@article{AssfalgSeligTolksdorfetal.2020, author = {Assfalg, Volker and Selig, Katharina and Tolksdorf, Johanna and van Meel, Marieke and de Vries, Erwin and Ramsoebhag, Anne-Marie and Rahmel, Axel and Renders, Lutz and Novotny, Alexander and Matevossian, Edouard and Schneeberger, Stefan and Rosenkranz, Alexander R. and Berlakovich, Gabriela and Ysebaert, Dirk and Knops, No{\"e}l and Kuypers, Dirk and Weekers, Laurent and Muehlfeld, Anja and Rump, Lars-Christian and Hauser, Ingeborg and Pisarski, Przemyslaw and Weimer, Rolf and Fornara, Paolo and Fischer, Lutz and Kliem, Volker and Sester, Urban and Stippel, Dirk and Arns, Wolfgang and Hau, Hans-Michael and Nitschke, Martin and Hoyer, Joachim and Thorban, Stefan and Weinmann-Menke, Julia and Heller, Katharina and Banas, Bernhard and Schwenger, Vedat and Nadalin, Silvio and Lopau, Kai and H{\"u}ser, Norbert and Heemann, Uwe}, title = {Repeated kidney re-transplantation—the Eurotransplant experience: a retrospective multicenter outcome analysis}, series = {Transplant International}, volume = {33}, journal = {Transplant International}, number = {6}, doi = {10.1111/tri.13569}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214161}, pages = {617 -- 631}, year = {2020}, abstract = {In Eurotransplant kidney allocation system (ETKAS), candidates can be considered unlimitedly for repeated re-transplantation. Data on outcome and benefit are indeterminate. We performed a retrospective 15-year patient and graft outcome data analysis from 1464 recipients of a third or fourth or higher sequential deceased donor renal transplantation (DDRT) from 42 transplant centers. Repeated re-DDRT recipients were younger (mean 43.0 vs. 50.2 years) compared to first DDRT recipients. They received grafts with more favorable HLA matches (89.0\% vs. 84.5\%) but thereby no statistically significant improvement of patient and graft outcome was found as comparatively demonstrated in 1st DDRT. In the multivariate modeling accounting for confounding factors, mortality and graft loss after 3rd and ≥4th DDRT (P < 0.001 each) and death with functioning graft (DwFG) after 3rd DDRT (P = 0.001) were higher as compared to 1st DDRT. The incidence of primary nonfunction (PNF) was also significantly higher in re-DDRT (12.7\%) than in 1st DDRT (7.1\%; P < 0.001). Facing organ shortage, increasing waiting time, and considerable mortality on dialysis, we question the current policy of repeated re-DDRT. The data from this survey propose better HLA matching in first DDRT and second DDRT and careful selection of candidates, especially for ≥4th DDRT.}, language = {en} } @article{WeibelBasseLuesebrinkHessetal.2013, author = {Weibel, Stephanie and Basse-Luesebrink, Thomas Christian and Hess, Michael and Hofmann, Elisabeth and Seubert, Carolin and Langbein-Laugwitz, Johanna and Gentschev, Ivaylo and Sturm, Volker J{\"o}rg Friedrich and Ye, Yuxiang and Kampf, Thomas and Jakob, Peter Michael and Szalay, Aladar A.}, title = {Imaging of Intratumoral Inflammation during Oncolytic Virotherapy of Tumors by \(^{19}\)F-Magnetic Resonance Imaging (MRI)}, series = {PLoS ONE}, volume = {8}, journal = {PLoS ONE}, number = {3}, doi = {10.1371/journal.pone.0056317}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130311}, pages = {e56317}, year = {2013}, abstract = {Background Oncolytic virotherapy of tumors is an up-coming, promising therapeutic modality of cancer therapy. Unfortunately, non-invasive techniques to evaluate the inflammatory host response to treatment are rare. Here, we evaluate \(^{19}\)F magnetic resonance imaging (MRI) which enables the non-invasive visualization of inflammatory processes in pathological conditions by the use of perfluorocarbon nanoemulsions (PFC) for monitoring of oncolytic virotherapy. Methodology/Principal Findings The Vaccinia virus strain GLV-1h68 was used as an oncolytic agent for the treatment of different tumor models. Systemic application of PFC emulsions followed by \(^1H\)/\(^{19}\)F MRI of mock-infected and GLV-1h68-infected tumor-bearing mice revealed a significant accumulation of the \(^{19}\)F signal in the tumor rim of virus-treated mice. Histological examination of tumors confirmed a similar spatial distribution of the \(^{19}\)F signal hot spots and \(CD68^+\)-macrophages. Thereby, the \(CD68^+\)-macrophages encapsulate the GFP-positive viral infection foci. In multiple tumor models, we specifically visualized early inflammatory cell recruitment in Vaccinia virus colonized tumors. Furthermore, we documented that the \(^{19}\)F signal correlated with the extent of viral spreading within tumors. Conclusions/Significance These results suggest \(^{19}\)F MRI as a non-invasive methodology to document the tumor-associated host immune response as well as the extent of intratumoral viral replication. Thus, \(^{19}\)F MRI represents a new platform to non-invasively investigate the role of the host immune response for therapeutic outcome of oncolytic virotherapy and individual patient response.}, language = {en} } @article{StanglHaasEichneretal.2020, author = {Stangl, Stephanie and Haas, Kirsten and Eichner, Felizitas A. and Grau, Anna and Selig, Udo and Ludwig, Timo and Fehm, Tanja and St{\"u}bner, Tanja and Rashid, Asarnusch and Kerscher, Alexander and Bargou, Ralf and Hermann, Silke and Arndt, Volker and Meyer, Martin and Wildner, Manfred and Faller, Hermann and Schrauder, Michael G. and Weigel, Michael and Schlembach, Ulrich and Heuschmann, Peter U. and W{\"o}ckel, Achim}, title = {Development and proof-of-concept of a multicenter, patient-centered cancer registry for breast cancer patients with metastatic disease — the "Breast cancer care for patients with metastatic disease" (BRE-4-MED) registry}, series = {Pilot and Feasibility Studies}, volume = {6}, journal = {Pilot and Feasibility Studies}, doi = {10.1186/s40814-019-0541-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229149}, year = {2020}, abstract = {Background: Patients with metastatic breast cancer (MBC) are treated with a palliative approach with focus oncontrolling for disease symptoms and maintaining high quality of life. Information on individual needs of patients andtheir relatives as well as on treatment patterns in clinical routine care for this specific patient group are lacking or arenot routinely documented in established Cancer Registries. Thus, we developed a registry concept specifically adaptedfor these incurable patients comprising primary and secondary data as well as mobile-health (m-health) data. Methods: The concept for patient-centered "Breast cancer care for patients with metastatic disease"(BRE-4-MED)registry was developed and piloted exemplarily in the region of Main-Franconia, a mainly rural region in Germanycomprising about 1.3 M inhabitants. The registry concept includes data on diagnosis, therapy, progression, patient-reported outcome measures (PROMs), and needs of family members from several sources of information includingroutine data from established Cancer Registries in different federal states, treating physicians in hospital as well as inoutpatient settings, patients with metastatic breast cancer and their family members. Linkage with routine cancerregistry data was performed to collect secondary data on diagnosis, therapy, and progression. Paper and online-basedquestionnaires were used to assess PROMs. A dedicated mobile application software (APP) was developed to monitorneeds, progression, and therapy change of individual patients. Patient's acceptance and feasibility of data collection inclinical routine was assessed within a proof-of-concept study. Results: The concept for the BRE-4-MED registry was developed and piloted between September 2017 and May 2018.In total n= 31 patients were included in the pilot study, n= 22 patients were followed up after 1 month. Recordlinkage with the Cancer Registries of Bavaria and Baden-W{\"u}rttemberg demonstrated to be feasible. The voluntary APP/online questionnaire was used by n= 7 participants. The feasibility of the registry concept in clinical routine waspositively evaluated by the participating hospitals. Conclusion: The concept of the BRE-4-MED registry provides evidence that combinatorial evaluation of PROMs, needsof family members, and raising clinical parameters from primary and secondary data sources as well as m-healthapplications are feasible and accepted in an incurable cancer collective.