TY - THES A1 - Weber, Judith T1 - Immunhistochemische Analysen zur Expression von cellular FLICE (FADD-like-IL-1β-converting enzyme)-inhibitory protein (cFLIP) in epithelialen und melanozytären Tumoren der Haut T1 - Immunohistochemical analysis of cellular FLICE (FADD-like-IL-1β-converting enzyme)-inhibitory protein (cFLIP) in melanocytic and epithelial skin lesions N2 - Die Resistenz von Tumorzellen gegenüber Apoptose stellt einen zentralen Baustein in der Pathogenese von Tumorerkrankungen dar. cFLIP inhibiert rezeptornah die Todesrezeptor-vermittelte Apoptose und spielt somit eine bedeutende Rolle als Regulator der Apoptose. Eine verstärkte Expression von cFLIP kann folglich hinweisend auf eine Fehlregulation der Apoptose bei der Entstehung und Progression von Tumoren sein. In der vorliegenden Arbeit wurde die Expression von cFLIP in kutanen epithelialen und melanozytären Tumoren mit formalinfixierten und paraffinierten Gewebeproben untersucht. Bei der zunächst durchgeführten Charakterisierung der käuflich erhältlichen monoklonalen cFLIP-Antikörper mittels cFLIP-überexprimierenden HaCaT-Keratinozyten wurde überraschenderweise die fehlende Spezifität eines Antikörpers (KlonEPR8438(2)) nachgewiesen, was zur Folge hatte, dass der Hersteller die Produktion nach Mitteilung der Befunde eingestellt hat. Daher wurden die weiteren Untersuchungen unter Verwendung des Antikörper-Klons G11, der sowohl im Western Blot als auch immunhistochemisch die beiden cFLIP-Splicevarianten cFLIPL und cFLIPS spezifisch nachweist, durchgeführt. Hierbei konnte gezeigt werden, dass cFLIP in epithelialen Hauttumoren in erheblichem Maß exprimiert wird. In jeweils 40% der untersuchten aktinischen Keratosen und Morbi Bowen konnte cFLIP nachgewiesen werden. Im Vergleich dazu zeigte sich in den fortgeschrittenen Formen epithelialer Hauttumoren eine deutlich höhere Expressionsrate. Eine Expression wiesen zudem 100% der untersuchten Keratoakanthome und 95% der Plattenepithelkarzinome (mit überwiegend gutem Differenzierungsgrad) auf. Dementsprechend war es nicht verwunderlich, dass alle untersuchten Metastasen von Plattenepithelkarzinomen cFLIP überexprimierten. Die Analyse melanozytärer Läsionen ergab, dass cFLIP in melanozytären Nävi wie auch superfiziell spreitenden Melanomen, Lentigo-maligna-Melanomen und akral lentiginösen Melanomen nur in einer sehr geringen Anzahl der untersuchten Präparate überexprimiert wurde. Erstaunlicherweise konnte jedoch in 65% der nodulären Melanome sowie in 60% der Melanommetastasen cFLIP nachgewiesen werden. Bezüglich der Expression von cFLIP im Primärtumor sowie der Metastase desselben Patienten konnte kein eindeutiger Trend festgestellt werden. Die Ergebnisse dieser Arbeit deuten darauf hin, dass die frühe Hemmung des extrinsischen Apoptoseweges durch das antiapoptotische Protein cFLIP an der Entstehung, dem Wachstum und möglicherweise der Metastasierung epithelialer Hauttumore beteiligt sein dürfte. Die auffallend hohe Expressionsrate im nodulären Melanom sowie den untersuchten Melanommetastasen könnte einen zukünftigen therapeutischen Angriffspunkt darstellen. N2 - It is already known, that cFLIP is an effective inhibitor of death receptor-mediated apoptosis. Due to its ability to block one of the most proximal steps of the extrinsic apoptotic cascade, every kind of dysregulation concerning cFLIP may have serious consequences for tissue homeostasis. Therefore, it is possible that cFLIP-mediated prevention of death receptor-mediated apoptosis represents one critical step during the development of malignancy. In the present study, the