@phdthesis{Rauschenberger2021, author = {Rauschenberger, Vera}, title = {Stiff-person syndrome - Pathophysiological mechanisms of glycine receptor autoantibodies}, doi = {10.25972/OPUS-20958}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-209588}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {The Stiff-person syndrome (SPS) is a rare autoimmune disease that is characterized by symptoms including stiffness in axial and limb muscles as well as painful spasms. Different variants of SPS are known ranging from moderate forms like the stiff-limb syndrome to the most severe form progressive encephalomyelitis with rigidity and myoclonus (PERM). SPS is elicited by autoantibodies that target different pre- or postsynaptic proteins. The focus of the present work is on autoantibodies against the glycine receptor (GlyR). At start of the present thesis, as main characteristic of the GlyR autoantibody pathology, receptor cross-linking followed by enhanced receptor internalization and degradation via the lysosomal pathway was described. If binding of autoantibodies modulates GlyR function and therefore contributes to the GlyR autoantibody pathology has not yet been investigated. Moreover, not all patients respond well to plasmapheresis or other treatments used in the clinic. Relapses with even higher autoantibody titers regularly occur. In the present work, further insights into the disease pathology of GlyRα autoantibodies were achieved. We identified a common GlyRα1 autoantibody epitope located in the far N-terminus including amino acids A1-G34 which at least represent a part of the autoantibody epitope. This part of the receptor is easily accessible for autoantibodies due to its location at the outermost surface of the GlyRα1 extracellular domain. It was further investigated if the glycosylation status of the GlyR interferes with autoantibody binding. Using a GlyRα1 de-glycosylation mutant exhibited that patient autoantibodies are able to detect the de-glycosylated GlyRα1 variant as well. The direct modulation of the GlyR analyzed by electrophysiological recordings demonstrated functional alterations of the GlyR upon autoantibody binding. Whole cell patch clamp recordings revealed that autoantibodies decreased the glycine potency, shown by increased EC50 values. Furthermore, an influence on the desensitization behavior of the receptor was shown. The GlyR autoantibodies, however, had no impact on the binding affinity of glycine. These issues can be explained by the localization of the GlyR autoantibody epitope. The determined epitope has been exhibited to influence GlyR desensitization upon binding of allosteric modulators and differs from the orthosteric binding site for glycine, which is localized much deeper in the structure at the interface between two adjacent subunits. To neutralize GlyR autoantibodies, two different methods have been carried out. Transfected HEK293 cells expressing GlyRα1 and ELISA plates coated with the GlyRα1 extracellular domain were used to efficiently neutralize the autoantibodies. Finally, the successful passive transfer of GlyRα1 autoantibodies into zebrafish larvae and mice was shown. The autoantibodies detected their target in spinal cord and brain regions rich in GlyRs of zebrafish and mice. A passive transfer of human GlyRα autoantibodies to zebrafish larvae generated an impaired escape behavior in the animals compatible with the abnormal startle response in SPS or PERM patients.}, subject = {Glycinrezeptor}, language = {en} } @article{ZieglerEhlisWeberetal.2021, author = {Ziegler, Georg C. and Ehlis, Ann-Christine and Weber, Heike and Vitale, Maria Rosaria and Z{\"o}ller, Johanna E. M. and Ku, Hsing-Ping and Schiele, Miriam A. and K{\"u}rbitz, Laura I. and Romanos, Marcel and Pauli, Paul and Kalisch, Raffael and Zwanzger, Peter and Domschke, Katharina and Fallgatter, Andreas J. and Reif, Andreas and Lesch, Klaus-Peter}, title = {A Common CDH13 Variant is Associated with Low Agreeableness and Neural Responses to Working Memory Tasks in ADHD}, series = {Genes}, volume = {12}, journal = {Genes}, number = {9}, issn = {2073-4425}, doi = {10.3390/genes12091356}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-245220}, year = {2021}, abstract = {The cell—cell signaling gene CDH13 is associated with a wide spectrum of neuropsychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD), autism, and major depression. CDH13 regulates axonal outgrowth and synapse formation, substantiating its relevance for neurodevelopmental processes. Several studies support the influence of CDH13 on personality traits, behavior, and executive functions. However, evidence for functional effects of common gene variation in the CDH13 gene in humans is sparse. Therefore, we tested for association of a functional intronic CDH13 SNP rs2199430 with ADHD in a sample of 998 adult patients and 884 healthy controls. The Big Five personality traits were assessed by the NEO-PI-R questionnaire. Assuming that altered neural correlates of working memory and cognitive response inhibition show genotype-dependent alterations, task performance and electroencephalographic event-related potentials were measured by n-back and continuous performance (Go/NoGo) tasks. The rs2199430 genotype was not associated with adult ADHD on the categorical diagnosis level. However, rs2199430 was significantly associated with agreeableness, with minor G allele homozygotes scoring lower than A allele carriers. Whereas task performance was not affected by genotype, a significant heterosis effect limited to the ADHD group was identified for the n-back task. Heterozygotes (AG) exhibited significantly higher N200 amplitudes during both the 1-back and 2-back condition in the central electrode position Cz. Consequently, the common genetic variation of CDH13 is associated with personality traits and impacts neural processing during working memory tasks. Thus, CDH13 might contribute to symptomatic core dysfunctions of social and cognitive impairment in ADHD.}, language = {en} } @article{BankogluSchueleStopper2021, author = {Bankoglu, Ezgi Eyluel and Schuele, Carolin and Stopper, Helga}, title = {Cell survival after DNA damage in the comet assay}, series = {Archives of Toxicology}, volume = {95}, journal = {Archives of Toxicology}, number = {12}, doi = {10.1007/s00204-021-03164-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265339}, pages = {3803-3813}, year = {2021}, abstract = {The comet assay is widely used in basic research, genotoxicity testing, and human biomonitoring. However, interpretation of the comet assay data might benefit from a better understanding of the future fate of a cell with DNA damage. DNA damage is in principle repairable, or if extensive, can lead to cell death. Here, we have correlated the maximally induced DNA damage with three test substances in TK6 cells with the survival of the cells. For this, we selected hydrogen peroxide (H\(_{2}\)O\(_{2}\)) as an oxidizing agent, methyl methanesulfonate (MMS) as an alkylating agent and etoposide as a topoisomerase II inhibitor. We measured cell viability, cell proliferation, apoptosis, and micronucleus frequency on the following day, in the same cell culture, which had been analyzed in the comet assay. After treatment, a concentration dependent increase in DNA damage and in the percentage of non-vital and apoptotic cells was found for each substance. Values greater than 20-30\% DNA in tail caused the death of more than 50\% of the cells, with etoposide causing slightly more cell death than H\(_{2}\)O\(_{2}\) or MMS. Despite that, cells seemed to repair of at least some DNA damage within few hours after substance removal. Overall, the reduction of DNA damage over time is due to both DNA repair and death of heavily damaged cells. We recommend that in experiments with induction of DNA damage of more than 20\% DNA in tail, survival data for the cells are provided.}, language = {en} } @phdthesis{HilligardtgebRueck2021, author = {Hilligardt [geb. R{\"u}ck], Deborah}, title = {Methylierung pro- und antiinflammatorischer T-Helfer-Zell-spezifischer Transkriptionsfaktoren bei ausgew{\"a}hlten Krankheitsbildern}, doi = {10.25972/OPUS-24949}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-249499}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Die Regulation krankheitsrelevanter Gene und deren Proteine {\"u}ber Ver{\"a}nderungen in der DNA-Methylierung stellen einen wichtigen und zugleich noch unzureichend erforschten Bereich bei Erkrankungen mit inflammatorischer Komponente dar. In dieser Arbeit wurde die Methylierung pro- und antiinflammatorischer Gene im hypoxischen Setting hervorgerufen durch Pr{\"a}eklampsie, Angsterkrankung und Inflammation bei Sklerodermie untersucht. Zur Bestimmung der prozentualen Methylierung wurde Pyrosequenzierung durchgef{\"u}hrt. Bei einem Teil der Proben erfolgte zus{\"a}tzlich die Bestimmung der Genexpression mittels Real Time PCR. Bei Angsterkrankung zeigte sich eine signifikante Hypermethylierung am Promotor des Treg spezifischen Transkriptionsfaktors FOXP3. Daraus k{\"o}nnte eine beeintr{\"a}chtigte Funktion der Tregs und somit eine erh{\"o}hte Komorbidit{\"a}t resultieren. In der Gruppe der an Sklerodermie erkrankten Personen zeigte sich entgegen den Erwartungen eine signifikant h{\"o}here RORC1 und RORC2 Methylierung. Eine Genexpressionsanalyse erbrachte eine signifikant niedrigere Expression von RORC bei Sklerodermie im Vergleich zu gesunden Kontrollen. Diese {\"u}berraschenden Ergebnisse k{\"o}nnten der Methodik geschuldet sein. Auf eine Auftrennung der verschiedenen T-Zellen vor Messung der Methylierung wurde verzichtet. Plazentagewebe bei Pr{\"a}eklampsie zeigte eine signifikant geringere Methylierung am FOXP3 Promotor als Plazentagewebe von gesunden Schwangeren. Die Ver{\"a}nderbarkeit der DNA-Methylierung durch {\"a}ußere Einfl{\"u}sse und Medikamente stellt hierbei einen vielversprechenden Ansatzpunkt f{\"u}r zuk{\"u}nftige Therapien dar und sollte in weiteren Studien konkretisiert werden.}, subject = {Methylierung}, language = {de} } @phdthesis{Volk2021, author = {Volk, Simone}, title = {Prospektiv-randomisierte, kontrollierte Evaluation der Auswirkungen zweier postoperativer Nachbehandlungskonzepte auf die Rerupturrate nach operativer Rekonstruktion der Rotatorenmanschette}, doi = {10.25972/OPUS-24954}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-249547}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Aufgrund der divergierenden Studienlage bez{\"u}glich der physiotherapeutischen Nachbehandlung nach operativer Rotatorenmanschettenrefixation erfolgte im Rahmen einer prospektiv randomisierten Studie die Evaluation zweier Nachbehandlungsmodelle nach operativer Refixation vollschichtiger RM-Rupturen in Mini-Open-Technik. Hierf{\"u}r wurden 57 Patienten pr{\"a}operativ, 3 Wochen, 6 Wochen sowie 6 Monate postoperativ nachuntersucht und ausgewertet. Die Scores beinhalteten den NRS-Score, Constant-Score, DASH-Score, ASES-Score, NHP-Score, SF-36-Score sowie eine sonographische Untersuchung zur Beurteilung der Reruptur nach 6 Monaten postoperativ. Einheitlich erfolgte die Ruhigstellung im Gilchrist-Verband f{\"u}r 6 Wochen. In der konservativen Nachbehandlungsgruppe wurden bis 6 Wochen postoperativ lediglich Pendel{\"u}bungen durchgef{\"u}hrt, in der progressiven Nachbehandlungsgruppe erfolgte eine passive Be{\"u}bung direkt postoperativ bis an die Schmerzgrenze mit Ausnahme der Adduktion. Im Gesamtkollektiv war eine Rerupturrate von 5,3\% zu verzeichnen mit 3,7\% in der konservativen und 6,7\% in der progressiven Nachbehandlungsgruppe ohne signifikanten Gruppenunterschied (p=0,540). Bez{\"u}glich der klinischen und psychischen Ergebnisse zeigte sich 6 Monate postoperativ lediglich eine Einschr{\"a}nkung der aktiven Außenrotation in der konservativen Nachbehandlungsgruppe (46,2∘ vs. 39,7∘, p=0,031), sonst war kein signifikanter Gruppenunterschied zu sehen. Weiterhin erfolgten Subgruppenanalysen insbesondere hinsichtlich Alter und Geschlecht der Patienten. Dabei haben Patienten {\"u}ber 65 Jahren unabh{\"a}ngig von der Nachbehandlungsgruppe k{\"u}rzer Analgetika eingenommen und waren 6 Wochen postoperativ weniger bewegungseingeschr{\"a}nkt. Aufgrund einer Tendenz zu vermehrten Rerupturen nach progressiver Nachbehandlung in der Literatur werden daher weiterf{\"u}hrende Studien ben{\"o}tigt um zu evaluieren, ob {\"a}ltere Patienten von einer vermehrten Ruhigstellung profitieren k{\"o}nnten. Diese Studie pr{\"a}sentiert im Gegensatz zu der {\"u}berwiegend in der Literatur verwendeten arthroskopischen OP-Technik Ergebnisse nach RM-Refixation in Mini-Open-Technik. Damit liefert sie eine gute Grundlage f{\"u}r weiterf{\"u}hrende Studien insbesondere in der Behandlung von gr{\"o}ßeren RM-Rupturen, welche ein erh{\"o}htes Rerupturrisiko besitzen und von einer konservativen Nachbehandlung profitieren k{\"o}nnten.