@article{DoranFuldeGratzetal.2016, author = {Doran, Kelly S. and Fulde, Marcus and Gratz, Nina and Kim, Brandon J. and Nau, Roland and Prasadarao, Nemani and Schubert-Unkmeir, Alexandra and Tuomanen, Elaine I. and Valentin-Weigand, Peter}, title = {Host-pathogen interactions in bacterial meningitis}, series = {Acta Neuropathologica}, volume = {131}, journal = {Acta Neuropathologica}, number = {2}, doi = {10.1007/s00401-015-1531-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-191034}, pages = {185-209}, year = {2016}, abstract = {Bacterial meningitis is a devastating disease occurring worldwide with up to half of the survivors left with permanent neurological sequelae. Due to intrinsic properties of the meningeal pathogens and the host responses they induce, infection can cause relatively specific lesions and clinical syndromes that result from interference with the function of the affected nervous system tissue. Pathogenesis is based on complex host-pathogen interactions, some of which are specific for certain bacteria, whereas others are shared among different pathogens. In this review, we summarize the recent progress made in understanding the molecular and cellular events involved in these interactions. We focus on selected major pathogens, Streptococcus pneumonia, S. agalactiae (Group B Streptococcus), Neisseria meningitidis, and Escherichia coli K1, and also include a neglected zoonotic pathogen, Streptococcus suis. These neuroinvasive pathogens represent common themes of host-pathogen interactions, such as colonization and invasion of mucosal barriers, survival in the blood stream, entry into the central nervous system by translocation of the blood-brain and blood-cerebrospinal fluid barrier, and induction of meningeal inflammation, affecting pia mater, the arachnoid and subarachnoid spaces.}, language = {en} } @phdthesis{Nono2012, author = {Nono, Justin}, title = {Immunomodulation through Excretory/Secretory Products of the parasitic Helminth Echinococcus multilocularis}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-85449}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2012}, abstract = {Die Alveol{\"a}re Echinokokkose (AE) ist eine lebensbedrohliche Zoonose, die durch das Metazestoden-Larvenstadium des Fuchsbandwurms Echinococcus multilocularis ausgel{\"o}st wird. Nach Eintritt des Parasiten in den Zwischenwirt wird zun{\"a}chst eine potentiell anti-parasitische, Th1-dominierte Immunantwort ausgel{\"o}st, welche anschließend in der chronischen Phase graduell durch eine permissive, Th2-dominierte Antwort ersetzt wird. Als Ergebnis einer zugrunde liegenden Immunmodulation durch den Parasiten k{\"o}nnen Echinococcus-Larven f{\"u}r Jahre bis Jahrzehnte im Wirt persistieren und verhalten sich {\"a}hnlich einem perfekt transplantierten Organ. {\"U}ber die molekulare Basis der Immunmodulation durch den Parasiten ist derzeit wenig bekannt. In dieser Arbeit wurden geeignete Kultursysteme f{\"u}r verschiedene E. multilocularis Larvenstadien verwendet, um den Einfluss exkretorisch/sekretorischer Metaboliten (E/S-Produkte) auf Wirts-Immuneffektor-Zellen zu studieren. E/S-Produkte kultivierter Larven, die die fr{\"u}he (Prim{\"a}rzellen) und chronische (Metazestode) Phase der Infektion repr{\"a}sentieren induzierten Apoptose und tolerogene Eigenschaften in Dendritischen Zellen (DC) des Wirts, w{\"a}hrend solche von Kontroll-Larven (Protoskolizes) keine derartigen Effekte zeigten. Dies zeigt, dass die fr{\"u}hen infekti{\"o}sen Stadien von E. multilocularis in DC ein tolerierendes Milieu erzeugen, welches sehr wahrscheinlich die initiale Etablierung des Parasiten in einer Phase beg{\"u}nstigt, in der er h{\"o}chst sensitiv gegen{\"u}ber Wirtsangriffen ist. Interessanterweise f{\"o}rderten E/S-Produkte des Metazestoden in vitro die Konversion von CD4+ T-Zellen in Foxp3+, regulatorische T-Zellen (Treg) w{\"a}hrend E/S-Produkte von Prim{\"a}rzellen oder Protoskolizes dies nicht vermochten. Da Foxp3+ Tregs generell als immunosuppressorisch bekannt sind, deuten diese Daten an, dass der Metazestode aktiv eine Induktion von Tregs herbeif{\"u}hrt, um eine permissive Immunsuppression w{\"a}hrend einer Infektion zu erreichen. Eine substantielle Zunahme von Anzahl und Frequenz Foxp3+ Tregs konnte zudem in Peritoneal-Exsudaten von M{\"a}uuen nach intraperitonealer Injektion von Parasitengewebe gemessen werden, was anzeigt, dass eine Expansion von Foxp3+ Tregs auch w{\"a}hrend der in vivo Infektion von Bedeutung ist. Interessanterweise konnte in dieser Arbeit ein Activin-Orthologes des Parasiten, EmACT, identifiziert werden, weleches vom Metazestoden sekretiert wird und {\"a}hnlich wie humanes Activin in der Lage ist, eine TGF-β-abh{\"a}ngige Expansion von Tregs in vitro zu induzieren. Dies zeigt an, dass E. multilocularis evolutionsgeschichtlich konservierte Zytokine nutzt, um aktiv die Wirts-Immunantwort zu beeinflussen. Zusammenfassend deuten die gewonnenen Daten auf eine wichtige Rolle Foxp3+ Tregs, welche u.a. durch EmACT induziert werden, im immunologischen geschehen der AE hin. Ein weiterer Parasiten-Faktor, EmTIP, mit signifikanten Homologien zum T-cell Immunomodulatory Protein (TIP) des Menschen wurde in dieser Arbeit n{\"a}her charakterisiert. EmTIP konnte in der E/S-Fraktion von Prim{\"a}rzellen nachgewiesen werden und induzierte die Freisetzung von IFN-γ in CD4+ T-Helferzellen. Durch Zugabe von anti-EmTIP-Antik{\"o}rpern konnte zudem die Entwicklung des Parasiten zum Metazestoden in vitro gehemmt werden. EmTIP d{\"u}rfte daher einerseits bei der fr{\"u}hen Parasiten-Entwicklung im Zwischenwirt eine Rolle spielen und k{\"o}nnte im Zuge dessen auch die Auspr{\"a}gung der fr{\"u}hen, Th-1-dominierten Immunantwort w{\"a}hrend der AE beg{\"u}nstigen. Zusammenfassend wurden in dieser Arbeit zwei E. multilocularis E/S-Faktoren identifiziert, EmACT und EmTIP, die ein hohes immunmodulatorisches Potential besitzen. Die hier vorgestellten Daten liefern neue, fundamentale Einsichten in die molekularen Mechanismen der Parasiten-induzierten Immunmodulation bei der AE und sind hoch relevant f{\"u}r die Entwicklung anti-parasitischer Immuntherapien.