@article{ScherzadHagenHackenberg2019,
  author    = {Scherzad, Agmal and Hagen, Rudolf and Hackenberg, Stephan},
  title     = {Current Understanding of Nasal Epithelial Cell Mis-Differentiation},
  series = {Journal of Inflammation Research},
  volume    = {12},
  journal   = {Journal of Inflammation Research},
  doi       = {10.2147/JIR.S180853},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228562},
  pages     = {309-317},
  year      = {2019},
  abstract  = {The functional role of the respiratory epithelium is to generate a physical barrier. In addition, the epithelium supports the innate and acquired immune system through various cytokines and chemokines. However, epithelial cells are also involved in the pathogenesis of various respiratory diseases, some of which are mediated by increased permeability of the mucosal membrane or disturbed mucociliary transport. In addition, it has been shown that epithelial cells are involved in the development of inflammatory respiratory diseases. The following review article focuses on the aspects of epithelial mis-differentiation, in particular with respect to nasal mucosal barrier function, epithelial immunogenicity, nasal epithelial-mesenchymal transition and nasal microbiome.},
  language  = {en}
}
@article{MeyerGerhardHartmannLodesetal.2021,
  author    = {Meyer, Till Jasper and Gerhard-Hartmann, Elena and Lodes, Nina and Scherzad, Agmal and Hagen, Rudolf and Steinke, Maria and Hackenberg, Stephan},
  title     = {Pilot study on the value of Raman spectroscopy in the entity assignment of salivary gland tumors},
  series = {PLoS One},
  volume    = {16},
  journal   = {PLoS One},
  number    = {9},
  doi       = {10.1371/journal.pone.0257470},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264736},
  year      = {2021},
  abstract  = {Background The entity assignment of salivary gland tumors (SGT) based on histomorphology can be challenging. Raman spectroscopy has been applied to analyze differences in the molecular composition of tissues. The aim of this study was to evaluate the suitability of RS for entity assignment in SGT. Methods Raman data were collected in deparaffinized sections of pleomorphic adenomas (PA) and adenoid cystic carcinomas (ACC). Multivariate data and chemometric analysis were completed using the Unscrambler software. Results The Raman spectra detected in ACC samples were mostly assigned to nucleic acids, lipids, and amides. In a principal component-based linear discriminant analysis (LDA) 18 of 20 tumor samples were classified correctly. Conclusion In this proof of concept study, we show that a reliable SGT diagnosis based on LDA algorithm appears possible, despite variations in the entity-specific mean spectra. However, a standardized workflow for tissue sample preparation, measurement setup, and chemometric algorithms is essential to get reliable results.},
  language  = {en}
}
@article{RadeloffRadeloffTiradoetal.2019,
  author    = {Radeloff, Katrin and Radeloff, Andreas and Tirado, Mario Ramos and Scherzad, Agmal and Hagen, Rudolf and Kleinsasser, Norbert H. and Hackenberg, Stephan},
  title     = {Long-Term Impact of Zinc Oxide Nanoparticles on Differentiation and Cytokine Secretion of Human Adipose-Derived Stromal Cells},
  series = {Materials},
  volume    = {12},
  journal   = {Materials},
  number    = {1823},
  doi       = {10.3390/ma12111823},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-224779},
  pages     = {1-14},
  year      = {2019},
  abstract  = {Zinc oxide nanoparticles (ZnO-NPs) are widely utilized, for example in manufacturing paints and in the cosmetic industry. In addition, there is raising interest in the application of NPs in stem cell research. However, cytotoxic, genotoxic and pro-inflammatory effects were shown for NPs. The aim of this study was to evaluate the impact of ZnO-NPs on cytokine secretion and differentiation properties of human adipose tissue-derived stromal cells (ASCs). Human ASCs were exposed to the subtoxic concentration of 0.2 mu g/mL ZnO-NPs for 24 h. After four weeks of cultivation, adipogenic and osteogenic differentiation procedures were performed. The multi-differentiation potential was confirmed histologically and using polymerase chain reaction (PCR). In addition, the gene expression of IL-6, IL-8, vascular endothelial growth factor (VEGF) and caspase 3 was analyzed. Over the course of four weeks after ZnO-NPs exposure, no significant differences were detected in the gene expression of IL-6, IL-8, VEGF and caspase 3 compared to non-exposed cells. The differentiation was also not affected by the ZnO-NPs. These findings underline the fact, that functionality of ASCs is likely to be unaffected by ZnO-NPs, despite a long-term disposition of NPs in the cells, supposing that the starting concentration was safely in the non-toxic range. This might provide important information for single-use nanomedical applications of ZnO-NPs.},
  language  = {en}
}
@article{RadeloffRamosTiradoHaddadetal.2021,
  author    = {Radeloff, Katrin and Ramos Tirado, Mario and Haddad, Daniel and Breuer, Kathrin and M{\"u}ller, Jana and Hochmuth, Sabine and Hackenberg, Stephan and Scherzad, Agmal and Kleinsasser, Norbert and Radeloff, Andreas},
  title     = {Superparamagnetic iron oxide particles (VSOPs) show genotoxic effects but no functional impact on human adipose tissue-derived stromal cells (ASCs)},
  series = {Materials},
  volume    = {14},
  journal   = {Materials},
  number    = {2},
  issn      = {1996-1944},
  doi       = {10.3390/ma14020263},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222970},
  year      = {2021},