}, language = {en} } @article{SchmidtSticherlingSardyetal.2020, author = {Schmidt, Enno and Sticherling, Michael and S{\´a}rdy, Mikl{\´o}s and Eming, R{\"u}diger and Goebeler, Matthias and Hertl, Michael and Hofmann, Silke C. and Hunzelmann, Nicolas and Kern, Johannes S. and Kramer, Harald and Nast, Alexander and Orzechowski, Hans-Dieter and Pfeiffer, Christiane and Schuster, Volker and Sitaru, Cassian and Zidane, Miriam and Zillikens, Detlef and Worm, Margitta}, title = {S2k guidelines for the treatment of pemphigus vulgaris/foliaceus and bullous pemphigoid: 2019 update}, series = {JDDG: Journal der Deutschen Dermatologischen Gesellschaft}, volume = {18}, journal = {JDDG: Journal der Deutschen Dermatologischen Gesellschaft}, number = {5}, doi = {10.1111/ddg.14097}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-217806}, pages = {516 -- 526}, year = {2020}, language = {en} } @article{KramerBinningerSchirrmacheretal.1986, author = {Kramer, Michael D. and Binninger, Linda and Schirrmacher, Volker and Moll, Heidrun and Prester, Marlot and Nerz, Gaby and Simon, Markus M.}, title = {Characterization and isolation of a trypsin-like serine protease from a long-term culture cytolytic t cell line andits expression by functionally distinct T cells}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-31636}, year = {1986}, abstract = {No abstract available}, subject = {Biologie}, language = {en} } @article{BrueningWehnerHausneretal.2016, author = {Br{\"u}ning, Christoph and Wehner, Johannes and Hausner, Julian and Wenzel, Michael and Engel, Volker}, title = {Exciton dynamics in perturbed vibronic molecular aggregates}, series = {Structural Dynamics}, volume = {3}, journal = {Structural Dynamics}, doi = {10.1063/1.4936127}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126085}, pages = {043201}, year = {2016}, abstract = {A site specific perturbation of a photo-excited molecular aggregate can lead to a localization of excitonic energy. We investigate this localization dynamics for laser-prepared excited states. Changing the parameters of the electric field significantly influences the exciton localization which offers the possibility for a selective control of this process. This is demonstrated for aggregates possessing a single vibrational degree of freedom per monomer unit. It is shown that the effects identified for the molecular dimer can be generalized to larger aggregates with a high density of vibronic states.}, language = {en} } @article{FrantzKlaiberBabaetal.2013, author = {Frantz, Stefan and Klaiber, Michael and Baba, Hideo A. and Oberwinkler, Heinz and V{\"o}lker, Katharina and Gaßner, Birgit and Bayer, Barbara and Abeßer, Marco and Schuh, Kai and Feil, Robert and Hofmann, Franz and Kuhn, Michaela}, title = {Stress-dependent dilated cardiomyopathy in mice with cardiomyocyte-restricted inactivation of cyclic GMP-dependent protein kinase I}, series = {European Heart Journal}, volume = {34}, journal = {European Heart Journal}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-134693}, pages = {1233-1244}, year = {2013}, abstract = {Aims: Cardiac hypertrophy is a common and often lethal complication of arterial hypertension. Elevation of myocyte cyclic GMP levels by local actions of endogenous atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) or by pharmacological inhibition of phosphodiesterase-5 was shown to counter-regulate pathological hypertrophy. It was suggested that cGMP-dependent protein kinase I (cGKI) mediates this protective effect, although the role in vivo is under debate. Here, we investigated whether cGKI modulates myocyte growth and/or function in the intact organism. Methods and results: To circumvent the systemic phenotype associated with germline ablation of cGKI, we inactivated the murine cGKI gene selectively in cardiomyocytes by Cre/loxP-mediated recombination. Mice with cardiomyocyte-restricted cGKI deletion exhibited unaltered cardiac morphology and function under resting conditions. Also, cardiac hypertrophic and contractile responses to β-adrenoreceptor stimulation by isoprenaline (at 40 mg/kg/day during 1 week) were unaltered. However, angiotensin II (Ang II, at 1000 ng/kg/min for 2 weeks) or transverse aortic constriction (for 3 weeks) provoked dilated cardiomyopathy with marked deterioration of cardiac function. This was accompanied by diminished expression of the \([Ca^{2+}]_i\)-regulating proteins SERCA2a and phospholamban (PLB) and a reduction in PLB phosphorylation at Ser16, the specific target site for cGKI, resulting in altered myocyte \(Ca^{2+}_i\) homeostasis. In isolated adult myocytes, CNP, but not ANP, stimulated PLB phosphorylation, \(Ca^{2+}_i\)-handling, and contractility via cGKI. Conclusion: These results indicate that the loss of cGKI in cardiac myocytes compromises the hypertrophic program to pathological stimulation, rendering the heart more susceptible to dysfunction. In particular, cGKI mediates stimulatory effects of CNP on myocyte \(Ca^{2+}_i\) handling and contractility.}, language = {en} } @article{WiegeringIsbertDietzetal.2014, author = {Wiegering, Armin and Isbert, Christoph and Dietz, Ulrich A. and Kunzmann, Volker and Ackermann, Sabine and Kerscher, Alexander and Maeder, Uwe and Flentje, Michael and Schlegel, Nicolas and Reibetanz, Joachim and Germer, Christoph-Thomas and Klein, Ingo}, title = {Multimodal therapy in treatment of rectal cancer is associated with improved survival and reduced local recurrence - a retrospective analysis over two decades}, doi = {10.1186/1471-2407-14-816}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110606}, year = {2014}, abstract = {Background The management of rectal cancer (RC) has substantially changed over the last decades with the implementation of neoadjuvant chemoradiotherapy, adjuvant therapy and improved surgery such as total mesorectal excision (TME). It remains unclear in which way these approaches overall influenced the rate of local recurrence and overall survival. Methods Clinical, histological and survival data of 658 out of 662 consecutive patients with RC were analyzed for treatment and prognostic factors from a prospectively expanded single-institutional database. Findings were then stratified according to time of diagnosis in patient groups treated between 1993 and 2001 and 2002 and 2010. Results The study population included 658 consecutive patients with rectal cancer between 1993 and 2010. Follow up data was available for 99.6\% of all 662 treated patients. During the time period between 2002 and 2010 significantly more patients underwent neoadjuvant chemoradiotherapy (17.6\% vs. 60\%) and adjuvant chemotherapy (37.9\% vs. 58.4\%). Also, the rate of reported TME during surgery increased. The rate of local or distant metastasis decreased over time, and tumor related 5-year survival increased significantly with from 60\% to 79\%. Conclusion In our study population, the implementation of treatment changes over the last decade improved the patient's outcome significantly. Improvements were most evident for UICC stage III rectal cancer.