@article{GerlichAndreicaKueffneretal.2020, author = {Gerlich, C. and Andreica, I. and K{\"u}ffner, R. and Krause, D. and Lakomek, H. J. and Reusch, A. and Braun, J.}, title = {Evaluation einer Basisschulung f{\"u}r Patienten mit rheumatoider Arthritis}, series = {Zeitschrift f{\"u}r Rheumatologie}, volume = {79}, journal = {Zeitschrift f{\"u}r Rheumatologie}, doi = {10.1007/s00393-020-00769-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-280359}, pages = {737-748}, year = {2020}, abstract = {Hintergrund Ein neues Rahmenkonzept hat die flexible Ableitung und Nutzung von rheumatologischen Schulungsprogrammen f{\"u}r unterschiedliche Versorgungsbereiche erm{\"o}glicht. Auf dieser Grundlage wurde eine 5‑st{\"u}ndige Basisschulung f{\"u}r Patienten mit rheumatoider Arthritis (RA) entwickelt, es wurden rheumatologische Fach{\"a}rzte und Psychologen trainiert, und dann wurde die Wirksamkeit nach dem Wirkmodell der Patientenschulung evaluiert. Methoden Mit dem Studiendesign einer extern randomisierten Wartekontrollgruppenstudie mit 3 Messzeitpunkten wurde gepr{\"u}ft, wie sich die 5‑st{\"u}ndige Basisschulung auf das Erkrankungs- und Behandlungswissen sowie auf die Gesundheitskompetenz von RA-Patienten (n = 249) auswirkt. Weitere Fragen betrafen Einstellungsparameter, Kommunikationskompetenz, Erkrankungsauswirkungen und die Zufriedenheit mit der Schulung. Die Auswertungen erfolgten auf Intention-to-treat-Basis mit Kovarianzanalysen f{\"u}r die Hauptzielgr{\"o}ßen unter Ber{\"u}cksichtigung des Ausgangswertes. Ergebnisse Die Analysen zeigen, dass die Basisschulung RA wirksam ist. Noch 3 Monate nach der Schulung verf{\"u}gten die Schulungsteilnehmer {\"u}ber mehr Wissen und Gesundheitskompetenz als die Wartekontrollgruppe mit kleinem bis mittelgroßem Effekt (d = 0,37 bzw. 0,38). In den Nebenzielgr{\"o}ßen zeigten sich mit Ausnahme der Krankheitskommunikation keine weiteren Schulungseffekte. Diskussion Die Basisschulung bietet eine gute Grundlage, auf der weitere Interventionen zur Verbesserung von Einstellungs- und Erkrankungsparametern aufbauen k{\"o}nnen. Sie eignet sich damit als zentraler Baustein f{\"u}r die rheumatologische Versorgung auf verschiedenen Ebenen.}, language = {de} } @article{HauerPoppTaheretal.2019, author = {Hauer, Nadine N. and Popp, Bernt and Taher, Leila and Vogl, Carina and Dhandapany, Perundurai S. and B{\"u}ttner, Christian and Uebe, Steffen and Sticht, Heinrich and Ferrazzi, Fulvia and Ekici, Arif B. and De Luca, Alessandro and Klinger, Patrizia and Kraus, Cornelia and Zweier, Christiane and Wiesener, Antje and Abou Jamra, Rami and Kunstmann, Erdmute and Rauch, Anita and Wieczorek, Dagmar and Jung, Anna-Marie and Rohrer, Tilman R. and Zenker, Martin and Doerr, Helmuth-Guenther and Reis, Andr{\´e} and Thiel, Christian T.}, title = {Evolutionary conserved networks of human height identify multiple Mendelian causes of short stature}, series = {European Journal of Human Genetics}, volume = {27}, journal = {European Journal of Human Genetics}, doi = {10.1038/s41431-019-0362-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227899}, pages = {1061-1071}, year = {2019}, abstract = {Height is a heritable and highly heterogeneous trait. Short stature affects 3\% of the population and in most cases is genetic in origin. After excluding known causes, 67\% of affected individuals remain without diagnosis. To identify novel candidate genes for short stature, we performed exome sequencing in 254 unrelated families with short stature of unknown cause and identified variants in 63 candidate genes in 92 (36\%) independent families. Based on systematic characterization of variants and functional analysis including expression in chondrocytes, we classified 13 genes as strong candidates. Whereas variants in at least two families were detected for all 13 candidates, two genes had variants in 6 (UBR4) and 8 (LAMA5) families, respectively. To facilitate their characterization, we established a clustered network of 1025 known growth and short stature genes, which yielded 29 significantly enriched clusters, including skeletal system development, appendage development, metabolic processes, and ciliopathy. Eleven of the candidate genes mapped to 21 of these clusters, including CPZ, EDEM3, FBRS, IFT81, KCND1, PLXNA3, RASA3, SLC7A8, UBR4, USP45, and ZFHX3. Fifty additional growth-related candidates we identified await confirmation in other affected families. Our study identifies Mendelian forms of growth retardation as an important component of idiopathic short stature.}, language = {en} } @article{GilderWackKaubetal.2018, author = {Gilder, Stuart A. and Wack, Michael and Kaub, Leon and Roud, Sophie C. and Petersen, Nikolai and Heinsen, Helmut and Hillenbrand, Peter and Milz, Stefan and Schmitz, Chistoph}, title = {Distribution of magnetic remanence carriers in the human brain}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, doi = {10.1038/s41598-018-29766-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233035}, year = {2018}, abstract = {That the human brain contains magnetite is well established; however, its spatial distribution in the brain has remained unknown. We present room temperature, remanent magnetization measurements on 822 specimens from seven dissected whole human brains in order to systematically map concentrations of magnetic remanence carriers. Median saturation remanent magnetizations from the cerebellum were approximately twice as high as those from the cerebral cortex in all seven cases (statistically significantly distinct, p = 0.016). Brain stems were over two times higher in magnetization on average than the cerebral cortex. The ventral (lowermost) horizontal layer of the cerebral cortex was consistently more magnetic than the average cerebral cortex in each of the seven studied cases. Although exceptions existed, the reproducible magnetization patterns lead us to conclude that magnetite is preferentially partitioned in the human brain, specifically in the cerebellum and brain stem.}, language = {en} } @article{GotruvanGeffenNagyetal.2019, author = {Gotru, Sanjeev Kiran and van Geffen, Johanna P. and Nagy, Magdolna and Mammadova-Bach, Elmina and Eilenberger, Julia and Volz, Julia and Manukjan, Georgi and Schulze, Harald and Wagner, Leonard and Eber, Stefan and Schambeck, Christian and Deppermann, Carsten and Brouns, Sanne and Nurden, Paquita and Greinacher, Andreas and Sachs, Ulrich and Nieswandt, Bernhard and Hermanns, Heike M. and Heemskerk, Johan W. M. and Braun, Attila}, title = {Defective Zn2+ homeostasis in mouse and human platelets with α- and δ-storage pool diseases}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-44751-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227455}, year = {2019}, abstract = {Zinc (Zn2+) can modulate platelet and coagulation activation pathways, including fibrin formation. Here, we studied the (patho)physiological consequences of abnormal platelet Zn2+ storage and release. To visualize Zn2+ storage in human and mouse platelets, the Zn2+ specific fluorescent dye FluoZin3 was used. In resting platelets, the dye transiently accumulated into distinct cytosolic puncta, which were lost upon platelet activation. Platelets isolated from Unc13d-/- mice, characterized by combined defects of α/δ granular release, showed a markedly impaired Zn2+ release upon activation. Platelets from Nbeal2-/- mice mimicking Gray platelet syndrome (GPS), characterized by primarily loss of the α-granule content, had strongly reduced Zn2+ levels, which was also confirmed in primary megakaryocytes. In human platelets isolated from patients with GPS, Hermansky-Pudlak Syndrome (HPS) and Storage Pool Disease (SPD) altered Zn2+ homeostasis was detected. In turbidity and flow based assays, platelet-dependent fibrin formation was impaired in both Nbeal2-/- and Unc13d-/- mice, and the impairment could be partially restored by extracellular Zn2+. Altogether, we conclude that the release of ionic Zn2+ store from secretory granules upon platelet activation contributes to the procoagulant role of Zn2+ in platelet-dependent fibrin formation.}, language = {en} } @article{GoreLocatelliZugmaieretal.2018, author = {Gore, Lia and Locatelli, Franco and Zugmaier, Gerhard and Handgretinger, Rupert and O'Brien, Maureen M. and Bader, Peter and Bhojwani, Deepa and Schlegel, Paul-Gerhardt and Tuglus, Catherine A. and Stackelberg, Arend von}, title = {Survival after blinatumomab treatment in pediatric patients with relapsed/refractory B-cell precursor acute lymphoblastic leukemia}, series = {Blood Cancer Journal}, volume = {8}, journal = {Blood Cancer Journal}, doi = {10.1038/s41408-018-0117-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230726}, year = {2018}, abstract = {no abstract available}, language = {en} } @article{FranchiniJonesXiongetal.2018, author = {Franchini, Paolo and Jones, Julia C. and Xiong, Peiwen and Kneitz, Susanne and Gompert, Zachariah and Warren, Wesley C. and Walter, Ronald B. and Meyer, Axel and Schartl, Manfred}, title = {Long-term experimental hybridisation results in the evolution of a new sex chromosome in swordtail fish}, series = {Nature Communications}, volume = {9}, journal = {Nature Communications}, doi = {10.1038/s41467-018-07648-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228396}, year = {2018}, abstract = {The remarkable diversity of sex determination mechanisms known in fish may be fuelled by exceptionally high rates of sex chromosome turnovers or transitions. However, the evolutionary causes and genomic mechanisms underlying this variation and instability are yet to be understood. Here we report on an over 30-year evolutionary experiment in which we tested the genomic consequences of hybridisation and selection between two Xiphophorus fish species with different sex chromosome systems. We find that introgression and imposing selection for pigmentation phenotypes results in the retention of an unexpectedly large maternally derived genomic region. During the hybridisation process, the sex-determining region of the X chromosome from one parental species was translocated to an autosome in the hybrids leading to the evolution of a new sex chromosome. Our results highlight the complexity of factors contributing to patterns observed in hybrid genomes, and we experimentally demonstrate that hybridisation can catalyze rapid evolution of a new sex chromosome.}, language = {en} } @phdthesis{Stuerzebecher2024, author = {St{\"u}rzebecher, Paulina Elena}, title = {Die Rolle von LASP1 in der Pathogenese der Atherosklerose im murinen Modell}, doi = {10.25972/OPUS-23935}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239353}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Das regulatorische Ger{\"u}st-Protein LASP1, welches aus der Krebsforschung bekannt ist, wurde 2012 in humanen Makrophagen, den Protagonisten der Atherosklerose nachgewiesen. LASP1 ist durch seine Lokalisation an dynamischen Aktinskelettkonstruktionen (vgl. Invadopodien, Podosomen), nachweislich an Zellmigration, Proliferation und Invasionsf{\"a}higkeit bestimmter Tumorzellen beteiligt. Aufgrund einer großen Schnittmenge der Entstehungsmechanismen und zugrundeliegenden Signalwegen von Krebserkrankungen und Atherosklerose wurde LASP1 im Zusammenhang der Atherosklerose untersucht. In einem 16 Wochen Hochfettdi{\"a}tversuch zeigten LASP1.Ldlr-/--M{\"a}use mehr atherosklerotische L{\"a}sionen in der Gesamtaorta als Ldlr-/--Tiere, was eine athero-protektive Rolle von LASP1 nahelegt. Passend hierzu f{\"u}hrte Stimulation mit oxLDL in Makrophagen zu einer Hochregulation von LASP1. Zus{\"a}tzlich internalisierten LASP1-/--Makrophagen signifikant mehr oxLDL im Vergleich zu LASP1-exprimierenden Zellen. Analog zu den Daten aus der Krebsforschung konnte eine reduzierte endotheliale Adh{\"a}sion sowie chemotaktische Migration von Ldlr.LASP1-/--Monozyten im Vergleich zu Ldlr-/-- Monozyten festgestellt werden. Dies ließe isoliert betrachtet eine pro-atherogene Rolle von LASP1 vermuten. Ein Nachweis von LASP1 im Zellkern von BMDMs konnte, zus{\"a}tzlich zum fehlenden Shuttelproteinpartner ZO-2, nicht erbracht werden. Die Interaktion von LASP1 mit Transkriptionsfaktoren scheint daher unwahrscheinlich. Kongruent mit diesen Ergebnissen zeigte sich keine Ver{\"a}nderung der Transkription, der Proteinexpression sowie Sekretion von TNF! und ADAM17 durch den LASP1-KO. Insgesamt kommt LASP1 eine zweifellos komplexe Rolle in der Atherogenese zu. Die Ergebnisse der HFD-Versuche legen nahe, dass die prim{\"a}r anti-atherosklerotischen Einfl{\"u}sse von LASP1 in vivo gegen{\"u}ber den eher pro-atherosklerotischen Effekten des Proteins in vitro {\"u}berwiegen.}, subject = {Arteriosklerose}, language = {de} } @phdthesis{Friedrich2024, author = {Friedrich, Anna-Lena}, title = {FoxO3-mediated, inhibitory effects of CNP on the profibrotic activation of lung fibroblasts}, doi = {10.25972/OPUS-35984}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-359845}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Idiopathic Pulmonary Fibrosis (IPF) is a progressive parenchymal lung disease with limited therapeutic treatments. Pathologically altered lung fibroblasts, called myofibroblasts, exhibit increased proliferation, migration, and collagen production, and drive IPF development and progression. Fibrogenic factors such as Platelet derived growth factor-BB (PDGF-BB) contribute to these pathological alterations. Endogenous counter-regulating factors are barely known. Published studies have described a protective role of exogenously administered C-type Natriuretic Peptide (CNP) in pathological tissue remodeling, for example in heart and liver fibrosis. CNP and its cyclic GMP producing guanylyl cyclase B (GC-B) receptor are expressed in the lungs, but it is unknown whether CNP can attenuate lung fibrosis by this pathway. To address this question, we performed studies in primary cultured lung fibroblasts. To examine the effects of the CNP/GC-B pathway on PDGF-BB-induced collagen production, proliferation, and migration in vitro, lung fibroblasts were cultured from wildtype control and GC-B knockout mice. Human lung fibroblasts from patients with IPF and healthy controls were obtained from the UGMLC Biobank. In RIA experiments, CNP, at 10nM and 100nM, markedly and similarly increased cGMP levels in both the murine and human lung fibroblasts, demonstrating GC-B/cGMP signaling. CNP reduced PDGF-BB induced proliferation and migration of lung fibroblasts in BrdU incorporation and gap closure assays, respectively. CNP strongly decreased PDGF-BB-induced collagen 1/3 expression as measured by immunocytochemistry and immunoblotting. Importantly, the protective actions of CNP were preserved in IPF fibroblasts. It is known that the profibrotic actions of PDGF-BB are partly mediated by phosphorylation and nuclear export of Forkhead Box O3 (FoxO3), a transcription factor downregulated in IPF. CNP prevented PDGF-BB elicited FoxO3 phosphorylation and nuclear exclusion in both murine and human control and IPF fibroblasts. CNP signaling and functions were abolished in GC-B-deficient lung fibroblasts. Taken together, the results show that CNP moderates the PDGF-BB-induced activation and differentiation of human and murine lung fibroblasts to myofibroblasts. This effect is mediated CNP-dependent by GC-B/cGMP signaling and FoxO3 regulation. To follow up the patho-physiological relevance of these results, we are generating mice with fibroblast-restricted GC-B deletion for studies in the model of bleomycin-induced pulmonary fibrosis.}, subject = {Idiopathische pulmonale Fibrose}, language = {en} } @phdthesis{Menger2024, author = {Menger, Kristina Rebekka}, title = {Bauchlagerung f{\"u}r nicht-intubierte ARDS- und COVID-19 Patient/innen: eine systematische {\"U}bersichtsarbeit}, doi = {10.25972/OPUS-35986}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-359865}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Die Bauchlagerung von intubierten ARDS-Patient/innen mit einer schlechten Oxygenierung wird laut Leitlinie seit mehreren Jahren als supportive Therapiemaßnahme empfohlen. Im Rahmen der COVID-19 Pandemie wurde nun erstmalig die Bauchlagerung auch bei hypox{\"a}mischen, nicht-intubierten Patient/innen untersucht. Diese Fragestellung wurde in der vorliegenden Arbeit mittels einer systematischen {\"U}bersichtsarbeit betrachtet. Aufgrund der aktuellen Pandemiesituation wurden neben ARDS-Patient/innen im Allgemeinen insbesondere COVID-19 Patient/innen mit einem akuten Lungenversagen als Subgruppe untersucht. Am 21.11.2020 wurde eine systematische Suche nach Studien in den Datenbanken MEDLINE, Cochrane COVID-19 Study Register und Living Overview of the Evidence platform durchgef{\"u}hrt. Die Ergebnisse wurden, wo m{\"o}glich, in Form einer Meta-Analyse zusammengefasst, in Tabellen darstellt oder deskriptiv beschrieben. Das Risiko f{\"u}r Bias wurde jeweils f{\"u}r die eingeschlossenen kontrollierten Studien mittels ROBINS-I beurteilt. Die Vertrauensw{\"u}rdigkeit der Evidenz der gesamten Arbeit wurde mit Hilfe des GRADE-Ansatzes untersucht. Insgesamt wurden 30 Studien eingeschlossen, davon 4 kontrollierte Studien, keine RCTs. In 3 der kontrollierten Studien wurde die Bauchlagerung bei COVID-19 Patient/innen untersucht, in einer bei Patient/innen mit einem anderweitig verursachten ARDS. Es ist unklar, ob die Bauchlagerung die Intubationsrate (RR = 0,92; 95\% KI: 0,59 - 1,44; I² = 65\%; sehr niedrige Vertrauensw{\"u}rdigkeit der Evidenz), die Mortalit{\"a}t (RR = 0,55; 95\% KI: 0,23 - 1,30; I² = 60\%; sehr niedrige Vertrauensw{\"u}rdigkeit der Evidenz) und die Wahrscheinlichkeit f{\"u}r eine Aufnahme auf die Intensivstation (RR = 0,94; 95\% KI: 0,54 - 1,63; I2 = 71\%; sehr niedrige Vertrauensw{\"u}rdigkeit der Evidenz) verringern kann. Auch f{\"u}r die anderen betrachteten Endpunkte konnte kein signifikanter Effekt der Bauchlagerung nachgewiesen werden Im Vergleich der Subgruppen „Nicht-COVID-19" (8 Studien) und „COVID-19" (22 Studien) konnten in Bezug auf alle betrachteten Endpunkte keine relevanten Unterschiede festgestellt werden. Insgesamt ist die Evidenz nicht ausreichend, um Vor- und Nachteile der Bauchlagerung f{\"u}r nicht-intubierte ARDS Patient/innen gegen{\"u}ber der {\"u}blichen R{\"u}ckenlagerung aufzuzeigen und diese f{\"u}r die Praxis zu empfehlen.}, subject = {Bauchlage}, language = {de} } @phdthesis{Hajduk2024, author = {Hajduk, Maurice Martin}, title = {Darf es etwas mehr sein? Neuroenhancement im Studium - eine Befragung an W{\"u}rzburger Hochschulen}, doi = {10.25972/OPUS-35981}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-359812}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Neuroenhancement (NE) bezeichnet die Einnahme psychotroper Substanzen mit dem Ziel der geistigen Leistungssteigerung oder Beruhigung. NE wird durch gesunde Perso- nen genutzt. Es besteht somit keine Indikation zur Einnahme psychotroper Wirkstoffe. Zum NE genutzte Substanzen sind z.B. Koffeintabletten, verschreibungspflichtige Medi- kamente oder illegale Substanzen. Die bisherige Forschung findet Hinweise auf einen Zusammenhang zwischen NE und ADHS-Symptomen, einigen Aspekten psychischer Gesundheit, sowie Substanzkonsum. Bisher gibt es keine Forschung zu NE am Hoch- schulstandort W{\"u}rzburg. Es wurde eine anonyme online Querschnittsbefragung im ersten Quartal 2021 durchge- f{\"u}hrt. Eingeladen waren 5600 Studierende der Julius-Maximilians-Universit{\"a}t W{\"u}rzburg und der Hochschule f{\"u}r angewandte Wissenschaften W{\"u}rzburg Schweinfurt. Der Frage- bogen bestand aus 53 Items und enthielt u. a. die folgenden validierten Messinstrumente: ASRS, PSS-10, PHQ-4 und AUDIT-C. Die Response Rate lag bei 18\% (n = 1011). Das Wissen {\"u}ber NE war weit unter den Stu- dierenden verbreitet. Die Pr{\"a}valenz f{\"u}r Neuroenhancement im Studium lag bei 12.7\%. Die drei meistgenannten Substanzen waren Koffeintabletten (6.6\%), Cannabis (4.5\%) und Methylphenidat (4.3\%). H{\"a}ufigster Anlass f{\"u}r NE war die Pr{\"u}fungsvorbereitung. Es zeigten sich deutliche Unterschiede zwischen den Fachbereichen, u.a. hinsichtlich der Pr{\"a}valenz von NE. ADHS-Symptomen, Stress, {\"A}ngstlichkeit, und Depressivit{\"a}t waren positiv mit NE assoziiert. Ein st{\"a}rkerer Effekt ergab sich f{\"u}r den Zusammenhang zwi- schen NE und riskanten Alkoholkonsum bzw. Tabakkonsum. Diese Ergebnisse wurden durch eine binomial logistische Regression best{\"a}tigt. Die konsumierten Substanzen, das Wissen {\"u}ber NE, die Pr{\"a}valenz von NE und die Gr{\"u}nde f{\"u}r dessen Nutzung f{\"u}gen sich nahtlos in die bisherige Forschung ein. Auch die Assoziation zwischen ADHS-Symptomen, Stress, {\"A}ngstlichkeit, Depressivit{\"a}t, riskan- tem Alkoholkonsum und Tabakkonsum best{\"a}tigt bisherige Forschungsergebnisse. Es konnte gezeigt werden, dass rund ein Zehntel der Studierenden NE bereits genutzt haben. In Anbetracht der gesundheitlichen Gefahren, die mit NE einhergehen ist die Etab- lierung bzw. der Ausbau von Aufkl{\"a}rung-, Beratungs- und Hilfsangeboten f{\"u}r Studie- rende anzustreben sowie weitere Forschung zum Thema indiziert.