  abstract  = {Adipose tissue-derived stromal cells (ASCs) represent a capable source for cell-based therapeutic approaches. For monitoring a cell-based application in vivo, magnetic resonance imaging (MRI) of cells labeled with iron oxide particles is a common method. It is the aim of the present study to analyze potential DNA damage, cytotoxicity and impairment of functional properties of human (h)ASCs after labeling with citrate-coated very small superparamagnetic iron oxide particles (VSOPs). Cytotoxic as well as genotoxic effects of the labeling procedure were measured in labeled and unlabeled hASCs using the MTT assay, comet assay and chromosomal aberration test. Trilineage differentiation was performed to evaluate an impairment of the differentiation potential due to the particles. Proliferation as well as migration capability were analyzed after the labeling procedure. Furthermore, the labeling of the hASCs was confirmed by Prussian blue staining, transmission electron microscopy (TEM) and high-resolution MRI. Below the concentration of 0.6 mM, which was used for the procedure, no evidence of genotoxic effects was found. At 0.6 mM, 1 mM as well as 1.5 mM, an increase in the number of chromosomal aberrations was determined. Cytotoxic effects were not observed at any concentration. Proliferation, migration capability and differentiation potential were also not affected by the procedure. Labeling with VSOPs is a useful labeling method for hASCs that does not affect their proliferation, migration and differentiation potential. Despite the absence of cytotoxicity, however, indications of genotoxic effects have been demonstrated.},
  language  = {en}
}
@article{ScherzadMeyerIckrathetal.2019,
  author    = {Scherzad, Agmal and Meyer, Till and Ickrath, Pascal and Gehrke, Thomas Eckhart and Bregenzer, Maximillian and Hagen, Rudolf and Dembski, Sofia and Hackenberg, Stephan},
  title     = {Cultivation of hMSCs in human plasma prevents the cytotoxic and genotoxic potential of ZnO-NP in vitro},
  series = {Applied Sciences},
  volume    = {9},
  journal   = {Applied Sciences},
  number    = {23},
  issn      = {2076-3417},
  doi       = {10.3390/app9234994},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-193063},
  year      = {2019},
  abstract  = {Zinc oxide nanoparticles (ZnO-NPs) are commonly used for industrial applications. Consequently, there is increasing exposure of humans to them. The in vitro analysis of cytotoxicity and genotoxicity is commonly performed under standard cell culture conditions. Thus, the question arises of how the results of genotoxicity and cytotoxicity experiments would alter if human plasma was used instead of cell culture medium containing of fetal calf serum (FCS). Human mesenchymal stem cells (hMSCs) were cultured in human plasma and exposed to ZnO-NPs. A cultivation in expansion medium made of DMEM consisting 10\% FCS (DMEM-EM) served as control. Genotoxic and cytotoxic effects were evaluated with the comet and MTT assay, respectively. hMSC differentiation capacity and ZnO-NP disposition were evaluated by histology and transmission electron microscopy (TEM). The protein concentration and the amount of soluble Zn2+ were measured. The cultivation of hMSCs in plasma leads to an attenuation of genotoxic and cytotoxic effects of ZnO-NPs compared to control. The differentiation capacity of hMSCs was not altered. The TEM showed ZnO-NP persistence in cytoplasm in both groups. The concentrations of protein and Zn2+ were higher in plasma than in DMEM-EM. In conclusion, the cultivation of hMSCs in plasma compared to DMEM-EM leads to an attenuation of cytotoxicity and genotoxicity in vitro.},
  language  = {en}
}
@article{ScherzadMeyerKleinsasseretal.2020,
  author    = {Scherzad, Agmal and Meyer, Till and Kleinsasser, Norbert and Hackenberg, Stephan},
  title     = {Erratum: Scherzad, A., et al. Molecular mechanisms of zinc oxide nanoparticle-induced genotoxicity short running title: Genotoxicity of ZnO NPs. Materials 2017, 10, 1427},
  series = {Materials},
  volume    = {13},
  journal   = {Materials},
  number    = {23},
  issn      = {1996-1944},
  doi       = {10.3390/ma13235462},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219440},
  year      = {2020},
  abstract  = {No abstract available},
  language  = {en}
}
@article{IckrathSpruegelBeyersdorfetal.2021,
  author    = {Ickrath, Pascal and Spr{\"u}gel, Lisa and Beyersdorf, Niklas and Scherzad, Agmal and Hagen, Rudolf and Hackenberg, Stephan},
  title     = {Detection of Candida albicans-Specific CD4+ and CD8+ T Cells in the Blood and Nasal Mucosa of Patients with Chronic Rhinosinusitis},
  series = {Journal of Fungi},
  volume    = {7},
  journal   = {Journal of Fungi},
  number    = {6},
  issn      = {2309-608X},
  doi       = {10.3390/jof7060403},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239671},
  year      = {2021},
  abstract  = {Candida albicans is ubiquitously present, and colonization in the nose and oral cavity is common. In healthy patients, it usually does not act as a pathogen, but in some cases can cause diseases. The influence of C. albicans as a trigger of T cell activation on the pathogenesis of chronic rhinosinusitis (CRS) is controversial, and its exact role is not clear to date. The aim of the present study was to detect and characterize C. albicans-specific CD4+ and CD8+ T cells in patients with CRS, with and without nasal polyps. Tissue and blood samples were collected from patients suffering from chronic rhinosinusitis with (CRSwNP) and without nasal polyps (CRSsNP), and from healthy controls. A peptide pool derived from C. albicans antigen was added to tissue and blood samples. After 6 days, lymphocytes were analyzed by multicolor flow cytometry. Activation was assessed by the intracellular marker Ki-67, and the cytokine secretion was measured. Tissue CD8+ T cells of CRSsNP patients showed a significantly higher proportion of Ki-67+ cells after activation with C. albicans antigen compared to peripheral blood CD8+ T cells. Cytokine secretion in response to C. albicans antigen was similar for all study groups. In this study, C. albicans-specific CD4+ and CD8+ T cells were detected in peripheral blood and mucosal tissue in all study groups. In patients suffering from CRSsNP, C. albicans-specific CD8+ T cells were relatively enriched in the nasal mucosa, suggesting that they might play a role in the pathogenesis of CRSsNP.},
