@article{StraubeReifRichteretal.2014, author = {Straube, B. and Reif, A. and Richter, J. and Lueken, U. and Weber, H. and Arolt, V. and Jansen, A. and Zwanzger, P. and Domschke, K. and Pauli, P. and Konrad, C. and Gerlach, A. L. and Lang, T. and Fydrich, T. and Alpers, G. W. and Stroehle, A. and Wittmann, A. and Pfleiderer, B. and Wittchen, H.-U. and Hamm, A. and Deckert, J. and Kircher, T.}, title = {The functional - 1019C/G HTR1A polymorphism and mechanisms of fear}, series = {Translational Psychiatry}, volume = {4}, journal = {Translational Psychiatry}, issn = {2158-3188}, doi = {10.1038/tp.2014.130}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-114369}, pages = {e490}, year = {2014}, abstract = {Serotonin receptor 1A gene (HTR1A) knockout mice show pronounced defensive behaviour and increased fear conditioning to ambiguous conditioned stimuli. Such behaviour is a hallmark of pathological human anxiety, as observed in panic disorder with agoraphobia (PD/AG). Thus, variations in HTR1A might contribute to neurophysiological differences within subgroups of PD/AG patients. Here, we tested this hypothesis by combining genetic with behavioural techniques and neuroimaging. In a clinical multicentre trial, patients with PD/AG received 12 sessions of manualized cognitive-behavioural therapy (CBT) and were genotyped for HTR1A rs6295. In four subsamples of this multicentre trial, exposure behaviour (n = 185), defensive reactivity measured using a behavioural avoidance test (BAT; before CBT: n = 245; after CBT: n = 171) and functional magnetic resonance imaging (fMRI) data during fear conditioning were acquired before and after CBT (n = 39). HTR1A risk genotype (GG) carriers more often escaped during the BAT before treatment. Exploratory fMRI results suggest increased activation of the amygdala in response to threat as well as safety cues before and after treatment in GG carriers. Furthermore, GG carriers demonstrated reduced effects of CBT on differential conditioning in regions including the bilateral insulae and the anterior cingulate cortex. Finally, risk genotype carriers demonstrated reduced self-initiated exposure behaviour to aversive situations. This study demonstrates the effect of HTR1A variation on defensive behaviour, amygdala activity, CBT-induced neural plasticity and normalization of defence behaviour in PD/AG. Our results, therefore, translate evidence from animal studies to humans and suggest a central role for HTR1A in differentiating subgroups of patients with anxiety disorders.}, language = {en} } @article{HammWilsmannTheisTsianakasetal.2021, author = {Hamm, H. and Wilsmann-Theis, D. and Tsianakas, A. and Gambichler, T. and Taipale, K. and Lauterbach, J. and Freudensprung, U. and Makepeace, C.}, title = {Efficacy and safety of fumaric acid esters in young patients aged 10-17 years with moderate-to-severe plaque psoriasis: a randomized, double-blinded, placebo-controlled trial}, series = {British Journal of Dermatology}, volume = {185}, journal = {British Journal of Dermatology}, number = {1}, doi = {10.1111/bjd.19747}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258318}, pages = {62-73}, year = {2021}, abstract = {Background Apart from biologics, no systemic drugs are approved in Europe for children with moderate-to-severe psoriasis. Retrospective observational studies have shown promising results for fumaric acid esters (FAE) in this setting. Objectives To show superiority of FAE over placebo in terms of treatment response after 20 weeks in children and adolescents aged 10-17 years. Methods In a multicentre, randomized, double-blind, placebo-controlled phase IIIb study, patients aged 10-17 years with moderate-to-severe plaque psoriasis requiring systemic therapy were randomized 2 : 1 to receive FAE (n = 91) or placebo (n = 43) over 20 weeks, followed by an open-label FAE treatment phase. The coprimary endpoints were ≥ 75\% improvement in Psoriasis Area and Severity Index (PASI 75) and Physician's Global Assessment (PGA) score of 0 or 1 (clear or almost clear) at week 20. The study was registered with EudraCT number 2012-000035-82. Results At week 20, 55\% [95\% confidence interval (CI) 0·44-0·65] of FAE-treated patients achieved a PASI 75 response vs. 19\% (95\% CI 0·08-0·33) in the placebo group (absolute difference 36\%, 95\% CI 0·20-0·53; P < 0·001). In total, 42\% (95\% CI 0·32-0·53) in the FAE group vs. 7\% (95\% CI 0·01-0·19) in the placebo group achieved a PGA score of 0 or 1 at week 20 (absolute difference 35\%, 95\% CI 0·21-0·49; P < 0·001). During the double-blind period, drug-related adverse events occurred more frequently in patients receiving FAE compared with placebo (76\% vs. 47\%). Gastrointestinal disorders were the most common adverse events. Conclusions FAE administered over a period of 20 weeks demonstrated a better response than placebo; the difference was statistically significant and clinically meaningful. Application up to 40 weeks was generally well tolerated. However, further studies are required.