@article{SemlerAnderlStraubUttneretal.2018, author = {Semler, Elisa and Anderl-Straub, Sarah and Uttner, Ingo and Diehl-Schmid, Janine and Danek, Adrian and Einsiedler, Beate and Fassbender, Klaus and Fliessbach, Klaus and Huppertz, Hans-J{\"u}rgen and Jahn, Holger and Kornhuber, Johannes and Landwehrmeyer, Bernhard and Lauer, Martin and Muche, Rainer and Prudlo, Johannes and Schneider, Anja and Schroeter, Matthias L. and Ludolph, Albert C. and Otto, Markus}, title = {A language-based sum score for the course and therapeutic intervention in primary progressive aphasia}, series = {Alzheimer's Research \& Therapy}, volume = {10}, journal = {Alzheimer's Research \& Therapy}, organization = {FLTD consortium}, doi = {10.1186/s13195-018-0345-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236277}, year = {2018}, abstract = {Background With upcoming therapeutic interventions for patients with primary progressive aphasia (PPA), instruments for the follow-up of patients are needed to describe disease progression and to evaluate potential therapeutic effects. So far, volumetric brain changes have been proposed as clinical endpoints in the literature, but cognitive scores are still lacking. This study followed disease progression predominantly in language-based performance within 1 year and defined a PPA sum score which can be used in therapeutic interventions. Methods We assessed 28 patients with nonfluent variant PPA, 17 with semantic variant PPA, 13 with logopenic variant PPA, and 28 healthy controls in detail for 1 year. The most informative neuropsychological assessments were combined to a sum score, and associations between brain atrophy were investigated followed by a sample size calculation for clinical trials. Results Significant absolute changes up to 20\% in cognitive tests were found after 1 year. Semantic and phonemic word fluency, Boston Naming Test, Digit Span, Token Test, AAT Written language, and Cookie Test were identified as the best markers for disease progression. These tasks provide the basis of a new PPA sum score. Assuming a therapeutic effect of 50\% reduction in cognitive decline for sample size calculations, a number of 56 cases is needed to find a significant treatment effect. Correlations between cognitive decline and atrophy showed a correlation up to r = 0.7 between the sum score and frontal structures, namely the superior and inferior frontal gyrus, as well as with left-sided subcortical structures. Conclusion Our findings support the high performance of the proposed sum score in the follow-up of PPA and recommend it as an outcome measure in intervention studies.}, language = {en} } @article{VaragnoloLinObieretal.2015, author = {Varagnolo, Linda and Lin, Quiong and Obier, Nadine and Plass, Christoph and Dietl, Johannes and Zenke, Martin and Claus, Rainer and M{\"u}ller, Albrecht M.}, title = {PRC2 inhibition counteracts the culture-associated loss of engraftment potential of human cord blood-derived hematopoietic stem and progenitor cells}, series = {Scientific Reports}, volume = {5}, journal = {Scientific Reports}, number = {12319}, doi = {10.1038/srep12319}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148374}, year = {2015}, abstract = {Cord blood hematopoietic stem cells (CB-HSCs) are an outstanding source for transplantation approaches. However, the amount of cells per donor is limited and culture expansion of CB-HSCs is accompanied by a loss of engraftment potential. In order to analyze the molecular mechanisms leading to this impaired potential we profiled global and local epigenotypes during the expansion of human CB hematopoietic stem and progenitor cells (HPSCs). Human CB-derived CD34+ cells were cultured in serum-free medium together with SCF, TPO, FGF, with or without Igfbp2 and Angptl5 (STF/STFIA cocktails). As compared to the STF cocktail, the STFIA cocktail maintains in vivo repopulation capacity of cultured CD34+ cells. Upon expansion, CD34+ cells genome-wide remodel their epigenotype and depending on the cytokine cocktail, cells show different HK4me3 and H3K27me3 levels. Expanding cells without Igfbp2 and Angptl5 leads to higher global H3K27me3 levels. ChIPseq analyses reveal a cytokine cocktail-dependent redistribution of H3K27me3 profiles. Inhibition of the PRC2 component EZH2 counteracts the culture-associated loss of NOD scid gamma (NSG) engraftment potential. Collectively, our data reveal chromatin dynamics that underlie the culture-associated loss of engraftment potential. We identify PRC2 component EZH2 as being involved in the loss of engraftment potential during the in vitro expansion of HPSCs.