TY - THES A1 - Schmitz, Sabine T1 - Infektionen durch Mycoplasma pneumoniae in Franken in den Jahren 2000-2003 : Untersuchungen eines Ausbruches in Ebrach sowie stationärer Patienten der Universitätskinderklinik Würzburg T1 - Infections due to Mycoplasma pneumoniae between 2000-2003 in Franken, Bavaria, Germany N2 - Die Studie diente der retrospektiven Untersuchung des Ausbruches von Mp-Infektionen in Ebrach, Franken, der von Oktober des Jahres 2000 bis Februar 2001 andauerte. Ziel war es, die epidemiologischen Charakteristika, also Informationen zu Verteilung und Ausbreitungsweisen der Erkrankung, aber auch zu Symptomen und Befunden, Manifestationsformen und Komplikationen, Therapie und Diagnostik zu erhalten. Darüber hinaus sollten Erkenntnisse zu Patienten mit Mykoplasmeninfektionen, die in den Jahren 2000 bis 2003 in der Universitätskinderklinik Würzburg behandelt wurden, gewonnen und mit Daten der Patienten aus Ebrach verglichen werden. In Ebrach bestand bei 177 Patienten der Verdacht einer akuten Mykoplasmeninfektion. Ausgehend von einer dritten Grundschulklasse, die einige Tage geschlossen werden musste, da innerhalb von 16 Tagen 9 Schüler an einer Pneumonie und 3 Schüler an einer Bronchitis erkrankt waren, hatte sich die Infektion auf insgesamt 78 Personen, vor allem Familienmitglieder, aber auch Nachbarn und Freunde der betroffenen Schüler ausgebreitet. Die meisten Patienten klagten über Husten und Fieber. In erster Linie traten Entzündungen des unteren Respirationstraktes (50% Bronchitiden, 38,5% Pneumonien) auf. Bei 9 Patienten wurde ein Exanthem beobachtet. Eine Patientin musste wegen eines Guillain-Barré-Syndroms in der neurologischen Abteilung der Universitätsklinik Würzburg behandelt werden. In den Jahren 2000 bis 2003 bestand bei 125 Patienten der Universitätskinderklinik Würzburg der Verdacht auf Vorliegen einer Mp-Infektion. Bestätigt wurde dieser in 43 Fällen. Die Patienten waren zwischen 3 und 16 Jahre alt. Insgesamt waren etwas mehr Jungen betroffen, Komplikationen traten deutlich häufiger bei Mädchen auf. Die Patienten, die einer stationären Behandlung bedurften, wiesen schwerere Erkrankungsverläufe oder seltenere Manifestationsformen auf (65% Pneumonien, 34% Komplikationen). So wurden unter anderem 6 Patienten mit Mykoplasmen-assoziierter Fazialisparese, 4 Patienten mit Meningitis und jeweils ein Patient mit Enzephalitis, Trochlearisparese, Vestibularisausfall, Hörverlust, Perimyokarditis und Uveitis anterior und nephrotischem Syndrom beobachtet. Pathognomonische Befunde konnten weder unter den Ebracher Patienten noch in der Kinderklinik ausgemacht werden. Vielmehr spricht die Konstellation bestimmter Symptome und Untersuchungsergebnisse wie Husten, Fieber, relativ guter Allgemeinzustand bei radiologischem Pneumonienachweis oder Differenz der Blutsenkungsreaktion bei Raumtemperatur und 4°C für das Vorliegen einer Mykoplasmeninfektion. Eine deutliche Erhöhung der Inzidenz von Mykoplasmeninfektionen in der Kinderklinik im Zeitraum des Ausbruches von Ebrach war nicht zu verzeichnen. Dass Schüler als Überträger der Infektion in Familien und unter Spielkameraden fungieren, war bekannt, die Ausbreitung der Erkrankung innerhalb des Klassenzimmers ist jedoch selten in diesem Ausmaß beobachtet worden und verdient weitere Untersuchungen. Festzuhalten bleibt also, dass bei der Diagnose einer Mykoplasmeninfektion mittels serologischer Methoden mit einer verzögerten Immunantwort zu rechnen ist und deshalb häufig ein Direktnachweis der Erreger mittels PCR notwendig wird. Darüber hinaus ist die Bestimmung der Blutkörperchensenkungsgeschwindigkeit bei Raum- und Kühlschranktemperatur ein einfaches Mittel, welches aber diagnostisch zusätzlich wichtige Hinweise auf eine Infektion mit Mycoplasma pneumoniae liefern kann. Im Gegensatz dazu erbringt die klinische Untersuchung häufig keine aussagekräftigen, diagnostisch weiterführenden Ergebnisse. Wichtig bezüglich der Therapie ist die frühzeitige und