}, language = {en} } @article{WeberScholzDomschkeetal.2012, author = {Weber, Heike and Scholz, Claus J{\"u}rgen and Domschke, Katharina and Baumann, Christian and Klauke, Benedikt and Jacob, Christian P. and Maier, Wolfgang and Fritze, J{\"u}rgen and Bandelow, Borwin and Zwanzger, Peter Michael and Lang, Thomas and Fehm, Lydia and Str{\"o}hle, Andreas and Hamm, Alfons and Gerlach, Alexander L. and Alpers, Georg W. and Kircher, Tilo and Wittchen, Hans-Ulrich and Arolt, Volker and Pauli, Paul and Deckert, J{\"u}rgen and Reif, Andreas}, title = {Gender Differences in Associations of Glutamate Decarboxylase 1 Gene (GAD1) Variants with Panic Disorder}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75830}, year = {2012}, abstract = {Background: Panic disorder is common (5\% prevalence) and females are twice as likely to be affected as males. The heritable component of panic disorder is estimated at 48\%. Glutamic acid dehydrogenase GAD1, the key enzyme for the synthesis of the inhibitory and anxiolytic neurotransmitter GABA, is supposed to influence various mental disorders, including mood and anxiety disorders. In a recent association study in depression, which is highly comorbid with panic disorder, GAD1 risk allele associations were restricted to females. Methodology/Principal Findings: Nineteen single nucleotide polymorphisms (SNPs) tagging the common variation in GAD1 were genotyped in two independent gender and age matched case-control samples (discovery sample n = 478; replication sample n = 584). Thirteen SNPs passed quality control and were examined for gender-specific enrichment of risk alleles associated with panic disorder by using logistic regression including a genotype6gender interaction term. The latter was found to be nominally significant for four SNPs (rs1978340, rs3762555, rs3749034, rs2241165) in the discovery sample; of note, the respective minor/risk alleles were associated with panic disorder only in females. These findings were not confirmed in the replication sample; however, the genotype6gender interaction of rs3749034 remained significant in the combined sample. Furthermore, this polymorphism showed a nominally significant association with the Agoraphobic Cognitions Questionnaire sum score. Conclusions/Significance: The present study represents the first systematic evaluation of gender-specific enrichment of risk alleles of the common SNP variation in the panic disorder candidate gene GAD1. Our tentative results provide a possible explanation for the higher susceptibility of females to panic disorder.}, subject = {Medizin}, language = {en} } @phdthesis{Voelker2013, author = {V{\"o}lker, Michael}, title = {Entwicklung, Charakterisierung und Anwendung neuer In-vitro-Methoden zur Untersuchung des Fremdstoffmetabolismus und der Inhibition fremdstoffmetabolisierender Enzyme}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-99434}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {Arzneistoffe werden nach ihrer Applikation durch verschiedene fremdstoff-metabolisierende Enzyme des Organismus biochemisch ver{\"a}ndert. Durch eine Hemmung dieser Enzyme, z. B. durch Grapefruitsaft oder einen gleichzeitig eingenommenen Arzneistoff, kann es insbesondere bei Arzneistoffen mit geringer therapeutischer Breite, wie z. B. Theophyllin oder Phenprocoumon, zu gef{\"a}hrlichen Nebenwirkungen kommen. Besonders gef{\"a}hrdet sind multimorbide Patienten, die eine Therapie mit einer Vielzahl von Arzneimitteln erhalten. Um den Metabolismus von neuen Wirkstoffen und deren Interaktionspotential zu untersuchen, werden u. a. In-vitro-Experimente mit Zellfraktionen oder einzelnen Enzymen durchgef{\"u}hrt. Bei Inhibitionsassays wird der Einfluss von Arzneistoffen auf die Umsetzung eines Testsubstrates untersucht. Ein Großteil dieser Arbeit besch{\"a}ftigt sich daher mit der Entwicklung von Methoden, mit denen die Inhibition wichtiger fremd-stoffmetabolisierender Enzyme, wie Cytochrom-P450-Enzyme (CYP-Enzyme), Glutathion-S-Transferasen (GSTs) und Carboxylesterasen (CES), untersucht werden kann. Dabei wurde auch eine Charakterisierung der Testsubstrate vorgenommen. Dar{\"u}ber hinaus wurden die Bioaktivierung von Clopidogrel und die Bildung von reaktiven Metaboliten untersucht. Aufgrund aktueller Diskussionen {\"u}ber die Interaktion zwischen Clopidogrel und Omeprazol wurde in dieser Arbeit die Bioaktivierung von Clopidogrel mit Hilfe von LC/MS/MS-Analysen und rekombinanten CYP-Enzymen sowie humanen Lebermikrosomen untersucht. Aufgrund der Instabilit{\"a}t des aktiven Metaboliten wurde in den inkubierten Proben eine Derivatisierung mit Dimedon durchgef{\"u}hrt. Die Untersuchungen zeigten, dass die Umwandlung zum 2-Oxo-Clopidogrel durch mehrere CYP-Enzyme erfolgt. Neben CYP2C19 sind CYP1A2, CYP2B6, CYP2C9 und CYP3A4 beteiligt. Anhand von selektiven Inhibitoren konnte CYP3A4 f{\"u}r die Bildung des aktiven Metaboliten aus 2-Oxo-Clopidogrel identifiziert werden. Neben der Biotransformation durch CYP-Enzyme wird haupts{\"a}chlich der Carbons{\"a}ureester des Clopidogrels hydrolysiert. Untersuchungen mit humanen Subzellfraktionen und rekombinanten Carboxylesterasen zeigen, dass die Esterhydrolyse durch CES1 katalysiert wird. Des Weiteren wurde der Metabolismus von Omeprazol untersucht. Es stellte sich heraus, dass die 5-Hydroxylierung und die 5-O-Demethylierung haupts{\"a}chlich durch CYP2C19 und CYP2D6 erfolgen. Dabei besitzt Omeprazol die h{\"o}chste Affinit{\"a}t zu CYP2C19. Die Bildung von Omeprazolsulfon wird hingegen nur durch CYP3A4 katalysiert. Mit Hilfe etablierter CYP-Inhibitionsassays wurde der Einfluss von Clopidogrel und Omeprazol auf neun verschiedene CYP-Enzyme untersucht. Durch Clopidogrel wurden CYP2B6 (IC50 = 6 nM), CYP2C19 (IC50 = 0.4 µM) und CYP1A2 (IC50 = 2.8 µM) gehemmt. Omeprazol inhibiert v. a. CYP2C19 (IC50 = 2 µM) und CYP3A4 (IC50 = 17 µM). Im Folgenden wurde auch der Einfluss von Omeprazol auf die Bildung von 2-Oxo-Clopidogrel untersucht. Die Bioaktivierung wurde allerdings erst bei einer Omeprazol-Konzentration von mehr als 10 µM beeinflusst. Am st{\"a}rksten wurde dabei CYP2C19 (IC50 ca. 100 µM) gehemmt. Aufgrund der recht schwachen Inhibition von CYP2C19 durch Omeprazol und der Tatsache, dass mehrere CYP-Enzyme die Bildung von 2-Oxo-Clopidogrel katalysieren, l{\"a}sst sich der Wirkungsverlust von Clopidogrel bei einer gleichzeitigen Einnahme von Omeprazol anhand der Ergebnisse der In-vitro-Versuche nicht durch eine Hemmung von CYP2C19 erkl{\"a}ren. Eine bisher nur wenig bei In-vitro-Interaktionsstudien untersuchte Klasse fremdstoffmetabolisierender Enzyme sind die Carboxylesterasen (CES), die v. a. bei der Bioaktivierung von Esterprodrugs eine wichtige Rolle spielen. F{\"u}r die Entwicklung von Inhibitionsassays wurden zun{\"a}chst verschiedene Modellsubstrate ausgew{\"a}hlt. Nach Inkubation dieser Substrate mit humanen Subzellfraktionen und rekombinanten Carboxylesterase-Enzymen wurden die Metaboliten mit Hilfe einer HPLC/UV-Analyse quantifiziert. Es zeigte sich, dass Methyl-4-nitrobenzoat und Mycophenolatmofetil selektiv durch CES1 hydrolysiert werden. Die Hydrolyse von Phenylacetat, p-Nitrophenylacetat und 4-Methylumbelliferylacetat wurde durch alle verwendeten Enzyme katalysiert. Dar{\"u}ber hinaus konnte eine Hydrolyse der aus Boswellia-Arten (Weihrauch) stammenden 3-O-Acetyl-11-keto--boswellias{\"a}ure durch CES2 beobachtet werden. Aufgrund der bei den meisten Modellsubstraten auftretenden Instabilit{\"a}t im Inkubationspuffer war eine Korrektur mit Hilfe von Blindproben erforderlich. Die Hydrolyse konnte durch Erniedrigung des pH-Wertes des Inkubationspuffers von 7.4 auf 6.5 und durch die Zugabe von Essigs{\"a}ure zur Stoppl{\"o}sung verlangsamt werden. Anschließend wurde die Beeinflussung der Hydrolyse von p-Nitrophenylacetat durch Pflanzenextrakte untersucht. Es zeigte sich, dass zahlreiche Extrakte die Esterasen aus der humanen Leber hemmten und die Aktivit{\"a}t bei einer Extraktkonzentration von 25-50 µg/ml weit unterhalb von 50 \% lag. Die Inhibition von CES durch Pflanzenextrakte stellt daher ein bisher unbekanntes Risiko f{\"u}r Arzneimittelinteraktionen dar. Cytochrom-P450-Enzyme (CYP-Enzyme) sind die wichtigste Gruppe fremdstoff-metabolisierender Enzyme. Zur Untersuchung der Beeinflussung dieser Enzyme durch neue Wirkstoffe werden daher standardm{\"a}ßig In-vitro-Interaktionsstudien durchgef{\"u}hrt. Von der Food and Drug Administration (FDA) wurden daher f{\"u}r jedes CYP-Enzym verschiedene Arzneistoffe als Testsubstrate vorgeschlagen. Zus{\"a}tzlich kommen bei solchen Untersuchungen Modellsubstrate zum Einsatz, deren Metaboliten fluoreszieren und die somit f{\"u}r ein Hochdurchsatz-Screening mit Hilfe von Mikrotiterplatten verwendet