@article{AbdelhameedEltamanyHaletal.2020, author = {Abdelhameed, Reda F. A. and Eltamany, Enas E. and Hal, Dina M. and Ibrahim, Amany K. and AboulMagd, Asmaa M. and Al-Warhi, Tarfah and Youssif, Khayrya A. and Abd El-kader, Adel M. and Hassanean, Hashim A. and Fayez, Shaimaa and Bringmann, Gerhard and Ahmed, Safwat A. and Abdelmohsen, Usama Ramadan}, title = {New cytotoxic cerebrosides from the Red Sea cucumber Holothuria spinifera supported by in-silico studies}, series = {Marine Drugs}, volume = {18}, journal = {Marine Drugs}, number = {8}, issn = {1660-3397}, doi = {10.3390/md18080405}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-211089}, year = {2020}, abstract = {Bioactivity-guided fractionation of a methanolic extract of the Red Sea cucumber Holothuria spinifera and LC-HRESIMS-assisted dereplication resulted in the isolation of four compounds, three new cerebrosides, spiniferosides A (1), B (2), and C (3), and cholesterol sulfate (4). The chemical structures of the isolated compounds were established on the basis of their 1D NMR and HRMS spectral data. Metabolic profiling of the H. spinifera extract indicated the presence of diverse secondary metabolites, mostly hydroxy fatty acids, diterpenes, triterpenes, and cerebrosides. The isolated compounds were tested for their in vitro cytotoxicities against the breast adenocarcinoma MCF-7 cell line. Compounds 1, 2, 3, and 4 displayed promising cytotoxic activities against MCF-7 cells, with IC\(_{50}\) values of 13.83, 8.13, 8.27, and 35.56 µM, respectively, compared to that of the standard drug doxorubicin (IC\(_{50}\) 8.64 µM). Additionally, docking studies were performed for compounds 1, 2, 3, and 4 to elucidate their binding interactions with the active site of the SET protein, an inhibitor of protein phosphatase 2A (PP2A), which could explain their cytotoxic activity. This study highlights the important role of these metabolites in the defense mechanism of the sea cucumber against fouling organisms and the potential uses of these active molecules in the design of new anticancer agents.}, language = {en} } @article{AbdelhameedHabibEltahawyetal.2020, author = {Abdelhameed, Reda F. A. and Habib, Eman S. and Eltahawy, Nermeen A. and Hassanean, Hashim A. and Ibrahim, Amany K. and Mohammed, Anber F. and Fayez, Shaimaa and Hayallah, Alaa M. and Yamada, Koji and Behery, Fathy A. and Al-Sanea, Mohammad M. and Alzarea, Sami I. and Bringmann, Gerhard and Ahmed, Safwat A. and Abdelmohsen, Usama Ramadan}, title = {New cytotoxic natural products from the Red Sea sponge Stylissa carteri}, series = {Marine Drugs}, volume = {18}, journal = {Marine Drugs}, number = {5}, issn = {1660-3397}, doi = {10.3390/md18050241}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-205795}, year = {2020}, abstract = {Bioactivity-guided isolation supported by LC-HRESIMS metabolic profiling led to the isolation of two new compounds, a ceramide, stylissamide A (1), and a cerebroside, stylissoside A (2), from the methanol extract of the Red Sea sponge Stylissa carteri. Structure elucidation was achieved using spectroscopic techniques, including 1D and 2D NMR and HRMS. The bioactive extract's metabolomic profiling showed the existence of various secondary metabolites, mainly oleanane-type saponins, phenolic diterpenes, and lupane triterpenes. The in vitro cytotoxic activity of the isolated compounds was tested against two human cancer cell lines, MCF-7 and HepG2. Both compounds, 1 and 2, displayed strong cytotoxicity against the MCF-7 cell line, with IC\(_{50}\) values at 21.1 ± 0.17 µM and 27.5 ± 0.18 µM, respectively. They likewise showed a promising activity against HepG2 with IC\(_{50}\) at 36.8 ± 0.16 µM for 1 and IC\(_{50}\) 30.5 ± 0.23 µM for 2 compared to the standard drug cisplatin. Molecular docking experiments showed that 1 and 2 displayed high affinity to the SET protein and to inhibitor 2 of protein phosphatase 2A (I2PP2A), which could be a possible mechanism for their cytotoxic activity. This paper spreads light on the role of these metabolites in holding fouling organisms away from the outer surface of the sponge, and the potential use of these defensive molecules in the production of novel anticancer agents.