  language  = {en}
}
@article{RadeloffRadeloffRamosTiradoetal.2020,
  author    = {Radeloff, Katrin and Radeloff, Andreas and Ramos Tirado, Mario and Scherzad, Agmal and Hagen, Rudolf and Kleinsasser, Norbert H. and Hackenberg, Stephan},
  title     = {Toxicity and functional impairment in human adipose tissue-derived stromal cells (hASCs) following long-term exposure to very small iron oxide particles (VSOPs)},
  series = {Nanomaterials},
  volume    = {10},
  journal   = {Nanomaterials},
  number    = {4},
  issn      = {2079-4991},
  doi       = {10.3390/nano10040741},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-203676},
  year      = {2020},
  abstract  = {Magnetic nanoparticles (NPs), such as very small iron oxide NPs (VSOPs) can be used for targeted drug delivery, cancer treatment or tissue engineering. Another important field of application is the labelling of mesenchymal stem cells to allow in vivo tracking and visualization of transplanted cells using magnetic resonance imaging (MRI). For these NPs, however, various toxic effects, as well as functional impairment of the exposed cells, are described. The present study evaluates the influence of VSOPs on the multilineage differentiation ability and cytokine secretion of human adipose tissue derived stromal cells (hASCs) after long-term exposure. Human ASCs were labelled with VSOPs, and the efficacy of the labelling was documented over 4 weeks in vitro cultivation of the labelled cells. Unlabelled hASCs served as negative controls. Four weeks after labelling, adipogenic and osteogenic differentiation was histologically evaluated and quantified by polymerase chain reaction (PCR). Changes in gene expression of IL-6, IL-8, VEGF and caspase 3 were determined over 4 weeks. Four weeks after the labelling procedure, labelled and unlabelled hASCs did not differ in the gene expression of IL-6, IL-8, VEGF and caspase 3. Furthermore, the labelling procedure had no influence on the multidifferentiation ability of hASC. The percentage of labelled cells decreased during in vitro expansion over 4 weeks. Labelling with VSOPs and long-term intracellular disposition probably have no influence on the physiological functions of hASCs. This could be important for the future in vivo use of iron oxide NPs.},
  language  = {en}
}
@article{MeyerStoethMoratinetal.2021,
  author    = {Meyer, Till Jasper and St{\"o}th, Manuel and Moratin, Helena and Ickrath, Pascal and Herrmann, Marietta and Kleinsasser, Norbert and Hagen, Rudolf and Hackenberg, Stephan and Scherzad, Agmal},
  title     = {Cultivation of head and neck squamous cell carcinoma cells with wound fluid leads to cisplatin resistance via epithelial-mesenchymal transition induction},
  series = {International Journal of Molecular Sciences},
  volume    = {22},
  journal   = {International Journal of Molecular Sciences},
  number    = {9},
  issn      = {1422-0067},
  doi       = {10.3390/ijms22094474},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258722},
  year      = {2021},
  abstract  = {Locoregional recurrence is a major reason for therapy failure after surgical resection of head and neck squamous cell carcinoma (HNSCC). The physiological process of postoperative wound healing could potentially support the proliferation of remaining tumor cells. The aim of this study was to evaluate the influence of wound fluid (WF) on the cell cycle distribution and a potential induction of epithelial-mesenchymal transition (EMT). To verify this hypothesis, we incubated FaDu and HLaC78 cells with postoperative WF from patients after neck dissection. Cell viability in dependence of WF concentration and cisplatin was measured by flow cytometry. Cell cycle analysis was performed by flow cytometry and EMT-marker expression by rtPCR. WF showed high concentrations of interleukin (IL)-6, IL-8, IL-10, CCL2, MCP-1, EGF, angiogenin, and leptin. The cultivation of tumor cells with WF resulted in a significant increase in cell proliferation without affecting the cell cycle. In addition, there was a significant enhancement of the mesenchymal markers Snail 2 and vimentin, while the expression of the epithelial marker E-cadherin was significantly decreased. After cisplatin treatment, tumor cells incubated with WF showed a significantly higher resistance compared with the control group. The effect of cisplatin-resistance was dependent on the WF concentration. In summary, proinflammatory cytokines are predominantly found in WF. Furthermore, the results suggest that EMT can be induced by WF, which could be a possible mechanism for cisplatin resistance.},
  language  = {en}
}
@article{IckrathWagnerScherzadetal.2017,
  author    = {Ickrath, Pascal and Wagner, Martin and Scherzad, Agmal and Gehrke, Thomas and Burghartz, Marc and Hagen, Rudolf and Radeloff, Katrin and Kleinsasser, Norbert and Hackenberg, Stephan},
  title     = {Time-Dependent Toxic and Genotoxic Effects of Zinc Oxide Nanoparticles after Long-Term and Repetitive Exposure to Human Mesenchymal Stem Cells},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {14},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {12},
  doi       = {10.3390/ijerph14121590},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-169932},
  pages     = {1590},
  year      = {2017},