werden k{\"o}nnen. In dieser Arbeit wurde eine Reihe von Modellsubstanzen (Cumarin- und Harman-Derivate) auf ihre Eignung als Substrate f{\"u}r CYP-Inhibitionsassays untersucht. Nach der Entwicklung von Methoden zur Detektion der Metaboliten, die durch LC/MS/MS-Analysen oder durch HPLC/Fluoreszenzanalysen erfolgte, wurden die CYP-Enzyme identifiziert, die an der Umsetzung der Substrate beteiligt sind und mit Hilfe von CYP-Enzymen und humanen Lebermikrosomen wurden die Km-Werte der Substrate bestimmt. Die Untersuchungen zur Stabilit{\"a}t der CYP-Enzyme {\"u}ber 60 min zeigten, dass diese bei 37 °C stark an Aktivit{\"a}t verlieren, insbesondere CYP1A2. F{\"u}r eine maximale Umsetzungsgeschwindigkeit war eine NADPH-Konzentration von 1 mM ausreichend. Die Untersuchung von 14 Standardsubstraten ergab, dass die Mehrheit selektiv durch das entsprechende CYP-Enzym umgesetzt wird. Die Amodiaquin-N-deethylierung, die Tolbutamidhydroxylierung, die Chlorzoxazon-6-hydroxylierung und die 4-Nitrophenol-2-hydroxylierung wurden durch mehrere CYP-Enzyme katalysiert. Als Positivkontrollen f{\"u}r die Inhibitionsassays und zur Identifizierung der am Metabolismus beteiligten CYP-Enzyme werden von der FDA verschiedene Inhibitoren vorgeschlagen. Da nicht zu allen Inhibitoren Daten {\"u}ber deren Isoenzymselektivit{\"a}t vorliegen, wurde mit Hilfe der Assays die inhibitorische Aktivit{\"a}t von zw{\"o}lf Inhibitoren auf neun verschiedene CYP-Enzyme untersucht. Alle Inhibitoren hemmten das jeweilige angegebene CYP-Enzym. Bei Furafyllin (CYP1A2), Tranylcypromin (CYP2A6), Clopidogrel (CYP2B6), Montelukast (CYP2C8), Sulfaphenazol (CYP2C9), Chinidin (CYP2D6) und Ketoconazol (CYP3A4) konnte eine Konzentration ermittelt werden, bei der nur ein CYP-Enzym gehemmt wird. F{\"u}r Quercetin, Nootkaton, Diethyldithiocarbamat, Sertralin und Ticlopidin wurde eine Inhibition mehrerer CYP-Enzyme festgestellt. Mit Hilfe der CYP-Inhibitionsassays wurden Extrakte lebertoxischer Arzneipflanzen, wie z. B. Tussilago farfara (Huflattich) oder Chelidonium majus (Sch{\"o}llkraut), untersucht. Alle Extrakte hemmten konzentrationsabh{\"a}ngig die CYP-Enzyme, am st{\"a}rksten die Enzyme der Subfamilie CYP2C. Als In-vitro-Substrate f{\"u}r CYP-Inhibitionsassays werden aufgrund ihrer starken Fluoreszenz h{\"a}ufig Cumarin-Derivate eingesetzt. In dieser Arbeit wurden daher 18 O-alkylierte bzw. O-benzylierte Derivate von 7-Hydroxycumarin, 7-Hydroxy-4-methylcumarin und 7-Hydroxy-4-trifluormethylcumarin synthetisiert und die Umsetzung durch verschiedene CYP-Enzyme mit Hilfe der zuvor optimierten LC/LC/Fluoreszenz-basierten Assays untersucht. An der O-Desalkylierung der Cumarin-Derivate waren haupts{\"a}chlich CYP1A2, CYP2B6 und im geringeren Ausmaß CYP2C19, CYP2D6 und CYP2E1 beteiligt. Die h{\"o}chste Affinit{\"a}t besaßen die Substrate zu CYP1A2. Debenzylierungen wurden neben CYP1A2 haupts{\"a}chlich durch CYP3A4 katalysiert. Die h{\"o}chsten Umsetzungsgeschwindigkeiten wurden f{\"u}r die Debenzylierung von 7-Benzyloxy-4-methylcumarin (BMC, 14 pmol/pmol P450/min) und 7-Benzyloxy-4-trifluormethylcumarin (BFC, 9 pmol/pmol P450/min) beobachtet. F{\"u}r 7-Methoxy-4-trifluormethylcumarin (MFC) war die Umsetzungs¬geschwindigkeit f{\"u}r die O-Demethylierung mit CYP1A2 und CYP2B6 im Vergleich zu CYP2C9 deutlich h{\"o}her. MFC und 7-Ethoxy-4-trifluormethylcumarin (EFC) eignen sich daher v. a. f{\"u}r Inhibitionsuntersuchungen von CYP2B6. Bei den untersuchten 7 Alkyloxycumarinen handelt es sich in allen F{\"a}llen nicht um selektive CYP-Substrate. Sie k{\"o}nnen demnach nicht f{\"u}r Inhibitionsuntersuchungen mit humanen Lebermikrosomen verwendet werden. Ein Einsatz f{\"u}r Simultanbestimmungen der Hemmung mehrerer CYP-Enzyme in einem Versuch (Cocktail-Assay) ist aus diesem Grund ebenfalls nicht m{\"o}glich. Durch LC/MS-Analysen nach Inkubation der Cumarin-Derivate mit humanen Lebermikrosomen zeigte sich, dass neben den entsprechenden O Desalkylmetaboliten mehrere Hydroxymetaboliten entstehen und der O Desalkylmetabolit insbesondere bei Derivaten mit l{\"a}ngeren Alkylsubstituenten nicht der Hauptmetabolit ist. Ein Ziel der Arbeitsgruppe ist es zudem, neue In-vitro-Substrate zur Untersuchung der Inhibition von CYP-Enzymen mit besseren enzymkinetischen und analytischen Eigenschaften zu entwickeln. Grundstruktur hierf{\"u}r ist das -Carbolin, da -Carbolin-Derivate eine starke Fluoreszenz aufweisen. Von dem Naturstoff Harmin ist bekannt, dass dieser durch CYP1A2, CYP2C9, CYP2C19 und CYP2D6 O-demethyliert wird. Durch Modifizierung der Harman-Struktur sollte die CYP-Isoenzymselektivit{\"a}t f{\"u}r die O-Dealkylierung gesteigert werden und Substrate f{\"u}r weitere CYP-Enzyme erhalten werden. Hierf{\"u}r wurden in der Arbeitsgruppe u. a. 2-Benzyl-7-benzyloxyharman (BBH), 2-Benzyl-7-methoxyharman (BMH), 7-Methoxy-9-(4-carboxybenzyl)harman (MCBH) und 2-Methyl-7-methoxyharman (MMH) hergestellt. In dieser Arbeit wurden LC/LC/Fluoreszenz- und LC/MS/MS-Methoden zur Quantifizierung der aus diesen Derivaten entstehenden O-Desalkylmetaboliten entwickelt und die Substrate charakterisiert. Die Einf{\"u}hrung von Benzylsubstituenten an der phenolischen Hydroxylgruppe von Harmol (BBH) f{\"u}hrte zum Metabolismus durch CYP3A4 und die Substitution mit einem Carboxybenzylrest am Indolstickstoff (MCBH) verst{\"a}rkte die Selektivit{\"a}t zu den Enzymen der Subfamilie 2C. Durch die Methylierung des Pyridin-Stickstoffs des Harmins (MMH) wurde ein selektives Substrat f{\"u}r CYP2D6 erhalten, weshalb bei dieser Substanz auch humane Lebermikrosomen verwendet werden k{\"o}nnen. Durch die im Vergleich zu anderen CYP2D6-Substraten erhaltene hohe Umsetzungsgeschwindigkeit l{\"a}sst sich die Proteinkonzentration minimieren. F{\"u}r die {\"u}berwiegend an der O-Dealkylierung der Substrate beteiligten CYP-Enzyme wurden die Km-Werte ermittelt. Bei der Untersuchung von verschiedenen CYP-Inhibitoren zeigte sich, dass mit diesen Substraten vergleichbare IC50-Werte, wie mit den Standardsubstraten, erhalten werden. Die Harman-Derivate k{\"o}nnen daher zur Untersuchung der Inhibition wichtiger CYP-Enzyme eingesetzt werden und bieten eine Alternative zu den bisher vorhandenen Fluoreszenz-Substraten. Durch die Einstellung des pH-Wertes im Anschluss an die Inkubation lassen sich die Metaboliten ebenfalls fluorimetrisch in der Mikrotiterplatte detektieren und k{\"o}nnen f{\"u}r ein Hochdurchsatz-Screening eingesetzt werden. Allerdings m{\"u}ssen die Fluoreszenzeigenschaften weiter verbessert werden, um eine kontinuierliche Bestimmung w{\"a}hrend der Inkubation zu erm{\"o}glichen. In der pharmazeutischen Industrie besteht ein großes Interesse an der Detektion von reaktiven Metaboliten, um eine potentielle Lebertoxizit{\"a}t von neuen Wirkstoffen vorhersagen zu k{\"o}nnen. Hierf{\"u}r werden die Testsubstanzen mit humanen Lebermikrosomen inkubiert und die reaktiven Metaboliten mit Glutathion abgefangen. Zur Optimierung der LC/MS/MS-Analysen wurde in dieser Arbeit die Fragmentierung solcher Addukte anhand von Standardsubstanzen untersucht. Bei allen untersuchten Glutathion-Addukten trat eine Abspaltung der Pyroglutamins{\"a}ure bei positiver Polarit{\"a}t mit einer vergleichbaren Signalintensit{\"a}t auf, weshalb eine Detektion dieses Fragmentes durch einen Neutral-Loss-Scan am besten geeignet erschien. Mit Hilfe der Screening-Methode wurden zuerst Arzneistoffe untersucht, von denen reaktive Metaboliten bekannt sind. F{\"u}r die Bioaktivierung von Clozapin konnten CYP1A2, CYP2D6 und CYP3A4 identifiziert werden, w{\"a}hrend die Toxifizierung von Paracetamol haupts{\"a}chlich durch CYP1A2 und CYP3A4 erfolgte. Auff{\"a}llig war, dass mit steigender Paracetamolkonzentration keine S{\"a}ttigung der Umsetzung auftrat. Durchgef{\"u}hrte Molek{\"u}lver{\"a}nderungen am Glutathion, wie die Einf{\"u}hrung eines Dansylrestes oder eines Biotins, f{\"u}hrten zu keiner deutlichen Verbesserung der Detektion der reaktiven Metaboliten. Dar{\"u}ber hinaus zeigte sich, dass bei den markierten GSH-Derivaten die Umsetzung durch GSTs erheblich reduziert ist. Mit der