TY - JOUR A1 - Luetkens, Karsten Sebastian A1 - Grunz, Jan-Peter A1 - Kunz, Andreas Steven A1 - Huflage, Henner A1 - Weißenberger, Manuel A1 - Hartung, Viktor A1 - Patzer, Theresa Sophie A1 - Gruschwitz, Philipp A1 - Ergün, Süleyman A1 - Bley, Thorsten Alexander A1 - Feldle, Philipp T1 - Ultra-high-resolution photon-counting detector CT arthrography of the ankle: a feasibility study JF - Diagnostics N2 - This study was designed to investigate the image quality of ultra-high-resolution ankle arthrography employing a photon-counting detector CT. Bilateral arthrograms were acquired in four cadaveric specimens with full-dose (10 mGy) and low-dose (3 mGy) scan protocols. Three convolution kernels with different spatial frequencies were utilized for image reconstruction (ρ\(_{50}\); Br98: 39.0, Br84: 22.6, Br76: 16.5 lp/cm). Seven radiologists subjectively assessed the image quality regarding the depiction of bone, hyaline cartilage, and ligaments. An additional quantitative assessment comprised the measurement of noise and the computation of contrast-to-noise ratios (CNR). While an optimal depiction of bone tissue was achieved with the ultra-sharp Br98 kernel (S ≤ 0.043), the visualization of cartilage improved with lower modulation transfer functions at each dose level (p ≤ 0.014). The interrater reliability ranged from good to excellent for all assessed tissues (intraclass correlation coefficient ≥ 0.805). The noise levels in subcutaneous fat decreased with reduced spatial frequency (p < 0.001). Notably, the low-dose Br76 matched the CNR of the full-dose Br84 (p 0.999) and superseded Br98 (p < 0.001) in all tissues. Based on the reported results, a photon-counting detector CT arthrography of the ankle with an ultra-high-resolution collimation offers stellar image quality and tissue assessability, improving the evaluation of miniscule anatomical structures. While bone depiction was superior in combination with an ultra-sharp convolution kernel, soft tissue evaluation benefited from employing a lower spatial frequency. KW - photon-counting CT KW - arthrography KW - ankle KW - cartilage KW - radiation dosage Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362622 SN - 2075-4418 VL - 13 IS - 13 ER - TY - JOUR A1 - Elsner, Clara A1 - Kunz, Andreas Steven A1 - Wagner, Nicole A1 - Huflage, Henner A1 - Hübner, Stefan A1 - Luetkens, Karsten Sebastian A1 - Bley, Thorsten Alexander A1 - Schmitt, Rainer A1 - Ergün, Süleyman A1 - Grunz, Jan-Peter T1 - MRI-based evaluation of the flexor digitorum superficialis anatomy: investigating the prevalence and morphometry of the “chiasma antebrachii” JF - Diagnostics N2 - Recent dissection studies resulted in the introduction of the term “chiasma antebrachii”, which represents an intersection of the flexor digitorum superficialis (FDS) tendons for digits 2 and 3 in the distal third of the forearm. This retrospective investigation aimed to provide an MRI-based morphologic analysis of the chiasma antebrachii. In 89 patients (41 women, 39.3 ± 21.3 years), MRI examinations of the forearm (2010–2021) were reviewed by two radiologists, who evaluated all studies for the presence and length of the chiasma as well as its distance from the distal radioulnar and elbow joint. The chiasma antebrachii was identified in the distal third of the forearm in 88 patients (98.9%), while one intersection was located more proximally in the middle part. The chiasma had a median length of 28 mm (interquartile range: 24–35 mm). Its distances to the distal radioulnar and elbow joint were 16 mm (8–25 mm) and 215 mm (187–227 mm), respectively. T1-weighted post-contrast sequences were found to be superior to T2- or proton-density-weighted sequences in 71 cases (79.8%). To conclude, the chiasma antebrachii is part of the standard FDS anatomy. Knowledge of its morphology is important, e.g., in targeted injections of therapeutics or reconstructive surgery. KW - flexor digitorum superficialis KW - flexor tendon KW - chiasma antebrachii KW - magnetic resonance imaging Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362631 SN - 2075-4418 VL - 13 IS - 14 ER - TY - JOUR A1 - Moratin, Helena A1 - Thöle, Anna A1 - Lang, Josephine A1 - Ehret Kasemo, Totta A1 - Stöth, Manuel A1 - Hagen, Rudolf A1 - Scherzad, Agmal A1 - Hackenberg, Stephan T1 - Ag- but not ZnO-nanoparticles disturb the airway epithelial barrier at subtoxic concentrations JF - Pharmaceutics N2 - Inhalation is considered to be the most relevant source of human exposure to nanoparticles (NPs); however, only a few investigations have addressed the influence of exposing the respiratory mucosal barrier to subcytotoxic doses. In the nasal respiratory epithelium, cells of the mucosa represent one of the first contact points of the human organism with airborne NPs. Disruption of the epithelial barrier by harmful materials can lead to inflammation in addition to potential intrinsic toxicity of the particles. The aim of this study was to investigate whether subtoxic concentrations of zinc oxide (ZnO)- and silver (Ag)-NPs have an influence on upper airway barrier integrity. Nasal epithelial cells from 17 donors were cultured at the air–liquid interface and exposed to ZnO- and Ag-NPs. Barrier function, quantified by transepithelial electrical resistance (TEER), decreased after treatment with 10 µg/mL Ag-NPs, but FITC-dextran permeability remained stable and no change in mRNA levels of tight junction proteins and E-cadherin was detected by real-time quantitative PCR (RT-qPCR). The results indicate that subtoxic concentrations of Ag-NPs may already induce damage of the upper airway epithelial barrier in vitro. The lack of similar disruption by ZnO-NPs of similar size suggests a specific effect by Ag-NPs. KW - epithelial barrier KW - nanoparticles KW - tight junctions KW - zinc oxide KW - silver Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357403 SN - 1999-4923 VL - 15 IS - 10 ER - TY - JOUR A1 - Israel, Ina A1 - Riehl, Gabriele A1 - Butt, Elke A1 - Buck, Andreas K. A1 - Samnick, Samuel T1 - Gallium-68-labeled KISS1-54 peptide for mapping KISS1 receptor via PET: initial evaluation in human tumor cell lines and in tumor-bearing mice JF - Pharmaceuticals N2 - Kisspeptins (KPs, KISS1) and their receptor (KISS1R) play a pivotal role as metastasis suppressor for many cancers. Low or lost KP expression is associated with higher tumor grade, increased metastatic potential, and poor prognosis. Therefore, KP expression has prognostic relevance and correlates with invasiveness in cancers. Furthermore, KISS1R represents a very promising target for molecular imaging and therapy for KISS1R-expressing tumors. The goal of this study was to evaluate the developed KISS1-54 derivative, [\(^{68}\)Ga]KISS1-54, as a PET-imaging probe for KISS1R-expressing tumors. The NODAGA-KISS1-54 peptide was labeled by Gallium-68, and the stability of the resulting [\(^{68}\)Ga]KISS1-54 evaluated in injection solution and human serum, followed by an examination in different KISS1R-expressing tumor cell lines, including HepG2, HeLa, MDA-MB-231, MCF7, LNCap, SK-BR-3, and HCT116. Finally, [\(^{68}\)Ga]KISS1-54 was tested in LNCap- and MDA-MB-231-bearing mice, using µ-PET, assessing its potential as an imaging probe for PET. [\(^{68}\)Ga]KISS1-54 was obtained in a 77 ± 7% radiochemical yield and at a >99% purity. The [\(^{68}\)Ga]KISS1-54 cell uptake amounted to 0.6–4.4% per 100,000 cells. Moreover, the accumulation of [\(^{68}\)Ga]KISS1-54 was effectively inhibited by nonradioactive KISS1-54. In [\(^{68}\)Ga]KISS1-54-PET, KISS1R-positive LNCap-tumors were clearly visualized as compared to MDA-MB-231-tumor implant with predominantly intracellular KISS1R expression. Our first results suggest that [\(^{68}\)Ga]KISS1-54 is a promising candidate for a radiotracer for targeting KISS1R-expressing tumors via PET. KW - [\(^{68}\)]KISS1-54 KW - KISS1 receptor KW - GPR54 KW - kisspeptin KW - human tumor cell lines KW - positron emission tomography KW - PET KW - KISS1-54 Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-355898 SN - 1424-8247 VL - 17 IS - 1 ER - TY - JOUR A1 - Odorfer, Thorsten M. A1 - Volkmann, Jens T1 - Deep brain stimulation for focal or segmental craniocervical dystonia in patients who have failed botulinum neurotoxin therapy - a narrative review of the literature JF - Toxins N2 - (1) Background: The first-line treatment for patients with focal or segmental dystonia with a craniocervical distribution is still the intramuscular injection of botulinum neurotoxin (BoNT). However, some patients experience primary or secondary treatment failure from this potential immunogenic therapy. Deep brain stimulation (DBS) may then be used as a backup strategy in this situation. (2) Methods: Here, we reviewed the current study literature to answer a specific question regarding the efficacy and safety of the use of DBS, particularly for cervical dystonia (CD) and Meige syndrome (MS) in patients with documented treatment failure under BoNT. (3) Results: There are only two studies with the highest level of evidence in this area. Despite this clear limitation, in the context of the narrowly defined research question of this paper, it is possible to report 161 patients with CD or MS who were included in studies that were able to show a statistically significant reduction in dystonic symptoms using DBS. Safety and tolerability data appeared adequate. However, much of the information is based on retrospective observations. (4) Conclusions: The evidence base in this area is in need of further scientific investigation. Most importantly, more randomized, controlled and double-blind trials are needed, possibly including a head-to-head comparison of DBS and BoNT. KW - cervical dystonia KW - Meige syndrome KW - deep brain stimulation KW - internal globus pallidus KW - subthalamic nucleus KW - botulinum neurotoxin KW - medication therapy failure KW - symptom control KW - safety and tolerability Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357707 SN - 2072-6651 VL - 15 IS - 10 ER - TY - JOUR A1 - Watzling, Martin A1 - Klaus, Lorenz A1 - Weidemeier, Tamara A1 - Horder, Hannes A1 - Ebert, Regina A1 - Blunk, Torsten A1 - Bauer-Kreisel, Petra T1 - Three-dimensional breast cancer model to investigate CCL5/CCR1 expression mediated by direct contact between breast cancer cells and adipose-derived stromal cells or adipocytes JF - Cancers N2 - The tumor microenvironment (TME) in breast cancer is determined by the complex crosstalk of cancer cells with adipose tissue-inherent cells such as adipose-derived stromal cells (ASCs) and adipocytes resulting from the local invasion of tumor cells in the mammary fat pad. This leads to heterotypic cellular contacts between these cell types. To adequately mimic the specific cell-to-cell interaction in an in vivo-like 3D environment, we developed a direct co-culture spheroid model using ASCs or differentiated adipocytes in combination with MDA-MB-231 or MCF-7 breast carcinoma cells. Co-spheroids were generated in a well-defined and reproducible manner in a high-throughput process. We compared the expression of the tumor-promoting chemokine CCL5 and its cognate receptors in these co-spheroids to indirect and direct standard 2D co-cultures. A marked up-regulation of CCL5 and in particular the receptor CCR1 with strict dependence on cell–cell contacts and culture dimensionality was evident. Furthermore, the impact of direct contacts between ASCs and tumor cells and the involvement of CCR1 in promoting tumor cell migration were demonstrated. Overall, these results show the importance of direct 3D co-culture models to better represent the complex tumor–stroma interaction in a tissue-like context. The unveiling of tumor-specific markers that are up-regulated upon direct cell–cell contact with neighboring stromal cells, as demonstrated in the 3D co-culture spheroids, may represent a promising strategy to find new targets for the diagnosis and treatment of invasive breast cancer. KW - 3D breast cancer model KW - adipose-derived stromal cells KW - adipocytes KW - adipose tissue KW - spheroids KW - co-culture Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362502 SN - 2072-6694 VL - 15 IS - 13 ER - TY - THES A1 - Stark, Irmgard Katharina T1 - Einfluss von Interferon auf das Infektionsverhalten von Herpes simplex Virus 1 und seiner DUB - Mutante C65A in der Zellkultur T1 - The influence of interferon on infection of Herpes simplex Virus 1 and its DUB – mutant C65A in cell culture N2 - Die Erforschung viraler Proteine ist wichtig, um virale Infektionen besser verstehen und damit therapieren zu können. Die Aufklärung der DUB-Funktion auf dem viralen Herpesprotein pUL36 ermöglicht ein besseres Verständnis des Infektionshergangs und könnte zur Entwicklung eines Enzyminhibitors führen, der nur an diesem Enzym ansetzt, nachdem es sich von den zellulären DUBs unterscheidet (Kattenhorn et al., 2005). In dieser Arbeit konnten die vorherigen Daten, die eine stärkere Hemmung der DUB- Mutante unter Interferoneinfluss zeigten, in unterschiedlichen Assay-Designs bestätigt werden. Auch Versuche mit einem anderen Herpes simplex Virus Strang, bestätigten die vorherigen Daten. Die Ergebnisse zeigen, dass die DUB-Funktion für HSV-1 wichtig ist für die virale Evasion der zellulären Immunantwort. Die genaue Funktion der DUB in der Infektion ist jedoch unklar. Aufgrund der vorbestehenden Datenlage erschien am wahrscheinlichsten, dass die DUB-Funktion vor Eindringen des Herpes Simplex Virus in den Zellkern zum Tragen kommt, womit es nach Abnahme des Interferons nicht zu einer viralen Reaktivierung käme. Deshalb wurden Untersuchungen unternommen, um eine mögliche Reaktivierung nach Abnahme des Interferons näher zu untersuchen. Hierfür wurden zwei verschiedene Experimente entwickelt. Einmal wurde das Interferon direkt nach Infektion und einmal 3 Tage nach Infektion (3dpi) abgenommen. Die Ergebnisse zeigten beide eine stärkere Hemmung der DUB-HSV-1-Mutante unter Interferoneinfluss. Bei Abnahme des Interferons direkt nach Infektion lag bei Wildtyp und Mutante ein leichter Anstieg der Plaquezahlen vor, wobei dieser Effekt von der Dosis des Interferons abhängig war. Eine hohe Interferondosis begünstigte bei beiden eine stärkere Hemmung, allerdings bei beiden auch eine leichte Erhöhung der Plaquezahl nach Abnahme. Bei einer niedrigen Dosis konnte nur eine stärkere Hemmung der DUB-Mutante, jedoch keine Reaktivierung bei Wildtyp und Mutante nach Abnahme des Interferons gezeigt werden. Bei Abnahme drei Tage nach Infektion zeigte sich sowohl bei dem Wildtyp-Virus als auch der DUB- Mutante kein Anstieg in den Plaquezahlen. Es sind, nachdem Deubiquitinierung nicht nur eine Rolle in der Verhinderung des proteosomalen Abbaus von in die Zelle eingedrungenem Virus spielt, sondern auch der Zellregulation, mehrere Szenarien denkbar, die diesen Phänotyp erklären könnten. Die DUB-Funktion könnte zwar den proteosomalen Abbau durch Deubiqutinierung und damit Verhinderung der Markierung des Virus zum zellulären Abbau verhindern. Allerdings könnten sich durch einen langsameren Transport aus der Zelle oder in den Nucleus auch weniger Plaques bei der Mutante als wie beim Wildtyp unter Interferoneinfluss bilden, nachdem das Virus dann leichter Ziel antiviraler Proteine werden könnte. Oder die DUB-Funktion spielt eine Rolle beim Eintritt in den Kern durch Modifikationen anderer Proteine. Virengenome könnten auch durch eine fehlende DUB-Funktion reprimiert werden oder die Zelle durch Apoptose absterben. Interessanterweise konnte keine Hemmung der DUB-Mutante in Interferon behandelten U-2 OS Zellen gezeigt werden, von denen ein Defekt im STING- vermittelten Signalweg bekannt ist. Vielleicht zeigt dies, dass das STING-Protein an dem gezeigten DUB-Phänotyp beteiligt ist. Nachgewiesen ist außerdem bereits eine Funktion des Enzyms bei der zweiten Umhüllung der Kapside bei Pseudorabiesvirus (Möhl, 2011). Weitere Untersuchungen unter Einsatz bspw. von Immunfluoreszenz, Proteasominhibitoren oder weiteren Zelllinien wie Saos-2, sind nötig, um die genaue Funktion zu klären. N2 - The study of viral proteins is important to better understand and thus treat viral infections. Elucidation of DUB function on the viral herpes protein pUL36 provides a better understanding of the infection process and could lead to the development of an enzyme inhibitor that targets only this enzyme after it is different from cellular DUBs (Kattenhorn et al., 2005). In this work, previous data showing greater inhibition of the DUB- mutant under interferon influence were confirmed in different assay designs. Also, experiments with a different herpes simplex virus strand, confirmed the previous data. The results indicate that DUB function for HSV-1 is important for viral evasion of the cellular immune response. However, the exact function of DUB in infection is unclear. Based on the preexisting data, it seemed most likely that DUB function would come into play before herpes simplex virus enters the nucleus, which would mean that viral reactivation would not occur after interferon depletion. Therefore, studies were undertaken to further investigate a possible reactivation after decrease of interferon. Two different experiments were developed for this purpose. Once the interferon was withdrawn immediately after infection and once 3 days after infection (3dpi). The results both showed a stronger inhibition of the DUB-HSV-1 mutant under interferon influence. When interferon was decreased immediately after infection, a slight increase in plaque counts was present in both wild type and mutant, although this effect was dependent on the dose of interferon. A high dose of interferon promoted greater inhibition in both, but also a slight increase in plaque numbers after decrease in both. A low dose showed only greater inhibition of the DUB mutant but no reactivation in wild type and mutant after decrease of interferon. When decreased three days after infection, there was no increase in plaque counts for either the wild-type virus or the DUB- mutant. Given that deubiquitination plays a role not only in preventing proteosomal degradation of virus that has entered the cell but also in cell regulation, several scenarios are conceivable that could explain this phenotype. To be sure, DUB function could prevent proteosomal degradation by deubiqutinating and thereby preventing the virus from being labeled for cellular degradation. However, slower transport out of the cell or into the nucleus could also result in fewer plaques forming in the mutant than in the wild type under interferon influence, after which the virus could more easily become a target of antiviral proteins. Alternatively, DUB function may play a role in entry into the nucleus through modifications of other proteins. Viral genomes could also be repressed by a lack of DUB function or the cell could die by apoptosis. Interestingly, no inhibition of the DUB mutant was shown in interferon-treated U-2 OS cells, which are known to have a defect in the STING-mediated signaling pathway. Perhaps this indicates that the STING protein is involved in the DUB phenotype shown. Furthermore, a function of the enzyme in the second envelope of capsids in pseudorabies virus has already been demonstrated (Möhl, 2011). Further studies using e.g. immunofluorescence, proteasome inhibitors or additional cell lines such as Saos-2, are necessary to clarify the exact function. KW - Herpes simplex Virus DUB C65A KW - DUB Mutante KW - Herpes simplex virus C65A KW - Interferon KW - Zellkultur Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-351950 ER - TY - JOUR A1 - Güder, Gülmisal A1 - Rein, Eva von A1 - Flohr, Thomas A1 - Weismann, Dirk A1 - Schmitt, Dominik A1 - Störk, Stefan A1 - Frantz, Stefan A1 - Kratzer, Vincent A1 - Kendi, Christian T1 - Motion detectors as additional monitoring devices in the intensive care unit — a proof-of-concept study JF - Applied Sciences N2 - Background: Monitoring the vital signs of delirious patients in an intensive care unit (ICU) is challenging, as they might (un-)intentionally remove devices attached to their bodies. In mock-up scenarios, we systematically assessed whether a motion detector (MD) attached to the bed may help in identifying emergencies. Methods: We recruited 15 employees of the ICU and equipped an ICU bed with an MD (IRON Software GmbH, Grünwald, Germany). Participants were asked to replay 22 mock-up scenes of one-minute duration each: 12 scenes with movements and 10 without movements, of which 5 were emergency scenes (“lying dead-still, with no or very shallow breathing”). Blinded recordings were presented to an evaluation panel consisting of an experienced ICU nurse and a physician, who was asked to assess and rate the presence of motions. Results: Fifteen participants (nine women; 173 ± 7.0 cm; 78 ± 19 kg) joined the study. In total, 286 out of 330 scenes (86.7%) were rated correctly. Ratings were false negative (FN: “no movements detected, but recorded”) in 7 out of 180 motion scenes (3.9%). Ratings were false positive (FP: “movements detected, but not recorded”) in 37 out of 150 scenes (24.7%), more often in men than women (26 out of 60 vs. 11 out of 90, respectively; p < 0.001). Of note, in 16 of these 37 FP-rated scenes, a vibrating mobile phone was identified as a potential confounder. The emergency scenes were correctly rated in 64 of the 75 runs (85.3%); 10 of the 11 FP-rated scenes occurred in male subjects. Conclusions: The MD allowed for identifying motions of test subjects with high sensitivity (96%) and acceptable specificity (75%). Accuracy might increase further if activities are recorded continuously under real-world conditions. KW - motion detector KW - noncontact monitoring KW - Internet of Things devices Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362404 SN - 2076-3417 VL - 13 IS - 16 ER - TY - JOUR A1 - Hiew, Shawn A1 - Eibeck, Leila A1 - Nguemeni, Carine A1 - Zeller, Daniel T1 - The influence of age and physical activity on locomotor adaptation JF - Brain Sciences N2 - Background: Aging increases individual susceptibility to falls and injuries, suggesting poorer adaptation of balance responses to perturbation during locomotion, which can be measured with the locomotor adaptation task (LAT). However, it is unclear how aging and lifestyle factors affect these responses during walking. Hence, the present study investigates the relationship between balance and lifestyle factors during the LAT in healthy individuals across the adult lifespan using a correlational design. Methods: Thirty participants aged 20–78 years performed an LAT on a split-belt treadmill (SBT). We evaluated the magnitude and rate of adaptation and deadaptation during the LAT. Participants reported their lifelong physical and cognitive activity. Results: Age positively correlated with gait-line length asymmetry at the late post-adaptation phase (p = 0.007). These age-related effects were mediated by recent physical activity levels (p = 0.040). Conclusion: Our results confirm that locomotor adaptive responses are preserved in aging, but the ability to deadapt newly learnt balance responses is compromised with age. Physical activity mediates these age-related effects. Therefore, gait symmetry post-adaptation could effectively measure the risk of falling, and maintaining physical activity could protect against declines in balance. KW - locomotor adaptation KW - walking KW - physical activity KW - exercise KW - aging KW - balance Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362478 SN - 2076-3425 VL - 13 IS - 9 ER - TY - THES A1 - Gaballa, Abdallah Hatem Hassan Hosny Ahmed T1 - PAF1c drives MYC-mediated immune evasion in pancreatic ductal adenocarcinoma T1 - PAF1c treibt die MYC-vermittelte Immunevasion im duktalen Adenokarzinom der Bauchspeicheldrüse an N2 - The expression of the MYC proto-oncogene is elevated in a large proportion of patients with pancreatic ductal adenocarcinoma (PDAC). Previous findings in PDAC have shown that this increased MYC expression mediates immune evasion and promotes S-phase progression. How these functions are mediated and whether a downstream factor of MYC mediates these functions has remained elusive. Recent studies identifying the MYC interactome revealed a complex network of interaction partners, highlighting the need to identify the oncogenic pathway of MYC in an unbiased manner. In this work, we have shown that MYC ensures genomic stability during S-phase and prevents transcription-replication conflicts. Depletion of MYC and inhibition of ATR kinase showed a synergistic effect to induce DNA damage. A targeted siRNA screen targeting downstream factors of MYC revealed that PAF1c is required for DNA repair and S-phase progression. Recruitment of PAF1c to RNAPII was shown to be MYC dependent. PAF1c was shown to be largely dispensable for cell proliferation and regulation of MYC target genes. Depletion of CTR9, a subunit of PAF1c, caused strong tumor regression in a pancreatic ductal adenocarcinoma model, with long-term survival in a subset of mice. This effect was not due to induction of DNA damage, but to restoration of tumor immune surveillance. Depletion of PAF1c resulted in the release of RNAPII with transcription elongation factors, including SPT6, from the bodies of long genes, promoting full-length transcription of short genes. This resulted in the downregulation of long DNA repair genes and the concomitant upregulation of short genes, including MHC class I genes. These data demonstrate that a balance between long and short gene transcription is essential for tumor progression and that interference with PAF1c levels shifts this balance toward a tumor-suppressive transcriptional program. It also directly links MYC-mediated S-phase progression to immune evasion. Unlike MYC, PAF1c has a stable, known folded structure; therefore, the development of a small molecule targeting PAF1c may disrupt the immune evasive function of MYC while sparing its physiological functions in cellular growth. N2 - Die Expression des MYC-Proto-Onkogens ist bei einem großen Teil der Patienten mit duktalem Adenokarzinom der Bauchspeicheldrüse (PDAC) erhöht. Bisherige Erkenntnisse in der Erforschung des ankreaskarzinoms zeigen, dass die erhöhte MYCExpression die Umgehung des Immunsystems bewirkt und die Progression der S-Phase fördert. Wie diese Funktionen vermittelt werden und ob ein nachgeschalteter Faktor von MYC für diese Funktion verantwortlich ist, blieb jedoch bisher ungeklärt. Jüngste Studien zur Identifizierung des MYC-Interaktoms haben ein sehr komplexes Netzwerk an Interaktionspartnern von MYC aufgedeckt, was die Notwendigkeit unterstreicht, die onkogenen Eigenschaften von MYC und seinen Interaktionspartnern unvoreingenommen und genau zu untersuchen. In dieser Arbeit konnte gezeigt werden, dass MYC die genomische Stabilität während der S-Phase herstellt und Konflikte zwischen Transkription und Replikation verhindert. Die Depletion von MYC und die Hemmung der ATR-Kinase zeigten bei der Induktion von DNA Schäden eine synergistische Wirkung. Ein siRNA-Screen, der Gene beinhaltete, die MYC nachgeschaltet sind, ergab, dass PAF1c für die DNA-Reparatur und die S-PhasenProgression erforderlich ist. Es zeigte sich außerdem, dass die Rekrutierung von PAF1c an RNAPII von MYC abhängig ist. Für die Zellproliferation und die Regulierung von MYCZielgenen ist PAF1c jedoch weitgehend entbehrlich. Es konnte gezeigt werden, dass die Depletion von CTR9, einer Untereinheit von PAF1c, in einem murinen Modell des duktalen Adenokarzinoms der Bauchspeicheldrüse zu einer starken Tumorregression mit langfristigem Überleben einiger Mäuse führte. Diese Wirkung war nicht auf die Induktion von DNA-Schäden zurückzuführen, sondern auf die Wiederherstellung der Immunüberwachung des Tumors. Die Deletion von PAF1c führte zu einer Umverteilung von RNAPII und Trankriptionselongationsfaktoren wie SPT6, von langen Genen hin zu kurzen Genen. Dadurch wurden lange Gene wie zum Beispiel DNA Reparaturgene nicht vollständig transkribiert, kurze Gene wie MHC-Klasse-I-Gene hingegen schon. Diese Daten zeigen, dass ein Gleichgewicht zwischen der Transkription langer und kurzer Gene für die Tumorprogression wichtig ist und dass eine Verminderung der PAF1c-Konzentration dieses Gleichgewicht in Richtung eines tumorsuppressiven Transkriptionsprogramms verschiebt. Außerdem besteht ein direkter Zusammenhang zwischen der MYCvermittelten S-Phasen-Progression und der Umgehung des Immunsystems. Im Gegensatz zu MYC verfügt PAF1c über eine stabile und gut bekannte gefaltete Struktur. Daher könnte die Entwicklung eines kleinen Moleküls, das PAF1c hemmt, die Funktion von MYC zur Umgehung des Immunsystems stören und gleichzeitig seine physiologischen Funktionen für das Zellwachstum nicht beeinträchtigen. KW - Myc KW - Transkription KW - PAF1c KW - Transcription elongation KW - Immune evasion KW - Immunevasion Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360459 ER - TY - THES A1 - von der Heide, Julia Magdalena T1 - Ist eine Berechnung der Geometrie der Halswirbelkörper anhand ihrer Morphologie im Kindesalter und somit eine Individualisierung der CVM-Methode möglich? T1 - Is it possible to calculate the geometry of the cervical vertebral bodies based on their morphology in childhood and thus individualize the CVM method? N2 - Ziel der vorliegenden Studie war es zu untersuchen, ob anhand geometrischer Merkmale der HWK im Kindesalter eine sichere individuelle Vorhersage der Morphologie der HWK zum Ende der Entwicklung möglich ist. Hierdurch könnte eine Individualisierung der CVM-Methode und somit eine Einschätzung des bereits verstrichenen Wachstums erfolgen. Zu diesem Zweck wurden insgesamt 1377 FRS-Aufnahmen von 267 Patienten – 110 weibliche und 157 männliche – aus dem Archiv der Poliklinik für Kieferorthopädie des Universitätsklinikums Würzburg digitalisiert und untersucht. Die HWK wurden im Programm OnyxCeph (Herst.: Image Instruments GmbH) quantifiziert und die berechneten Werte mit der Software SPSS statistisch ausgewertet. Mittels linearer Regressionen wurde versucht, anhand der Morphologie der Wirbelkörper vor dem puberalen Wachstumsschub auf die Geometrie der HWK im Erwachsenenalter zu schließen. Zur Illustrierung wurden Streudiagramm und die dazugehörigen Abfolgen von Röntgenbildern dargestellt. Eine Schätzung der Geometrie der HWK im Erwachsenenalter würde bei den separat betrachteten Parametern und bei einer gemeinsamen Betrachtung der Parameter kaum zu korrekten Einschätzungen führen. Die Streudiagramme mit den Bilderabfolgen stützen diese These ebenfalls und illustrieren die mögliche Fehleinschätzung der Geometrie. Die Ergebnisse der Studie zeigen erneut, dass die Geometrie der HWK im Erwachsenenalter sehr variabel ist, wie komplex die Entwicklung der HWK ist und dass anhand ihrer Geometrie im Kindesalter keine sichere Einschätzung der skelettalen Reife möglich ist. Eine Individualisierung der CVM-Methode ist anhand der in dieser Studie untersuchten Parameter nicht möglich. Somit lässt sich schlussfolgern, dass die CVM-Methode nicht als alleinige Methode zur präzisen skelettalen Alterseinschätzung verlässlich genutzt werden kann, sondern für eine sichere Beurteilung weitere Reifeindikatoren hinzugezogen werden sollten. Allerdings sollten hierzu zusätzliche radiologische Untersuchungen, wie beispielsweise die Handröntgenaufnahme, nur dann durchgeführt werden, wenn diese dem ALARA-Prinzip entsprechen. N2 - The aim of the present study was to investigate whether a reliable individual prediction of the morphology of the cervical vertebral bodies at the end of development is possible based on their geometric features in childhood. This could allow the CVM method to be individualized and thus an assessment of the growth that has already occurred. For this purpose, a total of 1377 FRS images of 267 patients - 110 female and 157 male - from the archive of the Department of Orthodontics at the University Hospital of Würzburg were digitized and examined. The cervical vertebrae were quantified using the OnyxCeph program and the calculated values were statistically evaluated using the SPSS software. Through linear regressions an attempt was made to use the morphology of the cervical vertebral bodies before the pubertal growth spurt to draw conclusions about the geometry of the cervical vertebrae in adulthood. A scatter diagram and the associated sequences of X-ray images were displayed to illustrate this. An estimate of the geometry of the cervical vertebral bodies in adulthood would hardly lead to correct assessments wheter the parameters were considered separately or together. The scatter diagrams with the image sequences also support this thesis and illustrate the possible misjudgement of the geometry. The results of the study show once again the geometrical variability and the complexity of the development of the cervical vertebral bodies, which makes it impossible to give a reliable assessment of skeletal maturity based on its geometry in childhood. It is not possible to individualize the CVM method based on the parameters examined in this study. It can therefore be concluded that the CVM method cannot be used reliably as the sole method for precise skeletal age assessment, but that further maturity indicators should be involved for a reliable assessment. However, additional radiological