}, language = {en} } @article{AbdelhameedHabibGodaetal.2020, author = {Abdelhameed, Reda F. A. and Habib, Eman S. and Goda, Marwa S. and Fahim, John Refaat and Hassanean, Hashem A. and Eltamany, Enas E. and Ibrahim, Amany K. and AboulMagd, Asmaa M. and Fayez, Shaimaa and Abd El-kader, Adel M. and Al-Warhi, Tarfah and Bringmann, Gerhard and Ahmed, Safwat A. and Abdelmohsen, Usama Ramadan}, title = {Thalassosterol, a New Cytotoxic Aromatase Inhibitor Ergosterol Derivative from the Red Sea Seagrass Thalassodendron ciliatum}, series = {Marine Drugs}, volume = {18}, journal = {Marine Drugs}, number = {7}, doi = {10.3390/md18070354}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236085}, year = {2020}, abstract = {Thalassodendron ciliatum (Forssk.) Den Hartog is a seagrass belonging to the plant family Cymodoceaceae with ubiquitous phytoconstituents and important pharmacological potential, including antioxidant, antiviral, and cytotoxic activities. In this work, a new ergosterol derivative named thalassosterol (1) was isolated from the methanolic extract of T. ciliatum growing in the Red Sea, along with two known first-reported sterols, namely ergosterol (2) and stigmasterol (3), using different chromatographic techniques. The structure of the new compound was established based on 1D and 2D NMR spectroscopy and high-resolution mass spectrometry (HR-MS) and by comparison with the literature data. The new ergosterol derivative showed significant in vitro antiproliferative potential against the human cervical cancer cell line (HeLa) and human breast cancer (MCF-7) cell lines, with IC\(_{50}\) values of 8.12 and 14.24 µM, respectively. In addition, docking studies on the new sterol 1 explained the possible binding interactions with an aromatase enzyme; this inhibition is beneficial in both cervical and breast cancer therapy. A metabolic analysis of the crude extract of T. ciliatum using liquid chromatography combined with high-resolution electrospray ionization mass spectrometry (LC-ESI-HR-MS) revealed the presence of an array of phenolic compounds, sterols and ceramides, as well as di- and triglycerides.}, language = {en} } @phdthesis{Abt2020, author = {Abt, Alexander}, title = {Einfluss von HGF und Foretinib auf den Glukosestoffwechsel bei Zelllinien des oralen Plattenepithelkarzinoms}, doi = {10.25972/OPUS-20728}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207286}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Die Aktivierung des HGF/c-Met-Signalweges wird unter anderem seit l{\"a}ngerer Zeit als verantwortlicher Mechanismus f{\"u}r die Entwicklung von Resistenzen gegen den EGF-Rezeptor gerichteter Medikamente diskutiert. In verschiedenen Studien konnte die klinische Bedeutung des HGF/c-Met-Signalwegs belegt werden. In der j{\"u}ngeren Vergangenheit konzentriert sich die Forschung immer mehr auf das Tumormikromilieu und dessen Einfluss auf die Tumorprogression. So konnte gezeigt werden, dass erh{\"o}hte Laktatwerte, resultierend aus einer gesteigerten Glykolyse, zytotoxische T-Zellen inhibieren. Es wurden vier etablierte Zelllinien des oralen Plattenepithelkarzinoms sowie eine Zelllinie eines Mukoepidermoidkarzinom verwendet, um den Einfluss von HGF und des Tyrosinkinaseinhibitors Foretinib auf den Glukosemetabolismus zu pr{\"u}fen. Bei allen Zelllinien konnte der c-Met-Rezeptor nachgewiesen werden. Ebenso konnte in einem ELISA belegt werden, dass die Zelllinien selbst kein HFG produzieren. Es wurden proliferationsf{\"o}rdernde Effekte f{\"u}r HGF sowie zytotoxische Effekte durch Foretinib aufgezeigt. Ferner konnte der proliferationsf{\"o}rdernde Effekt