}, subject = {Immunmodulation}, language = {en} } @article{BrehonyTrotterRamsayetal.2014, author = {Brehony, Carina and Trotter, Caronline L. and Ramsay, Mary E. and Chandra, Manosree and Jolley, Keith A. and van der Ende, Arie and Carion, Fran{\c{c}}oise and Berthelsen, Lene and Hoffmann, Steen and Harðard{\´o}ttir, Hj{\"o}rd{\´i}s and Vazques, Julio A. and Murphy, Karen and Toropainen, Maija and Cani{\c{c}}a, Manuela and Ferreira, Eugenia and Diggle, Mathew and Edwards, Giles F. and Taha, Muhamed-Kheir and Stefanelli, Paola and Kriz, Paula and Gray, Steve J. and Fox, Andrew J. and Jacobsson, Susanne and Claus, Heike and Vogel, Ulrich and Tzanakaki, Georgina and Heuberger, Sigrid and Caugant, Dominique A. and Frosch, Matthias and Maiden, Martin C. J.}, title = {Implications of Differential Age Distribution of Disease-Associated Meningococcal Lineages for Vaccine Development}, series = {Clinical and Vaccine Immunology : CVI}, volume = {21}, journal = {Clinical and Vaccine Immunology : CVI}, number = {6}, doi = {10.1128/cvi.00133-14}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-120808}, pages = {847-53}, year = {2014}, abstract = {New vaccines targeting meningococci expressing serogroup B polysaccharide have been developed, with some being licensed in Europe. Coverage depends on the distribution of disease-associated genotypes, which may vary by age. It is well established that a small number of hyperinvasive lineages account for most disease, and these lineages are associated with particular antigens, including vaccine candidates. A collection of 4,048 representative meningococcal disease isolates from 18 European countries, collected over a 3-year period, were characterized by multilocus sequence typing (MLST). Age data were available for 3,147 isolates. The proportions of hyperinvasive lineages, identified as particular clonal complexes (ccs) by MLST, differed among age groups. Subjects <1 year of age experienced lower risk of sequence type 11 (ST-11) cc, ST-32 cc, and ST-269 cc disease and higher risk of disease due to unassigned STs, 1- to 4-year-olds experienced lower risk of ST-11 cc and ST-32 cc disease, 5- to 14-year-olds were less likely to experience ST-11 cc and ST-269 cc disease, and ≥25-year-olds were more likely to experience disease due to less common ccs and unassigned STs. Younger and older subjects were vulnerable to a more diverse set of genotypes, indicating the more clonal nature of genotypes affecting adolescents and young adults. Knowledge of temporal and spatial diversity and the dynamics of meningococcal populations is essential for disease control by vaccines, as coverage is lineage specific. The nonrandom age distribution of hyperinvasive lineages has consequences for the design and implementation of vaccines, as different variants, or perhaps targets, may be required for different age groups.}, language = {en} } @article{StockPetrašMelteretal.2016, author = {Stock, Nina Katharina and Petr{\´a}š, Petr and Melter, Oto and Kapounov{\´a}, Gabriela and Vopalkov{\´a}, Petra and Kubele, Jan and Vaniš, V{\´a}clav and Tkadlec, Jan and Buk{\´a}čkov{\´a}, Eva and Machov{\´a}, Ivana and Jindr{\´a}k, Vlastimil}, title = {Importance of Multifaceted Approaches in Infection Control: A Practical Experience from an Outbreak Investigation}, series = {PLoS ONE}, volume = {11}, journal = {PLoS ONE}, number = {6}, doi = {10.1371/journal.pone.0157981}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-166891}, pages = {e0157981}, year = {2016}, abstract = {Background This study presents the results of a multidisciplinary, nosocomial MRSA outbreak investigation in an 8-bed medical intensive care unit (ICU). The identification of seven MRSA positive patients in the beginning of 2014 led to the closure of the ward for several weeks. A multidisciplinary, retrospective investigation was initiated in order to identify the reason and the source for the outbreak, describe MRSA transmission in the department and identify limitations in infection control. Methods The investigation comprised an epidemiological description of MRSA cases from 2012 to 2014 and a characterization of MRSA isolates, including phage-, spa- and PFGE-typing. Additionally, MRSA screening was performed from the hospital staff and the environment. To identify the reason for the outbreak, work-related, psychological and behavioral factors were investigated by impartial audits and staff interviews. Results Thirty-one MRSA cases were registered during the study period, and 36 isolates were investigated. Molecular typing determined the outbreak strain (phage type 54/812, PFGE type A4, spa type t003) and identified the probable index case. Nasal carriage in one employee and a high environmental contamination with the outbreak strain was documented. Important gaps in nursing procedures and general management were identified. Elevated stress levels and communication problems preceded the outbreak. Compliance with hand hygiene and isolation procedures was evaluated as appropriate. Conclusion This study demonstrates the complexity of controlling hospital-associated infections. The combined use of different typing methods is beneficial for outbreak investigations. Psychological, behavioral and other work-related factors have an important impact on the spread of nosocomial pathogens. These factors should be addressed and integrated in routine infection control practice.}, language = {en} } @article{KohlmorgenEliasSchoen2017, author = {Kohlmorgen, Britta and Elias, Johannes and Schoen, Christoph}, title = {Improved performance of the artus Mycobacterium tuberculosis RG PCR kit in a low incidence setting: a retrospective monocentric study}, series = {Scientific Reports}, volume = {7}, journal = {Scientific Reports}, number = {14127}, doi = {10.1038/s41598-017-14367-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159248}, year = {2017}, abstract = {Tuberculosis (TB) and the spread of Mycobacterium tuberculosis complex (MTBC) strains resistant against rifampin (RIF) and isoniazid (INH) pose a serious threat to global health. However, rapid and reliable MTBC detection along with RIF/INH susceptibility testing are challenging in low prevalence countries due to the higher rate of false positives. Here, we provide the first performance data for the artus MTBC PCR assay in a low prevalence setting. We analyze 1323 respiratory and 311 non-respiratory samples with the artus MTBC PCR assay as well as by mycobacterial culture and microscopy. We propose retesting of specimens in duplicate and consideration of a determined cycle-threshold value cut-off greater than 34, as this significantly increases accuracy, specificity, and negative predictive value without affecting sensitivity. Furthermore, we tested fourteen MTBC positive samples with the GenoType MTBDRplus test and demonstrate that using an identical DNA extraction protocol for both assays does not impair downstream genotypic testing for RIF and INH susceptibility. In conclusion, our procedure optimizes the use of the artus MTB assay with workload efficient methods in a low incidence setting. Combining the modified artus MTB with the GenoType MTBDRplus assays allows rapid and accurate detection of MTBC and RIF/INH resistance.