  abstract  = {Zinc oxide nanoparticles (ZnO-NP) are widely spread in consumer products. Data about the toxicological characteristics of ZnO-NP is still under controversial discussion. The human skin is the most important organ concerning ZnO-NP exposure. Intact skin was demonstrated to be a sufficient barrier against NPs; however, defect skin may allow NP contact to proliferating cells. Within these cells, stem cells are the most important toxicological target for NPs. The aim of this study was to evaluate the genotoxic and cytotoxic effects of ZnO-NP at low-dose concentrations after long-term and repetitive exposure to human mesenchymal stem cells (hMSC). Cytotoxic effects of ZnO-NP were measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Furthermore, genotoxicity was evaluated by the comet assay. For long-term observation over 6 weeks, transmission electron microscopy (TEM) was applied. The results of the study indicated cytotoxic effects of ZnO-NP beginning at high concentrations of 50 μg/mL and genotoxic effects in hMSC exposed to 1 and 10 μg/mL ZnO-NP. Repetitive exposure enhanced cyto- but not genotoxicity. Intracellular NP accumulation was observed up to 6 weeks. The results suggest cytotoxic and genotoxic potential of ZnO-NP. Even low doses of ZnO-NP may induce toxic effects as a result of repetitive exposure and long-term cellular accumulation. This data should be considered before using ZnO-NP on damaged skin.},
  language  = {en}
}
@article{MoratinIckrathScherzadetal.2021,
  author    = {Moratin, Helena and Ickrath, Pascal and Scherzad, Agmal and Meyer, Till Jasper and Naczenski, Sebastian and Hagen, Rudolf and Hackenberg, Stephan},
  title     = {Investigation of the immune modulatory potential of zinc oxide nanoparticles in human lymphocytes},
  series = {Nanomaterials},
  volume    = {11},
  journal   = {Nanomaterials},
  number    = {3},
  issn      = {2079-4991},
  doi       = {10.3390/nano11030629},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234016},
  year      = {2021},
  abstract  = {Zinc oxide nanoparticles (ZnO-NP) are commonly used for a variety of applications in everyday life. In addition, due to its versatility, nanotechnology supports promising approaches in the medical sector. NP can act as drug-carriers in the context of targeted chemo- or immunotherapy, and might also exhibit autonomous immune-modulatory characteristics. Knowledge of potential immunosuppressive or stimulating effects of NP is indispensable for the safety of consumers as well as patients. In this study, primary human peripheral blood lymphocytes of 9 donors were treated with different sub-cytotoxic concentrations of ZnO-NP for the duration of 1, 2, or 3 days. Flow cytometry was performed to investigate changes in the activation profile and the proportion of T cell subpopulations. ZnO-NP applied in this study did not induce any significant alterations in the examined markers, indicating their lack of impairment in terms of immune modulation. However, physicochemical characteristics exert a major influence on NP-associated bioactivity. To allow a precise simulation of the complex molecular processes of immune modulation, a physiological model including the different components of an immune response is needed.},
  language  = {en}
}
@article{GehrkeScherzadHagenetal.2022,
  author    = {Gehrke, Thomas and Scherzad, Agmal and Hagen, Rudolf and Hackenberg, Stephan},
  title     = {Deep neck infections with and without mediastinal involvement: treatment and outcome in 218 patients},
  series = {European Archives of Oto-Rhino-Laryngology},
  volume    = {279},
  journal   = {European Archives of Oto-Rhino-Laryngology},
  number    = {3},
  issn      = {1434-4726},
  doi       = {10.1007/s00405-021-06945-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266814},
  pages     = {1585-1592},
  year      = {2022},
  abstract  = {Purpose Infections of the deep neck, although becoming scarcer due to the widespread use of antibiotics, still represent a dangerous and possibly deadly disease, especially when descending into the mediastinum. Due to the different specialities involved in the treatment and the heterogenous presentation of the disease, therapeutic standard is still controversial. This study analyzes treatment and outcome in these patients based on a large retrospective review and proposes a therapeutic algorithm. Methods The cases of 218 adult patients treated with deep neck abscesses over a 10-year period at a tertiary university hospital were analyzed retrospectively. Clinical, radiological, microbiological and laboratory findings were compared between patients with and without mediastinal involvement. Results Forty-five patients (20.64\%) presented with abscess formation descending into the mediastinum. Those patients had significantly (all items p < 0.0001) higher rates of surgical interventions (4.27 vs. 1.11) and tracheotomies (82\% vs. 3.4\%), higher markers of inflammation (CRP 26.09 vs. 10.41 mg/dl), required more CT-scans (3.58 vs. 0.85), longer hospitalization (39.78 vs 9.79 days) and more frequently needed a change in antibiotic therapy (44.44\% vs. 6.40\%). Multi-resistant pathogens were found in 6.67\% vs. 1.16\%. Overall mortality rate was low with 1.83\%. Conclusion Despite of the high percentage of mediastinal involvement in the present patient collective, the proposed therapeutic algorithm resulted in a low mortality rate. Frequent CT-scans, regular planned surgical revisions with local drainage and lavage, as well as an early tracheotomy seem to be most beneficial regarding the outcome.},
  language  = {en}
}
@article{KrausHackenbergShehataDieleretal.2022,
  author    = {Kraus, Fabian and Hackenberg, Stephan and Shehata-Dieler, Wafaa and Hagen, Rudolf},
  title     = {High-sensitivity FEES\(^{®}\) with the professional image enhancement technology "PIET"},
  series = {European Archives of Oto-Rhino-Laryngology},
  volume    = {279},
  journal   = {European Archives of Oto-Rhino-Laryngology},
  number    = {1},
  issn      = {1434-4726},
  doi       = {10.1007/s00405-021-07067-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266822},
  pages     = {293-298},
  year      = {2022},