}, subject = {Psychische Gesundheit}, language = {de} } @phdthesis{Hammel2024, author = {Hammel, Clara}, title = {Einfluss longitudinaler Ver{\"a}nderungen der linksventrikul{\"a}ren Ejektionsfraktion auf das Langzeit{\"u}berleben bei Herzinsuffizienzpatienten mit leicht reduzierter Ejektionsfraktion oder reduzierter Ejektionsfraktion}, doi = {10.25972/OPUS-36002}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-360025}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Diese retrospektive Studie an der Universit{\"a}tsklinik W{\"u}rzburg diente der Beurteilung der longitudinalen Funktion in Bezug auf die Gesamtmortalit{\"a}t bei Patienten mit HFmrEF und HFrEF. Die Gruppierung erfolgte anhand der jeweiligen Baseline LVEF. Eine weitere Unterteilung erfolgte in eine isch{\"a}mische oder nicht-isch{\"a}mische Genese der HF. Die Subgruppen wurden anhand der Baseline klinischen Charakteristika sowie der echokardiographischen Parameter verglichen. Hier ließ sich ein relativ {\"a}hnliches Patientenklientel mit vergleichbarem Alter, Geschlecht, BMI sowie kardialen Risikofaktoren zeigen. Signifikante Unterschiede ergab der Vergleich des NYHA-Stadiums, der Nierenfunktion sowie des Auftretens von Myokardinfarkten. Die Ver{\"a}nderung der LVEF {\"u}ber die Zeit hat einen zentralen Stellenwert zur Evaluation des Outcomes von Patienten mit HFmrEF und HFrEF. Eine Verbesserung der LVEF fand sich signifikant h{\"a}ufiger bei HFrEF Patienten als bei HFmrEF Patienten, welche {\"u}ber die Zeit signifikant h{\"a}ufiger eine stabile LVEF aufwiesen. Außerdem war nach Auswertung der {\"U}berlebenskurven nach Kaplan-Meier in HFmrEF Patienten eine verbesserte oder unver{\"a}nderte LVEF {\"u}ber die Zeit mit einem besseren {\"U}berleben verbunden, vor allem bei Patienten mit isch{\"a}mischer {\"A}tiologie. In der HFrEF Gruppe konnte gezeigt werden, dass sowohl Patienten mit isch{\"a}mischer als auch mit nicht-isch{\"a}mischer {\"A}tiologie bei Vorliegen einer verbesserten oder unver{\"a}nderten LVEF {\"u}ber die Zeit ein besseres Outcome aufwiesen. Eine erniedrigte MAPSE bedeutete vor allem bei HFmrEF Patienten mit nicht-isch{\"a}mischer {\"A}tiologie ein schlechteres Outcome. Die Ergebnisse dienten unter anderem der weiteren Charakterisierung der HFmrEF und HFrEF Gruppe sowie der Identifikation von Faktoren zur Beurteilung der Ver{\"a}nderung der LVEF {\"u}ber die Zeit und der Prognose des Langzeit{\"u}berlebens beider Gruppen. Ziel f{\"u}r die Zukunft sollte sein, auch f{\"u}r HFmrEF Patienten evidenzbasierte Herzinsuffizienz Therapien zu etablieren.}, subject = {Transthorakale Echokardiographie}, language = {de} } @article{AllertFoersterSvenssonetal.2018, author = {Allert, Stefanie and F{\"o}rster, Toni M. and Svensson, Carl-Magnus and Richardson, Jonathan P. and Pawlik, Tony and Hebecker, Betty and Rudolphi, Sven and Juraschitz, Marc and Schaller, Martin and Blagojevic, Mariana and Morschh{\"a}user, Joachim and Figge, Marc Thilo and Jacobsen, Ilse D. and Naglik, Julian R. and Kasper, Lydia and Mogavero, Selene and Hube, Bernhard}, title = {\(Candida\) \(albicans\)-Induced Epithelial Damage Mediates Translocation through Intestinal Barriers}, series = {mBio}, volume = {9}, journal = {mBio}, number = {3}, doi = {10.1128/mBio.00915-18}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-221084}, pages = {1-20}, year = {2018}, abstract = {Life-threatening systemic infections often occur due to the translocation of pathogens across the gut barrier and into the bloodstream. While the microbial and host mechanisms permitting bacterial gut translocation are well characterized, these mechanisms are still unclear for fungal pathogens such as Candida albicans, a leading cause of nosocomial fungal bloodstream infections. In this study, we dissected the cellular mechanisms of translocation of C. albicans across intestinal epithelia in vitro and identified fungal genes associated with this process. We show that fungal translocation is a dynamic process initiated by invasion and followed by cellular damage and loss of epithelial integrity. A screen of >2,000 C. albicans deletion mutants identified genes required for cellular damage of and translocation across enterocytes. Correlation analysis suggests that hypha formation, barrier damage above a minimum threshold level, and a decreased epithelial integrity are required for efficient fungal translocation. Translocation occurs predominantly via a transcellular route, which is associated with fungus-induced necrotic epithelial damage, but not apoptotic cell death. The cytolytic peptide toxin of C. albicans, candidalysin, was found to be essential for damage of enterocytes and was a key factor in subsequent fungal translocation, suggesting that transcellular translocation of C. albicans through intestinal layers is mediated by candidalysin. However, fungal invasion and low-level translocation can also occur via non-transcellular routes in a candidalysin-independent manner. This is the first study showing translocation of a human-pathogenic fungus across the intestinal barrier being mediated by a peptide toxin. IMPORTANCE Candida albicans, usually a harmless fungus colonizing human mucosae, can cause lethal bloodstream infections when it manages to translocate across the intestinal epithelium. This can result from antibiotic treatment, immune dysfunction, or intestinal damage (e.g., during surgery). However, fungal processes may also contribute. In this study, we investigated the translocation process of C. albicans using in vitro cell culture models. Translocation occurs as a stepwise process starting with invasion, followed by epithelial damage and loss of epithelial integrity. The ability to secrete candidalysin, a peptide toxin deriving from the hyphal protein Ece1, is key: C. albicans hyphae, secreting candidalysin, take advantage of a necrotic weakened epithelium to translocate through the intestinal layer.}, language = {en} } @phdthesis{Bredemeyer2024, author = {Bredemeyer, Cynthia Natascha}, title = {Akademisierung und Professionalisierung der Zahnheilkunde, insbesondere der Zahnchirurgie, in W{\"u}rzburg und Unterfranken im 19. Jahrhundert}, doi = {10.25972/OPUS-36387}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-363878}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Die Arbeit befasst sich mit der Akademisierung und Professionalisierung der Zahnheilkunde, insbesondere der Zahnchirurgie, in W{\"u}rzburg und Unterfranken im 19. Jahrhundert. Dies wurde insbesondere anhand des zahnchirurgischen Teils der Lehrchirurgischen Instrumentensammlung der Universit{\"a}t W{\"u}rzburg bzw. des Juliusspitals erforscht. Der zahnchirurgische Teil der Instrumentensammlung war bisher noch nicht erforscht worden und besteht aktuell aus 34+1 Instrumenten, die f{\"u}r diese Arbeit komplett katalogisiert wurden. F{\"u}r die Entwicklung der Instrumente im Verlauf des 19. Jahrhunderts wurde die Provenienz der Teilsammlung ergr{\"u}ndet und diese in den Kontext der Akademisierungsbewegung des 19. Jahrhunderts eingeordnet. Die Forschung wurde anhand der tats{\"a}chlich in der Praxis t{\"a}tigen und nach und nach akademisch ausgebildeten Personen nachvollzogen. Hierzu wurden neben den Instrumenten als Quelle die Adressb{\"u}cher der Stadt W{\"u}rzburg und die Matrikel-, Personal- und Vorlesungsverzeichnisse der Universit{\"a}t W{\"u}rzburg des gesamten 19. Jahrhunderts systematisch durchgearbeitet. Außerdem wurden Lehrb{\"u}cher aus dem nichtakademischen zahnchirurigischen Bereich (Bader) mit denen aus dem sich beginnenden akademischen Bereich analysiert. Anhand dieser Forschungsarbeit konnte dargelegt werden, dass die Zahnchirurgie sich analog zur Chiurgie aus dem handwerklichen Bereich abgekoppelt und nach und nach auf verschiedenen Stufen akademisiert hat. Die Zahnchirurgie hat sich "von unten nach oben" durch das Bestreben nichtakademisch ausgebildeter Menschen akademisiert.}, subject = {Zahnchirurgie}, language = {de} } @phdthesis{Papay2024, author = {Papay, Marion}, title = {Notwendigkeit der pr{\"a}operativen Reposition von distalen, nach dorsal dislozierten Radiusfrakturen bei bestehender Operationsindikation im Hinblick auf das Schmerzniveau sowie postoperative Ergebnisse}, doi = {10.25972/OPUS-36388}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-363882}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Die distale Radiusfraktur geh{\"o}rt zu den h{\"a}ufigsten Frakturen in Deutschland mit einem Inzidenzanstieg im Alter unter Betonung des weiblichen Geschlechts. Dabei zeigt sich ein zunehmender Trend in Richtung operative Versorgung, allen voran die Versorgung mittels winkelstabiler Plattensysteme. Instabile, distale Radiusfrakturen werden dabei vor geplanter operativer Versorgung im Rahmen der Initialbehandlung {\"u}blicherweise geschlossen reponiert und im Gipsverband retiniert. Ziel der vorliegenden monozentrischen, prospektiv randomisierten Studie mit zwei Studiengruppen war es herauszufinden, ob sich das Unterlassen der Reposition vor geplanter Operation nachteilig auf das Schmerzniveau in der pr{\"a}operativen Phase auswirkt und ob sich durch die Dislokation Nachteile in Bezug auf den Nervus medianus im Sinne eines Traktionsschadens sowie bez{\"u}glich des klinisch-radiologischen Ausheilungsergebnisses zeigen. Die Studie zeigte, dass das Schmerzempfinden w{\"a}hrend der pr{\"a}operativen Gipsbehandlung unabh{\"a}ngig von einer vorherigen Reposition war. F{\"u}r den prim{\"a}ren Endpunkt an Tag 1 nach der Akutbehandlung konnte statistisch signifikante Nichtunterlegenheit der Gruppe ohne Reposition gegen{\"u}ber der Gruppe mit Reposition nachgewiesen werden. Gleiches galt f{\"u}r Tag 2, sowohl f{\"u}r die absoluten Schmerzniveaus als auch f{\"u}r die Schmerzlinderung. Das Unterlassen der Reposition hatte zudem keine nachteiligen Effekte auf den Nervus medianus. Gleiches zeigte sich f{\"u}r das klinische und radiologische Ausheilungsergebnis. F{\"u}r die funktionellen DASH- und Krimmer-Scores konnte ein Jahr postoperativ ebenfalls statistisch signifikante Nichtunterlegenheit der Gruppe ohne Reposition nachgewiesen werden. Diese Erkenntnisse best{\"a}tigen die in der Literatur vorhandenen Ergebnisse verschiedener Studien dahingehend, dass das Unterlassen der Reposition keine nachteiligen Effekte auf das postoperative Outcome hat. Einige Studien verdeutlichen zudem, dass es nach Reposition, insbesondere bei Vorliegen gewisser Risiko- und Instabilit{\"a}tsfaktoren, ohnehin zur sekund{\"a}ren Dislokation kommt, sodass die generelle Notwendigkeit der Reposition vor Gipsanlage sowohl vor einer operativen als auch vor einer konservativen Weiterbehandlung angezweifelt werden muss.}, subject = {distale Radiusfraktur}, language = {de} } @phdthesis{Krings2024, author = {Krings, Moritz}, title = {Universit{\"a}re Psychiatrie um 1900 : Die Anfangsjahre der psychiatrischen Klinik in W{\"u}rzburg}, doi = {10.25972/OPUS-36140}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-361407}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Ende des 19. Jahrhunderts standen sich in Deutschland zwei verschiedene Arten psychiatrischer Institutionen gegen{\"u}ber, die Anstaltspsychiatrien auf der einen, die universit{\"a}ren psychiatrischen Kliniken auf der anderen Seite. Die psychiatriehistorische Forschung widmete sich {\"u}berwiegend psychiatrischen Anstalten w{\"a}hrend Kliniken hier unterrepr{\"a}sentiert sind. Die vorliegende Arbeit m{\"o}chte zur historischen Kenntnis universit{\"a}rer psychiatrischer Einrichtungen beitragen. Hierzu werden die Charakteristika einer psychiatrischen Klinik um 1900 anhand des Beispiels der psychiatrischen Klinik der Universit{\"a}t W{\"u}rzburg betrachtet. Der Fokus liegt hierbei neben Lage und Aufbau der Klinik sowie deren Personal auf den drei Bereichen Patient*innen, Forschung und Lehre.}, subject = {Julius-Maximilians-Universit{\"a}t W{\"u}rzburg}, language = {de} } @phdthesis{Zuber2024, author = {Zuber, Jonas Maximilian}, title = {Evaluation von Sedierungen und Allgemeinan{\"a}sthesien zur Durchf{\"u}hrung bildgebender Verfahren bei S{\"a}uglingen bis zum 6. Lebensmonat}, doi = {10.25972/OPUS-36111}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-361111}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Vorliegende Untersuchung am Universit{\"a}tsklinikum W{\"u}rzburg sowie die Befragung von An{\"a}sthesisten/An{\"a}sthesistinnen im Raum der 3 DACH-L{\"a}nder zeigen, dass bildgebende Verfahren bei S{\"a}uglingen mit einer niedrigen Rate an Komplikationen, zumeist in medikament{\"o}ser Sedierung mit Propofol, durchgef{\"u}hrt werden. Wie international {\"u}blich ist im S{\"a}uglingsalter die Magnetresonanztomographie das bildgebende Verfahren der Wahl und wird, mit {\"u}berzeugender H{\"a}ufigkeit, erfolgreich durchgef{\"u}hrt. Die Untersuchung am Universit{\"a}tsklinikum W{\"u}rzburg legt nahe, dass m{\"a}nnliche S{\"a}uglinge h{\"a}ufiger eine Bildgebung ben{\"o}tigen und h{\"a}ufiger h{\"o}heren ASA-Kategorie zugeschrieben werden. Dabei scheinen sie auch h{\"a}ufiger Komplikationen zu erleben und bed{\"u}rfen daher besonderer Aufmerksamkeit. Eine eventuelle Alternative zur Sedierung kann dabei die „feed-and-sleep" Methode darstellen. In unserer Umfrage konnten wir erheben, dass diese Methode bisher wenig verbreitet ist, obwohl in diesem Zusammenhang eventuell Abl{\"a}ufe und Prozesszeiten strukturiert und optimiert werden k{\"o}nnen, da beispielsweise die Nach{\"u}berwachung entf{\"a}llt. Vorstellbar w{\"a}re beispielsweise, mehrere S{\"a}uglinge zum gleichen Zeitpunkt ins MRT zu bestellen, um gegebenenfalls den am fr{\"u}hesten eingeschlafenen S{\"a}ugling vorzuziehen. Diese Methode sollte zuk{\"u}nftig Einzug in die wissenschaftliche Untersuchung von bildgebenden Verfahren bei S{\"a}uglingen finden. Die Umfrage im deutschsprachigen Raum zeigt eine Leitlinien-gerechte Betreuung von S{\"a}uglingen f{\"u}r bildgebende Verfahren, die mit einer hohen Qualit{\"a}t, und zumeist erfolgreich von erfahrenen An{\"a}sthesisten/An{\"a}sthesistinnen durchgef{\"u}hrt wird. Eventuelle Verbesserungen k{\"o}nnen im Bereich der Ausbildung nachfolgender {\"A}rztinnen/{\"A}rzte und in der h{\"a}ufigeren Verwendung der „feed-and-sleep" Methode liegen, die vielen Kollegen/Kolleginnen bekannt ist, aber nur selten durchgef{\"u}hrt wird. Ziel ist eine qualitativ hochwertige, schnellstm{\"o}glich durchgef{\"u}hrte Bildgebung, die ohne oder mit der niedrigst m{\"o}glichen Dosierung eines sedierenden Medikamentes zu erreichen ist.}, subject = {Sedierung}, language = {de} } @phdthesis{Dalkmann2024, author = {Dalkmann, Theresa}, title = {Evaluierung prognostischer und pr{\"a}diktiver Biomarker beim neoadjuvant vorbehandelten Rektumkarzinom}, doi = {10.25972/OPUS-36336}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-363368}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Fragestellung. Osteopontin (OPN) kann im Blut nachgewiesen werden und wird bei vielen Tumorentit{\"a}ten exprimiert, wie auch der Tyrosinkinaserezeptor c-Met und sein Ligand, das Zytokin Hepatocyte Growth Factor (HGF). In der vorliegenden Arbeit untersuchten wir die prognostische und pr{\"a}diktive Wertigkeit der Plasmakonzentrationen von OPN, c-Met und HGF bei Patienten mit lokal fortgeschrittenem Rektumkarzinom (LARC). Methodik. Das Plasma von 63 Patienten mit LARC wurde untersucht. Die Blutentnahmen (EDTA-Plasma) erfolgten vor Therapiebeginn sowie im Verlauf. Die Plasmaspiegel von OPN, c-Met und HGF wurden mittels Enzyme-Linked Immunosorbent Assay analysiert. Die Konzentrationen wurden auf eine Korrelation mit den klinischen Parametern untersucht. Ergebnisse. 68 Patienten wurden neoadjuvant mit einer Radiochemotherapie behandelt, 63 Blutproben wurden untersucht. Initial befanden sich nach UICC 14 Patienten in Stadium II, 47 in Stadium III und 7 in Stadium IV. Das mediane Follow-Up betrug 29,87 Monate. 20 der 68 Patienten (29,4 \%) verstarben, 19 entwickelten Fernmetastasen. OPN korrelierte signifikant mit dem {\"U}berleben (p=0,001). OPN-Werte korrelierten mit dem pT-Stadium (R:0,445 p=0,018) und dem pUICC-Stadium (R:0,412 p=0,018), sowie mit dem Auftreten von Fernmetastasen (R:0,271 p=0,031). Eine Korrelation zwischen OPN und dem Therapieansprechen konnte gezeigt werden: pathologisch komplette Remission (pCR) (R:0,379 p=0,001), NAR-Score (R:0,373 p=0,015), TRG (R:0,380 p=0,020). Die logistische Regressionsanalyse ergab eine Pr{\"a}diktivit{\"a}t OPNs f{\"u}r pCR (OR:0,990 p=0,009), NAR-Score (OR:1,008 p=0,007), TRG (OR:0,459 p=0,008). C-Met und HGF korrelierten nicht mit dem {\"U}berleben. F{\"u}r c-Met und HGF ergab sich keine Korrelation zu initialen klinischen Daten und Therapieansprechen. Die logistische Regression ergab keinen pr{\"a}diktiven Wert. Schlussfolgerung. Die Plasmakonzentration von OPN besitzt prognostische und pr{\"a}diktive Wertigkeit beim LARC. Die Konzentrationen von c-Met und HGF sind nicht prognostisch f{\"u}r das {\"U}berleben oder pr{\"a}diktiv f{\"u}r das Therapieansprechen.}, subject = {Biomarker}, language = {de} } @article{GhoshHoenscheidDueckersetal.2017, author = {Ghosh, Sujal and H{\"o}nscheid, Andrea and D{\"u}ckers, Gregor and Ginzel, Sebastian and Gohlke, Holger and Gombert, Michael and Kempkes, Bettina and Klapper, Wolfram and Kuhlen, Michaela and Laws, Hans-J{\"u}rgen and Linka, Ren{\´e} Martin and Meisel, Roland and Mielke, Christian and Niehues, Tim and Schindler, Detlev and Schneider, Dominik and Schuster, Friedhelm R. and Speckmann, Carsten and Borkhardt, Arndt}, title = {Human RAD52 - a novel player in DNA repair in cancer and immunodeficiency}, series = {Haematologica}, volume = {102}, journal = {Haematologica}, number = {2}, doi = {10.3324/haematol.2016.155838}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-180862}, pages = {e69-e72}, year = {2017}, abstract = {No abstract available.}, language = {en} } @article{HernandezJoseRamirezMinguillonetal.2018, author = {Hern{\´a}ndez, Gonzalo and Jos{\´e} Ram{\´i}rez, Mar{\´i}a and Minguill{\´o}n, Jordi and Quiles, Paco and Ruiz de Garibay, Gorka and Aza-Carmona, Miriam and Bogliolo, Massimo and Pujol, Roser and Prados-Carvajal, Rosario and Fern{\´a}ndez, Juana and Garc{\´i}a, Nadia and L{\´o}pez, Adri{\`a} and Guti{\´e}rrez-Enr{\´i}quez, Sara and Diez, Orland and Ben{\´i}tez, Javier and Salinas, M{\´o}nica and Teul{\´e}, Alex and Brunet, Joan and Radice, Paolo and Peterlongo, Paolo and Schindler, Detlev and Huertas, Pablo and Puente, Xose S. and L{\´a}zaro, Conxi and {\`A}ngel Pujana, Miquel and Surrall{\´e}s, Jordi}, title = {Decapping protein EDC4 regulates DNA repair and phenocopies BRCA1}, series = {Nature Communications}, volume = {9}, journal = {Nature Communications}, doi = {10.1038/s41467-018-03433-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-319929}, year = {2018}, abstract = {BRCA1 is a tumor suppressor that regulates DNA repair by homologous recombination. Germline mutations in BRCA1 are associated with increased risk of breast and ovarian cancer and BRCA1 deficient tumors are exquisitely sensitive to poly (ADP-ribose) polymerase (PARP) inhibitors. Therefore, uncovering additional components of this DNA repair pathway is of extreme importance for further understanding cancer development and therapeutic vulnerabilities. Here, we identify EDC4, a known component of processing-bodies and regulator of mRNA decapping, as a member of the BRCA1-BRIP1-TOPBP1 complex. EDC4 plays a key role in homologous recombination by stimulating end resection at double-strand breaks. EDC4 deficiency leads to genome instability and hypersensitivity to DNA interstrand cross-linking drugs and PARP inhibitors. Lack-of-function mutations in EDC4 were detected in BRCA1/2-mutation-negative breast cancer cases, suggesting a role in breast cancer susceptibility. Collectively, this study recognizes EDC4 with a dual role in decapping and DNA repair whose inactivation phenocopies BRCA1 deficiency.}, language = {en} } @article{MuellerCosentinoFoerstneretal.2018, author = {M{\"u}ller, Laura S. M. and Cosentino, Ra{\´u}l O. and F{\"o}rstner, Konrad U. and Guizetti, Julien and Wedel, Carolin and Kaplan, Noam and Janzen, Christian J. and Arampatzi, Panagiota and Vogel, J{\"o}rg and Steinbiss, Sascha and Otto, Thomas D. and Saliba, Antoine-Emmanuel and Sebra, Robert P. and Siegel, T. Nicolai}, title = {Genome organization and DNA accessibility control antigenic variation in trypanosomes}, series = {Nature}, volume = {563}, journal = {Nature}, doi = {10.1038/s41586-018-0619-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-224265}, pages = {121-125}, year = {2018}, abstract = {Many evolutionarily distant pathogenic organisms have evolved similar survival strategies to evade the immune responses of their hosts. These include antigenic variation, through which an infecting organism prevents clearance by periodically altering the identity of proteins that are visible to the immune system of the host1. Antigenic variation requires large reservoirs of immunologically diverse antigen genes, which are often generated through homologous recombination, as well as mechanisms to ensure the expression of one or very few antigens at any given time. Both homologous recombination and gene expression are affected by three-dimensional genome architecture and local DNA accessibility2,3. Factors that link three-dimensional genome architecture, local chromatin conformation and antigenic variation have, to our knowledge, not yet been identified in any organism. One of the major obstacles to studying the role of genome architecture in antigenic variation has been the highly repetitive nature and heterozygosity of antigen-gene arrays, which has precluded complete genome assembly in many pathogens. Here we report the de novo haplotype-specific assembly and scaffolding of the long antigen-gene arrays of the model protozoan parasite Trypanosoma brucei, using long-read sequencing technology and conserved features of chromosome folding4. Genome-wide chromosome conformation capture (Hi-C) reveals a distinct partitioning of the genome, with antigen-encoding subtelomeric regions that are folded into distinct, highly compact compartments. In addition, we performed a range of analyses—Hi-C, fluorescence in situ hybridization, assays for transposase-accessible chromatin using sequencing and single-cell RNA sequencing—that showed that deletion of the histone variants H3.V and H4.V increases antigen-gene clustering, DNA accessibility across sites of antigen expression and switching of the expressed antigen isoform, via homologous recombination. Our analyses identify histone variants as a molecular link between global genome architecture, local chromatin conformation and antigenic variation.