TY  - JOUR
A1  - Neuhaus, Winfried
A1  - Samwer, Fabian
A1  - Kunzmann, Steffen
A1  - Muellenbach, Ralph
A1  - Wirth, Michael
A1  - Speer, Christian P.
A1  - Roewer, Norbert
A1  - Förster, Carola
T1  - Lung endothelial cells strengthen, but brain endothelial cells weaken barrier properties of a human alveolar epithelium cell culture model
JF  - Differentiation
N2  - The blood-air barrier in the lung consists of the alveolar epithelium, the underlying capillary endothelium, their basement membranes and the interstitial space between the cell layers. Little is known about the interactions between the alveolar and the blood compartment. The aim of the present study was to gain first insights into the possible interplay between these two neighboured cell layers. We established an in vitro Transwell model of the alveolar epithelium based on human cell line H441 and investigated the influence of conditioned medium obtained from human lung endothelial cell line HPMEC-ST1.6R on the barrier properties of the H441 layers. As control for tissue specificity H441 layers were exposed to conditioned medium from human brain endothelial cell line hCMEC/D3. Addition of dexamethasone was necessary to obtain stable H441 cell layers. Moreover, dexamethasone increased expression of cell type I markers (caveolin-1, RAGE) and cell type II marker SP-B, whereas decreased the transepithelial electrical resistance (TEER) in a concentration dependent manner. Soluble factors obtained from the lung endothelial cell line increased the barrier significantly proven by TEER values and fluorescein permeability on the functional level and by the differential expression of tight junctional proteins on the molecular level. In contrast to this, soluble factors derived from brain endothelial cells weakened the barrier significantly. In conclusion, soluble factors from lung endothelial cells can strengthen the alveolar epithelium barrier in vitro, which suggests communication between endothelial and epithelial cells regulating the integrity of the blood-air barrier.
KW  - alveolar epithelium in vitro model, claudin-1, claudin-3, claudin-4, claudin-5
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-90284
UR  - http://www.sciencedirect.com/science/article/pii/S0301468112001144
VL  - 84
IS  - 4
ER  - 
TY  - JOUR
A1  - Kredel, Markus
A1  - Kunzmann, Steffen
A1  - Schlegel, Paul-Gerhardt
A1  - Wölfl, Matthias
A1  - Nordbeck, Peter
A1  - Bühler, Christoph
A1  - Lotz, Christopher
A1  - Lepper, Philipp M.
A1  - Wirbelauer, Johannes
A1  - Roewer, Norbert
A1  - Muellenbach, Ralf M.
T1  - Double Peripheral Venous and Arterial Cannulation for Extracorporeal Membrane Oxygenation in Combined Septic and Cardiogenic Shock
JF  - American Journal of Case Reports
N2  - Background: 
The use of venoarterial extracorporeal membrane oxygenation (va-ECMO) via peripheral cannulation for septic shock is limited by blood flow and increased afterload for the left ventricle.

Case Report: 
A 15-year-old girl with acute myelogenous leukemia, suffering from severe septic and cardiogenic shock, was treated by venoarterial extracorporeal membrane oxygenation (va-ECMO). Sufficient extracorporeal blood flow matching the required oxygen demand could only be achieved by peripheral cannulation of both femoral arteries. Venous drainage was performed with a bicaval cannula inserted via the left V. femoralis. To accomplish left ventricular unloading, an additional drainage cannula was placed in the left atrium via percutaneous atrioseptostomy (va-va-ECMO). Cardiac function recovered and the girl was weaned from the ECMO on day 6. Successful allogenic stem cell transplantation took place 2 months later.

Conclusions: 
In patients with vasoplegic septic shock and impaired cardiac contractility, double peripheral venoarterial extracorporeal membrane oxygenation (va-va-ECMO) with transseptal left atrial venting can by a lifesaving option.
KW  - extracorporeal membrane oxygenation
KW  - myeloid
KW  - leukemia
KW  - acute
KW  - shock
KW  - cardiogenic
KW  - septic
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158193
VL  - 18
ER  -