@article{ZadehKhorasaniNolteMuelleretal.2013,
  author    = {Zadeh-Khorasani, Maryam and Nolte, Thomas and Mueller, Thomas D. and Pechlivanis, Markos and Rueff, Franziska and Wollenberg, Andreas and Fricker, Gert and Wolf, Eckhard and Siebeck, Matthias and Gropp, Roswitha},
  title     = {NOD-scid IL2R \(\gamma^{null}\) mice engrafted with human peripheral blood mononuclear cells as a model to test therapeutics targeting human signaling pathways},
  series = {Journal of Translational Medicine},
  volume    = {11},
  journal   = {Journal of Translational Medicine},
  number    = {4},
  issn      = {1479-5876},
  doi       = {10.1186/1479-5876-11-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-122960},
  year      = {2013},
  abstract  = {Background: Animal models of human inflammatory diseases have limited predictive quality for human clinical trials for various reasons including species specific activation mechanisms and the immunological background of the animals which markedly differs from the genetically heterogeneous and often aged patient population. Objective: Development of an animal model allowing for testing therapeutics targeting pathways involved in the development of Atopic Dermatitis (AD) with better translatability to the patient. Methods: NOD-scid IL2R \(\gamma^{null}\) mice engrafted with human peripheral blood mononuclear cells (hPBMC) derived from patients suffering from AD and healthy volunteers were treated with IL-4 and the antagonistic IL-4 variant R121/Y124D (Pitrakinra). Levels of human (h) IgE, amount of B-, T- and plasma-cells and ratio of CD4 : CD8 positive cells served as read out for induction and inhibition of cell proliferation and hIgE secretion. Results were compared to in vitro analysis. Results: hIgE secretion was induced by IL-4 and inhibited by the IL-4 antagonist Pitrakinra in vivo when formulated with methylcellulose. B-cells proliferated in response to IL-4 in vivo; the effect was abrogated by Pitrakinra. IL-4 shifted CD4 : CD8 ratios in vitro and in vivo when hPBMC derived from healthy volunteers were used. Pitrakinra reversed the effect. Human PBMC derived from patients with AD remained inert and engrafted mice reflected the individual responses observed in vitro. Conclusion: NOD-scid IL2R \(\gamma^{null}\) mice engrafted with human PBMC reflect the immunological history of the donors and provide a complementary tool to in vitro studies. Thus, studies in this model might provide data with better translatability from bench to bedside.},
  language  = {en}
}
@phdthesis{Waetzig2010,
  author    = {W{\"a}tzig, Christine},
  title     = {Klinische Ergebnisse der Schulterendoprothetik bei Patienten mit Erkrankungen aus dem rheumatischen Formenkreis im Vergleich zu Patienten mit degenerativ bedingter Omarthrose},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-47566},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2010},
  abstract  = {Im Rahmen dieser retrospektiven Studie wurden 23 Patienten mit Erkrankungen aus dem rheumatischen Formenkreis, {\"u}berwiegend rheumatoide Arthritis und 22 Kontrollpersonen mit degenerativ bedingter Omarthrose, welchen zwischen 1993 und 2005 eine Schulterendoprothese unterschiedlichen Typs implantiert worden war, durchschnittlich 28 Monate postoperativ klinisch und radiologisch nachuntersucht. Das Alter zum Zeitpunkt der Operation betrug im Mittel 65 Jahre. Die Ergebnisse wurden anhand des Constant Score erhoben. Durch die Operation verbesserten die 23 Patienten mit Erkrankungen aus dem rheumatischen Formenkreis ihren Constant Score von durchschnittlich 21,7\% auf 79,9\%. Die Kontrollgruppe wies sowohl pr{\"a}operativ (28,7\%) als auch postoperativ (96,3\%) eine signifikant bessere Schulterfunktion auf. Innerhalb beider Kollektive waren ca. 95\% der Patienten mit dem Operationsergebnis sehr zufrieden bzw. zufrieden.},
  subject      = {Rheumatoide Arthritis},
  language  = {de}
}
@phdthesis{Wingenfeld2001,
  author    = {Wingenfeld, Bianca},
  title     = {Effekt der Radiosynoviorthese anhand klinischer, laborchemischer und bildgebender Parameter},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-1182669},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2001},
  abstract  = {Ziel: Der Therapieerfolg der Radiosynoviorthese sollte bei rheumatoider Arthritis und anderen entz{\"u}ndlichen Gelenkerkrankungen anhand subjektiver, objektiver, so wie laborchemischer und bildgebender Parameter prospektiv beurteilt werden. Methode: Es wurden insgesamt 174 Gelenke bei 97 Patienten behandelt, wobei 55\% der Patienten an einer rheumatoiden Arthritis und 23\% an einer aktivierten Arthrose litten.Die Ver{\"a}nderungen 6 Monate nach einer Radiosynoviorthese wurden sowohl an subjektiven, wie auch an objektiven Parametern (Schmerz, Schwellung, Gelenk-beweglichkeit) evaluiert. Zus{\"a}tzlich wurden laborchemische Parameter (CRP, BSG), bildgebende Verfahren (Skelett-szintigraphie, MRT) und Einnahme von Medikamenten beurteilt. Eine weitere Befragung zum Wiederauftreten