}, subject = {Rotatorenmanschettenruptur}, language = {de} } @phdthesis{Fuchs2021, author = {Fuchs, Katharina}, title = {Validierung verschiedener pr{\"a}disponierender Faktoren f{\"u}r die Entwicklung eines Lagerungsplagiozephalus}, doi = {10.25972/OPUS-25147}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-251471}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Bei seiner Geburt und innerhalb der ersten Lebensmonate ist der S{\"a}uglingssch{\"a}del verh{\"a}ltnism{\"a}ßig leicht verformbar. Dies birgt die Gefahr einer unphysiologischen Verformung durch externe modellierende Kr{\"a}fte. Die auf diesem Weg am h{\"a}ufigsten verursachte Deformation ist der Lagerungsplagiozephalus (LP). In der vorliegenden Studie wurden 455 S{\"a}uglinge, die zun{\"a}chst in drei unterschiedliche Gruppen bez{\"u}glich ihrer Kopfform unterteilt worden sind, hinsichtlich verschiedener Parameter miteinander verglichen. Anhand des U-Heftes und einem speziell f{\"u}r die craniofaciale Sprechstunde des CFCW W{\"u}rzburg angefertigten Fragebogen wurden Pr{\"a}diktoren f{\"u}r die Entwicklung eines LP evaluiert. Die herausgearbeiteten pr{\"a}disponierenden Faktoren waren das m{\"a}nnliche Geschlecht, Fr{\"u}hgeburtlichkeit, eine unphysiologische Geburtslage, Notkaiserschnitt oder geburtshilfliche Maßnahmen, verminderte Geburtsgr{\"o}ße, vermindertes Geburtsgewicht und ein l{\"a}ngerer Krankenhausaufenthalt im Anschluss an die Geburt. Als prognostisch g{\"u}nstiger Faktor hinsichtlich der Entwicklung einer physiologischen Sch{\"a}delform konnte in der vorliegenden Studie eine l{\"a}ngere Stilldauer best{\"a}tigt werden. Dies galt ebenso f{\"u}r Gabe von Flaschennahrung aus alternierenden Positionen. Hinsichtlich der pr{\"a}ventiven Aufkl{\"a}rung von Eltern Neugeborener liefert die vorliegende Studie einige wichtige Ans{\"a}tze. Sie untermauert jedoch auch den hohen Bedarf an weiterer Forschung bez{\"u}glich pr{\"a}disponierender Faktoren f{\"u}r die Entwicklung des LP. Dies kann dazu beitragen die Pr{\"a}vention und Fr{\"u}herkennung eines LP mittels fl{\"a}chendeckender qualitativ hochwertiger Aufkl{\"a}rung stetig zu verbessern und notwendig gewordene Behandlungen durch standardisierte Therapieempfehlungen zu optimieren.}, subject = {Lagerungsplagiozephalus}, language = {de} } @article{KuhlemannBeliuJanzenetal.2021, author = {Kuhlemann, Alexander and Beliu, Gerti and Janzen, Dieter and Petrini, Enrica Maria and Taban, Danush and Helmerich, Dominic A. and Doose, S{\"o}ren and Bruno, Martina and Barberis, Andrea and Villmann, Carmen and Sauer, Markus and Werner, Christian}, title = {Genetic Code Expansion and Click-Chemistry Labeling to Visualize GABA-A Receptors by Super-Resolution Microscopy}, series = {Frontiers in Synaptic Neuroscience}, volume = {13}, journal = {Frontiers in Synaptic Neuroscience}, issn = {1663-3563}, doi = {10.3389/fnsyn.2021.727406}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-251035}, year = {2021}, abstract = {Fluorescence labeling of difficult to access protein sites, e.g., in confined compartments, requires small fluorescent labels that can be covalently tethered at well-defined positions with high efficiency. Here, we report site-specific labeling of the extracellular domain of γ-aminobutyric acid type A (GABA-A) receptor subunits by genetic code expansion (GCE) with unnatural amino acids (ncAA) combined with bioorthogonal click-chemistry labeling with tetrazine dyes in HEK-293-T cells and primary cultured neurons. After optimization of GABA-A receptor expression and labeling efficiency, most effective variants were selected for super-resolution microscopy and functionality testing by whole-cell patch clamp. Our results show that GCE with ncAA and bioorthogonal click labeling with small tetrazine dyes represents a versatile method for highly efficient site-specific fluorescence labeling of proteins in a crowded environment, e.g., extracellular protein domains in confined compartments such as the synaptic cleft.}, language = {en} } @article{PetersKaiserFinketal.2021, author = {Peters, Simon and Kaiser, Lena and Fink, Julian and Schumacher, Fabian and Perschin, Veronika and Schlegel, Jan and Sauer, Markus and Stigloher, Christian and Kleuser, Burkhard and Seibel, Juergen and Schubert-Unkmeir, Alexandra}, title = {Click-correlative light and electron microscopy (click-AT-CLEM) for imaging and tracking azido-functionalized sphingolipids in bacteria}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, number = {1}, doi = {10.1038/s41598-021-83813-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259147}, pages = {4300}, year = {2021}, abstract = {Sphingolipids, including ceramides, are a diverse group of structurally related lipids composed of a sphingoid base backbone coupled to a fatty acid side chain and modified terminal hydroxyl group. Recently, it has been shown that sphingolipids show antimicrobial activity against a broad range of pathogenic microorganisms. The antimicrobial mechanism, however, remains so far elusive. Here, we introduce 'click-AT-CLEM', a labeling technique for correlated light and electron microscopy (CLEM) based on the super-resolution array tomography (srAT) approach and bio-orthogonal click chemistry for imaging of azido-tagged sphingolipids to directly visualize their interaction with the model Gram-negative bacterium Neisseria meningitidis at subcellular level. We observed ultrastructural damage of bacteria and disruption of the bacterial outer membrane induced by two azido-modified sphingolipids by scanning electron microscopy and transmission electron microscopy. Click-AT-CLEM imaging and mass spectrometry clearly revealed efficient incorporation of azido-tagged sphingolipids into the outer membrane of Gram-negative bacteria as underlying cause of their antimicrobial activity.}, language = {en} } @article{FioreVaccaTuminoetal.2021, author = {Fiore, Piera Filomena and Vacca, Paola and Tumino, Nicola and Besi, Francesca and Pelosi, Andrea and Munari, Enrico and Marconi, Marcella and Caruana, Ignazio and Pistoia, Vito and Moretta, Lorenzo and Azzarone, Bruno}, title = {Wilms' tumor primary cells display potent immunoregulatory properties on NK cells and macrophages}, series = {Cancers}, volume = {13}, journal = {Cancers}, number = {2}, issn = {2072-6694}, doi = {10.3390/cancers13020224}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222981}, year = {2021}, abstract = {The immune response plays a crucial defensive role in cancer growth and metastasis and is a promising target in different tumors. The role of the immune system in Wilm's Tumor (WT), a common pediatric renal malignancy, is still to be explored. The characterization of the immune environment in WT could allow the identification of new therapeutic strategies for targeting possible inhibitory mechanisms and/or lowering toxicity of the current treatments. In this study, we stabilized four WT primary cultures expressing either a blastematous (CD56\(^+\)/CD133\(^-\)) or an epithelial (CD56\(^-\)/CD133\(^+\)) phenotype and investigated their interactions with innate immune cells, namely NK cells and monocytes. We show that cytokine-activated NK cells efficiently kill WT cells. However, after co-culture with WT primary cells, NK cells displayed an impaired cytotoxic activity, decreased production of IFNγ and expression of CD107a, DNAM-1 and NKp30. Analysis of the effects of the interaction between WT cells and monocytes revealed their polarization towards alternatively activated macrophages (M2) that, in turn, further impaired NK cell functions. In conclusion, we show that both WT blastematous and epithelial components may contribute directly and indirectly to a tumor immunosuppressive microenvironment that is likely to play a role in tumor progression.}, language = {en} } @article{PiroEckesKasaragodetal.2021, author = {Piro, Inken and Eckes, Anna-Lena and Kasaragod, Vikram Babu and Sommer, Claudia and Harvey, Robert J. and Schaefer, Natascha and Villmann, Carmen}, title = {Novel Functional Properties of Missense Mutations in the Glycine Receptor β Subunit in Startle Disease}, series = {Frontiers in Molecular Neuroscience}, volume = {14}, journal = {Frontiers in Molecular Neuroscience}, issn = {1662-5099}, doi = {10.3389/fnmol.2021.745275}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246676}, year = {2021}, abstract = {Startle disease is a rare disorder associated with mutations in GLRA1 and GLRB, encoding glycine receptor (GlyR) α1 and β subunits, which enable fast synaptic inhibitory transmission in the spinal cord and brainstem. The GlyR β subunit is important for synaptic localization via interactions with gephyrin and contributes to agonist binding and ion channel conductance. Here, we have studied three GLRB missense mutations, Y252S, S321F, and A455P, identified in startle disease patients. For Y252S in M1 a disrupted stacking interaction with surrounding aromatic residues in M3 and M4 is suggested which is accompanied by an increased EC\(_{50}\) value. By contrast, S321F in M3 might stabilize stacking interactions with aromatic residues in M1 and M4. No significant differences in glycine potency or efficacy were observed for S321F. The A455P variant was not predicted to impact on subunit folding but surprisingly displayed increased maximal currents which were not accompanied by enhanced surface expression, suggesting that A455P is a gain-of-function mutation. All three GlyR β variants are trafficked effectively with the α1 subunit through intracellular compartments and inserted into the cellular membrane. In vivo, the GlyR β subunit is transported together with α1 and the scaffolding protein gephyrin to synaptic sites. The interaction of these proteins was studied using eGFP-gephyrin, forming cytosolic aggregates in non-neuronal cells. eGFP-gephyrin and β subunit co-expression resulted in the recruitment of both wild-type and mutant GlyR β subunits to gephyrin aggregates. However, a significantly lower number of GlyR β aggregates was observed for Y252S, while for mutants S321F and A455P, the area and the perimeter of GlyR β subunit aggregates was increased in comparison to wild-type β. Transfection of hippocampal neurons confirmed differences in GlyR-gephyrin clustering with Y252S and A455P, leading to a significant reduction in GlyR β-positive synapses. Although none of the mutations studied is directly located within the gephyrin-binding motif in the GlyR β M3-M4 loop, we suggest that structural changes within the GlyR β subunit result in differences in GlyR β-gephyrin interactions. Hence, we conclude that loss- or gain-of-function, or alterations in synaptic GlyR clustering may underlie disease pathology in startle disease patients carrying GLRB mutations.}, language = {en} } @article{BriegelAndritschky2021, author = {Briegel, Wolfgang and Andritschky, Christoph}, title = {Psychological adjustment of children and adolescents with 22q11.2 deletion syndrome and their mothers' stress and coping — a longitudinal study}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {5}, issn = {1660-4601}, doi = {10.3390/ijerph18052707}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234101}, year = {2021}, abstract = {At present, there is a lack of longitudinal studies on the psychological adjustment of both children and adolescents with 22q11.2 deletion syndrome (22q11.2DS) and their primary caregivers. To fill this gap, we performed a four-year follow-up study. Mothers filled out the Child Behavior Checklist 4-18, the Social Orientation of Parents with Handicapped Children questionnaire to assess maternal stress and coping strategies, and the Freiburger Personality Inventory-Revised — subscales strain and life satisfaction. Fifty-five subjects with 22q11.2DS (26 males and 29 females; age: M = 10.79 years, SD = 3.56 years) and their biological mothers (age: M = 40.84 years, SD = 4.68 years) were included in this study. Significantly higher levels of behavior problems than in the general population and an increase in these problems, especially internalizing ones, over time could be found. In contrast, maternal stress did not change significantly over time, but mothers demonstrated increased levels of strain and reduced life satisfaction at T2. Thus, careful monitoring as well as early and adequate interventions, if indicated, should be offered to families with a child with 22q11.2DS, not only for somatic complaints but also for problems with psychological adjustment.}, language = {en} } @article{KhatriChungWerneretal.2021, author = {Khatri, Wajahat and Chung, Hyun Woo and Werner, Rudolf A. and Leal, Jeffrey P. and Pienta, Kenneth J. and Lodge, Martin A. and Gorin, Michael A. and Pomper, Martin G. and Rowe, Steven P.}, title = {Effect of point-spread function reconstruction for indeterminate PSMA-RADS-3A lesions on PSMA-targeted PET imaging of men with prostate cancer}, series = {Diagnostics}, volume = {11}, journal = {Diagnostics}, number = {4}, issn = {2075-4418}, doi = {10.3390/diagnostics11040665}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236528}, year = {2021}, abstract = {Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is emerging as an important modality for imaging patients with prostate cancer (PCa). As with any imaging modality, indeterminate findings will arise. The PSMA reporting and data system (PSMA-RADS) version 1.0 codifies indeterminate soft tissue findings with the PSMA-RADS-3A moniker. We investigated the role of point-spread function (PSF) reconstructions on categorization of PSMA-RADS-3A lesions. Methods: This was a post hoc analysis of an institutional review board approved prospective trial. Around 60 min after the administration of 333 MBq (9 mCi) of PSMA-targeted \(^{18}\)F-DCFPyL, patients underwent PET/computed tomography (CT) acquisitions from the mid-thighs to the skull vertex. The PET data were reconstructed with and without PSF. Scans were categorized according to PSMA-RADS version 1.0, and all PSMA-RADS-3A lesions on non-PSF images were re-evaluated to determine if any could be re-categorized as PSMA-RADS-4. The maximum standardized uptake values (SUVs) of the lesions, mean SUVs of blood pool, and the ratios of those values were determined. Results: A total of 171 PSMA-RADS-3A lesions were identified in 30 patients for whom both PSF reconstructions and cross-sectional imaging follow-up were available. A total of 13/171 (7.6\%) were re-categorized as PSMA-RADS-4 lesions with PSF reconstructions. A total of 112/171 (65.5\%) were found on follow-up to be true positive for PCa, with all 13 of the re-categorized lesions being true positive on follow-up. The lesions that were re-categorized trended towards having higher SUV\(_{max}\)-lesion and SUV\(_{max}\)-lesion/SUV\(_{mean}\)-blood-pool metrics, although these relationships were not statistically significant. Conclusions: The use of PSF reconstructions for \(^{18}\)F-DCFPyL PET can allow the appropriate re-categorization of a small number of indeterminate PSMA-RADS-3A soft tissue lesions as more definitive PSMA-RADS-4 lesions. The routine use of PSF reconstructions for PSMA-targeted PET may be of value at those sites that utilize this technology.