Screening-Methode wurden allerdings viele falsch positive Signale erhalten, so dass diese nicht f{\"u}r eine Untersuchung von Extrakten lebertoxischer Pflanzen eingesetzt werden konnte. F{\"u}r eine eindeutige und schnelle Identifizierung der Signale als Glutathion-Addukte ist daher die hochaufl{\"o}sende Massenspektrometrie erforderlich. Eine weitere Klasse fremdstoffmetabolisierender Enzyme sind die Glutathion-S-Transferasen (GSTs), {\"u}ber deren Inhibition durch Arzneistoffe und Pflanzenextrakte in der Literatur nur wenige Daten vorliegen. Zur Entwicklung von Inhibitionsassays wurden die in der Literatur beschriebenen Substrate 1-Chlor-2,4-dinitrobenzol, 4 Nitrochinolin-N-oxid, 1,2-Dichlor-4-nitrobenzol und 4-Nitrobenzylchlorid verwendet. Die Detektion der Metaboliten erfolgte im Gegensatz zu der h{\"a}ufig eingesetzten Photometrie mit Hilfe der HPLC/UV- bzw. einer LC/MS/MS-Analyse. F{\"u}r die Kalibrierung wurden zun{\"a}chst die entsprechenden Glutathionkonjugate aus den Substraten synthetisiert. Bei den durchgef{\"u}hrten diskontinuierlichen Assays stellte die h{\"a}ufig auftretende nichtenzymatische Reaktion der Substrate mit Glutathion ein Problem dar. Durch die Erniedrigung des pH-Wertes des Inkubationspuffers von 7.4 auf 6.5 und der Senkung der Inkubationstemperatur von 37 °C auf 25 °C konnte die nichtenzymatische Reaktion w{\"a}hrend der Inkubation erheblich verlangsamt werden. Die nichtenzymatische Reaktion nach der Inkubation konnte durch Zugabe von Oxidationsmitteln gestoppt werden. Von den getesteten humanen Lebersubzell¬fraktionen besaß die cytosolische Fraktion bei allen Substraten die h{\"o}chste Aktivit{\"a}t. Im Rahmen der Assayentwicklung wurde die Glutathion-, die Proteinkonzentration und die Inkubationszeit optimiert. Es wurden die Km- und Vmax-Werte f{\"u}r die Umsetzung der Substrate ermittelt. Als Positivkontrolle diente das ebenfalls synthetisierte Glutathionkonjugat der Etacryns{\"a}ure, f{\"u}r das die IC50-Werte mit jedem Substrat bestimmt wurden. Dabei konnte ein Einfluss des pH-Wertes des Inkubationspuffers und der Inkubationstemperatur auf die gemessene inhibitorische Aktivit{\"a}t beobachtet werden. Anschließend wurde ein Screening von Arzneistoffen, ausgew{\"a}hlten Naturstoffen und etwa 50 Pflanzenextrakten auf eine Inhibition der GSTs in humanem Lebercytosol mit 1-Chlor-2,4-dinitrobenzol, das am schnellsten von allen Substraten umgesetzt wurde, durchgef{\"u}hrt. Von den getesteten Naturstoffen fiel eine ausgepr{\"a}gte Hemmung durch Biflavonoide auf. Nahezu alle untersuchten Pflanzenextrakte hemmten die GSTs. Eine starke Inhibition der GSTs zeigten Extrakte aus Cinnamomum cassia (Zimt), die sich als nicht-kompetitiv herausstellte. Weiterhin wurde eine starke Hemmung der Extrakte gerbstoffhaltiger Pflanzen, wie z. B. Hamamelis virginiana (virginische Zaubernuss) oder Krameria triandra (Ratanhia), beobachtet. Hier resultierten IC50-Werte zwischen 5 und 30 µg/ml. Ein Vergleich verschiedener Methoden zur Detektion des Metaboliten 2,4 Dinitrophenyl-S-glutathion zeigte, dass die Photometrie f{\"u}r die Untersuchung der Inhibition von Pflanzenextrakten aufgrund der St{\"o}rung durch die Pflanzenmatrix ungeeignet ist. Mit Hilfe der verwendeten HPLC/UV- sowie der LC/MS/MS-Analyse konnte der Metabolit selektiv erfasst werden und reproduzierbare Ergebnisse f{\"u}r die Inhibition der GSTs durch Pflanzenextrakte erzielt werden. Neben den GSTs wurde auch die Beeinflussung der Glutathionreduktase (GR) in dieser Arbeit untersucht. Hierf{\"u}r wurde ein HPLC-basierter Assay entwickelt, bei dem das reduzierte Glutathion mit 5,5´-Dithiobis(2-nitrobenzoes{\"a}ure) derivatisiert und das entstandene gemischte Disulfid aus Glutathion und 5-Thio-2-nitrobenzoes{\"a}ure quantifiziert wurde. Zur Untersuchung der Inhibition durch Pflanzenextrakte wurde humanes Lebercytosol verwendet, das von allen humanen Lebersubzellfraktionen die h{\"o}chste Aktivit{\"a}t besaß. Im Vergleich zu den GSTs wurde die GR durch die {\"u}berwiegende Zahl der ausgew{\"a}hlten Pflanzenextrakte kaum gehemmt. Eine nennenswerte Inhibition der GR konnte nur bei Extrakten von Juglans regia (Walnuss) beobachtet werden. Fazit In dieser Arbeit wurden eine Reihe von In-vitro-Methoden zur Untersuchung der Inhibition von CYP-Enzymen und weiteren fremdstoffmetabolisierenden Enzymen, wie CES oder GSTs, entwickelt. Aufgrund der dabei angewendeten selektiven HPLC-basierten Quantifizierung der Metaboliten durch UV-, Fluoreszenz- oder MS-Detektion k{\"o}nnen mit diesen Methoden auch Proben mit komplexer Matrix untersucht werden. F{\"u}r alle Assays wurden die Inkubationsbedingungen optimiert und die enzymkinetischen Parameter vieler Substrate ermittelt. Dar{\"u}ber hinaus wurden wichtige Erkenntnisse {\"u}ber die Isoenzymselektivit{\"a}t dieser Substrate gewonnen. Die Eignung der Assays wurde anhand von Standardinhibitoren bewiesen. Schließlich wurde die inhibitorische Aktivit{\"a}t von zahlreichen Pflanzenextrakten bestimmt, deren Auswirkung auf fremdstoffmetabolisierende Enzyme bisher unbekannt war. Die in dieser Arbeit beschriebenen Methoden k{\"o}nnen f{\"u}r die Untersuchung des Metabolismus von Arzneistoffen und der Inhibition fremdstoffmetabolisierender Enzyme, die f{\"u}r eine Zulassung neuer Wirkstoffe erforderlich ist, routinem{\"a}ßig eingesetzt werden.}, subject = {Xenobiotikum}, language = {de} } @article{EckardtStasikKrameretal.2021, author = {Eckardt, Jan-Niklas and Stasik, Sebastian and Kramer, Michael and R{\"o}llig, Christoph and Kr{\"a}mer, Alwin and Scholl, Sebastian and Hochhaus, Andreas and Crysandt, Martina and Br{\"u}mmendorf, Tim H. and Naumann, Ralph and Steffen, Bj{\"o}rn and Kunzmann, Volker and Einsele, Hermann and Schaich, Markus and Burchert, Andreas and Neubauer, Andreas and Sch{\"a}fer-Eckart, Kerstin and Schliemann, Christoph and Krause, Stefan W. and Herbst, Regina and H{\"a}nel, Mathias and Frickhofen, Norbert and Noppeney, Richard and Kaiser, Ulrich and Baldus, Claudia D. and Kaufmann, Martin and R{\´a}cil, Zdenek and Platzbecker, Uwe and Berdel, Wolfgang E. and Mayer, Jiř{\´i} and Serve, Hubert and M{\"u}ller-Tidow, Carsten and Ehninger, Gerhard and St{\"o}lzel, Friedrich and Kroschinsky, Frank and Schetelig, Johannes and Bornh{\"a}user, Martin and Thiede, Christian and Middeke, Jan Moritz}, title = {Loss-of-function mutations of BCOR are an independent marker of adverse outcomes in intensively treated patients with acute myeloid leukemia}, series = {Cancers}, volume = {13}, journal = {Cancers}, number = {9}, issn = {2072-6694}, doi = {10.3390/cancers13092095}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236735}, year = {2021}, abstract = {Acute myeloid leukemia (AML) is characterized by recurrent genetic events. The BCL6 corepressor (BCOR) and its homolog, the BCL6 corepressor-like 1 (BCORL1), have been reported to be rare but recurrent mutations in AML. Previously, smaller studies have reported conflicting results regarding impacts on outcomes. Here, we retrospectively analyzed a large cohort of 1529 patients with newly diagnosed and intensively treated AML. BCOR and BCORL1 mutations were found in 71 (4.6\%) and 53 patients (3.5\%), respectively. Frequently co-mutated genes were DNTM3A, TET2 and RUNX1. Mutated BCORL1 and loss-of-function mutations of BCOR were significantly more common in the ELN2017 intermediate-risk group. Patients harboring loss-of-function mutations of BCOR had a significantly reduced median event-free survival (HR = 1.464 (95\%-Confidence Interval (CI): 1.005-2.134), p = 0.047), relapse-free survival (HR = 1.904 (95\%-CI: 1.163-3.117), p = 0.01), and trend for reduced overall survival (HR = 1.495 (95\%-CI: 0.990-2.258), p = 0.056) in multivariable analysis. Our study establishes a novel role for loss-of-function mutations of BCOR regarding risk stratification in AML, which may influence treatment allocation.