}, language = {en} } @article{WalterCollenburgJaptoketal.2016, author = {Walter, T. and Collenburg, L. and Japtok, L. and Kleuser, B. and Schneider-Schaulies, S. and M{\"u}ller, N. and Becam, J. and Schubert-Unkmeir, A. and Kong, J. N. and Bieberich, E. and Seibel, J.}, title = {Incorporation and visualization of azido-functionalized N-oleoyl serinol in Jurkat cells, mouse brain astrocytes, 3T3 fibroblasts and human brain microvascular endothelial cells}, series = {Chemical Communications}, volume = {52}, journal = {Chemical Communications}, number = {55}, doi = {10.1039/c6cc02879a}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-191263}, pages = {8612-8614}, year = {2016}, abstract = {The synthesis and biological evaluation of azido-N-oleoyl serinol is reported. It mimicks biofunctional lipid ceramides and has shown to be capable of click reactions for cell membrane imaging in Jurkat and human brain microvascular endothelial cells.}, language = {en} } @article{GomesWestermannSauerweinetal.2019, author = {Gomes, Sara F. Martins and Westermann, Alexander J. and Sauerwein, Till and Hertlein, Tobias and F{\"o}rstner, Konrad U. and Ohlsen, Knut and Metzger, Marco and Shusta, Eric V. and Kim, Brandon J. and Appelt-Menzel, Antje and Schubert-Unkmeir, Alexandra}, title = {Induced pluripotent stem cell-derived brain endothelial cells as a cellular model to study Neisseria meningitidis infection}, series = {Frontiers in Microbiology}, volume = {10}, journal = {Frontiers in Microbiology}, number = {1181}, doi = {10.3389/fmicb.2019.01181}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201562}, year = {2019}, abstract = {Meningococcal meningitis is a severe central nervous system infection that occurs when Neisseria meningitidis (Nm) penetrates brain endothelial cells (BECs) of the meningeal blood-cerebrospinal fluid barrier. As a human-specific pathogen, in vivo models are greatly limited and pose a significant challenge. In vitro cell models have been developed, however, most lack critical BEC phenotypes limiting their usefulness. Human BECs generated from induced pluripotent stem cells (iPSCs) retain BEC properties and offer the prospect of modeling the human-specific Nm interaction with BECs. Here, we exploit iPSC-BECs as a novel cellular model to study Nm host-pathogen interactions, and provide an overview of host responses to Nm infection. Using iPSC-BECs, we first confirmed that multiple Nm strains and mutants follow similar phenotypes to previously described models. The recruitment of the recently published pilus adhesin receptor CD147 underneath meningococcal microcolonies could be verified in iPSC-BECs. Nm was also observed to significantly increase the expression of pro-inflammatory and neutrophil-specific chemokines IL6, CXCL1, CXCL2, CXCL8, and CCL20, and the secretion of IFN-γ and RANTES. For the first time, we directly observe that Nm disrupts the three tight junction proteins ZO-1, Occludin, and Claudin-5, which become frayed and/or discontinuous in BECs upon Nm challenge. In accordance with tight junction loss, a sharp loss in trans-endothelial electrical resistance, and an increase in sodium fluorescein permeability and in bacterial transmigration, was observed. Finally, we established RNA-Seq of sorted, infected iPSC-BECs, providing expression data of Nm-responsive host genes. Altogether, this model provides novel insights into Nm pathogenesis, including an impact of Nm on barrier properties and tight junction complexes, and suggests that the paracellular route may contribute to Nm traversal of BECs.}, language = {en} } @phdthesis{Lee2006, author = {Lee, Sae Kyung}, title = {Interaction of Helicobacter pylori flagellins with the host innate immune system}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-19917}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2006}, abstract = {Helicobacter pylori (H. pylori) is a gram-negative, microaerophilic, spiral-shaped bacterium. It resides in the gastric mucous layer and epithelial lining of the stomach, often clustering at the junction of epithelial cells. H. pylori colonization usually occurs during childhood, and, when left untreated, generally persists for the host's lifetime. Persistent H. pylori infection can cause chronic superficial gastritis and gastric duodenal ulcers, which is possibly linked to the development of gastric carcinoma and primary gastric lymphoma, especially of the mucosa-associated lymphoid tissue (MALT) type. It was recently defined as a class 1 carcinogen. The gastric inflammatory response to H. pylori infection is characterized by infiltration of the mucosa by neutrophils, T and B cells, plasma cells and macrophages. This reaction is initially induced by H. pylori attachment, followed by cytokine release by gastric epithelial cells. Epidemiological studies revealed that more than 50\% of adults are infected with H. pylori all over the world. However, interestingly, only a subset of individuals develops serious H. pylori-related disease, while most infected individuals show no clinical symptoms. Gastric epithelial cells, like intestinal epithelial cells, express a subset of Toll-like receptors (TLRs) and similar pattern recognition receptors, which are important for the activation of the innate immune system. Bacterial components such as lipopeptides, peptidoglycan, LPS, flagellin, and CpG DNA are the ligands of TLRs. Thus, TLRs in gastric epithelial cells might be able to contribute to innate immune responses to H. pylori infection. However, there is scant knowledge about the mechanisms of innate immune response to acute and chronic H. pylori infection. This study is focused on host cell interaction with H. pylori flagellins, which are major components of the flagellar apparatus, and innate immune responses against them. The flagellins, which are essential for bacterial motility, are important for