}, language = {en} } @article{KiemLeischNeureiteretal.2021, author = {Kiem, Dominik and Leisch, Michael and Neureiter, Daniel and Haslauer, Theresa and Egle, Alexander and Melchardt, Thomas and Topp, Max S. and Greil, Richard}, title = {Two cases of pancytopenia with Coombs-negative hemolytic anemia after chimeric antigen receptor T-cell therapy}, series = {International Journal of Molecular Sciences}, volume = {22}, journal = {International Journal of Molecular Sciences}, number = {11}, issn = {1422-0067}, doi = {10.3390/ijms22115449}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-284977}, year = {2021}, abstract = {Background: Chimeric antigen receptor (CAR) T-cells are changing the therapeutic landscape of hematologic malignancies. Severe side effects include cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), but prolonged cytopenia has also been reported. The underlying mechanism for prolonged cytopenia is poorly understood so far. Cases: Severe pancytopenia with grade 2-3 anemia was marked 2-3 months after treatment. Laboratory evaluation revealed undetectable levels of haptoglobin with increased reticulocyte counts. Coomb's tests were negative, no schistocytes were detected on blood smear, and infectious causes were ruled out. Increased erythropoiesis without lymphoma infiltration was noted on bone marrow biopsy. A spontaneous increase in haptoglobin and hemoglobin levels was observed after several weeks. For one patient, peripheral CAR-T levels were monitored over time. We observed a decline at the same time as hemoglobin levels began to rise, implying a potential causality. Conclusion: To our knowledge, we describe the first two cases of Coombs-negative hemolytic anemia after CAR-T treatment for B-cell lymphoma. We encourage routine monitoring for hemolytic anemia after CAR-T treatment and also encourage further investigations on the underlying mechanism.}, language = {en} } @article{MeyerWatermannDreyeretal.2021, author = {Meyer, Malin Tordis and Watermann, Christoph and Dreyer, Thomas and Wagner, Steffen and Wittekindt, Claus and Klussmann, Jens Peter and Erg{\"u}n, S{\"u}leyman and Baumgart-Vogt, Eveline and Karnati, Srikanth}, title = {Differential expression of peroxisomal proteins in distinct types of parotid gland tumors}, series = {International Journal of Molecular Sciences}, volume = {22}, journal = {International Journal of Molecular Sciences}, number = {15}, issn = {1422-0067}, doi = {10.3390/ijms22157872}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261047}, year = {2021}, abstract = {Salivary gland cancers are rare but aggressive tumors that have poor prognosis and lack effective cure. Of those, parotid tumors constitute the majority. Functioning as metabolic machinery contributing to cellular redox balance, peroxisomes have emerged as crucial players in tumorigenesis. Studies on murine and human cells have examined the role of peroxisomes in carcinogenesis with conflicting results. These studies either examined the consequences of altered peroxisomal proliferators or compared their expression in healthy and neoplastic tissues. None, however, examined such differences exclusively in human parotid tissue or extended comparison to peroxisomal proteins and their associated gene expressions. Therefore, we examined differences in peroxisomal dynamics in parotid tumors of different morphologies. Using immunofluorescence and quantitative PCR, we compared the expression levels of key peroxisomal enzymes and proliferators in healthy and neoplastic parotid tissue samples. Three parotid tumor subtypes were examined: pleomorphic adenoma, mucoepidermoid carcinoma and acinic cell carcinoma. We observed higher expression of peroxisomal matrix proteins in neoplastic samples with exceptional down regulation of certain enzymes; however, the degree of expression varied between tumor subtypes. Our findings confirm previous experimental results on other organ tissues and suggest peroxisomes as possible therapeutic targets or markers in all or certain subtypes of parotid neoplasms.}, language = {en} } @article{HaackBaikerSchlegeletal.2021, author = {Haack, Stephanie and Baiker, Sarah and Schlegel, Jan and Sauer, Markus and Sparwasser, Tim and Langenhorst, Daniela and Beyersdorf, Niklas}, title = {Superagonistic CD28 stimulation induces IFN-γ release from mouse T helper 1 cells in vitro and in vivo}, series = {European Journal of Immunology}, volume = {51}, journal = {European Journal of Immunology}, number = {3}, doi = {10.1002/eji.202048803}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239028}, pages = {738 -- 741}, year = {2021}, abstract = {Like human Th1 cells, mouse Th1 cells also secrete IFN-γ upon stimulation with a superagonistic anti-CD28 monoclonal antibody (CD28-SA). Crosslinking of the CD28-SA via FcR and CD40-CD40L interactions greatly increased IFN-γ release. Our data stress the utility of the mouse as a model organism for immune responses in humans.}, language = {en} } @article{SchlechtVallonWagneretal.2021, author = {Schlecht, Anja and Vallon, Mario and Wagner, Nicole and Erg{\"u}n, S{\"u}leyman and Braunger, Barbara M.}, title = {TGFβ-Neurotrophin Interactions in Heart, Retina, and Brain}, series = {Biomolecules}, volume = {11}, journal = {Biomolecules}, number = {9}, issn = {2218-273X}, doi = {10.3390/biom11091360}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246159}, year = {2021}, abstract = {Ischemic insults to the heart and brain, i.e., myocardial and cerebral infarction, respectively, are amongst the leading causes of death worldwide. While there are therapeutic options to allow reperfusion of ischemic myocardial and brain tissue by reopening obstructed vessels, mitigating primary tissue damage, post-infarction inflammation and tissue remodeling can lead to secondary tissue damage. Similarly, ischemia in retinal tissue is the driving force in the progression of neovascular eye diseases such as diabetic retinopathy (DR) and age-related macular degeneration (AMD), which eventually lead to functional blindness, if left untreated. Intriguingly, the easily observable retinal blood vessels can be used as a window to the heart and brain to allow judgement of microvascular damages in diseases such as diabetes or hypertension. The complex neuronal and endocrine interactions between heart, retina and brain have also been appreciated in myocardial infarction, ischemic stroke, and retinal diseases. To describe the intimate relationship between the individual tissues, we use the terms heart-brain and brain-retina axis in this review and focus on the role of transforming growth factor β (TGFβ) and neurotrophins in regulation of these axes under physiologic and pathologic conditions. Moreover, we particularly discuss their roles in inflammation and repair following ischemic/neovascular insults. As there is evidence that TGFβ signaling has the potential to regulate expression of neurotrophins, it is tempting to speculate, and is discussed here, that cross-talk between TGFβ and neurotrophin signaling protects cells from harmful and/or damaging events in the heart, retina, and brain.}, language = {en} } @article{ToppvanMeertenHouotetal.2021, author = {Topp, Max S. and van Meerten, Tom and Houot, Roch and Minnema, Monique C. and Bouabdallah, Krimo and Lugtenburg, Pieternella J. and Thieblemont, Catherine and Wermke, Martin and Song, Kevin W. and Avivi, Irit and Kuruvilla, John and D{\"u}hrsen, Ulrich and Zheng, Yan and Vardhanabhuti, Saran and Dong, Jinghui and Bot, Adrian and Rossi, John M. and Plaks, Vicki and Sherman, Marika and Kim, Jenny J. and Kerber, Anne and Kersten, Marie Jos{\´e}}, title = {Earlier corticosteroid use for adverse event management in patients receiving axicabtagene ciloleucel for large B-cell lymphoma}, series = {British Journal of Haematology}, volume = {195}, journal = {British Journal of Haematology}, number = {3}, doi = {10.1111/bjh.17673}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258342}, pages = {388-398}, year = {2021}, abstract = {Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for relapsed or refractory large B-cell lymphoma (R/R LBCL). To reduce axi-cel-related toxicity, several exploratory safety management cohorts were added to ZUMA-1 (NCT02348216), the pivotal phase 1/2 study of axi-cel in refractory LBCL. Cohort 4 evaluated the rates and severity of cytokine release syndrome (CRS) and neurologic events (NEs) with earlier corticosteroid and tocilizumab use. Primary endpoints were incidence and severity of CRS and NEs. Patients received 2 × 106 anti-CD19 CAR T cells/kg after conditioning chemotherapy. Forty-one patients received axi-cel. Incidences of any-grade CRS and NEs were 93\% and 61\%, respectively (grade ≥ 3, 2\% and 17\%). There was no grade 4 or 5 CRS or NE. Despite earlier dosing, the cumulative cortisone-equivalent corticosteroid dose in patients requiring corticosteroid therapy was lower than that reported in the pivotal ZUMA-1 cohorts. With a median follow-up of 14·8 months, objective and complete response rates were 73\% and 51\%, respectively, and 51\% of treated patients were in ongoing response. Earlier and measured use of corticosteroids and/or tocilizumab has the potential to reduce the incidence of grade ≥ 3 CRS and NEs in patients with R/R LBCL receiving axi-cel.}, 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{MakbulKhayenkoMaricetal.2021, author = {Makbul, Cihan and Khayenko, Vladimir and Maric, Hans Michael and B{\"o}ttcher, Bettina}, title = {Conformational Plasticity of Hepatitis B Core Protein Spikes Promotes Peptide Binding Independent of the Secretion Phenotype}, series = {Microorganisms}, volume = {9}, journal = {Microorganisms}, number = {5}, issn = {2076-2607}, doi = {10.3390/microorganisms9050956}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236720}, year = {2021}, abstract = {Hepatitis B virus is a major human pathogen, which forms enveloped virus particles. During viral maturation, membrane-bound hepatitis B surface proteins package hepatitis B core protein capsids. This process is intercepted by certain peptides with an "LLGRMKG" motif that binds to the capsids at the tips of dimeric spikes. With microcalorimetry, electron cryo microscopy and peptide microarray-based screens, we have characterized the structural and thermodynamic properties of peptide binding to hepatitis B core protein capsids with different secretion phenotypes. The peptide "GSLLGRMKGA" binds weakly to hepatitis B core protein capsids and mutant capsids with a premature (F97L) or low-secretion phenotype (L60V and P5T). With electron cryo microscopy, we provide novel structures for L60V and P5T and demonstrate that binding occurs at the tips of the spikes at the dimer interface, splaying the helices apart independent of the secretion phenotype. Peptide array screening identifies "SLLGRM" as the core binding motif. This shortened motif binds only to one of the two spikes in the asymmetric unit of the capsid and induces a much smaller conformational change. Altogether, these comprehensive studies suggest that the tips of the spikes act as an autonomous binding platform that is unaffected by mutations that affect secretion phenotypes.}, language = {en} } @article{SchlechtThienWolfetal.2021, author = {Schlecht, Anja and Thien, Adrian and Wolf, Julian and Prinz, Gabriele and Agostini, Hansj{\"u}rgen and Schlunck, G{\"u}nther and Wieghofer, Peter and Boneva, Stefaniya and Lange, Clemens}, title = {Immunosenescence in choroidal neovascularization (CNV) — Transcriptional profiling of na{\"i}ve and CNV-associated retinal myeloid cells during aging}, series = {International Journal of Molecular Sciences}, volume = {22}, journal = {International Journal of Molecular Sciences}, number = {24}, issn = {1422-0067}, doi = {10.3390/ijms222413318}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-284342}, year = {2021}, abstract = {Immunosenescence is considered a possible factor in the development of age-related macular degeneration and choroidal neovascularization (CNV). However, age-related changes of myeloid cells (MCs), such as microglia and macrophages, in the healthy retina or during CNV formation are ill-defined. In this study, Cx3cr1-positive MCs were isolated by fluorescence-activated cell sorting from six-week (young) and two-year-old (old) Cx3cr1\(^{GFP/+}\) mice, both during physiological aging and laser-induced CNV development. High-throughput RNA-sequencing was performed to define the age-dependent transcriptional differences in MCs during physiological aging and CNV development, complemented by immunohistochemical characterization and the quantification of MCs, as well as CNV size measurements. These analyses revealed that myeloid cells change their transcriptional profile during both aging and CNV development. In the steady state, senescent MCs demonstrated an upregulation of factors contributing to cell proliferation and chemotaxis, such as Cxcl13 and Cxcl14, as well as the downregulation of microglial signature genes. During CNV formation, aged myeloid cells revealed a significant upregulation of angiogenic factors such as Arg1 and Lrg1 concomitant with significantly enlarged CNV and an increased accumulation of MCs in aged mice in comparison to young mice. Future studies need to clarify whether this observation is an epiphenomenon or a causal relationship to determine the role of immunosenescence in CNV formation.