durch HGF durch die Behandlung mit Foretinib aufgehoben werden. Im RT-PCR-Verfahren wurden die Auswirkungen auf die Transkription verschiedener Gene, die f{\"u}r wichtige Enzyme des Glukosemetabolismus kodieren, nach der Stimulation mit HGF sowie der Inhibition mit Foretinib untersucht. Es konnten substanzielle Ver{\"a}nderungen in der Expression einzelner Gene nachgewiesen werden. Zelllinien{\"u}bergreifend konnte allerdings keine verst{\"a}rkte bzw. verminderte Transkription durch die Behandlung mit HGF bzw. Foretinib nachgewiesen werden. Die Ergebnisse lassen auf die Komplexit{\"a}t der Regulierung des Glukosemetabolismus schließen. In der Durchflusszytometrie konnte gezeigt werden, dass eine Behandlung mit HGF nicht zu einer Zunahme des GLUT1 in der Zellmembran f{\"u}hrt, wohingegen eine Behandlung mit Foretinib mit einer gesteigerten Menge von GLUT1 einhergeht. Die Ergebnisse der vorliegenden Arbeit belegen einen Einfluss des HGF/c-Met-Signalwegs auf den Glukosemetabolismus bei Zelllinien des oralen Plattenepithelkarzinoms.}, subject = {Hepatozyten-Wachstumsfaktor}, language = {de} } @phdthesis{Ackermann2020, author = {Ackermann, Sabine}, title = {Auswirkungen der multimodalen Therapie und der Einf{\"u}hrung der Vorsorgekoloskopie auf die {\"U}berlebensraten beim Kolonkarzinom}, doi = {10.25972/OPUS-20611}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-206118}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Ziel dieser Arbeit war es, die Auswirkungen der {\"A}nderungen der Therapiestandards in der Behandlung des Kolonkarzinoms und die Auswirkungen der Einf{\"u}hrung der Vorsorgekoloskopie auf die {\"U}berlebensraten der Patienten mit Kolonkarzinom zu untersuchen. Die umfassende Analyse der therapieabh{\"a}ngigen {\"U}berlebensraten von 1016 Patienten mit Kolonkarzinom aus 20 Jahren zeigt eine Verbesserung der {\"U}berlebenswahrscheinlichkeit durch den Einsatz adjuvanter Therapie und multimodaler Therapieregime. Durch Neuerungen in der Therapie konnten die 5-Jahres-{\"U}berlebensraten seit Anfang der 90er Jahre nahezu verdoppelt werden. Als wichtigste Pr{\"a}diktoren f{\"u}r das Langzeit{\"u}berleben stellten sich das Alter der Patienten bei Erstdiagnose, das UICC Stadium und die Art der adjuvanten Therapie heraus. Der {\"U}berlebenszeit verl{\"a}ngernde Effekt war f{\"u}r den Einsatz der heutigen Standardtherapie mit 5-Flourouracil (5-FU) schon signifikant und zeigt sich f{\"u}r die Kombination mit neueren Medikamenten, insbesondere Oxaliplatin, noch deutlicher. Neue Operationstechniken, Fortschritte in der Metastasenchirurgie, ein optimiertes supportives Management und weitere Erkenntnisse onkologischer Prinzipien beeinflussten die erzielten Erfolge synergistisch. Das Gesamt{\"u}berleben der Patienten, die per Vorsorgekoloskopie detektiert werden ist besser als das der Patienten, die aufgrund klinischer Symptome diagnostiziert werden. Neben dem signifikanten {\"U}berlebensvorteil der Fr{\"u}herkennungs-Patienten, der sich durch die niedrigeren UICC Stadien in dieser Gruppe ergibt, finden sich auch Trends bez{\"u}glich eines besseren Outcomes dieser Patienten innerhalb der selben UICC Stadien. Die Patienten, deren Tumor im Rahmen des Screenings detektiert wurde, waren signifikant j{\"u}nger, wiesen signifikant weniger Begleiterkrakungen auf und zeigten signifikant niedrigere Tumorstadien. Eine adjuvante Therapie wurde in der Screening-Gruppe signifikant h{\"a}ufiger durchgef{\"u}hrt. Mehr als einer von f{\"u}nf tumorbedingten Todesf{\"a}llen der Patienten, die augrund von Symptomen diagnostiziert wurden, h{\"a}tte in dieser Studienpopulation verhindert werden k{\"o}nnen, wenn eine routinem{\"a}ßige Vorsorgekoloskopie durchgef{\"u}hrt worden w{\"a}re. Das Fazit lautet: die Vorsorgekoloskopie ist effektiv. Die Tumorgenese kann durch Entfernung von Vor{\"a}uferl{\"a}sionen durchbrochen werden, Tumoren k{\"o}nnen in fr{\"u}hen asymptomatischen Stadien detektiert werden. Screeningprogramme sollten erweitert werden, um die Inzidenz und die Mortalit{\"a}t von Darmkrebs weiter zu senken.