}, language = {en} } @article{WinterAndelovicKampfetal.2021, author = {Winter, Patrick M. and Andelovic, Kristina and Kampf, Thomas and Hansmann, Jan and Jakob, Peter Michael and Bauer, Wolfgang Rudolf and Zernecke, Alma and Herold, Volker}, title = {Simultaneous measurements of 3D wall shear stress and pulse wave velocity in the murine aortic arch}, series = {Journal of Cardiovascular Magnetic Resonance}, volume = {23}, journal = {Journal of Cardiovascular Magnetic Resonance}, number = {1}, doi = {10.1186/s12968-021-00725-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259152}, pages = {34}, year = {2021}, abstract = {Purpose Wall shear stress (WSS) and pulse wave velocity (PWV) are important parameters to characterize blood flow in the vessel wall. Their quantification with flow-sensitive phase-contrast (PC) cardiovascular magnetic resonance (CMR), however, is time-consuming. Furthermore, the measurement of WSS requires high spatial resolution, whereas high temporal resolution is necessary for PWV measurements. For these reasons, PWV and WSS are challenging to measure in one CMR session, making it difficult to directly compare these parameters. By using a retrospective approach with a flexible reconstruction framework, we here aimed to simultaneously assess both PWV and WSS in the murine aortic arch from the same 4D flow measurement. Methods Flow was measured in the aortic arch of 18-week-old wildtype (n = 5) and ApoE\(^{-/-}\) mice (n = 5) with a self-navigated radial 4D-PC-CMR sequence. Retrospective data analysis was used to reconstruct the same dataset either at low spatial and high temporal resolution (PWV analysis) or high spatial and low temporal resolution (WSS analysis). To assess WSS, the aortic lumen was labeled by semi-automatically segmenting the reconstruction with high spatial resolution. WSS was determined from the spatial velocity gradients at the lumen surface. For calculation of the PWV, segmentation data was interpolated along the temporal dimension. Subsequently, PWV was quantified from the through-plane flow data using the multiple-points transit-time method. Reconstructions with varying frame rates and spatial resolutions were performed to investigate the influence of spatiotemporal resolution on the PWV and WSS quantification. Results 4D flow measurements were conducted in an acquisition time of only 35 min. Increased peak flow and peak WSS values and lower errors in PWV estimation were observed in the reconstructions with high temporal resolution. Aortic PWV was significantly increased in ApoE\(^{-/-}\) mice compared to the control group (1.7 ± 0.2 versus 2.6 ± 0.2 m/s, p < 0.001). Mean WSS magnitude values averaged over the aortic arch were (1.17 ± 0.07) N/m\(^2\) in wildtype mice and (1.27 ± 0.10) N/m\(^2\) in ApoE\(^{-/-}\) mice. Conclusion The post processing algorithm using the flexible reconstruction framework developed in this study permitted quantification of global PWV and 3D-WSS in a single acquisition. The possibility to assess both parameters in only 35 min will markedly improve the analyses and information content of in vivo measurements.}, language = {en} } @article{AndelovicWinterKampfetal.2021, author = {Andelovic, Kristina and Winter, Patrick and Kampf, Thomas and Xu, Anton and Jakob, Peter Michael and Herold, Volker and Bauer, Wolfgang Rudolf and Zernecke, Alma}, title = {2D Projection Maps of WSS and OSI Reveal Distinct Spatiotemporal Changes in Hemodynamics in the Murine Aorta during Ageing and Atherosclerosis}, series = {Biomedicines}, volume = {9}, journal = {Biomedicines}, number = {12}, issn = {2227-9059}, doi = {10.3390/biomedicines9121856}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-252164}, year = {2021}, abstract = {Growth, ageing and atherosclerotic plaque development alter the biomechanical forces acting on the vessel wall. However, monitoring the detailed local changes in wall shear stress (WSS) at distinct sites of the murine aortic arch over time has been challenging. Here, we studied the temporal and spatial changes in flow, WSS, oscillatory shear index (OSI) and elastic properties of healthy wildtype (WT, n = 5) and atherosclerotic apolipoprotein E-deficient (Apoe\(^{-/-}\), n = 6) mice during ageing and atherosclerosis using high-resolution 4D flow magnetic resonance imaging (MRI). Spatially resolved 2D projection maps of WSS and OSI of the complete aortic arch were generated, allowing the pixel-wise statistical analysis of inter- and intragroup hemodynamic changes over time and local correlations between WSS, pulse wave velocity (PWV), plaque and vessel wall characteristics. The study revealed converse differences of local hemodynamic profiles in healthy WT and atherosclerotic Apoe\(^{-/-}\) mice, and we identified the circumferential WSS as potential marker of plaque size and composition in advanced atherosclerosis and the radial strain as a potential marker for vascular elasticity. Two-dimensional (2D) projection maps of WSS and OSI, including statistical analysis provide a powerful tool to monitor local aortic hemodynamics during ageing and atherosclerosis. The correlation of spatially resolved hemodynamics and plaque characteristics could significantly improve our understanding of the impact of hemodynamics on atherosclerosis, which may be key to understand plaque progression towards vulnerability.}, language = {en} } @article{KoelbelRoosvanderVenetal.2020, author = {K{\"o}lbel, Heike and Roos, Andreas and van der Ven, Peter F. M. and Evangelista, Teresinha and Nolte, Kay and Johnson, Katherine and T{\"o}pf, Ana and Wilson, Michael and Kress, Wolfram and Sickmann, Albert and Straub, Volker and Kollipara, Laxmikanth and Weis, Joachim and F{\"u}rst, Dieter O. and Schara, Ulrike}, title = {First clinical and myopathological description of a myofibrillar myopathy with congenital onset and homozygous mutation in FLNC}, series = {Human Mutation}, volume = {41}, journal = {Human Mutation}, number = {9}, doi = {10.1002/humu.24062}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-215481}, pages = {1600 -- 1614}, year = {2020}, abstract = {Filamin C (encoded by the FLNC gene) is a large actin-cross-linking protein involved in shaping the actin cytoskeleton in response to signaling events both at the sarcolemma and at myofibrillar Z-discs of cross-striated muscle cells. Multiple mutations in FLNC are associated with myofibrillar myopathies of autosomal-dominant inheritance. Here, we describe for the first time a boy with congenital onset of generalized muscular hypotonia and muscular weakness, delayed motor development but no cardiac involvement associated with a homozygous FLNC mutation c.1325C>G (p.Pro442Arg). We performed ultramorphological, proteomic, and functional investigations as well as immunological studies of known marker proteins for dominant filaminopathies. We show that the mutant protein is expressed in similar quantities as the wild-type variant in control skeletal muscle fibers. The proteomic signature of quadriceps muscle is altered and ultrastructural perturbations are evident. Moreover, filaminopathy marker proteins are comparable both in our homozygous and a dominant control case (c.5161delG). Biochemical investigations demonstrate that the recombinant mutant protein is less stable and more prone to degradation by proteolytic enzymes than the wild-type variant. The unusual congenital presentation of the disease clearly demonstrates that homozygosity for mutations in FLNC severely aggravates the phenotype.