expression of cFLIP was examined by immunohistochemistry in a panel of 110 epithelial and 140 melanocytic skin lesions. Therefore, we used the purchased monoclonal mouse antibody clone G11 (Santa Cruz Biotechnology, Heidelberg). cFLIP expression was undetectable in all analyzed basal cell carcinomas, whereas both actinic keratosis and Bowen’s disease (8/20 (40%)) were positive for cFLIP. Consistent to previous data, all 20 (100 %) keratoacanthomas were positive for cFLIP, too. Furthermore, almost all (19/20 (95%)) squamous cell carcinomas were positive for cFLIP as well as 10/10 (100 %) metastases of squamous cell carcinomas. Melanocytic nevi expressed cFLIP (7/20 (35 %)). In Melanoma, cFLIP expression was different in melanoma subtypes and type of tissue. While only 15% of superficial spreading melanomas and 10 % of lentigo-maligna melanomas were positive, 25% of acral lentiginous melanomas were positive for cFLIP expression. The majority (13/20 (64 %)) of nodular melanomas and of melanoma metastases (12/20 (60 %)) were positive for cFLIP. Additionally, we examined cFLIP expression in ten primary melanomas as well as one of their regional lymph node/skin metastases. Due to the small sample size and the heterogeneity of analyzed primary melanomas/metastases a connection between expression of cFLIP in primary tumors and metastases could neither be proved nor denied and needs to be elucidated in more detail. In conclusion, our study confirms that cFLIP expression is selectively detected in different melanocytic and epithelial skin lesions. In respect to the high proportion of melanoma metastase and metastases of squamous cell carcinomas, our findings demonstrate that cFLIP may be implicated in tumor development and progression and therefore could serve as a biomarker or as a target for future therapies. KW - Melanom KW - Plattenepithelcarcinom KW - Apoptose KW - Signaltransduktion KW - Immunhistochemie KW - cFLIP KW - Apoptoseresistenz KW - extrinsischer Signalweg Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-209918 ER - TY - JOUR A1 - Couch, Fergus J. A1 - Wang, Xianshu A1 - McGuffog, Lesley A1 - Lee, Andrew A1 - Olswold, Curtis A1 - Kuchenbaecker, Karoline B. A1 - Soucy, Penny A1 - Fredericksen, Zachary A1 - Barrowdale, Daniel A1 - Dennis, Joe A1 - Gaudet, Mia M. A1 - Dicks, Ed A1 - Kosel, Matthew A1 - Healey, Sue A1 - Sinilnikova, Olga M. A1 - Lee, Adam A1 - Bacot, Françios A1 - Vincent, Daniel A1 - Hogervorst, Frans B. L. A1 - Peock, Susan A1 - Stoppa-Lyonnet, Dominique A1 - Jakubowska, Anna A1 - Radice, Paolo A1 - Schmutzler, Rita Katharina A1 - Domchek, Susan M. A1 - Piedmonte, Marion A1 - Singer, Christian F. A1 - Friedman, Eitan A1 - Thomassen, Mads A1 - Hansen, Thomas V. O. A1 - Neuhausen, Susan L. A1 - Szabo, Csilla I. A1 - Blanco, Ingnacio A1 - Greene, Mark H. A1 - Karlan, Beth Y. A1 - Garber, Judy A1 - Phelan, Catherine M. A1 - Weitzel, Jeffrey N. A1 - Montagna, Marco A1 - Olah, Edith A1 - Andrulis, Irene L. A1 - Godwin, Andrew K. A1 - Yannoukakos, Drakoulis A1 - Goldgar, David E. A1 - Caldes, Trinidad A1 - Nevanlinna, Heli A1 - Osorio, Ana A1 - Terry, Mary Beth A1 - Daly, Mary B. A1 - van Rensburg, Elisabeth J. A1 - Hamann, Ute A1 - Ramus, Susan J. A1 - Toland, Amanda Ewart A1 - Caligo, Maria A. A1 - Olopade, Olufunmilayo I. A1 - Tung, Nadine A1 - Claes, Kathleen A1 - Beattie, Mary S. A1 - Southey, Melissa C. A1 - Imyanitov, Evgeny N. A1 - Tischkowitz, Marc A1 - Janavicius, Ramunas A1 - John, Esther M. A1 - Kwong, Ava A1 - Diez, Orland A1 - Kwong, Ava A1 - Balmaña, Judith A1 - Barkardottir, Rosa B. A1 - Arun, Banu