}, subject = {Kolonkarzinom}, language = {de} } @article{AdakuChilakaMally2020, author = {Adaku Chilaka, Cynthia and Mally, Angela}, title = {Mycotoxin Occurrence, Exposure and Health Implications in Infants and Young Children in Sub-Saharan Africa: A Review}, series = {Foods}, volume = {9}, journal = {Foods}, number = {11}, issn = {2304-8158}, doi = {10.3390/foods9111585}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219250}, year = {2020}, abstract = {Infants and young children (IYC) remain the most vulnerable population group to environmental hazards worldwide, especially in economically developing regions such as sub-Saharan Africa (SSA). As a result, several governmental and non-governmental institutions including health, environmental and food safety networks and researchers have been proactive toward protecting this group. Mycotoxins, toxic secondary fungal metabolites, contribute largely to the health risks of this young population. In SSA, the scenario is worsened by socioeconomic status, poor agricultural and storage practices, and low level of awareness, as well as the non-establishment and lack of enforcement of regulatory limits in the region. Studies have revealed mycotoxin occurrence in breast milk and other weaning foods. Of concern is the early exposure of infants to mycotoxins through transplacental transfer and breast milk as a consequence of maternal exposure, which may result in adverse health effects. The current paper presents an overview of mycotoxin occurrence in foods intended for IYC in SSA. It discusses the imperative evidence of mycotoxin exposure of this population group in SSA, taking into account consumption data and the occurrence of mycotoxins in food, as well as biomonitoring approaches. Additionally, it discusses the health implications associated with IYC exposure to mycotoxins in SSA.}, language = {en} } @article{AdolfBraunFussetal.2020, author = {Adolf, Christian and Braun, Leah T. and Fuss, Carmina T. and Hahner, Stefanie and K{\"u}nzel, Heike and Handgriff, Laura and Sturm, Lisa and Heinrich, Daniel A. and Schneider, Holger and Bidlingmaier, Martin and Reincke, Martin}, title = {Spironolactone reduces biochemical markers of bone turnover in postmenopausal women with primary aldosteronism}, series = {Endocrine}, volume = {69}, journal = {Endocrine}, number = {3}, issn = {1355-008X}, doi = {10.1007/s12020-020-02348-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-315966}, pages = {625-633}, year = {2020}, abstract = {Context Primary aldosteronism (PA) is the most frequent form of endocrine hypertension. Besides its deleterious impact on cardiovascular target organ damage, PA is considered to cause osteoporosis. Patients and methods We assessed bone turnover in a subset of 36 postmenopausal women with PA. 18 patients had unilateral PA and were treated by adrenalectomy, whereas 18 patients had bilateral PA and received mineralocorticoid receptor antagonist (MRA) therapy respectively. 18 age- and BMI-matched females served as controls. To estimate bone remodeling, we measured the bone turnover markers intact procollagen 1 N-terminal propeptide, bone alkaline phosphatase, osteocalcin and tartrate resistant acid phosphatase 5b in plasma by chemiluminescent immunoassays at time of diagnosis and one year after initiation of treatment. Study design Observational longitudinal cohort study. Setting Tertiary care hospital. Results Compared with controls, patients with PA had mildly elevated osteocalcin at baseline (p = 0.013), while the other bone markers were comparable between both groups. There were no differences between the unilateral and the bilateral PA subgroup. One year after initiation of MRA treatment with spironolactone bone resorption and bone formation markers had significantly decreased in patients with bilateral PA. In contrast, patients adrenalectomized because of unilateral PA showed no significant change of bone turnover markers. Conclusion This study shows that aldosterone excess in postmenopausal women with PA is not associated with a relevant increase of bone turnover markers at baseline. However, we observed a significant decrease of bone markers in patients treated with spironolactone, but not in patients treated by adrenalectomy.