  abstract  = {Purpose Flexible endoscopic evaluation of swallowing (FEES\(^{®}\)) is a standard diagnostic tool in dysphagia. The combination of FEES® and narrow band light (narrow band imaging; NBI) provides a more precise and detailed investigation method. So far, this technique could only be performed with the NBI illumination. The new version of the "professional image enhancement technique" (PIET) provides another image enhancing system. This study investigates the eligibility of PIET in the FEES\(^{®}\) procedure. Methods Both techniques, NBI and PIET, were compared using a target system. Furthermore, the image enhancement during FEES\(^{®}\) was performed and recorded with the two systems during daily routine. Results Performing an image enhancement during FEES\(^{®}\) is possible with both systems PIET and NBI. On the target system, the contrast of the PIET showed a brighter and a more detailed picture. In dysphagia patients, no difference between PIET and NBI was detected. Conclusion PIET proved to be non-inferior to NBI during image enhancement FEES\(^{®}\). So far, image enhancement FEES\(^{®}\) was exclusively connected to NBI. With the PIET system, an alternative endoscopy technology is available for certain indications.},
  language  = {en}
}
@article{GehrkeHackenbergTecleetal.2021,
  author    = {Gehrke, Thomas and Hackenberg, Stephan and Tecle, Nyat and Hagen, Rudolf and Scherzad, Agmal},
  title     = {Tuberculosis in the Head and Neck: Changing Trends and Age-Related Patterns},
  series = {The Laryngoscope},
  volume    = {131},
  journal   = {The Laryngoscope},
  number    = {12},
  doi       = {10.1002/lary.29668},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-257524},
  pages     = {2701-2705},
  year      = {2021},
  abstract  = {Objective To evaluate changing trends in patient collectives, age-related patterns of manifestation, and diagnostic pathways of patients with extrapulmonary head and neck tuberculosis (TB), and to provide strategies to fasten diagnosis in these patients. Study design Case control study. Methods A 10-year retrospective analysis of 35 patients diagnosed with extrapulmonary TB in the head and neck at a tertiary university institution from 2009 to 2019, with special focus on the influence of the patient's age on consideration of TB and clinical patterns. Results The vast majority of patients younger than 40 years had their origin in countries with high TB burden (P = .0003), and TB was considered very early as a differential diagnosis (P = .0068), while most patients older than 40 years were domestic citizens initially suspected for a malignancy, who more often had an underlying immunosuppressive condition (0.0472). Most frequent manifestations in both groups were the lymph nodes, larynx, and oropharynx. Surprisingly, no differences in the rates of open TB or history of TB infection in the family anamnesis were found. Conclusion The two groups of patients found most often are younger patients migrating from regions with high TB burden and elderly domestic patients suffering from immunosuppressive conditions, with the latter often being misdiagnosed as malignancies. TB remains an important but difficult differential diagnosis, due to the initially unspecific symptoms and the great variety in the presentation of manifestations in the head and neck.},
  language  = {en}
}
@article{MeyerScherzadMoratinetal.2019,
  author    = {Meyer, Till Jasper and Scherzad, Agmal and Moratin, Helena and Gehrke, Thomas Eckert and Killisperger, Julian and Hagen, Rudolf and Wohlleben, Gisela and Polat, B{\"u}lent and Dembski, Sofia and Kleinsasser, Norbert and Hackenberg, Stephan},
  title     = {The radiosensitizing effect of zinc oxide nanoparticles in sub-cytotoxic dosing is associated with oxidative stress in vitro},
  series = {Materials},
  volume    = {12},
  journal   = {Materials},
  number    = {24},
  issn      = {1996-1944},
  doi       = {10.3390/ma12244062},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-193897},
  pages     = {4062},
  year      = {2019},
  abstract  = {Radioresistance is an important cause of head and neck cancer therapy failure. Zinc oxide nanoparticles (ZnO-NP) mediate tumor-selective toxic effects. The aim of this study was to evaluate the potential for radiosensitization of ZnO-NP. The dose-dependent cytotoxicity of ZnO-NP\(_{20 nm}\) and ZnO-NP\(_{100 nm}\) was investigated in FaDu and primary fibroblasts (FB) by an MTT assay. The clonogenic survival assay was used to evaluate the effects of ZnO-NP alone and in combination with irradiation on FB and FaDu. A formamidopyrimidine-DNA glycosylase (FPG)-modified single-cell microgel electrophoresis (comet) assay was applied to detect oxidative DNA damage in FB as a function of ZnO-NP and irradiation exposure. A significantly increased cytotoxicity after FaDu exposure to ZnO-NP\(_{20 nm}\) or ZnO-NP\(_{100 nm}\) was observed in a concentration of 10 µg/mL or 1 µg/mL respectively in 30 µg/mL of ZnO-NP\(_{20 nm}\) or 20 µg/mL of ZnO-NP\(_{100 nm}\) in FB. The addition of 1, 5, or 10 µg/mL ZnO-NP\(_{20 nm}\) or ZnO-NP\(_{100 nm}\) significantly reduced the clonogenic survival of FaDu after irradiation. The sub-cytotoxic dosage of ZnO-NP\(_{100 nm}\) increased the oxidative DNA damage compared to the irradiated control. This effect was not significant for ZnO-NP\(_{20 nm}\). ZnO-NP showed radiosensitizing properties in the sub-cytotoxic dosage. At least for the ZnO-NP\(_{100 nm}\), an increased level of oxidative stress is a possible mechanism of the radiosensitizing effect.},
  language  = {en}
}
@article{FischerDirksKlaussneretal.2022,
  author    = {Fischer, Jonas and Dirks, Johannes and Klaussner, Julia and Haase, Gabriele and Holl-Wieden, Annette and Hofmann, Christine and Hackenberg, Stephan and Girschick, Hermann and Morbach, Henner},
  title     = {Effect of clonally expanded PD-1\(^h\)\(^i\)\(^g\)\(^h\) CXCR5-CD4+ peripheral T Helper cells on B cell differentiation in the joints of patients with antinuclear antibody-positive juvenile idiopathic arthritis},
  series = {Arthritis \& Rheumatology},
  volume    = {74},
  journal   = {Arthritis \& Rheumatology},
  number    = {1},