}, language = {en} } @article{KaemmererGiresPfetzeretal.2015, author = {K{\"a}mmerer, Ulrike and Gires, Olivier and Pfetzer, Nadja and Wiegering, Armin and Klement, Rainer Johannes and Otto, Christoph}, title = {TKTL1 expression in human malign and benign cell lines}, series = {BMC Cancer}, volume = {15}, journal = {BMC Cancer}, number = {2}, doi = {10.1186/1471-2407-15-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126397}, year = {2015}, abstract = {Background Overexpression of transketolase-like 1 protein TKTL1 in cancer cells has been reported to correlate with enhanced glycolysis and lactic acid production. Furthermore, enhanced TKTL1 expression was put into context with resistance to chemotherapy and ionizing radiation. Here, a panel of human malign and benign cells, which cover a broad range of chemotherapy and radiation resistance as well as reliance on glucose metabolism, was analyzed in vitro for TKTL1 expression. Methods 17 malign and three benign cell lines were characterized according to their expression of TKTL1 on the protein level with three commercially available anti-TKTL1 antibodies utilizing immunohistochemistry and Western blot, as well as on mRNA level with three published primer pairs for RT-qPCR. Furthermore, sensitivities to paclitaxel, cisplatin and ionizing radiation were assessed in cell survival assays. Glucose consumption and lactate production were quantified as surrogates for the "Warburg effect". Results Considerable amounts of tktl1 mRNA and TKTL1 protein were detected only upon stable transfection of the human embryonic kidney cell line HEK293 with an expression plasmid for human TKTL1. Beyond that, weak expression of endogenous tktl1 mRNA was measured in the cell lines JAR and U251. Western blot analysis of JAR and U251 cells did not detect TKTL1 at the expected size of 65 kDa with all three antibodies specific for TKTL1 protein and immunohistochemical staining was observed with antibody JFC12T10 only. All other cell lines tested here revealed expression of tktl1 mRNA below detection limits and were negative for TKTL1 protein. However, in all cell lines including TKTL1-negative HEK293-control cells, antibody JFC12T10 detected multiple proteins with different molecular weights. Importantly, JAR and U251 did neither demonstrate an outstanding production of lactic acid nor increased resistance against chemotherapeutics or to ionizing radiation, respectively. Conclusion Using RT-qPCR and three different antibodies we observed only exceptional occurrence of TKTL1 in a panel of malignant human cell lines in vitro. The presence of TKTL1 was unrelated to either the rate of glucose consumption/lactic acid production or resistance against chemo- and radiotherapy.}, language = {en} } @article{HamoudaOezkurSinhaetal.2015, author = {Hamouda, Khaled and Oezkur, Mehmet and Sinha, Bhanu and Hain, Johannes and Menkel, Hannah and Leistner, Marcus and Leyh, Rainer and Schimmer, Christoph}, title = {Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery: an observational study}, series = {Journal of Cardiothoracic Surgery}, volume = {10}, journal = {Journal of Cardiothoracic Surgery}, number = {25}, doi = {10.1186/s13019-015-0225-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124977}, year = {2015}, abstract = {Background All international guidelines recommend perioperative antibiotic prophylaxis (PAB) should be routinely administered to patients undergoing cardiac surgery. However, the duration of PAB is heterogeneous and controversial. Methods Between 01.01.2011 and 31.12.2011, 1096 consecutive cardiac surgery patients were assigned to one of two groups receiving PAB with a second-generation cephalosporin for either 56 h (group I) or 32 h (group II). Patients' characteristics, intraoperative data, and the in-hospital follow-up were analysed. Primary endpoint was the incidence of surgical site infection (deep and superficial sternal wound-, and vein harvesting site infection; DSWI/SSWI/VHSI). Secondary endpoints were the incidence of respiratory-, and urinary tract infection, as well as the mortality rate. Results 615/1096 patients (56,1\%) were enrolled (group I: n = 283 versus group II: n = 332). There were no significant differences with regard to patient characteristics, comorbidities, and procedure-related variables. No statistically significant differences were demonstrated concerning primary and secondary endpoints. The incidence of DSWI/SSWI/VHSI were 4/283 (1,4\%), 5/283 (1,7\%), and 1/283 (0,3\%) in group I versus 6/332 (1,8\%), 9/332 (2,7\%), and 3/332 (0,9\%) in group II (p = 0,76/0,59/0,63). In univariate analyses female gender, age, peripheral arterial obstructive disease, operating-time, ICU-duration, transfusion, and respiratory insufficiency were determinants for nosocomial infections (all ≤ 0,05). Subgroup analyses of these high-risk patients did not show any differences between the two regimes (all ≥ 0,05). Conclusions Reducing the duration of PAB from 56 h to 32 h in adult cardiac surgery patients was not associated with an increase of nosocomial infection rate, but contributes to reduce antibiotic resistance and health care costs.