von Beschwerden (Rezidiv) erfolgte in Zeit-r{\"a}umen zwischen einem und drei Jahren nach der Radiosynoviorthese. Ergebnisse: Gute Erfolge in 60 bis 80\% der F{\"a}lle zeigten sich bei der klinischen Symptomatik, sowohl auf subjektiver, als auch auf objektiver Ebene, wobei sich in der Korrelationsanalyse niedrige Werte zwischen den subjektiven und objektiven Parametern ergeben hatten. Bei 55\% der Gelenke hatte sich die Schmerzintensit{\"a}t verringert, 23\% waren g{\"a}nzlich schmerzfrei. Die objektiv gemessene {\"A}nderung der Gelenkbeweglichkeit hatte bei 73\% eine Besserung ergeben, 12\% waren uneingeschr{\"a}nkt beweglich, bei 68\% war die Schwellung zur{\"u}ckgegangen. Die Radionuklidaufnahme in der Weichteilphase der Sklettszintigraphie verminderte sich bei 58\% der Gelenke, die Kernspin-tomographie ergab bei 44\% der Kniegelenke einen Entz{\"u}ndungsr{\"u}ckgang. Rezidive traten nach einem bis drei Jahren nur bei 15\% der Patienten auf.Die labor-chemischen Parameter sowie die Medikamenteneinnahme wurden durch die Radiosynoviorthese nicht beeinflusst. Schlussfolgerung: Die Radiosynoviorthese liefert auf subjektiver und objektiver Ebene gute Ergebnisse im Sinne einer Besserung. Sie ist dabei eine schonende Therapieform, die ohne Risiken einer Operation gleichzeitig an mehreren Gelenke vorgenommen und gegebenfalls wiederholt werden kann. Sie bietet damit somit eine gute Therapie-m{\"o}glichkeit im Rahmen der interdisziplin{\"a}ren Behandlungsformen dar.},
  language  = {de}
}
@phdthesis{Spranger2005,
  author    = {Spranger, Ingo},
  title     = {Reliabilit{\"a}ts-, Validit{\"a}ts- und {\"A}nderungssensitivit{\"a}tspr{\"u}fung des Funktionsfragebogen Bewegungsapparat (SMFA-D) bei Patienten mit konservativ behandelter Rheumatoider Arthritis},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-15207},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2005},
  abstract  = {Einleitung: Der SMFA-D (Funktionsfragebogen Bewegungsapparat) ist ein neuer Patientenfragebogen zur Erfassung des Funktionszustands des Bewegungsapparates. Er ist die {\"u}bersetzte und kulturadaptierte Version des in den USA entwickelten SMFA. Der f{\"u}r den deutschen Sprachraum adaptierte Fragebogen wurde bislang erfolgreich an operativ behandelten Gruppen von Patienten mit Erkrankungen des Bewegungsapparates (Coxarthrose, Gonarthrose, Rotatorenmanschettendefekt und Rheumatoide Arthritis) sowie an konservativ behandelten Patienten mit Coxarthrose evaluiert. Ziel der vorliegenden Arbeit ist die {\"U}berpr{\"u}fung der Eignung des SMFA-D bei der Rehabilitation von Patienten mit Rheumatoider Arthritis, die ausschließlich konservative Therapie erhielten. Es werden die Testg{\"u}tekriterien (Reliabilit{\"a}t, Validit{\"a}t und {\"A}nderungssensitivit{\"a}t) {\"u}berpr{\"u}ft und Vergleiche zu anderen Frageb{\"o}gen vorgenommen. Patienten und Methode: In einer prospektiven Studie an 56 Patienten mit konservativ behandelter Rheumatoider Arthritis wurden der SMFA-D, SF-36, Health Assessment Questionnaire (HAQ) und Funktionsfragebogen Hannover Polyarthritis (FFbH-P) zu drei Messzeitpunkten erhoben. Des Weiteren wurden von den Patienten die Schmerzen, der allgemeine Gesundheitszustand sowie der Funktionszustand ihres Bewegungsapparates eingesch{\"a}tzt und es wurde eine Einsch{\"a}tzung des Arztes bez{\"u}glich des Funktionszustands und der Erkrankungsschwere erhoben. Ergebnisse: Die Reliabilit{\"a}tskennwerte sind gut bis sehr gut (Cronbachs alpha: 0,93 bis 0,98; ICC: 0,87 bis 0,93.) Die Indizes des SMFA-D korrelieren zu den drei Messzeitpunkten jeweils signifikant mit FFbH-P (r = -0.72 bis -0.86), HAQ (r = 0.75 bis 0.85) und den Skalen des SF-36 (r = -0.27 bis -0.84) als Ausdruck der Konstruktvalidit{\"a}t. Auch zu den Einsch{\"a}tzungen des Arztes und der Patienten zeigen sich bedeutsame Korrelationen als Hinweis auf Kriteriumsvalidit{\"a}t. Die Effektst{\"a}rken zur Erfassung der {\"A}nderungssensitivit{\"a}t sind beim SMFA-D {\"a}hnlich wie bei den anderen verwandten Frageb{\"o}gen, sie k{\"o}nnen also als gut bewertet werden. Zusammenfassung: Der SMFA-D stellt auch bei konservativ behandelten Patienten mit Rheumatoider Arthritis ein praktikables, reliables, valides und {\"a}nderungssensitives Instrument dar.},
  language  = {de}
}
@phdthesis{SoutoCarneiro2000,
  author    = {Souto-Carneiro, Maria Margarida},
  title     = {Molecular and functional analyses of human synovial B-lymphocytes in rheumatoid arthritis},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-2308},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2000},