}, language = {en} } @article{MunzRichterLoosetal.2018, author = {Munz, Matthias and Richter, Gesa M. and Loos, Bruno G. and Jepsen, S{\o}ren and Divaris, Kimon and Offenbacher, Steven and Teumer, Alexander and Holtfreter, Birte and Kocher, Thomas and Bruckmann, Corinna and Jockel-Schneider, Yvonne and Graetz, Christian and Munoz, Loreto and Bhandari, Anita and Tennstedt, Stephanie and Staufenbiel, Ingmar and van der Velde, Nathalie and Uitterlinden, Andr{\´e} G. and de Groot, Lisette C. P. G. M. and Wellmann, J{\"u}rgen and Berger, Klaus and Krone, Bastian and Hoffmann, Per and Laudes, Matthias and Lieb, Wolfgang and Andre, Franke and Dommisch, Henrik and Erdmann, Jeanette and Schaefer, Arne S.}, title = {Genome-wide association meta-analysis of coronary artery disease and periodontitis reveals a novel shared risk locus}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, doi = {10.1038/s41598-018-31980-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-231647}, year = {2018}, abstract = {Evidence for a shared genetic basis of association between coronary artery disease (CAD) and periodontitis (PD) exists. To explore the joint genetic basis, we performed a GWAS meta-analysis. In the discovery stage, we used a German aggressive periodontitis sample (AgP-Ger; 680 cases vs 3,973 controls) and the CARDIoGRAMplusC4D CAD meta-analysis dataset (60,801 cases vs 123,504 controls). Two SNPs at the known CAD risk loci ADAMTS7 (rs11634042) and VAMP8 (rs1561198) passed the pre-assigned selection criteria (PAgP-Ger < 0.05; PCAD < 5 × 10-8; concordant effect direction) and were replicated in an independent GWAS meta-analysis dataset of PD (4,415 cases vs 5,935 controls). SNP rs1561198 showed significant association (PD[Replication]: P = 0.008 OR = 1.09, 95\% CI = [1.02-1.16]; PD [Discovery + Replication]: P = 0.0002, OR = 1.11, 95\% CI = [1.05-1.17]). For the associated haplotype block, allele specific cis-effects on VAMP8 expression were reported. Our data adds to the shared genetic basis of CAD and PD and indicate that the observed association of the two disease conditions cannot be solely explained by shared environmental risk factors. We conclude that the molecular pathway shared by CAD and PD involves VAMP8 function, which has a role in membrane vesicular trafficking, and is manipulated by pathogens to corrupt host immune defense.}, language = {en} } @phdthesis{MathewSchmitt2024, author = {Mathew-Schmitt, Sanjana}, title = {Development of blood-brain barrier spheroid models based on human induced pluripotent stem cells (hiPSCs) and investigation of shear stress on hiPSC-derived brain capillary endothelial-like cells}, doi = {10.25972/OPUS-32247}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-322475}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {A highly regulated microenvironment is essential in maintaining normal functioning of the central nervous system (CNS). The existence of a biological barrier, termed as the blood-brain barrier (BBB), at the blood to brain interface effectively allows for selective passage of substances and pathogens into the brain (Kadry, Noorani et al. 2020). The BBB chiefly serves in protecting the brain from extrinsic toxin entry and pathogen invasions. The BBB is formed mainly by brain capillary endothelial cells (BCECs) which are responsible for excluding ∼ 100\% of large-molecule neurotherapeutics and more than 98\% of all small-molecule drugs from entry into the brain. Minimal BBB transport of major potential CNS drugs allows for attenuated effective treatments for majority of CNS disorders (Appelt-Menzel, Oerter et al. 2020). Animals are generally used as model systems to study neurotherapeutic delivery into the brain, however due to species based disparity, experimental animal models lead to several false positive or false negative drug efficacy predictions thereby being unable to fully predict effects in humans (Ruck, Bittner et al. 2015). An example being that over the last two decades, much of the studies involving animals lead to high failure rates in drug development with ~ 97\% failure in cancers and ~ 99\% failure for Alzheimer´s disease (Pound 2020). Widespead failures in clinical trials associated with neurological disorders have resulted in questions on whether existing preclinical animal models are genuinely reflective of the human condition (Bhalerao, Sivandzade et al. 2020). Apart from high failure rates in humans, the costs for animal testings is extremely high. According to the Organisation for Economic Co-operation and Development (OECD), responsible for determining animal testing guidelines and methodology for government, industry, and independent laboratories the average cost of a single two-generation reproductive animal toxicity study worldwide is 318,295 € and for Europe alone is ~ 285,842 € (Van Norman 2019). Due to these reasons two separate movements exist within the scientific world, one being to improve animal research and the other to promote new approach methodologies with the European government setting 2025 - 2035 as a deadline for gradually disposing the use of animals in pharmaceutical testing (Pound 2020). The discovery of human induced pluripotent stem cell (hiPSC) technology in 2006 (Takahashi and Yamanaka 2006, Takahashi, Tanabe et al. 2007) revolutionized the field of drug discovery in-vitro. HiPSCs can be differentiated into various tissue types that mimic disease phenotypes, thereby offering the possibility to deliver humanized in-vitro test systems. With respect to the BBB, several strategies to differentiate hiPSCs to BCECs (iBCECs) are reported over the years (Appelt-Menzel, Oerter et al. 2020). However, iBCECs are said to possess an epithelial or undifferentiated phenotype causing incongruity in BBB lineage specifications (Lippmann, 7 Azarin et al. 2020). Therefore, in order to identify a reliable differentiation strategy in deriving iBCECs possessing hallmark BBB characteristics, which can be used for downstream applications, the work in this thesis compared two methods, namely the co-differentiation (CD) and the directed differentiation (DD). Briefly, CD mimics a brain like niche environment for iBCEC specification (Lippmann, Al-Ahmad et al. 2014), while DD focuses on induction of the mesoderm followed by iBCEC specification (Qian, Maguire et al. 2017). The results obtained verified that while iBCECs derived via CD, in comparison to human BCEC cell line hCMEC/D3 showed the presence of epithelial transcripts such as E-Cadherin (CDH1), and gene level downregulation of endothelial specific platelet endothelial cell adhesion molecule-1 (PECAM-1) and VE-cadherin (CDH5) but demonstrated higher barrier integrity. The CD strategy essentially presented iBCECs with a mean trans-endothelial electrical resistance (TEER) of ~ 2000 - 2500 Ω*cm2 and low permeability coefficients (PC) of < 0.50 μm/min for small molecule transport of sodium fluorescein (NaF) and characteristic BCEC tight junction (TJ) protein expression of claudin-5 and occludin. Additionally, iBCECs derived via CD did not form tubes in response to angiogenic stimuli. DD on the other hand resulted in iBCECs with similar down regulations in PECAM-1 and CDH5 gene expression. They were additionally characterized by lower barrier integrity, measured by mean TEER of only ~ 250 - 450 Ω*cm2 and high PC of > 5 μm/min in small molecule transport of NaF. Although iBCECs derived via DD formed tubes in response to angiogenic stimuli, they did not show positive protein expression of characteristic BCEC TJs such as claudin-5 and occludin. These results led to the hypothesis that maturity and lineage specification of iBCECs could be improved by incorporating in-vivo like characteristics in-vitro, such as direct co-culture with neurovascular unit (NVU) cell types via spheroid formation and by induction of shear stress and fluid flow. In comparison to standard iBCEC transwell mono-cultures, BBB spheroids showed enhanced transcript expression of PECAM-1 and reduced expression of epithelial markers such as CDH1 and claudin-6 (CLDN6). BBB spheroids showed classical BCEC-like ultrastructure that was identified by TJ particles on the protoplasmic face (P-face) and exoplasmic face (E-face) of the plasma membrane. TJ strands were organized as particles and particle-free grooves on the E-face, while on the P-face, partly beaded particles and partly continuous strands were identified. BBB spheroids also showed positive protein expression of claudin-5, VE-cadherin, PECAM-1, glucose transporter-1 (GLUT-1), P-glycoprotein (P-gp) and transferrin receptor-1 (Tfr-1). BBB spheroids demonstrated higher relative impedance percentages in comparison to spheroids without an iBCEC barrier. Barrier integrity assessments additionally corresponded with lower permeability to small molecule tracer NaF, with spheroids containing iBCECs showing higher relative fluorescence unit percentages (RFU\%) of ~ 90\% in apical compartments, compared to ~ 80\% in spheroids without iBCECs. In summary, direct cellular contacts in the complex spheroid model resulted in enhanced maturation of iBCECs. 8 A bioreactor system was used to further assess the effect of shear stress. This system enabled inclusion of fluidic flow and shear stress conditions in addition to non-invasive barrier integrity measurements (Choi, Mathew et al. 2022). iBCECs were cultured for a total of seven days post differentiation (d17) within the bioreactor and barrier integrity was non-invasively monitored. Until d17 of long-term culture, TEER values of iBCECs steadily dropped from ~ 1800 Ω*cm2 ~ 400 Ω*cm2 under static conditions and from ~ 2500 Ω*cm2 to ~ 250 Ω*cm2 under dynamic conditions. Transcriptomic analyses, morphometric analyses and protein marker expression showed enhanced maturation of iBECs under long-term culture and dynamic flow. Importantly, on d10 claudin-5 was expressed mostly in the cytoplasm with only ~ 5\% iBCECs showing continuous staining at the cell borders. With increase in culture duration, iBCECs at d17 of static culture showed ~ 18\% of cells having continuous cell border expression, while dynamic conditions showed upto ~ 30\% of cells with continuous cell-cell border expression patterns. Similarly, ~ 33\% of cells showed cell-cell border expression of occludin on d10 with increases to ~ 55\% under d17 static and up to ~ 65\% under d17 dynamic conditions, thereby indicating iBCEC maturation. In conclusion, the data presented within this thesis demonstrates the maturation of iBCECs in BBB spheroids, obtained via direct cellular contacts and by the application of flow and shear stress. Both established novel models need to be further validated for pharmaceutical drug applications together with in-vitro-in-vivo correlations in order to exploit their full potential.}, subject = {Blut-Hirn-Schranke}, language = {en} } @phdthesis{PaetzelgebDitter2024, author = {P{\"a}tzel [geb. Ditter], Katharina Sabine}, title = {Molekulare Charakterisierung eines Mitgliedes der TNF-Rezeptor-Superfamilie des Fuchsbandwurmes \(Echinococcus\) \(multilocularis\)}, doi = {10.25972/OPUS-36939}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369397}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Die alveol{\"a}re Echinokokkose (AE), die durch den Fuchsbandwurm Echinococcus multilocularis verursacht wird, ist eine seltene jedoch schwere und oft t{\"o}dlich verlaufende Erkrankung. Aufgrund der sp{\"a}ten Diagnosestellung sind kurative Behandlungsmethoden h{\"a}ufig nicht durchf{\"u}hrbar und als einzige Behandlungsm{\"o}glichkeit bleibt eine lebenslange und nebenwirkungsreiche Therapie mit Benzimidazolen. Verbesserte Therapieoptionen durch die Entwicklung neuer Medikamente sind dringend notwendig. Hierf{\"u}r kann es hilfreich sein die Biologie des Fuchsbandwurmes und die Kommunikationswege zwischen Parasit und Wirt zu verstehen. Bereits in vorherigen Arbeiten als auch in dieser Arbeit erwiesen sich evolutionsgeschichtlich konservierte Signalwege als Kommunikationsweg zwischen dem Fuchsbandwurm und seinem Wirt von zentraler Rolle. Die Entschl{\"u}sselung des Echinococcus-Genoms gab Hinweise darauf, dass ein Mitglied der Tumornekrosefaktor-Rezeptor-Superfamilie, jedoch kein endogener TNF α {\"a}hnlicher Ligand im Genom kodiert wird. Ein Mitglied der TNFR-Superfamilie des Fuchsbandwurmes (EmTNFR) wurde in dieser Arbeit als membranst{\"a}ndiger Rezeptor mit einer intrazellul{\"a}ren Todesdom{\"a}ne (DD) und hoher {\"A}hnlichkeit zum humanen Typ 16 der TNF-Rezeptor-Superfamilie, auch 〖p75〗^NTR genannt, charakterisiert. Sowohl in bioinformatischen als auch in Sequenzanalysen wurden drei alternative Splicing-Formen von emtnfr (emtnfr, emtnfr-v2 und emtnfr-v3) nachgewiesen. emtnfr-v2 entsteht durch Alternatives Splicing und kodiert ein Protein, das keine intrazellul{\"a}re Todesdom{\"a}ne besitzt. emtnfr-v3 verwendet einen alternativen Transkriptionstart und wird von den letzten 3 Exons von emtnfr kodiert. emtnfr-v3, kodiert ein Protein ohne extrazellul{\"a}re Region, aber mit intrazellul{\"a}rer Todesdom{\"a}ne. Ein l{\"o}slicher TNF-Rezeptor konnte auf Proteinebene nicht nachgewiesen werden. Aufgrund von phylogenetischen Analysen und der Rezeptor-Struktur ist zu vermuten, dass EmTNFR ein p75NTR Homolog ist und damit der urspr{\"u}nglichen Form der TNF-Rezeptoren entspricht. Mitglieder eines intrazellul{\"a}ren TNF-Signalweges wurden in bioinformatischen Analysen beim Fuchsbandwurm E. multilocularis identifiziert. Expressionsuntersuchungen zeigten sowohl in Trankriptomdaten als auch auf Proteinebene eine starke Expression von EmTNFR in Prim{\"a}rzellen und im Metazestoden (MZ), dem pathogenen Stadium f{\"u}r den Zwischenwirt. Echinococcus-Stammzellkulturen zeigten nach RNA-Interferenz-basiertem Knockdown des EmTNFR-kodierenden Gens deutliche Entwicklungsdefekte. Des Weiteren zeigten Echinococcus-Stammzellkulturen nach einer Behandlung mit TNF-α, einem potentiellen Liganden des TNF-Rezeptors und einem zentralen Zytokin in der Immunabwehr des Zwischenwirtes, Entwicklungsfortschritte, wie eine verbesserte Bildung von MZ aus Stammzellen. Zus{\"a}tzlich wurde in whole-mount in situ Hybridisierungs-Versuchen eine ubiquit{\"a}re Expression von emtnfr in der Germinalschicht des MZ sowie eine Spezifit{\"a}t von emtnfr f{\"u}r den MZ, welcher urs{\"a}chlich f{\"u}r die AE ist, nachgewiesen. Somit scheinen sowohl EmTNFR als auch TNF-α eine wichtige Funktion bei der Entwicklung und Etablierung des Fuchsbandwurmes w{\"a}hrend der fr{\"u}hen Phase der Infektion des Zwischenwirtes zu haben. TNF-α k{\"o}nnte ein weiterer Faktor f{\"u}r den ausgepr{\"a}gten Organtropismus des Parasiten zur Leber sein, denn dort bestehen durch Kupfferzellen produzierte hohe lokale Konzentration von TNF-α. Zusammenfassend deuten die hier erarbeiteten Daten darauf hin, dass EmTNFR {\"u}ber die Bindung von Wirts-TNF-α bei der fr{\"u}hen Entwicklung des Echincoccus-Metazestoden eine Rolle spielt.}, subject = {Fuchsbandwurm}, language = {de} } @phdthesis{Weiss2024, author = {Weiß, Eva Maria}, title = {Einfluss von Makrophagen auf autophagische Vorg{\"a}nge in Schwann´schen Zellen unter den Bedingungen von Nervenl{\"a}sion und genetisch bedingter Neuropathie}, doi = {10.25972/OPUS-36967}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369674}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Charcot-Marie-Tooth (CMT) Neuropathien stellen als h{\"a}ufigste erblich bedingte neurologische Erkrankungen eine Gruppe genetisch heterogener, chronisch progredienter peripherer Polyneuropathien dar. Die Lebensqualit{\"a}t der Patienten ist bei fehlender kurativer Therapieoption vor allem durch motorische und sensorische Defizite deutlich eingeschr{\"a}nkt. In verschiedenen Studien konnte die pathophysiologische Relevanz einer sekund{\"a}ren Entz{\"u}ndungsreaktion, insbesondere durch Makrophagen und Lymphozyten vermittelt, in Mausmodellen dreier CMT1 Subtypen (CMT1A, CMT1B, CMT1X) aufgezeigt werden. Auch in Folge einer L{\"a}sion peripherer Nerven ist eine akute Entz{\"u}ndungsreaktion von entscheidender Bedeutung, wobei sich bereits Gemeinsamkeiten zwischen der postl{\"a}sionalen Waller´schen Degeneration (WD) und CMT1 Neuropathien identifizieren ließen. W{\"a}hrend die aktive Beteiligung der Autophagie Schwann´scher Zellen (hier kurz SZ Autophagie genannt) an der Myelindegradation im Falle einer WD jedoch vielfach beschrieben wurde, ist {\"A}hnliches in CMT1 Neuropathien bisher nur unzureichend untersucht. Da in einer Studie in Cx32def Mausmodellen der CMT1X Erkrankung auch nach Reduktion endoneuraler Makrophagen anhaltende Demyelinisierung beobachtet werden konnte, sollte das Vorkommen von SZ Autophagie sowie deren m{\"o}gliche Beeinflussung durch Makrophagen in diesen Myelinmutanten untersucht werden. In der vorliegenden Arbeit wurden sowohl Wildtyp (Wt) M{\"a}use in ex vivo und in vivo Modellen einer WD als auch Cx32def Myelinmutanten zweier Altersstufen (4 und 12 Monate) mit einem niedermolekularen CSF1-Rezeptor-Inhibitor (CSF1RI) zur Reduktion endoneuraler Makrophagen behandelt, wobei sich vergleichende histochemische bzw. immunhistochemische Analysen peripherer Nerven behandelter und unbehandelter Tiere anschlossen. Im Rahmen der Etablierung immunhistochemischer Methodik zeigte sich hierbei unter den kontrollierten Bedingungen einer ex vivo Ischiasnervenkultur eine vermehrte Aktivierung der SZ Autophagie in behandelten Wt M{\"a}usen. Auch 4 Monate alte behandelte Cx32def Tiere wiesen, verglichen mit unbehandelten Myelinmutanten bzw. Wt M{\"a}usen derselben Altersstufe, eine vermehrte autophagische Aktivit{\"a}t in SZ auf. Diese scheint sich jedoch im weiteren Verlauf der Erkrankung zu reduzieren, da im Falle der 12 Monate alten Cx32def Modelltiere weniger autophagisch aktive SZ Profile bzw. kaum Unterschiede zwischen behandelten und unbehandelten Tieren beobachtet werden konnten. Die Ergebnisse lassen somit eine m{\"o}gliche aktive Beteiligung von SZ Autophagie insbesondere in der Pathophysiologie der fr{\"u}hen Phase einer CMT1X Erkrankung sowie deren Beeinflussung durch endoneurale Makrophagen vermuten. Dies sollte vornehmlich in der Entwicklung von Therapiestrategien der CMT1X bedacht werden, da sich eine fr{\"u}he Reduktion pathophysiologisch relevanter endoneuraler Makrophagen somit auch nachteilig auf die Myelinintegrit{\"a}t auswirken k{\"o}nnte.}, subject = {Schwann-Zelle}, language = {de} } @phdthesis{RuppertgebRapp2024, author = {Ruppert [geb. Rapp], Elisabeth Marlene}, title = {Einfluss von sozialem Stress und 5-Htt-Genotyp: Quantitative Untersuchung der Morphologie von Neuronen der lateralen Amygdala und der CA3-Region des Hippocampus von M{\"a}usen der Serotonintransporter-Knockout-Linie}, doi = {10.25972/OPUS-36948}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369488}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {In dieser Arbeit wurde der Einfluss sozialer Stresserfahrung sowie des 5-Htt-Genotyps auf die neuronale Morphologie bestimmter Hirnregionen anhand eines Mausmodells untersucht. Es wurde in mit Golgi-Cox gef{\"a}rbten Gehirnen der 5-HTT-KO-Linie in der lateralen Amygdala (LA) die Apikal- und Basaldendriten pyramidenzell{\"a}hnlicher Neurone und die Apikaldendriten der Pyramidenzellen der Cornu ammonis (CA)3-Region des Hippocampus mithilfe des Neurolucidasystems rekonstruiert und die so gewonnenen Daten anschließend statistisch ausgewertet. Die erzielten Ergebnisse belegen, dass vor allem die Erfahrung von sozialem Verteidigungsstress aber auch der 5-Htt-Genotyp (WT, HET, KO) im Mausmodell signifikanten Einfluss auf die Morphologie der Neurone der LA und der CA3-Region besitzen. Um die in dieser Arbeit mit allen drei 5-Htt-Genotypen erzielten Ergebnisse der LA-Neurone besser mit den Ergebnissen von Nietzer und Bonn (nur WT, KO) vergleichen zu k{\"o}nnen (Nietzer et al., 2011), wurden die von mir erhobenen Daten nicht nur in einem 3er-Vergleich, sondern auch einem 2er-Vergleich (WT vs. KO) statistisch analysiert. Untersuchungen der LA-Neurone aller drei 5-Htt-Genotypen zeigen, dass sozialer Stress zu einer Zunahme der Komplexit{\"a}t der Dendritenb{\"a}ume durch l{\"a}ngere und auch st{\"a}rker verzweigte Dendriten vor allem in der Gruppe der WT-M{\"a}use f{\"u}hrt. HET- und KO-M{\"a}use zeigten keinen entsprechenden Stress-Effekt. Dar{\"u}ber hinaus zeigten sich deutliche Genotypeffekte. Unabh{\"a}ngig vom Stresserleben besitzen HET-M{\"a}use l{\"a}ngere Dendriten als WT-M{\"a}use sowie eine h{\"o}here Spinedichte als WT- und KO-M{\"a}use. Die Hypothese, die in der Arbeit von Nietzer et al. aufgestellt wurde, dass eine vollst{\"a}ndige 5-HTT-Defizienz zu mehr Spines f{\"u}hrt, ließ sich hier weder durch den 3er- noch durch den 2er-Vergleich replizieren. Die Pyramidenzellen der CA3-Region, die in dieser Studie zum ersten Mal analysiert wurden, zeigen in Bezug auf die durch den Stress ausgel{\"o}sten Ver{\"a}nderungen ein im Vergleich zu den LA-Neuronen entgegengesetzten Effekt. Der soziale Stress f{\"u}hrt hier zu einer Dendritenatrophie in der WT-Gruppe mit k{\"u}rzeren und weniger komplexen Dendriten. Außerdem f{\"u}hrte er zu einer geringeren Spinedichte bei den HET-M{\"a}usen. Es zeigten sich klare Genotypeffekte, unabh{\"a}ngig von der Stresserfahrung, mit einer reduzierten Spinedichte der KO-M{\"a}use gegen{\"u}ber den WT-M{\"a}usen und einer nur in den Kontrollen detektierten, reduzierten Spinedichte der KO-M{\"a}use im Vergleich zu den WT- und HET-M{\"a}usen. Sowohl in der LA als auch in der CA3-Region lassen sich Kompensationsmechanismen des 5-HTT-Defizits der HET-Tiere vermuten, {\"u}ber die die KO-Tiere nicht verf{\"u}gen. Die in LA und CA3 gezeigten gegens{\"a}tzlichen Auswirkungen des sozialen Stresses weisen auf die unterschiedlichen Funktionen dieser beiden Regionen im Furchtkreislauf und/oder bei der Verarbeitung von Stress hin. Dar{\"u}ber hinaus deutet diese Arbeit darauf hin, dass Arbeiten mit {\"a}hnlichen Untersuchungsmethoden und sogar gleichem Untersuchungsmaterial unterschiedliche Ergebnisse liefern k{\"o}nnen.