}, language = {en} } @article{BusseStrotmannStreckeretal.2014, author = {Busse, Kathy and Strotmann, Rainer and Strecker, Karl and Wegner, Florian and Devanathan, Vasudharani and Gohla, Antje and Sch{\"o}neberg, Torsten and Schwarz, Johannes}, title = {Adaptive Gene Regulation in the Striatum of RGS9-Deficient Mice}, series = {PLOS ONE}, volume = {9}, journal = {PLOS ONE}, number = {3}, doi = {10.1371/journal.pone.0092605}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-117048}, pages = {e92605}, year = {2014}, abstract = {Background: RGS9-deficient mice show drug-induced dyskinesia but normal locomotor activity under unchallenged conditions. Results: Genes related to Ca2+ signaling and their functions were regulated in RGS9-deficient mice. Conclusion: Changes in Ca2+ signaling that compensate for RGS9 loss-of-function can explain the normal locomotor activity in RGS9-deficient mice under unchallenged conditions. Significance: Identified signaling components may represent novel targets in antidyskinetic therapy. The long splice variant of the regulator of G-protein signaling 9 (RGS9-2) is enriched in striatal medium spiny neurons and dampens dopamine D2 receptor signaling. Lack of RGS9-2 can promote while its overexpression prevents drug-induced dyskinesia. Other animal models of drug-induced dyskinesia rather pointed towards overactivity of dopamine receptor-mediated signaling. To evaluate changes in signaling pathways mRNA expression levels were determined and compared in wild-type and RGS9-deficient mice. Unexpectedly, expression levels of dopamine receptors were unchanged in RGS9-deficient mice, while several genes related to Ca2+ signaling and long-term depression were differentially expressed when compared to wild type animals. Detailed investigations at the protein level revealed hyperphosphorylation of DARPP32 at Thr34 and of ERK1/2 in striata of RGS9-deficient mice. Whole cell patch clamp recordings showed that spontaneous synaptic events are increased (frequency and size) in RGS9-deficient mice while long-term depression is reduced in acute brain slices. These changes are compatible with a Ca2+-induced potentiation of dopamine receptor signaling which may contribute to the drug-induced dyskinesia in RGS9-deficient mice.}, language = {en} } @article{MengMusekampSeekatzetal.2013, author = {Meng, Karin and Musekamp, Gunda and Seekatz, Bettina and Glatz, Johannes and Karger, Gabriele and Kiwus, Ulrich and Knoglinger, Ernst and Schubmann, Rainer and Westphal, Ronja and Faller, Hermann}, title = {Evaluation of a self-management patient education program for patients with chronic heart failure undergoing inpatient cardiac rehabilitation: study protocol of a cluster randomized controlled trial}, series = {BMC Cardiovascular Disorders}, journal = {BMC Cardiovascular Disorders}, doi = {10.1186/1471-2261-13-60}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96852}, year = {2013}, abstract = {Background Chronic heart failure requires a complex treatment regimen on a life-long basis. Therefore, self-care/self-management is an essential part of successful treatment and comprehensive patient education is warranted. However, specific information on program features and educational strategies enhancing treatment success is lacking. This trial aims to evaluate a patient-oriented and theory-based self-management educational group program as compared to usual care education during inpatient cardiac rehabilitation in Germany. Methods/Design The study is a multicenter cluster randomized controlled trial in four cardiac rehabilitation clinics. Clusters are patient education groups that comprise HF patients recruited within 2 weeks after commencement of inpatient cardiac rehabilitation. Cluster randomization was chosen for pragmatic reasons, i.e. to ensure a sufficient number of eligible patients to build large-enough educational groups and