examinations, such as hand X-rays, should only be carried out if they comply with the ALARA principle. KW - Skelett KW - CVM-Methode KW - Altersbestimmung Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360753 ER - TY - THES A1 - Cruz de Casas, Paulina T1 - Sphingolipids as modulators of T cell function T1 - Sphingolipide als Modulatoren der T-Zell-Funktion N2 - The immune system is responsible for the preservation of homeostasis whenever a given organism is exposed to distinct kinds of perturbations. Given the complexity of certain organisms like mammals, and the diverse types of challenges that they encounter (e.g. infection or disease), the immune system evolved to harbor a great variety of distinct immune cell populations with specialized functions. For instance, the family of T cells is sub-divided into conventional (Tconv) and unconventional T cells (UTCs). Tconv form part of the adaptive arm of the immune system and are comprised of αβ CD4+ or CD8+ cells that differentiate from naïve to effector and memory populations upon activation and are essential during infection and cancer. Furthermore, UTCs, which include γδ T cells, NKT and MAIT, are involved in innate and adaptive immune responses, due to their dual mode of activation, through cytokines (innate-like) or TCR (adaptive), and function. Despite our understanding of the basic functions of T cells in several contexts, a great number of open questions related to their basic biology remain. For instance, the mechanism behind the differentiation of naïve CD4+ and CD8+ T cells into effector and memory populations is not fully understood. Moreover, the exact function and relevance of distinct UTC subpopulations in a physiological context have not been fully clarified. Here, we investigated the factors mediating naïve CD8+ T cell differentiation into effector and memory cells. By using flow cytometry, mass spectrometry, enzymatic assays, and transgenic mouse models, we found that the membrane bound enzyme sphingomyelin-phosphodiesterase acid-like 3b (Smpdl3b) is crucial for the maintenance of memory CD8+ T cells. Our data show that the absence of Smpdl3b leads to diminished CD8+ T cell memory, and a loss of stem-like memory populations due to an aggravated contraction. Our scRNA-seq data suggest that Smpdl3b could be involved in clathrinmediated endocytosis through modulation of Huntingtin interacting protein 1 (Hip1) levels, likely regulating TCR-independent signaling events. Furthermore, in this study we explored the role of UTCs in lymph node-specific immune responses. By using transgenic mouse models for photolabeling, lymph node transplantation models, infection models and flow cytometry, we demonstrate that S1P regulates the migration of tissue-derived UTC from tissues to draining lymph nodes, resulting in heterogeneous immune responses mounted by lymph nodes draining different tissues. Moreover, our unbiased scRNAseq and single lineage-deficient mouse models analysis revealed that all UTC lineages (γδ T cells, NKT and MAIT) are organized in functional units, based on transcriptional homogeneity, shared microanatomical location and migratory behavior, and numerical and functional redundancy. Taken together, our studies describe additional cell intrinsic (Smpdl3b) and extrinsic (S1Pmediated migration) functions of sphingolipid metabolism modulating T cell biology. We propose the S1P/S1PR1/5 signaling axis as the potential survival pathway for Smpdl3b+ memory CD8+ T cells and UTCs, mainly in lymph nodes. Possibly, Smpdl3b regulates S1P/S1PR signaling by balancing ligandreceptor endocytosis, while UTCs migrate to lymph nodes during homeostasis to be exposed to specific levels of S1P that assure their maintenance. Our results are clinically relevant, since several drugs modulating the S1P/S1PR signaling axis or the levels of Smpdl3b are currently used to treat human diseases, such as multiple sclerosis and B cell-mediated diseases. We hope that our discoveries will inspire future studies focusing on sphingolipid metabolism in immune cell biology. N2 - Das Immunsystem ist für die Aufrechterhaltung der Homöostase verantwortlich, wenn ein bestimmter Organismus verschiedenen Arten von Störungen ausgesetzt ist. In Anbetracht der Komplexität bestimmter Organismen wie Säugetiere und der verschiedenen Arten von Störungen, denen sie ausgesetzt sein können (z. B. Infektionen oder Krankheiten), hat sich das Immunsystem so entwickelt, dass es eine große Vielfalt verschiedener Immunzellpopulationen mit spezialisierten Funktionen beherbergt. So wird beispielsweise die Familie der T-Zellen in konventionelle (Tconv) und unkonventionelle T-Zellen (UTC) unterteilt. Tconv sind Teil des adaptiven Arms des Immunsystems und bestehen aus αβ-CD4+- oder CD8+-Zellen, die sich bei der Aktivierung von naiven zu Effektor- und Gedächtnispopulationen differenzieren und bei Infektionen und Krebs eine wichtige Rolle spielen. Darüber hinaus sind UTCs, zu denen γδ-T-Zellen, NKT und MAIT gehören, aufgrund ihrer dualen Aktivierungsweise durch Zytokine (angeboren) oder TCR (adaptiv) und ihrer Funktion an angeborenen und adaptiven Immunantworten beteiligt. Trotz unseres Verständnisses der grundlegenden Funktionen von T-Zellen in verschiedenen Zusammenhängen gibt es nach wie vor eine große Anzahl offener Fragen im Zusammenhang mit ihrer grundlegenden Biologie. So ist beispielsweise der Mechanismus der Differenzierung naiver CD4+ und CD8+ T-Zellen in Effektor- und Gedächtnispopulationen noch nicht ausreichend verstanden. Auch die genaue Funktion und Bedeutung der verschiedenen UTCSubpopulationen im physiologischen Kontext sind noch nicht vollständig geklärt. Wir haben die Faktoren untersucht, die die Differenzierung naiver CD8+ T-Zellen in Effektorund Gedächtniszellen vermitteln. Mithilfe von Durchflusszytometrie, Massenspektrometrie, enzymatischen Assays und transgenen Mausmodellen konnten wir feststellen, dass das membrangebundene Enzym Sphingomyelin-Phosphodiesterase acid-like 3b (Smpdl3b) für die Aufrechterhaltung der CD8+ T-Zell-Gedächtnisfunktion entscheidend ist. Unsere Daten zeigen, dass das Fehlen von Smpdl3b zu einer verminderten Anzahl and CD8+ T Gedächtniszellen durch eine verstärke Kontraktion sowie einem Verlust von stammzellartigen Gedächtnispopulationen führt. Unsere scRNAseq- Daten deuten jedoch darauf hin, dass Smpdl3b an der Clathrin-vermittelten Endozytose beteiligt sein könnte, indem es die Spiegel des Huntingtin interacting protein 1 (Hip1) moduliert und wahrscheinlich TCR-unabhängige Signalereignisse reguliert. Darüber hinaus untersuchten wir in dieser Studie die Rolle von UTCs bei lymphknotenspezifischen Immunantworten. Mit Hilfe von transgenen Mausmodellen für Photolabeling, Lymphknotentransplantationsmodellen, Infektionsmodellen und Durchflusszytometrie konnten wir zeigen, dass S1P die Migration von UTCs aus dem Gewebe in die drainierenden Lymphknoten reguliert, was zu heterogenen Immunantworten in den Lymphknoten führt, die verschiedene Gewebe drainieren. Ausserdem ergab unsere Analyse von scRNA-seq-Daten, sowie Mausmodelle mit einer genetischen Defizienz einzelner UTC-Linien (γδ-T-Zellen, NKT und MAIT), dass diese zusammen in funktionellen Einheiten organisiert sind, die auf transkriptioneller Homogenität, gemeinsamer mikroanatomischer Lage und Migrationsverhalten sowie numerischer und funktioneller Redundanz basieren. Zusammengenommen beschreiben unsere Studien zusätzliche zellinterne (Smpdl3b) und - externe (S1P-vermittelte Migration) Funktionen des Sphingolipid-Stoffwechsels, welche die T-Zell- Biologie modulieren. Wir schlagen die S1P/S1PR1/5-Signalachse als potenziellen Überlebensweg für Smpdl3b+ Gedächtnis-CD8+-T-Zellen und UTCs ausschließlich in Lymphknoten vor. Möglicherweise reguliert Smpdl3b die S1P/S1PR-Signalübertragung, indem es die Endozytose des Liganden-Rezeptors reguliert. Dadurch könnte deren Exposition zu bestimmten S1P-Mengen in der Homöostase im Lymphknoten reguliert werden, die wiederum das Überleben der UTC steuern. Unsere Ergebnisse sind klinisch relevant, da mehrere Medikamente, die die S1P/S1PR-Signalachse oder die Smpdl3b- Konzentration modulieren, derzeit zur Behandlung menschlicher Krankheiten eingesetzt werden, z. B. bei Multipler Sklerose und B-Zell-vermittelten Krankheiten. Wir hoffen, dass unsere Entdeckungen zukünftige Studien anregen werden, die sich auf den Sphingolipid-Stoffwechsel in der Immunzellbiologie konzentrieren. KW - T-Lymphozyt KW - Infektion KW - Lymphknoten KW - Cytokine KW - Sphingolipide KW - CD8+ T cell differentiation KW - Unconventional T cells KW - Sphingolipid biology KW - Immunology Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359698 ER - TY - THES A1 - Wußmann, Maximiliane T1 - Humane organotypische 3D Modelle des Malignen Melanoms als in vitro Testsystem für die Bewertung der Wirksamkeit von anti-Tumor Therapeutika T1 - Human organotypic 3D models of malignant melanoma as an in vitro test system to evaluate the efficacy of anti-tumor therapeutics N2 - Das maligne Melanom, eine der seltensten, aber gleichzeitig auch die tödlichste dermatologische Malignität, gekennzeichnet durch die Neigung zu einer frühen Metastasierung sowie die rasche Entwicklung von Therapieresistenzen, zählt zu den Tumorentitäten mit dem höchsten Anstieg der Inzidenz weltweit. Mausmodelle werden häufig verwendet, um die Melanomagenese zu erforschen und neue effektive therapeutische Strategien zu entwickeln, spiegeln die menschliche Physiologie allerdings nur unzureichend wider. In zweidimensionalen (2D) Zellkulturen mangelt es dagegen an wichtigen Komponenten der Mikroumgebung des Tumors und dem dreidimensionalen Gewebekontext. Um dieses Manko zu beheben und die Entwicklung von auf den Menschen übertragbaren Tumormodellen in der onkologischen Forschung voranzutreiben, wurde als Alternative zu Zellkulturen und Tierversuchen humane organotypische dreidimensionale (3D) Melanom-Modelle als in vitro Testsystem für die Bewertung der Wirksamkeit von anti-Tumor Therapeutika entwickelt. Im Zuge dieser Arbeit konnte das in vitro Melanom-Modell entscheidend weiterentwickelt werden. So konnten Modelle unterschiedlichster Komplexität etabliert werden, wobei abhängig von der Fragestellung einfachere epidermale bis hin zu unterschiedlich komplexen Vollhautmodellen Anwendung finden. Durch Simulation der Tumor-Mikroumgebung eignen sich diese zur präklinischen Validierung neuer Tumor-Therapeutika, sowie der Erforschung pathologischer Vorgänge, von der Tumor-Formierung bis zur Metastasierung. Zudem konnten erfolgreich unterschiedlichste humane Melanomzelllinien ins Modell integriert werden; dadurch, dass sich diese durch ihre Treibermutationen, die zur Krankheitsentstehung beitragen, unterscheiden, stellen sie unterschiedliche Ansprüche an potentielle therapeutische Angriffspunkte und ermöglichen das Widerspiegeln vieler Melanom-Subtypen im Modell. Ferner ist es möglich, verschiedene Stadien der Tumor-Entwicklung über die Zugabe von Melanomzellen in Einzelsuspension bzw. von Melanom-Sphäroiden widerzuspiegeln. Es konnte für bestimmte Therapie-Ansätze, wie zielgerichtete Therapien, z.B. die Gabe von sich in der Klinik im Einsatz befindlicher BRAF-/MEK-Inhibitoren, gezeigt werden, dass sich die etablierten Modelle hervorragend als präklinische Testsysteme zur Wirksamkeitsbewertung eignen. Zudem bieten sich einzigartige Möglichkeiten, um die Interaktion humaner Tumorzellen und gesunder Zellen in einem Gewebeverband zu untersuchen. Ferner konnten drei neue technische Analyse-Verfahren zur nicht-invasiven Detektion der Tumor- Pro- und Regression, Beurteilung der Wirksamkeit von potenziellen Anti-Tumor-Therapien sowie der Evaluierung des Tumor-Metabolismusses implementiert werden. Perspektivisch ermöglichen immun-kompetente Melanom-Modelle die Austestung neuer Immun- und Zelltherapien in einem voll humanen System; gleichzeitig leisten die etablierten Modelle einen signifikanten Beitrag zur Reduktion von Tierexperimenten. N2 - Malignant melanoma, one of the rarest but also the most lethal dermatological malignancies, characterized by a propensity for early metastasis as well as the rapid development of therapy resistance, is among the tumor entities with the highest increase in incidence worldwide. Mouse models are widely used to study melanomagenesis and develop new effective therapeutic strategies, but do not adequately reflect human physiology. In contrast, twodimensional (2D) cell cultures lack important components of the tumor microenvironment and three-dimensional tissue context. To address this shortcoming and to advance the development of human-transferable tumor models in oncology research, human organotypic three-dimensional (3D) models of malignant melanoma were developed as an alternative to cell cultures and animal experiments as an in vitro test system for evaluating the efficacy of anti-tumor therapeutics. In the course of this work, the in vitro melanoma model could be significantly further developed. Thus, melanoma models of different complexity could be established, with simpler epidermal to differently complex full skin models being applied, depending on the research question. By simulating the tumor microenvironment, these are suitable for the preclinical validation of new tumor therapeutics, as well as the study of pathological processes, from tumor shaping to metastasis. In addition, a wide variety of human melanoma cell lines have been successfully integrated into the model; by differing in their driver mutations that contribute to disease development, they pose different requirements for potential therapeutic targets and allow many melanoma subtypes to be reflected in the model. Furthermore, it is possible to reflect different stages of tumor development via the addition of melanoma cells in single suspension or melanoma spheroids. For certain therapeutic approaches in malignant melanoma, such as targeted therapies, e.g. the administration of BRAF/MEK inhibitors currently in use in the clinic, it could be shown that the established models are excellently suited as preclinical test systems for efficacy evaluation. In addition, unique opportunities are provided to study the interaction of human tumor cells and healthy cells in a tissue composite. Furthermore, three new technical analysis methods for non-invasive detection of tumor progression and regression, assessment of efficacy of potential anti-tumor therapies, and evaluation of tumor metabolism could be implemented. In perspective, immune-competent melanoma models enable the testing of new immune and cell therapies in a fully human system; at the same time, the established models contribute significantly to the reduction of animal experiments. KW - Melanom KW - In vitro KW - anti-Tumor Therapeutika KW - Wirksamkeitsbewertung KW - 3D Modell KW - Dreidimensionales Modell Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-361005 ER - TY - THES A1 - Keicher, Franca T1 - Muskuläre Einflüsse der Rotatorenmanschette auf die Early Onset Arthrose der Schulter T1 - Muscular Influences of the Rotator Cuff on Early Onset Shoulder Osteoarthritis N2 - Introduction: The etiology of early onset shoulder arthritis (EOA) remains unclear. Due to the influence of the muscles of the rotator cuff (RC) on glenohumeral kinematics, muscular causes are being discussed. The aim of the study was to identify corresponding factors on EOA based on volume measurements of the RC and examinations of the adjacent bony structures in MRI imaging, as well as the collection of patient-specific characteristics. Methods: In a case-control study, shoulders of 15 patients (14 men, 1 woman) with shoulder arthritis before the age of 60 and 13 control subjects (13 men) were examined. Anthropometric body measurements and clinical characteristics were collected. The volumes of the RC were calculated using manual tracing of the individual muscle cross- sections on MRI scans. In addition, the angles between the coracoid or scapular spine and scapular body were measured. The position of the scapula to the thorax was determined by recording the angle of the scapula to the plane of the table. The glenoid retroversion, morphological types, and humeral head subluxation were also collected. The analysis was conducted using descriptive and comparative statistical methods, as well as logistic and linear regression analyses. Results: The volumes of the RC did not differ significantly between the patients with EOA and the control subjects, either in absolute terms or in relative proportions. However, significantly higher values of thorax circumference and diameter, body weight, and BMI were found in the diseased individuals compared to the controls. Furthermore, these individuals were significantly more likely to have occupations that expended more than 1400 kcal per day. The risk of EOA increased with the steeper angle of the scapula to the thorax. Patients with B2-glenoid had significantly larger angles between the coracoid and scapular body as well as higher values of transverse thorax diameter, than those with B1-glenoid. Regardless of whether EOA was present or not, engaging in overhead sports was associated with a higher subluxation index. Conclusion: While the RC did not show any abnormalities in EOA patients, male gender, BMI, thoracic shape and scapular position, as well as certain occupations and sports, were associated with EOA. Further studies are needed to investigate these risk factors in EOA more precisely and develop possible treatment concepts. Peripheral shoulder muscles (such as teres major or pectoralis major) should also be included in the investigations. N2 - Einleitung: Die Ätiologie der Early Onset Arthrose (EOA) der Schulter ist bislang ungeklärt. Aufgrund des Einflusses der Muskeln der Rotatorenmanschette (RM) auf die glenohumerale Kinematik werden muskuläre Ursachen diskutiert. Ziel der Studie war es, entsprechende Faktoren anhand von Volumenmessungen der RM und Untersuchungen der angrenzenden knöchernen Strukturen in der MRT-Bildgebung sowie der Erfassung patientenspezifischer Charakteristika zu identifizieren. Methoden: In einer Fall-Kontroll-Studie wurden Schultern von 15 PatientInnen (14 Männer, 1 Frau) mit einer Omarthrose vor dem 60. Lebensjahr und 13 Kontrollpersonen (ausschließlich Männer) untersucht. Dabei wurden anthropometrische Körpermessungen sowie klinische Charakteristika erhoben. Anhand von MRT-Bildern wurden die Volumina der RM mittels manueller Umrandung der einzelnen Muskelquerschnitte berechnet. Weiterhin wurden die Winkel zwischen Coracoid bzw. Spina scapulae und Scapulakörper gemessen. Die Stellung der Scapula zum Thorax wurde anhand des Winkels der Scapula zur Tischebene erhoben. Zudem wurden die Glenoidretroversion, -morphologietypen und Humeruskopfsubluxation ermittelt. Die Auswertung erfolgte anhand deskriptiver und vergleichender statistischer Verfahren sowie logistischer und linearer Regressionsanalysen. Ergebnisse: Die Volumina der RM von PatientInnen mit EOA unterschieden sich weder absolut noch im relativen Verhältnis von denen der Kontrollpersonen. Dagegen konnten im Vergleich signifikant höhere Werte des Thoraxumfangs und -durchmessers, des Körpergewichts sowie des BMI bei erkrankten Personen nachgewiesen werden. Weiterhin übten diese signifikant häufiger Berufe aus, die mehr als 1400 kcal pro Tag verbrauchten. Das Risiko einer EOA nahm zu, je steiler die Scapula zum Thorax stand. PatientInnen mit B2-Glenoid wiesen signifikant größere Winkel zwischen Coracoid und Scapulakörper sowie höhere Werte des transversalen Thoraxdurchmessers auf, als erkrankte Personen mit einem B1-Glenoid. Unabhängig von einer Erkrankung mit EOA zeigte sich, dass das Ausüben einer Überkopfsportart mit einem höheren Subluxationsindex assoziiert war. Fazit: Während die RM keine Auffälligkeiten bei PatientInnen mit EOA zeigte, waren ein männliches Geschlecht, der BMI, die Thoraxform und Scapulastellung, sowie die Ausübung bestimmter Berufe und Sportarten mit der Erkrankung assoziiert. Weitere Studien müssen folgen, um diese Risikofaktoren bei EOA genauer zu untersuchen und mögliche Therapiekonzepte zu entwickeln. Dabei sollte auch die periphere Schultermuskulatur (z. B. M. teres major oder M. pectoralis major) in die Untersuchungen miteinbezogen werden. KW - Arthrose KW - Schultergelenk KW - Early Onset Schulterarthrose KW - Rotatorenmanschette Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360557 ER - TY - THES A1 - Rehlinghaus, Christine T1 - Retrospektive Evaluation der intravenösen Dexamethason- bzw. Methylprednisolon-Pulstherapie bei ausgeprägter Alopecia areata T1 - Retrospective evaluation of intravenous dexamethasone or methylprednisolone pulse therapy for severe alopecia areata N2 - Hintergrund: Bei der Entscheidung für eine intravenöse Kortikosteroid-Pulstherapie bei schweren Formen der AA ist die Abwägung von Therapieaufwand, Nebenwirkungen und Risiken einerseits und der Erfolgsaussicht andererseits von zentraler Bedeutung. Ziel: Ziel dieser retrospektiven Analyse war es daher, die Wirksamkeit und Sicherheit der intravenösen Kortikosteroid-Pulstherapie bei Patient:innen mit ausgeprägter AA klinikintern als qualitätssichernde Maßnahme zu untersuchen, prognostisch bedeutsame Faktoren für den Therapieeffekt zu ermitteln und hierdurch die beste Indikation herauszuarbeiten. Methode: 126 Patient:innen (13 Kinder und Jugendliche) erhielten Dexamethason 100 mg (122 Patienten) oder Methylprednisolon 20-30 mg/kg/KG (max. 1000 mg, 4 Patienten) an drei aufeinanderfolgenden Tagen für ein bis drei Zyklen. Ergebnisse: Patienten mit einer AA partialis bzw. diffusa zeigten im Hinblick auf ein vollständiges oder kosmetisch akzeptables Wiederwachstum die besten Ansprechraten (44,3%, n=43). Unter den Ophiasis-Patienten und den Patienten mit AA totalis/universalis sprach nur etwa ein Viertel auf die Therapie an (Ophiasis 23,8%, n=5; AA totalis/universalis: 25%, n=2). Schwerwiegende unerwünschte Nebenwirkungen wurden nicht beobachtet. Schlussfolgerung: In der vorliegenden Untersuchung ließen sich eine längere Bestandsdauer der Erkrankung und Erkrankungsepisode (über 6 Monate), ein schwerer Ausprägungsgrad (Ophiasis, AA totalis/universalis) und krankheitstypische Nagelveränderungen als wichtige ungünstige prognostische Faktoren nachweisen. Dagegen wirkten sich die untersuchten Kriterien Alter, Geschlecht, atopisches Ekzem und andere Erkrankungen des atopischen Formenkreises, Schilddrüsen- und Autoimmunerkrankungen in der Eigenanamnese sowie AA in der Familienanamnese nicht negativ auf den Behandlungserfolg aus. Patienten mit AA partialis und einer Bestandsdauer der AA von maximal 6 Monaten haben die besten Erfolgsaussichten. N2 - Background: When deciding in favour of intravenous corticosteroid pulse therapy for severe forms of AA, it is of central importance to weigh up the therapeutic effort, side effects and risks on the one hand and the prospects of success on the other. Aim: The aim of this retrospective analysis was therefore to investigate the efficacy and safety of intravenous corticosteroid pulse therapy in patients with pronounced AA within the clinic as a quality assurance measure, to determine prognostically significant factors for the therapeutic effect and thus to identify the best indication. Methods: 126 patients (13 children and adolescents) received dexamethasone 100 mg (122 patients) or methylprednisolone 20-30 mg/kg/KG (max. 1000 mg, 4 patients) on three consecutive days for one to three cycles. Results: Patients with AA partialis or diffusa showed the best response rates in terms of complete or cosmetically acceptable regrowth (44.3%, n=43). Among the ophiasis patients and the patients with AA totalis/universalis, only about a quarter responded to the therapy (ophiasis 23.8%, n=5; AA totalis/universalis: 25%, n=2). No serious adverse events were observed. Conclusion: In the present study, a longer duration of the disease and disease episode (more than 6 months), a severe degree of severity (ophiasis, AA totalis/universalis) and nail changes typical of the disease were found to be important unfavourable prognostic factors. In contrast, the investigated criteria of age, gender, atopic eczema and other atopic diseases, thyroid and autoimmune diseases in the patient's own medical history and AA in the family history did not have a negative effect on the success of treatment. Patients with AA partialis and a maximum duration of AA of 6 months have the best chances of success. KW - Alopecia areata Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360711 ER - TY - THES A1 - Fieber, Tabea T1 - Retrospektive unizentrische Analyse des Komplikationsmanagements bei Anastomoseninsuffizienz nach linksseitiger Kolon- und Rektumresektion T1 - Retrospective unicenter study of management of anastomotic leakage after left hemicolectomy and rectal resection N2 - Eine gefürchtete Komplikation nach Resektionen am Kolon mit Wiederherstellung der Kontinuität ist das Auftreten einer Anastomoseninsuffizienz (AI). Der Prozess der Diagnosestellung und das therapeutische Vorgehen sind zentrumsspezifisch und sehr heterogen. Ziel dieser Promotionsarbeit war die deskriptive Darstellung der Prävalenz, Diagnostik und Therapie von AI, um anhand dieser Daten ein bestimmtes zu favorisierendes Vorgehen zur AI-Behandlung herauszuarbeiten. Es wurde eine retrospektive unizentrische Analyse durchgeführt. Diese umfasste eine Kohorte von 744 Patienten, welche von 2009 bis 2013 am Universitätsklinikum Würzburg unter Kontinuitätserhalt kolorektal reseziert wurden. Es erfolgte eine deskriptive und statistische Auswertung mittels uni- und multivariater Analysen in Bezug auf Demographie, Risikofaktoren für die Entwicklung einer AI und den Erfolg der einzelnen Therapiekonzepte. Während der Nachbeobachtungsphase vom im Mittel 2,5 Jahren entwickelten 10,48% der Patienten eine AI. 60% der Insuffizienzen wurden während der ersten 7 postoperativen Tage detektiert. Als Risikofaktoren konnten indikationsunabhängig männliches Geschlecht, offener Zugangsweg und pulmonale Erkrankungen herausgearbeitet werden. Indikationsspezifisch zeigte sich eine Zunahme des AI-Risikos bei Divertikulitis-Patienten mit pulmonalen Erkrankungen (OR 4,5) und Cortisoneinnahme (OR 5,4). Auffällig wurden Patienten mit AI durch heterogene und teils unspezifische Symptome – am häufigsten durch Fieber (28,21%) und auffällige Laborwerte (48,72%). Eine folgende CT-Diagnostik bestätigte die Diagnose in 76,32% der Fälle und war in 24,48% falsch negativ. Patienten mit schlechtem AZ bei Diagnose der AI zeigten eine signifikant höhere Mortalität. Ein protektives Stoma konnte eine AI nicht verhindern, aber ihre Symptome und die Schwere des Verlaufs abmildern. Gemessen an der Überlebensrate und der Revisionspflichtigkeit unterschieden sich die durchgeführten Maßnahmen beim Versuch der kontinuitätserhaltenden Therapie nicht in Bezug auf den Erfolg der Therapie. Wie Insuffizienz- und Mortalitätsrate nach AI zeigen, ist diese unizentrische Analyse international vergleichbar. Die Ableitung einer generellen Empfehlung zur therapeutischen Vorgehensweise bei AI ist nicht möglich. Vielmehr sind alle dargestellten Maßnahmen zur Beherrschung der AI sinnvoll, während die Wahl der Vorgehensweise weiterhin eine Individualentscheidung bleibt. N2 - Anastomotic leakage (AL) is a feared complication following continuity-preserving colon resection. The process of making the diagnosis and the planning of a therapeutic strategy are center-specific and very heterogeneous. The aim of this doctoral thesis is to describe the prevalence, diagnosis and therapy of AL, in order to use this data to identify a specific strategy that would overall improve outcomes while treating AL. A retrospective unicentric analysis was performed. This included a cohort of 744 patients who underwent colorectal resection with continuity preservation at the Würzburg University Hospital from 2009 to 2013. A descriptive and statistical evaluation was carried out using univariate and multivariate analyzes regarding demographics, risk factors for the development of AL and the success of the individual therapy concepts. During the follow-up period of a mean of 2.5 years, 10.48% of patients developed AL. 60% of the insufficiencies were detected during the first 7 postoperative days. Male gender, open access and pulmonary diseases were identified as non-surgery-related risk factors, while diverticulitis patients with pulmonary diseases (OR 4.5) and patients taking cortisone (OR 5.4) were identified as surgery-related risk factor. Patients with AL were characterized by heterogeneous and sometimes non-specific symptoms - most commonly fever (28.21%) and abnormal laboratory values (48.72%). A follow-up CT scan confirmed the diagnosis in 76.32% of cases and was false negative in 24.48%. Patients with poor general health at the time of diagnosing AL showed a significantly higher mortality rate. A protective stoma did not prevent AL, however showed to alleviate its symptoms and course severity. Measured in terms of the survival rate and the need for revision surgery, the measures carried out did not differ in success of the therapy when attempting continuity-preserving therapy. The rates of insufficiency and mortality after AL demonstrate, that this unicentric analysis is internationally comparable. It is was, however, at the time of this study not possible to derive a general recommendation for the therapeutic strategy towards AL. Rather, all of the measures presented for mastering AL make sense, while the choice of the strategy remains an individual decision. KW - Darmanastomose KW - Anastomoseninsuffizienz KW - Komplikationsmanagement KW - Rektumresektion Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360730 ER - TY - THES A1 - Enzensberger, Eva T1 - Stellenwert der Dobutamin-Stress-Echokardiographie bei der Unterscheidung einer hochgradigen von einer pseudo-hochgradigen Aortenklappenstenose und Bestimmung deren echokardiographischer Prädiktoren T1 - Value of dobutamine stress echocardiography in differentiating between true-severe and pseudo-severe low-gradient aortic stenosis and determining their echocardiographic predictors N2 - Ziel dieser Studie war es, zu eruieren, ob die DSE zur Unterscheidung einer TS- von einer PSAS beitragen kann. Ebenfalls untersuchten wir, ob es bestimmte echokardiographische Prädiktoren für eine TS- und eine PSAS gibt und ob die LVEF bei Patienten mit einer LGAS eine entscheidende Rolle spielt. Methoden: Es wurde bei 130 Patienten mit einer asymptomatischen AS im Uniklinikum Würzburg zwischen Januar 2011 und Dezember 2016 sowohl eine TTE als auch eine DSE durchgeführt. Mittels TTE wurden verschiedene echokardiographische Daten erhoben und falls die Patienten eine AVAi  0,6 cm2/m2 und eine PGmean < 40 mmHg aufwiesen, wurden sie in die Studie eingeschlossen. Sie wurden in zwei Gruppen aufgeteilt, je nachdem ob sie eine LGAS mit einer LVEF  50% oder < 50% aufwiesen. Bei allen Patienten wurde in der DSE die AVAproj berechnet und sie wurden daraufhin in zwei Untergruppen aufgeteilt, Patienten mit einer AVAproj  1 cm2 wurden der Gruppe mit einer hochgradigen LGAS (TS-LGAS) und Patienten mit einer AVAproj > 1cm2 der Gruppe mit einer pseudo-hochgradigen LGAS (PS-LGAS) zugeteilt. Alle Patientendaten wurden manuell ausgewertet. Das klinische Follow Up fand frühestens ein Jahr nach der DSE statt und bestand aus einem Telefoninterview oder einer klinischen Untersuchung. Ergebnisse: Die DSE ist zur Diagnose einer TS-LGAS bei Patienten mit einer erhaltenen LVEF von großem Nutzen. Die in der TTE gemessene AVA ist ein unabhängiger Prädiktor für eine TS-LGAS bei Patienten mit erhaltener und reduzierter LVEF. Eine verringerte MAPSE und eine reduzierte TDI-s´ sprechen bei Patienten mit erhaltener LVEF für eine TS-LGAS. Bei Patienten mit reduzierter LVEF weisen ein erhöhter sPAP und eine verringerte AV Geschwindigkeits Ratio auf eine TS-LGAS hin. Bei Zweifeln können weitere bildgebende Verfahren zur Diagnosefindung hinzugezogen werden. N2 - The aim of this study was to determine whether DSE can help differentiate between TS- and PSAS. We also investigated whether there are specific echocardiographic predictors for TS- and PSAS, and whether LVEF plays a crucial role in patients with LGAS. Methods: Both TTE and DSE were performed on 130 patients with asymptomatic AS at the University Hospital Würzburg between January 2011 and December 2016. Various echocardiographic data were collected via TTE, and if the patients had an AVAi ≤ 0.6 cm²/m² and a PGmean < 40 mmHg, they were included in the study. They were divided into two groups depending on whether they had LGAS with an LVEF ≥ 50% or < 50%. In all patients, the AVAproj was calculated during the DSE, and they were then divided into two subgroups: patients with an AVAproj ≤ 1 cm² were assigned to the true-severe LGAS group (TS-LGAS), and patients with an AVAproj > 1 cm² were assigned to the pseudo-severe LGAS group (PS-LGAS). All patient data were manually evaluated. The clinical follow-up took place at least one year after the DSE and consisted of a telephone interview or a clinical examination. Results: DSE is very useful for diagnosing TS-LGAS in patients with preserved LVEF. The AVA measured in TTE is an independent predictor for TS-LGAS in patients with preserved and reduced LVEF. A decreased MAPSE and a reduced TDI-s' indicate