  doi       = {10.1002/art.41913},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-256607},
  pages     = {150-162},
  year      = {2022},
  abstract  = {Objective Antinuclear antibody (ANA)-positive juvenile idiopathic arthritis (JIA) is characterized by synovial B cell hyperactivity, but the precise role of CD4+ T cells in promoting local B cell activation is unknown. This study was undertaken to determine the phenotype and function of synovial CD4+ T cells that promote aberrant B cell activation in JIA. Methods Flow cytometry was performed to compare the phenotype and cytokine patterns of PD-1\(^h\)\(^i\)\(^g\)\(^h\)CD4+ T cells in the synovial fluid (SF) of patients with JIA and T follicular helper cells in the tonsils of control individuals. TCRVB next-generation sequencing was used to analyze T cell subsets for signs of clonal expansion. The functional impact of these T cell subsets on B cells was examined in cocultures in vitro. Results Multidimensional flow cytometry revealed the expansion of interleukin-21 (IL-21) and interferon-γ (IFNγ)-coexpressing PD-1\(^h\)\(^i\)\(^g\)\(^h\)CXCR5-HLA-DR+CD4+ T cells that accumulate in the joints of ANA-positive JIA patients. These T cells exhibited signs of clonal expansion with restricted T cell receptor clonotypes. The phenotype resembled peripheral T helper (Tph) cells with an extrafollicular chemokine receptor pattern and high T-bet and B lymphocyte-induced maturation protein 1 expression, but low B cell lymphoma 6 expression. SF Tph cells, by provision of IL-21 and IFNy, skewed B cell differentiation toward a CD21\(^l\)\(^o\)\(^w\)\(^/\)\(^-\)CD11c+ phenotype in vitro. Additionally, SF Tph cell frequencies correlated with the appearance of SF CD21\(^l\)\(^o\)\(^w\)\(^/\)\(^-\)CD11c+CD27-IgM- double-negative (DN) B cells in situ.},
  language  = {en}
}
@article{SivarajanKessieOberwinkleretal.2021,
  author    = {Sivarajan, Rinu and Kessie, David Komla and Oberwinkler, Heike and Pallmann, Niklas and Walles, Thorsten and Scherzad, Agmal and Hackenberg, Stephan and Steinke, Maria},
  title     = {Susceptibility of Human Airway Tissue Models Derived From Different Anatomical Sites to Bordetella pertussis and Its Virulence Factor Adenylate Cyclase Toxin},
  series = {Frontiers in Cellular and Infection Microbiology},
  volume    = {11},
  journal   = {Frontiers in Cellular and Infection Microbiology},
  issn      = {2235-2988},
  doi       = {10.3389/fcimb.2021.797491},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-253302},
  year      = {2021},
  abstract  = {To study the interaction of human pathogens with their host target structures, human tissue models based on primary cells are considered suitable. Complex tissue models of the human airways have been used as infection models for various viral and bacterial pathogens. The Gram-negative bacterium Bordetella pertussis is of relevant clinical interest since whooping cough has developed into a resurgent infectious disease. In the present study, we created three-dimensional tissue models of the human ciliated nasal and tracheo-bronchial mucosa. We compared the innate immune response of these models towards the B. pertussis virulence factor adenylate cyclase toxin (CyaA) and its enzymatically inactive but fully pore-forming toxoid CyaA-AC\(^-\). Applying molecular biological, histological, and microbiological assays, we found that 1 µg/ml CyaA elevated the intracellular cAMP level but did not disturb the epithelial barrier integrity of nasal and tracheo-bronchial airway mucosa tissue models. Interestingly, CyaA significantly increased interleukin 6, interleukin 8, and human beta defensin 2 secretion in nasal tissue models, whereas tracheo-bronchial tissue models were not significantly affected compared to the controls. Subsequently, we investigated the interaction of B. pertussis with both differentiated primary nasal and tracheo-bronchial tissue models and demonstrated bacterial adherence and invasion without observing host cell type-specific significant differences. Even though the nasal and the tracheo-bronchial mucosa appear similar from a histological perspective, they are differentially susceptible to B. pertussis CyaA in vitro. Our finding that nasal tissue models showed an increased innate immune response towards the B. pertussis virulence factor CyaA compared to tracheo-bronchial tissue models may reflect the key role of the nasal airway mucosa as the first line of defense against airborne pathogens.},
  language  = {en}
}
@article{GehrkeScherzadHagenetal.2019,
  author    = {Gehrke, Thomas and Scherzad, Agmal and Hagen, Rudolf and Hackenberg, Stephan},
  title     = {Risk factors for children requiring adenotonsillectomy and their impact on postoperative complications: a retrospective analysis of 2000 patients},
  series = {Anaesthesia},
  volume    = {74},
  journal   = {Anaesthesia},
  number    = {12},
  doi       = {10.1111/anae.14844},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-204787},
  pages     = {1572-1579},
  year      = {2019},
  abstract  = {Adenotonsillectomies are commonly performed procedures and sleep-disordered breathing is becoming increasingly important as an indication for surgery. Because of the higher risks in patients with obstructive sleep apnoea, the required level of postoperative care for these patients is currently under discussion, and better identification of patients at risk may reduce unnecessary postoperative monitoring. To evaluate the influence of obstructive sleep apnoea, and other risk factors, on peri-operative complications in children requiring adenotonsillectomy, we performed a retrospective case-control study that included 1995 patients treated between January 2009 and June 2017. In our analysis, young age (OR 3.8, 95\%CI 2.1-7.1), low body weight (OR 2.6, 95\%CI 1.5-4.4), obstructive sleep apnoea (OR 2.4, 95\%CI 1.5-3.8), pre-existing craniofacial or syndromal disorders (OR 2.3, 95\%CI 1.4-3.8) and adenotonsillectomy, compared with adenoidectomy alone, (OR 7.9, 95\%CI 4.7-13.1) were identified as risk factors for complications during or after surgery, p < 0.001. All 13 patients suffering from complications more than 3 h postoperatively had obstructive sleep apnoea plus at least one more of these risk factors. Patients at risk of postoperative complications can therefore be identified by several criteria pre-operatively, and should be monitored postoperatively using pulse oximetry overnight. For all other patients, postoperative observation on a surgical ward without extra monitoring is sufficient. Admission to paediatric intensive care should be reserved for patients suffering serious intra-operative complications.},