}, language = {en} } @article{TaegerMuellerGraffLukasetal.2021, author = {Taeger, Johannes and M{\"u}ller-Graff, Franz-Tassilo and Lukas, Ilgen and Schendzielorz, Philipp and Hagen, Rudolf and Neun, Tilman and Rak, Kristen}, title = {Cochlear duct length measurements in computed tomography and magnetic resonance imaging using newly developed techniques}, series = {OTO Open}, volume = {5}, journal = {OTO Open}, number = {3}, doi = {10.1177/2473974X211045312}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-263922}, pages = {1-8}, year = {2021}, abstract = {Objective Growing interest in measuring the cochlear duct length (CDL) has emerged, since it can influence the selection of cochlear implant electrodes. Currently the measurements are performed with ionized radiation imaging. Only a few studies have explored CDL measurements in magnetic resonance imaging (MRI). Therefore, the presented study aims to fill this gap by estimating CDL in MRI and comparing it with multislice computed tomography (CT). Study Design Retrospective data analyses of 42 cochleae. Setting Tertiary care medical center. Methods Diameter (A value) and width (B value) of the cochlea were measured in HOROS software. The CDL and the 2-turn length were determined by the elliptic circular approximation (ECA). In addition, the CDL, the 2-turn length, and the angular length were determined via HOROS software by the multiplanar reconstruction (MPR) method. Results CDL values were significantly shorter in MRI by MPR (d = 1.38 mm, P < .001) but not by ECA. Similar 2-turn length measurements were significantly lower in MRI by MPR (d = 1.67 mm) and ECA (d = 1.19 mm, both P < .001). In contrast, angular length was significantly higher in MRI (d = 26.79°, P < .001). When the values were set in relation to the frequencies of the cochlea, no clinically relevant differences were estimated (58 Hz at 28-mm CDL). Conclusion In the presented study, CDL was investigated in CT and MRI by using different approaches. Since no clinically relevant differences were found, diagnostics with radiation may be omitted prior to cochlear implantation; thus, a concept of radiation-free cochlear implantation could be established.}, language = {en} } @article{TaegerMuellerGraffNeunetal.2021, author = {Taeger, Johannes and M{\"u}ller-Graff, Franz-Tassilo and Neun, Tilmann and K{\"o}ping, Maria and Schendzielorz, Philipp and Hagen, Rudolf and Rak, Kristen}, title = {Highly precise navigation at the lateral skull base by the combination of flat-panel volume CT and electromagnetic navigation}, series = {Science Progress}, volume = {104}, journal = {Science Progress}, number = {3}, issn = {2047-7163}, doi = {10.1177/00368504211032090}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-250268}, year = {2021}, abstract = {This study aimed to evaluate the feasibility and accuracy of electromagnetic navigation at the lateral skull base in combination with flat panel volume computed tomography (fpVCT) datasets. A mastoidectomy and a posterior tympanotomy were performed on 10 samples of fresh frozen temporal bones. For registration, four self-drilling titanium screws were applied as fiducial markers. Multi-slice computed tomography (MSCT; 600 µm), conventional flat panel volume computed tomography (fpVCT; 466 µm), micro-fpVCT (197 µm) and secondary reconstructed fpVCT (100 µM) scans were performed and data were loaded into the navigation system. The resulting fiducial registration error (FRE) was analysed, and control of the navigation accuracy was performed. The registration process was very quick and reliable with the screws as fiducials. Compared to using the MSCT data, the micro-fpVCT data led to significantly lower FRE values, whereas conventional fpVCT and secondary reconstructed fpVCT data had no advantage in terms of accuracy. For all imaging modalities, there was no relevant visual deviation when targeting defined anatomical points with a navigation probe. fpVCT data are very well suited for electromagnetic navigation at the lateral skull base. The use of titanium screws as fiducial markers turned out to be ideal for comparing different imaging methods. A further evaluation of this approach by a clinical trial is required.}, 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{VonaMazaheriLinetal.2021, author = {Vona, Barbara and Mazaheri, Neda and Lin, Sheng-Jia and Dunbar, Lucy A. and Maroofian, Reza and Azaiez, Hela and Booth, Kevin T. and Vitry, Sandrine and Rad, Aboulfazl and R{\"u}schendorf, Franz and Varshney, Pratishtha and Fowler, Ben and Beetz, Christian and Alagramam, Kumar N. and Murphy, David and Shariati, Gholamreza and Sedaghat, Alireza and Houlden, Henry and Petree, Cassidy and VijayKumar, Shruthi and Smith, Richard J. H. and Haaf, Thomas and El-Amraoui, Aziz and Bowl, Michael R. and Varshney, Gaurav K. and Galehdari, Hamid}, title = {A biallelic variant in CLRN2 causes non-syndromic hearing loss in humans}, series = {Human Genetics}, volume = {140}, journal = {Human Genetics}, number = {6}, issn = {1432-1203}, doi = {10.1007/s00439-020-02254-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-267740}, pages = {915-931}, year = {2021}, abstract = {Deafness, the most frequent sensory deficit in humans, is extremely heterogeneous with hundreds of genes involved. Clinical and genetic analyses of an extended consanguineous family with pre-lingual, moderate-to-profound autosomal recessive sensorineural hearing loss, allowed us to identify CLRN2, encoding a tetraspan protein, as a new deafness gene. Homozygosity mapping followed by exome sequencing identified a 14.96 Mb locus on chromosome 4p15.32p15.1 containing a likely pathogenic missense variant in CLRN2 (c.494C > A, NM_001079827.2) segregating with the disease. Using in vitro RNA splicing analysis, we show that the CLRN2 c.494C > A variant leads to two events: (1) the substitution of a highly conserved threonine (uncharged amino acid) to lysine (charged amino acid) at position 165, p.(Thr165Lys), and (2) aberrant splicing, with the retention of intron 2 resulting in a stop codon after 26 additional amino acids, p.(Gly146Lysfs*26). Expression studies and phenotyping of newly produced zebrafish and mouse models deficient for clarin 2 further confirm that clarin 2, expressed in the inner ear hair cells, is essential for normal organization and maintenance of the auditory hair bundles, and for hearing function. Together, our findings identify CLRN2 as a new deafness gene, which will impact future diagnosis and treatment for deaf patients.}, language = {en} } @article{BrodehlMeshkovMyasnikovetal.2021, author = {Brodehl, Andreas and Meshkov, Alexey and Myasnikov, Roman and Kiseleva, Anna and Kulikova, Olga and Klauke, B{\"a}rbel and Sotnikova, Evgeniia and Stanasiuk, Caroline and Divashuk, Mikhail and Pohl, Greta Marie and Kudryavtseva, Maria and Klingel, Karin and Gerull, Brenda and Zharikova, Anastasia and Gummert, Jan and Koretskiy, Sergey and Schubert, Stephan and Mershina, Elena and G{\"a}rtner, Anna and Pilus, Polina and Laser, Kai Thorsten and Sinitsyn, Valentin and Boytsov, Sergey and Drapkina, Oxana and Milting, Hendrik}, title = {Hemi- and homozygous loss-of-function mutations in DSG2 (desmoglein-2) cause recessive arrhythmogenic cardiomyopathy with an early onset}, series = {International Journal of Molecular Sciences}, volume = {22}, journal = {International Journal of Molecular Sciences}, number = {7}, issn = {1422-0067}, doi = {10.3390/ijms22073786}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285279}, year = {2021}, abstract = {About 50\% of patients with arrhythmogenic cardiomyopathy (ACM) carry a pathogenic or likely pathogenic mutation in the desmosomal genes. However, there is a significant number of patients without positive familial anamnesis. Therefore, the molecular reasons for ACM in these patients are frequently unknown and a genetic contribution might be underestimated. Here, we used a next-generation sequencing (NGS) approach and in addition single nucleotide polymor-phism (SNP) arrays for the genetic analysis of two independent index patients without familial medical history. Of note, this genetic strategy revealed a homozygous splice site mutation (DSG2-c.378+1G>T) in the first patient and a nonsense mutation (DSG2-p.L772X) in combination with a large deletion in DSG2 in the second one. In conclusion, a recessive inheritance pattern is likely for both cases, which might contribute to the hidden medical history in both families. This is the first report about these novel loss-of-function mutations in DSG2 that have not been previously identi-fied. Therefore, we suggest performing deep genetic analyses using NGS in combination with SNP arrays also for ACM index patients without obvious familial medical history. In the future, this finding might has relevance for the genetic counseling of similar cases.}, language = {en} } @article{WeineltKarathanasisSmithetal.2021, author = {Weinelt, Nadine and Karathanasis, Christos and Smith, Sonja and Medler, Juliane and Malkusch, Sebastian and Fulda, Simone and Wajant, Harald and Heilemann, Mike and van Wijk, Sjoerd J. L.}, title = {Quantitative single-molecule imaging of TNFR1 reveals zafirlukast as antagonist of TNFR1 clustering and TNFα-induced NF-ĸB signaling}, series = {Journal of Leukocyte Biology}, volume = {109}, journal = {Journal of Leukocyte Biology}, number = {2}, doi = {10.1002/JLB.2AB0420-572RR}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-215960}, pages = {363 -- 371}, year = {2021}, abstract = {TNFR1 is a crucial regulator of NF-ĸB-mediated proinflammatory cell survival responses and programmed cell death (PCD). Deregulation of TNFα- and TNFR1-controlled NF-ĸB signaling underlies major diseases, like cancer, inflammation, and autoimmune diseases. Therefore, although being routinely used, antagonists of TNFα might also affect TNFR2-mediated processes, so that alternative approaches to directly antagonize TNFR1 are beneficial. Here, we apply quantitative single-molecule localization microscopy (SMLM) of TNFR1 in physiologic cellular settings to validate and characterize TNFR1 inhibitory substances, exemplified by the recently described TNFR1 antagonist zafirlukast. Treatment of TNFR1-mEos2 reconstituted TNFR1/2 knockout mouse embryonic fibroblasts (MEFs) with zafirlukast inhibited both ligand-independent preligand assembly domain (PLAD)-mediated TNFR1 dimerization as well as TNFα-induced TNFR1 oligomerization. In addition, zafirlukast-mediated inhibition of TNFR1 clustering was accompanied by deregulation of acute and prolonged NF-ĸB signaling in reconstituted TNFR1-mEos2 MEFs and human cervical carcinoma cells. These findings reveal the necessity of PLAD-mediated, ligand-independent TNFR1 dimerization for NF-ĸB activation, highlight the PLAD as central regulator of TNFα-induced TNFR1 oligomerization, and demonstrate that TNFR1-mEos2 MEFs can be used to investigate TNFR1-antagonizing compounds employing single-molecule quantification and functional NF-ĸB assays at physiologic conditions.}, language = {en} } @article{GoebVollZimmermannetal.2021, author = {G{\"o}b, Vanessa and Voll, Maximilian G. and Zimmermann, Lena and Hemmen, Katharina and Stoll, Guido and Nieswandt, Bernhard and Schuhmann, Michael K. and Heinze, Katrin G. and Stegner, David}, title = {Infarct growth precedes cerebral thrombosis following experimental stroke in mice}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, number = {1}, doi = {10.1038/s41598-021-02360-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265791}, year = {2021}, abstract = {Ischemic stroke is among the leading causes of disability and death worldwide. In acute ischemic stroke, successful recanalization of occluded vessels is the primary therapeutic aim, but even if it is achieved, not all patients benefit. Although blockade of platelet aggregation did not prevent infarct progression, cerebral thrombosis as cause of secondary infarct growth has remained a matter of debate. As cerebral thrombi are frequently observed after experimental stroke, a thrombus-induced impairment of the brain microcirculation is considered to contribute to tissue damage. Here, we combine the model of transient middle cerebral artery occlusion (tMCAO) with light sheet fluorescence microscopy and immunohistochemistry of brain slices to investigate the kinetics of thrombus formation and infarct progression. Our data reveal that tissue damage already peaks after 8 h of reperfusion following 60 min MCAO, while cerebral thrombi are only observed at later time points. Thus, cerebral thrombosis is not causative for secondary infarct growth during ischemic stroke.}, language = {en} } @article{BeckStegnerLorochetal.2021, author = {Beck, Sarah and Stegner, David and Loroch, Stefan and Baig, Ayesha A. and G{\"o}b, Vanessa and Schumbutzki, Cornelia and Eilers, Eva and Sickmann, Albert and May, Frauke and Nolte, Marc W. and Panousis, Con and Nieswandt, Bernhard}, title = {Generation of a humanized FXII knock-in mouse-A powerful model system to test novel anti-thrombotic agents}, series = {Journal of Thrombosis and Haemostasis}, volume = {19}, journal = {Journal of Thrombosis and Haemostasis}, number = {11}, doi = {10.1111/jth.15488}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259567}, pages = {2835-2840}, year = {2021}, abstract = {Background Effective inhibition of thrombosis without generating bleeding risks is a major challenge in medicine. Accumulating evidence suggests that this can be achieved by inhibition of coagulation factor XII (FXII), as either its knock-out or inhibition in animal models efficiently reduced thrombosis without affecting normal hemostasis. Based on these findings, highly specific inhibitors for human FXII(a) are under development. However, currently, in vivo studies on their efficacy and safety are impeded by the lack of an optimized animal model expressing the specific target, that is, human FXII. Objective The primary objective of this study is to develop and functionally characterize a humanized FXII mouse model. Methods A humanized FXII mouse model was generated by replacing the murine with the human F12 gene (genetic knock-in) and tested it in in vitro coagulation assays and in in vivo thrombosis models. Results These hF12\(^{KI}\) mice were indistinguishable from wild-type mice in all tested assays of coagulation and platelet function in vitro and in vivo, except for reduced expression levels of hFXII compared to human plasma. Targeting FXII by the anti-human FXIIa antibody 3F7 increased activated partial thromboplastin time dose-dependently and protected hF12\(^{KI}\) mice in an arterial thrombosis model without affecting bleeding times. Conclusion These data establish the newly generated hF12\(^{KI}\) mouse as a powerful and unique model system for in vivo studies on anti-FXII(a) biologics, supporting the development of efficient and safe human FXII(a) inhibitors.