ausreichend lange (10 bis 14 Tage) Gabe von gegen Mykoplasmen wirksamen Antibiotika wie vor allem Makrolid-Antibiotika. N2 - This is a retrospective study of an outbreak of Mycoplasma pneumoniae infections between october 2000 and february 2001 in Ebrach, Franken, Germany. We wanted to get information about epidemiologic characteristics, such as spread of infection, clinical manifestations and complications, as well as influence of therapy, and possibilities of diagnostics. Furthermore we monitored patients with Mycoplasma pneumoniae infections which led to hospitalisation in the pediatric department of Würzburg university hospital and compared them to the patients in Ebrach. In Ebrach a total of 177 patients were thought to have an MP infection. It started in year 3 of primary school, where within 16 days 9 pupils suffered from pneumonia due to MP and 3 children had MP bronchitis. For this reason the pupils where not allowed to attend school for a few days. Beginning with the school children the infection reached 78 persons, mainly parents of the children but also neighbours and friends for example from the football team. Most of them suffered from coughs and fever. Manifestations were infections of the lower respiratory tract (38,5% pneumonia, 50% bronchitis), 9 patients suffered from cutaneous symptoms (exanthema). One patient had to be hospitalized because of a Guillain-Barre-syndrom. Between 2000 and 2003, 125 patients of the pediatric department of the Würzburg university hospital were thought to have MP infections. In 43 cases the MP infection was diagnosed. Patients were between 3 and 16 years old, there were bit more cases amongst males but females got more complications. Hospitalized patients showed more severe manifestatons (65% pneumonia) or complications (34%). These were for example 6 children with Bells palsy, 4 children with menigitis and one of each of the following manifestations: encephalitis, cranial nerve palsy of trochlearis and vestibularis, hearing loss, permyocarditis, uveitis anterior, nephrotic syndrom. No special symptoms which could be said to be pathognomonic were found in either Ebrach or amongst the hospitalized patients. The special constellation of pathological findings much rather suggests a diagnosis of an MP infection: cough, fever, quite good clinical condition, radiographic evidence of pneumonia, different wsg results at 37°C and 4°C. The incidence of MP infections among hospitalized patients did not increase during the time of the outbreak in Ebrach. It is already known that pupils are possible vectors but such a spread of MP infection in the classroom has seldom been observed before and needs further investigation. Serologic diagnosis needs more time because of the delayed immune response of the host and this is why pcr is often necessary. Antibiotic treatment with effective drugs such as macrolides should be taken into consideration early and administered for a long enough period. KW - Mycoplasma pneumoniae KW - Mycoplasma KW - Bakterielle Infektion KW - Guillain-Barre-Syndrom KW - Schulklasse KW - Klassenzimmer KW - Komplikation KW - Atypische Pneumonie KW - Mycoplasma pneumonia KW - Ausbruch KW - Schule KW - Komplikationen KW - Guillain-Barre-Syndrom KW - Hirnnervenausfall KW - mycoplasma pneumoniae KW - outbreak KW - classroom KW - complications KW - Guillain-Barre-syndrom KW - cranial nerve palsy Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-51713 ER - TY - JOUR A1 - Jessen, Christina A1 - Kreß, Julia K. C. A1 - Baluapuri, Apoorva A1 - Hufnagel, Anita A1 - Schmitz, Werner A1 - Kneitz, Susanne A1 - Roth, Sabine A1 - Marquardt, André A1 - Appenzeller, Silke A1 - Ade, Casten P. A1 - Glutsch, Valerie A1 - Wobser, Marion A1 - Friedmann-Angeli, José Pedro A1 - Mosteo, Laura A1 - Goding, Colin R. A1 - Schilling, Bastian A1 - Geissinger, Eva A1 - Wolf, Elmar A1 - Meierjohann, Svenja T1 - The transcription factor NRF2 enhances melanoma malignancy by blocking