}, subject = {Serotoninstoffwechsel}, language = {de} } @phdthesis{Kluepfel2024, author = {Kl{\"u}pfel, Marina Anna}, title = {Lagedarstellung und -Bewertung durch den Einsatz des Windm{\"u}hlenmodells - Einf{\"u}hrung und Nutzung im Rahmen der SARS-CoV-2 Pandemie}, doi = {10.25972/OPUS-36959}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369595}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Bei Großschadensereignissen oder Katastrophen arbeiten die Einsatzkr{\"a}fte verschiedener Organisationen und Krankenh{\"a}user zusammen, um die Schadenslage zu bew{\"a}ltigen. F{\"u}r die Koordinierung dieser Eins{\"a}tze ben{\"o}tigen die F{\"u}hrungskr{\"a}fte ein m{\"o}glichst genaues Bild der aktuellen Lage. Auch im Rahmen der SARS-CoV-2- Pandemie war eine {\"U}bersicht {\"u}ber die Versorgungslage der Krankenh{\"a}user erforderlich, um m{\"o}gliche lokale Ressourcenengp{\"a}sse fr{\"u}hzeitig zu erkennen und durch geeignete Maßnahmen zu beheben. Zu diesem Zweck wurde in Bayern im November 2021 das Windm{\"u}hlen-Modell eingef{\"u}hrt. Basierend auf einer Online-Plattform meldeten die zust{\"a}ndigen Bezirkskoordinierenden der bayerischen Regierungsbezirke t{\"a}glich die Versorgungslage ihrer Kliniken anhand der Komponenten Personal, Material und Raum. Außerdem gab es die M{\"o}glichkeit zur Dokumentation von Patientenverlegungen. Die {\"u}ber die Windm{\"u}hlen-Onlineplattform gesammelten Lagemeldungen und dokumentierten Verlegungen des Zeitraums von 21. November 2021 bis 20. Februar 2022 wurden in der vorliegenden Arbeit detailliert aufbereitet. Zus{\"a}tzlich wurden die erfassten Daten statistisch ausgewertet und mit den {\"o}rtlichen 7-Tage-Inzidenzwerten des SARS-CoV-2-Virus verglichen. Durch das Windm{\"u}hlen-Modell konnten Unterschiede in der Versorgungslage zwischen den Regierungsbezirken sehr effektiv sichtbar gemacht werden. Insgesamt waren Intensivstationen deutlich st{\"a}rker belastet als Normalstationen. Die Versorgungsqualit{\"a}t war in Covid-Bereichen st{\"a}rker beeintr{\"a}chtigt als auf Stationen ohne Covid-Patienten. Es konnte nachgewiesen werden, dass die Windm{\"u}hlen-Lagemeldungen nicht allein die regionalen Inzidenzwerte, sondern die tats{\"a}chliche Versorgungssituation vor Ort abbilden. Die dokumentierten Interhospitaltransfers erfolgten von Regionen mit hohen Inzidenzwerten und schlechter Ressourcenverf{\"u}gbarkeit in Bezirke mit weniger kritischer Versorgungslage. Damit konnten aus den Windm{\"u}hlen-Lagemeldungen auch konkrete Handlungskonsequenzen, wie strategische Patientenverlegungen, abgeleitet werden. Lagemeldungen sind wichtig f{\"u}r die abgestimmte Zusammenarbeit verschiedener Stellen bei der Bew{\"a}ltigung einer Krise. Die etablierten Systeme zur Lageerfassung sind meist quantitativ ausgelegt und nur wenig skalierbar. Die Anwendung in einem neuen Kontext erfordert oft zeitaufw{\"a}ndige Anpassungen. Im Gegensatz dazu bietet das Windm{\"u}hlen-Modell eine skalierbare, eher qualitativ ausgerichtete Lagedarstellung und ist aufgrund seines unkomplizierten Aufbaus innerhalb k{\"u}rzester Zeit f{\"u}r eine Nutzung in verschiedensten Schadenslagen adaptierbar.}, subject = {Katastrophenmedizin}, language = {de} } @phdthesis{Reissland2024, author = {Reissland, Michaela}, title = {USP10 is a \(de\) \(novo\) tumour-specific regulator of β-Catenin and contributes to cancer stem cell maintenance and tumour progression}, doi = {10.25972/OPUS-31957}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-319579}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Colorectal Cancer (CRC) is the third most common cancer in the US. The majority of CRC cases are due to deregulated WNT-signalling pathway. These alterations are mainly caused by mutations in the tumour suppressor gene APC or in CTNNB1, encoding the key effector protein of this pathway, β-Catenin. In canonical WNT-signalling, β-Catenin activates the transcription of several target genes, encoding for proteins involved in proliferation, such as MYC, JUN and NOTCH. Being such a critical regulator of these proto-oncogenes, the stability of β-Catenin is tightly regulated by the Ubiquitin-Proteasome System. Several E3 ligases that ubiquitylate and degrade β-Catenin have been described in the past, but the antagonists, the deubiquitylases, are still unknown. By performing an unbiased siRNA screen, the deubiquitylase USP10 was identified as a de novo positive regulator of β-Catenin stability in CRC derived cells. USP10 has previously been shown in the literature to regulate both mutant and wild type TP53 stability, to deubiquitylate NOTCH1 in endothelial cells and to be involved in the regulation of AMPKα signalling. Overall, however, its role in colorectal tumorigenesis remains controversial. By analysing publicly available protein and gene expression data from colorectal cancer patients, we have shown that USP10 is strongly upregulated or amplified upon transformation and that its expression correlates positively with CTNNB1 expression. In contrast, basal USP10 levels were found in non-transformed tissues, but surprisingly USP10 is upregulated in intestinal stem cells. Endogenous interaction studies in CRC-derived cell lines, with different extend of APCtruncation, revealed an APC-dependent mode of action for both proteins. Furthermore, by utilising CRISPR/Cas9, shRNA-mediated knock-down and overexpression of USP10, we could demonstrate a regulation of β-Catenin stability by USP10 in CRC cell lines. It is widely excepted that 2D cell culture systems do not reflect complexity, architecture and heterogeneity and are therefore not suitable to answer complex biological questions. To overcome this, we established the isolation, cultivation and genetically modification of murine intestinal organoids and utilised this system to study Usp10s role ex vivo. By performing RNA sequencing, dependent on different Usp10 levels, we were able to recapitulate the previous findings and demonstrated Usp10 as important regulator of β-dependent regulation of stem cell homeostasis. Since genetic depletion of USP10 resulted in down-regulation of β-Catenin-dependent transcription, therapeutic intervention of USP10 in colorectal cancer was also investigated. Commercial and newly developed inhibitors were tested for their efficacy against USP10, but failed to significantly inhibit USP10 activity in colorectal cancer cells. To validate the findings from this work also in vivo, development of a novel mouse model for colorectal cancer has begun. By combining CRISPR/Cas9 and classical genetic engineering with viral injection strategies, WT and genetically modified mice could be transformed and, at least in some animals, intestinal lesions were detectable at the microscopic level. The inhibition of USP10, which we could describe as a de novo tumour-specific regulator of β-Catenin, could become a new therapeutic strategy for colorectal cancer patients.}, subject = {Biomedizin}, language = {en} } @article{MorimotoShimadaSugimotoOtowaetal.2018, author = {Morimoto, Yoshiro and Shimada-Sugimoto, Mihoko and Otowa, Takeshi and Yoshida, Shintaro and Kinoshita, Akira and Mishima, Hiroyuki and Yamaguchi, Naohiro and Mori, Takatoshi and Imamura, Akira and Ozawa, Hiroki and Kurotaki, Naohiro and Ziegler, Christiane and Domschke, Katharina and Deckert, J{\"u}rgen and Umekage, Tadashi and Tochigi, Mamoru and Kaiya, Hisanobu and Okazaki, Yuji and Tokunaga, Katsushi and Sasaki, Tsukasa and Yoshiura, Koh-ichiro and Ono, Shinji}, title = {Whole-exome sequencing and gene-based rare variant association tests suggest that PLA2G4E might be a risk gene for panic disorder}, series = {Translational Psychiatry}, volume = {8}, journal = {Translational Psychiatry}, doi = {10.1038/s41398-017-0088-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-224192}, year = {2018}, abstract = {Panic disorder (PD) is characterized by recurrent and unexpected panic attacks, subsequent anticipatory anxiety, and phobic avoidance. Recent epidemiological and genetic studies have revealed that genetic factors contribute to the pathogenesis of PD. We performed whole-exome sequencing on one Japanese family, including multiple patients with panic disorder, which identified seven rare protein-altering variants. We then screened these genes in a Japanese PD case-control group (384 sporadic PD patients and 571 controls), resulting in the detection of three novel single nucleotide variants as potential candidates for PD (chr15: 42631993, T>C in GANC; chr15: 42342861, G>T in PLA2G4E; chr20: 3641457, G>C in GFRA4). Statistical analyses of these three genes showed that PLA2G4E yielded the lowest p value in gene-based rare variant association tests by Efficient and Parallelizable Association Container Toolbox algorithms; however, the p value did not reach the significance threshold in the Japanese. Likewise, in a German case-control study (96 sporadic PD patients and 96 controls), PLA2G4E showed the lowest p value but again did not reach the significance threshold. In conclusion, we failed to find any significant variants or genes responsible for the development of PD. Nonetheless, our results still leave open the possibility that rare protein-altering variants in PLA2G4E contribute to the risk of PD, considering the function of this gene.}, language = {en} } @article{NerreterLetschertGoetzetal.2019, author = {Nerreter, Thomas and Letschert, Sebastian and G{\"o}tz, Ralph and Doose, S{\"o}ren and Danhof, Sophia and Einsele, Hermann and Sauer, Markus and Hudecek, Michael}, title = {Super-resolution microscopy reveals ultra-low CD19 expression on myeloma cells that triggers elimination by CD19 CAR-T}, series = {Nature Communications}, volume = {10}, journal = {Nature Communications}, doi = {10.1038/s41467-019-10948-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232258}, year = {2019}, abstract = {Immunotherapy with chimeric antigen receptor-engineered T-cells (CAR-T) is under investigation in multiple myeloma. There are reports of myeloma remission after CD19 CAR-T therapy, although CD19 is hardly detectable on myeloma cells by flow cytometry (FC). We apply single molecule-sensitive direct stochastic optical reconstruction microscopy (dSTORM), and demonstrate CD19 expression on a fraction of myeloma cells (10.3-80\%) in 10 out of 14 patients (density: 13-5,000 molecules per cell). In contrast, FC detects CD19 in only 2 of these 10 patients, on a smaller fraction of cells. Treatment with CD19 CAR-T in vitro results in elimination of CD19-positive myeloma cells, including those with <100 CD19 molecules per cell. Similar data are obtained by dSTORM analyses of CD20 expression on myeloma cells and CD20 CAR-T. These data establish a sensitivity threshold for CAR-T and illustrate how super-resolution microscopy can guide patient selection in immunotherapy to exploit ultra-low density antigens.}, language = {en} } @article{OdinChaudhuriVolkmannetal.2018, author = {Odin, Per and Chaudhuri, K. Ray and Volkmann, Jens and Antonini, Angelo and Storch, Alexander and Dietrichs, Espen and Pirtošek, Zvezdan and Henriksen, Tove and Horne, Malcolm and Devos, David and Bergquist, Filip}, title = {Viewpoint and practical recommendations from a movement disorder specialist panel on objective measurement in the clinical management of Parkinson's disease}, series = {npj Parkinson's Disease}, volume = {4}, journal = {npj Parkinson's Disease}, doi = {10.1038/s41531-018-0051-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234435}, year = {2018}, abstract = {Motor aspects of Parkinson's disease, such as fluctuations and dyskinesia, can be reliably evaluated using a variety of "wearable" technologies, but practical guidance on objective measurement (OM) and the optimum use of these devices is lacking. Therefore, as a first step, a panel of movement disorder specialists met to provide guidance on how OM could be assessed and incorporated into clinical guidelines. A key aspect of the incorporation of OM into the management of Parkinson's disease (PD) is defining cutoff values that separate "controlled" from "uncontrolled" symptoms that can be modified by therapy and that relate to an outcome that is relevant to the person with PD (such as quality of life). Defining cutoffs by consensus, which can be subsequently tested and refined, is the first step to optimizing OM in the management of PD. OM should be used by all clinicians that treat people with PD but the least experienced may find the most value, but this requires guidance from experts to allow non-experts to apply guidelines. While evidence is gained for devices that produce OM, expert opinion is needed to supplement the evidence base.}, language = {en} } @article{ScholzCosgareaSuesskindetal.2018, author = {Scholz, S. L. and Cosgarea, I. and S{\"u}ßkind, D. and Murali, R. and M{\"o}ller, I. and Reis, H. and Leonardelli, S. and Schilling, B. and Schimming, T. and Hadaschik, E. and Franklin, C. and Paschen, A. and Sucker, A. and Steuhl, K. P. and Schadendorf, D. and Westekemper, H. and Griewank, K. G.}, title = {NF1 mutations in conjunctival melanoma}, series = {British Journal of Cancer}, volume = {118}, journal = {British Journal of Cancer}, doi = {10.1038/s41416-018-0046-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233329}, pages = {1243-1247}, year = {2018}, abstract = {Background Conjunctival melanoma is a potentially deadly eye tumour. Despite effective local therapies, tumour recurrence and metastasis remain frequent. The genetics of conjunctival melanomas remain incompletely understood. Methods A large cohort of 63 conjunctival melanomas was screened for gene mutations known to be important in other melanoma subtypes by targeted next-generation sequencing. Mutation status was correlated with patient prognosis. Results Frequent mutations in genes activating the MAP kinase pathway were identified. NF1 mutations were most frequent (n = 21, 33\%). Recurrent activating mutations were also identified in BRAF (n = 16, 25\%) and RAS genes (n = 12, 19\%; 11 NRAS and 1 KRAS). Conclusions Similar to cutaneous melanomas, conjunctival melanomas can be grouped genetically into four groups: BRAF-mutated, RAS-mutated, NF1-mutated and triple wild-type melanomas. This genetic classification may be useful for assessment of therapeutic options for patients with metastatic conjunctival melanoma}, language = {en} } @article{BruchhagenJarickMewisetal.2018, author = {Bruchhagen, Christin and Jarick, Marcel and Mewis, Carolin and Hertlein, Tobias and Niemann, Silke and Ohlsen, Knut and Peters, Georg and Planz, Oliver and Ludwig, Stephan and Ehrhardt, Christina}, title = {Metabolic conversion of CI-1040 turns a cellular MEK-inhibitor into an antibacterial compound}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, doi = {10.1038/s41598-018-27445-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-221648}, year = {2018}, abstract = {Influenza virus (IV) infections cause severe respiratory illnesses that can be complicated by bacterial super-infections. Previously, we identified the cellular Raf-MEK-ERK cascade as a promising antiviral target. Inhibitors of MEK, such as CI-1040, showed potent antiviral activity. However, it remained unclear if this inhibitor and its active form, ATR-002, might sensitize host cells to either IV or secondary bacterial infections. To address these questions, we studied the anti-pathogen activity of ATR-002 in comparison to CI-1040, particularly, its impact on Staphylococcus aureus (S. aureus), which is a major cause of IV super-infections. We analysed IV and S. aureus titres in vitro during super-infection in the presence and absence of the drugs and characterized the direct impact of ATR-002 on bacterial growth and phenotypic changes. Importantly, neither CI-1040 nor ATR-002 treatment led to increased bacterial titres during super-infection, indicating that the drug does not sensitize cells for bacterial infection. In contrast, we rather observed reduced bacterial titres in presence of ATR-002. Surprisingly, ATR-002 also led to reduced bacterial growth in suspension cultures, reduced stress- and antibiotic tolerance without resistance induction. Our data identified for the first time that a particular MEK-inhibitor metabolite exhibits direct antibacterial activity, which is likely due to interference with the bacterial PknB kinase/Stp phosphatase signalling system.}, language = {en} } @article{CastilhoHochleitnerWilsonetal.2018, author = {Castilho, Miguel and Hochleitner, Gernot and Wilson, Wouter and van Rietbergen, Bert and Dalton, Paul D. and Groll, J{\"u}rgen and Malda, Jos and Ito, Keita}, title = {Mechanical behavior of a soft hydrogel reinforced with three-dimensional printed microfibre scaffolds}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, doi = {10.1038/s41598-018-19502-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222280}, year = {2018}, abstract = {Reinforcing hydrogels with micro-fibre scaffolds obtained by a Melt-Electrospinning Writing (MEW) process has demonstrated great promise for developing tissue engineered (TE) constructs with mechanical properties compatible to native tissues. However, the mechanical performance and reinforcement mechanism of the micro-fibre reinforced hydrogels is not yet fully understood. In this study, FE models, implementing material properties measured experimentally, were used to explore the reinforcement mechanism of fibre-hydrogel composites. First, a continuum FE model based on idealized scaffold geometry was used to capture reinforcement effects related to the suppression of lateral gel expansion by the scaffold, while a second micro-FE model based on micro-CT images of the real construct geometry during compaction captured the effects of load transfer through the scaffold interconnections. Results demonstrate that the reinforcement mechanism at higher scaffold volume fractions was dominated by the load carrying-ability of the fibre scaffold interconnections, which was much higher than expected based on testing scaffolds alone because the hydrogel provides resistance against buckling of the scaffold. We propose that the theoretical understanding presented in this work will assist the design of more effective composite constructs with potential applications in a wide range of TE conditions.}, language = {en} } @article{AlZabenMedyukhinaDietrichetal.2019, author = {Al-Zaben, Naim and Medyukhina, Anna and Dietrich, Stefanie and Marolda, Alessandra and H{\"u}nniger, Kerstin and Kurzai, Oliver and Figge, Marc Thilo}, title = {Automated tracking of label-free cells with enhanced recognition of whole tracks}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-39725-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-221093}, year = {2019}, abstract = {Migration and interactions of immune cells are routinely studied by time-lapse microscopy of in vitro migration and confrontation assays. To objectively quantify the dynamic behavior of cells, software tools for automated cell tracking can be applied. However, many existing tracking algorithms recognize only rather short fragments of a whole cell track and rely on cell staining to enhance cell segmentation. While our previously developed segmentation approach enables tracking of label-free cells, it still suffers from frequently recognizing only short track fragments. In this study, we identify sources of track fragmentation and provide solutions to obtain longer cell tracks. This is achieved by improving the detection of low-contrast cells and by optimizing the value of the gap size parameter, which defines the number of missing cell positions between track fragments that is accepted for still connecting them into one track. We find that the enhanced track recognition increases the average length of cell tracks up to 2.2-fold. Recognizing cell tracks as a whole will enable studying and quantifying more complex patterns of cell behavior, e.g. switches in migration mode or dependence of the phagocytosis efficiency on the number and type of preceding interactions. Such quantitative analyses will improve our understanding of how immune cells interact and function in health and disease.}, language = {en} } @article{deJongDinizSalomaetal.2018, author = {de Jong, Simone and Diniz, Mateus Jose Abdalla and Saloma, Andiara and Gadelha, Ary and Santoro, Marcos L. and Ota, Vanessa K. and Noto, Cristiano and Curtis, Charles and Newhouse, Stephen J. and Patel, Hamel and Hall, Lynsey S. and O'Reilly, Paul F. and Belangero, Sintia I. and Bressan, Rodrigo A. and Breen, Gerome}, title = {Applying polygenic risk scoring for psychiatric disorders to a large family with bipolar disorder and major depressive disorder}, series = {Communications Biology}, volume = {1}, journal = {Communications Biology}, organization = {Major Depressive Disorder and Bipolar Disorder Working Groups of the Psychiatric Genomics Consortium}, doi = {10.1038/s42003-018-0155-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223622}, year = {2018}, abstract = {Psychiatric disorders are thought to have a complex genetic pathology consisting of interplay of common and rare variation. Traditionally, pedigrees are used to shed light on the latter only, while here we discuss the application of polygenic risk scores to also highlight patterns of common genetic risk. We analyze polygenic risk scores for psychiatric disorders in a large pedigree (n ~ 260) in which 30\% of family members suffer from major depressive disorder or bipolar disorder. Studying patterns of assortative mating and anticipation, it appears increased polygenic risk is contributed by affected individuals who married into the family, resulting in an increasing genetic risk over generations. This may explain the observation of anticipation in mood disorders, whereby onset is earlier and the severity increases over the generations of a family. Joint analyses of rare and common variation may be a powerful way to understand the familial genetics of psychiatric disorders.