  abstract  = {B-cells of the rheumatoid synovial tissue are a constant part of and, in some histopathological subtypes, the dominant population of the inflammatory infiltrate, located in the region of tissue destruction. The pattern of B-cell distribution and the relationship to the corresponding antigen-presenting cells (follicular dendritic reticulum cells: FDCs) show a great variety. B-cells may exhibit (i) a follicular organization forming secondary follicles; (ii) follicle-like patterns with irregularly formed FDC networks, and (iii) a diffuse pattern of isolated FDCs. Molecular analysis of immunoglobulin VH and VL genes from human synovial B-cell hybridomas and synovial tissue demonstrates somatic mutations due to antigen activation. The FDC formations in the synovial tissue may therefore serve as an environment for B-cell maturation, which is involved in the generation of autoantibodies. An autoantibody is defined as "pathogenic" if it fulfills the Witebsky-Rose-Koch criteria for classical autoimmune diseases: definition of the autoantibody; induction of the disease by transfer of the autoantibody; and isolation of the autoantibody from the disease-specific lesion. B-cells from rheumatoid synovial tissue show specificity for FcIgG, type II collagen, COMP, sDNA, tetanus toxoid, mitochondrial antigens (M2), filaggrin and bacterial HSPs. The contributions of these antigens to the pathogenesis of RA are still hypothetical. A possible contribution could derive from crossreactivity and epitope mimicry: due to crossreaction, an antibody directed originally against a foreign infectious agent could react with epitopes from articular tissues, perpetuating the local inflammatory process. The characteristic distribution pattern, the localisation within the area of tissue destruction, the hypermutated IgVH and IgVL genes, and their exclusive function to recognize conformation-dependent antigens suggest a central role for B-cells in the inflammatory process of rheumatoid arthritis. Therefore, the analysis of synovial B-cell hybridomas and experimental expression of synovial IgVH and IgVL genes will help to characterise the antigens responsible for the pathogenesis of rheumatoid arthritis. In the present study 55 IgVH genes amplified from 3 different anatomical regions of a RA patient were analysed adding further information on synovial B-cell maturation and recirculation in RA. This analysis demonstrated somatically mutated IgVh genes in all different regions with amino acid deletions and mixed IgVh molecules, suggesting the existence of a novel pathway to generate (auto)antibody specificities. The comparison of amino acid sequences of amplified genes belonging to the VH1 family (with predominantly the same germline counterpart) exhibited a strong homology, indicating an apparently conserved mutational pattern. This suggests that the number of antigens activating B-cells in the different locations is restricted. The most striking result was the finding of clonally related sequences in different anatomical regions indicating a recirculation of activated B-cells between the different affected joints. Also in the present study a synovial B-cell hybridoma was analyzed for its specific recognition of cartilage antigens. A heptameric peptide of cartilage oligomeric protein (COMP) could be defined as the target structure. The IgVH-gene (IgHV4-59*01) of the IgG2l hybridoma has somatically mutated genes with high R/S values in the CDR regions (9:2). Thus, indicating that this hybridoma originates from a synovial B-cell which has been antigen activated/selected for its affinity. To analyse the presence of the clonotypic IgHV4-59*01 sequences in other cases of RA and osteoarthritis (OA) synovitis, primers specific for the CDR3 rearrangement of this hybridoma were used. The clonotypic and clone related sequences (98 per cent ± 1 per cent homology) could only be detected in synovitis of RA cases but not in OA cases indicating that this B-cell is specific to RA synovitis. The identified heptameric peptide of COMP was used in a peptide ELISA to analyse whether there is a specific binding in RA serum samples. Serum samples (IgG) from RA patients (n=22) showed a significant higher efficiency to the COMP heptamer than the OA sera (n=24) and the age matched healthy controls (n=20) (for both p<1x10-4, Students t-test). The specificity of this B-cell hybridoma may therefore be defined as RA specific. Since COMP is restricted to cartilage and tendons which are organs specifically affected in RA this COMP specific autoantibody represents the first organ specific autoantibody in RA. The IgG2 COMP specific autoantibody with somatically mutated IgVH genes is different from germline encoded, antigen clearing IgM autoantibodies and may therefore be directly involved as an "arthritogenic autoantibody" in cartilage and tendons destruction by complement activation.},
  subject      = {Rheumatoide Arthritis},
  language  = {en}
}
@article{SchmidtHaywardCoelhoetal.2019,
  author    = {Schmidt, Thomas S. B. and Hayward, Matthew R. and Coelho, Luiis P. and Li, Simone S. and Costea, Paul I. and Voigt, Anita Y. and Wirbel, Jakob and Maistrenko, Oleksandr M. and Alves, Renato J. C. and Bergsten, Emma and de Beaufort, Carine and Sobhani, Iradj and Heintz-Buschart, Anna and Sunagawa, Shinichi and Zeller, Georg and Wilmes, Paul and Bork, Peer},
  title     = {Extensive transmission of microbes along the gastrointestinal tract},