H. pylori to survive in the stomach mucus during the whole infectious cycle. Flagellins are known to act as the main determinant of many mucosal pathogenic bacteria that mediates proinflammatory signaling, including transcriptional factor NF-\&\#61547;B activation via TLR5. In the first part of the study, we investigated the effects of H. pylori flagellins on TLR5 expression, NF-\&\#61547;B activation and IL-8 production in various human intestinal and gastric epithelial cell lines by using Western blotting, semi-quantitative RT-PCR and ELISA. IL-8 is a potent neutrophil-activating chemokine expressed by gastric epithelial cells. When we stimulated the cells with the native form of or E. coli-expressed recombinant H. pylori flagellins, FlaA and FlaB, IL-8 was not induced in any case, while S. typhimurium flagellin (FliC) induced it significantly. H. pylori was able to modulate TLR5 protein expression and NF-\&\#61547;B activation in epithelial cells regardless of the presence of flagellins. Having established the finding that H. pylori flagellins have unusually low immune-stimulatory properties, we further investigated to find out possible reasons why H. pylori flagellins are distinct from other flagellins of pathogenic bacteria in terms of immune-stimulatory activity. From amino acid sequence comparisons, we found that some regions in the terminal D0D1 protein domains of H. pylori flagellins are different from flagellins of other pathogenic bacteria. D0D1 is the domain which is known to interact with TLR5 in Salmonella FliC. To examine whether the differences endow H. pylori flagellins with low immune-stimulatory properties, we created several mutated H. pylori flagellins (FlaA and FlaB) by site-directed mutagenesis that contain one to four epitopes of Salmonella flagellin D0D1 domain amino acid sequences. The mutant flagellins expressed both in H. pylori and E. coli were used to determine their influence on TLR5-signaling mediators and cytokines, such as MAPkinases, (ERK, p38), NF-\&\#61547;B, IL-8, and MIP-3\&\#61537;. Salmonella FliC expressed in E. coli induced activation of p38, I\&\#61547;B\&\#61537; and NF-\&\#61547;B leading to IL-8 and MIP-3\&\#61537; production in gastric epithelial cells. However, none of the H. pylori flagellin mutants activated MAP kinases or induced those cytokines. In a co-immunoprecipitation assay none of the recombinant wild type or mutated H. pylori flagellins showed any direct physical interaction with TLR5, while Salmonella FliC significantly co-precipitated with TLR5. Interestingly, we found H. pylori flagellins bind to the surface of gastric epithelial cells like FliC, although they do not bind to or stimulate TLR5. Based on the physical interaction of H. pylori flagellins and FliC with human gastric epithelial cells, we further analyzed transcriptional regulation by H. pylori flagellin in these host cells using microarray analysis. The result showed that H. pylori flagellins modulate host cell gene expression, and many of the identified regulation events overlap with the genes regulated by FliC. These findings imply that H. pylori flagellins do play a role in gene regulation of host cells probably through still unknown factors or receptors, although they do not trigger TLR5-related signaling pathways. The results of our study suggest that, in addition to the low immune-stimulatory activity of H. pylori LPS, the evolutionary reduction in stimulating activity of H. pylori flagellins on the local innate immune responses in the stomach in vivo might be a further strategy of this chronic mucosal pathogen to evade and minimize deleterious host responses, thereby promoting life-long persistence in the host, and possibly contributing to cancerogenesis.}, subject = {Helicobacter pylori}, language = {en} } @article{ForsterDichtlWagener2022, author = {Forster, Johannes and Dichtl, Karl and Wagener, Johannes}, title = {Lower beta-1,3-D-glucan testing cut-offs increase sensitivity for non-albicans Candida species bloodstream infections}, series = {Mycoses}, volume = {65}, journal = {Mycoses}, number = {5}, doi = {10.1111/myc.13421}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-276515}, pages = {500 -- 507}, year = {2022}, abstract = {Purpose Fungal biomarkers support early diagnosis of invasive fungal infections. In this study, we evaluated the impact of a recent update to the manufacturer-recommended cut-off for beta-1,3-D-glucan (BDG) testing (Fujifilm Wako BDG assay) on sensitivity and specificity for the detection of candidemia. Additionally, we compared the performance with tests for Candida antigen (Ag by Serion ELISA antigen Candida, Virion\Serion) and anti-mannan antibodies (Ab by Hemkit Candida IHA, Ravo Diagnostika). Methods Sera of 82 patients with candidemia, which were sampled with a maximum distance of ±14 days from the date of sampling of the corresponding positive blood cultures, were retrospectively analysed for BDG, Ag and Ab. Results of BDG testing were compared with results from sera of 129 patients with candidemia from a different hospital. Results Sensitivity of BDG testing (47\%) was higher than for Ag (17\%) or Ab (20\%). By combining Ag and Ab testing, sensitivity was raised to 32\%. Lowering the cut-off of BDG from 11 pg/ml to the newly recommended cut-off of 7 pg/ml resulted in a significant increase in sensitivity (47\% vs 58\%, p = .01 and 63\% vs 71\% p < .01). At both centres, the increase was significant in NAC but not in C. albicans candidemia. No significant effects on specificity were observed. Conclusion BDG testing outperformed Ag and Ab testing and its combination. Lowering the BDG cut-off had no significant impact on specificity. The increase in sensitivity can be mainly attributed to a gain in sensitivity for non-albicans Candida species bloodstream infections.