K. A1 - Rennert, Gad A1 - Teo, Soo-Hwang A1 - Ganz, Patricia A. A1 - Campbell, Ian A1 - van der Hout, Annemarie H. A1 - van Deurzen, Carolien H. M. A1 - Seynaeve, Caroline A1 - Garcia, Encarna B. Gómez A1 - van Leeuwen, Flora E. A1 - Meijers-Heijboer, Hanne E. J. A1 - Gille, Johannes J. P. A1 - Ausems, Magreet G. E. M. A1 - Blok, Marinus J. A1 - Ligtenberg, Marjolinjin J. L. A1 - Rookus, Matti A. A1 - Devilee, Peter A1 - Verhoef, Senno A1 - van Os, Theo A. M. A1 - Wijnen, Juul T. A1 - Frost, Debra A1 - Ellis, Steve A1 - Fineberg, Elena A1 - Platte, Radke A1 - Evans, D. Gareth A1 - Izatt, Luise A1 - Eeles, Rosalind A. A1 - Adlard, Julian A1 - Eccles, Diana M. A1 - Cook, Jackie A1 - Brewer, Carole A1 - Douglas, Fiona A1 - Hodgson, Shirley A1 - Morrison, Patrick J. A1 - Side, Lucy E. A1 - Donaldson, Alan A1 - Houghton, Catherine A1 - Rogers, Mark T. A1 - Dorkins, Huw A1 - Eason, Jacqueline A1 - Gregory, Helen A1 - McCann, Emma A1 - Murray, Alex A1 - Calender, Alain A1 - Hardouin, Agnès A1 - Berthet, Pascaline A1 - Delnatte, Capucine A1 - Nogues, Catherine A1 - Lasset, Christine A1 - Houdayer, Claude A1 - Leroux,, Dominique A1 - Rouleau, Etienne A1 - Prieur, Fabienne A1 - Damiola, Francesca A1 - Sobol, Hagay A1 - Coupier, Isabelle A1 - Venat-Bouvet, Laurence A1 - Castera, Laurent A1 - Gauthier-Villars, Marion A1 - Léoné, Mélanie A1 - Pujol, Pascal A1 - Mazoyer, Sylvie A1 - Bignon, Yves-Jean A1 - Zlowocka-Perlowska, Elzbieta A1 - Gronwald, Jacek A1 - Lubinski,, Jan A1 - Durda, Katarzyna A1 - Jaworska, Katarzyna A1 - Huzarski, Tomasz A1 - Spurdle, Amanda B. A1 - Viel, Alessandra A1 - Peissel, Bernhard A1 - Bonanni, Bernardo A1 - Melloni, Guilia A1 - Ottini, Laura A1 - Papi, Laura A1 - Varesco, Liliana A1 - Tibiletti, Maria Grazia A1 - Peterlongo, Paolo A1 - Volorio, Sara A1 - Manoukian, Siranoush A1 - Pensotti, Valeria A1 - Arnold, Norbert A1 - Engel, Christoph A1 - Deissler, Helmut A1 - Gadzicki, Dorothea A1 - Gehrig, Andrea A1 - Kast, Karin A1 - Rhiem, Kerstin A1 - Meindl, Alfons A1 - Niederacher, Dieter A1 - Ditsch, Nina A1 - Plendl, Hansjoerg A1 - Preisler-Adams, Sabine A1 - Engert, Stefanie A1 - Sutter, Christian A1 - Varon-Mateeva, Raymenda A1 - Wappenschmidt, Barbara A1 - Weber, Bernhard H. F. A1 - Arver, Brita A1 - Stenmark-Askmalm, Marie A1 - Loman, Niklas A1 - Rosenquist, Richard A1 - Einbeigi, Zakaria A1 - Nathanson, Katherine L. A1 - Rebbeck, Timothy R. A1 - Blank, Stephanie V. A1 - Cohn, David E. A1 - Rodriguez, Gustavo C. A1 - Small, Laurie A1 - Friedlander, Michael A1 - Bae-Jump, Victoria L. A1 - Fink-Retter, Anneliese A1 - Rappaport, Christine A1 - Gschwantler-Kaulich, Daphne A1 - Pfeiler, Georg A1 - Tea, Muy-Kheng A1 - Lindor, Noralane M. A1 - Kaufman, Bella A1 - Paluch, Shani Shimon A1 - Laitman, Yael A1 - Skytte, Anne-Bine A1 - Gerdes, Anne-Marie A1 - Pedersen, Inge Sokilde A1 - Moeller, Sanne Traasdahl A1 - Kruse, Torben A. A1 - Jensen, Uffe Birk A1 - Vijai, Joseph A1 - Sarrel, Kara A1 - Robson, Mark A1 - Kauff, Noah A1 - Mulligan, Anna Marie A1 - Glendon, Gord A1 - Ozcelik, Hilmi A1 - Ejlertsen, Bent A1 - Nielsen, Finn C. A1 - Jønson, Lars A1 - Andersen, Mette K. A1 - Ding, Yuan Chun A1 - Steele, Linda A1 - Foretova, Lenka A1 - Teulé, Alex A1 - Lazaro, Conxi A1 - Brunet, Joan A1 - Pujana, Miquel Angel A1 - Mai, Phuong L. A1 - Loud, Jennifer T. A1 - Walsh, Christine A1 - Lester, Jenny A1 - Orsulic, Sandra A1 - Narod, Steven A. A1 - Herzog, Josef A1 - Sand, Sharon R. A1 - Tognazzo, Silvia A1 - Agata, Simona A1 - Vaszko, Tibor A1 - Weaver, Joellen A1 - Stravropoulou, Alexandra V. A1 - Buys, Saundra S. A1 - Romero, Atocha A1 - de la Hoya, Miguel A1 - Aittomäki, Kristiina A1 - Muranen, Taru A. A1 - Duran, Mercedes A1 - Chung, Wendy K. A1 - Lasa, Adriana A1 - Dorfling, Cecilia M. A1 - Miron, Alexander A1 - Benitez, Javier A1 - Senter, Leigha A1 - Huo, Dezheng A1 - Chan, Salina B. A1 - Sokolenko, Anna P. A1 - Chiquette, Jocelyne A1 - Tihomirova, Laima A1 - Friebel, Tara M. A1 - Agnarsson, Bjarne A. A1 - Lu, Karen H. A1 - Lejbkowicz, Flavio A1 - James, Paul A. A1 - Hall, Per A1 - Dunning, Alison M. A1 - Tessier, Daniel A1 - Cunningham, Julie A1 - Slager, Susan L. A1 - Chen, Wang A1 - Hart, Steven A1 - Stevens, Kristen A1 - Simard, Jacques A1 - Pastinen, Tomi A1 - Pankratz, Vernon S. A1 - Offit, Kenneth A1 - Easton, Douglas F. A1 - Chenevix-Trench, Georgia A1 - Antoniou, Antonis C. T1 - Genome-Wide Association Study in BRCA1 Mutation Carriers Identifies Novel Loci Associated with Breast and Ovarian Cancer Risk JF - PLOS Genetics N2 - BRCA1-associated breast and ovarian cancer risks can be modified by common genetic variants. To identify further cancer risk-modifying loci, we performed a multi-stage GWAS of 11,705 BRCA1 carriers (of whom 5,920 were diagnosed with breast and 1,839 were diagnosed with ovarian cancer), with a further replication in an additional sample of 2,646 BRCA1 carriers. We identified a novel breast cancer risk modifier locus at 1q32 for BRCA1 carriers (rs2290854, P = 2.7 x 10(-8), HR = 1.14, 95% CI: 1.09-1.20). In addition, we identified two novel ovarian cancer risk modifier loci: 17q21.31 (rs17631303, P = 1.4 x 10(-8), HR = 1.27, 95% CI: 1.17-1.38) and 4q32.3 (rs4691139, P = 3.4 x 10(-8), HR = 1.20, 95% CI: 1.17-1.38). The 4q32.3 locus was not associated with ovarian cancer risk in the general population or BRCA2 carriers, suggesting a BRCA1-specific association. The 17q21.31 locus was also associated with ovarian cancer risk in 8,211 BRCA2 carriers (P = 2 x 10(-4)). These loci may lead to an improved understanding of the etiology of breast and ovarian tumors in BRCA1 carriers. Based on the joint distribution of the known BRCA1 breast cancer risk-modifying loci, we estimated that the breast cancer lifetime risks for the 5% of BRCA1 carriers at lowest risk are 28%-50% compared to 81%-100% for the 5% at highest risk. Similarly, based on the known ovarian cancer risk-modifying loci, the 5% of BRCA1 carriers at lowest risk have an estimated lifetime risk of developing ovarian cancer of 28% or lower, whereas the 5% at highest risk will have a risk of 63% or higher. Such differences in risk may have important implications for risk prediction and clinical management for BRCA1 carriers. KW - common variants KW - susceptibility alleles KW - genetic variants KW - modifiers KW - ZNF365 KW - investigators KW - population KW - consortium KW - selection KW - subtypes Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-127947 SN - 1553-7404 VL - 9 IS - 3 ER - TY - JOUR A1 - Jaite, Charlotte A1 - Bühren, Katharina A1 - Dahmen, Brigitte A1 - Dempfle, Astrid A1 - Becker, Katja A1 - Correll, Christoph U. A1 - Egberts, Karin M. A1 - Ehrlich, Stefan A1 - Fleischhaker, Christian A1 - von Gontard, Alexander A1 - Hahn, Freia A1 - Kolar, David A1 - Kaess, Michael A1 - Legenbauer, Tanja A1 - Renner, Tobias J. A1 - Schulze, Ulrike A1 - Sinzig, Judith A1 - Thomae, Ellen A1 - Weber, Linda A1 - Wessing, Ida A1 - Antony, Gisela A1 - Hebebrand, Johannes A1 - Föcker, Manuel A1 - Herpertz-Dahlmann, Beate T1 - Clinical Characteristics of Inpatients with Childhood vs. Adolescent Anorexia Nervosa JF - Nutrients N2 - We aimed to compare the clinical data at