  series = {eLife},
  volume    = {8},
  journal   = {eLife},
  doi       = {10.7554/eLife.42693},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228954},
  pages     = {e42693, 1-18},
  year      = {2019},
  abstract  = {The gastrointestinal tract is abundantly colonized by microbes, yet the translocation of oral species to the intestine is considered a rare aberrant event, and a hallmark of disease. By studying salivary and fecal microbial strain populations of 310 species in 470 individuals from five countries, we found that transmission to, and subsequent colonization of, the large intestine by oral microbes is common and extensive among healthy individuals. We found evidence for a vast majority of oral species to be transferable, with increased levels of transmission in colorectal cancer and rheumatoid arthritis patients and, more generally, for species described as opportunistic pathogens. This establishes the oral cavity as an endogenous reservoir for gut microbial strains, and oral-fecal transmission as an important process that shapes the gastrointestinal microbiome in health and disease.},
  subject      = {Barrier},
  language  = {en}
}
@article{MitchellMacarthurGanetal.2014,
  author    = {Mitchell, Anna L. and Macarthur, Katie D. R. and Gan, Earn H. and Baggott, Lucy E. and Wolff, Anette S. B. and Skinningsrud, Beate and Platt, Hazel and Short, Andrea and Lobell, Anna and Kampe, Olle and Bensing, Sophie and Betterle, Corrado and Kasperlik-Zaluska, Anna and Zurawek, Magdalena and Fichna, Marta and Kockum, Ingrid and Eriksson, Gabriel Nordling and Ekwall, Olov and Wahlberg, Jeanette and Dahlqvist, Per and Hulting, Anna-Lena and Penna-Martinez, Marissa and Meyer, Gesine and Kahles, Heinrich and Badenhoop, Klaus and Hahner, Stephanie and Quinkler, Marcus and Falorni, Alberto and Phipps-Green, Amanda and Merriman, Tony R. and Ollier, William and Cordell, Heather J. and Undlien, Dag and Czarnocka, Barbara and Husebye, Eystein and Pearce, Simon H. S.},
  title     = {Association of Autoimmune Addison's Disease with Alleles of STAT4 and GATA3 in European Cohorts},
  series = {PLOS ONE},
  volume    = {9},
  journal   = {PLOS ONE},
  number    = {3},
  doi       = {10.1371/journal.pone.0088991},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-117105},
  pages     = {e88991},
  year      = {2014},
  abstract  = {Background: Gene variants known to contribute to Autoimmune Addison's disease (AAD) susceptibility include those at the MHC, MICA, CIITA, CTLA4, PTPN22, CYP27B1, NLRP-1 and CD274 loci. The majority of the genetic component to disease susceptibility has yet to be accounted for. Aim: To investigate the role of 19 candidate genes in AAD susceptibility in six European case-control cohorts. Methods: A sequential association study design was employed with genotyping using Sequenom iPlex technology. In phase one, 85 SNPs in 19 genes were genotyped in UK and Norwegian AAD cohorts (691 AAD, 715 controls). In phase two, 21 SNPs in 11 genes were genotyped in German, Swedish, Italian and Polish cohorts (1264 AAD, 1221 controls). In phase three, to explore association of GATA3 polymorphisms with AAD and to determine if this association extended to other autoimmune conditions, 15 SNPs in GATA3 were studied in UK and Norwegian AAD cohorts, 1195 type 1 diabetes patients from Norway, 650 rheumatoid arthritis patients from New Zealand and in 283 UK Graves' disease patients. Meta-analysis was used to compare genotype frequencies between the participating centres, allowing for heterogeneity. Results: We report significant association with alleles of two STAT4 markers in AAD cohorts (rs4274624: P = 0.00016; rs10931481: P = 0.0007). In addition, nominal association of AAD with alleles at GATA3 was found in 3 patient cohorts and supported by meta-analysis. Association of AAD with CYP27B1 alleles was also confirmed, which replicates previous published data. Finally, nominal association was found at SNPs in both the NF-kappa B1 and IL23A genes in the UK and Italian cohorts respectively. Conclusions: Variants in the STAT4 gene, previously associated with other autoimmune conditions, confer susceptibility to AAD. Additionally, we report association of GATA3 variants with AAD: this adds to the recent report of association of GATA3 variants with rheumatoid arthritis.},
  language  = {en}
}
@article{KleinertTonyKrauseetal.2012,
  author    = {Kleinert, Stefan and Tony, Hans-Peter and Krause, Andreas and Feuchtenberger, Martin and Wassenberg, Siegfried and Richter, Constanze and R{\"o}ther, Ekkehard and Spieler, Wolfgang and Gnann, Holger and Wittig, Bianca M.},
  title     = {Impact of patient and disease characteristics on therapeutic success during adalimumab treatment of patients with rheumatoid arthritis: data from a German},
  series = {Rheumatology International},
  volume    = {32},
  journal   = {Rheumatology International},
  number    = {9},
  doi       = {10.1007/s00296-011-2033-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126220},