}, language = {en} } @article{KurotschkaTiedemannWolfetal.2021, author = {Kurotschka, Peter Konstantin and Tiedemann, Elena and Wolf, Dominik and Thier, Nicola and Forster, Johannes and Liese, Johannes G. and Gagyor, Ildiko}, title = {Management of common infections in German primary care: a cross-sectional survey of knowledge and confidence among General Practitioners and outpatient pediatricians}, series = {Antibiotics}, volume = {10}, journal = {Antibiotics}, number = {9}, issn = {2079-6382}, doi = {10.3390/antibiotics10091131}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246272}, year = {2021}, abstract = {Outpatient antibiotic use is closely related to antimicrobial resistance and in Germany, almost 70\% of antibiotic prescriptions in human health are issued by primary care physicians (PCPs). The aim of this study was to explore PCPs, namely General Practitioners' (GPs) and outpatient pediatricians' (PDs) knowledge of guideline recommendations on rational antimicrobial treatment, the determinants of confidence in treatment decisions and the perceived need for training in this topic in a large sample of PCPs from southern Germany. Out of 3753 reachable PCPs, 1311 completed the survey (overall response rate = 34.9\%). Knowledge of guideline recommendations and perceived confidence in making treatment decisions were high in both GPs and PDs. The two highest rated influencing factors on prescribing decisions were reported to be guideline recommendations and own clinical experiences, hence patients' demands and expectations were judged as not influencing treatment decisions. The majority of physicians declared to have attended at least one specific training course on antibiotic use, yet almost all the participating PCPs declared to need more training on this topic. More studies are needed to explore how consultation-related and context-specific factors could influence antibiotic prescriptions in general and pediatric primary care in Germany beyond knowledge. Moreover, efforts should be undertaken to explore the training needs of PCPs in Germany, as this would serve the development of evidence-based educational interventions targeted to the improvement of antibiotic prescribing decisions rather than being focused solely on knowledge of guidelines.}, language = {en} } @article{SchoenKischkiesEliasetal.2014, author = {Schoen, Christoph and Kischkies, Laura and Elias, Johannes and Ampattu, Biju Joseph}, title = {Metabolism and virulence in Neisseria meningitidis}, doi = {10.3389/fcimb.2014.00114}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-113118}, year = {2014}, abstract = {A longstanding question in infection biology addresses the genetic basis for invasive behavior in commensal pathogens. A prime example for such a pathogen is Neisseria meningitidis. On the one hand it is a harmless commensal bacterium exquisitely adapted to humans, and on the other hand it sometimes behaves like a ferocious pathogen causing potentially lethal disease such as sepsis and acute bacterial meningitis. Despite the lack of a classical repertoire of virulence genes in N. meningitidis separating commensal from invasive strains, molecular epidemiology suggests that carriage and invasive strains belong to genetically distinct populations. In recent years, it has become increasingly clear that metabolic adaptation enables meningococci to exploit host resources, supporting the concept of nutritional virulence as a crucial determinant of invasive capability. Here, we discuss the contribution of core metabolic pathways in the context of colonization and invasion with special emphasis on results from genome-wide surveys. The metabolism of lactate, the oxidative stress response, and, in particular, glutathione metabolism as well as the denitrification pathway provide examples of how meningococcal metabolism is intimately linked to pathogenesis. We further discuss evidence from genome-wide approaches regarding potential metabolic differences between strains from hyperinvasive and carriage lineages and present new data assessing in vitro growth differences of strains from these two populations. We hypothesize that strains from carriage and hyperinvasive lineages differ in the expression of regulatory genes involved particularly in stress responses and amino acid metabolism under infection conditions.}, language = {en} } @article{RufBrantlWagener2018, author = {Ruf, Dominik and Brantl, Victor and Wagener, Johannes}, title = {Mitochondrial Fragmentation in \(Aspergillus\) \(fumigatus\) as Early Marker of Granulocyte Killing Activity}, series = {Frontiers in Cellular and Infection Microbiology}, volume = {8}, journal = {Frontiers in Cellular and Infection Microbiology}, number = {128}, doi = {10.3389/fcimb.2018.00128}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227133}, year = {2018}, abstract = {The host's defense against invasive mold infections relies on diverse antimicrobial activities of innate immune cells. However, studying these mechanisms in vitro is complicated by the filamentous nature of such pathogens that typically form long, branched, multinucleated and compartmentalized hyphae. Here we describe a novel method that allows for the visualization and quantification of the antifungal killing activity exerted by human granulocytes against hyphae of the opportunistic pathogen Aspergillus fumigatus. The approach relies on the distinct impact of fungal cell death on the morphology of mitochondria that were visualized with green fluorescent protein (GFP). We show that oxidative stress induces complete fragmentation of the tubular mitochondrial network which correlates with cell death of affected hyphae. Live cell microscopy revealed a similar and non-reversible disruption of the mitochondrial morphology followed by fading of fluorescence in Aspergillus hyphae that were killed by human granulocytes. Quantitative microscopic analysis of fixed samples was subsequently used to estimate the antifungal activity. By utilizing this assay, we demonstrate that lipopolysaccharides as well as human serum significantly increase the killing efficacy of the granulocytes. Our results demonstrate that evaluation of the mitochondrial morphology can be utilized to assess the fungicidal activity of granulocytes against A. fumigatus hyphae.