}, language = {en} } @phdthesis{Ahrens2020, author = {Ahrens, Lea Marlen}, title = {The Role of Attentional Control and Fear Acquisition and Generalization in Social Anxiety Disorder}, doi = {10.25972/OPUS-17162}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171622}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Although Social Anxiety Disorder (SAD) is one of the most prevalent mental disorders, still little is known about its development and maintenance. Cognitive models assume that deviations in attentional as well as associative learning processes play a role in the etiology of SAD. Amongst others, deficits in inhibitory attentional control as well as aberrations during fear generalization, which have already been observed in other anxiety disorders, are two candidate mechanisms that might contribute to the onset and retention of SAD. However, a review of the literature shows that there is a lack of research relating to these topics. Thus, the aim of the present thesis was to examine in which way individuals with SAD differ from healthy controls regarding attentional control and generalization of acquired fear during the processing of social stimuli. Study 1 tested whether impairment in the inhibitory control of attention is a feature of SAD, and how it might be influenced by emotional expression and gaze direction of an interactional partner. For this purpose, individuals with SAD and healthy controls (HC) participated in an antisaccade task with faces displaying different emotional expressions (angry, neutral and happy) and gaze directions (direct and averted) serving as target stimuli. While the participants performed either pro- or antisaccades in response to the peripherally presented faces, their gaze behavior was recorded via eye-tracking, and ratings of valence and arousal were obtained. Results revealed that both groups showed prolonged latencies and increased error rates in trials with correct anti- compared to prosaccades. However, there were no differences between groups with regard to response latency or error rates, indicating that SAD patients did not exhibit impairment on inhibitory attentional control in comparison to HC during eye-tracking. Possible explanations for this finding could be that reduced inhibitory attentional control in SAD only occurs under certain circumstances, for example, when these individuals currently run the risk of being negatively evaluated by others and not in the mere presence of phobic stimuli, or when the cognitive load of a task is so high that it cannot be unwound by compensatory strategies, such as putting more effort into a task. As not only deviations in attentional, but also associative learning processes might be pathogenic markers of SAD, these mechanisms were further addressed in the following experiments. Study 2 is the first that attempted to investigate the generalization of conditioned fear in patients with SAD. To this end, patients with SAD and HC were conditioned to two neutral female faces serving as conditioned stimuli (CS+: reinforced; CS-: non-reinforced) and a fearful face paired with a loud scream serving as unconditioned stimulus (US). Fear generalization was tested by presenting morphs of the two faces (GS: generalization stimuli), which varied in their similarity to the original faces. During the whole experiment, self-report ratings, heart rate (HR) and skin conductance responses (SCR) were