}, language = {en} } @article{HammHoeger2011, author = {Hamm, Henning and H{\"o}ger, Peter H}, title = {Skin Tumors in Childhood}, series = {Deutsches {\"A}rzteblatt International}, volume = {108}, journal = {Deutsches {\"A}rzteblatt International}, number = {20}, doi = {10.3238/arztebl.2011.0347}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142402}, pages = {347-353}, year = {2011}, abstract = {Background: Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. Methods: Selective literature review. Results: Only 1-2\% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of malignancy include rapid growth, firm consistency, diameter exceeding 3 cm, ulceration, a non-movable mass, and presence in the neonatal period. The more common malignant skin tumors in adults-basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma-are very rare in childhood. Congenital melanocytic nevi and sebaceous nevi bear a lower malignant potential than previously believed; nevertheless, their excision is often indicated. A Spitz nevus can mimic a melanoma both clinically and histologically. Some benign skin tumors of childhood tend to regress spontaneously within a few years but may cause complications at particular locations and when multiple. For infantile hemangiomas requiring systemic treatment because of imminent obstruction or ulceration, propranolol seems to have a far more favorable risk-benefit ratio than corticosteroids. Conclusion: Physicians need specialized knowledge in order to decide whether a skin tumor in a child should be excised, non-surgically treated, or further evaluated, or whether it can be safely left untreated because of the likelihood of spontaneous remission.}, language = {en} } @article{ZieglerRichterMahretal.2016, author = {Ziegler, C. and Richter, J. and Mahr, M. and Gajewska, A. and Schiele, M.A. and Gehrmann, A. and Schmidt, B. and Lesch, K.-P. and Lang, T. and Helbig-Lang, S. and Pauli, P. and Kircher, T. and Reif, A. and Rief, W. and Vossbeck-Elsebusch, A.N. and Arolt, V. and Wittchen, H.-U. and Hamm, A.O. and Deckert, J. and Domschke, K.}, title = {MAOA gene hypomethylation in panic disorder-reversibility of an epigenetic risk pattern by psychotherapy}, series = {Translational Psychiatry}, journal = {Translational Psychiatry}, number = {6}, doi = {10.1038/tp.2016.41}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-164422}, pages = {e773}, year = {2016}, abstract = {Epigenetic signatures such as methylation of the monoamine oxidase A (MAOA) gene have been found to be altered in panic disorder (PD). Hypothesizing temporal plasticity of epigenetic processes as a mechanism of successful fear extinction, the present psychotherapy-epigenetic study for we believe the first time investigated MAOA methylation changes during the course of exposure-based cognitive behavioral therapy (CBT) in PD. MAOA methylation was compared between N=28 female Caucasian PD patients (discovery sample) and N=28 age- and sex-matched healthy controls via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells. MAOA methylation was furthermore analyzed at baseline (T0) and after a 6-week CBT (T1) in the discovery sample parallelized by a waiting time in healthy controls, as well as in an independent sample of female PD patients (N=20). Patients exhibited lower MAOA methylation than healthy controls (P<0.001), and baseline PD severity correlated negatively with MAOA methylation (P=0.01). In the discovery sample, MAOA methylation increased up to the level of healthy controls along with CBT response (number of panic attacks; T0-T1: +3.37±2.17\%), while non-responders further decreased in methylation (-2.00±1.28\%; P=0.001). In the replication sample, increases in MAOA methylation correlated with agoraphobic symptom reduction after CBT (P=0.02-0.03). The present results support previous evidence for MAOA hypomethylation as a PD risk marker and suggest reversibility of MAOA hypomethylation as a potential epigenetic correlate of response to CBT. The emerging notion of epigenetic signatures as a mechanism of action of psychotherapeutic interventions may promote epigenetic patterns as biomarkers of lasting extinction effects.}, language = {en} }