TS-LGAS in patients with preserved LVEF. In patients with reduced LVEF, an increased sPAP and a decreased AV velocity ratio indicate TS-LGAS. Additional imaging techniques may be used for diagnosis in cases of doubt. KW - Aortenstenose KW - Dobutamin-Stress-Echokardiographie KW - true-severe aortic stenosis KW - pseudo-severe aortic stenosis Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360146 ER - TY - THES A1 - Buchta, Ulrike T1 - Hörergebnisse und Vestibularisfunktion nach transtemporaler Resektion von intrameatalen Vestibularisschwannomen mit Evaluation der postoperativen, konservativen Hörgeräteversorgung T1 - Hearing results and vestibular function after tumor removal of small vestibular schwannomas by the middle fossa approach and evaluation of the hearing rehabilitation with classical hearing devices postoperatively N2 - Das Vestibularisschwannom ist ein Tumor, dessen Entstehung noch nicht vollständig geklärt ist. Jeder kann von dieser seltenen Erkrankung betroffen sein. Darum ist es wichtig, die Ergebnisse der verschiedenen Therapieoptionen regelmäßig aufzuarbeiten und die Möglichkeiten einer Hörrehabilitation mit konventionellen oder implantierbaren Hörsystemen sowie Ansätze zur Schwindelrehabilitation oder einer möglichen Prähabilitation zu evaluieren. Mit der transtemporalen mikrochirurgischen Tumorexstirpation kann eine Heilung und bei einem großen Teil der Patienten auch ein Hörerhalt erzielt werden. Je jünger die Patienten sind, aber vor allem auch je besser sie vor der Operation hören, desto höher sind auch die Chancen auf einen Hörerhalt. Es zeigte sich jedoch auch, dass bei Patienten mit initial schlechterem Hören, welche dann operiert wurden, dieses zum Teil wieder verbessert werden konnte. Daher sind Ansätze, mehr Patienten eine transtemporale Tumorresektion anzubieten durchaus sinnvoll, auch um die Chancen auf eine Hörverbesserung zu ermöglichen. Des Weiteren sollte auch bei Patienten mit Schwindelbeschwerden eine Operation als Behandlungsoption erwogen werden. Die Prähabilitation mit Gentamicin-Injektionen in das Mittelohr scheint eine neue Möglichkeit zu sein, das zentrale Nervensystem schon auf den Ausfall des Vestibularorgans vorzubereiten. Durch die ototoxische Wirkung des Gentamicins und den potenziellen Hörverlust, wäre jedoch eine Kombination dieser Prähabilitation mit einem hörerhaltenden Eingriff über den transtemporalen Zugang risikobehaftet. Eine zentrale Kompensation der Schwindelbeschwerden sollte nach dem Eingriff mit einer gezielten Schwindelrehabilitation unterstützt werden. Während bei dieser vor allem physiotherapeutische Übungen angewandt werden, gibt es im Hinblick auf eine Hörrehabilitation schon verschiedene medizintechnische Optionen. Aktuell gibt es vor allem Studien zu den implantierbaren Hörhilfen und neue Daten zu den konservativen Möglichkeiten einer Hörrehabilitation sind eher die Ausnahme. Die Nutzung einer konservativen Hörhilfe sollte jedoch vor dem Entscheid zu einer operativen Lösung über implantierbare Systeme konsequent angewandt werden. Die in dieser Arbeit aufgezeigten positiven Momente bei der Versorgung von VS-Patienten prä- und posttherapeutisch mit herkömmlichen Hörgeräten sollten weiteren Eingang in die klinische Routine finden. N2 - The origin of the vestibular schwannoma is not fully understood yet, still anyone can be affected by it. Therefore it´s even more important to compare the different therapeutic options and evaluate the possible option of vestibular and auditory rehabilitation. The tumor removal by the middle fossa approach offers a good therapeutic option with possibility of preserving the natural hearing, especially in younger patients. Some patients even showed an improvement of hearing post-surgery. In patient suffering from vertigo surgery can be an option too. Preoperativly applicated Gentamicin Injections inside the middle ear could be an option to prepare the central nervous system for surgery, on the opposite it acts ototoxic and is not suitable for the goal of a hearing preservation during surgery. While for vestibular rehabilitation physiotherapeutic treatment can be used, there are different ways to accomplish hearing rehabilitation. On one side there are classical hearing aids which should be tried in every case, if these devices are not suiting the needs of the patient implantable hearing aids might be a better option. The results of this study showed a positive outcome for patients treated with both kinds of hearing aids pre- and postoperatively. KW - Akustikustumor KW - Vestibularisschwannom KW - Hörklassifikation KW - transtemporal Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360246 ER - TY - THES A1 - Kühnemundt, Johanna T1 - Defined microphysiologic 3D tumour models with aspects from the tumour microenvironment for the evaluation of cellular immunotherapies T1 - Definierte mikrophysiologische 3D-Tumormodelle mit Aspekten aus der Tumormikroumgebung zur Evaluierung von zellulären Immuntherapien N2 - Adoptive cellular immunotherapy with chimeric antigen receptor (CAR) T cells is highly effective in haematological malignancies. This success, however, has not been achieved in solid tumours so far. In contrast to hematologic malignancies, solid tumours include a hostile tumour microenvironment (TME), that poses additional challenges for curative effects and consistent therapeutic outcome. These challenges manifest in physical and immunological barriers that dampen efficacy of the CAR T cells. Preclinical testing of novel cellular immunotherapies is performed mainly in 2D cell culture and animal experiments. While 2D cell culture is an easy technique for efficacy analysis, animal studies reveal information about toxicity in vivo. However, 2D cell culture cannot fully reflect the complexity observed in vivo, because cells are cultured without anchorage to a matrix and only short-term periods are feasible. Animal studies provide a more complex tissue environment, but xenografts often lack human stroma and tumour inoculation occurs mostly ectopically. This emphasises the need for standardisable and scalable tumour models with incorporated TME-aspects, which enable preclinical testing with enhanced predictive value for the clinical outcome of immunotherapies. Therefore, microphysiologic 3D tumour models based on the biological SISmuc (Small Intestinal mucosa and Submucosa) matrix with preserved basement membrane were engaged and improved in this work to serve as a modular and versatile tumour model for efficacy testing of CAR T cells. In order to reflect a variety of cancer entities, TME-aspects, long-term stability and to enhance the read-out options they were further adapted to achieve scalable and standardisable defined microphysiologic 3D tumour models. In this work, novel culture modalities (semi-static, sandwich-culture) were characterised and established that led to an increased and organised tissue generation and long-term stability. Application of the SISmuc matrix was extended to sarcoma and melanoma models and serial bioluminescence intensity (BLI)-based in vivo imaging analysis was established in the microphysiologic 3D tumour models, which represents a time-efficient read-out method for quality evaluation of the models and treatment efficacy analysis, that is independent of the cell phenotype. Isolation of cancer-associated-fibroblasts (CAFs) from lung (tumour) tissue was demonstrated and CAF-implementation further led to stromal-enriched microphysiologic 3D tumour models with in vivo-comparable tissue-like architecture. Presence of CAFs was confirmed by CAF-associated markers (FAP, α-SMA, MMP-2/-9) and cytokines correlated with CAF phenotype, angiogenesis, invasion and immunomodulation. Additionally, an endothelial cell barrier was implemented for static and dynamic culture in a novel bioreactor set-up, which is of particular interest for the analysis of immune cell diapedesis. Studies in microphysiologic 3D Ewing’s sarcoma models indicated that sarcoma cells could be sensitised for GD2-targeting CAR T cells. After enhancing the scale of assessment of the microphysiologic 3D tumour models and improving them for CAR T cell testing, the tumour models were used to analyse their sensitivity towards differently designed receptor tyrosine kinase-like orphan receptor 1 (ROR1) CAR T cells and to study the effects of the incorporated TME-aspects on the CAR T cell treatment respectively. ROR1 has been described as a suitable target for several malignancies including triple negative breast cancer (TNBC), as well as lung cancer. Therefore, microphysiologic 3D TNBC and lung cancer models were established. Analysis of ROR1 CAR T cells that differed in costimulation, spacer length and targeting domain, revealed, that the microphysiologic 3D tumour models are highly sensitive and can distinguish optimal from sub-optimal CAR design. Here, higher affinity of the targeting domain induced stronger anti-tumour efficacy and anti-tumour function depended on spacer length, respectively. Long-term treatment for 14 days with ROR1 CAR T cells was demonstrated in dynamic microphysiologic 3D lung tumour models, which did not result in complete tumour cell removal, whereas direct injection of CAR T cells into TNBC and lung tumour models represented an alternative route of application in addition to administration via the medium flow, as it induced strong anti-tumour response. Influence of the incorporated TME-aspects on ROR1 CAR T cell therapy represented by CAF-incorporation and/or TGF-β supplementation was analysed. Presence of TGF-β revealed that the specific TGF-β receptor inhibitor SD-208 improves ROR1 CAR T cell function, because it effectively abrogated immunosuppressive effects of TGF-β in TNBC models. Implementation of CAFs should provide a physical and immunological barrier towards ROR1 CAR T cells, which, however, was not confirmed, as ROR1 CAR T cell function was retained in the presence of CAFs in stromal-enriched microphysiologic 3D lung tumour models. The absence of an effect of CAF enrichment on CAR T cell efficacy suggests a missing component for the development of an immunosuppressive TME, even though immunomodulatory cytokines were detected in co-culture models. Finally, improved gene-edited ROR1 CAR T cells lacking exhaustion-associated genes (PD-1, TGF-β-receptor or both) were challenged by the combination of CAF-enrichment and TGF-β in microphysiologic 3D TNBC models. Results indicated that the absence of PD-1 and TGF-β receptor leads to improved CAR T cells, that induce strong tumour cell lysis, and are protected against the hostile TME. Collectively, the microphysiologic 3D tumour models presented in this work reflect aspects of the hostile TME of solid tumours, engage BLI-based analysis and provide long-term tissue homeostasis. Therefore, they present a defined, scalable, reproducible, standardisable and exportable model for translational research with enhanced predictive value for efficacy testing and candidate selection of cellular immunotherapy, as exemplified by ROR1 CAR T cells. N2 - Die adoptive Immuntherapie mit chimären Antigenrezeptor (CAR) exprimierenden T-Zellen zeigt bei hämatologischen Krebsformen eine hohe Wirksamkeit. Bisher konnte dieser Erfolg für solide Tumore nicht erreicht werden. Im Gegensatz zu hämatologischen Krebsformen zeigen solide Tumore eine feindliche Tumormikroumgebung (TME), die zusätzliche Herausforderungen für die Erlangung kurativer Effekte und konsistenter Therapieergebnisse darstellen. Diese Herausforderungen äußern sich in physikalischen und immunologischen Barrieren, welche die Wirksamkeit der CAR-T-Zellen abschwächt. Zur präklinischen Testung neuartiger zellulärer Immuntherapien werden hauptsächlich 2D-Zellkulturen und Tierstudien durchgeführt. 2D-Zellkulturexperimente eignen sich vor allem für Wirksamkeitsanalysen, während Tierstudien Aufschluss über die Toxizität in-vivo geben können. Allerdings kann die 2D-Zellkultur die Komplexität der in-vivo Situation nicht vollständig widerspiegeln, da die Zellen ohne Verankerung an einer Matrix kultiviert werden und nur kurzfristige Zeiträume abgebildet werden können. Tierstudien bieten einen komplexeren Gewebekontext, wobei Xenografts aber oft das humane Stroma fehlt und die Tumorinokulation meist ektopisch erfolgt. Dies unterstreicht den Bedarf an standardisierbaren und skalierbaren Tumormodellen mit inkorporierten TME-Aspekten, die präklinische Testungen mit erhöhtem Vorhersagewert für den klinischen Erfolg von Immuntherapien ermöglichen. Daher wurden in dieser Arbeit mikrophysiologische 3D-Tumormodelle auf Basis der biologischen SISmuc (Small Intestinal mukosa und Submukosa)-Matrix mit erhaltener Basalmembran eingesetzt und verbessert, um als modulares und vielseitiges Tumormodell für die Wirksamkeitsprüfung von CAR T-Zellen zu dienen. Um eine Vielzahl von Krebsentitäten, TME-Aspekte und Langzeitstabilität abzubilden und um die Ausleseparamter zu verbessern, wurden die Tumormodelle weiter angepasst um skalierbare und standardisierbare definierte mikrophysiologische 3D Tumormodelle zu erhalten. In der vorliegenden Arbeit wurden neue Kulturmodalitäten (semistatische Kultur, Sandwich-Kultur) charakterisiert und etabliert, die zu einer vermehrten und erhöhten Gewebebildung sowie Langzeitstabilität der Modelle führen. Die Anwendung der SISmuc-Matrix wurde auf Sarkom- und Melanom-Modelle erweitert und in den mikrophysiologischen 3D-Tumormodellen wurde ein serielles Biolumineszenz-Intensitäts (BLI)-basiertes In-vivo-Analyse-Verfahren etabliert, welches eine zeiteffiziente Methode für die Qualitätsbewertung der Modelle sowie die Analyse der Therapiewirksamkeit darstellt, welche unabhängig vom Zell-Phänotyp ist. Die Isolation von Krebs-assoziierten Fibroblasten (CAFs) aus Lungen-(Tumor) Gewebe wurde demonstriert und die CAF-Implementierung führte des Weiteren zu stromal-angereicherten mikrophysiologischen 3D-Tumormodellen mit in-vivo vergleichbarer gewebeähnlicher Architektur. CAFs wurden mit Hilfe von CAF-assoziierten Markern (FAP, α-SMA, MMP-2/-9) und einer Zytokinanalyse in den Modellen identifiziert. Diese bestätigte ebenfalls Zytokine, welche mit Angiogenese, Invasion und Immunmodulation assoziiert sind. Zusätzlich wurde eine Endothelzellbarriere sowohl in statischer als auch in der dynamischen Kultur implementiert, wofür ein neuer Bioreaktoraufbau verwendet wurde, welcher insbesondere für die Analyse der Immunzelldiapedesis interessant ist. Studien in mikrophysiologischen 3D-Ewing-Sarkom-Modellen zeigten, dass diese für GD2-spezifische CAR-T-Zellen sensibilisiert werden können. Nach der Erweiterung des Untersuchungsumfangs der mikrophysiologischen 3D-Tumormodelle und deren Verbesserung für die CAR-T-Zell-Testung wurden die Tumormodelle verwendet, um ihre Sensitivität gegenüber unterschiedlich designten Rezeptor-Tyrosinkinase-like Orphan-Rezeptor 1 (ROR1) -spezifischen CAR-T-Zellen zu analysieren. Des Weiteren wurden die Auswirkungen der eingebauten TME-Aspekte auf die CAR-T-Therapie untersucht. ROR1 wurde als geeignetes Ziel für verschiedene maligne Erkrankungen beschrieben, darunter auch triple-negtive-breast-cancer (TNBC) und Lungenkrebs. Daher wurden mikrophysiologische 3D-TNBC- und Lungenkrebs-Modelle für die Testungen aufgebaut. Die Analyse von ROR1-CAR-T-Zellen, die sich in Kostimulation, Spacerlänge und der Ziel-Domäne unterschieden, zeigte, dass die mikrophysiologischen 3D-Tumormodelle eine hohe Sensitivität zur Unterscheidung von suboptimal und optimal designten CARs aufweisen. Dabei induzierte eine Ziel-Domäne mit höherer Affinität eine stärkere Anti-Tumor-Wirkung. Zusätzlich war die Anti-Tumor-Funktion abhängig von der Spacerlänge. In dynamischen mikrophysiologischen 3D-Lungentumormodellen wurde eine Langzeitbehandlung über 14 Tage mit ROR1-CAR-T-Zellen realisiert, die jedoch nicht zu einer vollständigen Entfernung der Tumorzellen führte. Die direkte Injektion von CAR-T-Zellen in TNBC- und Lungentumormodellen induzierte eine starke Anti-Tumorantwort und stellt somit neben der Zugabe über den Medienstrom einen alternativen Applikationsweg dar. Des Weiteren wurde der Einfluss der inkorporierten TME-Aspekte auf die ROR1 CAR T-Zelltherapie untersucht, welche sich durch CAF-Inkorporation und/oder TGF-β-Supplementierung darstellten. Die Zugabe von TGF-β zeigte, dass der spezifische TGF-β-Rezeptor-Inhibitor SD-208 die Funktion der ROR1 CAR T-Zellen verbesserte, da er die immunsuppressiven Effekte von TGF-β in TNBC-Modellen effektiv aufhob. Die Implementierung von CAFs sollte eine physikalische und immunologische Barriere gegenüber ROR1 CAR T-Zellen darstellen, was sich jedoch nicht bestätigte, da die Funktion der ROR1 CAR T-Zellen in Anwesenheit von CAFs in stromal-angereicherten mikrophysiologischen 3D-Lungentumormodellen erhalten blieb. Das Fehlen eines Effekts der CAF-Anreicherung auf die CAR T-Zell-Effektivität deutet auf eine fehlende Komponente für die Entwicklung eines immunsuppressiven TME hin, obwohl immunmodulatorische Zytokine in Co-Kultur-Modellen nachgewiesen wurden. Schließlich wurden verbesserte gen-editierte ROR1-CAR-T-Zellen, denen erschöpfungsassoziierte Gene (PD-1, TGF-β-Rezeptor oder beide) fehlten, durch die Kombination von CAF-Anreicherung und TGF-β in mikrophysiologischen 3D-TNBC-Modellen herausgefordert. Die Ergebnisse zeigten, dass ROR1 CAR T Zellen ohne PD-1 und TGF-β-Rezeptor überlegen sind, eine starke Tumorzell-Lyse induzieren und vor der feindlichen TME geschützt sind. Zusammenfassend spiegeln die in dieser Arbeit vorgestellten mikrophysiologischen 3D-Tumormodelle Aspekte der feindlichen TME solider Tumore wider, ermöglichen BLI-basierte Analysen und bieten eine langfristige Gewebehomöostase. Daher stellen sie ein definiertes, skalierbares, reproduzierbares, standardisierbares und exportierbares Modell für die translationale Forschung mit erhöhtem Vorhersagewert dar. Sie können für die Wirksamkeitsprüfung sowie Kandidatenauswahl von zellulären Immuntherapie verwendet werden, was vor allem am Beispiel der ROR1 CAR T-Zellen gezeigt wurde. KW - CAR T cell KW - immunotherapy KW - 3D tumour model KW - solid tumour KW - tumour microenvironment KW - TNBC KW - lung cancer KW - tumour stroma KW - microphysiologic 3D tumour model KW - Immuntherapie KW - Lungenkrebs KW - Stroma KW - Tumormikroumgebung Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-276674 ER - TY - JOUR A1 - Gröbner, Susanne N. A1 - Worst, Barbara C. A1 - Weischenfeldt, Joachim A1 - Buchhalter, Ivo A1 - Kleinheinz, Kortine A1 - Rudneva, Vasilisa A. A1 - Johann, Pascal D. A1 - Balasubramanian, Gnana Prakash A1 - Segura-Wang, Maia A1 - Brabetz, Sebastian A1 - Bender, Sebastian A1 - Hutter, Barbara A1 - Sturm, Dominik A1 - Pfaff, Elke A1 - Hübschmann, Daniel A1 - Zipprich, Gideon A1 - Heinold, Michael A1 - Eils, Jürgen A1 - Lawerenz, Christian A1 - Erkek, Serap A1 - Lambo, Sander A1 - Waszak, Sebastian A1 - Blattmann, Claudia A1 - Borkhardt, Arndt A1 - Kuhlen, Michaela A1 - Eggert, Angelika A1 - Fulda, Simone A1 - Gessler, Manfred A1 - Wegert, Jenny A1 - Kappler, Roland A1 - Baumhoer, Daniel A1 - Stefan, Burdach A1 - Kirschner-Schwabe, Renate A1 - Kontny, Udo A1 - Kulozik, Andreas E. A1 - Lohmann, Dietmar A1 - Hettmer, Simone A1 - Eckert, Cornelia A1 - Bielack, Stefan A1 - Nathrath, Michaela A1 - Niemeyer, Charlotte A1 - Richter, Günther H. A1 - Schulte, Johannes A1 - Siebert, Reiner A1 - Westermann, Frank A1 - Molenaar, Jan J. A1 - Vassal, Gilles A1 - Witt, Hendrik A1 - Burkhardt, Birgit A1 - Kratz, Christian P. A1 - Witt, Olaf A1 - van Tilburg, Cornelis M. A1 - Kramm, Christof M. A1 - Fleischhack, Gudrun A1 - Dirksen, Uta A1 - Rutkowski, Stefan A1 - Frühwald, Michael A1 - Hoff, Katja von A1 - Wolf, Stephan A1 - Klingebeil, Thomas A1 - Koscielniak, Ewa A1 - Landgraf, Pablo A1 - Koster, Jan A1 - Resnick, Adam C. A1 - Zhang, Jinghui A1 - Liu, Yanling A1 - Zhou, Xin A1 - Waanders, Angela J. A1 - Zwijnenburg, Danny A. A1 - Raman, Pichai A1 - Brors, Benedikt A1 - Weber, Ursula D. A1 - Northcott, Paul A. A1 - Pajtler, Kristian W. A1 - Kool, Marcel A1 - Piro, Rosario M. A1 - Korbel, Jan O. A1 - Schlesner, Matthias A1 - Eils, Roland A1 - Jones, David T. W. A1 - Lichter, Peter A1 - Chavez, Lukas A1 - Zapatka, Marc A1 - Pfister, Stefan M. T1 - The landscape of genomic alterations across childhood cancers JF - Nature N2 - Pan-cancer analyses that examine commonalities and differences among various cancer types have emerged as a powerful way to obtain novel insights into cancer biology. Here we present a comprehensive analysis of genetic alterations in a pan-cancer cohort including 961 tumours from children, adolescents, and young adults, comprising 24 distinct molecular types of cancer. Using a standardized workflow, we identified marked differences in terms of mutation frequency and significantly mutated genes in comparison to previously analysed adult cancers. Genetic alterations in 149 putative cancer driver genes separate the tumours into two classes: small mutation and structural/copy-number variant (correlating with germline variants). Structural variants, hyperdiploidy, and chromothripsis are linked to TP53 mutation status and mutational signatures. Our data suggest that 7–8% of the children in this cohort carry an unambiguous predisposing germline variant and that nearly 50% of paediatric neoplasms harbour a potentially druggable event, which is highly relevant for the design of future clinical trials. KW - cancer genomics KW - oncogenesis KW - paediatric cancer KW - predictive markers KW - translational research Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-229579 VL - 555 ER - TY - JOUR A1 - Harnoš, Jakub A1 - Cañizal, Maria Consuelo Alonso A1 - Jurásek, Miroslav A1 - Kumar, Jitender A1 - Holler, Cornelia A1 - Schambony, Alexandra A1 - Hanáková, Kateřina A1 - Bernatík, Ondřej A1 - Zdráhal, Zbynêk A1 - Gömöryová, Kristína A1 - Gybeľ, Tomáš A1 - Radaszkiewicz, Tomasz Witold A1 - Kravec, Marek A1 - Trantírek, Lukáš A1 - Ryneš, Jan A1 - Dave, Zankruti A1 - Fernández-Llamazares, Ana Iris A1 - Vácha, Robert A1 - Tripsianes, Konstantinos A1 - Hoffmann, Carsten A1 - Bryja, Vítězslav T1 - Dishevelled-3 conformation dynamics analyzed by FRET-based biosensors reveals a key role of casein kinase 1 JF - Nature Communications N2 - Dishevelled (DVL) is the key component of the Wnt signaling pathway. Currently, DVL conformational dynamics under native conditions is unknown. To overcome this limitation, we develop the Fluorescein Arsenical Hairpin Binder- (FlAsH-) based FRET in vivo approach to study DVL conformation in living cells. Using this single-cell FRET approach, we demonstrate that (i) Wnt ligands induce open DVL conformation, (ii) DVL variants that are predominantly open, show more even subcellular localization and more efficient membrane recruitment by Frizzled (FZD) and (iii) Casein kinase 1 ɛ (CK1ɛ) has a key regulatory function in DVL conformational dynamics. In silico modeling and in vitro biophysical methods explain how CK1ɛ-specific phosphorylation events control DVL conformations via modulation of the PDZ domain and its interaction with DVL C-terminus. In summary, our study describes an experimental tool for DVL conformational sampling in living cells and elucidates the essential regulatory role of CK1ɛ in DVL conformational dynamics. KW - biological techniques KW - cell signalling KW - phosphorylation Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227837 VL - 10 ER - TY - JOUR A1 - Gottschalk, Michael G. A1 - Richter, Jan A1 - Ziegler, Christiane A1 - Schiele, Miriam A. A1 - Mann, Julia A1 - Geiger, Maximilian J. A1 - Schartner, Christoph A1 - Homola, György A. A1 - Alpers, Georg W. A1 - Büchel, Christian A1 - Fehm, Lydia A1 - Fydrich, Thomas A1 - Gerlach, Alexander L. A1 - Gloster, Andrew T. A1 - Helbig-Lang, Sylvia A1 - Kalisch, Raffael A1 - Kircher, Tilo A1 - Lang, Thomas A1 - Lonsdorf, Tina B. A1 - Pané-Farré, Christiane A. A1 - Ströhle, Andreas A1 - Weber, Heike A1 - Zwanzger, Peter A1 - Arolt, Volker A1 - Romanos, Marcel A1 - Wittchen, Hans-Ulrich A1 - Hamm, Alfons A1 - Pauli, Paul A1 - Reif, Andreas A1 - Deckert, Jürgen A1 - Neufang, Susanne A1 - Höfler, Michael A1 - Domschke, Katharina T1 - Orexin in the anxiety spectrum: association of a HCRTR1 polymorphism with panic disorder/agoraphobia, CBT treatment response and fear-related intermediate phenotypes JF - Translational Psychiatry N2 - Preclinical studies point to a pivotal role of the orexin 1 (OX1) receptor in arousal and fear learning and therefore suggest the HCRTR1 gene as a prime candidate in panic disorder (PD) with/without agoraphobia (AG), PD/AG treatment response, and PD/AG-related intermediate phenotypes. Here, a multilevel approach was applied to test the non-synonymous HCRTR1 C/T Ile408Val gene variant (rs2271933) for association with PD/AG in two independent case-control samples (total n = 613 cases, 1839 healthy subjects), as an outcome predictor of a six-weeks exposure-based cognitive behavioral therapy (CBT) in PD/AG patients (n = 189), as well as with respect to agoraphobic cognitions (ACQ) (n = 483 patients, n = 2382 healthy subjects), fMRI alerting network activation in healthy subjects (n = 94), and a behavioral avoidance task in PD/AG pre- and post-CBT (n = 271). The HCRTR1 rs2271933 T allele was associated with PD/AG in both samples independently, and in their meta-analysis (p = 4.2 × 10−7), particularly in the female subsample (p = 9.8 × 10−9). T allele carriers displayed a significantly poorer CBT outcome (e.g., Hamilton anxiety rating scale: p = 7.5 × 10−4). The T allele count was linked to higher ACQ sores in PD/AG and healthy subjects, decreased inferior frontal gyrus and increased locus coeruleus activation in the alerting network. Finally, the T allele count was associated with increased pre-CBT exposure avoidance and autonomic arousal as well as decreased post-CBT improvement. In sum, the present results provide converging evidence for an involvement of HCRTR1 gene variation in the etiology of PD/AG and PD/AG-related traits as well as treatment response to CBT, supporting future therapeutic approaches targeting the orexin-related arousal system. KW - human behaviour KW - molecular neuroscience KW - personalized medicine KW - predictive markers KW - psychiatric disorders Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227479 VL - 9 ER - TY - JOUR A1 - Giampaolo, Sabrina A1 - Wójcik, Gabriela A1 - Klein-Hessling, Stefan A1 - Serfling, Edgar A1 - Patra, Amiya K. T1 - B cell development is critically dependent on NFATc1 activity JF - Cellular & Molecular Immunology N2 - B cell development in bone marrow is a precisely regulated complex process. Through successive stages of differentiation, which are regulated by a multitude of signaling pathways and an array of lineage-specific transcription factors, the common lymphoid progenitors ultimately give rise to mature B cells. Similar to early thymocyte development in the thymus, early B cell development in bone marrow is critically dependent on IL-7 signaling. During this IL-7-dependent stage of differentiation, several transcription factors, such as E2A, EBF1, and Pax5, among others, play indispensable roles in B lineage specification and maintenance. Although recent studies have implicated several other transcription factors in B cell development, the role of NFATc1 in early B cell developmental stages is not known. Here, using multiple gene-manipulated mouse models and applying various experimental methods, we show that NFATc1 activity is vital for early B cell differentiation. Lack of NFATc1 activity in pro-B cells suppresses EBF1 expression, impairs immunoglobulin gene rearrangement, and thereby preBCR formation, resulting in defective B cell development. Overall, deficiency in NFATc1 activity arrested the pro-B cell transition to the pre-B cell stage, leading to severe B cell lymphopenia. Our findings suggest that, along with other transcription factors, NFATc1 is a critical component of the signaling mechanism that facilitates early B cell differentiation. KW - differentiation KW - EBF1 KW - NFATc1 KW - pro-B KW - pre-B Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-233006 VL - 16 ER - TY - JOUR A1 - Schwab, Andrea A1 - Meeuwsen, Annick A1 - Ehlicke, Franziska A1 - Hansmann, Jan A1 - Mulder, Lars A1 - Smits, Anthal A1 - Walles, Heike A1 - Kock, Linda T1 - Ex vivo culture platform for assessment of cartilage repair treatment strategies JF - ALTEX - Alternatives to animal experimentation N2 - There is a great need for valuable ex vivo models that allow for assessment of cartilage repair strategies to reduce the high number of animal experiments. In this paper we present three studies with our novel ex vivo osteochondral culture platform. It consists of two separated media compartments for cartilage and bone, which better represents the in vivo situation and enables supply of factors pecific to the different needs of bone and cartilage. We investigated whether separation of the cartilage and bone compartments and/or culture media results in the maintenance of viability, structural and functional properties of cartilage tissue. Next, we valuated for how long we can preserve cartilage matrix stability of osteochondral explants during long-term culture over 84 days. Finally, we determined the optimal defect size that does not show spontaneous self-healing in this culture system. It was demonstrated that separated compartments for cartilage and bone in combination with tissue-specific medium allow for long-term culture of osteochondral explants while maintaining cartilage viability, atrix tissue content, structure and mechanical properties for at least 56 days. Furthermore, we could create critical size cartilage defects of different sizes in the model. The osteochondral model represents a valuable preclinical ex vivo tool for studying clinically relevant cartilage therapies, such as cartilage biomaterials, for their regenerative potential, for evaluation of drug and cell therapies, or to study mechanisms of cartilage regeneration. It will undoubtedly reduce the number of animals needed for in vivotesting. KW - ex vivo model KW - osteochondral biopsy KW - cartilage repair KW - critical size defect KW - replacement Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-181665 VL - 34 IS - 2 ER - TY - THES A1 - Bröhl, Kathleen T1 - „Lanfranks ‚Chirurgia parva‘ in der Abschrift Konrad Schrecks von Aschaffenburg“ als Quelle zur spätmittelalterlich-frühneuzeitlichen Traumatologie T1 - "Lanfrank's 'Chirurgia parva' in the transcript by Konrad Schreck of Aschaffenburg" as a source on late medieval-early modern traumatology N2 - Ziel der vorliegenden Arbeit ist es, „Lanfranks ‚Chirurgia parva‘ in der Abschrift Konrad Schrecks von Aschaffenburg“1 anhand der von Ralf Vollmuth in seiner Habilitationsschrift „Traumatologie und Feldchirurgie an der Wende vom Mittelalter zur Neuzeit“ erarbeiteten Strukturvorgabe inhaltlich zu erschließen. Durch die Aufarbeitung verschiedener chirurgischer Fachbücher und Manuale unter Verwendung einer gemeinsamen Strukturvorlage soll ermöglicht werden, medizinhistorische Quellen kritisch-kontrastiv zu vergleichen. Das bedeutet, dass die Quellen zuerst ediert und anschließend gegebenenfalls übersetzt werden müssen. Im nächsten Schritt werden die verwendeten Arzneimittel – pflanzlicher, tierischer, mineralischer Herkunft – identifiziert und bestimmt. Im Anschluss werden Monographien mit den bestimmenden Inhaltsstoffen und Eigenschaften erstellt. Anhand dieser Pflanzen- und Arzneistoffmonographien, die im Sinne einer Datenbank aufeinander aufbauen, sollte es dann möglich sein, unter modernen pharmakologischen Gesichtspunkten die Wirksamkeit der verwendeten Arzneimittel zu erschließen. Eine ausreichende Zahl von Quellen, die nach einer gemeinsamen Strukturvorlage bearbeitet wurden, kann es schließlich ermöglichen, zu beurteilen, welche der beschriebenen Anwendungen repräsentativ waren, welche Außenseiterstellung einnahmen oder nur theoretische Ansätze bildeten, die praktisch keine Verwendung fanden. N2 - The aim of this dissertation is to analyse the content of "Lanfrank's 'Chirurgia parva' in the transcript by Konrad Schreck of Aschaffenburg " using the structural template developed by Ralf Vollmuth in his habilitation thesis "Traumatologie und Feldchirurgie an der Wende vom Mittelalter zur Neuzeit". By analysing various surgical textbooks and manuals using a common structural template, it should be possible to compare medical-historical sources critically and contrastively. This means that the sources must first be edited and then, if necessary, translated. In the next step, the medicines used - of plant, animal and mineral origin - are identified and determined. Monographs with the determining ingredients and properties are then compiled. On the basis of these plant and drug monographs, which build on each other in the sense of a database, it should then be possible to determine the efficacy of the drugs used from a modern pharmacological point of view. A sufficient number of sources, which have been processed according to a common structural template, can ultimately make it possible to assess which of the applications described were representative, which were outsiders or which were only theoretical approaches that were not used in practice. KW - Konrad Schreck von Aschaffenburg KW - Lanfrancus, Mediolanensis KW - Traumatologie KW - Spätmittelalter KW - Schreck, Konrad KW - Lanfrank, von Mailand Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359227 ER - TY - THES A1 - Kellner [geb. Friedel], Theresa T1 - Suizid durch Selbstverbrennung im Freien - Eine bildmorphologische Analyse der Intensität und Verteilung von Verbrennungen im Zusammenhang mit der Körperposition während des Brandgeschehens T1 - Suicide by self-immolation in the open air - A photo-based analysis of the intensity and distribution of burns in relation to body position during the burn event N2 - Ziel dieser Dissertation ist es, etwaige Gemeinsamkeiten und Unterschiede hinsichtlich der Distribution und Intensität von Brandverletzungen bei suizidaler Selbstverbrennung im Freien in Abhängigkeit von der jeweiligen Körperposition zum Auffindezeitpunkt anhand der Aktenlage herauszuarbeiten. Das Studienkollektiv umfasst 38 Fälle aus 9 deutschen rechtsmedizinischen Instituten, darunter 13 (34,2 %) weibliche und 25 (65,8 %) männliche Suizidenten/-innen im Alter von 18 – 77 Jahren. Neben einer deskriptiven visuellen Analyse erfolgt die Auswertung der Verteilung der Verbrennungen mittels der Software BurnCase 3D, die es ermöglicht, eine Sortierung der einzelnen Körperbereiche nach deren durchschnittlicher Verbrennungsintensität innerhalb verschiedener Cluster für die unterschiedlichen Auffindepositionen am Tatort (Rückenlage, Bauchlage, Seitenlage, Aufrecht, Sitzend) vorzunehmen. Am ehesten auf das in aufrechter Haltung beginnende Brandgeschehen zurückzuführen ist eine clusterübergreifend auftretende, intensive und nach kranial an Intensität abnehmende Verbrennung des Halses sowie der lateralen und perioralen Kopfbereiche. Geringe Verbrennungsfolgen weisen die distalen unteren Extremitäten sowie die Auflageflächen des Körpers auf dem Untergrund auf. Es zeigt sich eine Beeinflussung der lokalen Verbrennungstiefe durch ein hohes Fettgewebevorkommen. Ebenfalls clusterübergreifend können verstärkte Brandwirkungen an den Oberschenkelinnenseiten festgestellt werden. In Rücken- und Bauchlage liegt zudem eine höhere Verbrennungsintensität an den Flanken, den Arminnenseiten und im Unterbauchbereich vor. Bei in Seitenlage verbrannten Körpern ergeben sich Hinweise darauf, dass die nach oben gerichtete Körperseite vermehrt Verbrennungen aufweist. In aufrechter und sitzender Position konzentriert sich der Brandfokus überwiegend auf Torso, Hals und Kopf. Zusätzlich wurde eine Betrachtung des Entstehungsmusters kutaner Hitzerisse durchgeführt. Hier ergaben sich Übereinstimmungen u.a. mit dem Verlauf der Hautfaltlinien nach Pinkus. Ein Körperschema mit Abbildung der beobachteten Orientierungen der Risse wurde angefertigt. Die wichtigsten Limitationen ergeben sich aus einer geringen Fallzahl, einer fotografischen Dokumentation, die nicht alle Körperbereiche in ausreichender Qualität und Detailliertheit abdeckt, sowie dem subjektiven Bias hinsichtlich der Bewertung der Verbrennungsintensitäten. N2 - The aim of this dissertation is to identify any similarities and differences with regard to the distribution and intensity of burn injuries in suicidal self-immolation in the open air depending on the respective body position at the time of discovery on the basis of the records. The study collective comprises 38 cases from 9 German forensic medical institutes, including 13 (34.2 %) female and 25 (65.8 %) male suicides aged between 18 and 77 years. In addition to a descriptive visual analysis, the distribution of burns was evaluated using the BurnCase 3D software, which enables the individual body areas to be sorted according to their average burn intensity within different clusters for the different positions at the crime scene (supine, prone, lateral, upright, sitting). Burns to the neck and the lateral and perioral areas of the head are most likely to be due to the burns beginning in the upright position and occurring across all clusters. The distal lower extremities and the areas where the body rests on the ground show minor burn effects. The local burn depth is influenced by a high occurrence of fatty tissue. Increased burn effects on the inner thighs can also be observed across all clusters. In the supine and prone positions, there is also a higher intensity of burns on the flanks, inner sides of the arms and in the lower abdomen. In the case of bodies burned in the lateral position, there are indications that the upward-facing side of the body shows increased burns. In the upright and sitting position, the focus of the burn is predominantly on the torso, neck and head. In addition, the development pattern of cutaneous heat lacerations was examined. This revealed similarities with the course of the skin fold lines according to Pinkus, among others. A body diagram showing the observed orientations of the lacerations was drawn up. The most important limitations result from a small number of cases, photographic documentation that does not cover all areas of the body in sufficient quality and detail, and the subjective bias with regard to the assessment of burn intensities. KW - Selbstverbrennung KW - Hitzerisse KW - Suizid KW - Verbrennung Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359193 ER - TY - THES A1 - Landmesser, Patricia Sophia T1 - Seroprävalenz von SARS-CoV-2 Antikörpern bei Medizinstudierenden im zweiten klinischen Semester von Juli 2020 bis Juni 2021 T1 - Seroprevalence of SARS-CoV-2 antibodies in medical students in the second clinical semester from July 2020 to June 2021 N2 - Im sechsten Semester des Medizinstudiums an der Julius-Maximilians-Universität Würzburg findet das verpflichtende Praktikum „Impfkurs“ statt. Im Rahmen dieses Kurses wurde vom Sommersemester 2020 bis zum Sommersemester 2021 ein standardisierter online Fragebogen erhoben, der unter anderem demographische Daten sowie Expositionsmöglichkeiten gegenüber SARS-CoV-2 im privaten, beruflichen und universitären Umfeld erfragte. Zusätzlich wurde im gleichen Zeitraum der SARS-CoV-2 Serostatus der Medizinstudierenden erhoben und ausgewertet und dieser mit den Daten des Fragebogens zusammengeführt. Dafür wurden Blutproben entnommen, welche im Labor des Instituts für Virologie der Universität Würzburg mittels Western Blot auf IgG/IgM/IgA Antikörper gegen SARS-CoV-2 untersucht wurden. N2 - In the sixth semester of medical studies at the Julius-Maximilians-Universität Würzburg, the compulsory internship “vaccination course” takes place. As part of this course, a standardized online questionnaire was collected from the summer semester 2020 to the summer semester 2021, which, among other things, collected demographic data and exposure to SARS-CoV-2 in the private, professional and university environment. In addition, the SARS-CoV-2 serostatus of the medical students was collected and evaluated during the same period and merged with the data from the questionnaire. For this purpose, blood samples were taken, which were tested for IgG/IgM/IgA antibodies against SARS-CoV-2 by Western blot. KW - SARS-CoV-2 KW - Medizinstudent Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359246 ER - TY - THES A1 - Adam, Pia Sophie T1 - Expression von PD-L1 und FGFR1-4 beim anaplastischen und gering differenzierten Schilddrüsenkarzinom - Evaluation als präklinische diagnostische Marker T1 - FGF-Receptors and PD-L1 in Anaplastic and Poorly Differentiated Thyroid Cancer: Evaluation of the Preclinical Rationale N2 - Background: Treatment options for poorly differentiated (PDTC) and anaplastic (ATC) thyroid carcinoma are unsatisfactory and prognosis is generally poor. Lenvatinib (LEN), a multi-tyrosine kinase inhibitor targeting fibroblast growth factor receptors (FGFR) 1-4 is approved for advanced radioiodine refractory thyroid carcinoma, but response to single agent is poor in ATC. Recent reports of combining LEN with PD-1 inhibitor pembrolizumab (PEM) are promising. Materials and methods: Primary ATC (n=93) and PDTC (n=47) tissue samples diagnosed 1997-2019 at five German tertiary care centers were assessed for PD-L1 expression by immunohistochemistry using Tumor Proportion Score (TPS). FGFR 1-4 mRNA was quantified in 31 ATC and 14 PDTC with RNAscope in-situ hybridization. Normal thyroid tissue (NT) and papillary thyroid carcinoma (PTC) served as controls. Disease specific survival (DSS) was the primary outcome variable. Results: PD-L1 TPS≥50% was observed in 42% of ATC and 26% of PDTC specimens. Mean PD-L1 expression was significantly higher in ATC (TPS 30%) than in PDTC (5%; p<0.01) and NT (0%, p<0.001). 53% of PDTC samples had PD-L1 expression ≤5%. FGFR mRNA expression was generally low in all samples but combined FGFR1-4 expression was significantly higher in PDTC and ATC compared to NT (each p<0.001). No impact of PD-L1 and FGFR 1-4 expression was observed on DSS. Conclusion: High tumoral expression of PD-L1 in a large proportion of ATCs and a subgroup of PDTCs provides a rationale for immune checkpoint inhibition. FGFR expression is low thyroid tumor cells. The clinically observed synergism of PEM with LEN may be caused by immune modulation. N2 - Hintergrund: Die therapeutischen Optionen für das gering differenzierte (PDTC) und anaplastische (ATC) Schilddrüsenkarzinom sind limitiert, weshalb diese Erkrankungen überwiegend mit einer schlechten Prognose einhergehen. Lenvatinib (LEN) ist ein Multityrosinkinase-Inhibitor, der unter anderem die Fibroblasten-Wachstumsfaktor-Rezeptoren (FGFR) 1-4 inhibiert und zur Therapie des fortgeschrittenen radiojodrefraktären Schilddrüsenkarzinoms zugelassen ist. Es zeigt sich nur ein geringes Ansprechen auf die Monotherapie bei ATCs, wobei neuere Studien eine therapeutische Überlegenheit der Kombination aus LEN und dem PD-1-Inhibitor Pembrolizumab (PEM) beschreiben. Material und Methoden: Die Expression von PD-L1 wurde in ATC (n=93)- und PDTC (n=47)-Primärtumorgewebe von 1997-2019 aus fünf deutschen (Universitäts-)Kliniken mittels Immunhistochemie analysiert und mit dem Tumor Proportion Score (TPS) quantifiziert. Der Nachweis von FGFR1-4-mRNA wurde bei 31 ATC- und 14 PDTC-Gewebeproben mittels RNAscope In-situ-Hybridisierung quantifiziert. Als Kontrollgruppe wurde normales Schilddrüsengewebe (NT) und Gewebe von papillären Schilddrüsenkarzinomen (PTC) verwendet. Der primäre Endpunkt war das krankheitsspezifische Überleben (DSS). Ergebnisse: Eine PD-L1-Expression mit einem TPS ≥50% konnte in 42% der ATC- und in 26% der PDTC-Proben nachgewiesen werden. Die mediane PD-L1-Expression war in ATC-(TPS 30%) signifikant höher im Vergleich zu PDTC-Proben (5%; p<0,01) und NT (0%; p<0,001). 53% der PDTC-Proben zeigten eine PD-L1-Expression ≤5%. Die Expression von FGFR-mRNA war in allen Proben sehr gering, wobei die kombinierte FGFR1-4-Expression in PDTC- und ATC-Gewebe im Vergleich zu normalem Schilddrüsengewebe signifikant höher war (jeweils p<0,001). Es ergab sich keine Assoziation zwischen der PD-L1- und FGFR1-4-Expression mit dem krankheitsspezifischen Überleben. Schlussfolgerung: Eine hohe PD-L1-Expression in einem großen Anteil der ATCs und einem Viertel der PDTCs, könnte auf eine Rationale zur Therapieentscheidung für Immuncheckpoint-Inhibioren hinweisen. Die FGFR-Expression war in allen Schilddrüsenkarzinomen sehr gering. Der klinisch beobachtete Synergismus von PEM und LEN könnte durch immunmodulatorische Effekte hervorgerufen werden. KW - Schilddrüsenkrebs KW - Immun-Checkpoint KW - FGFR KW - PD-L1 KW - Immuncheckpointinhibitor KW - Tyrosinkinaseinhibitor KW - Anaplastisches Schilddrüsenkarzinom KW - Gering differenziertes Schilddrüsenkarzinom KW - Protein-Tyrosin-Kinasen KW - Immuntherapie KW - Tyrosinkinase Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359391 ER - TY - THES A1 - Yu, Yanying T1 - Applied machine learning for the analysis of CRISPR-Cas systems T1 - Angewandtes maschinelles Lernen für die Analyse von CRISPR-Cas-Systemen N2 - Among the defense strategies developed in microbes over millions of years, the innate adaptive CRISPR-Cas immune systems have spread across most of bacteria and archaea. The flexibility, simplicity, and specificity of CRISPR-Cas systems have laid the foundation for CRISPR-based genetic tools. Yet, the efficient administration of CRISPR-based tools demands rational designs to maximize the on-target efficiency and off-target specificity. Specifically, the selection of guide RNAs (gRNAs), which play a crucial role in the target recognition of CRISPR-Cas systems, is non-trivial. Despite the fact that the emerging machine learning techniques provide a solution to aid in gRNA design with prediction algorithms, design rules for many CRISPR-Cas systems are ill-defined, hindering their broader applications. CRISPR interference (CRISPRi), an alternative gene silencing technique using a catalytically dead Cas protein to interfere with transcription, is a leading technique in bacteria for functional interrogation, pathway manipulation, and genome-wide screens. Although the application is promising, it also is hindered by under-investigated design rules. Therefore, in this work, I develop a state-of-art predictive machine learning model for guide silencing efficiency in bacteria leveraging the advantages of feature engineering, data integration, interpretable AI, and automated machine learning. I first systematically investigate the influential factors that attribute to the extent of depletion in multiple CRISPRi genome-wide essentiality screens in Escherichia coli and demonstrate the surprising dominant contribution of gene-specific effects, such as gene expression level. These observations allowed me to segregate the confounding gene-specific effects using a mixed-effect random forest (MERF) model to provide a better estimate of guide efficiency, together with the improvement led by integrating multiple screens. The MERF model outperformed existing tools in an independent high-throughput saturating screen. I next interpret the predictive model to extract the design rules for robust gene silencing, such as the preference for cytosine and disfavoring for guanine and thymine within and around the protospacer adjacent motif (PAM) sequence. I further incorporated the MERF model in a web-based tool that is freely accessible at www.ciao.helmholtz-hiri.de. When comparing the MERF model with existing tools, the performance of the alternative gRNA design tool optimized for CRISPRi in eukaryotes when applied to bacteria was far from satisfying, questioning the robustness of prediction algorithms across organisms. In addition, the CRISPR-Cas systems exhibit diverse mechanisms albeit with some similarities. The captured predictive patterns from one dataset thereby are at risk of poor generalization when applied across organisms and CRISPR-Cas techniques. To fill the gap, the machine learning approach I present here for CRISPRi could serve as a blueprint for the effective development of prediction algorithms for specific organisms or CRISPR-Cas systems of interest. The explicit workflow includes three principle steps: 1) accommodating the feature set for the CRISPR-Cas system or technique; 2) optimizing a machine learning model using automated machine learning; 3) explaining the model using interpretable AI. To illustrate the applicability of the workflow and diversity of results when applied across different bacteria and CRISPR-Cas systems, I have applied this workflow to analyze three distinct CRISPR-Cas genome-wide screens. From the CRISPR base editor essentiality screen in E. coli, I have determined the PAM preference and sequence context in the editing window for efficient editing, such as A at the 2nd position of PAM, A/TT/TG downstream of PAM, and TC at the 4th to 5th position of gRNAs. From the CRISPR-Cas13a screen in E. coli, in addition to the strong correlation with the guide depletion, the target expression level is the strongest predictor in the model, supporting it as a main determinant of the activation of Cas13-induced immunity and better characterizing the CRISPR-Cas13 system. From the CRISPR-Cas12a screen in Klebsiella pneumoniae, I have extracted the design rules for robust antimicrobial activity across K. pneumoniae strains and provided a predictive algorithm for gRNA design, facilitating CRISPR-Cas12a as an alternative technique to tackle antibiotic resistance. Overall, this thesis presents an accurate prediction algorithm for CRISPRi guide efficiency in bacteria, providing insights into the determinants of efficient silencing and guide designs. The systematic exploration has led to a robust machine learning approach for effective model development in other bacteria and CRISPR-Cas systems. Applying the approach in the analysis of independent CRISPR-Cas screens not only sheds light on the design rules but also the mechanisms of the CRISPR-Cas systems. Together, I demonstrate that applied machine learning paves the way to a deeper understanding and a broader application of CRISPR-Cas systems. N2 - Unter den Verteidigungsstrategien, welche sich über Millionen von Jahren in Mikroben entwickelt haben, hat sich das angeborene adaptive CRISPR-Cas Immunsystem in vielen Bakterien und den meisten Archaeen verbreitet. Flexibilität, Einfachheit und Spezifizität von CRISPR-Cas Systemen bilden die Grundlage für CRISPR-basierten genetischen Werkzeugen. Dennoch verlangt die effiziente Anwendung CRISPR-basierter genetischer Werkzeuge ein rationales Design, um die Effektivität zu maximieren und Spezifizität zu gewährleisten. Speziell die Auswahl an Leit-RNAs, oder auch „guide“ RNAs (gRNAs), welche eine essentielle Rolle in der Ziel-Erkennung des CRISPR-Cas Systems spielen, ist nicht trivial. Trotz aufkommender Techniken des maschinellen Lernens, die mit Hilfe von Vorhersage-Algorithmen eine Unterstützung im gRNA-Design darstellen, sind die Design-Regeln für viele CRISPR-Cas Systeme schlecht definiert und die breite Anwendung dadurch bisher gehindert. CRISPR Interferenz (CRISPRi), eine Methode der Genrepression, nutzt ein katalytisch inaktives Cas-Protein, um die Gen-Transkription zu verhindern und ist eine führende Technik für Gen-Funktionsstudien, der Manipulation von Stoffwechselwegen und genomweiter Screens in Bakterien. Auch wenn viele der Anwendungen vielversprechend sind, ist die Umsetzung aufgrund der wenig untersuchten Design-Regeln schwierig. Daher entwickele ich in dieser Arbeit ein hochmodernes auf maschinellem Lernen basierendes Modell für die Vorhersage der gRNA Genrepressions-Effizienz in Bakterien, wobei die Merkmalskonstruktion, Datenintegration, interpretierbare künstliche Intelligenz (KI) und automatisiertes maschinelles Lernen genutzt wurden. Zuerst untersuche ich systematisch die Einflussfaktoren, welche zum Ausmaß der Depletion in genomweiten CRISPRi-Screens zur Gen-Essentialität in Escherichia coli beitragen und demonstriere den überraschend dominanten Beitrag genspezifischer Effekte, wie z. B. dem Genexpressionslevel. Diese Beobachtungen erlaubten mir die genspezifischen Störvariablen mit einem sogenannten mixed-effect random forest (MERF) Modell zu segregieren, um eine bessere Einschätzung der gRNA Effizienz zu erreichen und durch die Integration zusätzlicher Screen-Daten noch weiter zu verbessern. Das MERF Modell übertraf dabei bereits existierende Werkzeuge in einem unabhängigen Hochdurchsatz Sättigungs-Screen. Als nächstes interpretiere ich die Modell Vorhersage, um Design-Regeln für eine solide Genrepression zu extrahieren, wie z. B. eine Präferenz für Cytosin und eine Abneigung gegenüber Guanin und Thymin innerhalb und der „protospacer adjacent motif“ (PAM) direkt umgebenden Sequenz. Weiterhin integrierte ich das MERF Modell in einem Web-basierten Werkzeug, welches unter www.ciao.helmholtz-hiri.de frei zugänglich ist. Ein Vergleich von existierenden Werkzeugen mit dem MERF Modell zeigt, dass alternative, für CRISPRi in Eukaryoten optimierte, gRNA Design-Werkzeuge schlecht abschneiden, sobald sie in Bakterien angewandt werden. Dies lässt Zweifel an einer robusten Übertragbarkeit dieser Vorhersage-Algorithmen zwischen verschiedenen Organismen. Zusätzlich haben CRISPR-Cas Systeme, trotz einiger genereller Gemeinsamkeiten, höchst diverse Wirkungsmechanismen. Die Vorhersagemuster eines Datensets sind daher schlecht generalisierbar, sobald sie auf andere Organismen oder CRISPR-Cas Techniken angewandt werden. Diese Lücke kann mit dem hier präsentierten Ansatz des maschinellen Lernens für CRISPRi geschlossen werden und als eine Vorlage für die Entwicklung effektiver Vorhersage-Algorithmen für spezifische Organismen oder CRISPR-Cas Systeme dienen. Der explizite Arbeitsablauf beinhaltet drei Hauptschritte: 1) Aufnehmen des Merkmalsets des jeweiligen CRISPR-Cas Systems bzw. der CRISPR-Cas Technik; 2) Optimierung des maschinellen Lernen Modells durch automatisiertes maschinelles Lernen; 3) Erklärung des Modells mit interpretierbarer KI. Um die Anwendbarkeit des Arbeitsablaufs und die Diversität der Ergebnisse, im Zusammenhang mit unterschiedlichen Organismen und CRISPR-Cas Systemen, zu demonstrieren, habe ich diese Arbeitsschritte zur Analyse drei unterschiedlicher genomweiter Screens angewandt. Von dem CRISPR „base editor“ Essentialitäts-Screen in E. coli, konnten die PAM Präferenzen und der Sequenzkontext innerhalb des Editierungsfensters für eine effiziente Editierung abgeleitet werden. Beispielsweise tragen ein A an der zweiten PAM Position, ein A/TT/TG an der PAM direkt nachgeschalten Position und ein TC an der vierten oder fünften gRNA Position zur effizienten Editierung bei. Im CRISPR-Cas13a Screen in E. coli, stellten wir eine starke Korrelation zwischen dem Genexpressionslevel und der gRNA-Depletion fest. Zusätzlich ist das Expressionslevel des Ziel-Gens der stärkste Vorhersagefaktor des Modells, was das Expressionslevel als Hauptdeterminante für die Cas13-induzierte Immunität hervorhebt und die bessere Charakterisierung von CRISPR-Cas13 Systemen ermöglicht. Aus dem CRISPR-Cas12a Screen in Klebsiella pneumoniae, habe ich gRNA Design Regeln für die robuste antimikrobielle Aktivität über unterschiedliche K. pneumoniae Stämme hinweg extrahiert und einen Vorhersage-Algorithmus für das gRNA Design bereitgestellt. Dies ermöglicht die Nutzung von Cas12a als eine alternative Lösung, um Antibiotikaresistenzen zu bekämpfen. Zusammengefasst präsentiert diese Thesis einen akkuraten Vorhersage-Algorithmus für die CRISPRi gRNA Effizienz in Bakterien und gibt Einblicke in die Determinanten für eine effiziente Genrepression und optimales gRNA Design. Die systematische Exploration führte zu einem robusten Ansatz des maschinellen Lernens für effektive Modell Entwicklungen in unterschiedlichen bakteriellen Spezies und CRISPR-Cas Systemen. Durch die Anwendung dieses Ansatzes auf unabhängige CRISPR-Cas Screens, konnte ich nicht nur wichtige Design Regeln ableiten, sondern auch die Mechanismen der jeweiligen CRISPR-Cas Systeme besser erleuchten. Zu guter Letzt demonstriere ich hier, dass angewandtes maschinelles Lernen den Weg zu einem tieferen Verständnis und einer breiteren Anwendung von CRISPR-Cas Systemen ebnen kann. KW - Maschinelles Lernen KW - CRISPR/Cas-Methode KW - Bakterien KW - machine learning KW - CRISPR-Cas KW - guide effiiciency Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-320219 ER - TY - JOUR A1 - Belic, Stanislav A1 - Page, Lukas A1 - Lazariotou, Maria A1 - Waaga-Gasser, Ana Maria A1 - Dragan, Mariola A1 - Springer, Jan A1 - Loeffler, Juergen A1 - Morton, Charles Oliver A1 - Einsele, Hermann A1 - Ullmann, Andrew J. A1 - Wurster, Sebastian T1 - Comparative Analysis of Inflammatory Cytokine Release and Alveolar Epithelial Barrier Invasion in a Transwell® Bilayer Model of Mucormycosis JF - Frontiers in Microbiology N2 - Understanding the mechanisms of early invasion and epithelial defense in opportunistic mold infections is crucial for the evaluation of diagnostic biomarkers and novel treatment strategies. Recent studies revealed unique characteristics of the immunopathology of mucormycoses. We therefore adapted an alveolar Transwell® A549/HPAEC bilayer model for the assessment of epithelial barrier integrity and cytokine response to Rhizopus arrhizus, Rhizomucor pusillus, and Cunninghamella bertholletiae. Hyphal penetration of the alveolar barrier was validated by 18S ribosomal DNA detection in the endothelial compartment. Addition of dendritic cells (moDCs) to the alveolar compartment led to reduced fungal invasion and strongly enhanced pro-inflammatory cytokine response, whereas epithelial CCL2 and CCL5 release was reduced. Despite their phenotypic heterogeneity, the studied Mucorales species elicited the release of similar cytokine patterns by epithelial and dendritic cells. There were significantly elevated lactate dehydrogenase concentrations in the alveolar compartment and epithelial barrier permeability for dextran blue of different molecular weights in Mucorales-infected samples compared to Aspergillus fumigatus infection. Addition of monocyte-derived dendritic cells further aggravated LDH release and epithelial barrier permeability, highlighting the influence of the inflammatory response in mucormycosis-associated tissue damage. An important focus of this study was the evaluation of the reproducibility of readout parameters in independent experimental runs. Our results revealed consistently low coefficients of variation for cytokine concentrations and transcriptional levels of cytokine genes and cell integrity markers. As additional means of model validation, we confirmed that our bilayer model captures key principles of Mucorales biology such as accelerated growth in a hyperglycemic or ketoacidotic environment or reduced epithelial barrier invasion upon epithelial growth factor receptor blockade by gefitinib. Our findings indicate that the Transwell® bilayer model provides a reliable and reproducible tool for assessing host response in mucormycosis. KW - mucormycosis KW - alveolar epithelium KW - in vitro model KW - cytokines KW - dendritic cells Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-252477 VL - 9 ER - TY - JOUR A1 - Balasubramanian, Srikkanth A1 - Skaf, Joseph A1 - Holzgrabe, Ulrike A1 - Bharti, Richa A1 - Förstner, Konrad U. A1 - Ziebuhr, Wilma A1 - Humeida, Ute H. A1 - Abdelmohsen, Usama R. A1 - Oelschlaeger, Tobias A. T1 - A new bioactive compound from the marine sponge-derived Streptomyces sp. SBT348 inhibits staphylococcal growth and biofilm formation JF - Frontiers in Microbiology N2 - Staphylococcus epidermidis, the common inhabitant of human skin and mucosal surfaces has emerged as an important pathogen in patients carrying surgical implants and medical devices. Entering the body via surgical sites and colonizing the medical devices through formation of multi-layered biofilms leads to refractory and persistent device-related infections (DRIs). Staphylococci organized in biofilms are more tolerant to antibiotics and immune responses, and thus are difficult-to-treat. The consequent morbidity and mortality, and economic losses in health care systems has strongly necessitated the need for development of new anti-bacterial and anti-biofilm-based therapeutics. In this study, we describe the biological activity of a marine sponge-derived Streptomyces sp. SBT348 extract in restraining staphylococcal growth and biofilm formation on polystyrene, glass, medically relevant titan metal, and silicone surfaces. A bioassay-guided fractionation was performed to isolate the active compound (SKC3) from the crude SBT348 extract. Our results demonstrated that SKC3 effectively inhibits the growth (MIC: 31.25 \(\mu\)g/ml) and biofilm formation (sub-MIC range: 1.95-<31.25 \(\mu\)g/ml) of S. epidermidis RP62A in vitro. Chemical characterization of SKC3 by heat and enzyme treatments, and mass spectrometry (HRMS) revealed its heat-stable and non-proteinaceous nature, and high molecular weight (1258.3 Da). Cytotoxicity profiling of SKC3 in vitro on mouse fibroblast (NIH/3T3) and macrophage (J774.1) cell lines, and in vivo on the greater wax moth larvae Galleria mellonella revealed its non-toxic nature at the effective dose. Transcriptome analysis of SKC3 treated S. epidermidis RP62A has further unmasked its negative effect on central metabolism such as carbon flux as well as, amino acid, lipid, and energy metabolism. Taken together, these findings suggest a potential of SKC3 as a putative drug to prevent staphylococcal DRIs. KW - marine sponges KW - Streptomyces KW - Staphylococci KW - device-related infections KW - bioassay-guided fractionation KW - transcriptome Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-221408 VL - 9 ER - TY - JOUR A1 - Joos, J. P. A1 - Saadatmand, A. R. A1 - Schnabel, C. A1 - Viktorinová, I. A1 - Brand, T. A1 - Kramer, M. A1 - Nattel, S. A1 - Dobrev, D. A1 - Tomancak, P. A1 - Backs, J. A1 - Kleinbongard, P. A1 - Heusch, G. A1 - Lorenz, K. A1 - Koch, E. A1 - Weber, S. A1 - El-Armouche, A. T1 - Ectopic expression of S28A-mutated Histone H3 modulates longevity, stress resistance and cardiac function in Drosophila JF - Scientific Reports N2 - Histone H3 serine 28 (H3S28) phosphorylation and de-repression of polycomb repressive complex (PRC)-mediated gene regulation is linked to stress conditions in mitotic and post-mitotic cells. To better understand the role of H3S28 phosphorylation in vivo, we studied a Drosophila strain with ectopic expression of constitutively-activated H3S28A, which prevents PRC2 binding at H3S28, thus mimicking H3S28 phosphorylation. H3S28A mutants showed prolonged life span and improved resistance against starvation and paraquat-induced oxidative stress. Morphological and functional analysis of heart tubes revealed smaller luminal areas and thicker walls accompanied by moderately improved cardiac function after acute stress induction. Whole-exome deep gene-sequencing from isolated heart tubes revealed phenotype-corresponding changes in longevity-promoting and myotropic genes. We also found changes in genes controlling mitochondrial biogenesis and respiration. Analysis of mitochondrial respiration from whole flies revealed improved efficacy of ATP production with reduced electron transport-chain activity. Finally, we analyzed posttranslational modification of H3S28 in an experimental heart failure model and observed increased H3S28 phosphorylation levels in HF hearts. Our data establish a critical role of H3S28 phosphorylation in vivo for life span, stress resistance, cardiac and mitochondrial function in Drosophila. These findings may pave the way for H3S28 phosphorylation as a putative target to treat stress-related disorders such as heart failure. KW - cardiac hypertrophy KW - epigenetics KW - heart failure Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323637 VL - 8 ER - TY - JOUR A1 - Knop, Janin A1 - Spilgies, Lisanne M. A1 - Rufli, Stefanie A1 - Reinhart, Ramona A1 - Vasilikos, Lazaros A1 - Yabal, Monica A1 - Owsley, Erika A1 - Jost, Philipp J. A1 - Marsh, Rebecca A. A1 - Wajant, Harald A1 - Robinson, Mark D. A1 - Kaufmann, Thomas A1 - W. Wei-Lynn, Wong T1 - TNFR2 induced priming of the inflammasome leads to a RIPK1-dependent cell death in the absence of XIAP JF - Cell Death & Disease N2 - The pediatric immune deficiency X-linked proliferative disease-2 (XLP-2) is a unique disease, with patients presenting with either hemophagocytic lymphohistiocytosis (HLH) or intestinal bowel disease (IBD). Interestingly, XLP-2 patients display high levels of IL-18 in the serum even while in stable condition, presumably through spontaneous inflammasome activation. Recent data suggests that LPS stimulation can trigger inflammasome activation through a TNFR2/TNF/TNFR1 mediated loop in xiap−/− macrophages. Yet, the direct role TNFR2-specific activation plays in the absence of XIAP is unknown. We found TNFR2-specific activation leads to cell death in xiap−/− myeloid cells, particularly in the absence of the RING domain. RIPK1 kinase activity downstream of TNFR2 resulted in a TNF/TNFR1 cell death, independent of necroptosis. TNFR2-specific activation leads to a similar inflammatory NF-kB driven transcriptional profile as TNFR1 activation with the exception of upregulation of NLRP3 and caspase-11. Activation and upregulation of the canonical inflammasome upon loss of XIAP was mediated by RIPK1 kinase activity and ROS production. While both the inhibition of RIPK1 kinase activity and ROS production reduced cell death, as well as release of IL-1β, the release of IL-18 was not reduced to basal levels. This study supports targeting TNFR2 specifically to reduce IL-18 release in XLP-2 patients and to reduce priming of the inflammasome components. KW - cell death and immune response KW - inflammation Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325946 VL - 10 ER - TY - JOUR A1 - Kraus, Amelie J. A1 - Brink, Benedikt G. A1 - Siegel, T. Nicolai T1 - Efficient and specific oligo-based depletion of rRNA JF - Scientific Reports N2 - In most organisms, ribosomal RNA (rRNA) contributes to >85% of total RNA. Thus, to obtain useful information from RNA-sequencing (RNA-seq) analyses at reasonable sequencing depth, typically, mature polyadenylated transcripts are enriched or rRNA molecules are depleted. Targeted depletion of rRNA is particularly useful when studying transcripts lacking a poly(A) tail, such as some non-coding RNAs (ncRNAs), most bacterial RNAs and partially degraded or immature transcripts. While several commercially available kits allow effective rRNA depletion, their efficiency relies on a high degree of sequence homology between oligonucleotide probes and the target RNA. This restricts the use of such kits to a limited number of organisms with conserved rRNA sequences. In this study we describe the use of biotinylated oligos and streptavidin-coated paramagnetic beads for the efficient and specific depletion of trypanosomal rRNA. Our approach reduces the levels of the most abundant rRNA transcripts to less than 5% with minimal off-target effects. By adjusting the sequence of the oligonucleotide probes, our approach can be used to deplete rRNAs or other abundant transcripts independent of species. Thus, our protocol provides a useful alternative for rRNA removal where enrichment of polyadenylated transcripts is not an option and commercial kits for rRNA are not available. KW - parasite biology KW - RNA sequencing KW - transcriptomics Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-224829 VL - 9 ER - TY - JOUR A1 - Kotz, Frederik A1 - Risch, Patrick A1 - Arnold, Karl A1 - Sevim, Semih A1 - Puigmartí-Luis, Josep A1 - Quick, Alexander A1 - Thiel, Michael A1 - Hrynevich, Andrei A1 - Dalton, Paul D. A1 - Helmer, Dorothea A1 - Rapp, Bastian E. T1 - Fabrication of arbitrary three-dimensional suspended hollow microstructures in transparent fused silica glass JF - Nature Communications N2 - Fused silica glass is the preferred material for applications which require long-term chemical and mechanical stability as well as excellent optical properties. The manufacturing of complex hollow microstructures within transparent fused silica glass is of particular interest for, among others, the miniaturization of chemical synthesis towards more versatile, configurable and environmentally friendly flow-through chemistry as well as high-quality optical waveguides or capillaries. However, microstructuring of such complex three-dimensional structures in glass has proven evasive due to its high thermal and chemical stability as well as mechanical hardness. Here we present an approach for the generation of hollow microstructures in fused silica glass with high precision and freedom of three-dimensional designs. The process combines the concept of sacrificial template replication with a room-temperature molding process for fused silica glass. The fabricated glass chips are versatile tools for, among other, the advance of miniaturization in chemical synthesis on chip. KW - chemical engineering KW - fluidics KW - materials for optics Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-224787 VL - 10 ER - TY - JOUR A1 - Hommers, L. G. A1 - Richter, J. A1 - Yang, Y. A1 - Raab, A. A1 - Baumann, C. A1 - Lang, K. A1 - Schiele, M. A. A1 - Weber, H. A1 - Wittmann, A. A1 - Wolf, C. A1 - Alpers, G. W. A1 - Arolt, V. A1 - Domschke, K. A1 - Fehm, L. A1 - Fydrich, T. A1 - Gerlach, A. A1 - Gloster, A. T. A1 - Hamm, A. O. A1 - Helbig-Lang, S. A1 - Kircher, T. A1 - Lang, T. A1 - Pané-Farré, C. A. A1 - Pauli, P. A1 - Pfleiderer, B. A1 - Reif, A. A1 - Romanos, M. A1 - Straube, B. A1 - Ströhle, A. A1 - Wittchen, H.