}, language = {en} } @phdthesis{Konrad2007, author = {Konrad, Christian}, title = {Molecular analysis of insulin signaling mechanisms in Echinococcus multilocularis and their role in the host-parasite interaction in the alveolar echinococcosis}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-22636}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2007}, abstract = {The insulin receptor ortholog EmIR of the fox-tapeworm Echinococcus multilocularis displays significant structural homology to the human insulin receptor (HIR) and has been suggested to be involved in insulin sensing mechanisms of the parasite's metacestode larval stage. In the present work, the effects of host insulin on Echinococcus metacestode vesicles and the proposed interaction between EmIR and mammalian insulin have been studied using biochemical and cell-biological approaches. Human insulin, exogenously added to in vitro cultivated parasite larvae, (i) significantly stimulated parasite survival and growth, (ii) induced DNA de novo synthesis in Echinococcus, (iii) affected overall protein phosphorylation in the parasite, and (iv) specifically induced the phosphorylation of the parasite's Erk-like MAP kinase orthologue EmMPK1. These results clearly indicated that Echinococcus metacestode vesicles are able to sense exogenous host insulin which induces a mitogenic response. To investigate whether EmIR mediates these effects, anti-EmIR antibodies were produced and utilized in biochemical assays and immunohistochemical analyses. EmIR was shown to be expressed in the germinal layer of the parasite both on the surface of glycogen storing cells and undifferentiated germinal cells. Upon addition of exogenous insulin to metacestode vesicles, the phosphorylation of EmIR was significantly induced, an effect which was suppressed in the presence of specific inhibitors of insulin receptor-like tyrosine kinases. Furthermore, upon expression of EmIR/HIR receptor chimera containing the extracellular ligand binding domain of EmIR in HEK 293 cells, a specific autophosphorylation of the chimera could be induced through the addition of exogenous insulin. These results indicated the capability of EmIR to sense and to transmit host insulin signals to the Echinococcus signaling machinery. The importance of insulin signaling mechanisms for parasite survival and growth were underscored by in vitro cultivation experiments in which the addition of an inhibitor of insulin receptor tyrosine kinases led to vesicle degradation and death. Based on the above outlined molecular data on the interaction between EmIR and mammalian insulin, the parasite's insulin receptor orthologue most probably mediates the insulin effects on parasite growth and is, therefore, a potential candidate factor for host-parasite communication via evolutionary conserved pathways. In a final set of experiments, signaling mechanisms that act downstream of EmIR have been analyzed. These studies revealed significant differences between insulin signaling in Echinococcus and the related cestode parasite Taenia solium. These differences could be associated with differences in the organo-tropism of both species.}, subject = {Fuchsbandwurm}, language = {en} } @phdthesis{Koike2023, author = {Koike, Akito}, title = {Molekular und zellbiologischer Ansatz hin zu neuartigen Medikamenten gegen \(Echinococcus\) \(multilocularis\)}, doi = {10.25972/OPUS-28864}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-288649}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2023}, abstract = {Echinococcosis is an important zoonosis. The causative agent of Alveolar Echinococcosis (AE) is Echinococcus multilocularis. The treatment of human AE is limited to surgery and chemotherapy with albendazole (ABZ). However, ABZ works only parasitostatically and it needs to be taken for long periods, although it causes adverse side effects. Thus, development of new, parasiticidal drug with selective toxicity is required. Because undifferentiated stem cells of E. multilocularis play key role in its longevity and regenerative capacity, targeting stem cells is especially important. In vitro screening of protein kinases inhibitors demonstrated that human PIM kinases inhibitors have detrimental effects on E. multilocularis. Through yeast two hybrid assay, the interaction of parasite PIM kinase (EmPIM) and its CDC25 (EmCDC25) was indicated. Through in situ hybridization, expression of EmPIM in the stem cells was observed. Therefore, EmPim is likely to be a positive regulator of cell cycle progression, the same as human Pim1. In addition, 20 compounds against EmPIM were selected through in silico screening and synthesized. One of them has a detrimental effect on E.multilocularis comparable to human pan-PIM inhibitors, but has much weaker toxicity on human cell lines. Furthermore, triclabendazole (TCBZ) and its metabolite TCBZSX, which are approved for another flatworm disease, Fascioliasis were tried on E. multilocularis. With two stem cell markers, damage to stem cells by TCBZSX was shown. In addition, primary cells from treated vesicles never regenerated and the damage to stem cells proved to be irreversible. Our in silico screening method used in EmPIM research has potential to identify compounds which overcome the side effect problem in ABZ-based chemotherapy. On the other hand, it is expected that my research of TCBZ can lead to development of a practical parasiticidal chemotherapy by combining TCBZ, which damages stem cells, and ABZ, which damages differentiated cells.}, subject = {Bandw{\"u}rmer}, language = {en} } @phdthesis{Hemer2012, author = {Hemer, Sarah}, title = {Molecular characterization of evolutionarily conserved signaling systems of Echinococcus multilocularis and their utilization for the development of novel drugs against Echinococosis}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-74007}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2012}, abstract = {Alveolar echinococcosis (AE), a severe and life-threatening disease is caused by the small fox tapeworm Echinococcus multilocularis. Currently, the options of chemotherapeutic treatment are very limited and are based on benzimidazole compounds, which act merely parasitostatic in vivo and often display strong side effects. Therefore, new therapeutic drugs and targets are urgently needed. In the present work the role of two evolutionarily conserved signalling pathways in E. multilocularis, namely the insulin signalling cascade and Abl kinases, has been studied in regard to host-parasite interaction and the possible use in anti-AE chemotherapy.