patient Blood Management: a cost-benefit analysis based on a meta-analysis},
  series = {Vox Sanguinis},
  volume    = {115},
  journal   = {Vox Sanguinis},
  number    = {2},
  doi       = {10.1111/vox.12873},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214084},
  pages     = {182 -- 188},
  year      = {2020},
  abstract  = {Background and Objectives Patient Blood Management (PBM) is the timely application of evidence-based medical and surgical concepts designed to improve haemoglobin concentration, optimize haemostasis and minimize blood loss in an effort to improve patient outcomes. The focus of this cost-benefit analysis is to analyse the economic benefit of widespread implementation of a multimodal PBM programme. Materials and Methods Based on a recent meta-analysis including 17 studies (>235 000 patients) comparing PBM with control care and data from the University Hospital Frankfurt, a cost-benefit analysis was performed. Outcome data were red blood cell (RBC) transfusion rate, number of transfused RBC units, and length of hospital stay (LOS). Costs were considered for the following three PBM interventions as examples: anaemia management including therapy of iron deficiency, use of cell salvage and tranexamic acid. For sensitivity analysis, a Monte Carlo simulation was performed. Results Iron supplementation was applied in 3·1\%, cell salvage in 65\% and tranexamic acid in 89\% of the PBM patients. In total, applying these three PBM interventions costs €129·04 per patient. However, PBM was associated with a reduction in transfusion rate, transfused RBC units per patient, and LOS which yielded to mean savings of €150·64 per patient. Thus, the overall benefit of PBM implementation was €21·60 per patient. In the Monte Carlo simulation, the cost savings on the outcome side exceeded the PBM costs in approximately 2/3 of all repetitions and the total benefit was €1 878 000 in 100·000 simulated patients. Conclusion Resources to implement a multimodal PBM concept optimizing patient care and safety can be cost-effectively.},
  language  = {en}
}