}, language = {en} } @article{DekkerDiekstraPulitetal.2019, author = {Dekker, Annelot M. and Diekstra, Frank P. and Pulit, Sara L. and Tazelaar, Gijs H. P. and van der Spek, Rick A. and van Rheenen, Wouter and van Eijk, Kristel R. and Calvo, Andrea and Brunetti, Maura and Van Damme, Philip and Robberecht, Wim and Hardiman, Orla and McLaughlin, Russell and Chi{\`o}, Adriano and Sendtner, Michael and Ludolph, Albert C. and Weishaupt, Jochen H. and Pardina, Jesus S. Mora and van den Berg, Leonard H. and Veldink, Jan H.}, title = {Exome array analysis of rare and low frequency variants in amyotrophic lateral sclerosis}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-42091-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223686}, year = {2019}, abstract = {Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that affects 1 in ~350 individuals. Genetic association studies have established ALS as a multifactorial disease with heritability estimated at ~61\%, and recent studies show a prominent role for rare variation in its genetic architecture. To identify rare variants associated with disease onset we performed exome array genotyping in 4,244 cases and 3,106 controls from European cohorts. In this largest exome-wide study of rare variants in ALS to date, we performed single-variant association testing, gene-based burden, and exome-wide individual set-unique burden (ISUB) testing to identify single or aggregated rare variation that modifies disease risk. In single-variant testing no variants reached exome-wide significance, likely due to limited statistical power. Gene-based burden testing of rare non-synonymous and loss-of-function variants showed NEK1 as the top associated gene. ISUB analysis did not show an increased exome-wide burden of deleterious variants in patients, possibly suggesting a more region-specific role for rare variation. Complete summary statistics are released publicly. This study did not implicate new risk loci, emphasizing the immediate need for future large-scale collaborations in ALS that will expand available sample sizes, increase genome coverage, and improve our ability to detect rare variants associated to ALS.}, language = {en} } @article{DiehlSchmidLicataGoldhardtetal.2019, author = {Diehl-Schmid, Janine and Licata, Abigail and Goldhardt, Oliver and F{\"o}rstl, Hans and Yakushew, Igor and Otto, Markus and Anderl-Straub, Sarah and Beer, Ambros and Ludolph, Albert Christian and Landwehrmeyer, Georg Bernhard and Levin, Johannes and Danek, Adrian and Fliessbach, Klaus and Spottke, Annika and Fassbender, Klaus and Lyros, Epameinondas and Prudlo, Johannes and Krause, Bernd Joachim and Volk, Alexander and Edbauer, Dieter and Schroeter, Matthias Leopold and Drzezga, Alexander and Kornhuber, Johannes and Lauer, Martin and Grimmer, Timo}, title = {FDG-PET underscores the key role of the thalamus in frontotemporal lobar degeneration caused by C9ORF72 mutations}, series = {Translational Psychiatry}, volume = {9}, journal = {Translational Psychiatry}, organization = {FTLDc Study Group}, doi = {10.1038/s41398-019-0381-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-225308}, year = {2019}, abstract = {C9ORF72 mutations are the most common cause of familial frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). MRI studies have investigated structural changes in C9ORF72-associated FTLD (C9FTLD) and provided first insights about a prominent involvement of the thalamus and the cerebellum. Our multicenter, 18F-fluorodeoxyglucose positron-emission tomography study of 22 mutation carriers with FTLD, 22 matched non-carriers with FTLD, and 23 cognitively healthy controls provided valuable insights into functional changes in C9FTLD: compared to non-carriers, mutation carriers showed a significant reduction of glucose metabolism in both thalami, underscoring the key role of the thalamus in C9FTLD. Thalamic metabolism did not correlate with disease severity, duration of disease, or the presence of psychotic symptoms. Against our expectations we could not demonstrate a cerebellar hypometabolism in carriers or non-carriers. Future imaging and neuropathological studies in large patient cohorts are required to further elucidate the central role of the thalamus in C9FTLD.}, language = {en} } @article{DietrichKrugKrastletal.2019, author = {Dietrich, Thomas and Krug, Ralf and Krastl, Gabriel and Tomson, Philip L.}, title = {Restoring the unrestorable! Developing coronal tooth tissue with a minimally invasive surgical extrusion technique}, series = {British Dental Journal}, volume = {226}, journal = {British Dental Journal}, doi = {10.1038/s41415-019-0268-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-225333}, pages = {789-793}, year = {2019}, abstract = {Surgical extrusion is a recognised treatment option for teeth that have insufficient coronal tooth structure remaining due to deep caries, resorption or traumatic injury. However, the technique has not been widely adopted, arguably because extraction of a severely compromised tooth may be difficult to achieve in a gentle and predictable way. In this paper, we present our novel approach to surgical extrusion and subsequent management of teeth using a vertical extraction system (Benex), which has become the method of choice in the authors' practice for many teeth that would otherwise be deemed unrestorable. We describe the clinical procedure in detail and discuss the advantages and disadvantages compared to alternative approaches, including surgical crown lengthening and orthodontic extrusion.}, language = {en} } @article{HauerPoppSchoelleretal.2018, author = {Hauer, Nadine N. and Popp, Bernt and Schoeller, Eva and Schuhmann, Sarah and Heath, Karen E. and Hisado-Oliva, Alfonso and Klinger, Patricia and Kraus, Cornelia and Trautmann, Udo and Zenker, Martin and Zweier, Christiane and Wiesener, Antje and Jamra, Rami Abou and Kunstmann, Erdmute and Wieczorek, Dagmar and Uebe, Steffen and Ferrazzi, Fulvia and B{\"u}ttner, Christian and Ekici, Arif B. and Rauch, Anita and Sticht, Heinrich and D{\"o}rr, Helmuth-G{\"u}nther and Reis, Andr{\´e} and Thiel, Christian T.}, title = {Clinical relevance of systematic phenotyping and exome sequencing in patients with short stature}, series = {Genetics in Medicine}, volume = {20}, journal = {Genetics in Medicine}, doi = {10.1038/gim.2017.159}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227888}, pages = {630-638}, year = {2018}, abstract = {Purpose Short stature is a common condition of great concern to patients and their families. Mostly genetic in origin, the underlying cause often remains elusive due to clinical and genetic heterogeneity. Methods We systematically phenotyped 565 patients where common nongenetic causes of short stature were excluded, selected 200 representative patients for whole-exome sequencing, and analyzed the identified variants for pathogenicity and the affected genes regarding their functional relevance for growth. Results By standard targeted diagnostic and phenotype assessment, we identified a known disease cause in only 13.6\% of the 565 patients. Whole-exome sequencing in 200 patients identified additional mutations in known short-stature genes in 16.5\% of these patients who manifested only part of the symptomatology. In 15.5\% of the 200 patients our findings were of significant clinical relevance. Heterozygous carriers of recessive skeletal dysplasia alleles represented 3.5\% of the cases. Conclusion A combined approach of systematic phenotyping, targeted genetic testing, and whole-exome sequencing allows the identification of the underlying cause of short stature in at least 33\% of cases, enabling physicians to improve diagnosis, treatment, and genetic counseling. Exome sequencing significantly increases the diagnostic yield and consequently care in patients with short stature.}, language = {en} } @article{LudwigDelforgeFaconetal.2018, author = {Ludwig, Heinz and Delforge, Michel and Facon, Thierry and Einsele, Hermann and Gay, Francesca and Moreau, Philippe and Avet-Loiseau, Herv{\´e} and Boccadoro, Mario and Hajek, Roman and Mohty, Mohamad and Cavo, Michele and Dimopoulos, Meletios A and San-Miguel, Jes{\´u}s F and Terpos, Evangelos and Zweegman, Sonja and Garderet, Laurent and Mateos, Mar{\´i}a-Victoria and Cook, Gordon and Leleu, Xavier and Goldschmidt, Hartmut and Jackson, Graham and Kaiser, Martin and Weisel, Katja and van de Donk, Niels W. C. J. and Waage, Anders and Beksac, Meral and Mellqvist, Ulf H. and Engelhardt, Monika and Caers, Jo and Driessen, Christoph and Blad{\´e}, Joan and Sonneveld, Pieter}, title = {Prevention and management of adverse events of novel agents in multiple myeloma: a consensus of the European Myeloma Network}, series = {Leukemia}, volume = {32}, journal = {Leukemia}, doi = {10.1038/s41375-018-0040-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237338}, pages = {1542-1560}, year = {2018}, abstract = {During the last few years, several new drugs have been introduced for treatment of patients with multiple myeloma, which have significantly improved the treatment outcome. All of these novel substances differ at least in part in their mode of action from similar drugs of the same drug class, or are representatives of new drug classes, and as such present with very specific side effect profiles. In this review, we summarize these adverse events, provide information on their prevention, and give practical guidance for monitoring of patients and for management of adverse events.}, language = {en} } @article{LanghauserCasasDaoetal.2018, author = {Langhauser, Friederike and Casas, Ana I. and Dao, Vu-Thao-Vi and Guney, Emre and Menche, J{\"o}rg and Geuss, Eva and Kleikers, Pamela W. M. and L{\´o}pez, Manuela G. and Barab{\´a}si, Albert-L. and Kleinschnitz, Christoph and Schmidt, Harald H. H. W.}, title = {A diseasome cluster-based drug repurposing of soluble guanylate cyclase activators from smooth muscle relaxation to direct neuroprotection}, series = {npj Systems Biology and Applications}, volume = {4}, journal = {npj Systems Biology and Applications}, doi = {10.1038/s41540-017-0039-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236381}, year = {2018}, abstract = {Network medicine utilizes common genetic origins, markers and co-morbidities to uncover mechanistic links between diseases. These links can be summarized in the diseasome, a comprehensive network of disease-disease relationships and clusters. The diseasome has been influential during the past decade, although most of its links are not followed up experimentally. Here, we investigate a high prevalence unmet medical need cluster of disease phenotypes linked to cyclic GMP. Hitherto, the central cGMP-forming enzyme, soluble guanylate cyclase (sGC), has been targeted pharmacologically exclusively for smooth muscle modulation in cardiology and pulmonology. Here, we examine the disease associations of sGC in a non-hypothesis based manner in order to identify possibly previously unrecognized clinical indications. Surprisingly, we find that sGC, is closest linked to neurological disorders, an application that has so far not been explored clinically. Indeed, when investigating the neurological indication of this cluster with the highest unmet medical need, ischemic stroke, pre-clinically we find that sGC activity is virtually absent post-stroke. Conversely, a heme-free form of sGC, apo-sGC, was now the predominant isoform suggesting it may be a mechanism-based target in stroke. Indeed, this repurposing hypothesis could be validated experimentally in vivo as specific activators of apo-sGC were directly neuroprotective, reduced infarct size and increased survival. Thus, common mechanism clusters of the diseasome allow direct drug repurposing across previously unrelated disease phenotypes redefining them in a mechanism-based manner. Specifically, our example of repurposing apo-sGC activators for ischemic stroke should be urgently validated clinically as a possible first-in-class neuroprotective therapy.}, language = {en} } @article{LiaoTtofaliSlotkowskietal.2019, author = {Liao, Chunyu and Ttofali, Fani and Slotkowski, Rebecca A. and Denny, Steven R. and Cecil, Taylor D. and Leenay, Ryan T. and Keung, Albert J. and Beisel, Chase L.}, title = {Modular one-pot assembly of CRISPR arrays enables library generation and reveals factors influencing crRNA biogenesis}, series = {Nature Communications}, volume = {10}, journal = {Nature Communications}, doi = {10.1038/s41467-019-10747-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236843}, year = {2019}, abstract = {CRISPR-Cas systems inherently multiplex through CRISPR arrays—whether to defend against different invaders or mediate multi-target editing, regulation, imaging, or sensing. However, arrays remain difficult to generate due to their reoccurring repeat sequences. Here, we report a modular, one-pot scheme called CRATES to construct CRISPR arrays and array libraries. CRATES allows assembly of repeat-spacer subunits using defined assembly junctions within the trimmed portion of spacers. Using CRATES, we construct arrays for the single-effector nucleases Cas9, Cas12a, and Cas13a that mediated multiplexed DNA/RNA cleavage and gene regulation in cell-free systems, bacteria, and yeast. CRATES further allows the one-pot construction of array libraries and composite arrays utilized by multiple Cas nucleases. Finally, array characterization reveals processing of extraneous CRISPR RNAs from Cas12a terminal repeats and sequence- and context-dependent loss of RNA-directed nuclease activity via global RNA structure formation. CRATES thus can facilitate diverse multiplexing applications and help identify factors impacting crRNA biogenesis.}, language = {en} } @article{LevyBoulleEmeritetal.2019, author = {Levy, Marion J. F. and Boulle, Fabien and Emerit, Michel Boris and Poilbout, Corinne and Steinbusch, Harry W. M. and Van den Hove, Daniel L. A. and Kenis, Gunter and Lanfumey, Laurence}, title = {5-HTT independent effects of fluoxetine on neuroplasticity}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-42775-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236759}, year = {2019}, abstract = {Selective serotonin reuptake inhibitors are among the most prescribed antidepressants. Fluoxetine is the lead molecule which exerts its therapeutic effects, at least in part, by promoting neuroplasticity through increased brain-derived neurotrophic factor (BDNF)/tropomyosin-related receptor kinase B (TrkB) signalling. It is unclear however, to which extent the neuroplastic effects of fluoxetine are solely mediated by the inhibition of the serotonin transporter (5-HTT). To answer this question, the effects of fluoxetine on neuroplasticity were analysed in both wild type (WT) and 5-Htt knock-out (KO) mice. Using Western blotting and RT-qPCR approaches, we showed that fluoxetine 10 µM activated BDNF/TrkB signalling pathways in both CD1 and C57BL/6J mouse primary cortical neurons. Interestingly, effects on BDNF signalling were observed in primary cortical neurons from both 5-Htt WT and KO mice. In addition, a 3-week in vivo fluoxetine treatment (15 mg/kg/d; i.p.) increased the expression of plasticity genes in brains of both 5-Htt WT and KO mice, and tended to equally enhance hippocampal cell proliferation in both genotypes, without reaching significance. Our results further suggest that fluoxetine-induced neuroplasticity does not solely depend on 5-HTT blockade, but might rely, at least in part, on 5-HTT-independent direct activation of TrkB.}, language = {en} } @article{KurabiSchaererNoacketal.2018, author = {Kurabi, Arwa and Schaerer, Daniel and Noack, Volker and Bernhardt, Marlen and Pak, Kwang and Alexander, Thomas and Husseman, Jacob and Nguyen, Quyen and Harris, Jeffrey P. and Ryan, Allen F.}, title = {Active Transport of Peptides Across the Intact Human Tympanic Membrane}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, doi = {10.1038/s41598-018-30031-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230929}, year = {2018}, abstract = {We previously identified peptides that are actively transported across the intact tympanic membrane (TM) of rats with infected middle ears. To assess the possibility that this transport would also occur across the human TM, we first developed and validated an assay to evaluate transport in vitro using fragments of the TM. Using this assay, we demonstrated the ability of phage bearing a TM-transiting peptide to cross freshly dissected TM fragments from infected rats or from uninfected rats, guinea pigs and rabbits. We then evaluated transport across fragments of the human TM that were discarded during otologic surgery. Human trans-TM transport was similar to that seen in the animal species. Finally, we found that free peptide, unconnected to phage, was transported across the TM at a rate comparable to that seen for peptide-bearing phage. These studies provide evidence supporting the concept of peptide-mediated drug delivery across the intact TM and into the middle ears of patients.}, language = {en} } @article{LopezKleinheinzAukemaetal.2019, author = {L{\´o}pez, Cristina and Kleinheinz, Kortine and Aukema, Sietse M. and Rohde, Marius and Bernhart, Stephan H. and H{\"u}bschmann, Daniel and Wagener, Rabea and Toprak, Umut H. and Raimondi, Francesco and Kreuz, Markus and Waszak, Sebastian M. and Huang, Zhiqin and Sieverling, Lina and Paramasivam, Nagarajan and Seufert, Julian and Sungalee, Stephanie and Russell, Robert B. and Bausinger, Julia and Kretzmer, Helene and Ammerpohl, Ole and Bergmann, Anke K. and Binder, Hans and Borkhardt, Arndt and Brors, Benedikt and Claviez, Alexander and Doose, Gero and Feuerbach, Lars and Haake, Andrea and Hansmann, Martin-Leo and Hoell, Jessica and Hummel, Michael and Korbel, Jan O. and Lawerenz, Chris and Lenze, Dido and Radlwimmer, Bernhard and Richter, Julia and Rosenstiel, Philip and Rosenwald, Andreas and Schilhabel, Markus B. and Stein, Harald and Stilgenbauer, Stephan and Stadler, Peter F. and Szczepanowski, Monika and Weniger, Marc A. and Zapatka, Marc and Eils, Roland and Lichter, Peter and Loeffler, Markus and M{\"o}ller, Peter and Tr{\"u}mper, Lorenz and Klapper, Wolfram and Hoffmann, Steve and K{\"u}ppers, Ralf and Burkhardt, Birgit and Schlesner, Matthias and Siebert, Reiner}, title = {Genomic and transcriptomic changes complement each other in the pathogenesis of sporadic Burkitt lymphoma}, series = {Nature Communications}, volume = {10}, journal = {Nature Communications}, organization = {ICGC MMML-Seq Consortium}, doi = {10.1038/s41467-019-08578-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237281}, year = {2019}, abstract = {Burkitt lymphoma (BL) is the most common B-cell lymphoma in children. Within the International Cancer Genome Consortium (ICGC), we performed whole genome and transcriptome sequencing of 39 sporadic BL. Here, we unravel interaction of structural, mutational, and transcriptional changes, which contribute to MYC oncogene dysregulation together with the pathognomonic IG-MYC translocation. Moreover, by mapping IGH translocation breakpoints, we provide evidence that the precursor of at least a subset of BL is a B-cell poised to express IGHA. We describe the landscape of mutations, structural variants, and mutational processes, and identified a series of driver genes in the pathogenesis of BL, which can be targeted by various mechanisms, including IG-non MYC translocations, germline and somatic mutations, fusion transcripts, and alternative splicing.}, language = {en} } @article{LuBoswellBoswelletal.2019, author = {Lu, Yuan and Boswell, Wiliam and Boswell, Mikki and Klotz, Barbara and Kneitz, Susanne and Regneri, Janine and Savage, Markita and Mendoza, Cristina and Postlethwait, John and Warren, Wesley C. and Schartl, Manfred and Walter, Ronald B.}, title = {Application of the Transcriptional Disease Signature (TDSs) to Screen Melanoma-Effective Compounds in a Small Fish Model}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-018-36656-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237322}, year = {2019}, abstract = {Cell culture and protein target-based compound screening strategies, though broadly utilized in selecting candidate compounds, often fail to eliminate candidate compounds with non-target effects and/or safety concerns until late in the drug developmental process. Phenotype screening using intact research animals is attractive because it can help identify small molecule candidate compounds that have a high probability of proceeding to clinical use. Most FDA approved, first-in-class small molecules were identified from phenotypic screening. However, phenotypic screening using rodent models is labor intensive, low-throughput, and very expensive. As a novel alternative for small molecule screening, we have been developing gene expression disease profiles, termed the Transcriptional Disease Signature (TDS), as readout of small molecule screens for therapeutic molecules. In this concept, compounds that can reverse, or otherwise affect known disease-associated gene expression patterns in whole animals may be rapidly identified for more detailed downstream direct testing of their efficacy and mode of action. To establish proof of concept for this screening strategy, we employed a transgenic strain of a small aquarium fish, medaka (Oryzias latipes), that overexpresses the malignant melanoma driver gene xmrk, a mutant egfr gene, that is driven by a pigment cell-specific mitf promoter. In this model, melanoma develops with 100\% penetrance. Using the transgenic medaka malignant melanoma model, we established a screening system that employs the NanoString nCounter platform to quantify gene expression within custom sets of TDS gene targets that we had previously shown to exhibit differential transcription among xmrk-transgenic and wild-type medaka. Compound-modulated gene expression was identified using an internet-accessible custom-built data processing pipeline. The effect of a given drug on the entire TDS profile was estimated by comparing compound-modulated genes in the TDS using an activation Z-score and Kolmogorov-Smirnov statistics. TDS gene probes were designed that target common signaling pathways that include proliferation, development, toxicity, immune function, metabolism and detoxification. These pathways may be utilized to evaluate candidate compounds for potential favorable, or unfavorable, effects on melanoma-associated gene expression. Here we present the logistics of using medaka to screen compounds, as well as, the development of a user-friendly NanoString data analysis pipeline to support feasibility of this novel TDS drug-screening strategy.