  pages     = {2759-2767},
  year      = {2012},
  abstract  = {The objective of this study was to use data from a noninterventional study to evaluate the effectiveness of adalimumab in rheumatoid arthritis (RA) patients during routine clinical practice and to explore the potential impact of patient and disease characteristics in response to adalimumab therapy. A total of 2,625 RA patients with specified data at baseline (prior to initiating adalimumab treatment) and 12 months entered this study between April 2003 and March 2009. We evaluated response to adalimumab therapy and conducted stepwise regression and subgroup analyses of factors influencing therapeutic response. During the 1-year adalimumab treatment period, disease activity decreased from a baseline mean disease activity score-28 joints (DAS28) of 5.9-3.9, while functional capacity improved from 59.0 to 68.4 Funktionsfragebogen Hannover (FFbH) percentage points. In multivariate regression models, high baseline DAS28 was the strongest positive predictor for decrease in disease activity, and high baseline functional capacity was associated with reduced gains in functional capacity. Male gender was a positive predictor of therapeutic response for both disease activity and functional capacity, while older age and multiple previous biologics were associated with a reduced therapeutic response. Subset analyses provided further support for the impact of baseline DAS28, FFbH, and prior biologic therapy on therapeutic response during treatment. We conclude that treatment with adalimumab leads to decreased disease activity and improved function during routine clinical practice. Patients with high disease activity and low functional capacity are particularly benefitted by adalimumab therapy.},
  language  = {en}
}
@phdthesis{Hell2019,
  author    = {Hell, Dennis},
  title     = {Development of self-adjusting cytokine neutralizer cells as a closed-loop delivery system of anti-inflammatory biologicals},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-175381},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2019},
  abstract  = {The current treatment strategies for diseases are assessed on the basis of diagnosed phenotypic changes due to an accumulation of asymptomatic events in physiological processes. Since a diagnosis can only be established at advanced stages of the disease, mainly due to insufficient early detection possibilities of physiological disorders, doctors are forced to treat diseases rather than prevent them. Therefore, it is desirable to link future therapeutic interventions to the early detection of physiological changes. So-called sensor-effector systems are designed to recognise disease-specific biomarkers and coordinate the production and delivery of therapeutic factors in an autonomous and automated manner. Such approaches and their development are being researched and promoted by the discipline of synthetic biology, among others. Against this background, this paper focuses on the in vitro design of cytokine-neutralizing sensor-effector cells designed for the potential treatment of recurrent autoimmune diseases, especially rheumatoid arthritis. The precise control of inducible gene expression was successfully generated in human cells. At first, a NF-κB-dependent promoter was developed, based on HIV-1 derived DNA-binding motives. The activation of this triggerable promoter was investigated using several inducers including the physiologically important NF-κB inducers tumor necrosis factor alpha (TNFα) and interleukin 1 beta (IL-1β). The activation strength of the NF-κB-triggered promoter was doubled by integrating a non-coding RNA. The latter combined expressed RNA structures, which mimic DNA by double stranded RNAs and have been demonstrated to bind to p50 or p65 by previous publications. The sensitivity was investigated for TNFα and IL-1β. The detection limit and the EC50 values were in in the lower picomolar range. Besides the sensitivity, the reversibility and dynamic of the inducible system were characterized. Hereby a close correlation between pulse times and expression profile was shown. The optimized NF-κB-dependent promoter was then coupled to established TNFα- and IL-1-blocking biologicals to develop sensor-effector systems with anti-inflammatory activity, and thus potential use against autoimmune diseases such as rheumatoid arthritis. The biologicals were differentiated between ligand-blocking and receptor-blocking biologicals and different variants were selected: Adalimumab, etanercept and anakinra. The non-coding RNA improved again the activation strength of NF-κB-dependent expressed biologicals, indicating its universal benefit. Furthermore, it was shown that the TNFα-induced expression of NF-κB-regulated TNFα-blocking biologics led to an extracellular negative feedback loop. Interestingly, the integration of the non-coding RNA and this negative feedback loop has increased the dynamics and reversibility of the NF-κB-regulated gene expression. The controllability of drug release can also be extended by the use of inhibitors of classical NF-κB signalling such as TPCA-1. The efficacy of the expressed biologicals was detected through neutralization of the cytokines using different experiments. For future in vivo trials, first alginate encapsulations of the cells were performed. Furthermore, the activation of NF-κB-dependent promoter was demonstrated using co-cultures with human plasma samples or using synovial liquids. With this generated sensor-effector system we have developed self-adjusting cytokine neutralizer cells as a closed-loop delivery system for anit-inflammatory biologics.},