}, subject = {Fuchsbandwurm}, language = {en} } @phdthesis{Herz2015, author = {Herz, Michaela}, title = {Molecular characterization of the serotonin and cAMP-signalling pathways in Echinococcus}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-139249}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2015}, abstract = {Alveolar and cystic echinococcosis, caused by Echinococcus multilocularis and Echinococcus granulosus respectively, are severe zoonotic diseases with limited treatment options. The sole curative treatment is the surgical removal of the complete parasite material. Due to late diagnosis, chemotherapeutic treatment often is the only treatment option. Treatment is based on benzimidazoles, which merely act parasitostatic and often display strong side effects. Therefore, new therapeutic drugs are urgently needed. Evolutionarily conserved signalling pathways are known to be involved in hostparasite cross-communication, parasite development and survival. Moreover, they represent potential targets for chemotherapeutic drugs. In this context the roles of the serotonin- and cAMP-signalling pathways in Echinococcus were studied. Genes encoding serotonin receptors, a serotonin transporter and enzymes involved in serotonin biosynthesis could be identified in the E. multilocularis and E. granulosus genomes indicating that these parasites are capable of synthesizing and perceiving serotonin signals. Also the influence of exogenous serotonin on parasite development was studied. Serotonin significantly increased metacestode vesicle formation from primary cells and re-differentiation of protoscoleces. Inhibition of serotonin transport with citalopram significantly reduced metacestode vesicle formation from primary cells and caused death of protoscoleces and metacestodes. Furthermore, it could be shown that serotonin increased phosphorylation of protein kinase A substrates. Taken together, these results show that serotonin and serotonin transport are essential for Echinococcus development and survival. Consequently, components of the serotonin pathway represent potential drug targets. In this work the cAMP-signalling pathway was researched with focus on G-protein coupled receptors and adenylate cyclases. 76 G-protein coupled receptors, including members of all major families were identified in the E. multilocularis genome. Four genes homologous to adenylate cyclase IX were identified in the E. multilocularis genome and three in the E. granulosus genome. While glucagon caused no significant effects, the adenylate cyclase activator forskolin and the adenylate cyclase inhibitor 2', 5' didesoxyadenosine influenced metacestode vesicle formation from primary cells, re-differentiation of protoscoleces and survival of metacestodes. It was further shown that forskolin increases phosphorylation of protein kinase A substrates, indicating that forskolin activates the cAMP-pathway also in cestodes. These results indicate that the cAMP signalling pathway plays an important role in Echinococcus development and survival. To complement this work, the influence of different media and additives on E. granulosus protoscoleces was investigated. Anaerobic conditions and the presence of FBS prolonged protoscolex survival while different media influenced protoscolex activation and development. Taken together, this work provided important insights into developmental processes in Echinococcus and potential drug targets for echinococcosis chemotherapy.}, subject = {Serotonin}, language = {en} } @article{ZoranSeelbinderWhiteetal.2022, author = {Zoran, Tamara and Seelbinder, Bastian and White, Philip Lewis and Price, Jessica Sarah and Kraus, Sabrina and Kurzai, Oliver and Linde, Joerg and H{\"a}der, Antje and Loeffler, Claudia and Grigoleit, Goetz Ulrich and Einsele, Hermann and Panagiotou, Gianni and Loeffler, Juergen and Sch{\"a}uble, Sascha}, title = {Molecular profiling reveals characteristic and decisive signatures in patients after allogeneic stem cell transplantation suffering from invasive pulmonary aspergillosis}, series = {Journal of Fungi}, volume = {8}, journal = {Journal of Fungi}, number = {2}, issn = {2309-608X}, doi = {10.3390/jof8020171}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262105}, year = {2022}, abstract = {Despite available diagnostic tests and recent advances, diagnosis of pulmonary invasive aspergillosis (IPA) remains challenging. We performed a longitudinal case-control pilot study to identify host-specific, novel, and immune-relevant molecular candidates indicating IPA in patients post allogeneic stem cell transplantation (alloSCT). Supported by differential gene expression analysis of six relevant in vitro studies, we conducted RNA sequencing of three alloSCT patients categorized as probable IPA cases and their matched controls without Aspergillus infection (66 samples in total). We additionally performed immunoassay analysis for all patient samples to gain a multi-omics perspective. Profiling analysis suggested LGALS2, MMP1, IL-8, and caspase-3 as potential host molecular candidates indicating IPA in investigated alloSCT patients. MMP1, IL-8, and caspase-3 were evaluated further in alloSCT patients for their potential to differentiate possible IPA cases and patients suffering from COVID-19-associated pulmonary aspergillosis (CAPA) and appropriate control patients. Possible IPA cases showed differences in IL-8 and caspase-3 serum levels compared with matched controls. Furthermore, we observed significant differences in IL-8 and caspase-3 levels among CAPA patients compared with control patients. With our conceptual work, we demonstrate the potential value of considering the human immune response during Aspergillus infection to identify immune-relevant molecular candidates indicating IPA in alloSCT patients. These human host candidates together with already established fungal biomarkers might improve the accuracy of IPA diagnostic tools.}, language = {en} } @article{SilwedelHaarmannFehrholzetal.2019, author = {Silwedel, Christine and Haarmann, Axel and Fehrholz, Markus and Claus, Heike and Speer, Christian P. and Glaser, Kirsten}, title = {More than just inflammation: Ureaplasma species induce apoptosis in human brain microvascular endothelial cells}, series = {Journal of Neuroinflammation}, volume = {16}, journal = {Journal of Neuroinflammation}, doi = {10.1186/s12974-019-1413-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200711}, pages = {38}, year = {2019}, abstract = {Background Ureaplasma species (spp.) are commonly regarded as low-virulent commensals but may cause invasive diseases in immunocompromised adults and in neonates, including neonatal meningitis. The interactions of Ureaplasma spp. with host defense mechanisms are poorly understood. This study addressed Ureaplasma-driven cell death, concentrating on apoptosis as well as inflammatory cell death. Methods Human brain microvascular endothelial cells (HBMEC) were exposed to