differentiation and inducing COX2 expression JF - Oncogene N2 - The transcription factor NRF2 is the major mediator of oxidative stress responses and is closely connected to therapy resistance in tumors harboring activating mutations in the NRF2 pathway. In melanoma, such mutations are rare, and it is unclear to what extent melanomas rely on NRF2. Here we show that NRF2 suppresses the activity of the melanocyte lineage marker MITF in melanoma, thereby reducing the expression of pigmentation markers. Intriguingly, we furthermore identified NRF2 as key regulator of immune-modulating genes, linking oxidative stress with the induction of cyclooxygenase 2 (COX2) in an ATF4-dependent manner. COX2 is critical for the secretion of prostaglandin E2 and was strongly induced by H\(_2\)O\(_2\) or TNFα only in presence of NRF2. Induction of MITF and depletion of COX2 and PGE2 were also observed in NRF2-deleted melanoma cells in vivo. Furthermore, genes corresponding to the innate immune response such as RSAD2 and IFIH1 were strongly elevated in absence of NRF2 and coincided with immune evasion parameters in human melanoma datasets. Even in vitro, NRF2 activation or prostaglandin E2 supplementation blunted the induction of the innate immune response in melanoma cells. Transcriptome analyses from lung adenocarcinomas indicate that the observed link between NRF2 and the innate immune response is not restricted to melanoma. KW - NRF2 KW - melanoma malignancy KW - COX2 expression Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235064 SN - 0950-9232 VL - 39 ER - TY - JOUR A1 - Weigel, Tobias A1 - Schmitz, Tobias A1 - Pfister, Tobias A1 - Gaetzner, Sabine A1 - Jannasch, Maren A1 - Al-Hijailan, Reem A1 - Schürlein, Sebastian A1 - Suliman, Salwa A1 - Mustafa, Kamal A1 - Hansmann, Jan T1 - A three-dimensional hybrid pacemaker electrode seamlessly integrates into engineered, functional human cardiac tissue in vitro JF - Scientific Reports N2 - Pacemaker systems are an essential tool for the treatment of cardiovascular diseases. However, the immune system’s natural response to a foreign body results in the encapsulation of a pacemaker electrode and an impaired energy efficiency by increasing the excitation threshold. The integration of the electrode into the tissue is affected by implant properties such as size, mechanical flexibility, shape, and dimensionality. Three-dimensional, tissue-like electrode scaffolds render an alternative to currently used planar metal electrodes. Based on a modified electrospinning process and a high temperature treatment, a conductive, porous fiber scaffold was fabricated. The electrical and immunological properties of this 3D electrode were compared to 2D TiN electrodes. An increased surface of the fiber electrode compared to the planar 2D electrode, showed an enhanced electrical performance. Moreover, the migration of cells into the 3D construct was observed and a lower inflammatory response was induced. After early and late in vivo host response evaluation subcutaneously, the 3D fiber scaffold showed no adverse foreign body response. By embedding the 3D fiber scaffold in human cardiomyocytes, a tissue-electrode hybrid was generated that facilitates a high regenerative capacity and a low risk of fibrosis. This hybrid was implanted onto a spontaneously beating, tissue-engineered human cardiac patch to investigate if a seamless electronic-tissue interface is generated. The fusion of this hybrid electrode with a cardiac patch resulted in a mechanical stable and electrical excitable unit. Thereby, the feasibility of a seamless tissue-electrode interface was proven. KW - biomedical materials KW - cardiac device therapy KW - hybrid pacemaker Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-177368 VL - 8 IS - 14545 ER - TY - JOUR A1 - Jannasch, Maren A1 - Gaetzner, Sabine A1 - Weigel, Tobias A1 - Walles, Heike A1 - Schmitz, Tobias A1 - Hansmann, Jan T1 - A comparative multi-parametric in vitro