}, language = {en} } @article{VoelkerWeigelStrehletal.2018, author = {V{\"o}lker, Hans-Ullrich and Weigel, Michael and Strehl, Annette and Frey, Lea}, title = {Levels of uPA and PAI-1 in breast cancer and its correlation to Ki67-index and results of a 21-multigene-array}, series = {Diagnostic Pathology}, volume = {13}, journal = {Diagnostic Pathology}, number = {67}, doi = {10.1186/s13000-018-0737-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176960}, year = {2018}, abstract = {Background: Conventional parameters including Ki67, hormone receptor and Her2/neu status are used for risk stratification for breast cancer. The serine protease urokinase plasminogen activator (uPA) and the plasminogen activator inhibitor type-1 (PAI-1) play an important role in tumour invasion and metastasis. Increased concentrations in tumour tissue are associated with more aggressive potential of the disease. Multigene tests provide detailed insights into tumour biology by simultaneously testing several prognostically relevant genes. With OncotypeDX\(^{®}\), a panel of 21 genes is tested by means of quantitative real-time polymerase chain reaction. The purpose of this pilot study was to analyse whether a combination of Ki67 and uPA/PAI-1 supplies indications of the result of the multigene test. Methods: The results of Ki67, uPA/PAI-1 and OncotypeDX\(^{®}\) were analysed in 25 breast carcinomas (luminal type, pT1/2, max pN1a, G2). A statistical and descriptive analysis was performed. Results: With a proliferation index Ki67 of < 14\%, the recurrence score (RS) from the multigene test was on average in the low risk range, with an intermediate RS usually resulting if Ki67 was > 14\%. Not elevated values of uPA and PAI-1 showed a lower rate of proliferation (average 8.5\%) than carcinomas with an increase of uPA and/or PAI-1 (average 13.9\%); p = 0.054, Student's t-test. When Ki67 was > 14\% and uPA and/or PAI-1 was raised, an intermediate RS resulted. These differences were significant when compared to cases with Ki67 < 14\% with non-raised uPA/PAI-1 (p < 0.03, Student's t-test). Without taking into account the proliferative activity, an intermediate RS was also verifiable if both uPA and PAI-1 showed raised values. Conclusion: A combination of the values Ki67 and uPA/PAI-1 tended to depict the RS to be expected. From this it can be deduced that an appropriate analysis of this parameter combination may be undertaken before the multigene test in routine clinical practice. The increasing cost pressure makes it necessary to base the implementation of a multigene test on ancillary variables and to potentially leave it out if not required in the event of a certain constellation of results (Ki67 raised, uPA and PAI-1 raised).}, language = {en} } @article{AndelovicWinterJakobetal.2021, author = {Andelovic, Kristina and Winter, Patrick and Jakob, Peter Michael and Bauer, Wolfgang Rudolf and Herold, Volker and Zernecke, Alma}, title = {Evaluation of plaque characteristics and inflammation using magnetic resonance imaging}, series = {Biomedicines}, volume = {9}, journal = {Biomedicines}, number = {2}, issn = {2227-9059}, doi = {10.3390/biomedicines9020185}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228839}, year = {2021}, abstract = {Atherosclerosis is an inflammatory disease of large and medium-sized arteries, characterized by the growth of atherosclerotic lesions (plaques). These plaques often develop at inner curvatures of arteries, branchpoints, and bifurcations, where the endothelial wall shear stress is low and oscillatory. In conjunction with other processes such as lipid deposition, biomechanical factors lead to local vascular inflammation and plaque growth. There is also evidence that low and oscillatory shear stress contribute to arterial remodeling, entailing a loss in arterial elasticity and, therefore, an increased pulse-wave velocity. Although altered shear stress profiles, elasticity and inflammation are closely intertwined and critical for plaque growth, preclinical and clinical investigations for atherosclerosis mostly focus on the investigation of one of these parameters only due to the experimental limitations. However, cardiovascular magnetic resonance imaging (MRI) has been demonstrated to be a potent tool which can be used to provide insights into a large range of biological parameters in one experimental session. It enables the evaluation of the dynamic process of atherosclerotic lesion formation without the need for harmful radiation. Flow-sensitive MRI provides the assessment of hemodynamic parameters such as wall shear stress and pulse wave velocity which may replace invasive and radiation-based techniques for imaging of the vascular function and the characterization of early plaque development. In combination with inflammation imaging, the analyses and correlations of these parameters could not only significantly advance basic preclinical investigations of atherosclerotic lesion formation and progression, but also the diagnostic clinical evaluation for early identification of high-risk plaques, which are prone to rupture. In this review, we summarize the key applications of magnetic resonance imaging for the evaluation of plaque characteristics through flow sensitive and morphological measurements. The simultaneous measurements of functional and structural parameters will further preclinical research on atherosclerosis and has the potential to fundamentally improve the detection of inflammation and vulnerable plaques in patients.}, language = {en} } @article{WinterAndelovicKampfetal.2019, author = {Winter, Patrick and Andelovic, Kristina and Kampf, Thomas and Gutjahr, Fabian Tobias and Heidenreich, Julius and Zernecke, Alma and Bauer, Wolfgang Rudolf and Jakob, Peter Michael and Herold, Volker}, title = {Fast self-navigated wall shear stress measurements in the murine aortic archusing radial 4D-phase contrast cardiovascular magnetic resonance at 17.6 T}, series = {Journal of Cardiovascular Magnetic Resonance}, volume = {21}, journal = {Journal of Cardiovascular Magnetic Resonance}, doi = {10.1186/s12968-019-0566-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201120}, pages = {64}, year = {2019}, abstract = {Purpose 4D flow cardiovascular magnetic resonance (CMR) and the assessment of wall shear stress (WSS) are non-invasive tools to study cardiovascular risks in vivo. Major limitations of conventional triggered methods are the long measurement times needed for high-resolution data sets and the necessity of stable electrocardiographic (ECG) triggering. In this work an ECG-free retrospectively synchronized method is presented that enables accelerated high-resolution measurements of 4D flow and WSS in the aortic arch of mice. Methods 4D flow and WSS were measured in the aortic arch of 12-week-old wildtype C57BL/6 J mice (n = 7) with a radial 4D-phase-contrast (PC)-CMR sequence, which was validated in a flow phantom. Cardiac and respiratory motion signals were extracted from the radial CMR signal and were used for the reconstruction of 4D-flow data. Rigid motion correction and a first order B0 correction was used to improve the robustness of magnitude and velocity data. The aortic lumen was segmented semi-automatically. Temporally averaged and time-resolved WSS and oscillatory shear index (OSI) were calculated from the spatial velocity gradients at the lumen surface at 14 locations along the aortic arch. Reproducibility was tested in 3 animals and the influence of subsampling was investigated. Results Volume flow, cross-sectional areas, WSS and the OSI were determined in a measurement time of only 32 min. Longitudinal and circumferential WSS and radial stress were assessed at 14 analysis planes along the aortic arch. The average longitudinal, circumferential and radial stress values were 1.52 ± 0.29 N/m2, 0.28 ± 0.24 N/m2 and - 0.21 ± 0.19 N/m2, respectively. Good reproducibility of WSS values was observed. Conclusion This work presents a robust measurement of 4D flow and WSS in mice without the need of ECG trigger signals. The retrospective approach provides fast flow quantification within 35 min and a flexible reconstruction framework.