  language  = {en}
}
@article{ScherzadMeyerKleinsasseretal.2017,
  author    = {Scherzad, Agmal and Meyer, Till and Kleinsasser, Norbert and Hackenberg, Stephan},
  title     = {Molecular Mechanisms of Zinc Oxide Nanoparticle-Induced Genotoxicity Short Running Title: Genotoxicity of ZnO NPs},
  series = {Materials},
  volume    = {10},
  journal   = {Materials},
  number    = {12},
  doi       = {10.3390/ma10121427},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-169948},
  pages     = {1427},
  year      = {2017},
  abstract  = {Background: Zinc oxide nanoparticles (ZnO NPs) are among the most frequently applied nanomaterials in consumer products. Evidence exists regarding the cytotoxic effects of ZnO NPs in mammalian cells; however, knowledge about the potential genotoxicity of ZnO NPs is rare, and results presented in the current literature are inconsistent. Objectives: The aim of this review is to summarize the existing data regarding the DNA damage that ZnO NPs induce, and focus on the possible molecular mechanisms underlying genotoxic events. Methods: Electronic literature databases were systematically searched for studies that report on the genotoxicity of ZnO NPs. Results: Several methods and different endpoints demonstrate the genotoxic potential of ZnO NPs. Most publications describe in vitro assessments of the oxidative DNA damage triggered by dissoluted Zn2+ ions. Most genotoxicological investigations of ZnO NPs address acute exposure situations. Conclusion: Existing evidence indicates that ZnO NPs possibly have the potential to damage DNA. However, there is a lack of long-term exposure experiments that clarify the intracellular bioaccumulation of ZnO NPs and the possible mechanisms of DNA repair and cell survival.},
  language  = {en}
}
@article{BianchiSivarajanWallesetal.2021,
  author    = {Bianchi, Maria and Sivarajan, Rinu and Walles, Thorsten and Hackenberg, Stephan and Steinke, Maria},
  title     = {Susceptibility of primary human airway epithelial cells to Bordetella pertussis adenylate cyclase toxin in two- and three-dimensional culture conditions},
  series = {Innate Immunity},
  volume    = {27},
  journal   = {Innate Immunity},
  number    = {1},
  issn      = {1753-4259},
  doi       = {10.1177/1753425920979354},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219849},
  pages     = {89-98},
  year      = {2021},
  abstract  = {The human pathogen Bordetella pertussis targets the respiratory epithelium and causes whooping cough. Its virulence factor adenylate cyclase toxin (CyaA) plays an important role in the course of infection. Previous studies on the impact of CyaA on human epithelial cells have been carried out using cell lines derived from the airways or the intestinal tract. Here, we investigated the interaction of CyaA and its enzymatically inactive but fully pore-forming toxoid CyaA-AC- with primary human airway epithelial cells (hAEC) derived from different anatomical sites (nose and tracheo-bronchial region) in two-dimensional culture conditions. To assess possible differences between the response of primary hAEC and respiratory cell lines directly, we included HBEC3-KT in our studies. In comparative analyses, we studied the impact of both the toxin and the toxoid on cell viability, intracellular cAMP concentration and IL-6 secretion. We found that the selected hAEC, which lack CD11b, were differentially susceptible to both CyaA and CyaA-AC-. HBEC3-KT appeared not to be suitable for subsequent analyses. Since the nasal epithelium first gets in contact with airborne pathogens, we further studied the effect of CyaA and its toxoid on the innate immunity of three-dimensional tissue models of the human nasal mucosa. The present study reveals first insights in toxin-cell interaction using primary hAEC.},
  language  = {en}
}
@article{TecleHackenbergScheichetal.2023,
  author    = {Tecle, Nyat-Eyob and Hackenberg, Stephan and Scheich, Matthias and Scherzad, Agmal and Hagen, Rudolf and Gehrke, Thomas},
  title     = {Surgical management of lateral neck abscesses in children: a retrospective analysis of 100 cases},
  series = {European Journal of Pediatrics},
  volume    = {182},
  journal   = {European Journal of Pediatrics},
  number    = {1},
  doi       = {10.1007/s00431-022-04676-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324179},
  pages     = {431-438},
  year      = {2023},