-U. A1 - Frantz, S. A1 - Ertl, G. A1 - Lohse, M. J. A1 - Lueken, U. A1 - Deckert, J. T1 - A functional genetic variation of SLC6A2 repressor hsa-miR-579-3p upregulates sympathetic noradrenergic processes of fear and anxiety JF - Translational Psychiatry N2 - Increased sympathetic noradrenergic signaling is crucially involved in fear and anxiety as defensive states. MicroRNAs regulate dynamic gene expression during synaptic plasticity and genetic variation of microRNAs modulating noradrenaline transporter gene (SLC6A2) expression may thus lead to altered central and peripheral processing of fear and anxiety. In silico prediction of microRNA regulation of SLC6A2 was confirmed by luciferase reporter assays and identified hsa-miR-579-3p as a regulating microRNA. The minor (T)-allele of rs2910931 (MAFcases = 0.431, MAFcontrols = 0.368) upstream of MIR579 was associated with panic disorder in patients (pallelic = 0.004, ncases = 506, ncontrols = 506) and with higher trait anxiety in healthy individuals (pASI = 0.029, pACQ = 0.047, n = 3112). Compared to the major (A)-allele, increased promoter activity was observed in luciferase reporter assays in vitro suggesting more effective MIR579 expression and SLC6A2 repression in vivo (p = 0.041). Healthy individuals carrying at least one (T)-allele showed a brain activation pattern suggesting increased defensive responding and sympathetic noradrenergic activation in midbrain and limbic areas during the extinction of conditioned fear. Panic disorder patients carrying two (T)-alleles showed elevated heart rates in an anxiety-provoking behavioral avoidance test (F(2, 270) = 5.47, p = 0.005). Fine-tuning of noradrenaline homeostasis by a MIR579 genetic variation modulated central and peripheral sympathetic noradrenergic activation during fear processing and anxiety. This study opens new perspectives on the role of microRNAs in the etiopathogenesis of anxiety disorders, particularly their cardiovascular symptoms and comorbidities. KW - clinical genetics KW - psychiatric disorders Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-322497 VL - 8 ER - TY - JOUR A1 - Bury, Susanne A1 - Soundararajan, Manonmani A1 - Bharti, Richa A1 - von Bünau, Rudolf A1 - Förstner, Konrad U. A1 - Oelschlaeger, Tobias A. T1 - The probiotic escherichia coli strain Nissle 1917 combats lambdoid bacteriophages stx and lambda JF - Frontiers in Microbiology N2 - Shiga toxin (Stx) producing E. coli (STEC) such as Enterohemorrhagic E. coli (EHEC) are the major cause of foodborne illness in humans. In vitro studies showed the probiotic Escherichia coil strain Nissle 1917 (EcN) to efficiently inhibit the production of Stx. Life threatening EHEC strains as for example the serotype 0104:H4, responsible for the great outbreak in 2011 in Germany, evolutionary developed from certain E. coll strains which got infected by stx2-encoding lambdoid phages turning the E. coil into lysogenic and subsequently Stx producing strains. Since antibiotics induce stx genes and Stx production, EHEC infected persons are not recommended to be treated with antibiotics. Therefore, EcN might be an alternative medication. However, because even commensal E. coli strains might be converted into Stx-producers after becoming host to a stx encoding prophage, we tested EcN for stx-phage genome integration. Our experiments revealed the resistance of EcN toward not only stx-phages but also against lambda-phages. This resistance was not based on the lack of or by mutated phage receptors. Rather it involved the expression of a phage repressor (pr) gene of a defective prophage in EcN which was able to partially protect E. coli K-12 strain MG1655 against stx and lambda phage infection. Furthermore, we observed EcN to inactivate phages and thereby to protect E. coli K-12 strains against infection by stx- as well as lambda-phages. Inactivation of lambda-phages was due to binding of lambda-phages to LamB of EcN whereas inactivation of stx-phages was caused by a thermostable protein of EcN. These properties together with its ability to inhibit Stx production make EcN a good candidate for the prevention of illness caused by EHEC and probably for the treatment of already infected people. KW - probiotic KW - E. coli Nissle 1917 KW - EHEC KW - Shiga toxin producing E. coli KW - stx-phages KW - lambda-phages KW - lambdoid prophage KW - LamB Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-221960 VL - 9 ER - TY - JOUR A1 - Breitinger, Ulrike A1 - Bahnassawy, Lamiaa M. A1 - Janzen, Dieter A1 - Römer, Vera A1 - Becker, Cord-Michael A1 - Villmann, Carmen A1 - Breitinger, Hans-Georg T1 - PKA and PKC modulators affect ion channel function and internalization of recombinant alpha1 and alpha1-beta glycine receptors JF - Frontiers in Molecular Neurosience N2 - Glycine receptors (GlyRs) are important mediators of fast inhibitory neurotransmission in the mammalian central nervous system. Their function is controlled by multiple cellular mechanisms, including intracellular regulatory processes. Modulation of GlyR function by protein kinases has been reported for many cell types, involving different techniques, and often yielding contradictory results. Here, we studied the effects of protein kinase C (PKC) and cAMP-dependent protein kinase A (PKA) on glycine induced currents in HEK293 cells expressing human homomeric \(\alpha\)1 and heteromeric \(\alpha\)1-\(\beta\) GlyRs using whole-cell patch clamp techniques as well as internalization assays. In whole-cell patch-clamp measurements, modulators were applied in the intracellular buffer at concentrations between 0.1 \(\mu\)M and 0.5 \(\mu\)M. EC50 of glycine increased upon application of the protein kinase activators Forskolin and phorbol-12-myristate-13-acetate (PMA) but decreased in the presence of the PKC inhibitor Staurosporine aglycon and the PKA inhibitor H-89. Desensitization of recombinant \(\alpha\)1 receptors was significantly increased in the presence of Forskolin. Staurosporine aglycon, on the other hand decreased desensitization of heteromeric \(\alpha\)1-\(\beta\) GlyRs. The time course of receptor activation was determined for homomeric \(\alpha\)1 receptors and revealed two simultaneous effects: cells showed a decrease of EC50 after 3-6 min of establishing whole-cell configuration. This effect was independent of protein kinase modulators. All modulators of PKA and PKC, however, produced an additional shift of EC50, which overlay and eventually exceeded the cells intrinsic variation of EC50. The effect of kinase activators was abolished if the corresponding inhibitors were co-applied, consistent with PKA and PKC directly mediating the modulation of GlyR function. Direct effects of PKA-and PKC-modulators on receptor expression on transfected HEK cells were monitored within 15 min of drug application, showing a significant increase of receptor internalization with PKA and PKC activators, while the corresponding inhibitors had no significant effect on receptor surface expression or internalization. Our results confirm the observation that phosphorylation via PKA and PKC has a direct effect on the GlyR ion channel complex and plays an important role in the fine-tuning of glycinergic signaling. KW - glycine receptor KW - PKA KW - PKC KW - activators/inhibitors of phosphorylation KW - whole-cell currents KW - modulation kinetics KW - receptor internalization Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-220401 VL - 11 ER - TY - JOUR A1 - Bohmann, Ferdinand O. A1 - Kurka, Natalia A1 - du Mesnil de Rochemont, Richard A1 - Gruber, Katharina A1 - Guenther, Joachim A1 - Rostek, Peter A1 - Rai, Heike A1 - Zickler, Philipp A1 - Ertl, Michael A1 - Berlis, Ansgar A1 - Poli, Sven A1 - Mengel, Annerose A1 - Ringleb, Peter A1 - Nagel, Simon A1 - Pfaff, Johannes A1 - Wollenweber, Frank A. A1 - Kellert, Lars A1 - Herzberg, Moriz A1 - Koehler, Luzie A1 - Haeusler, Karl Georg A1 - Alegiani, Anna A1 - Schubert, Charlotte A1 - Brekenfeld, Caspar A1 - Doppler, Christopher E. J. A1 - Onur, Oezguer A. A1 - Kabbasch, Christoph A1 - Manser, Tanja A1 - Pfeilschifter, Waltraud T1 - Simulation-based training of the rapid evaluation and management of acute stroke (STREAM) — a prospective single-arm multicenter trial JF - Frontiers in Neurology N2 - Introduction: Acute stroke care delivered by interdisciplinary teams is time-sensitive. Simulation-based team training is a promising tool to improve team performance in medical operations. It has the potential to improve process times, team communication, patient safety, and staff satisfaction. We aim to assess whether a multi-level approach consisting of a stringent workflow revision based on peer-to-peer review and 2–3 one-day in situ simulation trainings can improve acute stroke care processing times in high volume neurocenters within a 6 months period. Methods and Analysis: The trial is being carried out in a pre-test-post-test design at 7 tertiary care university hospital neurocenters in Germany. The intervention is directed at the interdisciplinary multiprofessional stroke teams. Before and after the intervention, process times of all direct-to-center stroke patients receiving IV thrombolysis (IVT) and/or endovascular therapy (EVT) will be recorded. The primary outcome measure will be the “door-to-needle” time of all consecutive stroke patients directly admitted to the neurocenters who receive IVT. Secondary outcome measures will be intervention-related process times of the fraction of patients undergoing EVT and effects on team communication, perceived patient safety, and staff satisfaction via a staff questionnaire. Interventions: We are applying a multi-level intervention in cooperation with three “STREAM multipliers” from each center. First step is a central meeting of the multipliers at the sponsor's institution with the purposes of algorithm review in a peer-to-peer process that is recorded in a protocol and an introduction to the principles of simulation training and debriefing as well as crew resource management and team communication. Thereafter, the multipliers cooperate with the stroke team trainers from the sponsor's institution to plan and execute 2–3 one-day simulation courses in situ in the emergency department and CT room of the trial centers whereupon they receive teaching materials to perpetuate the trainings. Clinical Trial Registration: STREAM is a registered trial at https://clinicaltrials.gov/ct2/show/NCT03228251. KW - CRM KW - thrombolysis (tPA) KW - stroke KW - emergency care KW - simulation training Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-369239 SN - 1664-2295 VL - 10 ER - TY - JOUR A1 - Bolzoni, Francesco A1 - Esposti, Roberto A1 - Marchese, Silvia M. A1 - Pozzi, Nicoló G. A1 - Ramirez-Pasos, Uri E. A1 - Isaias, Ioannis U. A1 - Cavallari, Paolo T1 - Disrupt of intra-limb APA pattern in parkinsonian patients performing index-finger flexion JF - Frontiers in Physiology N2 - Voluntary movements induce postural perturbations which are counteracted by anticipatory postural adjustments (APAs). These actions are known to build up long fixation chains toward available support points (inter-limb APAs), so as to grant whole body equilibrium. Moreover, recent studies highlighted that APAs also build-up short fixation chains, within the same limb where a distal segment is moved (intra-limb APAs), aimed at stabilizing the proximal segments. The neural structures generating intra-limb APAs still need investigations; the present study aims to compare focal movement kinematics and intra-limb APA latencies and pattern between healthy subjects and parkinsonian patients, assuming the latter as a model of basal ganglia dysfunction. Intra-limb APAs that stabilize the arm when the index-finger is briskly flexed were recorded in 13 parkinsonian patients and in 10 age-matched healthy subjects. Index-finger movement was smaller in parkinsonian patients vs. healthy subjects (p = 0.01) and more delayed with respect to the onset of the prime mover flexor digitorum superficialis (FDS, p < 0.0001). In agreement with the literature, in all healthy subjects the FDS activation was preceded by an inhibitory intra-limb APA in biceps brachii (BB) and anterior deltoid (AD), and almost simultaneous to an excitatory intra-limb APA in triceps brachii (TB). In parkinsonian patients, no significant differences were found for TB and AD intra-limb APA timings, however only four patients showed an inhibitory intra-limb APA in BB, while other four did not show any BB intra-limb APAs and five actually developed a BB excitation. The frequency of occurrence of normal sign, lacking, and inverted BB APAs was different in healthy vs. parkinsonian participants (p = 0.0016). The observed alterations in index-finger kinematics and intra-limb APA pattern in parkinsonian patients suggest that basal ganglia, in addition to shaping the focal movement, may also contribute to intra-limb APA control. KW - intra-limb anticipatory postural adjustments KW - Parkinson disease KW - basal ganglia KW - motor control KW - human Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-369245 SN - 1664-042X VL - 9 ER - TY - JOUR A1 - Kessler, Almuth F. A1 - Frömbling, Greta E. A1 - Gross, Franziska A1 - Hahn, Mirja A1 - Dzokou, Wilfrid A1 - Ernestus, Ralf-Ingo A1 - Löhr, Mario A1 - Hagemann, Carsten T1 - Effects of tumor treating fields (TTFields) on glioblastoma cells are augmented by mitotic checkpoint inhibition JF - Cell Death Discovery N2 - Tumor treating fields (TTFields) are approved for glioblastoma (GBM) therapy. TTFields disrupt cell division by inhibiting spindle fiber formation. Spindle assembly checkpoint (SAC) inhibition combined with antimitotic drugs synergistically decreases glioma cell growth in cell culture and mice. We hypothesized that SAC inhibition will increase TTFields efficacy. Human GBM cells (U-87 MG, GaMG) were treated with TTFields (200 kHz, 1.7 V/cm) and/or the SAC inhibitor MPS1-IN-3 (IN-3, 4 µM). Cells were counted after 24, 48, and 72 h of treatment and at 24 and 72 h after end of treatment (EOT). Flow cytometry, immunofluorescence microscopy, Annexin-V staining and TUNEL assay were used to detect alterations in cell cycle and apoptosis after 72 h of treatment. The TTFields/IN-3 combination decreased cell proliferation after 72 h compared to either treatment alone (−78.6% vs. TTFields, P = 0.0337; −52.6% vs. IN-3, P = 0.0205), and reduced the number of viable cells (62% less than seeded). There was a significant cell cycle shift from G1 to G2/M phase (P < 0.0001). The apoptotic rate increased to 44% (TTFields 14%, P = 0.0002; IN-3 4%, P < 0.0001). Cell growth recovered 24 h after EOT with TTFields and IN-3 alone, but the combination led to further decrease by 92% at 72 h EOT if IN-3 treatment was continued (P = 0.0288). The combination of TTFields and SAC inhibition led to earlier and prolonged effects that significantly augmented the efficacy of TTFields and highlights a potential new targeted multimodal treatment for GBM. Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325744 VL - 4 ER - TY - JOUR A1 - Kästner, Niklas A1 - Richter, S. Helene A1 - Urbanik, Sarah A1 - Kunert, Joachim A1 - Waider, Jonas A1 - Lesch, Klaus-Peter A1 - Kaiser, Sylvia A1 - Sachser, Norbert T1 - Brain serotonin deficiency affects female aggression JF - Scientific Reports N2 - The neurotransmitter serotonin plays a key role in the control of aggressive behaviour. While so far most studies have investigated variation in serotonin levels, a recently created tryptophan hydroxylase 2 (Tph2) knockout mouse model allows studying effects of complete brain serotonin deficiency. First studies revealed increased aggressiveness in homozygous Tph2 knockout mice in the context of a resident-intruder paradigm. Focussing on females, this study aimed to elucidate effects of serotonin deficiency on aggressive and non-aggressive social behaviours not in a test situation but a natural setting. For this purpose, female Tph2 wildtype (n = 40) and homozygous knockout mice (n = 40) were housed with a same-sex conspecific of either the same or the other genotype in large terraria. The main findings were: knockout females displayed untypically high levels of aggressive behaviour even after several days of co-housing. Notably, in response to aggressive knockout partners, they showed increased levels of defensive behaviours. While most studies on aggression in rodents have focussed on males, this study suggests a significant involvement of serotonin also in the control of female aggression. Future research will show, whether the observed behavioural effects are directly caused by the lack of serotonin or by potential compensatory mechanisms. KW - animal behaviour KW - genetics of the nervous system KW - social behaviour Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325386 VL - 9 ER - TY - JOUR A1 - Hecht, Markus A1 - Meier, Friedegund A1 - Zimmer, Lisa A1 - Polat, Bülent A1 - Loquai, Carmen A1 - Weishaupt, Carsten A1 - Forschner, Andrea A1 - Gutzmer, Ralf A1 - Utikal, Jochen S. A1 - Goldinger, Simone M. A1 - Geier, Michael A1 - Hassel, Jessica C. A1 - Balermpas, Panagiotis A1 - Kiecker, Felix A1 - Rauschenberg, Ricarda A1 - Dietrich, Ursula A1 - Clemens, Patrick A1 - Berking, Carola A1 - Grabenbauer, Gerhard A1 - Schadendorf, Dirk A1 - Grabbe, Stephan A1 - Schuler, Gerold A1 - Fietkau, Rainer A1 - Distel, Luitpold V. A1 - Heinzerling, Lucie T1 - Clinical outcome of concomitant vs interrupted BRAF inhibitor therapy during radiotherapy in melanoma patients JF - British Journal of Cancer N2 - Background: Concomitant radiation with BRAF inhibitor (BRAFi) therapy may increase radiation-induced side effects but also potentially improve tumour control in melanoma patients. Methods: A total of 155 patients with BRAF-mutated melanoma from 17 European skin cancer centres were retrospectively analysed. Out of these, 87 patients received concomitant radiotherapy and BRAFi (59 vemurafenib, 28 dabrafenib), while in 68 patients BRAFi therapy was interrupted during radiation (51 vemurafenib, 17 dabrafenib). Overall survival was calculated from the first radiation (OSRT) and from start of BRAFi therapy (OSBRAFi). Results: The median duration of BRAFi treatment interruption prior to radiotherapy was 4 days and lasted for 17 days. Median OSRT and OSBRAFi in the entire cohort were 9.8 and 12.6 months in the interrupted group and 7.3 and 11.5 months in the concomitant group (P=0.075/P=0.217), respectively. Interrupted vemurafenib treatment with a median OSRT and OSBRAFi of 10.1 and 13.1 months, respectively, was superior to concomitant vemurafenib treatment with a median OSRT and OSBRAFi of 6.6 and 10.9 months (P=0.004/P=0.067). Interrupted dabrafenib treatment with a median OSRT and OSBRAFi of 7.7 and 9.8 months, respectively, did not differ from concomitant dabrafenib treatment with a median OSRT and OSBRAFi of 9.9 and 11.6 months (P=0.132/P=0.404). Median local control of the irradiated area did not differ in the interrupted and concomitant BRAFi treatment groups (P=0.619). Skin toxicity of grade ≥2 (CTCAE) was significantly increased in patients with concomitant vemurafenib compared to the group with treatment interruption (P=0.002). Conclusions: Interruption of vemurafenib treatment during radiation was associated with better survival and less toxicity compared to concomitant treatment. Due to lower number of patients, the relevance of treatment interruption in dabrafenib treated patients should be further investigated. The results of this analysis indicate that treatment with the BRAFi vemurafenib should be interrupted during radiotherapy. Prospective studies are desperately needed. KW - radiation KW - radiotherapy KW - BRAF KW - vemurafenib KW - dabrafenib Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227970 VL - 118 ER - TY - JOUR A1 - Knödler, Maren A1 - Körfer, Justus A1 - Kunzmann, Volker A1 - Trojan, Jörg A1 - Daum, Severin A1 - Schenk, Michael A1 - Kullmann, Frank A1 - Schroll, Sebastian A1 - Behringer, Dirk A1 - Stahl, Michael A1 - Al-Batran, Salah-Eddin A1 - Hacker, Ulrich A1 - Ibach, Stefan A1 - Lindhofer, Horst A1 - Lordick, Florian T1 - Randomised phase II trial to investigate catumaxomab (anti-EpCAM × anti-CD3) for treatment of peritoneal carcinomatosis in patients with gastric cancer JF - British Journal of Cancer N2 - Background Peritoneal carcinomatosis (PC) represents an unfavourable prognostic factor for patients with gastric cancer (GC). Intraperitoneal treatment with the bispecific and trifunctional antibody catumaxomab (EpCAM, CD3), in addition to systemic chemotherapy, could improve elimination of PC. Methods This prospective, randomised, phase II study investigated the efficacy of catumaxomab followed by chemotherapy (arm A, 5-fluorouracil, leucovorin, oxaliplatin, docetaxel, FLOT) or FLOT alone (arm B) in patients with GC and PC. Primary endpoint was the rate of macroscopic complete remission (mCR) of PC at the time of second diagnostic laparoscopy/laparotomy prior to optional surgery. Results Median follow-up was 52 months. Out of 35 patients screened, 15 were allocated to arm A and 16 to arm B. mCR rate was 27% in arm A and 19% in arm B (p = 0.69). Severe side effects associated with catumaxomab were nausea, infection, abdominal pain, and elevated liver enzymes. Median progression-free (6.7 vs. 5.4 months, p = 0.71) and overall survival (13.2 vs. 13.0 months, p = 0.97) were not significantly different in both treatment arms. Conclusions Addition of catumaxomab to systemic chemotherapy was feasible and tolerable in advanced GC. Although the primary endpoint could not be demonstrated, results are promising for future investigations integrating intraperitoneal immunotherapy into a multimodal treatment strategy. KW - cancer immunotherapy KW - gastric cancer Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325938 VL - 119 ER - TY - JOUR A1 - Altieri, Barbara A1 - Di Dato, Carla A1 - Martini, Chiara A1 - Sciammarella, Concetta A1 - Di Sarno, Antonella A1 - Colao, Annamaria A1 - Faggiano, Antongiulio T1 - Bone Metastases in Neuroendocrine Neoplasms: From Pathogenesis to Clinical Management JF - Cancers N2 - Bone represents a common site of metastases for several solid tumors. However, the ability of neuroendocrine neoplasms (NENs) to localize to bone has always been considered a rare and late event. Thanks to the improvement of therapeutic options, which results in longer survival, and of imaging techniques, particularly after the introduction of positron emission tomography (PET) with gallium peptides, the diagnosis of bone metastases (BMs) in NENs is increasing. The onset of BMs can be associated with severe skeletal complications that impair the patient's quality of life. Moreover, BMs negatively affect the prognosis of NEN patients, bringing out the lack of curative treatment options for advanced NENs. The current knowledge on BMs in gastro-entero-pancreatic (GEP) and bronchopulmonary (BP) NENs is still scant and is derived from a few retrospective studies and case reports. This review aims to perform a critical analysis of the evidence regarding the role of BMs in GEP- and BP-NENs, focusing on the molecular mechanisms underlining the development of BMs, as well as clinical presentation, diagnosis, and treatment of BMs, in an attempt to provide suggestions that can be used in clinical practice. KW - neuroendocrine neoplasms KW - bone metastases KW - bone microenvironment KW - skeletal-related events KW - epithelial-to-mesenchymal transition KW - microRNA KW - prognosis KW - treatment KW - denosumab Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-221079 VL - 11 ER - TY - JOUR A1 - El-Helou, Sabine M. A1 - Biegner, Anika-Kerstin A1 - Bode, Sebastian A1 - Ehl, Stephan R. A1 - Heeg, Maximilian A1 - Maccari, Maria E. A1 - Ritterbusch, Henrike A1 - Speckmann, Carsten A1 - Rusch, Stephan A1 - Scheible, Raphael A1 - Warnatz, Klaus A1 - Atschekzei, Faranaz A1 - Beider, Renata A1 - Ernst, Diana A1 - Gerschmann, Stev A1 - Jablonka, Alexandra A1 - Mielke, Gudrun A1 - Schmidt, Reinhold E. A1 - Schürmann, Gesine A1 - Sogkas, Georgios A1 - Baumann, Ulrich H. A1 - Klemann, Christian A1 - Viemann, Dorothee A1 - Bernuth, Horst von A1 - Krüger, Renate A1 - Hanitsch, Leif G. A1 - Scheibenbogen, Carmen M. A1 - Wittke, Kirsten A1 - Albert, Michael H. A1 - Eichinger, Anna A1 - Hauck, Fabian A1 - Klein, Christoph A1 - Rack-Hoch, Anita A1 - Sollinger, Franz M. A1 - Avila, Anne A1 - Borte, Michael A1 - Borte, Stephan A1 - Fasshauer, Maria A1 - Hauenherm, Anja A1 - Kellner, Nils A1 - Müller, Anna H. A1 - Ülzen, Anett A1 - Bader, Peter A1 - Bakhtiar, Shahrzad A1 - Lee, Jae-Yun A1 - Heß, Ursula A1 - Schubert, Ralf A1 - Wölke, Sandra A1 - Zielen, Stefan A1 - Ghosh, Sujal A1 - Laws, Hans-Juergen A1 - Neubert, Jennifer A1 - Oommen, Prasad T. A1 - Hönig, Manfred A1 - Schulz, Ansgar A1 - Steinmann, Sandra A1 - Klaus, Schwarz A1 - Dückers, Gregor A1 - Lamers, Beate A1 - Langemeyer, Vanessa A1 - Niehues, Tim A1 - Shai, Sonu A1 - Graf, Dagmar A1 - Müglich, Carmen A1 - Schmalzing, Marc T. A1 - Schwaneck, Eva C. A1 - Tony, Hans-Peter A1 - Dirks, Johannes A1 - Haase, Gabriele A1 - Liese, Johannes G. A1 - Morbach, Henner A1 - Foell, Dirk A1 - Hellige, Antje A1 - Wittkowski, Helmut A1 - Masjosthusmann, Katja A1 - Mohr, Michael A1 - Geberzahn, Linda A1 - Hedrich, Christian M. A1 - Müller, Christiane A1 - Rösen-Wolff, Angela A1 - Roesler, Joachim A1 - Zimmermann, Antje A1 - Behrends, Uta A1 - Rieber, Nikolaus A1 - Schauer, Uwe A1 - Handgretinger, Rupert A1 - Holzer, Ursula A1 - Henes, Jörg A1 - Kanz, Lothar A1 - Boesecke, Christoph A1 - Rockstroh, Jürgen K. A1 - Schwarze-Zander, Carolynne A1 - Wasmuth, Jan-Christian A1 - Dilloo, Dagmar A1 - Hülsmann, Brigitte A1 - Schönberger, Stefan A1 - Schreiber, Stefan A1 - Zeuner, Rainald A1 - Ankermann, Tobias A1 - Bismarck, Philipp von A1 - Huppertz, Hans-Iko A1 - Kaiser-Labusch, Petra A1 - Greil, Johann A1 - Jakoby, Donate A1 - Kulozik, Andreas E. A1 - Metzler, Markus A1 - Naumann-Bartsch, Nora A1 - Sobik, Bettina A1 - Graf, Norbert A1 - Heine, Sabine A1 - Kobbe, Robin A1 - Lehmberg, Kai A1 - Müller, Ingo A1 - Herrmann, Friedrich A1 - Horneff, Gerd A1 - Klein, Ariane A1 - Peitz, Joachim A1 - Schmidt, Nadine A1 - Bielack, Stefan A1 - Groß-Wieltsch, Ute A1 - Classen, Carl F. A1 - Klasen, Jessica A1 - Deutz, Peter A1 - Kamitz, Dirk A1 - Lassy, Lisa A1 - Tenbrock, Klaus A1 - Wagner, Norbert A1 - Bernbeck, Benedikt A1 - Brummel, Bastian A1 - Lara-Villacanas, Eusebia A1 - Münstermann, Esther A1 - Schneider, Dominik T. A1 - Tietsch, Nadine A1 - Westkemper, Marco A1 - Weiß, Michael A1 - Kramm, Christof A1 - Kühnle, Ingrid A1 - Kullmann, Silke A1 - Girschick, Hermann A1 - Specker, Christof A1 - Vinnemeier-Laubenthal, Elisabeth A1 - Haenicke, Henriette A1 - Schulz, Claudia A1 - Schweigerer, Lothar A1 - Müller, Thomas G. A1 - Stiefel, Martina A1 - Belohradsky, Bernd H. A1 - Soetedjo, Veronika A1 - Kindle, Gerhard A1 - Grimbacher, Bodo T1 - The German national registry of primary immunodeficiencies (2012-2017) JF - Frontiers in Immunology N2 - Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs. Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel. Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1-25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0-88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE-syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%-subcutaneous; 29%-intravenous; 1%-unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy. Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment. KW - registry for primary immunodeficiency KW - primary immunodeficiency (PID) KW - German PID-NET registry KW - PID prevalence KW - European Society for Immunodeficiencies (ESID) KW - IgG substitution therapy KW - CVID Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226629 VL - 10 ER - TY - JOUR A1 - Butt, Elke A1 - Raman, Dayanidhi T1 - New frontiers for the cytoskeletal protein LASP1 JF - Frontiers in Oncology N2 - In the recent two decades, LIM and SH3 protein 1 (LASP1) has been developed from a simple actin-binding structural protein to a tumor biomarker and subsequently to a complex, nuclear transcriptional regulator. Starting with a brief historical perspective, this review will mainly compare and contrast LASP1 and LASP2 from the angle of the newest data and importantly, examine their role in transcriptional regulation. We will summarize the current knowledge through pictorial models and tables including the roles of different microRNAs in the differential regulation of LASP1 levels and patient outcome rather than specify in detail all tumor entities. Finally, the novel functional roles of LASP1 in secretion of vesicles, expression of matrix metalloproteinases and transcriptional regulation as well as the activation of survival and proliferation pathways in different cancer types are described. KW - LASP1 KW - LASP2 KW - transcriptional regulation KW - nuclear role KW - matrix metalloproteinases KW - AP1 Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-221975 VL - 8 ER - TY - JOUR A1 - Doppler, Christopher E. J. A1 - Meyer, Linda A1 - Dovern, Anna A1 - Stühmer-Beckh, Jaro A1 - Weiss, Peter H. A1 - Fink, Gereon R. T1 - Differential impact of social and monetary reward on procedural learning and consolidation in aging and its structural correlates JF - Frontiers in Aging Neuroscience N2 - In young (n = 36, mean +/- SD: 24.8 +/- 4.5 years) and older (n = 34, mean +/- SD: 65.1 +/- 6.5 years) healthy participants, we employed a modified version of the Serial Reaction Time task to measure procedural learning (PL) and consolidation while providing monetary and social reward. Using voxel-based morphometry (VBM), we additionally determined the structural correlates of reward-related motor performance (RMP) and PL. Monetary reward had a beneficial effect on PL in the older subjects only. In contrast, social reward significantly enhanced PL in the older and consolidation in the young participants. VBM analyses revealed that motor performance related to monetary reward was associated with larger grey matter volume (GMV) of the left striatum in the young, and motor performance related to social reward with larger GMV of the medial orbitofrontal cortex in the older group. The differential effects of social reward in young (improved consolidation) and both social and monetary rewards in older (enhanced PL) healthy subjects point to the potential of rewards for interventions targeting aging-associated motor decline or stroke-induced motor deficits. KW - serial reaction time task KW - procedural learning KW - reinforcement learning KW - voxel-based morphometry KW - motor aging Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-222394 VL - 11 ER - TY - JOUR A1 - Doppler, Kathrin A1 - Brockmann, Kathrin A1 - Sedghi, Annahita A1 - Wurster, Isabel A1 - Volkmann, Jens A1 - Oertel, Wolfgang H. A1 - Sommer, Claudia T1 - Dermal phospho-alpha-synuclein deposition in patients with Parkinson's disease and mutation of the glucocerebrosidase gene JF - Frontiers in Neurology N2 - Heterozygous mutations in the glucocerebrosidase gene (GBA1) represent the most common genetic risk factor for Parkinson's disease (PD) and are histopathologically associated with a widespread load of alpha-synuclein in the brain. Therefore, PD patients with GBA1 mutations are a cohort of high interest for clinical trials on disease-modifying therapies targeting alpha-synuclein. There is evidence that detection of phospho-alpha-synuclein (p-syn) in dermal nerve fibers might be a biomarker for the histopathological identification of PD patients even at premotor or very early stages of disease. It is so far unknown whether dermal p-syn deposition can also be found in PD patients with GBA1 mutations and may serve as a biomarker for PD in these patients. Skin biopsies of 10 PD patients with different GBA1 mutations (six N3705, three E326K, one L444P) were analyzed by double-immunofluorescence labeling with anti-p-syn and anti-protein gene product 9.5 (PGP9.5, axonal marker) to detect intraaxonal p-syn deposition. Four biopsy sites (distal, proximal leg, paravertebral Th10, and C7) per patient were studied. P-syn was found in six patients (three N370S, three E326K). P-syn deposition was mainly detected in autonomic nerve fibers, but also in somatosensory fibers and was not restricted to a certain GBA1 mutation. In summary, dermal p-syn in PD patients with GBA1 mutations seems to offer a similar distribution and frequency as observed in patients without a known mutation. Skin biopsy may be suitable to study p-syn deposition in these patients or even to identify premotor patients with GBA1 mutations. KW - Parkinson's disease KW - glucocerebrosidase mutation KW - alpha-synuclein KW - skin biopsy KW - biomarker Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-222828 VL - 9 ER - TY - THES A1 - Kemmer, Luisa Diana T1 - Darstellung von Inflammation in Atherosklerose mit dem CXCR4-gerichteten PET-Tracer \(^{68}\)Ga-Pentixafor im Vergleich zur \(^{18}\)F-FDG-PET/CT T1 - Imaging inflammation in atherosclerosis with the CXCR4-targeted PET tracer \(^{68}\)Ga-Pentixafor compared to \(^{18}\)F-FDG-PET/CT N2 - Herz-Kreislauf-Erkrankungen zählen zu den häufigsten Todesursachen weltweit. Ein ihr zugrundeliegender pathologischer Prozess ist die Atherosklerose. Die Ruptur eines atheroskelrotischen Plaques kann lebensbedrohlich sein. Derzeit existieren weder ein evaluierter Biomarker noch eine Bildgebungstechnik, die das Risiko einer solchen Plaqueruptur und eines nachfolgenden akuten kardiovaskulären Ereignisses vorhersagen können. Um die bildgebenden Verfahren zur Detektion der Atherosklerose zu optimieren, wurde in dieser Dissertationsarbeit untersucht, ob der PET/CT-Tracer 68Ga-Pentixafor im Vergleich zu 18F-FDG bessere Ergebnisse in der Diagnostik der Atherosklerose erzielen kann. Insgesamt wurden 144 onkologische Patienten in die Studie einbezogen, bei denen die 18F-FDG-PET/CT sowie 68Ga-Pentifaxor-PET/CT aus klinischen Gründen indiziert waren. Befunde, bei denen eine gegenüber dem Hintergrund vermehrte Speicherung ohne physiologische Erklärung nachgewiesen werden konnte, wurden als positiv bewertet. Um Unterschiede zwischen den Patienten außer Acht lassen zu können, wurde die target-to-background-ratio (TBR) berechnet. Zur Beschreibung der Speicherintensität einer Läsion wurde der standardized uptake value (SUV) bestimmt. Nach Auswertung der Daten zeigte sich eine mäßige Korrelation der Anzahl von 68Ga-Pentixafor-positiven Läsionen mit der Anzahl der 18F-FDG positiven Läsionen. Die CXCR4-gerichtete Bildgebung mit 68Ga-Pentixafor identifizierte mehr Läsionen als die 18F-FDG-PET/CT. Bezüglich ihres Verteilungsmusters wiesen die beiden Tracer eine geringe Korrelation auf. Die Aufnahmeintensität beider Tracer korrelierte umgekehrt mit dem Ausmaß der Verkalkung. Stark verkalkte Plaques zeigten die niedrigste Traceraufnahme für beide PET-Tracer. Weitere Studien zur Aufklärung der zugrunde liegenden biologischen Mechanismen und Quellen der CXCR4-Positivität sind in hohem Maße gerechtfertigt. N2 - Cardiovascular diseases are among the most common causes of death worldwide. A pathological process underlying these diseases is atherosclerosis. The rupture of an atherosclerotic plaque can be life-threatening. Currently, there is neither an evaluated biomarker nor an imaging technique that can predict the risk of such a plaque rupture and subsequent acute cardiovascular event. To optimize imaging methods for the detection of atherosclerosis, this dissertation investigated whether the PET/CT tracer 68Ga-Pentixafor can achieve better diagnostic results for atherosclerosis compared to 18F-FDG. A total of 144 oncological patients were included in the study, for whom 18F-FDG-PET/CT and 68Ga-Pentixafor-PET/CT were clinically indicated. Lesions showing increased uptake compared to the background without physiological explanation were rated as positive. To disregard differences between patients, the target-to-background ratio (TBR) was calculated. To describe the uptake intensity of a lesion, the standardized uptake value (SUV) was determined. After evaluating the data, a moderate correlation was observed between the number of 68Ga-Pentixafor-positive lesions and the number of 18F-FDG-positive lesions. CXCR4-targeted imaging with 68Ga-Pentixafor identified more lesions than 18F-FDG-PET/CT. Regarding their distribution patterns, the two tracers showed a low correlation. The uptake intensity of both tracers inversely correlated with the extent of calcification. Highly calcified plaques exhibited the lowest tracer uptake for both PET tracers. Further studies to elucidate the underlying biological mechanisms and sources of CXCR4 positivity are highly warranted. KW - Arteriosklerose KW - Positronen-Emissions-Tomografie KW - Chemokinrezpetor KW - CXCR4 KW - \(^{68}\)Ga-Pentixafor KW - \(^{18}\)F-FDG Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360013 ER - TY - THES A1 - Zillig, Anna-Lena Christina T1 - Einfluss von Sicherheit auf die Schmerzverarbeitung T1 - The influence of safety on pain perception N2 - Im Rahmen des interdisziplinären Promotionsschwerpunkts Resilienzfaktoren der Schmerzverarbeitung des evangelischen Studienwerks in Zusammenarbeit mit der Julius-Maximilians-Universität Würzburg und der Otto-Friedrich-Universität Bamberg untersuche ich in diesem Promotionsprojekt den Einfluss von Sicherheit auf die Schmerzverarbeitung. Es ist bekannt, dass die Schmerzverarbeitung durch Emotionen moduliert werden kann. Man geht davon aus, dass negative Emotionen den Schmerz in der Regel verstärken, während positive Emotionen zu einer Schmerzreduktion führen. Frühere Studien fanden heraus, dass die Erwartung eines aversiven Ereignisses zu Bedrohung und stärkeren Schmerzen führt. Es stellt sich die Frage, ob das Gegenteil von Bedrohung, nämlich Sicherheit, zu einer Verringerung der Schmerzen führen kann. Um diese Hypothese zu untersuchen, habe ich drei Experimente an gesunden ProbandInnen durchgeführt. N2 - I am investigating the influence of safety on pain processing in the present dissertation project as part of the interdisciplinary doctoral program on resilience factors of pain processing of the Evangelisches Studienwerk in cooperation with the Julius-Maximilians-University of Würzburg and the Otto-Friedrich-University of Bamberg. It is known that pain processing is susceptible to an individual’s emotional state, such that negative emotions mostly increase pain while positive emotions lead to a pain decrease. Previous studies found that the anticipation of an aversive event induces threat and elevated pain. The question arises whether the exact opposite, namely safety, can lead to a reduction in pain. To investigate this hypothesis, I conducted three experiments in healthy volunteers. KW - Sicherheit KW - Schmerzverarbeitung Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359282 ER - TY - JOUR A1 - Jockel-Schneider, Yvonne A1 - Schlagenhauf, Ulrich A1 - Petsos, Hari A1 - Rüttermann, Stefan A1 - Schmidt, Jana A1 - Ziebolz, Dirk A1 - Wehner, Christian A1 - Laky, Markus A1 - Rott, Thea A1 - Noack, Michael A1 - Noack, Barbara A1 - Lorenz, Katrin T1 - Impact of 0.1% octenidine mouthwash on plaque re-growth in healthy adults: a multi-center phase 3 randomized clinical trial JF - Clinical Oral Investigations N2 - Objectives To investigate plaque inhibition of 0.1% octenidine mouthwash (OCT) vs. placebo over 5 days in the absence of mechanical plaque control. Materials and methods For this randomized, placebo-controlled, double-blind, parallel group, multi-center phase 3 study, 201 healthy adults were recruited. After baseline recording of plaque index (PI) and gingival index (GI), collection of salivary samples, and dental prophylaxis, subjects were randomly assigned to OCT or placebo mouthwash in a 3:1 ratio. Rinsing was performed twice daily for 30 s. Colony forming units in saliva were determined before and after the first rinse. At day 5, PI, GI, and tooth discoloration index (DI) were assessed. Non-parametric van Elteren tests were applied with a significance level of p < 0.05. Results Treatment with OCT inhibited plaque formation more than treatment with placebo (PI: 0.36 vs. 1.29; p < 0.0001). OCT reduced GI (0.04 vs. placebo 0.00; p = 0.003) and salivary bacterial counts (2.73 vs. placebo 0.24 lgCFU/ml; p < 0.0001). Tooth discoloration was slightly higher under OCT (DI: 0.25 vs. placebo 0.00; p = 0.0011). Mild tongue staining and dysgeusia occurred. Conclusions OCT 0.1% mouthwash inhibits plaque formation over 5 days. It therefore can be recommended when regular oral hygiene is temporarily compromised. Clinical relevance When individual plaque control is compromised, rinsing with octenidine mouthwash is recommended to maintain healthy oral conditions while side effects are limited. KW - octenidine KW - mouthrinse KW - bacterial counts KW - plaque index KW - gingival index KW - discoloration index Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307629 SN - 1432-6981 SN - 1436-3771 VL - 25 IS - 7 ER - TY - JOUR A1 - Brünnert, Daniela A1 - Seupel, Raina A1 - Goyal, Pankaj A1 - Bach, Matthias A1 - Schraud, Heike A1 - Kirner, Stefanie A1 - Köster, Eva A1 - Feineis, Doris A1 - Bargou, Ralf C. A1 - Schlosser, Andreas A1 - Bringmann, Gerhard A1 - Chatterjee, Manik T1 - Ancistrocladinium A induces apoptosis in proteasome inhibitor-resistant multiple myeloma cells: a promising therapeutic agent candidate JF - Pharmaceuticals N2 - The N,C-coupled naphthylisoquinoline alkaloid ancistrocladinium A belongs to a novel class of natural products with potent antiprotozoal activity. Its effects on tumor cells, however, have not yet been explored. We demonstrate the antitumor activity of ancistrocladinium A in multiple myeloma (MM), a yet incurable blood cancer that represents a model disease for adaptation to proteotoxic stress. Viability assays showed a potent apoptosis-inducing effect of ancistrocladinium A in MM cell lines, including those with proteasome inhibitor (PI) resistance, and in primary MM cells, but not in non-malignant blood cells. Concomitant treatment with the PI carfilzomib or the histone deacetylase inhibitor panobinostat strongly enhanced the ancistrocladinium A-induced apoptosis. Mass spectrometry with biotinylated ancistrocladinium A revealed significant enrichment of RNA-splicing-associated proteins. Affected RNA-splicing-associated pathways included genes involved in proteotoxic stress response, such as PSMB5-associated genes and the heat shock proteins HSP90 and HSP70. Furthermore, we found strong induction of ATF4 and the ATM/H2AX pathway, both of which are critically involved in the integrated cellular response following proteotoxic and oxidative stress. Taken together, our data indicate that ancistrocladinium A targets cellular stress regulation in MM and improves the therapeutic response to PIs or overcomes PI resistance, and thus may represent a promising potential therapeutic agent. KW - multiple myeloma KW - ancistrocladinium A KW - naphthylisoquinoline alkaloids KW - proteasome inhibitor resistance KW - RNA splicing KW - cellular stress response KW - proteasome subunit beta type-5 (PSMB5) KW - activating transcription factor 4 (ATF4) KW - ataxia teleagiectasia mutated (ATM) KW - H2A histone family member X (H2AX) Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362887 SN - 1424-8247 VL - 16 IS - 8 ER - TY - JOUR A1 - Winter, Anna A1 - Schulz, Stefan M. A1 - Schmitter, Marc A1 - Müller-Richter, Urs A1 - Kübler, Alexander A1 - Kasper, Sylvia A1 - Hartmann, Stefan T1 - Comprehensive geriatric assessment and quality of life aspects in patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) JF - Journal of Clinical Medicine N2 - To define frailty in older cancer patients, the aim of this study was to assess the geriatric status and quality of life (QoL) aspects in patients suffering from recurrent/metastatic head and neck squamous cell carcinoma (r/m HNSCC) under palliative treatment. A comprehensive geriatric assessment (CGA) was performed on 21 r/m HNSCC patients at two defined assessments, and the QoL aspects and the impact of descriptive data were evaluated. The Kolmogorov–Smirnov test, Spearman’s rho correlation, and two-way mixed ANOVA were used for statistical analysis. All patients were found to be “frail”. Pain, fatigue, and the burden of illness were the highest-rated symptoms. Oral function and orofacial appearance were highly impaired. A significant impact of descriptive data on the CGA and QoL results was found (all p ≤ 0.05). Thus, the CGA results revealed high frailty, severe comorbidities, and high impairments in QoL aspects. The CGA and QoL results were negatively affected by the primary HNSCC treatment approach, the need for prosthetic treatment, and worse oral functional capacity. Therefore, frailty in r/m HNSCC patients seems to be multidimensional. The evaluation of the CGA and QoL aspects in r/m HNSCC patients can be recommended to detect special needs, organize aftercare, and improve the support for frail and vulnerable cancer patients to create a multidisciplinary treatment approach. KW - frailty KW - geriatric cancer patient KW - recurrent/metastatic head and neck squamous cell carcinoma KW - oral health-related quality of life KW - prosthetic rehabilitation KW - oral functional capacity Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-363096 SN - 2077-0383 VL - 12 IS - 17 ER - TY - JOUR A1 - Heller, Bianca A1 - Reiter, Florian P. A1 - Leicht, Hans Benno A1 - Fiessler, Cornelia A1 - Bergheim, Ina A1 - Heuschmann, Peter U. A1 - Geier, Andreas A1 - Rau, Monika T1 - Salt-intake-related behavior varies between sexes and is strongly associated with daily salt consumption in obese patients at high risk for MASLD JF - Nutrients N2 - Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) imposes a significant burden on Westernized regions. The Western diet, high in salt intake, significantly contributes to disease development. However, there are a lack of data on salt literacy and salt intake among MASLD patients in Germany. Our study aims to analyze daily salt intake and salt-intake-related behavior in MASLD patients. Methods: 234 MASLD patients were prospectively included. Daily salt intake and salt-intake-related behavior were assessed via a food frequency questionnaire (FFQ—DEGS) and a salt questionnaire (SINU). Statistical analyses were performed using SPSS. Results: Mean daily salt intake was higher in men than in women (7.3 ± 5 g/d vs. 5.3 ± 4 g/d; p < 0.001). There was significant agreement between increased daily salt intake (6 g/d) and the behavioral salt index (SI) (p < 0.001). Men exhibited higher SI scores compared to women, indicating lower awareness of salt in everyday life. Multivariate analysis identified specific salt-intake-related behaviors impacting daily salt consumption. Conclusions: Our study reveals a strong link between daily salt intake and salt-intake-related behavior, highlighting sex-specific differences in an MASLD cohort. To enhance patient care in high-cardiovascular-risk populations, specific behavioral approaches may be considered, including salt awareness, to improve adherence to lifestyle changes, particularly in male patients. KW - MASLD KW - steatotic liver disease KW - salt consumption KW - salt-intake-related behavior Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-363107 SN - 2072-6643 VL - 15 IS - 18 ER - TY - THES A1 - Machwart, Khaled T1 - Modulatorischer Einfluss von Levosimendan bei dem Ischämie-Reperfusionsschaden auf die myokardiale Mitochondrienfunktion T1 - Impact of Levosimendan in the ischemia-reperfusion damage on the myocardial Mitochondrial function N2 - Die vorliegende Studie untersuchte den Effekt von Levosimendan auf die mitochondriale Funktionen im Herzmuskel, insbesondere im Zusammenhang mit dem Ischämie/Reperfusions-Schaden. Methoden: In der Studie wurde ein retrogrades Langendorff-Modell verwendet, um die Auswirkungen von Levosimendan, dem Ischämie/Reperfusions-Schaden sowie deren Kombination auf die mitochondrialen Funktionen im Herzmuskel zu untersuchen. Dazu wurden vier verschiedene Gruppen von Rattenherzen entsprechend den experimentellen Bedingungen perfundiert, und ihre Funktionen wurden analysiert. Ergebnisse: Der Ischämie/Reperfusions-Schaden beeinträchtigte die myokardiale Ventrikelfunktion. Zusätzlich wurde eine Hypopolarisation des mithochondrialen Membranpotentials in den mit Levosimendan oder Ischämie behandelten Gruppen festgestellt. Die ATP-Synthese in den Gruppen mit Levosimendan und Ischämie war reduziert. Schlussfolgerung: Levosimendan zeigt signifikante Einflüsse auf die Atmungsfunktion der mitochondrialen Komplexe IV und V sowie auf das Membranpotential. Diese Phänomene könnten einem mito-K+ ATP-abhängigen Mechanismus zugrunde liegen. Obwohl Levosimendan während des Ischämie/Reperfusionsschadens eine protektive Wirkung hinsichtlich einer Ca2+- Überlastung aufweist, bleibt der kumulative Einfluss der beeinträchtigten ATP-Generierung auf die gesamte Myokardfunktion zu klären. N2 - The present study investigated the effect of levosimendan on mitochondrial functions in the heart muscle, particularly in connection with ischemia/reperfusion injury. Methods: In the study, a retrograde Langendorff model was used to examine the effects of levosimendan, ischemia/reperfusion injury, and their combination on mitochondrial functions in the heart muscle. For this purpose, four different groups of rat hearts were perfused according to the experimental conditions, and their functions were analyzed. Results: Ischemia/reperfusion injury impaired myocardial ventricular function. Additionally, a hypopolarization of the mitochondrial membrane potential was observed in the groups treated with levosimendan or ischemia. ATP synthesis was reduced in the groups with levosimendan and ischemia. Conclusion: Levosimendan shows significant effects on the respiratory function of mitochondrial complexes IV and V, as well as on the membrane potential. These phenomena could be based on a mito-K+ ATP-dependent mechanism. Although levosimendan has a protective effect during ischemia/reperfusion injury regarding Ca2+ overload, the cumulative impact of impaired ATP generation on overall myocardial function remains to be clarified. KW - Ischämie KW - Ischämie Reperfusion Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-361021 ER - TY - THES A1 - Scheiner, Christin T1 - Vulnerability in adolescence: prevalence, pandemic impact and prevention T1 - Vulnerabilität im Jugendalter: Prävalenzen, Einfluss der Pandemie und Prävention N2 - This compilation focuses on adolescent mental disorders and their prevention. It comprises three distinct studies, each contributing to a deeper understanding of this critical topic. This work addresses a critical gap in the understanding of, and approach to, adolescent mental health, and as a result reveals a critically important and urgently needed policy implication for action. The thematic structure of these studies begins with an examination of the epidemiology of child and adolescent mental disorders. Baseline data were collected from N = 877 adolescents with a mean age of 12.43 years (SD = 0.65). Mental health problems, such as depressive symptoms, non-suicidal self-injury, suicidal ideation, symptoms of eating disorders, and gender differences, are thoroughly examined. Results revealed a significant portion of our sample displaying mental health problems as early as the 6th and 7th grades, with girls generally being more affected than boys. The findings underscore the importance of early adolescence in the emergence of mental health problems and thereby emphasize the need for preventive measures. Moving beyond prevalence estimates, the compilation delves into the etiology of these disorders, exploring their potential correlation with a COVID-19 infection. Understanding the early signs and risk factors is crucial for timely support. While numerous studies have investigated potential risk and protective factors during the pandemic, our focus shifts to adolescents’ coping when an infection with the virus was involved (N = 2,154, M = 12.31, SD = 0.67). We hypothesized that students infected or with close family members infected, would exhibit an increased psychopathology and a decreased functioning of protective factors such as self-efficacy or self-esteem. We found no connection between infection and the mental health status within our sample, but protective factors and mental well-being were positively associated. Thus, universal primary prevention appears to be the preferred approach for promoting mental health. Lastly, the compilation introduces LessStress, a noteworthy contribution to more evidence-based prevention programs. This universal approach is designed to reduce stress in schools, accompanied by a cluster-randomized trial to evaluate its effectiveness (estimated sample size N = 1,894). Existing studies have demonstrated the effectiveness of stress prevention, leading us to introduce a short and easy-to-implement prevention program. There is positive evidence for one-lesson interventions in schools for promoting well-being and health behaviors among adolescents. LessStress is designed based on a life skills approach that not only imparts psychoeducational content but also teaches skills relevant to everyday life and directly applicable. Throughout these studies, a common thread emerges: the pressing need to address mental disorders during childhood and adolescence. These formative years play a pivotal role in the development of mental health problems. These formative years play a crucial role in the development of mental health problems. They highlight the importance of epidemiological data collection and analysis based on the latest models to develop prevention interventions that are not only effective but also reach young people on a global level. N2 - Diese Zusammenstellung konzentriert sich auf psychische Störungen bei Jugendlichen und deren Prävention. Sie umfasst drei verschiedene Studien, die jeweils zu einem tieferen Verständnis dieses wichtigen Themas beitragen. Es wird eine kritische Lücke im Verständnis und Umgang mit der psychischen Gesundheit Jugendlicher adressiert und damit ein wichtiger und dringender politischer Handlungsbedarf aufgezeigt. Die thematische Struktur dieser Studien beginnt mit einer Untersuchung der Epidemiologie psychischer Störungen bei Kindern und Jugendlichen. Es wurden Ausgangsdaten von N = 877 Jugendlichen mit einem Durchschnittsalter von 12,43 Jahren (SD = 0,65) erhoben. Psychische Gesundheitsprobleme wie depressive Symptome, nicht-suizidale Selbstverletzungen, Suizidgedanken, Symptome von Essstörungen und geschlechtsspezifische Unterschiede werden eingehend untersucht. Die Ergebnisse zeigen, dass ein erheblicher Teil der Stichprobe bereits in der 6. und 7. Klasse psychische Probleme aufweist, wobei Mädchen stärker betroffen sind als Jungen. Die Ergebnisse unterstreichen die Bedeutung des frühen Jugendalters für die Entstehung psychischer Probleme und verdeutlichen damit die Notwendigkeit von Präventionsmaßnahmen. Die Zusammenstellung geht über Prävalenzschätzungen hinaus und befasst sich mit der Ätiologie dieser Störungen und untersucht ihren möglichen Zusammenhang mit einer COVID-19-Infektion. Während zahlreiche Studien potenzielle Risiko- und Schutzfaktoren während der Pandemie untersucht haben, konzentriert sich unsere Studie auf die Bewältigung von Jugendlichen im Zusammenhang mit einer Infektion mit dem Virus (N = 2.154, M = 12.31, SD = 0,67). Wir stellten die Hypothese auf, dass eine Infektion mit einer erhöhten Psychopathologie und einer verminderten Funktion von Schutzfaktoren einhergeht. Wir fanden keinen Zusammenhang zwischen der Infektion und dem psychischen Gesundheitszustand in unserer Stichprobe, aber Schutzfaktoren und psychisches Wohlbefinden waren positiv assoziiert. Somit scheint die universelle Primärprävention der bevorzugte Ansatz zur Förderung der psychischen Gesundheit zu sein. Schließlich wird in der Zusammenstellung mit LessStress ein entscheidender Beitrag zu evidenzbasierten Präventionsprogrammen vorgestellt. Dieses universelle Konzept zur Stress-reduzierung in Schulen wird von einer cluster-randomisierten Studie zur Bewertung seiner Wirksamkeit begleitet (geschätzte Stichprobengröße N = 1.894). LessStress wurde auf der Grundlage eines Life-Skills-Ansatzes entwickelt, der nicht nur psychoedukative Inhalte vermittelt, sondern auch alltagsrelevante und direkt anwendbare Fähigkeiten lehrt. Aus den drei vorgestellten Studien geht ein roter Faden hervor: die dringende Notwendigkeit, psychische Störungen im Kindes- und Jugendalter anzugehen. Diese prägenden Jahre spielen eine entscheidende Rolle bei der Entwicklung von Problemen der psychischen Gesundheit. Sie machen deutlich, wie wichtig die Sammlung epidemiologischer Daten und deren Analyse auf der Grundlage neuester Modelle für die Entwicklung von Präventionsmaßnahmen ist, die nicht nur wirksam sind, sondern auch junge Menschen auf globaler Ebene erreichen. KW - Jugend KW - Psychische Belastung KW - Resilienz KW - Stress KW - mental health KW - epidemiology KW - depression KW - etiology KW - Depression KW - Psychische Gesundheit KW - Epidemiologie KW - Ätiologie KW - COVID-19 KW - Primärprevention Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-351644 ER - TY - INPR A1 - Hennig, Thomas A1 - Prusty, Archana B. A1 - Kaufer, Benedikt A1 - Whisnant, Adam W. A1 - Lodha, Manivel A1 - Enders, Antje A1 - Thomas, Julius A1 - Kasimir, Francesca A1 - Grothey, Arnhild A1 - Herb, Stefanie A1 - Jürges, Christopher A1 - Meister, Gunter A1 - Erhard, Florian A1 - Dölken, Lars A1 - Prusty, Bhupesh K. T1 - Selective inhibition of miRNA 1 processing by a herpesvirus encoded miRNA N2 - Herpesviruses have mastered host cell modulation and immune evasion to augment productive infection, life-long latency and reactivation thereof 1,2. A long appreciated, yet elusively defined relationship exists between the lytic-latent switch and viral non-coding RNAs 3,4. Here, we identify miRNA-mediated inhibition of miRNA processing as a thus far unknown cellular mechanism that human herpesvirus 6A (HHV-6A) exploits to disrupt mitochondrial architecture, evade intrinsic host defense and drive the lytic-latent switch. We demonstrate that virus-encoded miR-aU14 selectively inhibits the processing of multiple miR-30 family members by direct interaction with the respective pri-miRNA hairpin loops. Subsequent loss of miR-30 and activation of the miR-30/p53/Drp1 axis triggers a profound disruption of mitochondrial architecture. This impairs induction of type I interferons and is necessary for both productive infection and virus reactivation. Ectopic expression of miR-aU14 triggered virus reactivation from latency, identifying viral miR-aU14 as a readily drugable master regulator of the herpesvirus lytic-latent switch. Our results show that miRNA-mediated inhibition of miRNA processing represents a generalized cellular mechanism that can be exploited to selectively target individual members of miRNA families. We anticipate that targeting miR-aU14 provides exciting therapeutic options for preventing herpesvirus reactivations in HHV-6-associated disorders. KW - Herpesvirus KW - HHV-6A KW - miRNA processing KW - miR-30 KW - mitochondria KW - fusion and fission KW - type I interferon KW - latency KW - virus reactivation Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-267862 ET - accepted version ER - TY - JOUR A1 - Hartmann, Nico A1 - Knierim, Maria A1 - Maurer, Wiebke A1 - Dybkova, Nataliya A1 - Hasenfuß, Gerd A1 - Sossalla, Samuel A1 - Streckfuss-Bömeke, Katrin T1 - Molecular and functional relevance of Na\(_V\)1.8-induced atrial arrhythmogenic triggers in a human SCN10A knock-out stem cell model JF - International Journal of Molecular Sciences N2 - In heart failure and atrial fibrillation, a persistent Na\(^+\) current (I\(_{NaL}\)) exerts detrimental effects on cellular electrophysiology and can induce arrhythmias. We have recently shown that Na\(_V\)1.8 contributes to arrhythmogenesis by inducing a I\(_{NaL}\). Genome-wide association studies indicate that mutations in the SCN10A gene (Na\(_V\)1.8) are associated with increased risk for arrhythmias, Brugada syndrome, and sudden cardiac death. However, the mediation of these Na\(_V\)1.8-related effects, whether through cardiac ganglia or cardiomyocytes, is still a subject of controversial discussion. We used CRISPR/Cas9 technology to generate homozygous atrial SCN10A-KO-iPSC-CMs. Ruptured-patch whole-cell patch-clamp was used to measure the I\(_{NaL}\) and action potential duration. Ca\(^{2+}\) measurements (Fluo 4-AM) were performed to analyze proarrhythmogenic diastolic SR Ca\(^{2+}\) leak. The I\(_{NaL}\) was significantly reduced in atrial SCN10A KO CMs as well as after specific pharmacological inhibition of Na\(_V\)1.8. No effects on atrial APD\(_{90}\) were detected in any groups. Both SCN10A KO and specific blockers of Na\(_V\)1.8 led to decreased Ca\(^{2+}\) spark frequency and a significant reduction of arrhythmogenic Ca\(^{2+}\) waves. Our experiments demonstrate that Na\(_V\)1.8 contributes to I\(_{NaL}\) formation in human atrial CMs and that Na\(_V\)1.8 inhibition modulates proarrhythmogenic triggers in human atrial CMs and therefore Na\(_V\)1.8 could be a new target for antiarrhythmic strategies. KW - Na\(_V\)1.8 KW - iPSC-cardiomyocytes KW - late Na\(^+\) current (I\(_{NaL}\)) KW - CRISPR Cas9 Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362708 SN - 1422-0067 VL - 24 IS - 12 ER - TY - JOUR A1 - Ewald, Andrea A1 - Fuchs, Andreas A1 - Boegelein, Lasse A1 - Grunz, Jan-Peter A1 - Kneist, Karl A1 - Gbureck, Uwe A1 - Hoelscher-Doht, Stefanie T1 - Degradation and bone-contact biocompatibility of two drillable magnesium phosphate bone cements in an in vivo rabbit bone defect model JF - Materials N2 - The use of bone-cement-enforced osteosynthesis is a growing topic in trauma surgery. In this context, drillability is a desirable feature for cements that can improve fracture stability, which most of the available cement systems lack. Therefore, in this study, we evaluated a resorbable and drillable magnesium-phosphate (MgP)-based cement paste considering degradation behavior and biocompatibility in vivo. Two different magnesium-phosphate-based cement (MPC) pastes with different amounts of phytic acid (IP 6) as setting retarder (MPC 22.5 and MPC 25) were implanted in an orthotopic defect model of the lateral femoral condyle of New Zealand white rabbits for 6 weeks. After explantation, their resorption behavior and material characteristics were evaluated by means of X-ray diffraction (XRD), porosimetry measurement, histological staining, peripheral quantitative computed tomography (pQCT), cone-beam computed tomography (CBCT) and biomechanical load-to-failure tests. Both cement pastes displayed comparable results in mechanical strength and resorption kinetics. Bone-contact biocompatibility was excellent without any signs of inflammation. Initial resorption and bone remodeling could be observed. MPC pastes with IP 6 as setting retardant have the potential to be a valuable alternative in distinct fracture patterns. Drillability, promising resorption potential and high mechanical strength confirm their suitability for use in clinical routine. KW - magnesium phosphate cement KW - phytic acid KW - drillability KW - bone replacement material Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362824 SN - 1996-1944 VL - 16 IS - 13 ER - TY - JOUR A1 - Heinz, Tizian A1 - Wild, Moritz A1 - Eidmann, Annette A1 - Weißenberger, Manuel A1 - Rak, Dominik A1 - Nedopil, Alexander Johannes A1 - Rudert, Maximilian A1 - Stratos, Ioannis T1 - Impact of COVID-19 on fracture incidence in germany: a comparative age and gender analysis of pre- and post-outbreak periods JF - Healthcare N2 - In March 2020, Germany imposed a nationwide lockdown to curb the spread of COVID-19, prompting questions about the impact on the incidence of common fractures. This study examined 15 fracture types in pre-outbreak (2010–2019) and post-outbreak (2020–2021) periods, using data categorized by age (18–64 years, 65 years) and sex (male, female). Linear regression assessed annual growth rates, and mean fracture numbers were compared across periods for significant differences. Results indicated a positive correlation between fracture incidence rates and time for various types, such as cervical, thoracic, lumbar, and pelvic spine fractures, rib fractures, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures. Frequencies of proximal humerus, distal radius, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures in 2020 and 2021 were within predicted ranges from previous years. However, rib fractures and spinal fractures (cervical, thoracic, lumbar, and pelvic spine) occurred less frequently during this time. Notably, this study found a consistent decline in most fracture types for individuals aged 18–64 after the pandemic’s onset, while the fracture incidence of hip fractures, often referred to as fragility fractures, for those over 65 remained unchanged. Fibula fractures showed the most considerable decrease in both age groups. In conclusion, the COVID-19 pandemic substantially impacted fracture incidence, with lower rates among individuals under 65 and unchanged fragility fractures in the elderly population. KW - COVID-19 KW - fracture incidence KW - age and gender analysis KW - pre- and post-outbreak comparison KW - fragility fractures KW - linear regression Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362686 SN - 2227-9032 VL - 11 IS - 15 ER - TY - JOUR A1 - Eidmann, Annette A1 - Heinz, Tizian A1 - Oberfeld, Jan A1 - Weißenberger, Manuel A1 - Rudert, Maximilian A1 - Stratos, Ioannis T1 - Epidemiology and trends in cartilage surgery of the foot and ankle in Germany: an analysis of national healthcare billing and reporting data from 2006 to 2020 JF - Medicina N2 - Background and objectives: Cartilage surgery constitutes a standard intervention in foot and ankle procedures. Currently, there is a lack of epidemiological data on its frequency, age distribution, and surgical options for cartilage surgery. This study aimed to investigate the current landscape of cartilage surgery in Germany and identify the most common procedures from an epidemiological standpoint. Materials and methods: Medical billing and reporting data from the Federal Statistical Office of Germany, encompassing the period 2006–2020, was examined, including all foot and ankle cartilage surgical procedures (summarized under OPS codes 5-812 and 5-801). The dataset incorporated information on the affected joint, patient age and sex, and surgery type. Each surgical procedure was categorized as “debridement”, “regeneration” or “refixation”. Linear and nonlinear regression analyses were employed, with a statistical significance threshold of 0.05. Results: From the total of 136,501 procedures conducted during the study period, the most frequently performed interventions were microfracture (58,252) and chondroplasty (56,135), and thus, debridement procedures were in the leading position. The use of acellular membranes was the most used regenerative technique (n = 11,414). At the ankle joint, interventions were mostly arthroscopic and in men, while foot cartilage surgeries were preferably performed via open surgery and mostly in women. Age distribution analysis revealed two primary peaks: the first in the 20–25-year-old group (ankle and foot) and the second in the 45–50-year-old group (ankle) and 55–60-year-old group (foot). Refixation and regenerative procedures were more frequent among younger individuals, while debriding procedures were more frequent among older individuals. Regenerative procedures, particularly in the ankle, significantly increased over time. Conclusions: Cartilage surgery of the foot and ankle was common, with two primary age groups predominantly affected. Notably, recent years have witnessed a considerable rise in cartilage regenerative procedures. KW - cartilage surgery KW - foot and ankle procedures KW - epidemiological analysis KW - regenerative therapies KW - age distribution Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-362835 SN - 1648-9144 VL - 59 IS - 7 ER - TY - THES A1 - Dereser, Katharina T1 - Real World Next Generation M³P Panel-Sequenzierung für die personalisierte Therapie des Multiplen Myeloms T1 - Real world M³P panel sequencing for the personalized therapy of multiple myleoma N2 - Obwohl es in den letzten 10-15 Jahren gelang, multiple MM-Genome mittels NGS auf eine kosteneffiziente Art und mit geringem Zeit- und Materialaufwand zu sequenzieren und hierdurch zum Teil bahnbrechende Erkenntnisse gewonnen werden konnten, sind molekulargenetische Untersuchungen im diagnostischen Workflow des MMs bisher nicht ausreichend implementiert, um eine personalisierte Therapieentscheidung zu ermöglichen. Vor diesem Hintergrund wurde in der vorliegenden Arbeit eine Gruppe an Patienten mit NDMM und RRMM anhand klinischer Parameter charakterisiert und durch Verwendung des M³P-Panels auf das Vorliegen bestimmter molekulargenetischer Veränderungen untersucht. Zusammenfassend lässt sich sagen, dass unsere Analyse die bisher veröffentliche M³P-Prävalenz in MM-Tumorproben bestätigt. Zu den am häufigsten mutierten Genen gehörten KRAS, NRAS, DIS3, ATM und BRAF. In der Gruppe der Patienten mit NRAS-Mutation oder del17p war die Zahl der relevanten Mutationen deutlich höher als ohne Vorliegen der entsprechenden Veränderung. Der Nachweis eines Double-Hit-Myeloms war erwartungsgemäß der stärkste ungünstige Faktor in unserer Kohorte. Unter den Patienten mit CRBN-Mutation waren alle IMiD-vorbehandelt und zeigten im Verlauf eine Refraktärität gegenüber dieser Substanzgruppe auf. Bezüglich der Überlebensanalysen bestätigten unsere Ergebnisse bereits bekannte prognostische Risikofaktoren wie Hochrisikozytogenetik, insbesondere del17p und gain1q, eine TP53-Mutation sowie ISS- und R-ISS-Stadium III. Die Ergebnisse der Mutationsanalysen dieser Arbeit verdeutlichen den großen wissenschaftlichen und therapeutischen Nutzen, der von molekulargenetischen Untersuchungen ausgeht. Zukünftig werden auch beim MM Therapieentscheidungen auf Grundlage genetischer Diagnostik getroffen werden, mit dem Ziel die Behandlung für MM-Patienten weiter zu verbessern. N2 - Although it has been possible in the last 10-15 years to sequence multiple MM genomes using NGS in a cost-efficient manner and with little time and material expenditure, which has led to some groundbreaking findings, molecular genetic examinations have not yet been sufficiently implemented in the diagnostic workflow of MM to enable a personalized therapy decision. Against this background, the present study characterized a group of patients with NDMM and RRMM on the basis of clinical parameters and examined them for the presence of certain molecular genetic alterations using the M³P panel. In summary, our analysis confirms the previously published M³P prevalence in MM tumor samples. The most frequently mutated genes included KRAS, NRAS, DIS3, ATM and BRAF. In the group of patients with NRAS mutation or del17p, the number of relevant mutations was significantly higher than without the corresponding mutation. As expected, the detection of a double-hit myeloma was the strongest unfavorable factor in our cohort. Among the patients with CRBN mutation, all were pretreated with IMiD and showed refractoriness to this drug group over time. With regard to survival analyses, our results confirmed already known prognostic risk factors such as high-risk cytogenetics, in particular del17p and gain1q, a TP53 mutation as well as ISS and R-ISS stage III. The results of the mutation analyses in this study illustrate the great scientific and therapeutic benefits of molecular genetic testing.In future, treatment decisions for MM will also be made on the basis of genetic diagnostics, with the aim of further improving treatment for MM patients. KW - Multiples Myelom KW - Panel-Sequenzierung KW - Plasmozytom KW - Molekulargenetik Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-352644 ER - TY - THES A1 - Meyer-Sautter, Pascal Willy T1 - Evaluation der postoperativen empirischen antibiotischen Therapie intraabdomineller Infektionen aus Sicht des Antimicrobical Stewardships (AMS) T1 - Evaluation of postoperative empirical antibiotic therapy of intra-abdominal infections from the perspective of antimicrobial stewardship (AMS) N2 - Ziele: Das Ziel dieser Dissertation ist es, die empirischen antibiotische Therapien (PAT) bei komplizierten intraabdominellen Infektionen (cIAI) in den Jahren 2016 – 2018 in einem großen deutschen Maximalversorger zu evaluieren. Aktuelle Studien legen nahe, dass viele Patienten keine Nachteile durch kürzere Therapien mit schmaler wirksamen Antibiotika oder das vermeiden einer nicht notwendigen antibiotischen Therapie haben. Methoden: Es wurde eine retrospektive Kohortenstudie durch Analyse von elektronischen Patientenakten an einem 1500-Betten-Universitätsklinikum in Deutschland durchgeführt, bei der die Dauer der Antibiotikatherapie nach Notfalloperationen erhoben und mit antibiotischen Leitlinien durch die hausinterne Antibiotic-Stewardship-Abteilung (AMS) verglichen. Ergebnisse: 767 Patienten konnten eingeschlossen werden, davon erhielten 404 (52.7%) eine PAT. Die Gesamtanzahl der Therapietage pro 100 Patiententagen ging von 47,0 auf 42,2 Tage zurück (p = 0,035) ohne einen Anstieg an Komplikationen. Patienten ohne Sepsis, bei denen eine initiale chirurgischer Fokuskontrolle möglich war profitierten nicht von einer Therapiedauer über 4 Tage (160 vs 100 Patienten). Bei Patienten, bei denen diese Bedingungen nicht gegeben waren, zeigte sich ebenfalls kein Vorteil bei längeren Behandlungen (über >7 Tage, 74 lang vs. 32 kurz behandelte Patienten). Es zeigte sich ebenfalls kein Vorteil von empirischen Therapien mit Carbapenem statt mit Piperacillin-Tazobactam (n=51 C vs n=40 vs Pip/Taz). Schlussfolgerung: Die Reduktion unnötiger, zu breiter und zu langer antibiotischer Therapien bei cIAI ist ohne einen Anstieg der postoperativen Komplikationen möglich. Weitere RCTs sind notwendig, um das Wissen um sichere Behandlungen zu vergrößern. N2 - Objectives: The aim of this dissertation is to evaluate empirical antibiotic therapies (PAT) for complicated intra-abdominal infections (cIAI) in 2016 - 2018 in a large German maximum care hospital. Current studies suggest that many patients have no disadvantages due to shorter therapies with less effective antibiotics or the avoidance of unnecessary antibiotic therapy. Methods: A retrospective cohort study was conducted by analyzing electronic patient records at a 1500-bed university hospital in Germany, in which the duration of antibiotic therapy after emergency surgery was collected and compared with antibiotic guidelines by the in-house antibiotic stewardship department (AMS). Results: 767 patients were included, of which 404 (52.7%) received PAT. The total number of days of therapy per 100 patient days decreased from 47.0 to 42.2 days (p = 0.035) without an increase in complications. Patients without sepsis in whom initial surgical focus control was possible did not benefit from a treatment duration of more than 4 days (160 vs 100 patients). In patients who did not meet these conditions, there was also no advantage to longer treatments (over >7 days, 74 patients treated for a long time vs. 32 for a short time). There was also no advantage of empirical treatment with carbapenem instead of piperacillin-tazobactam (n=51 C vs n=40 vs Pip/Taz). Conclusion: The reduction of unnecessary, too broad and too long antibiotic therapies in cIAI is possible without an increase in postoperative complications. Further RCTs are needed to increase the knowledge of safe treatments. KW - Bakterielle Infektion KW - Antibiotikum KW - Bauchfellentzündung KW - Intraabdominelle Infektion KW - Antibiotic Stewardship Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359201 ER - TY - THES A1 - Kusan, Simon Ferdinand T1 - Keimspektrum und antibiotische Therapie bei Morbus Crohn-assoziierten Abszessen : Eine retrospektive monozentrische Analyse T1 - Microbial spectrum and antibiotic therapy in Crohn's disease-associated abscesses : A retrospective monocentric analysis N2 - In dieser monozentrischen retrospektiven Analyse wurde das Keimspektrum und die antibiotische Therapie bei Morbus Crohn- assoziierten Abszessen untersucht. N2 - In this monocentric retrospective analysis, the bacterial spectrum and antibiotic therapy in Crohn's disease-associated abscesses were investigated. KW - Antibiotikum KW - Abszess KW - Abszesse KW - Antibiotika KW - Morbus Crohn KW - Keimspektrum KW - Crohn-Krankheit Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-359467 ER - TY - THES A1 - Knorr, Susanne T1 - Pathophysiology of early-onset isolated dystonia in a DYT-TOR1A rat model with trauma-induced dystonia-like movements T1 - Pathophysiologie der früh beginnenden, isolierten Dystonie in einem DYT-TOR1A Rattenmodell mit Trauma-induzierten Dystonie-ähnlichen Bewegungen N2 - Early-onset torsion dystonia (DYT-TOR1A, DYT1) is an inherited hyperkinetic movement disorder caused by a mutation of the TOR1A gene encoding the torsinA protein. DYT-TOR1A is characterized as a network disorder of the central nervous system (CNS), including predominantly the cortico-basal ganglia-thalamo-cortical loop resulting in a severe generalized dystonic phenotype. The pathophysiology of DYTTOR1A is not fully understood. Molecular levels up to large-scale network levels of the CNS are suggested to be affected in the pathophysiology of DYT-TOR1A. The reduced penetrance of 30% - 40% indicates a gene-environmental interaction, hypothesized as “second hit”. The lack of appropriate and phenotypic DYT-TOR1A animal models encouraged us to verify the “second hit” hypothesis through a unilateral peripheral nerve trauma of the sciatic nerve in a transgenic asymptomatic DYT-TOR1A rat model (∆ETorA), overexpressing the human mutated torsinA protein. In a multiscale approach, this animal model was characterized phenotypically and pathophysiologically. Nerve-injured ∆ETorA rats revealed dystonia-like movements (DLM) with a partially generalized phenotype. A physiomarker of human dystonia, describing increased theta oscillation in the globus pallidus internus (GPi), was found in the entopeduncular nucleus (EP), the rodent equivalent to the human GPi, of nerve-injured ∆ETorA rats. Altered oscillation patterns were also observed in the primary motor cortex. Highfrequency stimulation (HFS) of the EP reduced DLM and modulated altered oscillatory activity in the EP and primary motor cortex in nerve-injured ∆ETorA rats. Moreover, the dopaminergic system in ∆ETorA rats demonstrated a significant increased striatal dopamine release and dopamine turnover. Whole transcriptome analysis revealed differentially expressed genes of the circadian clock and the energy metabolism, thereby pointing towards novel, putative pathways in the pathophysiology of DYTTOR1A dystonia. In summary, peripheral nerve trauma can trigger DLM in genetically predisposed asymptomatic ΔETorA rats leading to neurobiological alteration in the central motor network on multiple levels and thereby supporting the “second hit” hypothesis. This novel symptomatic DYT-TOR1A rat model, based on a DYT-TOR1A genetic background, may prove as a valuable chance for DYT-TOR1A dystonia, to further investigate the pathomechanism in more detail and to establish new treatment strategies. N2 - Früh beginnende Torsionsdystonie (DYT-TOR1A, DYT1) ist eine genetisch bedingte hyperkinetische Bewegungsstörung, die aufgrund einer Mutation im TOR1A Gen verursacht wird, welches für das TorsinA-Protein codiert. DYT-TOR1A wird als zentrale Netzwerkstörung bezeichnet und betrifft hauptsächlich die kortiko-striatothalamo-kortikale Funktionsschleife, welches schließlich zu einem schweren generalisierten dystonen Phänotyp führt. Die Pathophysiologie von DYT-TOR1A ist nicht vollständig verstanden, man geht jedoch davon aus, dass Ebenen im Zentralnervensystem von molekularer Basis bis hin zu ganzen Netzwerken betroffen sind. Die reduzierte Penetranz von nur 30% bis 40% deutet auf eine Gen-UmweltInteraktion hin, im Sinne einer „2-Treffer-Hypothese“. Auch das Fehlen eines adäquaten DYT-TOR1A Tiermodelles hat uns dazu veranlasst, die „2-TrefferHypothese“ zu verifizieren, indem eine unilaterale periphere Quetschläsion des Nervus ischiadicus in einem transgenen, asymptomatischen DYT-TOR1A Rattenmodell (∆ETorA) durchgeführt wurde, welches das humane mutierte TorsinA-Protein überexprimiert. Das Tiermodell wurde phänotypisch und pathophysiologisch auf verschiedenen Analysenebenen charakterisiert. ∆ETorA Ratten mit Quetschläsion entwickelten Dystonie-ähnliche Bewegungen (DLM) mit teilweise generalisiertem Phänotyp. Erhöhte Theta-Oszillationen im Globus pallidus internus (GPi) sind bezeichnend für die humane Dystonie, welche auch im Nucleus entopeduncularis (EP), dem Äquivalent zum humanen GPi, von ∆ETorA Ratten mit Quetschläsion nachgewiesen wurden. Veränderte oszillatorische Muster wurden auch im primären Motorkortex gefunden. Hochfrequenz-Stimulation (HFS) des EP konnte das klinische Erscheinungsbild verbessern und hatte zudem auch einen modulatorischen Effekt auf die veränderte oszillatorische Aktivität des EP und des primären Motorcortex von ∆ETorA Ratten mit Quetschläsion. Auch das veränderte dopaminerge System erwies sich als ein pathologisches Merkmal in ∆ETorA Ratten. Es fand sich eine erhöhte striatale Ausschüttung von Dopamin und ein erhöhter Dopaminumsatz. In der Transkriptomanalyse kamen die zirkadiane Uhr und der Energiemetabolismus als weitere potentielle Signalwege in der Pathophysiologie der DYT-TOR1A Dystonie zum Vorschein. Zusammengefasst konnten DLM in genetisch prädisponierten, asymptomatischen ΔETorA Ratten mittels peripheren Nerventraumas ausgelöst werden, welches zu neurobiologischen Veränderungen in verschiedenen Ebenen des zentralen motorischen Netzwerk führte. Somit konnte die „2-Treffer-Hypothese“ bestätigt werden. Dieses neue symptomatische DYT-TOR1A Rattenmodell, fundiert auf der genetischen Grundlage von DYT-TOR1A, kann sich als wertvolle Möglichkeit für die DYT-TOR1A Dystonie erweisen, um Pathomechanismen genauer zu untersuchen und neue Behandlungsstrategien zu entwickeln. KW - Dystonie KW - Trauma KW - Ratte KW - Zentralnervensystem KW - DYT-TOR1A KW - early-onset isolated dystonia KW - gene-environmental interaction KW - peripheral nerve trauma KW - striatum KW - dopamine KW - deep brain stimulation Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-206096 ER - TY - THES A1 - Peña Mosca, María Josefina T1 - Local regulation of T-cell immunity in the intestinal mucosa T1 - Lokale Regulation der T-Zell-Immunität in der Darmschleimhaut N2 - After priming in Peyer's patches (PPs) and mesenteric lymph nodes (mLN) T- cells infiltrate the intestine through lymphatic draining and homing through the bloodstream. However, we found that in mouse models of acute graft-versus-host disease (GvHD), a subset of alloreactive T-cells directly migrates from PPs to the adjacent intestinal lamina propria (LP), bypassing the normal lymphatic drainage and vascular trafficking routes. Notably, this direct migration occurred in irradiated and unirradiated GvHD models, indicating that irradiation is not a prerequisite for this observed behavior. Next, we established a method termed serial intravascular staining (SIVS) in mouse models to systematically investigate the trafficking and migration of donor T- cells in the early stages of acute GvHD initiation. We found that the direct migration of T-cells from PPs to LP resulted in faster recruitment of cells after allogeneic hematopoietic cell transplantation (allo-HCT). These directly migrating T-cells were found to be in an activated and proliferative state, exhibiting a TH1/TH17-like phenotype and producing cytokines such as IFN-γ and TNF-α. Furthermore, we observed that the directly migrating alloreactive T-cells expressed specific integrins (α4+, αE+) and chemokine receptors (CxCR3+, CCR5+, and CCR9+). Surprisingly, blocking these integrins and chemokine-coupled receptors did not hinder the direct migration of T- cells from PPs to LP, suggesting the involvement of alternative mechanisms. Previous experiments ruled out the involvement of S1PR1 and topographical features of macrophages, leading us to hypothesize that mediators of cytoskeleton reorganization, such as Coro1a, Dock2, or Cdc42, may play a role in this unique migration process. Additionally, we observed that directly migrating T-cells created a local inflammatory microenvironment, which attracts circulating T-cells. Histological analysis confirmed that alloreactive PPs-derived T-cells and bloodborne T-cells colocalized. We employed two experimental approaches, including either photoconversion of T-cells in PPs or direct transfer of activated T-cells into the vasculature, to demonstrate this colocalization. We hypothesize that cytokines released by migrating T-cells, such as IFN-γ and TNF-α, may play a role in recruiting T-cells from the vasculature, as inhibiting chemokine-coupled receptors did not impair recruitment. N2 - Nach der Priming-Phase in den Peyer-Plaques (PPs) und mesenterialen Lymphknoten (mLN) migrieren T-Zellen über die lymphatische Drainage und den Blutkreislauf die Darmschleimhaut. Allerdings haben wir festgestellt, dass in Mausmodellen der akuten Graft-versus-Host Erkrankung (GvHD) eine Untergruppe alloreaktiver T-Zellen direkt von den Peyer-Plaques in das benachbarte intestinale Lamina propria (LP) migriert, ohne lymphatische Drainage- oder vaskuläre Transportwege zu nutzen. Bemerkenswert ist, dass diese direkte Migration sowohl in bestrahlten als auch in nicht bestrahlten GvHD-Modellen auftrat, was darauf hindeutet, dass Gewebeschaden durch ionisierende Strahlung keine Voraussetzung für dieses beobachtete T-Zell-Migrationsverhalten ist. Anschließend haben wir die Methode der "serielle intravaskulären Zellmarkierung" (SIVS) für Mausmodelle etabliert, um systematisch das Migrationsverhalten von alloreaktiven Spender-T-Zellen in den frühen Stadien der akuten GvHD-Initiierung zu untersuchen. Wir beobachteten, dass die direkte Migration von T-Zellen von PPs zu LP zu einer schnelleren Rekrutierung von Zellen nach allogener hämatopoetischer Zelltransplantation (allo-HCT) führte. Diese direkt migrierenden T-Zellen befanden sich in einem aktivierten und proliferativen Zustand, wiesen einen TH1-/TH17- ähnlichen Phänotyp auf und produzierten Zytokine wie IFN- γ und TNF-α. Darüber hinaus beobachteten wir, dass die direkt migrierenden alloreaktiven T-Zellen spezifische Integrine (α4+, αE+) und Chemokinrezeptoren (CxCR3+, CCR5+ und CCR9+) exprimierten. Überraschenderweise verhinderte die Blockierung dieser Integrine und Chemokinrezeptoren nicht die direkte Migration von T-Zellen aus PPs in LP, was auf die Beteiligung alternativer T- Zellmigrationsmechanismen schließen lässt. Vorangegangene Experimente schlossen die Beteiligung von S1PR1 und topografischer Merkmale gewebeständiger Makrophagen aus, was uns zu der Hypothese führte, dass Mediatoren der Zytoskelett- Reorganisation wie Coro1a, Dock2 oder Cdc42 eine Rolle in diesem einzigartigen Migrationsprozess spielen könnten. Zusätzlich beobachteten wir, dass direkt migrierende T-Zellen in der Darmschleimhaut ein lokales entzündliches Mikromilieu schaffen, welches zirkulierende T-Zellen anzieht. Die histologische Analyse bestätigte die Kolokalisation von direkt aus PP stammenden T-Zellen und T Zellen, welche über die Blutbahn in die Darmmukosa einwanderten. Um die direkte T-Zellmigration eindeutig zu bestätigen, wählten wir zwei experimentelle Ansätze: Die Photokonversion von T-Zellen in PPs während der Priming-Phase sowie den direkten Transfer aktivierter T-Zellen in das Gefäßsystem, um eine T-Zellkolokalisierung nachzuweisen. Aufbauend auf den Ergebnissen vermuten wir, dass Zytokine, die von migrierenden T-Zellen freigesetzt werden, wie zum Beispiel IFN-γ und TNF-α, möglicherweise eine Rolle bei der Rekrutierung von T-Zellen aus dem Gefäßsystem spielen, da die Hemmung von G- Protein-gekoppelter Rezeptoren (und somit aller Chemokinrezeptoren) die T-Zell- Rekrutierung nicht beeinträchtigte. KW - T-Lymphozyt KW - Transplantat-Wirt-Reaktion KW - Zellmigration KW - Darm KW - Peyer's patch KW - Graft versus Host disease KW - T-cell KW - Cell migration KW - Small intestine KW - Bone marrow transplantation Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-352665 ER - TY - JOUR A1 - Righesso, L. A. R. A1 - Terekhov, M. A1 - Götz, H. A1 - Ackermann, M. A1 - Emrich, T. A1 - Schreiber, L. M. A1 - Müller, W. E. G. A1 - Jung, J. A1 - Rojas, J. P. A1 - Al-Nawas, B. T1 - Dynamic contrast-enhanced magnetic resonance imaging for monitoring neovascularization during bone regeneration — a randomized in vivo study in rabbits JF - Clinical Oral Investigations N2 - Objectives Micro-computed tomography (μ-CT) and histology, the current gold standard methods for assessing the formation of new bone and blood vessels, are invasive and/or destructive. With that in mind, a more conservative tool, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), was tested for its accuracy and reproducibility in monitoring neovascularization during bone regeneration. Additionally, the suitability of blood perfusion as a surrogate of the efficacy of osteoplastic materials was evaluated. Materials and methods Sixteen rabbits were used and equally divided into four groups, according to the time of euthanasia (2, 3, 4, and 6 weeks after surgery). The animals were submitted to two 8-mm craniotomies that were filled with blood or autogenous bone. Neovascularization was assessed in vivo through DCE-MRI, and bone regeneration, ex vivo, through μ-CT and histology. Results The defects could be consistently identified, and their blood perfusion measured through DCE-MRI, there being statistically significant differences within the blood clot group between 3 and 6 weeks (p = 0.029), and between the former and autogenous bone at six weeks (p = 0.017). Nonetheless, no significant correlations between DCE-MRI findings on neovascularization and μ-CT (r =−0.101, 95% CI [−0.445; 0.268]) or histology (r = 0.305, 95% CI [−0.133; 0.644]) findings on bone regeneration were observed. Conclusions These results support the hypothesis that DCE-MRI can be used to monitor neovascularization but contradict the premise that it could predict bone regeneration as well. KW - animal experimentation KW - bone regeneration KW - multiparametric magnetic resonance imaging KW - neovascularization, physiologic KW - tissue engineering KW - translational medical research Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307614 SN - 1432-6981 SN - 1436-3771 VL - 25 IS - 10 ER - TY - JOUR A1 - Lenz, Dominic A1 - Pahl, Jens A1 - Hauck, Fabian A1 - Alameer, Seham A1 - Balasubramanian, Meena A1 - Baric, Ivo A1 - Boy, Nikolas A1 - Church, Joseph A. A1 - Crushell, Ellen A1 - Dick, Anke A1 - Distelmaier, Felix A1 - Gujar, Jidnyasa A1 - Indolfi, Giuseppe A1 - Lurz, Eberhard A1 - Peters, Bianca A1 - Schwerd, Tobias A1 - Serranti, Daniele A1 - Kölker, Stefan A1 - Klein, Christoph A1 - Hoffmann, Georg F. A1 - Prokisch, Holger A1 - Greil, Johann A1 - Cerwenka, Adelheid A1 - Giese, Thomas A1 - Staufner, Christian T1 - NBAS Variants Are Associated with Quantitative and Qualitative NK and B Cell Deficiency JF - Journal of Clinical Immunology N2 - Purpose Biallelic pathogenic NBAS variants manifest as a multisystem disorder with heterogeneous clinical phenotypes such as recurrent acute liver failure, growth retardation, and susceptibility to infections. This study explores how NBAS-associated disease affects cells of the innate and adaptive immune system. Methods Clinical and laboratory parameters were combined with functional multi-parametric immunophenotyping methods in fifteen NBAS-deficient patients to discover possible alterations in their immune system. Results Our study revealed reduced absolute numbers of mature CD56dim natural killer (NK) cells. Notably, the residual NK cell population in NBAS-deficient patients exerted a lower potential for activation and degranulation in response to K562 target cells, suggesting an NK cell–intrinsic role for NBAS in the release of cytotoxic granules. NBAS-deficient NK cell activation and degranulation was normalized upon pre-activation by IL-2 in vitro, suggesting that functional impairment was reversible. In addition, we observed a reduced number of naïve B cells in the peripheral blood associated with hypogammaglobulinemia. Conclusion In summary, we demonstrate that pathogenic biallelic variants in NBAS are associated with dysfunctional NK cells as well as impaired adaptive humoral immunity. KW - NBAS KW - inborn error of immunity KW - NK cell deficiency KW - B cell deficiency KW - vesicle trafficking KW - familial hemophagocytic lymphohistiocytosis Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308362 SN - 0271-9142 SN - 1573-2592 VL - 41 IS - 8 ER - TY - JOUR A1 - Estrada, Veronica A1 - Krebbers, Julia A1 - Voss, Christian A1 - Brazda, Nicole A1 - Blazyca, Heinrich A1 - Illgen, Jennifer A1 - Seide, Klaus A1 - Jürgens, Christian A1 - Müller, Jörg A1 - Martini, Rudolf A1 - Trieu, Hoc Khiem A1 - Müller, Hans Werner T1 - Low-pressure micro-mechanical re-adaptation device sustainably and effectively improves locomotor recovery from complete spinal cord injury JF - Communications Biology N2 - Traumatic spinal cord injuries result in impairment or even complete loss of motor, sensory and autonomic functions. Recovery after complete spinal cord injury is very limited even in animal models receiving elaborate combinatorial treatments. Recently, we described an implantable microsystem (microconnector) for low-pressure re-adaption of severed spinal stumps in rat. Here we investigate the long-term structural and functional outcome following microconnector implantation after complete spinal cord transection. Re-adaptation of spinal stumps supports formation of a tissue bridge, glial and vascular cell invasion, motor axon regeneration and myelination, resulting in partial recovery of motor-evoked potentials and a thus far unmet improvement of locomotor behaviour. The recovery lasts for at least 5 months. Despite a late partial decline, motor recovery remains significantly superior to controls. Our findings demonstrate that microsystem technology can foster long-lasting functional improvement after complete spinal injury, providing a new and effective tool for combinatorial therapies. KW - implants KW - preclinical research KW - spinal cord injury Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227357 VL - 1 ER - TY - JOUR A1 - Holländer, Olivia A1 - Schwender, Kristina A1 - Böhme, Petra A1 - Fleckhaus, Jan A1 - Haas, Cordula A1 - Han, Yang A1 - Heidorn, Frank A1 - Klein-Unseld, Rachel A1 - Lichtenwald, Julia A1 - Naue, Jana A1 - Neubauer, Jacqueline A1 - Poetsch, Micaela A1 - Schneider, Peter M. A1 - Wagner, Wolfgang A1 - Vennemann, Marielle T1 - Forensische DNA-Methylierungsanalyse T1 - Forensic DNA methylation analysis : First technical collaborative exercise by the working group on molecular age estimation of the German Society of Legal Medicine BT - Erster, technischer Ringversuch der Arbeitsgruppe „Molekulare Altersschätzung“ der Deutschen Gesellschaft für Rechtsmedizin JF - Rechtsmedizin N2 - Die quantitative Analyse der relativen DNA-Methylierung gilt als eine der vielversprechendsten Methoden der molekularen Altersschätzung. Viele Studien der letzten Jahre identifizierten geeignete Positionen im Genom, deren DNA-Methylierung sich altersabhängig verändert. Für den Einsatz dieser Methode in der Routine- bzw. Fallarbeit ist es von großer Bedeutung, angewandte Analysetechniken zu validieren. Als ein Teilaspekt dieser Validierung sollte die Vergleichbarkeit der Analyseergebnisse zur DNA-Methylierung mithilfe der Mini- und Pyrosequenzierung zwischen verschiedenen Laboren evaluiert werden. Die Arbeitsgruppe „Molekulare Altersschätzung“ der Deutschen Gesellschaft für Rechtsmedizin (DGRM) führte hierzu den ersten, technischen Ringversuch durch, der 4 Positionen in den Genen PDE4C, EDARADD, SST und KLF14 umfasste. Diese Marker waren in vorangegangenen Studien als altersabhängige Biomarker charakterisiert worden. Am Ringversuch nahmen 12 Labore teil, wobei jedes die Wahl zwischen der Minisequenzierung und/oder der Pyrosequenzierung für die quantitative Methylierungsanalyse hatte. Jedem teilnehmenden Labor wurden Blut- und Speichelproben von 3 Personen unterschiedlichen Alters übersandt. Die Wahl der Reagenzien für die Probenbearbeitung wurde den Teilnehmern freigestellt. Die Ergebnisse der Minisequenzierung zeigten systematische Abweichungen zwischen den