model identifies the power of test conditions to predict the fibrotic tendency of a biomaterial JF - Scientific Reports N2 - Despite growing effort to advance materials towards a low fibrotic progression, all implants elicit adverse tissue responses. Pre-clinical biomaterial assessment relies on animals testing, which can be complemented by in vitro tests to address the Russell and Burch’s 3R aspect of reducing animal burden. However, a poor correlation between in vitro and in vivo biomaterial assessments confirms a need for suitable in vitro biomaterial tests. The aim of the study was to identify a test setting, which is predictive and might be time- and cost-efficient. We demonstrated how sensitive in vitro biomaterial assessment based on human primary macrophages depends on test conditions. Moreover, possible clinical scenarios such as lipopolysaccharide contamination, contact to autologous blood plasma, and presence of IL-4 in an immune niche influence the outcome of a biomaterial ranking. Nevertheless, by using glass, titanium, polytetrafluorethylene, silicone, and polyethylene representing a specific material-induced fibrotic response and by comparison to literature data, we were able to identify a test condition that provides a high correlation to state-of-the-art in vivo studies. Most important, biomaterial ranking obtained under native plasma test conditions showed a high predictive accuracy compared to in vivo assessments, strengthening a biomimetic three-dimensional in vitro test platform. KW - inflammation KW - experimental models of disease KW - biomaterial tests KW - in vitro Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-170908 VL - 7 IS - 1689 ER - TY - JOUR A1 - Jannasch, Maren A1 - Weigel, Tobias A1 - Engelhardt, Lisa A1 - Wiezoreck, Judith A1 - Gaetzner, Sabine A1 - Walles, Heike A1 - Schmitz, Tobias A1 - Hansmann, Jan T1 - \({In}\) \({vitro}\) chemotaxis and tissue remodeling assays quantitatively characterize foreign body reaction JF - ALTEX - Alternatives to Animal Experimentation N2 - Surgical implantation of a biomaterial triggers foreign-body-induced fibrous encapsulation. Two major mechanisms of this complex physiological process are (I) chemotaxis of fibroblasts from surrounding tissue to the implant region, followed by (II) tissue remodeling. As an alternative to animal studies, we here propose a process-aligned \({in}\) \({vitro}\) test platform to investigate the material dependency of fibroblast chemotaxis and tissue remodeling mediated by material-resident macrophages. Embedded in a biomimetic three-dimensional collagen hydrogel, chemotaxis of fibroblasts in the direction of macrophage-material-conditioned cell culture supernatant was analyzed by live cell imaging. A combination of statistical analysis with a complementary parameterized random walk model allowed quantitative and qualitative characterization of the cellular walk process. We thereby identified an increasing macrophage-mediated chemotactic potential ranking of biomaterials from glass over polytetrafluorethylene to titanium. To address long-term effects of biomaterial-resident macrophages on fibroblasts in a three-dimensional microenvironment, we further studied tissue remodeling by applying macrophage-material-conditioned medium on fibrous \({in}\) \({vitro}\) tissue models. A high correlation of the \({in}\) \({vitro}\) tissue model to state of the art \({in}\) \({vivo}\) study data was found. Titanium exhibited a significantly lower tissue remodeling capacity compared to polytetrafluorethylene. With this approach, we identified a material dependency of both chemotaxis and tissue remodeling processes, strengthening knowledge on their specific contribution to the foreign body reaction. KW - medicine KW - foreign body reaction KW - fibroblast chemotaxis KW - tissue remodeling KW - in vitro KW - quanititative characterization Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-172080 VL - 34 IS - 2 ER -