}, language = {en} } @article{MeralProvasiPradaGraciaetal.2018, author = {Meral, Derya and Provasi, Davide and Prada-Gracia, Diego and M{\"o}ller, Jan and Marino, Kristen and Lohse, Martin J. and Filizola, Marta}, title = {Molecular details of dimerization kinetics reveal negligible populations of transient µ-opioid receptor homodimers at physiological concentrations}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, doi = {10.1038/s41598-018-26070-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223995}, year = {2018}, abstract = {Various experimental and computational techniques have been employed over the past decade to provide structural and thermodynamic insights into G Protein-Coupled Receptor (GPCR) dimerization. Here, we use multiple microsecond-long, coarse-grained, biased and unbiased molecular dynamics simulations (a total of ~4 milliseconds) combined with multi-ensemble Markov state models to elucidate the kinetics of homodimerization of a prototypic GPCR, the µ-opioid receptor (MOR), embedded in a 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC)/cholesterol lipid bilayer. Analysis of these computations identifies kinetically distinct macrostates comprising several different short-lived dimeric configurations of either inactive or activated MOR. Calculated kinetic rates and fractions of dimers at different MOR concentrations suggest a negligible population of MOR homodimers at physiological concentrations, which is supported by acceptor photobleaching fluorescence resonance energy transfer (FRET) experiments. This study provides a rigorous, quantitative explanation for some conflicting experimental data on GPCR oligomerization.}, language = {en} } @article{MedlerNelkeWeisenbergeretal.2019, author = {Medler, Juliane and Nelke, Johannes and Weisenberger, Daniela and Steinfatt, Tim and Rothaug, Moritz and Berr, Susanne and H{\"u}nig, Thomas and Beilhack, Andreas and Wajant, Harald}, title = {TNFRSF receptor-specific antibody fusion proteins with targeting controlled FcγR-independent agonistic activity}, series = {Cell Death \& Disease}, volume = {10}, journal = {Cell Death \& Disease}, doi = {10.1038/s41419-019-1456-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223948}, year = {2019}, abstract = {Antibodies specific for TNFRSF receptors that bind soluble ligands without getting properly activated generally act as strong agonists upon FcγR binding. Systematic analyses revealed that the FcγR dependency of such antibodies to act as potent agonists is largely independent from isotype, FcγR type, and of the epitope recognized. This suggests that the sole cellular attachment, achieved by Fc domain-FcγR interaction, dominantly determines the agonistic activity of antibodies recognizing TNFRSF receptors poorly responsive to soluble ligands. In accordance with this hypothesis, we demonstrated that antibody fusion proteins harboring domains allowing FcγR-independent cell surface anchoring also act as strong agonist provided they have access to their target. This finding defines a general possibility to generate anti-TNFRSF receptor antibodies with FcγR-independent agonism. Moreover, anti-TNFRSF receptor antibody fusion proteins with an anchoring domain promise superior applicability to conventional systemically active agonists when an anchoring target with localized disease associated expression can be addressed.}, language = {en} } @phdthesis{Hahn2024, author = {Hahn, Sarah}, title = {Investigating non-canonical, 5' UTR-dependent translation of MYC and its impact on colorectal cancer development}, doi = {10.25972/OPUS-36420}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-364202}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Colorectal cancer (CRC) is the second most common tumour disease in Germany, with the sequential accumulation of certain mutations playing a decisive role in the transition from adenoma to carcinoma. In particular, deregulation of the Wnt signalling pathway and the associated deregulated expression of the MYC oncoprotein play a crucial role. Targeting MYC thus represents an important therapeutic approach in the treatment of tumours. Since direct inhibition of MYC is challenging, various approaches have been pursued to date to target MYC indirectly. The MYC 5' UTR contains an internal ribosomal entry site (IRES), which has a particular role in the initiation of MYC translation, especially in multiple myeloma. As basis for this work, it was hypothesised on the basis of previous data that translation of MYC potentially occurs via its IRES in CRC as well. Based on this, two IRES inhibitors were tested for their potential to regulate MYC expression in CRC cells. In addition, alternative, 5' UTR-dependent translation of MYC and interacting factors were investigated. EIF3D was identified as a MYC 5' UTR binding protein which has the potential to regulate MYC expression in CRC. The results of this work suggest that there is a link between eIF3D and MYC expression/translation, rendering eIF3D a potential therapeutic target for MYC-driven CRCs.}, subject = {Myc}, language = {en} } @phdthesis{Boenninger2024, author = {B{\"o}nninger, Solveig Eva}, title = {F{\"o}rderliche und hinderliche Faktoren im Trauerprozess von Nahestehenden eines*r Verstorbenen}, doi = {10.25972/OPUS-36431}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-364319}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Laut Statistischem Bundesamt (Destatis) starben allein im Jahr 2020 zirka 985.500 Menschen. Die h{\"a}ufigsten Todesursachen waren Herz-Kreislauf- und Krebs-Erkrankungen (vgl. Destatis 2020). Die meisten Menschen haben den Wunsch zuhause zu sterben, doch die Mehrheit stirbt in Krankenh{\"a}usern, Alten- und Pflegeheimen (vgl. DHPV 2017; Dasch et al. 2015). Der Tod eines nahestehenden Menschen kann bei Hinterbliebenen zu großen Belastungen, gesundheitlichen Problemen sowie einer gesteigerten Mortalit{\"a}t f{\"u}hren (vgl. Stroebe et al. 2007). Ziel dieser Arbeit war es, mit Hilfe von halbstandardisierten Interviews mit 30 Trauernden Faktoren herauszuarbeiten, die sich f{\"o}rderlich oder hinderlich auf den Trauerprozess auswirken k{\"o}nnen. Die Interviews wurden mit der Transkriptionssoftware f4transkript verschriftlicht und mittels qualitativer Inhaltsanalyse nach Mayring ausgewertet. Es entstand ein Kategoriensystem mit je vier Oberkategorien innerhalb der zwei Hauptkategorien, F{\"o}rderliche und Hinderliche Faktoren. Folgende Faktoren konnten identifiziert werden: F{\"o}rderliche Faktoren in der Oberkategorie Betreuung der erkrankten und trauernden Person sind eine gute Symptomkontrolle sowie der verst{\"a}ndnisvolle Umgang mit den Nahestehenden, w{\"a}hrend mangelhafte Kommunikation wiederum hinderlich f{\"u}r eine positive Trauerbew{\"a}ltigung ist. In der Oberkategorie Intrapersonale Faktoren sind die Antizipation des Todes sowie die Auseinandersetzung mit der Trauer f{\"o}rderlich, w{\"a}hrend negative Gef{\"u}hle (z.B. Schuldgef{\"u}hle, Hilfslosigkeit) sich in besagter Hinsicht hinderlich auswirken. In der Oberkategorie Beziehung zur verstorbenen Person k{\"o}nnen die optimale Nutzung der verbliebenen Zeit sowie der offene Umgang mit der Erkrankung f{\"o}rderliche Faktoren darstellen, w{\"a}hrend ein "schwieriger" Abschied sowie ungekl{\"a}rte Konflikte oder offene Fragen Hindernisse f{\"u}r den Trauerprozess sein k{\"o}nnen. In der Oberkategorie Soziales Umfeld sind die unaufgeforderte Unterst{\"u}tzung, die emotionale Begleitung sowie ein flexibler Arbeitgeber f{\"o}rderlich. Streitigkeiten innerhalb der Familie und Unverst{\"a}ndnis der Mitmenschen dagegen sind hinderlich. Eine gute und w{\"u}rdevolle Sterbebegleitung, wie sie in der Palliativmedizin in der Regel gew{\"a}hrleistet ist, ist von großer Bedeutung f{\"u}r einen gelingenden Trauerprozess. Daher sollte eine palliative Haltung disziplin{\"u}bergreifend vorangebracht und ausgebaut werden. In der Gesellschaft sollte Trauernden mehr Toleranz und Verst{\"a}ndnis entgegengebracht und offen mit dem Thema Tod und Sterben umgegangen werden.}, subject = {Trauer}, language = {de} } @phdthesis{Morabbian2024, author = {Morabbian, Jasamin}, title = {Etablierung von Stammzell-Sph{\"a}roiden mit inkorporierten Biokeramik-Partikeln zur F{\"o}rderung der osteogenen Differenzierung}, doi = {10.25972/OPUS-36925}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369256}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {In der vorliegenden Dissertationsarbeit wurden Sph{\"a}roide aus mesenchymalen Stammzellen aus dem Fettgewebe oder dem Knochenmark mittels der Micromold-Methode hergestellt. Den Sph{\"a}roiden wurden entweder Calciumphosphat- oder Calcium-Magnesium-Phosphat-Partikel hinzugef{\"u}gt. Zum einen sollte {\"u}berpr{\"u}ft werden, ob die Zugabe von Partikeln die osteogene Differenzierung der Sph{\"a}roide f{\"o}rdert und somit zur weiteren Entwicklung von k{\"o}rpereigenem Knochenersatzmaterial in der regenerativen Medizin beitr{\"a}gt. Zum anderen sollte festgestellt werden, ob eine der beiden Biokeramiken hinsichtlich der osteogenen Differenzierung {\"u}berlegen ist.}, subject = {Stammzelle}, language = {de} } @phdthesis{Yabe2024, author = {Yabe, Marie}, title = {Untersuchung des Mental Rotation-Paradigmas bei Patienten mit fokaler Dystonie}, doi = {10.25972/OPUS-36392}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-363927}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Das mR-Paradigma beschreibt die F{\"a}higkeit Objekte gedanklich zu drehen und erfordert dabei komplexe neuronale Prozesse. Bisherige Studien konnten nicht kl{\"a}ren, ob es ein spezifisches Muster der Beeintr{\"a}chtigung im mR-Test bei fokalen Dystonien gibt. Die {\"u}bergeordnete Fragestellung der vorliegenden Arbeit war, ob eine verlangsamte Reaktion bei der mR von k{\"o}rperlichen Abbildungen einen stabilen Endoph{\"a}notyp fokaler Dystonien darstellt. Die Zielsetzung war die {\"U}berpr{\"u}fung der Hypothesen, 1) dass bisherige Ergebnisse, die eine verl{\"a}ngerte Reaktionszeit von CD-Patienten bei der mR von k{\"o}rperlichen Abbildungen aufzeigten, reproduzierbar sind und 2) dass eine erh{\"o}hte Reaktionszeit bei der mR von k{\"o}rperlichen Abbildungen auch bei Patienten mit BSP vorliegt. Um dabei die mR m{\"o}glichst spezifisch zu untersuchen, wurden folgende sekund{\"a}re Hypothesen formuliert: a) die kognitive Leistungsf{\"a}higkeit und b) das allgemeine Reaktionsverm{\"o}gen der Teilnehmer stellen potenzielle St{\"o}rfaktoren f{\"u}r die Reaktionszeit bei der mR-Aufgabe dar. Diese wurden neben der H{\"a}ndigkeit und der allgemeinen Geschicklichkeit systematisch erhoben. 23 CD-Patienten und 23 gesunde Kontrollpersonen sowie 21 BSP- und 19 HFS-Patienten wurden hinsichtlich Geschlechterverteilung, Alter und Bildungsstand verglichen. Zudem wurden H{\"a}ndigkeit, Fingergeschicklichkeit, allgemeine Reaktionszeit und kognitiver Status jedes Teilnehmers erhoben. Im mR-Test wurden Fotos von K{\"o}rperteilen (Hand, Fuß oder Kopf) und einem nicht-k{\"o}rperlichen Objekt (Auto) gezeigt, die in sechs verschiedene Winkelgrade um die eigene Achse in der Bildebene rotiert waren. Die Teilnehmer wurden gebeten, die Lateralit{\"a}t des dargestellten Bildes per Tastendruck anzugeben. Bewertet wurden sowohl Geschwindigkeit als auch Richtigkeit der Antworten. Im Vergleich zu gesunden Kontrollpersonen schnitten CD- und HFS-Patienten bei der mR der H{\"a}nde schlechter ab, w{\"a}hrend die BSP-Patienten vergleichbare Leistungen zeigten. Es bestand ein signifikanter Zusammenhang zwischen einer verl{\"a}ngerten mR-Reaktionszeit und reduzierten MoCA-Scores sowie einer erh{\"o}hten mR-Reaktionszeit und verl{\"a}ngerter allgemeiner Reaktionszeit. Nach Ausschluss der Patienten mit MCI zeigten CD-Patienten, nicht jedoch HFS-Patienten, im Vergleich zur gesunden Kontrollgruppe weiterhin verlangsamte Reaktionszeiten der H{\"a}nde. Die vorliegende Studie konnte die Frage, ob eine verlangsamte Reaktion bei der mR von k{\"o}rperlichen Abbildungen einen stabilen Endoph{\"a}notyp fokaler Dystonien darstellt, nicht sicher beantworten. Es stellte sich jedoch heraus, dass Kognition und allgemeine Reaktionszeit starke Einflussfaktoren bei der mR-Aufgabe sind. Dies wurde in den fr{\"u}heren Arbeiten nicht ber{\"u}cksichtigt und stellt daher ein neues und wichtiges Ergebnis dar. Die verlangsamte Reaktion bei der mR der H{\"a}nde bei CD-Patienten auch nach Ausschluss von Patienten mit MCI l{\"a}sst ein spezifisches Defizit der F{\"a}higkeit der mR vermuten. Das Vorliegen einer tiefergreifenden zugrundeliegenden Netzwerkst{\"o}rung, die sich auf die Leistung im mR-Test auswirkt, w{\"a}re dabei denkbar.}, language = {de} } @phdthesis{Laqua2024, author = {Laqua, Caroline}, title = {Association of myocardial tissue characteristics and functional outcome in biopsy-verified myocarditis assessed by cardiac magnetic resonance imaging}, doi = {10.25972/OPUS-36390}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-363903}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {The relation between LV function and cardiac MRI tissue characteristics in separate myocardial segments and their change over time has yet to be explored in myocarditis. Thus, our research aimed to investigate possible associations between global and regional myocardial T1 and T2 times and peak strain in patients with suspected myocarditis. From 2012 to 2015, 129 patients with clinically suspected myocarditis of the prospective, observational MyoRacer-Trial underwent systematic biventricular EMB at baseline and cardiac MRI at baseline and after three months as a follow-up. We divided the LV myocardium into 17 segments and estimated the segmental myocardial strain using FT. We registered T1 and T2 maps to the cine sequences and transferred the segmentations used for FT to ensure conformity of the myocardial segments. Multi-level multivariable linear mixed effects regression was applied to investigate the relation of segmental myocardial strain to relaxation times and their respective change from baseline to follow-up. We found a significant improvement in myocardial peak strain from baseline to follow-up (p < 0.001; all p-values given for likelihood ratio tests) and significant associations between higher T1 and T2 times and lower segmental myocardial peak strain (p ranging from < 0.001 to 0.049). E.g., regression coefficient (Reg. coef.) for segmental radial peak strain in short axis view (SRPS_SAX) and T1 time: -1.9, 95\% CI (-2.6;-1.2) \%/100 ms, p < 0.001. A decrease in T1 and T2 times from baseline to follow-up was also significantly related to a recovery of segmental peak strains (p ranging from < 0.001 to 0.050). E.g., Reg. coef. for SRPS_SAX per ΔT1: -1.8, 95\% CI (-2.5;-1.0) \%/100 ms, p < 0.001. Moreover, the higher the baseline T1 time, the more substantial the functional recovery from baseline to follow-up (p ranging from 0.004 to 0.042, e.g., for SRPS_SAX: Reg. coef. 1.3, 95\% CI (0.4;2.1) \%/100 ms, p 0.004). We did not find an effect modification by the presence of myocarditis in the EMB (p > 0.1). Our cross-sectional and longitudinal analyses provide evidence of dose-dependent correlations between T1 and T2 relaxation times and myocardial peak strain in patients with clinical presentation of myocarditis, regardless of the EMB result. Thus, assessing strain values and mapping relaxation times helps estimate the functional prognosis in patients with clinically suspected myocarditis.}, subject = {Myokarditis}, language = {en} } @article{SnaebjornssonSchulze2018, author = {Snaebjornsson, Marteinn T and Schulze, Almut}, title = {Non-canonical functions of enzymes facilitate cross-talk between cell metabolic and regulatory pathways}, series = {Experimental \& Molecular Medicine}, volume = {50}, journal = {Experimental \& Molecular Medicine}, doi = {10.1038/s12276-018-0065-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-238763}, pages = {1-16}, year = {2018}, abstract = {The metabolic rewiring that occurs during cell transformation is a hallmark of cancer. It is diverse in different cancers as it reflects different combinations of oncogenic drivers, tumor suppressors, and the microenvironment. Metabolic rewiring is essential to cancer as it enables uncontrolled proliferation and adaptation to the fluctuating availability of nutrients and oxygen caused by poor access to the vasculature due to tumor growth and a foreign microenvironment encountered during metastasis. Increasing evidence now indicates that the metabolic state in cancer cells also plays a causal role in tumor growth and metastasis, for example through the action of oncometabolites, which modulate cell signaling and epigenetic pathways to promote malignancy. In addition to altering the metabolic state in cancer cells, some multifunctional enzymes possess non-metabolic functions that also contribute to cell transformation. Some multifunctional enzymes that are highly expressed in cancer, such as pyruvate kinase M2 (PKM2), have non-canonical functions that are co-opted by oncogenic signaling to drive proliferation and inhibit apoptosis. Other multifunctional enzymes that are frequently downregulated in cancer, such as fructose-bisphosphatase 1 (FBP1), are tumor suppressors, directly opposing mitogenic signaling via their non-canonical functions. In some cases, the enzymatic and non-canonical roles of these enzymes are functionally linked, making the modulation of non-metabolic cellular processes dependent on the metabolic state of the cell.}, language = {en} } @article{SirtlKnollDieuThuyetal.2018, author = {Sirtl, Simon and Knoll, Gertrud and Dieu Thuy, Trinh and Lang, Isabell and Siegmund, Daniela and Gross, Stefanie and Schuler-Thurner, Beatrice and Neubert, Patrick and Jantsch, Jonathan and Wajant, Harald and Ehrenschwender, Martin}, title = {Hypertonicity-enforced BCL-2 addiction unleashes the cytotoxic potential of death receptors}, series = {Oncogene}, volume = {37}, journal = {Oncogene}, doi = {10.1038/s41388-018-0265-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-238327}, pages = {4122-4136}, year = {2018}, abstract = {Attempts to exploit the cytotoxic activity of death receptors (DR) for treating cancer have thus far been disappointing. DR activation in most malignant cells fails to trigger cell death and may even promote tumor growth by activating cell death-independent DR-associated signaling pathways. Overcoming apoptosis resistance is consequently a prerequisite for successful clinical exploitation of DR stimulation. Here we show that hyperosmotic stress in the tumor microenvironment unleashes the deadly potential of DRs by enforcing BCL-2 addiction of cancer cells. Hypertonicity robustly enhanced cytotoxicity of tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) and other DR ligands in various cancer entities. Initial events in TRAIL DR signaling remained unaffected, but hypertonic conditions unlocked activation of the mitochondrial death pathway and thus amplified the apoptotic signal. Mechanistically, we demonstrate that hyperosmotic stress imposed a BCL-2-addiction on cancer cells to safeguard the integrity of the outer mitochondrial membrane (OMM), essentially exhausting the protective capacity of BCL-2-like pro-survival proteins. Deprivation of these mitochondrial safeguards licensed DR-generated truncated BH3-interacting domain death agonist (tBID) to activate BCL-2-associated X protein (BAX) and initiated mitochondrial outer membrane permeabilization (MOMP). Our work highlights that hyperosmotic stress in the tumor environment primes mitochondria for death and lowers the threshold for DR-induced apoptosis. Beyond TRAIL-based therapies, our findings could help to strengthen the efficacy of other apoptosis-inducing cancer treatment regimens.}, language = {en} } @article{StegmannReichertsAndreattaetal.2019, author = {Stegmann, Yannik and Reicherts, Philipp and Andreatta, Marta and Pauli, Paul and Wieser, Matthias J.}, title = {The effect of trait anxiety on attentional mechanisms in combined context and cue conditioning and extinction learning}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-45239-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239394}, year = {2019}, abstract = {Sensory processing and attention allocation are shaped by threat, but the role of trait-anxiety in sensory processing as a function of threat predictability remains incompletely understood. Therefore, we measured steady-state visual evoked potentials (ssVEPs) as an index of sensory processing of predictable and unpredictable threat cues in 29 low (LA) and 29 high (HA) trait-anxious participants during a modified NPU-paradigm followed by an extinction phase. Three different contextual cues indicated safety (N), predictable (P) or unpredictable threat (U), while foreground cues signalled shocks in the P-condition only. All participants allocated increased attentional resources to the central P-threat cue, replicating previous findings. Importantly, LA individuals exhibited larger ssVEP amplitudes to contextual threat (U and P) than to contextual safety cues, while HA individuals did not differentiate among contextual cues in general. Further, HA exhibited higher aversive ratings of all contexts compared to LA. These results suggest that high trait-anxious individuals might be worse at discriminating contextual threat stimuli and accordingly overestimate the probability and aversiveness of unpredictable threat. These findings support the notion of aberrant sensory processing of unpredictable threat in anxiety disorders, as this processing pattern is already evident in individuals at risk of these disorders.