recorded. Results demonstrated that SAD patients rated all stimuli as less pleasant and more arousing, and overestimated the occurrence of the US compared to HC, indicating a general hyperarousal in individuals with SAD. In addition, ratings and SCR indicated that both groups generalized their acquired fear from the CS+ to intermediate GSs as a function of their similarity to the CS+. However, except for the HR data, which indicated that only SAD patients but not HC displayed a generalization response in this measure, most of the results did not support the hypothesis that SAD is characterized by overgeneralization. A plausible reason for this finding could be that overgeneralization is just a key characteristic of some anxiety disorders and SAD is not one of them. Still, other factors, such as comorbidities in the individuals with SAD, could also have had an influence on the results, which is why overgeneralization was further examined in study 3. The aim of study 3 was to investigate fear generalization on a neuronal level. Hence, high (HSA) and low socially anxious participants (LSA) underwent a conditioning paradigm, which was an adaption of the experimental design used study 2 for EEG. During the experiment, steady-state visually evoked potentials (ssVEPs) and ratings of valence and arousal were recorded. Analyses revealed significant generalization gradients in all ratings with highest fear responses to the CS+ and a progressive decline of these reactions with increasing similarity to the CS-. In contrast, the generalization gradient on a neuronal level showed highest amplitudes for the CS+ and a reduction in amplitude to the most proximal, but not distal GSs in the ssVEP signal, which might be interpreted as lateral inhibition in the visual cortex. The observed dissociation among explicit and implicit measures points to different functions of behavioral and sensory cortical processes during fear generalization: While the ratings might reflect an individual's consciously increased readiness to react to threat, the lateral inhibition pattern in the occipital cortex might serve to maximize the contrast among stimuli with and without affective value and thereby improve adaptive behavior. As no group differences could be observed, the finding of study 2 that overgeneralization does not seem to be a marker of SAD is further consolidated. In sum, the conducted experiments suggest that individuals with SAD are characterized by a general hyperarousal during the exposition to disorder-relevant stimuli as indicated by enhanced arousal and reduced valence ratings of the stimuli compared to HC. However, the hypotheses that reduced inhibitory attentional control and overgeneralization of conditioned fear are markers of SAD were mostly not confirmed. Further research is required to elucidate whether they only occur under certain circumstances, such as high cognitive load (e.g. handling two tasks simultaneously) or social stress (e.g. before giving a speech), or whether they are not characteristics of SAD at all. With the help of these findings, new interventions for the treatment of SAD can be developed, such as attentional bias modification or discrimination learning.}, subject = {Sozialangst}, language = {en} } @phdthesis{Aicha2020, author = {Aicha, Diaa}, title = {Hypertrophe obstruktive Kardiomyopathie: Vorhersagewert des ESC-Risikoscore f{\"u}r den pl{\"o}tzlichen Herztod bei Patienten nach Alkoholseptumablation}, doi = {10.25972/OPUS-19364}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-193649}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Abstrakt Hypertrophe Kardiomyopathie (HCM) ist eine genetisch bedingte Herzmuskelerkrankung mit einer Pr{\"a}valenz von 0,2 bis 0,6\% und einem SCD-Risiko von 0,5 bis 1\% pro Jahr. HCM ist die h{\"a}ufigste Ursache f{\"u}r pl{\"o}tzlichen Herztod in jungem Alter. Seit Jahrzehnten wird bei HCM der optimale Vorhersagescore