}, language = {en} } @article{SeitzerKlapperMazigoetal.2021, author = {Seitzer, Moritz and Klapper, Sylvia and Mazigo, Humphrey D. and Holzgrabe, Ulrike and Mueller, Andreas}, title = {Quality and composition of Albendazole, Mebendazole and Praziquantel available in Burkina Faso, C{\^o}te d'Ivoire, Ghana and Tanzania}, series = {PLoS Neglected Tropical Diseases}, volume = {15}, journal = {PLoS Neglected Tropical Diseases}, number = {1}, doi = {10.1371/journal.pntd.0009038}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270434}, year = {2021}, abstract = {Background Even though the international combat against Neglected Tropical Diseases such as schistosomiasis or soil-transmitted helminthiases depends on reliable therapeutics, anthelminthic pharmacovigilance has been neglected on many national African drug markets. Therefore, quality and composition of Albendazole, Mebendazole and Praziquantel locally collected in Burkina Faso, C{\^o}te d'Ivoire, Ghana and Tanzania were analysed. Methods Samples of 88 different batches were obtained from randomly selected facilities. Sampling took place in Northwest Tanzania, Western Burkina Faso, Southeast C{\^o}te d'Ivoire and Southwest Ghana. Visual examination of both packaging and samples was performed according to the WHO 'Be Aware' tool. Products were then screened with the GPHF Minilab, consisting of tests of mass uniformity, disintegration times and thin-layer chromatography (TLC). Confirmatory tests were performed according to international pharmacopoeiae, applying assays for dissolution profiles and high-performance liquid chromatography (HPLC). Findings Despite minor irregularities, appearance of the products did not hint at falsified medicines. However, 19.6\% of the brands collected in Ghana and Tanzania were not officially licensed for sale. Mass uniformity was confirmed in 53 out of 58 brands of tablets. 41 out of 56 products passed disintegration times; 10 out of the 15 failing products did not disintegrate at all. Evaluating TLC results, only 4 out of 83 batches narrowly missed specification limits, 18 batches slightly exceeded them. Not more than 46.3\% (31 / 67) of the tablets assayed passed the respective pharmaceutical criteria for dissolution. HPLC findings confirmed TLC results despite shifted specification limits: 10 out of 83 tested batches contained less than 90\%, none exceeded 110\%. Conclusion In the four study countries, no falsified anthelminthic medicine was encountered. The active pharmaceutical ingredient was not found to either exceed or fall below specification limits. Galenic characteristics however, especially dissolution profiles, revealed great deficits.}, language = {en} } @article{HelmprobstKneitzKlotzetal.2021, author = {Helmprobst, Frederik and Kneitz, Susanne and Klotz, Barbara and Naville, Magali and Dechaud, Corentin and Volff, Jean-Nicolas and Schartl, Manfred}, title = {Differential expression of transposable elements in the medaka melanoma model}, series = {PLoS One}, volume = {16}, journal = {PLoS One}, number = {10}, doi = {10.1371/journal.pone.0251713}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260615}, year = {2021}, abstract = {Malignant melanoma incidence is rising worldwide. Its treatment in an advanced state is difficult, and the prognosis of this severe disease is still very poor. One major source of these difficulties is the high rate of metastasis and increased genomic instability leading to a high mutation rate and the development of resistance against therapeutic approaches. Here we investigate as one source of genomic instability the contribution of activation of transposable elements (TEs) within the tumor. We used the well-established medaka melanoma model and RNA-sequencing to investigate the differential expression of TEs in wildtype and transgenic fish carrying melanoma. We constructed a medaka-specific TE sequence library and identified TE sequences that were specifically upregulated in tumors. Validation by qRT- PCR confirmed a specific upregulation of a LINE and an LTR element in malignant melanomas of transgenic fish.}, language = {en} } @article{NadernezhadRymaGencetal.2021, author = {Nadernezhad, Ali and Ryma, Matthias and Gen{\c{c}}, Hatice and Cicha, Iwona and J{\"u}ngst, Thomasz and Groll, J{\"u}rgen}, title = {Melt electrowriting of isomalt for high-resolution templating of embedded microchannels}, series = {Advanced Material Technologies}, volume = {6}, journal = {Advanced Material Technologies}, number = {8}, doi = {10.1002/admt.202100221}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-256401}, year = {2021}, abstract = {Fabrication of microchannels using 3D printing of sugars as fugitive material is explored in different fields, including microfluidics. However, establishing reproducible methods for the controlled production of sugar structures with sub-100 μm dimensions remains a challenge. This study pioneers the processing of sugars by melt electrowriting (MEW) enabling the fabrication of structures with so far unprecedented resolution from Isomalt. Based on a systematic variation of process parameters, fibers with diameters down to 20 μm can be fabricated. The flexibility in the adjustment of fiber diameter by on-demand alteration of MEW parameters enables generating constructs with perfusable channels within polydimethylsiloxane molds. These channels have a diameter that can be adjusted from 30 to 200 μm in a single design. Taken together, the experiments show that MEW strongly benefits from the thermal and physical stability of Isomalt, providing a robust platform for the fabrication of small-diameter embedded microchannel systems.}, language = {en} } @article{KaiserAggensteinerHoltmannetal.2021, author = {Kaiser, Anna and Aggensteiner, Pascal-M. and Holtmann, Martin and Fallgatter, Andreas and Romanos, Marcel and Abenova, Karina and Alm, Barbara and Becker, Katja and D{\"o}pfner, Manfred and Ethofer, Thomas and Freitag, Christine M. and Geissler, Julia and Hebebrand, Johannes and Huss, Michael and Jans, Thomas and Jendreizik, Lea Teresa and Ketter, Johanna and Legenbauer, Tanja and Philipsen, Alexandra and Poustka, Luise and Renner, Tobias and Retz, Wolfgang and R{\"o}sler, Michael and Thome, Johannes and Uebel-von Sandersleben, Henrik and von Wirth, Elena and Zinnow, Toivo and Hohmann, Sarah and Millenet, Sabina and Holz, Nathalie E. and Banaschewski, Tobias and Brandeis, Daniel}, title = {EEG data quality: determinants and impact in a multicenter study of children, adolescents, and adults with attention-deficit/hyperactivity disorder (ADHD)}, series = {Brain Sciences}, volume = {11}, journal = {Brain Sciences}, number = {2}, issn = {2076-3425}, doi = {10.3390/brainsci11020214}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228788}, year = {2021}, abstract = {Electroencephalography (EEG) represents a widely established method for assessing altered and typically developing brain function. However, systematic studies on EEG data quality, its correlates, and consequences are scarce. To address this research gap, the current study focused on the percentage of artifact-free segments after standard EEG pre-processing as a data quality index. We analyzed participant-related and methodological influences, and validity by replicating landmark EEG effects. Further, effects of data quality on spectral power analyses beyond participant-related characteristics were explored. EEG data from a multicenter ADHD-cohort (age range 6 to 45 years), and a non-ADHD school-age control group were analyzed (n\(_{total}\) = 305). Resting-state data during eyes open, and eyes closed conditions, and task-related data during a cued Continuous Performance Task (CPT) were collected. After pre-processing, general linear models, and stepwise regression models were fitted to the data. We found that EEG data quality was strongly related to demographic characteristics, but not to methodological factors. We were able to replicate maturational, task, and ADHD effects reported in the EEG literature, establishing a link with EEG-landmark effects. Furthermore, we showed that poor data quality significantly increases spectral power beyond effects of maturation and symptom severity. Taken together, the current results indicate that with a careful design and systematic quality control, informative large-scale multicenter trials characterizing neurophysiological mechanisms in neurodevelopmental disorders across the lifespan are feasible. Nevertheless, results are restricted to the limitations reported. Future work will clarify predictive value.}, language = {en} } @article{LoriniBescosAtinThavarajetal.2021, author = {Lorini, Luigi and Besc{\´o}s At{\´i}n, Coro and Thavaraj, Selvam and M{\"u}ller-Richter, Urs and Alberola Ferranti, Margarita and Pamias Romero, Jorge and S{\´a}ez Barba, Manel and de Pablo Garc{\´i}a-Cuenca, Alba and Bra{\~n}a Garc{\´i}a, Irene and Bossi, Paolo and Nuciforo, Paolo and Simonetti, Sara}, title = {Overview of oral potentially malignant disorders: from risk factors to specific therapies}, series = {Cancers}, volume = {13}, journal = {Cancers}, number = {15}, issn = {2072-6694}, doi = {10.3390/cancers13153696}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242779}, year = {2021}, abstract = {Oral squamous cell carcinoma (OSCC) is a very aggressive cancer, representing one of the most common malignancies worldwide. Oral potentially malignant disorders (OPMDs) regroup a variegate set of different histological lesions, characterized by the potential capacity to transform in OSCC. Most of the risk factors associated with OSCC are present also in OPMDs' development; however, the molecular mechanisms and steps of malignant transformation are still unknown. Treatment of OSCC, including surgery, systemic therapy and radiotherapy (alone or in combination), has suffered a dramatic change in last years, especially with the introduction of immunotherapy. However, most cases are diagnosed during the advanced stage of the disease, decreasing drastically the survival rate of the patients. Hence, early diagnosis of premalignant conditions (OPMDs) is a priority in oral cancer, as well as a massive education about risk factors, the understanding of mechanisms involved in malignant progression and the development of specific and more efficient therapies. The aim of this article is to review epidemiological, clinical, morphological and molecular features of OPMDs, with the purpose to lay the foundation for an exhaustive comprehension of these lesions and their ability of malignant transformation and for the development of more effective and personalized treatments.}, language = {en} } @article{MeirKannapinDiefenbacheretal.2021, author = {Meir, Michael and Kannapin, Felix and Diefenbacher, Markus and Ghoreishi, Yalda and Kollmann, Catherine and Flemming, Sven and Germer, Christoph-Thomas and Waschke, Jens and Leven, Patrick and Schneider, Reiner and Wehner, Sven and Burkard, Natalie and Schlegel, Nicolas}, title = {Intestinal epithelial barrier maturation by enteric glial cells is GDNF-dependent}, series = {International Journal of Molecular Sciences}, volume = {22}, journal = {International Journal of Molecular Sciences}, number = {4}, issn = {1422-0067}, doi = {10.3390/ijms22041887}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258913}, year = {2021}, abstract = {Enteric glial cells (EGCs) of the enteric nervous system are critically involved in the maintenance of intestinal epithelial barrier function (IEB). The underlying mechanisms remain undefined. Glial cell line-derived neurotrophic factor (GDNF) contributes to IEB maturation and may therefore be the predominant mediator of this process by EGCs. Using GFAP\(^{cre}\) x Ai14\(^{floxed}\) mice to isolate EGCs by Fluorescence-activated cell sorting (FACS), we confirmed that they synthesize GDNF in vivo as well as in primary cultures demonstrating that EGCs are a rich source of GDNF in vivo and in vitro. Co-culture of EGCs with Caco2 cells resulted in IEB maturation which was abrogated when GDNF was either depleted from EGC supernatants, or knocked down in EGCs or when the GDNF receptor RET was blocked. Further, TNFα-induced loss of IEB function in Caco2 cells and in organoids was attenuated by EGC supernatants or by recombinant GDNF. These barrier-protective effects were blunted when using supernatants from GDNF-deficient EGCs or by RET receptor blockade. Together, our data show that EGCs produce GDNF to maintain IEB function in vitro through the RET receptor.