  subject      = {Biologika},
  language  = {en}
}
@article{HeimAlmanzarSchmalzingetal.2021,
  author    = {Heim, Jana and Almanzar, Giovanni and Schmalzing, Marc and Gernert, Michael and Tony, Hans-Peter and Prelog, Martina},
  title     = {Induction of IL-9 in Peripheral Lymphocytes of Rheumatoid Arthritis Patients and Healthy Donors by Th17-Inducing Cytokine Conditions},
  series = {Frontiers in Immunology},
  volume    = {12},
  journal   = {Frontiers in Immunology},
  issn      = {1664-3224},
  doi       = {10.3389/fimmu.2021.668095},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237838},
  year      = {2021},
  abstract  = {IL-9-producing Th9 cells display a group of helper T cells with similarities to Th17 and Th2 T cells and have been shown to be involved in synovial inflammation in rheumatoid arthritis (RA) patients. So far, it is unclear which parameters drive Th9 differentiation in lymphocytes derived from RA patients compared to immunologically healthy individuals and whether autocrine mechanisms are able to enhance Th9 polarization. Further, parallel pathways of induction of IL-17-producing cells with Th9 phenotype have to be distinguished from exclusively Th9-inductive mechanisms. Thus, the present study aimed to determine the parameters of Th9 induction by simulation in a standardized inflammatory cytokine milieu.Peripheral naive and non-naive T cells of RA patients and healthy donors (HD) were cultured under Th9 and Th17-driving conditions and phenotypically analyzed by flow cytometry and molecular analysis.Our findings indicate a similar differentiation pathway of Th9 and Th17 cells and similar distributions of IL-9+ T cells in RA and HD regardless of Th9- or Th17-promoting cytokine milieus. Whereas the magnitude and direction of Th9- or Th17-polarization was about the same in RA and HD, IL-17+ CD4+ T cells were significantly stimulated by Th17-inducing conditions in HD. In conclusion, the results indicate that Th9- and Th17-inducing cytokine conditions mimicking autoimmune inflammation in RA may have similar stimulatory effects regarding polarization of peripheral naive and non-naive T cells into Th9 or Th17 cells. The results suggest that the differentiation of Th9 cells may be also induced by Th17-driving conditions.},
  language  = {en}
}
@article{HeidtKaemmererFobkeretal.2023,
  author    = {Heidt, Christina and K{\"a}mmerer, Ulrike and Fobker, Manfred and R{\"u}ffer, Andreas and Marquardt, Thorsten and Reuss-Borst, Monika},
  title     = {Assessment of intestinal permeability and inflammation bio-markers in patients with rheumatoid arthritis},
  series = {Nutrients},
  volume    = {15},
  journal   = {Nutrients},
  number    = {10},
  issn      = {2072-6643},
  doi       = {10.3390/nu15102386},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-319377},
  year      = {2023},
  abstract  = {Increased intestinal permeability and inflammation, both fueled by dysbiosis, appear to contribute to rheumatoid arthritis (RA) pathogenesis. This single-center pilot study aimed to investigate zonulin, a marker of intestinal permeability, and calprotectin, a marker of intestinal inflammation, measured in serum and fecal samples of RA patients using commercially available kits. We also analyzed plasma lipopolysaccharide (LPS) levels, a marker of intestinal permeability and inflammation. Furthermore, univariate, and multivariate regression analyses were carried out to determine whether or not there were associations of zonulin and calprotectin with LPS, BMI, gender, age, RA-specific parameters, fiber intake, and short-chain fatty acids in the gut. Serum zonulin levels were more likely to be abnormal with a longer disease duration and fecal zonulin levels were inversely associated with age. A strong association between fecal and serum calprotectin and between fecal calprotectin and LPS were found in males, but not in females, independent of other biomarkers, suggesting that fecal calprotectin may be a more specific biomarker than serum calprotectin is of intestinal inflammation in RA. Since this was a proof-of-principle study without a healthy control group, further research is needed to validate fecal and serum zonulin as valid biomarkers of RA in comparison with other promising biomarkers.},
  language  = {en}
}
@article{GernertSchmalzingTonyetal.2022,