f{\"u}r SCD untersucht. Der erste validierte SCD-Sore bei HCM wurde im Jahr 2014 in die ESC-Leitlinien integriert. Ziel der Studie: Vergleich des berechneten SCD-Scores bei HCM aus dem Jahr 2014 vor und nach Alkohol- Septum-Ablation (PTSMA) mit dem erreichten Endpunkt (SCD). Methoden: 56 Patienten mit hypertropher obstruktiver Kardiomyopathie (HOCM) und Erst-PTSMA im Jahr 2009 wurden eingeschlossen: Alter 53,9 ± 11,5 Jahre, 7\% positive Familienanamnese f{\"u}r SCD, 9\% ungekl{\"a}rte Synkope im letzten Jahr, 43\% NSVT, maximale LV-Wanddicke 20,2 ± 4,3 mm, maximaler LVOT-Gradient 118 ± 42 mmHg, LA-Durchmesser 45,3 ± 6,4 mm. Ergebnisse: Vor dem ersten PTSMA hatten die HOCM-Patienten einen errechneten SCD-Wert von 4,2 ± 3,2\%, nach PTSMA von 3,2 ± 2,2\%. Wir beobachteten 2 (3,6\%) SCD-F{\"a}lle in 5 Jahren. Die PTSMA f{\"u}hrte zu einer signifikanten Reduktion des errechneten SCD-Scores von 1,0 ± 2,8\%, p <0,05. Diese Reduktion war haupts{\"a}chlich durch die signifikante Reduktion des LVOT-Gradienten (durchschnittlich 54 ± 42 mmHg, p <0,05) zur{\"u}ckzuf{\"u}hren. Fazit: PTSMA ist eine etablierte Behandlung zur Verbesserung der Symptome bei HOCM-Patienten ohne Hinweis auf eine h{\"o}here Mortalit{\"a}t nach induziertem Infarkt. Der ESC-SCD-Score ist nur ein Hilfsalgorithmus f{\"u}r die individuelle Entscheidung bez{\"u}glich einer prim{\"a}rprophylaktischen AICD-Implantation.}, subject = {HCM}, language = {de} } @phdthesis{Aichholzer2020, author = {Aichholzer, Mareike}, title = {Ver{\"a}nderungen im intestinalen Mikrobiom bei Patienten mit akuter Leuk{\"a}mie im longitudinalen Verlauf}, doi = {10.25972/OPUS-19921}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-199213}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {In der vorliegenden Studie wurden Ver{\"a}nderungen des Darmmikrobioms anhand von Stuhlproben von Patienten mit akuter Leuk{\"a}mie longitudinal untersucht. Die Patienten wurden mit intensiver Chemotherapie behandelt. Die Therapie als auch die Erkrankung selbst f{\"u}hrte zu einer erheblichen Immunsuppression der Patienten. Prophylaktisch und therapeutisch wurden intensive Antibiotikatherapien bei allen Patienten durchgef{\"u}hrt. Das Mikrobiom wurde quantitativ und qualitativ analysiert. Die Bakterienmenge der Stuhlproben wurde mittels quantitativer Polymerase-Kettenreaktion und die Diversit{\"a}t des Mikrobioms mittels 16s rDNA Sequenzierung aufgezeigt. Zus{\"a}tzlich dazu fand eine mikrobiologische Kultivierung von Bakterien in Rektalabstrichen statt, um multiresistente Keime nachzuweisen. Ebenso wurde der klinische Verlauf der Patienten dokumentiert. Insgesamt wurde das Mikrobiom von drei verschiedenen Studiengruppen untersucht: Patienten mit akuter Leuk{\"a}mie, Patienten, die mit multiresistenten Keimen besiedelt waren und sich in der Nachsorge der W{\"u}rzburger interdisziplin{\"a}ren onkologischen Tagesklinik befanden sowie gesunde Probanden. Im Mikrobiom der Patienten mit akuter Leuk{\"a}mie war eine deutlich geringere Diversit{\"a}t sowie eine deutlich geringere Bakterienmenge im Vergleich zu beiden anderen Studiengruppen festzustellen. Das Mikrobiom {\"a}nderte sich w{\"a}hrend des Therapieverlaufs erheblich und am Beispiel von einigen Patienten konnte gezeigt werden, dass einzelne Bakterien das Mikrobiom dominierten. Des Weiteren waren im Mikrobiom der Patienten mit akuter Leuk{\"a}mie mehr potenziell pathogene sowie weniger potenziell protektive Bakterien im Vergleich zur Kontrollgruppe vorhanden. Zusammenfassend l{\"a}sst sich sagen, dass sich das Mikrobiom der Patienten mit akuter Leuk{\"a}mie deutlich von dem der anderen Studiengruppen unterscheidet. Um die Daten zu validieren und einen eventuellen Einfluss des Mikrobioms auf das {\"U}berleben der Patienten zu identifizieren, sollten die Untersuchungen an einer deutlich gr{\"o}ßeren Studienpopulation wiederholt werden.}, subject = {Akute Leuk{\"a}mie}, language = {de} }