}, language = {en} } @article{LueffeD'OrazioBaueretal.2021, author = {L{\"u}ffe, Teresa M. and D'Orazio, Andrea and Bauer, Moritz and Gioga, Zoi and Schoeffler, Victoria and Lesch, Klaus-Peter and Romanos, Marcel and Drepper, Carsten and Lillesaar, Christina}, title = {Increased locomotor activity via regulation of GABAergic signalling in foxp2 mutant zebrafish - implications for neurodevelopmental disorders}, series = {Translational Psychiatry}, volume = {11}, journal = {Translational Psychiatry}, doi = {10.1038/s41398-021-01651-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264713}, year = {2021}, abstract = {Recent advances in the genetics of neurodevelopmental disorders (NDDs) have identified the transcription factor FOXP2 as one of numerous risk genes, e.g. in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). FOXP2 function is suggested to be involved in GABAergic signalling and numerous studies demonstrate that GABAergic function is altered in NDDs, thus disrupting the excitation/inhibition balance. Interestingly, GABAergic signalling components, including glutamate-decarboxylase 1 (Gad1) and GABA receptors, are putative transcriptional targets of FOXP2. However, the specific role of FOXP2 in the pathomechanism of NDDs remains elusive. Here we test the hypothesis that Foxp2 affects behavioural dimensions via GABAergic signalling using zebrafish as model organism. We demonstrate that foxp2 is expressed by a subset of GABAergic neurons located in brain regions involved in motor functions, including the subpallium, posterior tuberculum, thalamus and medulla oblongata. Using CRISPR/Cas9 gene-editing we generated a novel foxp2 zebrafish loss-of-function mutant that exhibits increased locomotor activity. Further, genetic and/or pharmacological disruption of Gad1 or GABA-A receptors causes increased locomotor activity, resembling the phenotype of foxp2 mutants. Application of muscimol, a GABA-A receptor agonist, rescues the hyperactive phenotype induced by the foxp2 loss-of-function. By reverse translation of the therapeutic effect on hyperactive behaviour exerted by methylphenidate, we note that application of methylphenidate evokes different responses in wildtype compared to foxp2 or gad1b loss-of-function animals. Together, our findings support the hypothesis that foxp2 regulates locomotor activity via GABAergic signalling. This provides one targetable mechanism, which may contribute to behavioural phenotypes commonly observed in NDDs.}, language = {en} } @article{MorbachBeyersdorfKerkauetal.2021, author = {Morbach, Caroline and Beyersdorf, Niklas and Kerkau, Thomas and Ramos, Gustavo and Sahiti, Floran and Albert, Judith and Jahns, Roland and Ertl, Georg and Angermann, Christiane E. and Frantz, Stefan and Hofmann, Ulrich and St{\"o}rk, Stefan}, title = {Adaptive anti-myocardial immune response following hospitalization for acute heart failure}, series = {ESC Heart Failure}, volume = {8}, journal = {ESC Heart Failure}, number = {4}, doi = {10.1002/ehf2.13376}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258907}, pages = {3348-3353}, year = {2021}, abstract = {Aims It has been hypothesized that cardiac decompensation accompanying acute heart failure (AHF) episodes generates a pro-inflammatory environment boosting an adaptive immune response against myocardial antigens, thus contributing to progression of heart failure (HF) and poor prognosis. We assessed the prevalence of anti-myocardial autoantibodies (AMyA) as biomarkers reflecting adaptive immune responses in patients admitted to the hospital for AHF, followed the change in AMyA titres for 6 months after discharge, and evaluated their prognostic utility. Methods and results AMyA were determined in n = 47 patients, median age 71 (quartiles 60; 80) years, 23 (49\%) female, and 24 (51\%) with HF with preserved ejection fraction, from blood collected at baseline (time point of hospitalization) and at 6 month follow-up (visit F6). Patients were followed for 18 months (visit F18). The prevalence of AMyA increased from baseline (n = 21, 45\%) to F6 (n = 36, 77\%; P < 0.001). At F6, the prevalence of AMyA was higher in patients with HF with preserved ejection fraction (n = 21, 88\%) compared with patients with reduced ejection fraction (n = 14, 61\%; P = 0.036). During the subsequent 12 months after F6, that is up to F18, patients with newly developed AMyA at F6 had a higher risk for the combined endpoint of death or rehospitalization for HF (hazard ratio 4.79, 95\% confidence interval 1.13-20.21; P = 0.033) compared with patients with persistent or without AMyA at F6. Conclusions Our results support the hypothesis that AHF may induce patterns of adaptive immune responses. More studies in larger populations and well-defined patient subgroups are needed to further clarify the role of the adaptive immune system in HF progression.}, language = {en} } @article{LiuHanBlairetal.2021, author = {Liu, Fengming and Han, Kun and Blair, Robert and Kenst, Kornelia and Qin, Zhongnan and Upcin, Berin and W{\"o}rsd{\"o}rfer, Philipp and Midkiff, Cecily C. and Mudd, Joseph and Belyaeva, Elizaveta and Milligan, Nicholas S. and Rorison, Tyler D. and Wagner, Nicole and Bodem, Jochen and D{\"o}lken, Lars and Aktas, Bertal H. and Vander Heide, Richard S. and Yin, Xiao-Ming and Kolls, Jay K. and Roy, Chad J. and Rappaport, Jay and Erg{\"u}n, S{\"u}leyman and Qin, Xuebin}, title = {SARS-CoV-2 Infects Endothelial Cells In Vivo and In Vitro}, series = {Frontiers in Cellular and Infection Microbiology}, volume = {11}, journal = {Frontiers in Cellular and Infection Microbiology}, issn = {2235-2988}, doi = {10.3389/fcimb.2021.701278}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-241948}, year = {2021}, abstract = {SARS-CoV-2 infection can cause fatal inflammatory lung pathology, including thrombosis and increased pulmonary vascular permeability leading to edema and hemorrhage. In addition to the lung, cytokine storm-induced inflammatory cascade also affects other organs. SARS-CoV-2 infection-related vascular inflammation is characterized by endotheliopathy in the lung and other organs. Whether SARS-CoV-2 causes endotheliopathy by directly infecting endothelial cells is not known and is the focus of the present study. We observed 1) the co-localization of SARS-CoV-2 with the endothelial cell marker CD31 in the lungs of SARS-CoV-2-infected mice expressing hACE2 in the lung by intranasal delivery of adenovirus 5-hACE2 (Ad5-hACE2 mice) and non-human primates at both the protein and RNA levels, and 2) SARS-CoV-2 proteins in endothelial cells by immunogold labeling and electron microscopic analysis. We also detected the co-localization of SARS-CoV-2 with CD31 in autopsied lung tissue obtained from patients who died from severe COVID-19. Comparative analysis of RNA sequencing data of the lungs of infected Ad5-hACE2 and Ad5-empty (control) mice revealed upregulated KRAS signaling pathway, a well-known pathway for cellular activation and dysfunction. Further, we showed that SARS-CoV-2 directly infects mature mouse aortic endothelial cells (AoECs) that were activated by performing an aortic sprouting assay prior to exposure to SARS-CoV-2. This was demonstrated by co-localization of SARS-CoV-2 and CD34 by immunostaining and detection of viral particles in electron microscopic studies. Moreover, the activated AoECs became positive for ACE-2 but not quiescent AoECs. Together, our results indicate that in addition to pneumocytes, SARS-CoV-2 also directly infects mature vascular endothelial cells in vivo and ex vivo, which may contribute to cardiovascular complications in SARS-CoV-2 infection, including multipleorgan failure.}, language = {en} } @article{YurdadoganMalschKotsevaetal.2021, author = {Yurdadogan, Tino and Malsch, Carolin and Kotseva, Kornelia and Wood, David and Leyh, Rainer and Ertl, Georg and Karmann, Wolfgang and M{\"u}ller-Scholden, Lara and Morbach, Caroline and Breuning, Margret and Wagner, Martin and Gelbrich, G{\"o}tz and Bots, Michiel L. and Heuschmann, Peter U. and St{\"o}rk, Stefan}, title = {Functional versus morphological assessment of vascular age in patients with coronary heart disease}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, number = {1}, doi = {10.1038/s41598-021-96998-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265810}, year = {2021}, abstract = {Communicating cardiovascular risk based on individual vascular age (VA) is a well acknowledged concept in patient education and disease prevention. VA may be derived functionally, e.g. by measurement of pulse wave velocity (PWV), or morphologically, e.g. by assessment of carotid intima-media thickness (cIMT). The purpose of this study was to investigate whether both approaches produce similar results. Within the context of the German subset of the EUROASPIRE IV survey, 501 patients with coronary heart disease underwent (a) oscillometric PWV measurement at the aortic, carotid-femoral and brachial-ankle site (PWVao, PWVcf, PWVba) and derivation of the aortic augmentation index (AIao); (b) bilateral cIMT assessment by high-resolution ultrasound at three sites (common, bulb, internal). Respective VA was calculated using published equations. According to VA derived from PWV, most patients exhibited values below chronological age indicating a counterintuitive healthier-than-anticipated vascular status: for VA(PWVao) in 68\% of patients; for VA\(_{AIao}\) in 52\% of patients. By contrast, VA derived from cIMT delivered opposite results: e.g. according to VA\(_{total-cIMT}\) accelerated vascular aging in 75\% of patients. To strengthen the concept of VA, further efforts are needed to better standardise the current approaches to estimate VA and, thereby, to improve comparability and clinical utility.}, language = {en} } @article{MaasMischingerComperatetal.2021, author = {Maas, Moritz and Mischinger, Johannes and Comp{\´e}rat, Eva and Scharpf, Marcus and Fend, Falko and Todenh{\"o}fer, Timlan and Stenzl, Arnulf and Gakis, Georgios and Rausch, Steffen}, title = {Utility of pT3 substaging in lymph node-negative urothelial carcinoma of the bladder: do pathologic parameters add to prognostic sub-stratification?}, series = {World Journal of Urology}, volume = {39}, journal = {World Journal of Urology}, number = {11}, issn = {1433-8726}, doi = {10.1007/s00345-021-03697-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266535}, pages = {4021-4027}, year = {2021}, abstract = {Purpose The value of bladder cancer (BC) substaging into macroscopic (pT3b) and microscopic (pT3a) perivesical fat extension in lymph node (Ln)-negative patients is controversially discussed and limited evidence for prognostic relevance of additional histopathological factors in pT3 BC exists. We evaluated the prognostic value of pT3 substaging and established pathological and clinical parameters with focus on tumor invasive front (TIF) and tumor size. Methods Specimens of 52 patients treated with radical cystectomy (RC) for pT3 a/b muscle-invasive BC were reviewed and re-evaluated by a pathologist specialized in uropathology. Clinical variables and standard histopathologic characteristics were assessed including TIF and tumor size. Their value as prognosticators for overall survival (OS) and recurrence-free survival (RFS) was evaluated. Results Mean age of patients was 67.55 years. Tumors were staged pT3a in 28 patients (53.8\%) and pT3b in 24 (46.8\%). Median OS was 34.51 months. Median tumor size was 3.2 cm, median TIF was 11.0 mm. Differences in OS between pT3a and pT3b were not significant (p = 0.45). Carcinoma in situ (CIS) and lymphovascular invasion (LVI) were significantly associated with pT3b tumors. Univariate analysis could not identify pathological prognosticators like TIF or tumor size for OS and RFS (p for all > 0.05). Conclusion No significant differences in OS or RFS were observed comparing Ln-negative pT3 BC following radical cystectomy. Additional pathologic variables like TIF could not be identified as prognosticator. Relevance of pT3 BC substaging needs reevaluation in larger prospective cohorts.}, language = {en} } @phdthesis{Nguyen2021, author = {Nguyen, Ngoc Bich}, title = {Vitamin D bei Patienten mit idiopathischen Parkinson-Syndrom}, doi = {10.25972/OPUS-22302}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223026}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {In einer Vielzahl von epidemiologischen Studien zeigten Patienten, die an einem idiopathischen Parkinson-Syndrom (IPS) erkrankt waren, erniedrigte Vitamin D-Serumspiegel (25-(OH)-Vit D). Die Rolle von Vitamin D im Knochenstoffwechsel ist weitgehend bekannt, allerdings konnten Assoziationen zwischen Vitamin D und chronischen Erkrankungen, die das Nervensystem sowie das kardiovaskul{\"a}re und immunologische System betreffen, nachgewiesen werden. In Tiermodellen konnten anti-oxidative Effekte von Vitamin D im Nervensystem gezeigt werden. In den letzten Jahren h{\"a}uften sich allerdings Studien, die gegen einen direkten Zusammenhang zwischen IPS und Vitamin D sprechen. Demnach stellt sich die Frage, ob dem geh{\"a}uften Auftreten eines Vitamin D-Mangels bei IPS-Patienten eine krankheitsspezifische Ursache zugrunde liegt oder ob diese lediglich ein unspezifisches krankheitsbegleitendes Ph{\"a}nomen darstellt. In der vorliegenden Arbeit wurden in einer retrospektiven Analyse Parkinson-Patienten aus der neurogerontopsychiatrischen Tagesklinik sowie der neurogeriatrischen Fr{\"u}hrehastation der Neurologischen Klinik der Universit{\"a}tsklinik W{\"u}rzburg hinsichtlich ihres 25-(OH)-Vit D-Serumspiegel mit zwei Kontrollgruppen bestehend aus Patienten mit psychiatrischer bzw. anderweitig neurologischer Erkrankung, die keiner Parkinson-Erkrankung entsprach, verglichen. Im Anschluss wurde auf m{\"o}gliche Konfounder sowie der Zusammenhang zwischen IPS-Risiko bzw. Krankheitsschwere und 25-(OH)-Vit D-Serumspiegel untersucht. Der mittlere 25-(OH)-Vit D-Serumspiegel der Neurologie-Gruppe war im Vergleich zur Psychiatrie-Gruppe signifikant niedriger. Der Unterschied zwischen IPS-Gruppe und Psychiatrie- bzw. Neurologie-Gruppe war nicht signifikant. Bei Hinzunahme von weiteren rekrutierten Parametern (Body-Mass-Index, Frailty, Sturzanamnese, Gehhilfe, CHA2DS2-VASc-Score, C-reaktives Protein, H{\"a}moglobin) konnte kein signifikanter Unterschied zwischen der Neurologie- und Psychiatrie-Gruppe mehr gefunden werden. Das Risiko sowie die Krankheitsschwere einer Parkinson-Erkrankung, gemessen am Hoehn-Yahr-Stadium und den erreichten Werten im MDS UPDRS III, korrelierten mit dem Vitamin D-Serumspiegel. Allerdings war auch hier nach Hinzunahme von Kovariaten wie Alter, Geschlecht und Krankheitsdauer der Effekt nicht mehr signifikant. Die Ergebnisse unterst{\"u}tzen die Annahme, dass die vorgefundenen niedrigen 25-(OH)-Vit D-Serumspiegel bei Parkinson-Patienten ein krankheitsbegleitendes Ph{\"a}nomen ist, das wom{\"o}glich durch die eingeschr{\"a}nkten motorischen F{\"a}higkeiten mit resultierend niedriger Sonnenexposition bedingt ist und durch zunehmende Kranheitsdauer und damit Krankheitsschwere verst{\"a}rkt wird. Da es sich jedoch beim IPS um eine Krankheit handelt, die zum Einen mit motorischen Einschr{\"a}nkungen und resultierend erh{\"o}htem Sturzrisiko einhergeht und zum Anderen vorwiegend Menschen h{\"o}heren Alters betrifft, besteht ein erh{\"o}htes Osteoporose- und sturzbedingtes Frakturrisiko, sodass ein Monitoring des Vitamin D-Serumspiegels sowie eine gegebenenfalls notwendige Vitamin D-Supplementierung weiterhin eine Rolle in der Behandlung von Parkinson-Patienten spielen.