first presentation to inpatient treatment of children (<14 years) vs. adolescents (≥14 years) with anorexia nervosa (AN), focusing on duration of illness before hospital admission and body mass index (BMI) at admission and discharge, proven predictors of the outcomes of adolescent AN. Clinical data at first admission and at discharge in 289 inpatients with AN (children: n = 72; adolescents: n = 217) from a German multicenter, web-based registry for consecutively enrolled patients with childhood and adolescent AN were analyzed. Inclusion criteria were a maximum age of 18 years, first inpatient treatment due to AN, and a BMI <10th BMI percentile at admission. Compared to adolescents, children with AN had a shorter duration of illness before admission (median: 6.0 months vs. 8.0 months, p = 0.004) and higher BMI percentiles at admission (median: 0.7 vs. 0.2, p = 0.004) as well as at discharge (median: 19.3 vs. 15.1, p = 0.011). Thus, in our study, children with AN exhibited clinical characteristics that have been associated with better outcomes, including higher admission and discharge BMI percentile. Future studies should examine whether these factors are actually associated with positive long-term outcomes in children. KW - anorexia nervosa KW - children KW - adolescents KW - clinical characteristics KW - BMI KW - outcome Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-193160 SN - 2072-6643 VL - 11 IS - 11 ER - TY - JOUR A1 - Glutsch, Valerie A1 - Grän, Franziska A1 - Weber, Judith A1 - Gesierich, Anja A1 - Goebeler, Matthias A1 - Schilling, Bastian T1 - Response to combined ipilimumab and nivolumab after development of a nephrotic syndrome related to PD-1 monotherapy JF - Journal for ImmunoTherapy of Cancer N2 - Background High response rates of metastatic melanoma have been reported upon immune checkpoint inhibition by PD-1 blockade alone or in combination with CTLA-4 inhibitors. However, the majority of patients with a primary resistance to anti-PD-1 monotherapy is also refractory to a subsequent combined checkpoint inhibition. In BRAF wildtype patients with a primary resistance to PD-1 inhibitors, therapeutic options are therefore limited and immune-related adverse events (irAE) have to be taken into consideration when discussing a subsequent immunotherapy. Case presentation We report the case of a 68-year-old male patient with metastatic melanoma who experienced an acute renal failure with nephrotic syndrome due to a minimal change disease developing after a single dose of the anti-PD-1 antibody pembrolizumab. A kidney biopsy revealed a podocytopathy without signs of interstitial nephritis. Renal function recovered to almost normal creatinine and total urine protein levels upon treatment with oral steroids and diuretics. Unfortunately, a disease progression (PD, RECIST 1.1) was observed in a CT scan after resolution of the irAE. In a grand round, re-exposure to a PD-1-containing regime was recommended. Consensually, a combined immunotherapy with ipilimumab and nivolumab was initiated. Nephrotoxicity was tolerable during combined immunotherapy and a CT scan of chest and abdomen showed a deep partial remission (RECIST 1.1) after three doses of ipilimumab (3 mg/kg) and nivolumab (1 mg/kg). Conclusion This case illustrates that a fulminant response to combined checkpoint inhibition is possible after progression after anti-PD-1 monotherapy and a severe irAE. KW - PD-1 KW - Immune-related adverse event KW - Minimal change disease KW - Ipilimumab KW - Nivolumab Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201214 VL - 7 ER -