}, language = {en} } @article{HeroldKampfJakob2019, author = {Herold, Volker and Kampf, Thomas and Jakob, Peter Michael}, title = {Dynamic magnetic resonance scattering}, series = {Communications Physics}, volume = {2}, journal = {Communications Physics}, doi = {10.1038/s42005-019-0136-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201091}, pages = {46}, year = {2019}, abstract = {Dynamic light scattering is a popular technique to determine the size distribution of small particles in the sub micrometer region. It operates in reciprocal space, by analyzing the signal fluctuations with the photon auto correlation function. Equally, pulsed field gradient magnetic resonance is a technique generating data in the reciprocal space of the density distribution of an object. Here we show the feasibility of employing a magnetic resonance imaging system as a dynamic scattering device similar to dynamic light scattering appliances. By acquiring a time series of single data points from reciprocal space, analogue to dynamic light scattering, we demonstrate the examination of motion patterns of microscopic particles. This method allows the examination of particle dynamics significantly below the spatial resolution of magnetic resonance imaging. It is not limited by relaxation times and covers a wide field of applications for particle or cell motion in opaque media.}, language = {en} } @article{KesselHogardtAspacheretal.2022, author = {Kessel, Johanna and Hogardt, Michael and Aspacher, Lukas and Wichelhaus, Thomas A. and Gerkrath, Jasmin and Rosenow, Emely and Springer, Jan and Rickerts, Volker}, title = {Exclusion of Mucorales co-infection in a patient with Aspergillus flavus sinusitis by fluorescence in situ hybridization (FISH)}, series = {Journal of Fungi}, volume = {8}, journal = {Journal of Fungi}, number = {3}, issn = {2309-608X}, doi = {10.3390/jof8030306}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-267208}, year = {2022}, abstract = {Invasive fungal infections are associated with increased mortality in hematological patients. Despite considerable advances in antifungal therapy, the evaluation of suspected treatment failure is a common clinical challenge requiring extensive diagnostic testing to rule out potential causes, such as mixed infections. We present a 64-year-old patient with secondary AML, diabetes mellitus, febrile neutropenia, and sinusitis. While cultures from nasal tissue grew Aspergillus flavus, a microscopic examination of the tissue was suggestive of concomitant mucormycosis. However, fluorescence in situ hybridization (FISH) using specific probes targeting Aspergillus and Mucorales species ruled out mixed infection. This was confirmed by specific qPCR assays amplifying the DNA of Aspergillus, but not of Mucorales. These results provided a rational basis for step-down targeted therapy, i.e., the patient received posaconazole after seven days of calculated dual therapy with liposomal amphotericin B and posaconazole. Despite clinical response to the antifungal therapy, he died due to the progression of the underlying disease within two weeks after diagnosis of fungal infection. Molecular diagnostics applied to tissue blocks may reveal useful information on the etiology of invasive fungal infections, including challenging situations, such as with mixed infections. A thorough understanding of fungal etiology facilitates targeted therapy that may improve therapeutic success while limiting side effects.}, language = {en} } @article{HeroldHerzWinteretal.2017, author = {Herold, Volker and Herz, Stefan and Winter, Patrick and Gutjahr, Fabian Tobias and Andelovic, Kristina and Bauer, Wolfgang Rudolf and Jakob, Peter Michael}, title = {Assessment of local pulse wave velocity distribution in mice using k-t BLAST PC-CMR with semi-automatic area segmentation.}, series = {Journal of Cardiovascular Magnetic Resonance}, volume = {19}, journal = {Journal of Cardiovascular Magnetic Resonance}, number = {77}, doi = {10.1186/s12968-017-0382-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157696}, year = {2017}, abstract = {Background: Local aortic pulse wave velocity (PWV) is a measure for vascular stiffness and has a predictive value for cardiovascular events. Ultra high field CMR scanners allow the quantification of local PWV in mice, however these systems are yet unable to monitor the distribution of local elasticities. Methods: In the present study we provide a new accelerated method to quantify local aortic PWV in mice with phase-contrast cardiovascular magnetic resonance imaging (PC-CMR) at 17.6 T. Based on a k-t BLAST (Broad-use Linear Acquisition Speed-up Technique) undersampling scheme, total measurement time could be reduced by a factor of 6. The fast data acquisition enables to quantify the local PWV at several locations along the aortic blood vessel based on the evaluation of local temporal changes in blood flow and vessel cross sectional area. To speed up post processing and to eliminate operator bias, we introduce a new semi-automatic segmentation algorithm to quantify cross-sectional areas of the aortic vessel. The new methods were applied in 10 eight-month-old mice (4 C57BL/6J-mice and 6 ApoE\(^{(-/-)}\)-mice) at 12 adjacent locations along the abdominal aorta. Results: Accelerated data acquisition and semi-automatic post-processing delivered reliable measures for the local PWV, similiar to those obtained with full data sampling and manual segmentation. No statistically significant differences of the mean values could be detected for the different measurement approaches. Mean PWV values were elevated for the ApoE\(^{(-/-)}\)-group compared to the C57BL/6J-group (3.5 ± 0.7 m/s vs. 2.2 ± 0.4 m/s, p < 0.01). A more heterogeneous PWV-distribution in the ApoE \(^{(-/-)}\)-animals could be observed compared to the C57BL/6J-mice, representing the local character of lesion development in atherosclerosis. Conclusion: In the present work, we showed that k-t BLAST PC-MRI enables the measurement of the local PWV distribution in the mouse aorta. The semi-automatic segmentation method based on PC-CMR data allowed rapid determination of local PWV. The findings of this study demonstrate the ability of the proposed methods to non-invasively quantify the spatial variations in local PWV along the aorta of ApoE\(^{(-/-)}\)-mice as a relevant model of atherosclerosis.}, language = {en} } @article{GuthHueserRothetal.2021, author = {Guth, Sabine and H{\"u}ser, Stephanie and Roth, Angelika and Degen, Gisela and Diel, Patrick and Edlund, Karolina and Eisenbrand, Gerhard and Engel, Karl-Heinz and Epe, Bernd and Grune, Tilman and Heinz, Volker and Henle, Thomas and Humpf, Hans-Ulrich and J{\"a}ger, Henry and Joost, Hans-Georg and Kulling, Sabine E. and Lampen, Alfonso and Mally, Angela and Marchan, Rosemarie and Marko, Doris and M{\"u}hle, Eva and Nitsche, Michael A. and R{\"o}hrdanz, Elke and Stadler, Richard and van Thriel, Christoph and Vieths, Stefan and Vogel, Rudi F. and Wascher, Edmund and Watzl, Carsten and N{\"o}thlings, Ute and Hengstler, Jan G.}, title = {Contribution to the ongoing discussion on fluoride toxicity}, series = {Archives of Toxicology}, volume = {95}, journal = {Archives of Toxicology}, number = {7}, issn = {0340-5761}, doi = {10.1007/s00204-021-03072-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307161}, pages = {2571-2587}, year = {2021}, abstract = {Since the addition of fluoride to drinking water in the 1940s, there have been frequent and sometimes heated discussions regarding its benefits and risks. In a recently published review, we addressed the question if current exposure levels in Europe represent a risk to human health. This review was discussed in an editorial asking why we did not calculate benchmark doses (BMD) of fluoride neurotoxicity for humans. Here, we address the question, why it is problematic to calculate BMDs based on the currently available data. Briefly, the conclusions of the available studies are not homogeneous, reporting negative as well as positive results; moreover, the positive studies lack control of confounding factors such as the influence of well-known neurotoxicants. We also discuss the limitations of several further epidemiological studies that did not meet the inclusion criteria of our review. Finally, it is important to not only focus on epidemiological studies. Rather, risk analysis should consider all available data, including epidemiological, animal, as well as in vitro studies. Despite remaining uncertainties, the totality of evidence does not support the notion that fluoride should be considered a human developmental neurotoxicant at current exposure levels in European countries.}, language = {en} }