}, subject = {Vitamin D-Mangel}, language = {de} } @phdthesis{Pieper2021, author = {Pieper, Sabrina H.}, title = {Temporal information transfer by electrical stimulation in auditory implants}, doi = {10.25972/OPUS-22388}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223887}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {In deafness, which is caused by the malfunctioning of the inner ear, an implantation of a cochlear implant (CI) is able to restore hearing. The CI is a neural prosthesis that is located within the cochlea. It replaces the function of the inner hair cells by direct electrical stimulation of the auditory nerve fibers. The CI enables many deaf or severe hearing-impaired people to achieve a good speech perception. Nevertheless, there is a lot of potential for further improvements. Compared to normal-hearing listeners rate pitch discrimination is much worse. Rate pitch discrimination is the ability to distinguish the pitch of two stimuli with two different pulse rates. This ability is important for enjoying music as well as speech perception (in noise). Further, the small dynamic range in electrical hearing (compared to normal-hearing listeners) and therefore the small intensity resolution limits the performance of CI users. Both, rate pitch coding and dynamic range were investigated in this doctoral thesis. For the first issue, a pitch discrimination task was designed to determine the just-noticeable-difference (JND) in pitch with 200 and 400 pps as reference. Additionally to the default biphasic pulse (single pulse) the experiment was performed with double pulses. The double pulse consists out of two biphasic pulses directly after each other and a small interpulse interval (IPI) in between. Three different IPIs (15, 50, and 150 µs) were tested. The statistical analysis of JNDs revealed no significant effects between stimulation with single-pulse or double-pulse trains. A follow-up study investigated an alternating pulse train consisting of single and double pulses. To investigate if the 400 pps alternating pulse train is comparable in pitch with the 400 pps single-pulse train, a pairwise pitch comparison test was conducted. The alternating pulse train was compared with single-pulse trains at 200, 300 and 400 pps. The results showed that the alternating pulse train is for most subjects similar in pitch with the 200 pps single-pulse train. Therefore, pitch perception seemed to be dominated by the double pulses within the pulse train. Accordingly, double pulses with different amplitudes were tested. Based on the facilitation effect, a larger neuronal response was expected by stimulating with two pulses with a short IPI within the temporal facilitation range. In other studies, this effect was shown to be maximal in CIs of the manufacturer Cochlear, with first pulse amplitudes set at or slightly below the electrically evoked compound action potential (ECAP) threshold. The second pulse amplitude did not influence the facilitation effect and therefore could be choose at will. Similarly, this effect was tested in this thesis with CIs of the manufacturer MED-EL. Nevertheless, to achieve a proper signal-to-noise ratio, technical issues had to be addressed like a high noise floor, resulting in incorrect determination of the ECAP threshold. After solving this issues, the maximum facilitation effect was around the ECAP threshold as in the previous study with Cochlear. For future studies this effect could be used in a modified double pulse rate pitch experiment with the first pulse amplitude at ECAP threshold and the second pulse amplitude variable to set the most comfortable loudness level (MCL). The last study within this thesis investigated the loudness perception at two different loudness levels and the resulting dynamic range for different interphase-gaps (IPG). A larger IPG can reduce the amplitude at same loudness level to save battery power. However, it was unknown if the IPG has an influence on the dynamic range. Different IPGs (10 and 30 µs) were compared with the default IPG (2.1 µs) in a loudness matching experiment. The experiment was performed at the most comfortable loudness level (MCL) of the subject and the amplitude of half the dynamic range (50\%-ADR). An upper dynamic range was calculated from the results of MCL and 50\%-ADR (therefore not the whole dynamic range was covered). As expected from previous studies a larger IPG resulted in smaller amplitudes. However, the observed effect was larger at MCL than at 50\%-ADR which resulted in a smaller upper dynamic range. This is the first time a decrease of this dynamic range was shown.}, subject = {Cochlear-Implantat}, language = {en} } @phdthesis{Krakow2021, author = {Krakow, S{\"o}ren}, title = {CD14-Reexpression definiert einen immunregulatorischen Phänotyp Monozyten-gereifter Zellen nach IL-10/R848-Stimulation}, doi = {10.25972/OPUS-22428}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-224280}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Dendritische Zellen k{\"o}nnen als antigenpr{\"a}sentierende Zellen sowohl immunogene als auch tolerogene Funktionen im Immunsystem wahrnehmen und werden in der Therapie von Tumorerkrankungen und Autoimmunerkrankungen eingesetzt. IL-10 gilt als Induktor tolerogener dendritischer Zellen. Diese werden in der Literatur oft als unreif bezeichnet und stehen im Gegensatz zu den reifen immunogenen dendritischen Zellen, die durch die Expression des Reifungsmarkers CD83 gekennzeichnet sind. Ausdifferenzierte dendritische Zellen exprimieren zudem das Antigen CD86, das der T-Zell-Aktivierung dient. In der vorliegenden Arbeit wurde der Einfluss von IL-10 auf den Reifungsprozess dendritischer Zellen in vitro untersucht. Zur Generierung unreifer dendritischer Zellen wurden humane Monozyten nach etabliertem Protokoll mit IL-4 und GM-CSF stimuliert. Nach anschließender IL-10-Stimulation, insbesondere in Kombination mit einem TLR-Agonisten, bildeten sich zwei exklusive Zellpopulationen: eine CD14+ Population und eine CD83+ Population. Unreife CD14-CD83- dendritische Zellen reexprimierten einerseits CD14 oder exprimierten andererseits CD83. Dabei zeigte sich, dass das kostimulierende Antigen CD86 gleichermaßen sowohl mit als auch ohne IL-10-Inkubation hoch exprimiert wurde und IL-10 folglich keinen zus{\"a}tzlichen Einfluss auf dessen Expression hat. Insgesamt waren Ver{\"a}nderungen bez{\"u}glich der Oberfl{\"a}chenantigene, die bei der Betrachtung der Gesamtheit aller Zellen auffallen, auf eine quantitative Verschiebung der beiden Zellpopulationen zur{\"u}ckzuf{\"u}hren. IL-10 beeinflusst also nicht direkt einzelne kostimulierende oder inhibitorische Molek{\"u}le, sondern beeinflusst den Anteil der CD14+ Zellen gegen{\"u}ber den CD83+ dendritischen Zellen. Funktionell betrachtet zeigten die CD14+ Zellen eine gesteigerte Makropinozytose im Gegensatz zu den reifen CD83+ dendritischen Zellen. Zusammenfassend f{\"u}hrt IL-10 zu einer Reexpression von CD14 auf unreifen dendritischen Zellen und aktiviert einen alternativen Differenzierungsweg. Die CD14+ Zellen weisen einen stabilen immunregulatorischen Ph{\"a}notyp auf und unterscheiden sich somit von reifen dendritischen Zellen, die nach Inkubation mit IL-10 nicht reguliert werden. Damit muss die Begrifflichkeit und Klassifikation tolerogener dendritischer Zellen weiter diskutiert werden.}, subject = {Dendritische Zelle}, language = {de} } @phdthesis{Kuhn2021, author = {Kuhn, Anja}, title = {Rekrutierung von Stromazellen aus gef{\"a}ßwandresidenten Vorl{\"a}uferzellen w{\"a}hrend der Tumorgenese}, doi = {10.25972/OPUS-22431}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-224315}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Tumore bestehen nicht nur aus malignen Zellen, sondern ebenfalls aus einer Vielzahl an nicht tumorigenen Zellen, die den Tumor auf vielf{\"a}ltige Weise unterst{\"u}tzen und den Tumor vor therapeutischen Maßnahmen sch{\"u}tzen. Die Frage der Herkunft dieser Zellen insbesondere in einem nicht vaskularisierten Tumor ist daher auch f{\"u}r die Entwicklung zuk{\"u}nftiger Therapeutika relevant. In dieser Arbeit wurde eine Methode etabliert, die im dreidimensionalen Raum die Untersuchung des Einflusses von Tumorzellen auf die vaskul{\"a}re Adventitia am Model der Mausaorta erm{\"o}glicht. Dazu erfolgte die Einbettung von Alginatbeads aus verschiedenen Tumorzelllinien in eine gemeinsame Kollagenmatrix mit murinen Aortenringen. W{\"a}hrend des zehnt{\"a}gigem Versuchszeitraums wurde die Aussprossung von Zellen aus den Aortenringen beobachtet und quantifiziert. Es wurde festgestellt, dass die Auswanderung w{\"a}hrend des Versuchszeitraums zunimmt und dass die Konfrontation mit der Zytokinmischung der Tumorzellen zu einer st{\"a}rkeren Aussprossung f{\"u}hrt, als die Stimulation mit VEGF oder keine Stimulation. Eine gerichtete Auswanderung der Zellen in Richtung der Tumorbeads konnte nicht nachgewiesen bzw. best{\"a}tigt werden. Kapill{\"a}re Aussprossungen waren nur in geringem Ausmaß zu beobachten. Bei Charakterisierung der ausgewanderten Zellen mittels immunhistochemischer F{\"a}rbungen waren keine F4/80-positiven und nur einzelne CD34-positive Zellen zu finden. CD31-positive Endothelzellen stellten die Mehrheit der ausgewanderten Zellen bei Tumorzellkonfrontation. Perizyten, die mit dem Marker NG2 gef{\"a}rbt wurden, stellten eine Mehrheit der migrierten Zellen bei allen Bedingungen. Die in dieser Arbeit etablierte Methode des Aortenring-Bead-Konfrontationsassays erm{\"o}glicht es, in Echtzeit den Einfluss von Tumorzellen auf die Gef{\"a}ßwand im dreidimensionalen Raum zu beobachten. Der Aortenring-Bead-Konfrontationsassay bietet eine Vielzahl an Variationsm{\"o}glichkeiten und stellt daher eine vielversprechende M{\"o}glichkeit dar, die L{\"u}cke zwischen zweidimensionalen in vitro-Experimenten und kostenintensiven in vivo-Versuchen zu schließen.}, subject = {Stroma}, language = {de} } @phdthesis{Kroeger2021, author = {Kr{\"o}ger, Nils}, title = {Klinische und pedobarographische Ergebnisse nach operativ versorgten Talusfrakturen}, doi = {10.25972/OPUS-22272}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222722}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {We conducted a single-center-study at the Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Wuerzburg with 20 patients after the operative treatment of talar fractures between 2007-2015. Inclusion criteria were a singular, unilateral fracture, no psychiatric comorbidities and >17 years of age. Included were patients with talar neck and body fractures. All patients were treated with screw osteosynthesis. Clinical scores were compiled and the range of motion as well as the pedobarographical performance of each patient was measured. The range of motion of the injured side were significally reduced and correlated with the clinical scores. A higher degree of arthrosis and joint incongruity correlated with poor performance and scores. The degree of the injury correlated with the range of motion as well as the clinical outcome. No significant changes in gait could be found with the pedobarography}, subject = {Talus}, language = {de} } @phdthesis{Panidis2021, author = {Panidis, Theodoros}, title = {Pulssynchrone Ohrger{\"a}usche - Befunderhebung bei einer standardisiert untersuchten Patientengruppe}, doi = {10.25972/OPUS-22277}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222777}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Die Arbeit umfasst die Auswertung der klinischen Daten von 108 konsekutiv am Kopf- und Sch{\"a}delbasis-Zentrum, Klinikum Fulda, zwischen Juli 2013 und September 2015 nachuntersuchten Patienten mit pulssynchronen Ohrger{\"a}uschen. Die Patienten waren gem{\"a}ß eines einheitlichen, strukturierten und routinem{\"a}ßigen Diagnose- und Behandlungspfads untersucht worden. Die notwendige Bildgebung umfasste die Computertomographie, die Magnetresonanztomographie sowie die Magnetresonanzangiographie und die Sonographie der Halsgef{\"a}ße. Eine digitale Subtraktionsangiographie wurde nach strenger Indikationsstellung in ausgew{\"a}hlten F{\"a}llen vorgenommen. Ziel war es, zugrundeliegende Ursachen und Diagnosen f{\"u}r das Symptom pulssynchrones Ohrger{\"a}usch festzumachen. Die erhobenen Befunde wurden je nach Plausibilit{\"a}tsgrad in 4 Gruppen klassifiziert: eindeutig, wahrscheinlich, plausibel, und unklar. Zus{\"a}tzlich erfolgte die Auswertung der angewandten therapeutischen Behandlungsans{\"a}tze und ihrer Ergebnisse. Die h{\"a}ufigsten Ursachen waren ein hochstehender Bulbus der Vena jugularis interna mit 19\%, eine Schleife der Arteria cerebelli inferior anterior im inneren Geh{\"o}rgang mit 15\% gefolgt von einer arterioven{\"o}sen Fistel mit 10\% und Gef{\"a}ßstenosen mit 9\%. Bei ca. 30\% unseres Patientenkollektivs konnte keine Quelle f{\"u}r das pulsierende Ohrger{\"a}usch eruiert werden. Bei 29\% der Patienten konnte die Ursache als eindeutig klassifiziert werden, bei 25\% als plausible Ursache und bei 17\% als wahrscheinlich. Bei den insgesamt 14 Patienten, die entweder eine konservative oder eine interventionell/chirurgische Behandlung erhielten, kam es bei 71\% zu einer Beseitigung des Ohrger{\"a}usches. 