}, language = {en} } @article{SolimandoBrandlMattenheimeretal.2018, author = {Solimando, A G and Brandl, A and Mattenheimer, K and Graf, C and Ritz, M and Ruckdeschel, A and St{\"u}hmer, T and Mokhtari, Z and Rudelius, M and Dotterweich, J and Bittrich, M and Desantis, V and Ebert, R and Trerotoli, P and Frassanito, M A and Rosenwald, A and Vacca, A and Einsele, H and Jakob, F and Beilhack, A}, title = {JAM-A as a prognostic factor and new therapeutic target in multiple myeloma}, series = {Leukemia}, volume = {32}, journal = {Leukemia}, doi = {10.1038/leu.2017.287}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239069}, pages = {736-743}, year = {2018}, abstract = {Cell adhesion in the multiple myeloma (MM) microenvironment has been recognized as a major mechanism of MM cell survival and the development of drug resistance. Here we addressed the hypothesis that the protein junctional adhesion molecule-A (JAM-A) may represent a novel target and a clinical biomarker in MM. We evaluated JAM-A expression in MM cell lines and in 147 MM patient bone marrow aspirates and biopsies at different disease stages. Elevated JAM-A levels in patient-derived plasma cells were correlated with poor prognosis. Moreover, circulating soluble JAM-A (sJAM-A) levels were significantly increased in MM patients as compared with controls. Notably, in vitro JAM-A inhibition impaired MM migration, colony formation, chemotaxis, proliferation and viability. In vivo treatment with an anti-JAM-A monoclonal antibody (αJAM-A moAb) impaired tumor progression in a murine xenograft MM model. These results demonstrate that therapeutic targeting of JAM-A has the potential to prevent MM progression, and lead us to propose JAM-A as a biomarker in MM, and sJAM-A as a serum-based marker for clinical stratification.}, language = {en} } @article{SiegmundEhrenschwenderWajant2018, author = {Siegmund, Daniela and Ehrenschwender, Martin and Wajant, Harald}, title = {TNFR2 unlocks a RIPK1 kinase activity-dependent mode of proinflammatory TNFR1 signaling}, series = {Cell Death \& Disease}, volume = {9}, journal = {Cell Death \& Disease}, doi = {10.1038/s41419-018-0973-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-238034}, year = {2018}, abstract = {TNF is not only a major effector molecule of PAMP/DAMP-activated macrophages, but also regulates macrophage function and viability. We recently demonstrated that TNFR2 triggers necroptosis in macrophages with compromised caspase activity by two cooperating mechanisms: induction of endogenous TNF with subsequent stimulation of TNFR1 and depletion of cytosolic TRAF2-cIAP complexes. Here we show that TNFR2 activation in caspase-inhibited macrophages results in the production of endogenous TNF and TNFR1 stimulation followed by upregulation of A20, TRAF1, IL-6, and IL-1β. Surprisingly, TNFR1-mediated induction of IL-6 and IL-1β was clearly evident in response to TNFR2 stimulation but occurred not or only weakly in macrophages selectively and directly stimulated via TNFR1. Moreover, TNFR2-induced TNFR1-mediated gene induction was largely inhibited by necrostatin-1, whereas upregulation of A20 and TRAF1 by direct and exclusive stimulation of TNFR1 remained unaffected by this compound. Thus, treatment with TNFR2/ZVAD enables TNFR1 in macrophages to stimulate gene induction via a pathway requiring RIPK1 kinase activity. TNFR2/ZVAD-induced production of IL-6 and IL-1β was largely blocked in necroptosis-resistant MLKL- and RIPK3-deficient macrophages, whereas induction of A20 and TRAF1 remained unaffected. In sum, our results show that in caspase-inhibited macrophages TNFR2 not only triggers TNF/TNFR1-mediated necroptosis but also TNF/TNFR1-mediated RIPK3/MLKL-dependent and -independent gene induction.}, language = {en} } @article{VaethWangEcksteinetal.2019, author = {Vaeth, Martin and Wang, Yin-Hu and Eckstein, Miriam and Yang, Jun and Silverman, Gregg J. and Lacruz, Rodrigo S. and Kannan, Kasthuri and Feske, Stefan}, title = {Tissue resident and follicular Treg cell differentiation is regulated by CRAC channels}, series = {Nature Communications}, volume = {10}, journal = {Nature Communications}, doi = {10.1038/s41467-019-08959-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232148}, year = {2019}, abstract = {T regulatory (Treg) cells maintain immunological tolerance and organ homeostasis. Activated Treg cells differentiate into effector Treg subsets that acquire tissue-specific functions. Ca2+ influx via Ca2+ release-activated Ca2+ (CRAC) channels formed by STIM and ORAI proteins is required for the thymic development of Treg cells, but its function in mature Treg cells remains unclear. Here we show that deletion of Stim1 and Stim2 genes in mature Treg cells abolishes Ca2+ signaling and prevents their differentiation into follicular Treg and tissue-resident Treg cells. Transcriptional profiling of STIM1/STIM2-deficient Treg cells reveals that Ca2+ signaling regulates transcription factors and signaling pathways that control the identity and effector differentiation of Treg cells. In the absence of STIM1/STIM2 in Treg cells, mice develop a broad spectrum of autoantibodies and fatal multiorgan inflammation. Our findings establish a critical role of CRAC channels in controlling lineage identity and effector functions of Treg cells.}, language = {en} } @article{SulzerCassidyHorgaetal.2018, author = {Sulzer, David and Cassidy, Clifford and Horga, Guillermo and Kang, Un Jung and Fahn, Stanley and Casella, Luigi and Pezzoli, Gianni and Langley, Jason and Hu, Xiaoping P. and Zucca, Fabio A. and Isaias, Ioannis U. and Zecca, Luigi}, title = {Neuromelanin detection by magnetic resonance imaging (MRI) and its promise as a biomarker for Parkinson's disease}, series = {npj Parkinson's Disease}, volume = {4}, journal = {npj Parkinson's Disease}, doi = {10.1038/s41531-018-0047-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-240207}, year = {2018}, abstract = {The diagnosis of Parkinson's disease (PD) occurs after pathogenesis is advanced and many substantia nigra (SN) dopamine neurons have already died. Now that therapies to block this neuronal loss are under development, it is imperative that the disease be diagnosed at earlier stages and that the response to therapies is monitored. Recent studies suggest this can be accomplished by magnetic resonance imaging (MRI) detection of neuromelanin (NM), the characteristic pigment of SN dopaminergic, and locus coeruleus (LC) noradrenergic neurons. NM is an autophagic product synthesized via oxidation of catecholamines and subsequent reactions, and in the SN and LC it increases linearly during normal aging. In PD, however, the pigment is lost when SN and LC neurons die. As shown nearly 25 years ago by Zecca and colleagues, NM's avid binding of iron provides a paramagnetic source to enable electron and nuclear magnetic resonance detection, and thus a means for safe and noninvasive measure in living human brain. Recent technical improvements now provide a means for MRI to differentiate between PD patients and age-matched healthy controls, and should be able to identify changes in SN NM with age in individuals. We discuss how MRI detects NM and how this approach might be improved. We suggest that MRI of NM can be used to confirm PD diagnosis and monitor disease progression. We recommend that for subjects at risk for PD, and perhaps generally for older people, that MRI sequences performed at regular intervals can provide a pre-clinical means to detect presymptomatic PD.}, language = {en} } @article{UllrichWeberPostetal.2018, author = {Ullrich, M and Weber, M and Post, A M and Popp, S and Grein, J and Zechner, M and Gonz{\´a}lez, H Guerrero and Kreis, A and Schmitt, A G and {\"U}ҫeyler, N and Lesch, K-P and Schuh, K}, title = {OCD-like behavior is caused by dysfunction of thalamo-amygdala circuits and upregulated TrkB/ERK-MAPK signaling as a result of SPRED2 deficiency}, series = {Molecular Psychiatry}, volume = {23}, journal = {Molecular Psychiatry}, doi = {10.1038/mp.2016.232}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232096}, pages = {444-458}, year = {2018}, abstract = {Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disease affecting about 2\% of the general population. It is characterized by persistent intrusive thoughts and repetitive ritualized behaviors. While gene variations, malfunction of cortico-striato-thalamo-cortical (CSTC) circuits, and dysregulated synaptic transmission have been implicated in the pathogenesis of OCD, the underlying mechanisms remain largely unknown. Here we show that OCD-like behavior in mice is caused by deficiency of SPRED2, a protein expressed in various brain regions and a potent inhibitor of Ras/ERK-MAPK signaling. Excessive self-grooming, reflecting OCD-like behavior in rodents, resulted in facial skin lesions in SPRED2 knockout (KO) mice. This was alleviated by treatment with the selective serotonin reuptake inhibitor fluoxetine. In addition to the previously suggested involvement of cortico-striatal circuits, electrophysiological measurements revealed altered transmission at thalamo-amygdala synapses and morphological differences in lateral amygdala neurons of SPRED2 KO mice. Changes in synaptic function were accompanied by dysregulated expression of various pre- and postsynaptic proteins in the amygdala. This was a result of altered gene transcription and triggered upstream by upregulated tropomyosin receptor kinase B (TrkB)/ERK-MAPK signaling in the amygdala of SPRED2 KO mice. Pathway overactivation was mediated by increased activity of TrkB, Ras, and ERK as a specific result of SPRED2 deficiency and not elicited by elevated brain-derived neurotrophic factor levels. Using the MEK inhibitor selumetinib, we suppressed TrkB/ERK-MAPK pathway activity in vivo and reduced OCD-like grooming in SPRED2 KO mice. Altogether, this study identifies SPRED2 as a promising new regulator, TrkB/ERK-MAPK signaling as a novel mediating mechanism, and thalamo-amygdala synapses as critical circuitry involved in the pathogenesis of OCD.}, language = {en} } @article{TrautzFrankeBohnertetal.2019, author = {Trautz, Florian and Franke, Heike and Bohnert, Simone and Hammer, Niels and M{\"u}ller, Wolf and Stassart, Ruth and Tse, Rexson and Zwirner, Johann and Dreßler, Jan and Ondruschka, Benjamin}, title = {Survival-time dependent increase in neuronal IL-6 and astroglial GFAP expression in fatally injured human brain tissue}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-48145-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229037}, year = {2019}, abstract = {Knowledge on trauma survival time prior to death following a lethal traumatic brain injury (TBI) may be essential for legal purposes. Immunohistochemistry studies might allow to narrow down this survival interval. The biomarkers interleukin-6 (IL-6) and glial fibrillary acidic protein (GFAP) are well known in the clinical setting for their usability in TBI prediction. Here, both proteins were chosen in forensics to determine whether neuronal or glial expression in various brain regions may be associated with the cause of death and the survival time prior to death following TBI. IL-6 positive neurons, glial cells and GFAP positive astrocytes all concordantly increase with longer trauma survival time, with statistically significant changes being evident from three days post-TBI (p < 0.05) in the pericontusional zone, irrespective of its definite cortical localization. IL-6 staining in neurons increases significantly in the cerebellum after trauma, whereas increasing GFAP positivity is also detected in the cortex contralateral to the focal lesion. These systematic chronological changes in biomarkers of pericontusional neurons and glial cells allow for an estimation of trauma survival time. Higher numbers of IL-6 and GFAP-stained cells above threshold values in the pericontusional zone substantiate the existence of fatal traumatic changes in the brain with reasonable certainty.}, language = {en} } @article{TylekSchillingSchlegelmilchetal.2019, author = {Tylek, Tina and Schilling, Tatjana and Schlegelmilch, Katrin and Ries, Maximilian and Rudert, Maximilian and Jakob, Franz and Groll, J{\"u}rgen}, title = {Platelet lysate outperforms FCS and human serum for co-culture of primary human macrophages and hMSCs}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-40190-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229174}, year = {2019}, abstract = {In vitro co-cultures of different primary human cell types are pivotal for the testing and evaluation of biomaterials under conditions that are closer to the human in vivo situation. Especially co-cultures of macrophages and mesenchymal stem cells (MSCs) are of interest, as they are both present and involved in tissue regeneration and inflammatory reactions and play crucial roles in the immediate inflammatory reactions and the onset of regenerative processes, thus reflecting the decisive early phase of biomaterial contact with the host. A co-culture system of these cell types might thus allow for the assessment of the biocompatibility of biomaterials. The establishment of such a co-culture is challenging due to the different in vitro cell culture conditions. For human macrophages, medium is usually supplemented with human serum (hS), whereas hMSC culture is mostly performed using fetal calf serum (FCS), and these conditions are disadvantageous for the respective other cell type. We demonstrate that human platelet lysate (hPL) can replace hS in macrophage cultivation and appears to be the best option for co-cultivation of human macrophages with hMSCs. In contrast to FCS and hS, hPL maintained the phenotype of both cell types, comparable to that of their respective standard culture serum, as well as the percentage of each cell population. Moreover, the expression profile and phagocytosis activity of macrophages was similar to hS.}, language = {en} } @article{StraubFreudenbergSchleicheretal.2018, author = {Straub, Tobias and Freudenberg, Marina A. and Schleicher, Ulrike and Bogdan, Christian and Gasteiger, Georg and Pircher, Hanspeter}, title = {Bacterial coinfection restrains antiviral CD8 T-cell response via LPS-induced inhibitory NK cells}, series = {Nature Communications}, volume = {9}, journal = {Nature Communications}, doi = {10.1038/s41467-018-06609-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-240075}, year = {2018}, abstract = {Infection of specific pathogen-free mice with lymphocytic choriomeningitis virus (LCMV) is a widely used model to study antiviral T-cell immunity. Infections in the real world, however, are often accompanied by coinfections with unrelated pathogens. Here we show that in mice, systemic coinfection with E. coli suppresses the LCMV-specific cytotoxic T-lymphocyte (CTL) response and virus elimination in a NK cell- and TLR2/4-dependent manner. Soluble TLR4 ligand LPS also induces NK cell-mediated negative CTL regulation during LCMV infection. NK cells in LPS-treated mice suppress clonal expansion of LCMV-specific CTLs by a NKG2D- or NCR1-independent but perforin-dependent mechanism. These results suggest a TLR4-mediated immunoregulatory role of NK cells during viral-bacterial coinfections.}, language = {en} } @article{WentSudSpeedyetal.2018, author = {Went, Molly and Sud, Amit and Speedy, Helen and Sunter, Nicola J. and F{\"o}rsti, Asta and Law, Philip J. and Johnson, David C. and Mirabella, Fabio and Holroyd, Amy and Li, Ni and Orlando, Giulia and Weinhold, Niels and van Duin, Mark and Chen, Bowang and Mitchell, Jonathan S. and Mansouri, Larry and Juliusson, Gunnar and Smedby, Karin E and Jayne, Sandrine and Majid, Aneela and Dearden, Claire and Allsup, David J. and Bailey, James R. and Pratt, Guy and Pepper, Chris and Fegan, Chris and Rosenquist, Richard and Kuiper, Rowan and Stephens, Owen W. and Bertsch, Uta and Broderick, Peter and Einsele, Hermann and Gregory, Walter M. and Hillengass, Jens and Hoffmann, Per and Jackson, Graham H. and J{\"o}ckel, Karl-Heinz and Nickel, Jolanta and N{\"o}then, Markus M. and da Silva Filho, Miguel Inacio and Thomsen, Hauke and Walker, Brian A. and Broyl, Annemiek and Davies, Faith E. and Hansson, Markus and Goldschmidt, Hartmut and Dyer, Martin J. S. and Kaiser, Martin and Sonneveld, Pieter and Morgan, Gareth J. and Hemminki, Kari and Nilsson, Bj{\"o}rn and Catovsky, Daniel and Allan, James M. and Houlston, Richard S.}, title = {Genetic correlation between multiple myeloma and chronic lymphocytic leukaemia provides evidence for shared aetiology}, series = {Blood Cancer Journal}, volume = {9}, journal = {Blood Cancer Journal}, doi = {10.1038/s41408-018-0162-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233627}, year = {2018}, abstract = {The clustering of different types of B-cell malignancies in families raises the possibility of shared aetiology. To examine this, we performed cross-trait linkage disequilibrium (LD)-score regression of multiple myeloma (MM) and chronic lymphocytic leukaemia (CLL) genome-wide association study (GWAS) data sets, totalling 11,734 cases and 29,468 controls. A significant genetic correlation between these two B-cell malignancies was shown (Rg = 0.4, P = 0.0046). Furthermore, four of the 45 known CLL risk loci were shown to associate with MM risk and five of the 23 known MM risk loci associate with CLL risk. By integrating eQTL, Hi-C and ChIP-seq data, we show that these pleiotropic risk loci are enriched for B-cell regulatory elements and implicate B-cell developmental genes. These data identify shared biological pathways influencing the development of CLL and, MM and further our understanding of the aetiological basis of these B-cell malignancies.}, language = {en} } @article{WenFeilWoltersetal.2018, author = {Wen, Lai and Feil, Susanne and Wolters, Markus and Thunemann, Martin and Regler, Frank and Schmidt, Kjestine and Friebe, Andreas and Olbrich, Marcus and Langer, Harald and Gawaz, Meinrad and de Wit, Cor and Feil, Robert}, title = {A shear-dependent NO-cGMP-cGKI cascade in platelets acts as an auto-regulatory brake of thrombosis}, series = {Nature Communications}, volume = {9}, journal = {Nature Communications}, doi = {10.1038/s41467-018-06638-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233616}, year = {2018}, abstract = {Mechanisms that limit thrombosis are poorly defined. One of the few known endogenous platelet inhibitors is nitric oxide (NO). NO activates NO sensitive guanylyl cyclase (NO-GC) in platelets, resulting in an increase of cyclic guanosine monophosphate (cGMP). Here we show, using cGMP sensor mice to study spatiotemporal dynamics of platelet cGMP, that NO-induced cGMP production in pre-activated platelets is strongly shear-dependent. We delineate a new mode of platelet-inhibitory mechanotransduction via shear-activated NO-GC followed by cGMP synthesis, activation of cGMP-dependent protein kinase I (cGKI), and suppression of Ca2+ signaling. Correlative profiling of cGMP dynamics and thrombus formation in vivo indicates that high cGMP concentrations in shear-exposed platelets at the thrombus periphery limit thrombosis, primarily through facilitation of thrombus dissolution. We propose that an increase in shear stress during thrombus growth activates the NO-cGMP-cGKI pathway, which acts as an auto-regulatory brake to prevent vessel occlusion, while preserving wound closure under low shear.}, language = {en} } @article{WelzEickhoffAbdullahetal.2018, author = {Welz, M. and Eickhoff, S. and Abdullah, Z. and Trebicka, J. and Gartlan, K. H. and Spicer, J. A. and Demetris, A. J. and Akhlaghi, H. and Anton, M. and Manske, K. and Zehn, D. and Nieswandt, B. and Kurts, C. and Trapani, J. A. and Knolle, P. and Wohlleber, D. and Kastenm{\"u}ller, W.}, title = {Perforin inhibition protects from lethal endothelial damage during fulminant viral hepatitis}, series = {Nature Communications}, volume = {9}, journal = {Nature Communications}, doi = {10.1038/s41467-018-07213-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233593}, year = {2018}, abstract = {CD8 T cells protect the liver against viral infection, but can also cause severe liver damage that may even lead to organ failure. Given the lack of mechanistic insights and specific treatment options in patients with acute fulminant hepatitis, we develop a mouse model reflecting a severe acute virus-induced CD8 T cell-mediated hepatitis. Here we show that antigen-specific CD8 T cells induce liver damage in a perforin-dependent manner, yet liver failure is not caused by effector responses targeting virus-infected hepatocytes alone. Additionally, CD8 T cell mediated elimination of cross-presenting liver sinusoidal endothelial cells causes endothelial damage that leads to a dramatically impaired sinusoidal perfusion and indirectly to hepatocyte death. With the identification of perforin-mediated killing as a critical pathophysiologic mechanism of liver failure and the protective function of a new class of perforin inhibitor, our study opens new potential therapeutic angles for fulminant viral hepatitis.