to prevent contamination by interaction of patients from different treatment allocations during rehabilitation. Rehabilitants with chronic systolic heart failure (n = 540) will be consecutively recruited for the study at the beginning of inpatient rehabilitation. Data will be assessed at admission, at discharge and after 6 and 12 months using patient questionnaires. In the intervention condition, patients receive the new patient-oriented self-management educational program, whereas in the control condition, patients receive a short lecture-based educational program (usual care). The primary outcome is patients' self-reported self-management competence. Secondary outcomes include behavioral determinants and self-management health behavior (symptom monitoring, physical activity, medication adherence), health-related quality of life, and treatment satisfaction. Treatment effects will be evaluated separately for each follow-up time point using multilevel regression analysis, and adjusting for baseline values. Discussion This study evaluates the effectiveness of a comprehensive self-management educational program by a cluster randomized trial within inpatient cardiac rehabilitation in Germany. Furthermore, subgroup-related treatment effects will be explored. Study results will contribute to a better understanding of both the effectiveness and mechanisms of a self-management group program as part of cardiac rehabilitation.}, language = {en} } @article{KlementFrobelAlbersetal.2013, author = {Klement, Rainer Johannes and Frobel, Thomas and Albers, Torsten and Fikenzer, Sven and Prinzhausen, Jan and K{\"a}mmerer, Ulrike}, title = {A pilot case study on the impact of a self-prescribed ketogenic diet on biochemical parameters and running performance in healthy and physically active individuals}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-78901}, year = {2013}, abstract = {Background: Ketogenic diets (KDs) have gained some popularity not only as effective weight-loss diets and treatment options for several diseases, but also among healthy and physically active individuals for various reasons. However, data on the effects of ketosis in the latter group of individuals are scarce. We therefore collected pilot data on the physiological response to a self-prescribed ketogenic diet lasting 5-7 weeks in a small cohort of healthy and physically active individuals. Methods: Twelve subjects (7 males, 5 females, age 24-60 years) who followed moderate to intensive exercise routines underwent blood testing, bioelectrical impedance analysis (BIA) and spiroergometry during an incremental treadmill test. On the next day, they went on a self-prescribed KD for a median of 38 days (range 35-50 days), after which the same tests were performed again. Ketosis was self-monitored by urinary ketone strips. Subjective feeling during the diet was assessed by a questionnaire after the intervention. Due to the small and heterogenous sample, the results are interpreted in the context of the already existing literature. Results: The KDs were tolerated well by the majority of individuals. Impaired recovery from exercise remained the most frequently reported side effect until the end of the study. Most blood parameters remained stable during the intervention. However, there were significant elevations of total and LDL cholesterol concentrations (p<0.01) and a trend towards increased HDL-cholesterol (p=0.05). The drastic reduction of carbohydrates had no statistically significant influence on running performance judged by the time to exhaustion, VO2max and respiratory compensation points. BIA measurements showed significant increases in phase angle (p=0.01) indicating improvements of body composition with an estimated decrease of 3.4 kg of fat mass (p=0.002) and gain of 1.3 kg of fat free mass. We discuss the validity of these estimates taking into account a possibly altered hydration status due to the KD. Conclusions: Active healthy individuals will probably experience no major problems during a short term KD lasting several weeks. The drastically reduced carbohydrate content of the diet seems to be no limiting factor for running performance. In addition, improvements in body composition can be expected. While most biochemical parameters are not influenced by the diet, there seems to be an impact on the blood lipid profile that could be considered problematic with respect to cardiovascular disease risk. However, the predictive role of cholesterol levels alone in individuals undergoing regular physical activity remains to be elucidated.