5 von 7 Patienten mit einer a.v. Fistel waren, nach einer erfolgreichen endovaskul{\"a}ren Intervention, postoperativ beschwerdefrei. Eine angioplastische Intervention mittels Stenting f{\"u}hrte bei zwei Patienten mit einer ACI Stenose (>70\%) zur Beseitigung des Ohrger{\"a}usches. Jeweils ein Patient profitierte von der Behandlung einer Bogengangsdehiszenz, einer intrakraniellen Hypertension sowie einer chirurgischen Sanierung eines Paraganglioms, nach vorgegangener endovaskul{\"a}rer Embolisation, mit der daraus resultierenden Ausl{\"o}schung des Ohrger{\"a}usches. Bei den restlichen Patienten persistierte es trotz Behandlung. Ein pulssynchrones Ohrger{\"a}usch hat viele {\"a}ußerst unterschiedliche Ursachen. F{\"u}r eine sachgerechte Evaluation und ad{\"a}quate Behandlung von Patienten mit pulssynchronem Ohrger{\"a}usch ist eine enge multidisziplin{\"a}re Zusammenarbeit unabdingbar. Eine eindeutige Diagnose kann oft nur gestellt werden, wenn alle klinischen sowie alle bildmorphologischen Befunde, die auf einem einheitlichen, routinem{\"a}ßigen Untersuchungsprotokoll basieren, zusammengetragen und kritisch abgestimmt werden.}, subject = {Ohrger{\"a}usch}, language = {de} } @phdthesis{MuellerScholden2021, author = {M{\"u}ller-Scholden, Lara}, title = {Einfluss spezifischer kardiovaskul{\"a}rer Risikofaktoren und ihrer Kombination auf die Karotis-Intima-Media-Dicke und Erstellung von Normwerten - Ergebnisse der STAAB Kohortenstudie}, doi = {10.25972/OPUS-22029}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-220292}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Primary prevention in cardiovascular diseases is becoming more and more important as they are still the number one cause of morbidity and mortality in industrialized countries. Many cardiovascular events may even occur in clinically asymptomatic patients. The atherosclerosis as underlying pathogenesis is increasingly well understood and risk factors with a harmful influence are identified. However, by measuring the carotid-intima-media-thickness (CIMT) via B-mode ultrasound there is a widely accepted, safe, noninvasive, sensitive and reproducible technique to assess subclinical vascular diseases. The CIMT is established as a surrogate marker for atherosclerosis and its increase is associated with the presence of cardiovascular risk factors. The basic prerequisite for further risk stratification, according to the level of arteriosclerosis represented by the CIMT, is to define gender-, age- and region-specific reference values. The latest version of the international guidelines for cardiovascular risk prediction do no longer recommend the use of CIMT for cardiovascular risk prediction in the general population. This may be attributed to the fact, that the experts refer to studies in which only the measurement of a single segment was considered. Thus the aim of the present study was to assess a potential segment-specific impact of particular cardiovascular risk factors on the CIMT. Furthermore the goal was to evaluate the relevance of the existing models for risk prediction and to discuss the current recommendations for the use of CIMT. Additionally, reference values were developed from data of a representative group of the general population of W{\"u}rzburg and the reproducibility of the data collection was examined. Subjects derived from the population-based STAAB (Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression) cohort study, that included people of the general population of W{\"u}rzburg aged 30 to 79 years [12]. CIMT was measured on the far wall of both sides in three different predefined locations: common carotid artery (CCA), bulb, and internal carotid artery (ICA). Diabetes, dyslipidemia, hypertension, smoking and obesity were considered as risk factors. In multivariable logistic regression analysis, odds ratios of risk factors per location were estimated for the endpoint of individual age- and sex-adjusted 75th percentile of CIMT. These thresholds were derived from the standard values of the general population. An apparently healthy subpopulation was formed to generate these reference values, which consists only of people that did not exhibit any of the above mentioned risk factors or manifest cardiovascular diseases. 2492 subjects were included in the analysis. Segment-specific CIMT was highest in the bulb, followed by CCA, and lowest in the ICA. The reproducibility between the investigators was overall weaker than in comparable studies, therefore a potential improvement of the training protocol for inexperienced persons was assumed. Moreover, the results of the reproducibility analysis illustrate the need for a standardized, internationally recognized protocol for the training of CIMT investigators and an exact measurement protocol. The reference values of the apparently healthy population were consistent with values from other authors collected in a comparable way and formed the basis for further investigations. CIMT increases with age and independently with the number of risk factors. Dyslipidemia, hypertension, and smoking were associated with higher CIMT, but diabetes and obesity were not (OR (95\% CI) between 1.28 (0.98 - 1.65), ACC, and 1.86 (1.53 - 2.27), bulb). We observed no segment-specific association between the three different locations and risk factors, except for a possible interaction between smoking and ICA. As no segment-specific association between cardiovascular risk factors and CIMT became evident, one simple measurement of one location may suffice to assess the cardiovascular risk of an individual. In addition, the identified risk factors are reflected in the current models for risk prediction and prevention, so that the added value of the use of CIMT in the general population loses importance.}, subject = {Arteriosklerose}, language = {de} } @phdthesis{Weiss2021, author = {Weiß, Neele}, title = {Bedeutung des MEK5/ERK5-Signalwegs in der zielgerichteten Melanomtherapie}, doi = {10.25972/OPUS-21907}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219073}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {In dieser Dissertation wird der MEK5/ERK5- Signalweg als m{\"o}glicher Angriffspunkt in der zielgerichteten Melanomtherapie identifiziert. Die Adressierung von ERK5 bietet eine Alternative, um einer Resistenzentwicklung gegen{\"u}ber Inhibitoren des MAPK- Signalwegs entgegenzuwirken. Das maligne Melanom ist ein hochaggressiver Tumor mit steigender Inzidenz. Zunehmende Sonnenstunden im Rahmen des Klimawandels mit erh{\"o}hter Belastung der Haut durch UV-Strahlung werden die Problematik des malignen Melanoms f{\"u}r den Menschen in den n{\"a}chsten Jahren weiter zunehmen lassen. Die Aktivierung des MEK5/ERK5- Signalwegs scheint eine Reaktion von Tumorzellen auf Therapiestress zu sein. Diese Aktivierung liefert den Melanomzellen einen {\"U}berlebensvorteil und verhindert ein langfristiges Therapieansprechen. ERK5 beeinflusst den Zellzyklus von Melanomzellen und ist somit m{\"o}glicherweise von wichtiger Bedeutung in der Tumorgenese des malignen Melanoms. Patienten mit NRAS- Mutation profitieren auffallend weniger von einer gezielten MEKi-Therapie als solche mit BRAF Mutation. F{\"u}r ersteres Patientenkollektiv steht aktuell lediglich die Immuntherapie zur Verf{\"u}gung, wodurch oft nur ein kurzes, progressionsfreies Intervall erreicht werden kann und die Patienten h{\"a}ufig unter schweren Nebenwirkungen leiden. Grund f{\"u}r die problematische Behandlung k{\"o}nnte das h{\"a}ufige Auftreten einer basalen ERK5- Aktivierung in NRAS- mutierten Melanomen sein. Diese Arbeit liefert eine positive Prognose {\"u}ber den Nutzen einer ERK5- Inhibition als Erweiterung des Therapieschemas. Diese These gilt auch f{\"u}r Melanompatienten mit einer BRAF- Mutation. Patienten, die an einem malignen Melanom erkrankt sind, weisen zu 80\% eine Mutation in einem dieser beschriebenen Onkogene auf. Die Arbeit l{\"a}sst darauf schließen, dass eine ERK5- Inhibition in der Therapie von beiden Gruppen erfolgreich sein k{\"o}nnte und somit das Leben nahezu aller Melanompatienten betrifft.}, subject = {Melanom}, language = {de} } @phdthesis{Sorour2021, author = {Sorour, Ahmed Tarek Ali Ibrahim}, title = {Endovaskul{\"a}re Interventionen in der Behandlung der Epistaxis}, doi = {10.25972/OPUS-21917}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219179}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Trotz hoher Erfolgsrate und niedriger Komplikationsrate der arteriographischen Embolisation bei der Nasenblutung kommt diese Behandlungsmethode in vielen Institutionen nicht als Standard-Maßnahme im klinischen Kontext zum Einsatz und wird nur als alternativ im Falle eines Scheiterns der chirurgischen arteriellen Clippung in der Blutstillung eingesetzt. In der vorliegenden retrospektiven Arbeit wurden am Kopf- und Sch{\"a}delbasiszentrum des Klinikums Fulda die Effizienz und die Sicherheit der perkutanen Embolisation der A. sphenopalatina mit Polyvinylalkohol-Partikeln (150-250 µm) in der Behandlung, der mit konservativen Maßnahmen refrakt{\"a}ren Epistaxis untersucht. Methode: Retrospektive Analyse von 99 Patienten, die von Januar 2001 bis Dezember 2018 bei refrakt{\"a}rer, idiopathisch klassifizierter Epistaxis durch eine arteriographische endovaskul{\"a}re Embolisation behandelt wurden. Ergebnisse: Es wurden innerhalb des Berichtszeitraums insgesamt 100 Embolisationen bei Epistaxis durchgef{\"u}hrt. Nach Ausschluss von 2 Prozeduren mit bekannten Blutungsursachen wurden 98 Embolisationen bei 95 Patienten mit idiopathischer Epistaxis ausgewertet. Trotz technisch erfolgreicher Intervention in 95\% der F{\"a}lle, war die Blutung in 81,6\% der F{\"a}lle zu stillen. Leichte Komplikationen traten in 5\% der F{\"a}lle auf. Schwere Komplikationen dagegen wurden in keinem einzigen Fall erfasst. Schlussfolgerung: Das Ergebnis dieser Untersuchung best{\"a}tigt die Rolle der angiografischen Embolisation der A. sphenopalatina sowohl als einer erfolgreichen, als auch als einer sicheren Methode in der Behandlung der konservativ refrakt{\"a}ren Epistaxis. Aufgrund der geringen Invasivit{\"a}t, hohen Erfolgsrate und niedrigen Komplikationsrate sollte die transkutane Embolisation als Standard-Therapie nach dem Scheitern der konservativen Maßnahmen zur Blutstillung einer Epistaxis zum Einsatz kommen. Die chirurgische Blutstillung durch die arterielle Clippung sollte nur im Falle eines Misserfolgs der Embolisation als Verfahren der zweiten Wahl bei der Blutstillung eingesetzt werden.}, subject = {Nasenbluten}, language = {de} } @phdthesis{Waltermann2021, author = {Waltermann, Leopold-Maximilian Johannes}, title = {Charakterisierung und Standardisierung eines in-vitro Modells der oralen Mukosa f{\"u}r die pr{\"a}klinische Forschung}, doi = {10.25972/OPUS-22203}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222032}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Bisherige per Tissue Engineering hergestellte Testsysteme der Mundschleimhaut basieren in der Regel auf allogenen und teils dysplastischen Keratinozyten. Dies schm{\"a}lert die Aussagekraft der gewonnenen Ergebnisse hinsichtlich des Anspruchs, Nativgewebe bestm{\"o}glich nachzubilden. In der vorliegenden Arbeit sollte daher ein am Lehrstuhl f{\"u}r Tissue Engineering und Regenerative Medizin entwickeltes Protokoll zur Herstellung dreidimensionaler epidermaler Oralmukosa{\"a}quivalente auf Basis autologer Keratinozyten auf seine Eigenschaften und Einsatzm{\"o}glichkeit als in-vitro Testsystem untersucht werden. Nach erfolgreicher Isolierung und Kultivierung im Monolayer konnten insgesamt 420 Modelle zu drei verschiedenen Zeitpunkten (Passagen) aufgebaut werden. Die Untersuchung von Histologie, Viabilit{\"a}t und Barrierefunktion mittels MTT, TEER und Natriumfluoresceinpermeabilit{\"a}t konnte einen suffizienten Aufbau von verhorntem, mehrschichtigen oralen Plattenepithel nachweisen. Gleichzeitig konnte eine Abnahme der Epithelqualit{\"a}t mit steigendem Keratinozytenalter festgestellt werden. Eine sich anschließende Untersuchung von 14 Cytokeratinen sowie Apoptosemarkern per effizienzkorrigierter und normalisierter RT-qPCR konnte die {\"U}berlegenheit der dreidimensionalen autologen Oralmukosa{\"a}quivalente gegen{\"u}ber der zweidimensionalen Monolayerkultur auf Genebene zeigen.}, subject = {Tissue Engineering}, language = {de} } @phdthesis{Fischer2021, author = {Fischer, Gregor}, title = {Navigations- und Ultraschallgest{\"u}tzte Punktion der Leistenarterie beim transfemoralen Aortenklappenersatz}, doi = {10.25972/OPUS-23158}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-231586}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Transcatheter aortic valve replacement (TAVR) is an established procedure for treatment of aortic stenosis. In transfemoral TAVR local vascular complications at the puncture site are still an important issue and responsible for the majority of complications. To ensure safe puncture in a non-calcified vessel segment a new navigation technique with ultrasound guidance has been developed. We compared 67 consecutive patients undergoing TAVR using our new approach with 67 patients with fluoroscopic punction.}, subject = {Aortenklappenersatz}, language = {de} }