}, language = {en} } @article{WalkerMavrommatisWardelletal.2019, author = {Walker, Brian A. and Mavrommatis, Konstantinos and Wardell, Christopher P. and Ashby, T. Cody and Bauer, Michael and Davies, Faith and Rosenthal, Adam and Wang, Hongwei and Qu, Pingping and Hoering, Antje and Samur, Mehmet and Towfic, Fadi and Ortiz, Maria and Flynt, Erin and Yu, Zhinuan and Yang, Zhihong and Rozelle, Dan and Obenauer, John and Trotter, Matthew and Auclair, Daniel and Keats, Jonathan and Bolli, Niccolo and Fulciniti, Mariateresa and Szalat, Raphael and Moreau, Phillipe and Durie, Brian and Stewart, A. Keith and Goldschmidt, Hartmut and Raab, Marc S. and Einsele, Hermann and Sonneveld, Pieter and San Miguel, Jesus and Lonial, Sagar and Jackson, Graham H. and Anderson, Kenneth C. and Avet-Loiseau, Herve and Munshi, Nikhil and Thakurta, Anjan and Morgan, Gareth}, title = {A high-risk, Double-Hit, group of newly diagnosed myeloma identified by genomic analysis}, series = {Leukemia}, volume = {33}, journal = {Leukemia}, doi = {10.1038/s41375-018-0196-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233299}, pages = {159-170}, year = {2019}, abstract = {Patients with newly diagnosed multiple myeloma (NDMM) with high-risk disease are in need of new treatment strategies to improve the outcomes. Multiple clinical, cytogenetic, or gene expression features have been used to identify high-risk patients, each of which has significant weaknesses. Inclusion of molecular features into risk stratification could resolve the current challenges. In a genome-wide analysis of the largest set of molecular and clinical data established to date from NDMM, as part of the Myeloma Genome Project, we have defined DNA drivers of aggressive clinical behavior. Whole-genome and exome data from 1273 NDMM patients identified genetic factors that contribute significantly to progression free survival (PFS) and overall survival (OS) (cumulative R2 = 18.4\% and 25.2\%, respectively). Integrating DNA drivers and clinical data into a Cox model using 784 patients with ISS, age, PFS, OS, and genomic data, the model has a cumlative R2 of 34.3\% for PFS and 46.5\% for OS. A high-risk subgroup was defined by recursive partitioning using either a) bi-allelic TP53 inactivation or b) amplification (≥4 copies) of CKS1B (1q21) on the background of International Staging System III, comprising 6.1\% of the population (median PFS = 15.4 months; OS = 20.7 months) that was validated in an independent dataset. Double-Hit patients have a dire prognosis despite modern therapies and should be considered for novel therapeutic approaches.}, language = {en} } @article{WegertVokuhlCollordetal.2018, author = {Wegert, Jenny and Vokuhl, Christian and Collord, Grace and Del Castillo Velasco-Herrera, Martin and Farndon, Sarah J. and Guzzo, Charlotte and Jorgensen, Mette and Anderson, John and Slater, Olga and Duncan, Catriona and Bausenwein, Sabrina and Streitenberger, Heike and Ziegler, Barbara and Furtw{\"a}ngler, Rhoikos and Graf, Norbert and Stratton, Michael R. and Campbell, Peter J. and Jones, David TW and Koelsche, Christian and Pfister, Stefan M. and Mifsud, William and Sebire, Neil and Sparber-Sauer, Monika and Koscielniak, Ewa and Rosenwald, Andreas and Gessler, Manfred and Behjati, Sam}, title = {Recurrent intragenic rearrangements of EGFR and BRAF in soft tissue tumors of infants}, series = {Nature Communications}, volume = {9}, journal = {Nature Communications}, doi = {10.1038/s41467-018-04650-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233446}, year = {2018}, abstract = {Soft tissue tumors of infancy encompass an overlapping spectrum of diseases that pose unique diagnostic and clinical challenges. We studied genomes and transcriptomes of cryptogenic congenital mesoblastic nephroma (CMN), and extended our findings to five anatomically or histologically related soft tissue tumors: infantile fibrosarcoma (IFS), nephroblastomatosis, Wilms tumor, malignant rhabdoid tumor, and clear cell sarcoma of the kidney. A key finding is recurrent mutation of EGFR in CMN by internal tandem duplication of the kinase domain, thus delineating CMN from other childhood renal tumors. Furthermore, we identify BRAF intragenic rearrangements in CMN and IFS. Collectively these findings reveal novel diagnostic markers and therapeutic strategies and highlight a prominent role of isolated intragenic rearrangements as drivers of infant tumors.}, language = {en} } @article{AnanyKreckelFuellsacketal.2018, author = {Anany, Mohamed A. and Kreckel, Jennifer and F{\"u}llsack, Simone and Rosenthal, Alevtina and Otto, Christoph and Siegmund, Daniela and Wajant, Harald}, title = {Soluble TNF-like weak inducer of apoptosis (TWEAK) enhances poly(I:C)-induced RIPK1-mediated necroptosis}, series = {Cell Death \& Disease}, volume = {9}, journal = {Cell Death \& Disease}, doi = {10.1038/s41419-018-1137-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-221104}, year = {2018}, abstract = {TNF-like weak inducer of apoptosis (TWEAK) and inhibition of protein synthesis with cycloheximide (CHX) sensitize for poly(I:C)-induced cell death. Notably, although CHX preferentially enhanced poly(I:C)-induced apoptosis, TWEAK enhanced primarily poly(I:C)-induced necroptosis. Both sensitizers of poly(I:C)-induced cell death, however, showed no major effect on proinflammatory poly(I:C) signaling. Analysis of a panel of HeLa-RIPK3 variants lacking TRADD, RIPK1, FADD, or caspase-8 expression revealed furthermore similarities and differences in the way how poly(I:C)/TWEAK, TNF, and TRAIL utilize these molecules for signaling. RIPK1 turned out to be essential for poly(I:C)/TWEAK-induced caspase-8-mediated apoptosis but was dispensable for this response in TNF and TRAIL signaling. TRADD-RIPK1-double deficiency differentially affected poly(I:C)-triggered gene induction but abrogated gene induction by TNF completely. FADD deficiency abrogated TRAIL- but not TNF- and poly(I:C)-induced necroptosis, whereas TRADD elicited protective activity against all three death inducers. A general protective activity against poly(I:C)-, TRAIL-, and TNF-induced cell death was also observed in FLIPL and FLIPS transfectrants.}, language = {en} } @phdthesis{Elsner2024, author = {Elsner, Vianne}, title = {Vergleich von Selbst- und Fremdeinsch{\"a}tzung hinsichtlich der kommunikativen Kompetenz von Medizinstudenten in einem Anamnesegespr{\"a}ch mit Schauspielpatienten}, doi = {10.25972/OPUS-34973}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-349737}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Das Verst{\"a}ndnis der Beziehung zwischen Arzt und Patient befindet sich im Wandel. Die Patientenorientiertheit gewinnt an Relevanz, wobei insbesondere die Arzt-Patienten-Kommunikation in den Fokus r{\"u}ckt. Es ist belegt, dass eine effektive Kommunikation einen positiven Einfluss auf den emotionalen und den physiologischen Zustand des Patienten hat. Folglich wurde in den letzten Jahren auch hierzulande der Bereich Kommunikation in der universit{\"a}ren Ausbildung von {\"A}rzten zunehmend thematisiert - seit der {\"A}nderung der Approbationsordnung 2012 ist die Gespr{\"a}chsf{\"u}hrung offiziell Gegenstand der {\"a}rztlichen Ausbildung. Das Studium ist jedoch nach wie vor stark vom technisch-naturwissenschaftlichen Paradigma der Medizin gepr{\"a}gt. Die F{\"a}higkeit, sich selbst hinsichtlich seiner kommunikativen F{\"a}higkeiten einzusch{\"a}tzen, stellt ein wichtiges Merkmal angehender {\"A}rzte dar. Bestehende Studien zeigen auf, dass bei Medizinstudenten Diskrepanzen zwischen der Selbst- und der Fremdeinsch{\"a}tzung in unterschiedlichen Kompetenzfeldern bestehen. Um aus Fehlern lernen zu k{\"o}nnen, ben{\"o}tigt es zum einen die F{\"a}higkeit zur Eigenreflexion. Erg{\"a}nzend wird ein regelm{\"a}ßiger Abgleich der Selbsteinsch{\"a}tzung mit einer Fremdeinsch{\"a}tzung im Sinne einer „Realit{\"a}tskonfrontation" ben{\"o}tigt. Durch das Feedback k{\"o}nnen individuelle Differenzen hinsichtlich der kommunikativen F{\"a}higkeiten aufgezeigt, um dadurch dem Studenten den Anreiz zu geben, eine fortw{\"a}hrende Weiterbildung der eigenen kommunikativen F{\"a}higkeiten bereits im Studium zu etablieren. In der vorliegenden Studie wurde daher untersucht, inwieweit die Selbsteinsch{\"a}tzung von einem Studenten nach einem Anamnesegespr{\"a}ch mit der Fremdeinsch{\"a}tzung {\"u}bereinstimmt. Hierf{\"u}r wurde ein Anamnesegespr{\"a}ch mit einem Schauspielpatienten durch den Studenten, einen Experten sowie den betroffenen Schauspielpatienten bewertet. Mittels Cohens Kappa wurde die {\"U}bereinstimmung zwischen den Raterpaaren Student und Experte, Student und Schauspielpatient sowie der Fremdeinsch{\"a}tzung zwischen Schauspielpatient und Experte berechnet. Erg{\"a}nzend wurde der Einfluss der Variablen Selbstwirksamkeit (allgemein und spezifisch hinsichtlich der Anamneseerhebung), Empathie, Geschlecht, Alter und berufliche Vorerfahrung auf die {\"U}bereinstimmung von Selbst- und Fremdeinsch{\"a}tzung untersucht. Es konnte eine geringe {\"U}bereinstimmung zwischen allen drei Raterpaaren (Student \& Experte, Student \& Schauspielpatient sowie Schauspielpatient \& Experte) nachgewiesen werden. Die geringste {\"U}bereinstimmung zeigte sich zwischen der Selbst- und Fremdeinsch{\"a}tzung von Student und Experte, die gr{\"o}ßte {\"U}bereinstimmung in der Fremdeinsch{\"a}tzung zwischen Schauspielpatient und Experte. Die Hypothese bez{\"u}glich der {\"U}bersch{\"a}tzung der Studenten im Vergleich zur Fremdeinsch{\"a}tzung wurde nicht best{\"a}tigt. Weiter konnte eine h{\"o}here {\"U}bereinstimmung zwischen Selbst- und Fremdeinsch{\"a}tzung des Schauspielpatienten bei Studenten mit einem h{\"o}heren Maß an Empathie gezeigt werden. Bez{\"u}glich des Geschlechterunterschiedes konnte nachgewiesen werden, dass weibliche Studenten eine h{\"o}here {\"U}bereinstimmung zwischen Selbst- und Fremdeinsch{\"a}tzung mit Schauspielpatienten aufweisen. Auch in der Fremdeinsch{\"a}tzung durch Schauspielpatienten und Experten ist bei weiblichen Studenten eine h{\"o}here {\"U}bereinstimmung zu finden. Die Variablen Selbstwirksamkeit, Alter, berufliche Vorerfahrung sowie Selbstwirksamkeit hinsichtlich der Anamneseerhebung zeigen keine statistisch signifikanten Zusammenh{\"a}nge mit der {\"U}bereinstimmung zwischen Selbst- und Fremdeinsch{\"a}tzung. Der Vergleich zwischen der Gruppe, die ein Anamnesegespr{\"a}ch f{\"u}hrte, und derjenigen, die kein Anamnesegespr{\"a}ch f{\"u}hrte, zeigte, dass Studenten mit einer h{\"o}heren Selbstwirksamkeit eher ein Gespr{\"a}ch f{\"u}hrten. Die Ergebnisse dieser Arbeit verdeutlichen, dass angehende {\"A}rzte R{\"u}ckmeldung bez{\"u}glich ihrer kommunikativen Kompetenz ben{\"o}tigen, um durch die Fremdeinsch{\"a}tzung das Selbstbild ihrer Kompetenz erweitern zu k{\"o}nnen. {\"U}ber etwaige Diskrepanzen zwischen Fremdeinsch{\"a}tzung und Selbsteinsch{\"a}tzung erhalten sie konkretes Feedback, so dass das Kommunikationstraining an ihre individuellen Lernbedarfe angepasst werden kann. Hierf{\"u}r ist der Vergleich der Selbsteinsch{\"a}tzung eines Schauspielpatientengespr{\"a}ches mit der Fremdeinsch{\"a}tzung eine gut in der Ausbildungspraxis einzusetzende Methode.}, subject = {Arzt-Patient-Beziehung}, language = {de} } @phdthesis{Grimm2024, author = {Grimm, Anne Rosemarie}, title = {Prognostische Determinanten im kardiogenen und septischen Schock}, doi = {10.25972/OPUS-36995}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369953}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {In diese monozentrische retrospektive Studie eingeschlossen wurden insgesamt 132 Patienten mit Schock, darunter 75 Patienten mit kardiogenem- und 57 Patienten mit septischem Schock. Um potentielle Pr{\"a}diktoren f{\"u}r die Krankenhaussterblichkeit zu finden, wurden folgende Paramater untersucht: Alter, Geschlecht, BMI, kardiovaskul{\"a}re Risikofaktoren und Vorerkrankungen, Vitalparameter bei Aufnahme inkl. Schockindex, laborchemische Parameter inkl. BGA, maximaler Laktatanstieg im Verlauf, Interventionen inklusive Reanimation, Beatmung, Akutrevaskularisation und Anlage von mechanischen Kreislaufunterst{\"u}tzungssystemen, Katecholamintherapie und h{\"a}modynamisches Monitoring mit dem PiCCO-Verfahren. Hauptergebnis unserer Studie ist eine erhebliche Krankenhaussterblichkeit von 50\% bei einem mittleren Aufenthalt von 14 Tagen ohne signifikanten Unterschied zwischen kardiogenem- (45\%) und septischem Schock (55\%), obgleich Patienten mit kardiogenem Schock signifikant {\"a}lter und h{\"a}ufiger kardiovaskul{\"a}r vorerkrankt waren. Pr{\"a}diktoren f{\"u}r die Krankenhaussterblichkeit waren bei Patienten mit kardiogenem Schock die H{\"o}he des maximalen Laktatanstiegs, das Auftreten eines akuten Nierenversagens, die H{\"o}he der Transaminasen als Marker einer Schockleber, die fehlende M{\"o}glichkeit einer Akutrevaskularisation und die H{\"o}he des Troponins als Marker f{\"u}r das Ausmaß des Myokardschadens. Pr{\"a}diktoren f{\"u}r die Krankenhaussterblichkeit im septischen Schock waren ebenfalls die H{\"o}he des maximalen Laktatanstiegs, die Notwendigkeit einer Reanimation, sowie H{\"o}he des ELWI. Die {\"u}brigen klinischen, laborchemischen und h{\"a}modynamischen Parameter waren weder beim kardiogenen- noch beim septischen Schock pr{\"a}diktiv f{\"u}r die Mortalit{\"a}t. Die beste Strategie zur Senkung der hohen Mortalit{\"a}t beider Schockformen besteht in der Prophylaxe des jeweiligen Schockgeschehens. Bei bereits in Gang gesetzten Circulus vitiosus, m{\"u}ssen zuk{\"u}nftige Studien kl{\"a}ren, welches h{\"a}modynamische Monitoring zusammen mit klinischen Befunden und ggf. Bildgebung ein optimiertes Volumen- und Katecholamin-Management erlaubt. Bei Patienten mit kardiogenem Schock bleibt zu kl{\"a}ren, ob die in unserer Studie gefundene erhebliche Krankenhaussterblichkeit von 45\% durch den gezielten Einsatz moderner, perkutan implantierbarer Kreislaufunterst{\"u}tzungssysteme gebessert werden kann. Bei Patienten mit septischem Schock ist insbesondere bei pneumogener Sepsis das rechtzeitige Erkennen und die Therapie eines ARDS eine bleibende Herausforderung. Zuk{\"u}nftige Studien an gr{\"o}ßeren Patientenkollektiven m{\"u}ssen kl{\"a}ren, ob die Bestimmung des ELWI mit dem PiCCO-Verfahren hilfreich ist, die Entstehung eines ARDS fr{\"u}hzeitig erkennen und behandeln zu k{\"o}nnen.}, subject = {Schock}, language = {de} } @phdthesis{Pickert2024, author = {Pickert, Julia Felicia}, title = {Untersuchungen zum Einfluss des Insulin-like growth factor Rezeptors auf Signalnetzwerke im Multiplen Myelom}, doi = {10.25972/OPUS-36981}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369815}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Das MM ist eine maligne Erkrankung, die von biologischer und klinischer Heterogenit{\"a}t gepr{\"a}gt ist. Sie ist durch die monoklonale Vermehrung von Plasmazellen charakterisiert. In vorangegangenen Studien wurde eine H{\"a}ufung von Mutationen in RTK nachgewiesen. Diese gingen mit einem negativen Einfluss auf das {\"U}berleben von MM Patientinnen und Patienten einher. Im Rahmen dieser Arbeit wurde der Einfluss des IGF1R an HMZL mittels siRNA-vermitteltem IGF1R-Knockdown untersucht und dessen Effekt auf das Signalnetzwerk mittels Western Blot Analysen ermittelt. Um die Heterogenit{\"a}t des MM besser abzubilden, wurden sechs verschiedenen HMZL ausgew{\"a}hlt. Der IGF1R-Knockdown war in allen HMZL sowohl anhand der Reduktion der IGF1R-Expression als auch der IGF1R-Aktivierung deutlich nachweisbar. Stellvertretend f{\"u}r den PI3K/AKT Signalweg wurde die AKT-Aktivierung untersucht, welche nach IGF1R-Knockdown in allen Linien abnahm. Im Ras/Raf/MEK/ERK Signalweg fiel eine deutliche Reduktion der ERK1/2- und MEK-Aktivierung in den von PCL stammenden HMZL L-363 und MM.1S, sowie in JJN-3 mit der Hochrisikotranslokation t(14;16) auf. Entsprechend der Beobachtungen f{\"u}r die AKT-Aktivierung, nahm die PYK2-Aktivierung in allen HMZL nach IGF1R-Knockdown ab, was auf ein Zusammenspiel von IGF1R, PYK2 und AKT in allen HMZL hindeutet. Zuk{\"u}nftige Untersuchungen werden zeigen, ob IGF1R Inhibitoren alleine oder in Kombination mit z.B. AKT, PYK2 oder Proteasomen-Inhibitoren in bestimmten molekularen MM Subgruppen ein effektives therapeutisches Ziel sind.}, subject = {Plasmozytom}, language = {de} } @phdthesis{DasgebNitschke2024, author = {Das [geb. Nitschke], Felix Marcel}, title = {DNA-Methylierung und Genexpression von FKPB5 als Teil des Stresshormonsystems bei von Depressionen und Herzinsuffizienz Betroffenen sowie gesunden Kontrollen}, doi = {10.25972/OPUS-36973}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369730}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {FKBP5 stellt im Stresssystem der HPA-Achse ein zentrales Gen bei der Regulation der Sensitivit{\"a}t des Glukokortikoidrezeptors und somit der Reaktion auf Stress dar. Zur Adaptation an Umwelteinfl{\"u}sse ist es selbst in ein komplexes System von Regulationsmechanismen eingebettet, die unter anderem epigenetische Modifikationen in Form von DNA-Methylierung umfassen. Bisherige Studien legen eine starke Assoziation von FKBP5 zu stressinduzierten psychischen Erkrankungen nahe und weisen auf eine Dysregulation der HPA-Achse als m{\"o}glichen Pathomechanismus hin. F{\"u}r die enge klinische Interaktion von Depression und Herzinsuffizienz sowie eine ebenfalls vermutete Rolle der HPA-Achse in der Pathogenese letzterer, k{\"o}nnte FKBP5 daher ein entscheidendes Bindeglied darstellen. Gleichzeitig bietet die Identifikation einer {\"u}ber FKBP5 ausgedr{\"u}ckten Dysregulation der HPA-Achse einen biologischen Befund, der als Marker f{\"u}r das Ansprechen einer antidepressiven Therapie herangezogen werden k{\"o}nnte. Ziel dieser Arbeit war daher die Untersuchung eines m{\"o}glichen Einflusses regulatorischer Parameter von FKBP5 auf die Herzinsuffizienz sowie eine Pr{\"u}fung dieser als m{\"o}gliche Biomarker f{\"u}r einen Erfolg der antidepressiven Therapie. Dazu wurden Blutproben von ProbandInnen der GEParD- bzw. DaCFail-Studie mit Depression, Herzinsuffizienz sowie gesunde Kontrollen untersucht. Durch Pyrosequenzierung bisulfitkonvertierter DNA erfolgte die Bestimmung der Methylierung regulatorischer CpGs. Die Messung der relativen mRNA-Expression erfolgte durch den Einsatz einer qPCR. In der Auswertung fand sich keine differentielle mRNA-Expression oder Methylierung zwischen den vier Untersuchungsgruppen. Allerdings reagierten depressive PatientInnen verglichen mit der Kontrollgruppe mit einer geringeren Zunahme der mRNA-Expression als Reaktion auf den mDST. Das Therapieansprechen in der Depressionsgruppe wiederum war mit einer niedrigeren Methylierung auf CpG7 sowie einer h{\"o}heren mRNA-Expression zu Therapiebeginn assoziiert. Im Behandlungsverlauf f{\"u}hrte eine Abnahme der mRNA-Expression bei den Respondern zu einer Ann{\"a}herung beider Gruppen. Diese Arbeit konnte keine Hinweise f{\"u}r eine Rolle von FKBP5 in der Pathogenese der Herzinsuffizienz finden. Allerdings zeigten die Befunde zur Regulation des Gens bei Glukokortikoidstimulation eine hohe Konstanz zu vorherigen Ergebnissen. In diesen Kontext reihen sich auch die Ergebnisse f{\"u}r das Therapieansprechen ein, die aufgrund einer Herabregulation der HPA-Achse im Therapieverlauf die Idee einer urs{\"a}chlichen HPA-Dysregulation in der Gruppe der Responder bekr{\"a}ftigen. F{\"u}r sich allein genommen lassen sich mRNA-Expression und Methylierung aufgrund mangelnder Sensitivit{\"a}t und Spezifit{\"a}t nicht als Biomarker f{\"u}r das Therapieansprechen einsetzen. Die bisherigen Befunde best{\"a}rken aber eine m{\"o}gliche Rolle in einer Batterie unterschiedlicher Biomarker auf verschiedenen Ebenen, wie Klinik, Psychometrie und Physiologie.}, subject = {Gen FKBP5}, language = {de} } @phdthesis{Junghanns2024, author = {Junghanns, Lara Madeleine}, title = {Resistenzmechanismen gegen Amphotericin B in humanpathogenen Hefepilzen}, doi = {10.25972/OPUS-36986}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369861}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Die 2009 erstmals entdeckte Spezies C. auris erlangte binnen k{\"u}rzester Zeit zunehmend weltweite Aufmerksamkeit. Vor allem die Tendenz der Multiresistenzentwicklung und das rasche Ausl{\"o}sen von nosokomialen Infektionen erschweren den Umgang und die Therapie von C. auris Infektionen im Vergleich zu anderen Candida Spezien. Diese Dissertationsarbeit umfasst eine systematische Resistenzanalyse der im NRZMyk vorhandenen Stammsammlung aus C. auris und C. parapsilosis Isolaten, um Aufschluss {\"u}ber den Wirkmechanismus von Amphotericin B in Hefepilzen zu erlangen. Anhand der zun{\"a}chst durchgef{\"u}hrten Amphotericin B-Resistenztestungen kristallisierten sich CAU37 und CAU43 mit MHK-Werten bis zu 12 µg/ml als stark Amphotericin B-resistente Isolate heraus. Die Analyse der Sequenzierungsergebnisse zeigte bei beiden St{\"a}mmen eine Mutation im ERG4 Gen an Position 576, welche nicht eindeutig als alleinige Ursache f{\"u}r die verminderte Amphotericin B-Empfindlichkeit festgelegt werden konnte. Dennoch wurde im Rahmen eines Survival Assays bei beiden Amphotericin B-resistenten Isolaten anf{\"a}nglich eine konzentrationsabh{\"a}ngige Aktivit{\"a}t gegen{\"u}ber Amphotericin B festgestellt, bevor ein Nachwachsen der Kulturen beobachtet wurde. Somit wurde die Vermutung aufgestellt, dass lediglich ein Teil der aufgebrachten Candida-Zellen abget{\"o}tet wird und dies in einer Vermehrung der {\"u}berlebenden Zellen resultiert. Des Weiteren konnte im Rahmen von Resistenztestungen mit dem Sphingolipidinhibitor Myriocin nachgewiesen werden, dass vor allem in Amphotericin B-resistenten Isolaten eine deutliche Wirkungsverst{\"a}rkung des Polyens hervorgerufen wird. Diese Sensitivit{\"a}tssteigerung ist allgemein bei allen C. auris Isolaten zu beobachten, f{\"a}llt bei resistenten St{\"a}mmen jedoch deutlich st{\"a}rker aus. Hierdurch kam die Annahme auf, dass Amphotericin B-Resistenzen auch in m{\"o}glichen Ver{\"a}nderungen des Sphingolipid-Haushaltes begr{\"u}ndet sein k{\"o}nnten. Dar{\"u}ber hinaus scheint Myriocin keinen Einfluss auf Fluconazol-resistente oder FKS-mutierte Echinocandin-resistente C. auris St{\"a}mme zu haben. Das ebenfalls untersuchte und von Myriocin abgeleitete Medikament Fingolimod hatte jedoch ebenfalls keinen wirkungsverst{\"a}rkenden Effekt. Allerdings reagierte ein Großteil der C. auris Isolate (57,6 \%) sensitiv gegen{\"u}ber dem neusten medizinisch bekannten Triazol Isavuconazol und es konnte erstmalig ein ECV-Wert von 0,03125 µg/ml festgelegt werden. Ein valider Vergleich von C. auris zu C. parapsilosis war aufgrund der mangelnden Anzahl an C. parapsilosis Isolaten jedoch nicht m{\"o}glich}, subject = {Candida}, language = {de} }