  abstract  = {Cervical abscesses are relatively common infections in pediatric patients. There is an ongoing debate about the necessity and time point of surgical drainage. The identification of a focus of infection might play an important role in facilitating a therapeutic decision. In a retrospective study, 100 pediatric patients aged 1-18 years who underwent incision and drainage of a lateral cervical abscess at our institution were analyzed. Patients were divided into two groups based on whether a focus of infection could be identified or not. Data collection included patient characteristics, microbiological results, antibiotic regimen, and clinical course. A focus of infection was found in 29\% (29/100) of the patients, most frequently in the tonsils. A causative microorganism was found in 75\% (75/100) of all patients, with Staphylococcus aureus and Streptococcus pyogenes being the most common pathogens. All patients received an empiric antibiotic therapy in addition to surgery. Antibiotic medication was changed in 31\% in both groups (9/29 with a focus of infection and 22/71 without a focus of infection) during therapy. Children without an identified focus of infection generally were younger and had more comorbidities reducing immune response while also showing differences in the pathogens involved. There were no complications associated to surgery or antibiotic therapy in any of the patients involved. Conclusion: Children with an identified focus of infection show several differences compared to those with isolated lateral abscesses, especially regarding the microorganisms involved. But the focus of infection seems not to have an impact on patient's outcome. What is Known: • Neck abscesses are a relatively common disease in the pediatric population and may cause serious complications. • Therapy in general consists of intravenous antibiotics with or without surgery. What is New: • The focus identification has no impact on patient's outcome. • Children with an identified focus of infection show several differences compared to those with isolated lateral abscesses, especially regarding their medical history, age, and the microorganisms involved.},
  language  = {en}
}
@article{HackenbergMeyerHaefneretal.2022,
  author    = {Hackenberg, Stephan and Meyer, Till Jasper and H{\"a}fner, Johannes and Scheich, Matthias and St{\"o}th, Manuel and Al-Tinawi, Fadi and Neun, Tilmann and Mlynski, Robert and Hagen, Rudolf and Scherzad, Agmal},
  title     = {Surgical management of tympanojugular paragangliomas using the flexible CO\(_2\) laser},
  series = {European Archives of Oto-Rhino-Laryngology},
  volume    = {279},
  journal   = {European Archives of Oto-Rhino-Laryngology},
  number    = {12},
  doi       = {10.1007/s00405-022-07416-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324164},
  pages     = {5623-5630},
  year      = {2022},
  abstract  = {Purpose Surgery is a standard therapy for tympanojugular paragangliomas (TJP). Maintaining the quality of life (QoL) requires functional preservation. The flexible CO\(_2\) laser allows contact-free tumor removal. This retrospective study compares the postoperative functional outcomes of TJP surgery with and without the flexible CO\(_2\) laser. Methods Between 2005 and 2019, 51 patients with TJP were surgically treated at a tertiary hospital. Until 2012, 17 patients received conventional surgery. Thereafter, the flexible laser was used in 34 patients. Tumor extend, pre- and postoperative cranial nerve function, and complications were compared between the groups. Results The cohort consisted of 33 class A and B tumors and 18 class C and D tumors. Preoperative embolization was performed in 17 cases. Class C/D TJP were usually removed via an infratemporal fossa type A approach. Gross total tumor removal was achieved in 14/18 class C/D tumors. 3/51 patients suffered from long-term partial or complete facial palsy. No differences in post-therapeutic cranial nerve function or complications were noted between the conventional and laser group. One recurrence was observed after complete tumor resection. Conclusion The flexible CO\(_2\) laser was shown to be a safe and effective alternative to conventional bipolar cauterization, which is appreciated by the surgeon in these highly vascularized tumors. Both techniques allowed a high tumor control rate and good long-term results also from a functional point of view.},
  language  = {en}
}
@article{StefanakisBasslerWalczuchetal.2023,
  author    = {Stefanakis, Mona and Bassler, Miriam C. and Walczuch, Tobias R. and Gerhard-Hartmann, Elena and Youssef, Almoatazbellah and Scherzad, Agmal and St{\"o}th, Manuel Bernd and Ostertag, Edwin and Hagen, Rudolf and Steinke, Maria R. and Hackenberg, Stephan and Brecht, Marc and Meyer, Till Jasper},
  title     = {The impact of tissue preparation on salivary gland tumors investigated by Fourier-transform infrared microspectroscopy},
  series = {Journal of Clinical Medicine},
  volume    = {12},
  journal   = {Journal of Clinical Medicine},
  number    = {2},
  issn      = {2077-0383},
  doi       = {10.3390/jcm12020569},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304887},
  year      = {2023},
  abstract  = {Due to the wide variety of benign and malignant salivary gland tumors, classification and malignant behavior determination based on histomorphological criteria can be difficult and sometimes impossible. Spectroscopical procedures can acquire molecular biological information without destroying the tissue within the measurement processes. Since several tissue preparation procedures exist, our study investigated the impact of these preparations on the chemical composition of healthy and tumorous salivary gland tissue by Fourier-transform infrared (FTIR) microspectroscopy. Sequential tissue cross-sections were prepared from native, formalin-fixed and formalin-fixed paraffin-embedded (FFPE) tissue and analyzed. The FFPE cross-sections were dewaxed and remeasured. By using principal component analysis (PCA) combined with a discriminant analysis (DA), robust models for the distinction of sample preparations were built individually for each parotid tissue type. As a result, the PCA-DA model evaluation showed a high similarity between native and formalin-fixed tissues based on their chemical composition. Thus, formalin-fixed tissues are highly representative of the native samples and facilitate a transfer from scientific laboratory analysis into the clinical routine due to their robust nature. Furthermore, the dewaxing of the cross-sections entails the loss of molecular information. Our study successfully demonstrated how FTIR microspectroscopy can be used as a powerful tool within existing clinical workflows.},
  language  = {en}
}