  author    = {Gernert, Michael and Schmalzing, Marc and Tony, Hans-Peter and Strunz, Patrick-Pascal and Schwaneck, Eva Christina and Fr{\"o}hlich, Matthias},
  title     = {Calprotectin (S100A8/S100A9) detects inflammatory activity in rheumatoid arthritis patients receiving tocilizumab therapy},
  series = {Arthritis Research \& Therapy},
  volume    = {24},
  journal   = {Arthritis Research \& Therapy},
  number    = {1},
  doi       = {10.1186/s13075-022-02887-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300523},
  year      = {2022},
  abstract  = {Background Assessing serological inflammation is difficult in tocilizumab (TCZ)-treated rheumatoid arthritis (RA) patients, as standard inflammation parameters, like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), are influenced by interleukin-6-receptor inhibition. Calprotectin in the serum, also named S100A8/S100A9, might be a more useful inflammation parameter in TCZ-treated patients. Methods Sixty-nine RA patients taking TCZ were included. Serum-calprotectin levels were assessed, as well as ESR, CRP, need for a change in disease-modifying anti-rheumatic drugs due to RA activity (= active RA), and the RA clinical disease activity score (CDAI). Forty-five RA patients taking tumor-necrosis factor-inhibitors (TNFi) were investigated for the same parameters. Results TCZ-treated patients with active RA had higher calprotectin values than not active RA patients (4155.5 [inter quartile range 1865.3-6068.3] vs 1040.0 [676.0-1638.0] ng/ml, P < 0.001). A calprotectin cut-off value of 1916.5 ng/ml resulted in a sensitivity and specificity of 80.0 \%, respectively, for the detection of RA disease activity. Calprotectin values correlated with CDAI-scores (r = 0.228; P = 0.011). ESR and CRP were less suitable to detect RA activity in TCZ-treated patients. Also TNFi-treated patients with active RA had higher calprotectin values compared to not active RA (5422.0 [3749.0-8150.8] vs 1845.0 [832.0-2569.0] ng/ml, P < 0.001). The calprotectin value with the best sensitivity and specificity for detecting RA activity was 3690.5 ng/ml among TNFi-treated patients. Conclusion Calprotectin in the serum can be a useful inflammation parameter despite TCZ-treatment.},
  language  = {en}
}
@phdthesis{Ferschl2015,
  author    = {Ferschl, Michael},
  title     = {Untersuchung des Einflusses von Rituximab auf das Leichtkettenrepertoire bei Rheumatoider Arthritis in CD19+CD27+ B-Ged{\"a}chtniszellen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126593},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {B-Zellen spielen eine wichtige Rolle in der Pathogenese der Rheumatoiden Arthritis. Seit dem Jahr 2006 ist der Anti-CD20-Antik{\"o}rper Rituximab, welcher eine passagere B-Zell-Depletion induziert, zur Therapie der Rheumatoiden Arthritis zugelassen. In dieser Arbeit wurde das variable Kappa- und Lambda-Leichtkettenrepertoire der CD19+CD27+ B-Ged{\"a}chtniszellen bei einer Patientin mit aktiver Rheumatoider Arthritis vor und nach B-Zell-Depletion durch Rituximab verglichen. Hierzu wurden nach der Einzelzellsortierung von mononukl{\"a}ren Zellen des peripheren Blutes die Rearrangements des Kappa- und Lambda-Leichtkettenrepertoires amplifiziert, sequenziert und analysiert. Die gefundenen Daten sprechen f{\"u}r die Neubildung eines diversen, polyklonalen und hochmutierten Kappa- und Lambda-Leichtkettenrepertoires. Somit ist davon auszugehen, dass nach der CD20+ B-Zell-Depletion ein funktionsf{\"a}higes Repertoire entsteht, welches keine Restriktion f{\"u}r die Infektabwehr aufweist.},
  subject      = {Rheumatoide Arthritis},
  language  = {de}
}
@article{DrechslerGroetzingerHermanns2012,
  author    = {Drechsler, Johannes and Groetzinger, Joachim and Hermanns, Heike M.},
  title     = {Characterization of the Rat Oncostatin M Receptor Complex Which Resembles the Human, but Differs from the Murine Cytokine Receptor},
  series = {PLoS One},
  volume    = {7},
  journal   = {PLoS One},
  number    = {8},
  doi       = {10.1371/journal.pone.0043155},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-133879},
  year      = {2012},
  abstract  = {Evaluation of a pathophysiological role of the interleukin-6-type cytokine oncostatin M (OSM) for human diseases has been complicated by the fact that mouse models of diseases targeting either OSM or the OSM receptor (OSMR) complex cannot fully reflect the human situation. This is due to earlier findings that human OSM utilizes two receptor complexes, glycoprotein 130 (gp130)/leukemia inhibitory factor receptor (LIFR) (type I) and gp130/OSMR (type II), both with wide expression profiles. Murine OSM on the other hand only binds to the gp130/OSMR (type II) receptor complex with high affinity. Here, we characterize the receptor usage for rat OSM. Using different experimental approaches (knock-down of the OSMR expression by RNA interference, blocking of the LIFR by LIF-05, an antagonistic LIF variant and stably transfected Ba/F3 cells) we can clearly show that rat OSM surprisingly utilizes both, the type I and type II receptor complex, therefore mimicking the human situation. Furthermore, it displays cross-species activities and stimulates cells of human as well as murine origin. Its signaling capacities closely mimic those of human OSM in cell types of different origin in the way that strong activation of the Jak/STAT, the MAP kinase as well as the PI3K/Akt pathways can be observed. Therefore, rat disease models would allow evaluation of the relevance of OSM for human biology.},