Ureaplasma (U.) urealyticum serovar 8 (Uu8) and U. parvum serovar 3 (Up3). Resulting numbers of dead cells as well as mRNA levels and enzyme activity of key agents in programmed cell death were assessed by flow cytometry, RNA sequencing, and qRT-PCR, respectively. xCELLigence data were used for real-time monitoring of changes in cell adhesion properties. Results Both Ureaplasma isolates induced cell death (p < 0.05, vs. broth). Furthermore, Ureaplasma spp. enhanced mRNA levels for genes in apoptosis, including caspase 3 (Up3 p < 0.05, vs. broth), caspase 7 (p < 0.01), and caspase 9 (Up3 p < 0.01). Caspase 3 activity was increased upon Uu8 exposure (p < 0.01). Vice versa, Ureaplasma isolates downregulated mRNA levels for proteins involved in inflammatory cell death, namely caspase 1 (Uu8 p < 0.01, Up3 p < 0.001), caspase 4 (Uu8 p < 0.05, Up3 p < 0.01), NOD-like receptor pyrin domain-containing 3 (Uu8 p < 0.05), and receptor-interacting protein kinase 3 (p < 0.05). Conclusions By inducing apoptosis in HBMEC as main constituents of the blood-brain barrier, Ureaplasma spp. may provoke barrier breakdown. Simultaneous suppression of inflammatory cell death may additionally attenuate host defense strategies. Ultimate consequence could be invasive and long-term CNS infections by Ureaplasma spp.}, language = {en} } @article{SchubertUnkmeirKonradSlaninaetal.2010, author = {Schubert-Unkmeir, Alexandra and Konrad, Christian and Slanina, Heiko and Czapek, Florian and Hebling, Sabrina and Frosch, Matthias}, title = {Neisseria meningitidis Induces Brain Microvascular Endothelial Cell Detachment from the Matrix and Cleavage of Occludin: A Role for MMP-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-68589}, year = {2010}, abstract = {Disruption of the blood-brain barrier (BBB) is a hallmark event in the pathophysiology of bacterial meningitis. Several inflammatory mediators, such as tumor necrosis factor alpha (TNF-a), nitric oxide and matrix metalloproteinases (MMPs), contribute to this disruption. Here we show that infection of human brain microvascular endothelial cells (HBMEC) with Neisseria meningitidis induced an increase of permeability at prolonged time of infection. This was paralleled by an increase in MMP-8 activity in supernatants collected from infected cells. A detailed analysis revealed that MMP-8 was involved in the proteolytic cleavage of the tight junction protein occludin, resulting in its disappearance from the cell periphery and cleavage to a lower-sized 50-kDa protein in infected HBMEC. Abrogation of MMP-8 activity by specific inhibitors as well as transfection with MMP-8 siRNA abolished production of the cleavage fragment and occludin remained attached to the cell periphery. In addition, MMP-8 affected cell adherence to the underlying matrix. A similar temporal relationship was observed for MMP activity and cell detachment. Injury of the HBMEC monolayer suggested the requirement of direct cell contact because no detachment was observed when bacteria were placed above a transwell membrane or when bacterial supernatant was directly added to cells. Inhibition of MMP-8 partially prevented detachment of infected HBMEC and restored BBB permeability. Together, we established that MMP-8 activity plays a crucial role in disassembly of cell junction components and cell adhesion during meningococcal infection.}, subject = {Neisseria meningitidis}, language = {en} } @article{SilwedelSpeerHaarmannetal.2018, author = {Silwedel, Christine and Speer, Christian P. and Haarmann, Axel and Fehrholz, Markus and Claus, Heike and Buttmann, Mathias and Glaser, Kirsten}, title = {Novel insights into neuroinflammation: bacterial lipopolysaccharide, tumor necrosis factor α, and Ureaplasma species differentially modulate atypical chemokine receptor 3 responses in human brain microvascular endothelial cells}, series = {Journal of Neuroinflammation}, volume = {15}, journal = {Journal of Neuroinflammation}, number = {156}, doi = {10.1186/s12974-018-1170-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-175952}, year = {2018}, abstract = {Background: Atypical chemokine receptor 3 (ACKR3, synonym CXCR7) is increasingly considered relevant in neuroinflammatory conditions, in which its upregulation contributes to compromised endothelial barrier function and may ultimately allow inflammatory brain injury. While an impact of ACKR3 has been recognized in several neurological autoimmune diseases, neuroinflammation may also result from infectious agents, including Ureaplasma species (spp.). Although commonly regarded as commensals of the adult urogenital tract, Ureaplasma spp. may cause invasive infections in immunocompromised adults as well as in neonates and appear to be relevant pathogens in neonatal meningitis. Nonetheless, clinical and in vitro data on Ureaplasma-induced inflammation are scarce. Methods: We established a cell culture model of Ureaplasma meningitis, aiming to analyze ACKR3 variances as a possible pathomechanism in Ureaplasma-associated neuroinflammation. Non-immortalized human brain microvascular endothelial cells (HBMEC) were exposed to bacterial lipopolysaccharide (LPS) or tumor necrosis factor-α (TNF-α), and native as well as LPS-primed HBMEC were cultured with Ureaplasma urealyticum serovar 8 (Uu8) and U. parvum serovar 3 (Up3). ACKR3 responses were assessed via qRT-PCR, RNA sequencing, flow cytometry, and immunocytochemistry. Results: LPS, TNF-α, and Ureaplasma spp. influenced ACKR3 expression in HBMEC. LPS and TNF-α significantly induced ACKR3 mRNA expression (p < 0.001, vs. control), whereas Ureaplasma spp. enhanced ACKR3 protein expression in HBMEC (p < 0.01, vs. broth control). Co-stimulation with LPS and either Ureaplasma isolate intensified ACKR3 responses (p < 0.05, vs. LPS). Furthermore, stimulation wielded a differential influence on the receptor's ligands. Conclusions: We introduce an in vitro model of Ureaplasma meningitis. We are able to demonstrate a pro-inflammatory capacity of Ureaplasma spp. in native and, even more so, in LPS-primed HBMEC, underlining their clinical relevance particularly in a setting of co-infection. Furthermore, our data may indicate a novel role for ACKR3, with an impact not limited to auto-inflammatory diseases, but extending to infection-related neuroinflammation as well. AKCR3-induced blood-brain barrier breakdown might constitute a potential common pathomechanism.}, language = {en} }