}, subject = {Fettgehalt}, language = {en} } @phdthesis{Rainer2024, author = {Rainer, Johannes}, title = {Vaskulartoxische Wirkung von Taxanen bei fortgeschrittenen Tumorerkrankungen}, doi = {10.25972/OPUS-35072}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-350722}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Taxane (wie Paclitaxel oder Cabazitaxel) sind bew{\"a}hrte Arzneimittel in den systemischen Therapieschemata vieler b{\"o}sartiger Erkrankungen, einschließlich Brust- und Eierstockkrebs. Sie f{\"o}rdern die Stabilisierung der Mikrotubuli, was zu einem Stillstand des Zellzyklus w{\"a}hrend der Mitose f{\"u}hrt, auf den die Apoptose folgt. Neben dieser antimitotischen Wirkung von Taxanen ist seit einiger Zeit auch eine gef{\"a}ßver{\"a}ndernde Wirkung von Taxanen bekannt. K{\"u}rzlich wurde gezeigt, dass Taxane tats{\"a}chlich St{\"o}rungen in der Gef{\"a}ßarchitektur verursachen, indem sie den Kalziumeinstrom {\"u}ber TRPC6, einen unselektiven Kationenkanal, ausl{\"o}sen. Der erh{\"o}hte intrazellul{\"a}re Ca2+-Spiegel bewirkt eine Rundung der Endothelzellen, was zu einer St{\"o}rung des endothelialen Monolayers, Serumausfluss und Gef{\"a}ßkollaps f{\"u}hrt. In dieser Arbeit konzentrierten wir uns auf die Gef{\"a}ßbetten von peripheren Organen wie dem Herzen oder der Niere in Abh{\"a}ngigkeit vom Tumorstadium und der Taxol-Behandlung. Die Organe wurden mit immunhistochemischen Techniken angef{\"a}rbt, um Ver{\"a}nderungen in der Architektur und Morphologie der Blutgef{\"a}ße zu untersuchen. Wir fanden Ver{\"a}nderungen in der Morphologie der Kapillaren des Herzens und dar{\"u}ber hinaus Ver{\"a}nderungen in der Expression endothelialer Antigene in Abh{\"a}ngigkeit vom Tumorstadium, insbesondere eine zunehmende endotheliale Expression von TRPC6 in Abh{\"a}ngigkeit vom Tumorstadium. Diese Ergebnisse liefern neue Erkenntnisse f{\"u}r das Verst{\"a}ndnis der systemischen Auswirkungen maligner Erkrankungen und tragen dazu bei, Folgeerkrankungen bei Patienten mit fortgeschrittenem Krebs zu verhindern.}, subject = {Taxane}, language = {de} } @article{HanitschBaumannBoztugetal.2020, author = {Hanitsch, Leif and Baumann, Ulrich and Boztug, Kaan and Burkhard-Meier, Ulrike and Fasshauer, Maria and Habermehl, Pirmin and Hauck, Fabian and Klock, Gerd and Liese, Johannes and Meyer, Oliver and M{\"u}ller, Rainer and Pachlopnik-Schmid, Jana and Pfeiffer-Kascha, Dorothea and Warnatz, Klaus and Wehr, Claudia and Wittke, Kirsten and Niehues, Tim and von Bernuth, Horst}, title = {Treatment and management of primary antibody deficiency: German interdisciplinary evidence-based consensus guideline}, series = {European Journal of Immunology}, volume = {50}, journal = {European Journal of Immunology}, number = {10}, doi = {10.1002/eji.202048713}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-225731}, pages = {1432 -- 1446}, year = {2020}, abstract = {This evidence-based clinical guideline provides consensus-recommendations for the treatment and care of patients with primary antibody deficiencies (PADs). The guideline group comprised 20 clinical and scientific expert associations of the German, Swiss, and Austrian healthcare system and representatives of patients. Recommendations were based on results of a systematic literature search, data extraction, and evaluation of methodology and study quality in combination with the clinical expertise of the respective representatives. Consensus-based recommendations were determined via nominal group technique. PADs are the largest clinically relevant group of primary immunodeficiencies. Most patients with PADs present with increased susceptibility to infections, however immune dysregulation, autoimmunity, and cancer affect a significant number of patients and may precede infections. This guideline therefore covers interdisciplinary clinical and therapeutic aspects of infectious (e.g., antibiotic prophylaxis, management of bronchiectasis) and non-infectious manifestations (e.g., management of granulomatous disease, immune cytopenia). PADs are grouped into disease entities with definitive, probable, possible, or unlikely benefit of IgG-replacement therapy. Summary and consensus-recommendations are provided for treatment indication, dosing, routes of administration, and adverse events of IgG-replacement therapy. Special aspects of concomitant impaired T-cell function are highlighted as well as clinical data on selected monogenetic inborn errors of immunity formerly classified into PADs (APDS, CTLA-4-, and LRBA-deficiency).}, language = {en} }