  language  = {en}
}
@phdthesis{Armbruster2011,
  author    = {Armbruster, Nicole},
  title     = {Gentherapie der Rheumatoiden Arthritis mit foamyviralen Vektoren},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-65330},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2011},
  abstract  = {Die rheumatoide Arthritis (RA) ist eine Autoimmunerkrankung, die durch anhaltende Gelenksentz{\"u}ndungen gekennzeichnet ist und mit einer fortschreitenden Degradierung des Knorpels und Knochen einhergeht. Ungef{\"a}hr 2 \% der erwachsenen Bev{\"o}lkerung weltweit sind betroffen und leiden unter erheblichen Gelenkschmerzen und Beeintr{\"a}chtigungen. Der intraartikul{\"a}re Transfer anti-entz{\"u}ndlicher Gene (z.B. des Interleukin-1 Rezeptorantagonisten - IL1RA) zeigte signifikante Bedeutung in pr{\"a}klinischen und Phase-I klinischen Studien der RA Therapie. Die meisten dieser Studien verwendeten MLV-basierte orthoretrovirale Vektoren f{\"u}r eine stabile Transgenexpression, tragen aber das Risiko der Insertionsmutagenese. Wir haben foamyvirale Vektoren (FVV) etabliert, welche von apathogenen Elternviren abgeleitet sind und sich durch ein breites Wirtsspektrum und ein vorteilhaftes Integrationsmuster ins zellul{\"a}re Genom auszeichnen. In dieser Arbeit wurden IL1RA exprimierende prototypische foamyvirale Vektoren (PFV) generiert, deren chondroprotektives Potential in vitro und in einem indirekten Gentransferansatz in Kniegelenken von Wistar und athymischen Nacktratten in vivo evaluiert wurde. PFV Vektoren mit der kodierenden Sequenz f{\"u}r den humanen IL1RA, einer internen ribosomalen Eintrittsstelle (IRES) und EGFP wurden generiert und mit Verwendung eines Vier-Plasmidsystem, bestehend aus dem Vektorplasmid (IL1RA-IRES-EGFP) und den Expressionsplasmiden FV-gag, FV-pol und FV-env in 293T Zellen produziert. Ebenso wurden Kontrollvektoren welche nur EGFP exprimieren generiert. Transduktionsexperimente wurden mit prim{\"a}ren humanen mesenchymalen Stammzellen (MSZ) aus Knochenmarkaspiraten, der Tert-4 mesenchymalen Stammzelllinie, HT1080 Fibroblasten und prim{\"a}ren Ratten Synovialfibroblasten durchgef{\"u}hrt. Die Transgenexpression wurde mittels Fluoreszenzmikroskopie (EGFP), ELISA (IL1RA) und quantitativer Real-Time PCR (IL1RA) evaluiert. Die Funktionalit{\"a}t des IL1RA-Proteins wurde mit einem Prostaglandin E2 (PGE2) Assay gezeigt. Dazu wurden FV.IL1RA transduzierte Tert-4 Zellen und unbehandelte Zellen mit 10 ng/ml IL1 inkubiert. Als readout f{\"u}r die IL1-Stimulation dienten die PGE2 Mengen in den konditionierten Medien. Die Zellkultur{\"u}berst{\"a}nde wurden 48 h nach IL1-Gabe auf ihren PGE2 und IL1RA Gehalt hin untersucht. Die PGE2 Menge war dabei, im Vergleich zu den unbehandelten Kontrollen, in den FV.IL1RA transduzierten Zellen signifikant erniedrigt. Nach der Transplantation von foamyviral transduzierten Synovialfibroblasten in Kniegelenke von Wistar und athymischen Nacktratten, war die intraartikul{\"a}re (i.a.) Transgenexpression in den Wistar Ratten zun{\"a}chst hoch, fiel jedoch nach ungef{\"a}hr 3 Wochen ab. Im Gegensatz dazu war die foamyviral vermittelte IL1RA-Expression in den immundefizienten Ratten f{\"u}r 12 Wochen auf sehr hohen Leveln stabil. Ein Maximum wurde an Tag 10 nach i.a. Transplantation mit ca. 450 ng pro Gelenk erreicht. Untersuchungen zur Biodistribution zeigten keine extraartikul{\"a}re Transgenexpression in allen untersuchten Organen (Gehirn, Herz, Lunge, Leber, Niere, Milz, Gonaden und Serum). Diese Resultate, zusammen mit dem Ausbleiben von sekund{\"a}ren Erkrankungen, wie bspw. Tumoren, in allen behandelten Tieren, sprechen f{\"u}r die Sicherheit des Ansatzes. Die Arbeit zeigt, dass FVV verwendet werden k{\"o}nnen, um prim{\"a}re Synovialfibroblasten und MSZ effizient mit Markergenen und dem anti-entz{\"u}ndlichen IL1RA Transgen zu transduzieren. Die dabei erzielten Transgenlevel sind in der Lage, die Effekte von hochdosiertem IL1 zu blockieren. Die Ergebnisse sprechen daf{\"u}r, dass FVV sehr effiziente Werkzeuge f{\"u}r den ex vivo Gentransfer sind und unterstreichen ihr großes Potential f{\"u}r die Bereitstellung anti-entz{\"u}ndlicher Transgene in prim{\"a}ren Zellen und Geweben. Zuk{\"u}nftig soll diese Technologie in Tiermodellen der Arthritis angewendet werden. Das Fernziel der Arbeiten besteht in der Etablierung und Evaluierung eines Gentransfersystems, welches die in vivo Applikation am Menschen erlaubt.},
  subject      = {Rheumatoide Arthritis},
  language  = {de}
}