Laboren, die am ehesten auf die Verwendung unterschiedlicher Reagenzien und Analyseplattformen zurückzuführen sein können. Die Resultate der Pyrosequenzierung hingegen wiesen nicht auf systematische Abweichungen zwischen den Laboren hin, hier zeigte sich jedoch die Tendenz einer markerabhängigen Abweichung. Darüber hinaus konnten Unterschiede hinsichtlich technischer Probleme zwischen Laboren mit mehr Erfahrung in der jeweiligen Sequenzierungsmethode und Laboren mit weniger Erfahrung festgestellt werden. Sowohl die Beobachtung von systematischen als auch die von markerabhängigen Abweichungen lässt den Schluss zu, dass eine Übertragung von Analysemethoden zwischen Laboren grundsätzlich möglich ist, eine Anpassung des jeweiligen Modells zur Altersschätzung jedoch notwendig sein kann. N2 - Quantitative analysis of relative DNA methylation is currently one of the most promising methods of molecular age estimation. In recent years numerous studies identified potential DNA methylation markers showing age-dependent changes in their relative methylation state. For routine application of this method validation is an important prerequisite. One aspect of validation is the degree of comparability of analytical data between laboratories. The working group on molecular age estimation of the German Society for Legal Medicine (DGRM) conducted a first technical proficiency test comprising four age estimation markers within the genes PDE4C, EDARADD, SST and KLF14. These positions were previously characterized as age-dependent biomarkers. A total of 12 laboratories participated using pyrosequencing and/or minisequencing techniques for quantitative analysis of DNA methylation. Each laboratory received blood and buccal swab samples from three individuals of different ages. Laboratories were free in their choice of reagents and material for sequencing. Minisequencing results showed systematic deviations between laboratories, which are believed to originate from differing reagents and sequencing platforms. The results of pyrosequencing did not show clear signs of systematic deviation but did show differences in the comparability between markers. Different levels of technical problems were reported, which correlated with the amount of experience with the sequencing technology. Both systematic and specific differences between analytical data produced in different laboratory settings lead to the conclusion that while it is generally possible to transfer an age estimation method to another laboratory, a mathematical model for age estimation might need to be adjusted accordingly. KW - DNA-Methylierung KW - Pyrosequenzierung KW - Minisequenzierung KW - Ergebnisreproduzierbarkeit KW - Laborleistungstests KW - DNA methylation KW - minisequencing KW - pyrosequencing KW - reproducibility of results KW - laboratory proficiency testing Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307131 SN - 0937-9819 SN - 1434-5196 VL - 31 IS - 3 ER - TY - JOUR A1 - El-Mesery, Mohamed A1 - Rosenthal, Tina A1 - Rauert-Wunderlich, Hilka A1 - Schreder, Martin A1 - Stühmer, Thorsten A1 - Leich, Ellen A1 - Schlosser, Andreas A1 - Ehrenschwender, Martin A1 - Wajant, Harald A1 - Siegmund, Daniela T1 - The NEDD8-activating enzyme inhibitor MLN4924 sensitizes a TNFR1+ subgroup of multiple myeloma cells for TNF-induced cell death JF - Cell Death & Disease N2 - The NEDD8-activating enzyme (NAE) inhibitor MLN4924 inhibits cullin-RING ubiquitin ligase complexes including the SKP1-cullin-F-box E3 ligase βTrCP. MLN4924 therefore inhibits also the βTrCP-dependent activation of the classical and the alternative NFĸB pathway. In this work, we found that a subgroup of multiple myeloma cell lines (e.g., RPMI-8226, MM.1S, KMS-12BM) and about half of the primary myeloma samples tested are sensitized to TNF-induced cell death by MLN4924. This correlated with MLN4924-mediated inhibition of TNF-induced activation of the classical NFκB pathway and reduced the efficacy of TNF-induced TNFR1 signaling complex formation. Interestingly, binding studies revealed a straightforward correlation between cell surface TNFR1 expression in multiple myeloma cell lines and their sensitivity for MLN4924/TNF-induced cell death. The cell surface expression levels of TNFR1 in the investigated MM cell lines largely correlated with TNFR1 mRNA expression. This suggests that the variable levels of cell surface expression of TNFR1 in myeloma cell lines are decisive for TNF/MLN4924 sensitivity. Indeed, introduction of TNFR1 into TNFR1-negative TNF/MLN4924-resistant KMS-11BM cells, was sufficient to sensitize this cell line for TNF/MLN4924-induced cell death. Thus, MLN4924 might be especially effective in myeloma patients with TNFR1+ myeloma cells and a TNFhigh tumor microenvironment. KW - cancer therapy KW - tumour-necrosis factors Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226666 VL - 10 ER - TY - JOUR A1 - Adolph, Jonas E. A1 - Fleischhack, Gudrun A1 - Gaab, Christine A1 - Mikasch, Ruth A1 - Mynarek, Martin A1 - Rutkowski, Stefan A1 - Schüller, Ulrich A1 - Pfister, Stefan M. A1 - Pajtler, Kristian W. A1 - Milde, Till A1 - Witt, Olaf A1 - Bison, Brigitte A1 - Warmuth-Metz, Monika A1 - Kortmann, Rolf-Dieter A1 - Dietzsch, Stefan A1 - Pietsch, Torsten A1 - Timmermann, Beate A1 - Tippelt, Stephan T1 - Systemic chemotherapy of pediatric recurrent ependymomas: results from the German HIT-REZ studies JF - Journal of Neuro-Oncology N2 - Purpose Survival in recurrent ependymoma (EPN) depends mainly on the extent of resection achieved. When complete resection is not feasible, chemotherapy is often used to extend progression-free and overall survival. However, no consistent effect of chemotherapy on survival has been found in patients with recurrent EPN. Methods Systemic chemotherapeutic treatment of 138 patients enrolled in the German HIT-REZ-studies was analyzed. Survival depending on the use of chemotherapy, disease-stabilization rates (RR), duration of response (DOR) and time to progression (TTP) were estimated. Results Median age at first recurrence was 7.6 years (IQR: 4.0–13.6). At first recurrence, median PFS and OS were 15.3 (CI 13.3–20.0) and 36.9 months (CI 29.7–53.4), respectively. The Hazard Ratio for the use of chemotherapy in local recurrences in a time-dependent Cox-regression analysis was 0.99 (CI 0.74–1.33). Evaluable responses for 140 applied chemotherapies were analyzed, of which sirolimus showed the best RR (50%) and longest median TTP [11.51 (CI 3.98; 14.0) months] in nine patients, with the strongest impact found when sirolimus was used as a monotherapy. Seven patients with progression-free survival > 12 months after subtotal/no-resection facilitated by chemotherapy were found. No definitive survival advantage for any drug in a specific molecularly defined EPN type was found. Conclusion No survival advantage for the general use of chemotherapy in recurrent EPN was found. In cases with incomplete resection, chemotherapy was able to extend survival in individual cases. Sirolimus showed the best RR, DOR and TTP out of all drugs analyzed and may warrant further investigation. KW - ependymoma KW - chemotherapy KW - recurrence KW - children KW - sirolimus Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308302 SN - 0167-594X SN - 1573-7373 VL - 155 IS - 2 ER - TY - JOUR A1 - Dornquast, Christina A1 - Reinhold, Thomas A1 - Solak, Saliha A1 - Durak, Melike A1 - Becher, Heiko A1 - Riens, Burgi A1 - Icke, Katja A1 - Danquah, Ina A1 - Willich, Stefan N. A1 - Keil, Thomas A1 - Krist, Lilian T1 - Strategies to Enhance Retention in a Cohort Study Among Adults of Turkish Descent Living in Berlin JF - Journal of Immigrant and Minority Health N2 - Retention is important for statistical power and external validity in long-term cohort studies. The aims of our study were to evaluate different retention strategies within a cohort study of adults of Turkish descent in Berlin, Germany, and to compare participants and non-participants. In 2011–2012, a population-based study was conducted among adults of Turkish descent to primarily examine recruitment strategies. 6 years later, the participants were re-contacted and invited to complete a self-report questionnaire regarding their health status, health care utilization, and satisfaction with medical services. The retention strategy comprised letters in both German and Turkish, phone calls, and home visits (by bilingual staff). We calculated the response rate and retention rate, using definitions of the American Association for Public Opinion Research, as well as the relative retention rate for each level of contact. Associations of baseline recruitment strategy, sociodemographic, migration-related and health-related factors with retention were investigated by logistic regression analysis. Of 557 persons contacted, 249 (44.7%) completed the questionnaire. This was 50.1% of those whose contact information was available. The relative retention rate was lowest for phone calls (8.9%) and highest for home visits (18.4%). Participants were more often non-smokers and German citizens than non-participants. For all remaining factors, no association with retention was found. In this study, among adults of Turkish descent, the retention rate increased considerably with every additional level of contact. Implementation of comprehensive retention strategies provided by culturally matched study personnel may lead to higher validity and statistical power in studies on migrant health issues. KW - retention strategies KW - cohort studies KW - migrants KW - participation Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-344776 VL - 24 IS - 5 ER - TY - JOUR A1 - Amereller, Felix A1 - Deutschbein, Timo A1 - Joshi, Mamta A1 - Schopohl, Jochen A1 - Schilbach, Katharina A1 - Detomas, Mario A1 - Duffy, Leo A1 - Carroll, Paul A1 - Papa, Sophie A1 - Störmann, Sylvère T1 - Differences between immunotherapy-induced and primary hypophysitis—a multicenter retrospective study JF - Pituitary N2 - Objective Immune checkpoint inhibitors can cause various immune-related adverse events including secondary hypophysitis. We compared clinical characteristics of immunotherapy-induced hypophysitis (IIH) and primary hypophysitis (PH) Design Retrospective multicenter cohort study including 56 patients with IIH and 60 patients with PH. Methods All patients underwent extensive endocrine testing. Data on age, gender, symptoms, endocrine dysfunction, MRI, immunotherapeutic agents and autoimmune diseases were collected. Results Median time of follow-up was 18 months in IIH and 69 months in PH. The median time from initiation of immunotherapy to IIH diagnosis was 3 months. IIH affected males more frequently than PH (p < 0.001) and led to more impaired pituitary axes in males (p < 0.001). The distribution of deficient adenohypophysial axes was comparable between both entities, however, central hypocortisolism was more frequent (p < 0.001) and diabetes insipidus considerably less frequent in IIH (p < 0.001). Symptoms were similar except that visual impairment occurred more rarely in IIH (p < 0.001). 20 % of IIH patients reported no symptoms at all. Regarding MRI, pituitary stalk thickening was less frequent in IIH (p = 0.009). Concomitant autoimmune diseases were more prevalent in PH patients before the diagnosis of hypophysitis (p = 0.003) and more frequent in IIH during follow-up (p = 0.002). Conclusions Clinically, IIH and PH present with similar symptoms. Diabetes insipidus very rarely occurs in IIH. Central hypocortisolism, in contrast, is a typical feature of IIH. Preexisting autoimmunity seems not to be indicative of developing IIH. KW - primary hypophysitis KW - immunotherapy-induced hypophysitis KW - checkpoint inhibitors KW - immune-related adverse events KW - pembrolizumab KW - ipilimumab KW - nivolumab Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308704 SN - 1386-341X SN - 1573-7403 VL - 25 IS - 1 ER - TY - THES A1 - Kruse, Daniel T1 - Quantitative Analyse histologischer Aufnahmen der Haut T1 - Quantitative analysis of histological images of the skin N2 - Diese Arbeit hatte zum Ziel quantitative Analysen histologischer Aufnahmen der Haut nach unterschiedlichen Gesichtspunkten zu etablieren. Im ersten Abschnitt wurde die bildgestützte Quantifizierung der epidermalen Histomorphologie untersucht. Nach Sichtung und Beurteilung von 2145 hochauflösenden Fotografien HE-gefärbter Epidermis- und Vollhautmodellen jeglichen Zustands, wurde der BSGC-Score als Facettenklassifikation mit seinen insgesamt 40 Beurteilungskriterien aufgestellt. Die unterschiedlichen epidermalen Strata wurden mit Wichtungsfaktoren belegt. Die Bewertungskategorien sind mit einem Ampelsystem unterlegt. Eine Befundungsformel wurde aufgestellt. Weitere Bestandteile des BSGC-Scores sind eine Anleitung mit Bildbeilage sowie Dokumentationselemente. Die Anwendung erfolgte erfolgreich im Rahmen der Qualitätssicherung an Chargentests und zur Verlaufsbeurteilung eines In-vitro-Verbrennungsmodells aus humaner Epidermis durch Schneider et al. (2021) Der BSGC-Score dient als zügig durchführbares Evaluationstool zur Befundung von In-vitro-Epidermismodellen und nicht als diagnostisches Mittel. Der zweite Abschnitt beschäftigt sich mit der Vaskularisierung als Parameter der kutanen Wundheilung. Es wurden aSMA-IF-gefärbte Abbildungen porciner Verwundungsmodelle betrachtet und nach der Entfernung drüsiger Strukturen Gefäßanschnitte zu Beginn manuell ausgezählt. Hieraus wurden die nötigen Einstellungen für die Bildbearbeitungssoftware ImageJ ermittelt und die Abbildungen dieser anschließend zugeführt. Es erfolgte die automatisierte Quantifizierung elliptischer Formationen mit einer Größe ≥ 30 Pixel. Im nächsten Schritt wurden die Abbildungen in die Bereiche Wundrand, Wundgrund und Wundheilung unterteilt. In dem Bereich Wundheilung zeigte sich eine signifikant größere Revaskularisierung als in Wundgrund. Abschließend erfolgte der Vergleich sekundärer Wundauflagen. Der Vergleich der Quotienten Wundheilung/Wundgrund nicht-okklusiver und okklusiver Wundauflagen zeigte keinen signifikanten Unterschied in der Neovaskularisierung. Die isolierte Betrachtung der Revaskularisierung als einzelner Prozess der Wundheilung kann nicht als generelles Kriterium für die Gesamtbeurteilung dienen. Hier findet die gewählte Methodik ihre Limitation. Zukünftige Anwendungsbereiche des BSGC-Scores sind die Ausweitung auf Vollhautmodelle und andere Verwundungsmodalitäten. Eine automatisierte und durch eine KI-gestützte Befundung ist ebenfalls aufgrund des zugrundeliegenden umfangreichen Datensatzes denkbar. Auch kann eine automatisierte softwaregestützte Quantifizierung der Vaskularisierung als überblickende und zügige Beurteilung der Wundheilung sinnvoll erscheinen. N2 - This work aimed to establish quantitative analyses of histological images of the skin according to different aspects. In the first section, image-based quantification of epidermal histomorphology was investigated. After reviewing and assessing 2145 high-resolution photographs of HE-stained epidermis and full-thickness skin models of any condition, the BSGC score was established as a facet classification with its total of 40 assessment criteria. Weighting factors were assigned to the different epidermal strata. The assessment categories are underlaid with a color system. A scoring formula was established. Further components of the BSGC score are a manual with picture supplement as well as documentation elements. It was successfully applied in the context of quality assurance on batch tests and for progression assessment of an in vitro human epidermis burn model by Schneider et al. (2021). The BSGC score serves as a rapidly feasible evaluation tool for the reporting of in vitro epidermis models and not as a diagnostic tool. The second section focuses on vascularization as a parameter of cutaneous wound healing. ASMA-IF-stained images of porcine wounding models were considered, and after removal of glandular structures, vascular formations were manually counted at baseline. From this, the necessary settings for the image processing software ImageJ were determined and the images were subsequently fed to it. Automated quantification of elliptical formations with a size ≥ 30 pixels was performed. In the next step, the images were divided into the areas of wound margin, wound bed and wound healing. The wound healing area showed significantly greater revascularization than wound bed. Finally, secondary wound dressings were compared. The comparison of the wound healing/wound bed quotients of non-occlusive and occlusive wound dressings showed no significant difference in neovascularization. The isolated consideration of revascularization as a single process of wound healing cannot serve as a general criterion for the overall assessment. This is where the chosen methodology finds its limitation. Future areas of application of the BSGC score include extension to full-thickness skin models and other wound modalities. Automated and AI-assisted scoring is also conceivable due to the extensive underlying data set. Automated software-assisted quantification of vascularization may also appear useful as an overview and expeditious assessment of wound healing. KW - Wundheilung KW - Vaskularisation KW - Epidermis KW - Vaskularisierung KW - Epidermismodell KW - In-vitro-Testsystem KW - BSGC KW - invitro KW - Haut Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-352946 ER - TY - THES A1 - Rombach [geb. Grosso], Franziska T1 - Der Interaktionsrezeptor des Masernvirus auf hämatopoetischen Zellen T1 - The Measles Virus´ Interaction Receptor on Hematopoietic Cells N2 - Das Masernvirus (MV) kann in Erkrankten eine schwere, langanhaltende Immunsuppression verursachen, wodurch Infektionen mit opportunistischen Pathogenen begünstigt werden. Diese basiert auf einer Paralyse der hämatopoetischen Zellen, welche das Virus durch Kontakt eines viralen Glykoproteinkomplexes zu einem unbekannten RezeptorX auf der Zell- Oberfläche induzieren kann. Kerncharakterisitika hiervon sind unter anderem die Herabregulation der Akt-Kinase-Phosphorylierung, die Inhibition der zellulären Proliferation und die Aktivierung der neutralen Sphingomyelinase 2 (NSM2). In einem kinetischen Phosphoproteom konnten zwei potentielle Interaktionsrezeptoren des MV identifiziert werden: CD43 und P2X3. Das hochglykosylierte Oberflächenmolekül CD43 ist auf hämatopoetischen Zellen ubiquitär exprimiert und reguliert in T-Zellen deren Überleben, Proliferation, Aktivierung, Migration und Adhäsion. P2X3 wird in hämatopoetischen Zellen nur in geringem Maße exprimiert. Seine funktionelle Bedeutung ist in diesem Kompartiment nicht bekannt. Beide Kandidaten wurden mittels CRISPR/Cas9 Verfahren einzeln oder kombiniert aus Jurkat-T-Zellen ablatiert, welche nachfolgend nach MV-Kontakt hinsichtlich der oben erwähnten MV-modulierten Parameter getestet wurden. Zusätzlich wurden iso- und allosterische P2X3-Inhibitoren an primären und Jurkat-T-Zellen verwendet, um dessen Rolle in Ca2+-Mobilisierung und Proliferation nach T-Zell-Rezeptor Co-Stimulation zu analysieren. Die genetische Depletion beider Rezeptor-Kandidaten verringerte die Effekte des MV auf alle getesteten Parameter signifikant, was darauf hindeutet, dass beide Proteine entscheidend an der T-Zell-Suppression beteiligt sind. Während die isosterische Inhibition von P2X3 keinen Effekt hatte, wurde die Proliferation primärer T-Zellen durch dessen allosterische Inhibition vor Co-Stimulation fast verdoppelt und die Effizienz der Ca2+-Mobilisierung in Jurkat- und primären T-Zellen signifikant erhöht. In P2X3-depletierten Jurkat-Zellen hingegen war die Ca2+-Mobilisierung nach Stimulation signifikant geringer als in WT-Zellen. In dieser Arbeit konnten zwei wichtige Mediatoren der MV induzierten T-Zell-Suppression identifiziert werden. Vor allem P2X3, dessen Expression, Regulation und funktionelle Bedeutung im hämatopoetischen Kompartiment noch nicht erforscht wurde, könnte ein vielversprechender Kandidat für eine antivirale Therapie darstellen, da ein klinisch getesteter P2X3-Inhibitor bereits verfügbar ist. N2 - Measles virus (MV) infection induces a severe and long-lasting immunosuppression in patients resulting in infections through opportunistic pathogens. T cell paralysis is a major contributor to MV induced immunosuppression. This can be achieved through contact of a viral glycoprotein complex with an uncharacterized receptor X on the surface of hematopoietic cells. Contact-mediated downregulation of Akt-kinase phosphorylation, inhibition of proliferation and activation the neutral spingomyelinase 2 (NSM2) are key characteristics of T cell inhibition in vitro. Using a kinetic phosphoproteomic approach, two potential interaction receptor candidates were identified: CD43 and P2X3 receptor. The highly glycosylated surface protein CD43 is ubiquitously expressed on hematopoietic cells and is known to regulate T cell survival, proliferation, activation, migration and adhesion. The expression of P2X3 in this compartment is low and its functional importance unknown. It is widely expressed in neuronal cells where it is a major effector in the pathogenesis of chronic neuropathic pain. Using the CRISPR/Cas9 method both candidates were knocked down singly or combined in Jurkat T cells. Cells were then tested for the MV modulated parameters mentioned above upon MV challenge. In addition to that, iso- and allosteric functional inhibitors for P2X3 were employed on primary and Jurkat T cells to determine its role in calcium influx and proliferation after T cell receptor stimulation. The knockdown of both CD43 and P2X3 significantly decreased MV effects on all analyzed parameters (Akt-kinase phosphorylation, proliferation, NSM2 activation) indicating that both proteins play a major role in MV-induced T cell suppression. While isosteric inhibition of receptor P2X3 had no effect, its allosteric inhibition prior to stimulation increased proliferation of primary T cells almost twofold and significantly increased Ca2+ influx in Jurkat cells and primary T cells. In contrast, genetic depletion of P2X3 significantly reduced calcium influx after stimulation as compared to wildtype cells. In this study two important mediators of MV induced T cell suppression were identified. Amongst those, P2X3 whose expression, regulation and functional importance in the hematopoietic compartment has not been investigated yet, may represent a promising candidate for anti-viral therapy due to the existence of a clinically tested inhibitor. KW - Masernvirus KW - Immunsuppression KW - JURKAT-Zelle KW - T-Zellen KW - Interaktionsrezeptor KW - T-Lymphozyt Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-353394 ER - TY - JOUR A1 - Merzenich, Hiltrud A1 - Baaken, Dan A1 - Schmidt, Marcus A1 - Bekes, Inga A1 - Schwentner, Lukas A1 - Janni, Wolfgang A1 - Woeckel, Achim A1 - Bartkowiak, Detlef A1 - Wiegel, Thomas A1 - Blettner, Maria A1 - Wollschläger, Daniel A1 - Schmidberger, Heinz T1 - Cardiac late effects after modern 3D-conformal radiotherapy in breast cancer patients: a retrospective cohort study in Germany (ESCaRa) JF - Breast Cancer Research and Treatment N2 - Purpose Radiotherapy (RT) was identified as a risk factor for long-term cardiac effects in breast cancer patients treated until the 1990s. However, modern techniques reduce radiation exposure of the heart, but some exposure remains unavoidable. In a retrospective cohort study, we investigated cardiac mortality and morbidity of breast cancer survivors treated with recent RT in Germany. Methods A total of 11,982 breast cancer patients treated between 1998 and 2008 were included. A mortality follow-up was conducted until 06/2018. In order to assess cardiac morbidity occurring after breast cancer treatment, a questionnaire was sent out in 2014 and 2019. The effect of breast cancer laterality on cardiac mortality and morbidity was investigated as a proxy for radiation exposure. We used Cox Proportional Hazards regression analysis, taking potential confounders into account. Results After a median follow-up time of 11.1 years, there was no significant association of tumor laterality with cardiac mortality in irradiated patients (hazard ratio (HR) for left-sided versus right-sided tumor 1.09; 95% confidence interval (CI) 0.85–1.41). Furthermore, tumor laterality was not identified as a significant risk factor for cardiac morbidity (HR = 1.05; 95%CI 0.88–1.25). Conclusions Even though RT for left-sided breast cancer on average incurs higher radiation dose to the heart than RT for right-sided tumors, we found no evidence that laterality is a strong risk factor for cardiac disease after contemporary RT. However, larger sample sizes, longer follow-up, detailed information on individual risk factors and heart dose are needed to assess clinically manifest late effects of current cancer therapy. KW - breast cancer KW - 3D-conformal radiotherapy KW - cardiac mortality KW - cardiac morbidity KW - cohort study KW - survival Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308606 SN - 0167-6806 SN - 1573-7217 VL - 191 IS - 1 ER - TY - JOUR A1 - Kosmala, Aleksander A1 - Gruschwitz, Philipp A1 - Veldhoen, Simon A1 - Weng, Andreas Max A1 - Krauss, Bernhard A1 - Bley, Thorsten Alexander A1 - Petritsch, Bernhard T1 - Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume JF - The International Journal of Cardiovascular Imaging N2 - Abstract To compare intravenous contrast material (CM) injection protocols for dual-energy CT pulmonary angiography (CTPA) in patients with suspected acute pulmonary embolism with regard to image quality and pulmonary perfused blood volume (PBV) values. A total of 198 studies performed with four CM injection protocols varying in CM volume and iodine delivery rates (IDR) were retrospectively included: (A) 60 ml at 5 ml/s (IDR = 1.75gI/s), (B) 50 ml at 5 ml/s (IDR = 1.75gI/s), (C) 50 ml at 4 ml/s (IDR = 1.40gI/s), (D) 40 ml at 3 ml/s (IDR = 1.05gI/s). Image quality and PBV values at different resolution settings were compared. Pulmonary arterial tract attenuation was highest for protocol A (397 ± 110 HU; p vs. B = 0.13; vs. C = 0.02; vs. D < 0.001). CTPA image quality of protocol A was rated superior compared to protocols B and D by reader 1 (p = 0.01; < 0.001), and superior to protocols B, C and D by reader 2 (p < 0.001; 0.02; < 0.001). Otherwise, there were no significant differences in CTPA quality ratings. Subjective iodine map ratings did not vary significantly between protocols A, B, and C. Both readers rated protocol D inferior to all other protocols (p < 0.05). PBV values did not vary significantly between protocols A and B at resolution settings of 1, 4 and 10 (p = 0.10; 0.10; 0.09), while otherwise PBV values displayed a decreasing trend from protocol A to D (p < 0.05). Higher CM volume and IDR are associated with superior CTPA and iodine map quality and higher absolute PBV values. KW - CT KW - dual-energy CT KW - pulmonary embolism KW - contrast media Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-314739 SN - 1569-5794 SN - 1573-0743 VL - 36 IS - 10 ER - TY - JOUR A1 - Ohlmann, Brigitte A1 - Bömicke, Wolfgang A1 - Behnisch, Rouven A1 - Rammelsberg, Peter A1 - Schmitter, Marc T1 - Variability of sleep bruxism — findings from consecutive nights of monitoring JF - Clinical Oral Investigations N2 - Objectives To determine sleep bruxism (SB) behavior during five consecutive nights and to identify correlations between SB episodes per hour (SB index) and sleep-time masseter-muscle activity (sMMA). Material and methods Thirty-one participants were included in the study. Of these, 10 were classified as sleep bruxers (group SB-1) and nine as non-sleep bruxers (group non-SB). The bruxism status of these 19 patients was identified by means of questionnaires, an assessment of clinical symptoms, and electromyographic/electrocardiographic data (Bruxoff® device). The remaining 12 participants were also identified as bruxers, but based exclusively on data from the Bruxoff device (group SB-2). Data analysis included descriptive statistics and Spearman’s correlation to assess the relationship between the SB index and sMMA. Results Participants in group SB-1 showed an overall mean SB index of 3.1 ± 1.6 and a mean total sMMA per night of 62.9 ± 38.3. Participants in group SB-2 had an overall mean SB index of 2.7 ± 1.5 and a mean total sMMA of 56.0 ± 29.3. In the non-SB group, participants showed an overall mean SB index of 0.8 ± 0.5 and a mean total sMMA of 56.8 ± 30.3. Spearman’s correlation yielded values of − 0.27 to 0.71 for the correlation between sMMA and SB index. Conclusions The data revealed variable SB activity and the absence of a reliable correlation between sMMA and the SB index. Clinical relevance The high variation in SB activity and lack of correlation between sMMA and the SB index should be considered when diagnosing SB. Trial registration Clinical Trials [NIH], clinical trial no. NCT03039985. KW - sleep bruxism KW - fluctuation KW - electromyography KW - electrocardiography KW - portable Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307645 SN - 1436-3771 VL - 26 IS - 4 ER - TY - GEN A1 - Kosmala, Aleksander A1 - Gruschwitz, Philipp A1 - Veldhoen, Simon A1 - Weng, Andreas Max A1 - Krauss, Bernhard A1 - Bley, Thorsten Alexander A1 - Petritsch, Bernhard T1 - Correction to: Dual-energy CT angiography in suspected pulmonary embolism: infuence of injection protocols on image quality and perfused blood volume T2 - The International Journal of Cardiovascular Imaging N2 - No abstract available. KW - correction Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-350830 VL - 38 IS - 3 SP - 707 ER - TY - JOUR A1 - Denk, S. A1 - Schmidt, S. A1 - Schurr, Y. A1 - Schwarz, G. A1 - Schote, F. A1 - Diefenbacher, M. A1 - Armendariz, C. A1 - Dejure, F. A1 - Eilers, M. A1 - Wiegering, Armin T1 - CIP2A regulates MYC translation (via its 5′UTR) in colorectal cancer JF - International Journal of Colorectal Disease N2 - Background Deregulated expression of MYC is a driver of colorectal carcinogenesis, suggesting that decreasing MYC expression may have significant therapeutic value. CIP2A is an oncogenic factor that regulates MYC expression. CIP2A is overexpressed in colorectal cancer (CRC), and its expression levels are an independent marker for long-term outcome of CRC. Previous studies suggested that CIP2A controls MYC protein expression on a post-transcriptional level. Methods To determine the mechanism by which CIP2A regulates MYC in CRC, we dissected MYC translation and stability dependent on CIP2A in CRC cell lines. Results Knockdown of CIP2A reduced MYC protein levels without influencing MYC stability in CRC cell lines. Interfering with proteasomal degradation of MYC by usage of FBXW7-deficient cells or treatment with the proteasome inhibitor MG132 did not rescue the effect of CIP2A depletion on MYC protein levels. Whereas CIP2A knockdown had marginal influence on global protein synthesis, we could demonstrate that, by using different reporter constructs and cells expressing MYC mRNA with or without flanking UTR, CIP2A regulates MYC translation. This interaction is mainly conducted by the MYC 5′UTR. Conclusions Thus, instead of targeting MYC protein stability as reported for other tissue types before, CIP2A specifically regulates MYC mRNA translation in CRC but has only slight effects on global mRNA translation. In conclusion, we propose as novel mechanism that CIP2A regulates MYC on a translational level rather than affecting MYC protein stability in CRC. KW - CIP2A KW - MYC KW - translation KW - colon cancer Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-280092 VL - 36 IS - 5 ER - TY - JOUR A1 - Reddersen, Kirsten A1 - Güllmar, André A1 - Tonndorf-Martini, Silke A1 - Sigusch, Bernd W. A1 - Ewald, Andrea A1 - Dauben, Thomas J. A1 - Martin, Karin A1 - Wiegand, Cornelia T1 - Critical parameters in cultivation of experimental biofilms using the example of Pseudomonas fluorescens JF - Journal of Materials Science: Materials in Medicine N2 - Formation and treatment of biofilms present a great challenge for health care and industry. About 80% of human infections are associated with biofilms including biomaterial centered infections, like infections of prosthetic heart valves, central venous catheters, or urinary catheters. Additionally, biofilms can cause food and drinking water contamination. Biofilm research focusses on application of experimental biofilm models to study initial adherence processes, to optimize physico-chemical properties of medical materials for reducing interactions between materials and bacteria, and to investigate biofilm treatment under controlled conditions. Exploring new antimicrobial strategies plays a key role in a variety of scientific disciplines, like medical material research, anti-infectious research, plant engineering, or wastewater treatment. Although a variety of biofilm models exist, there is a lack of standardization for experimental protocols, and designing experimental setups remains a challenge. In this study, a number of experimental parameters critical for material research have been tested that influence formation and stability of an experimental biofilm using the non-pathogenic model strain of Pseudomonas fluorescens. These parameters include experimental time frame, nutrient supply, inoculum concentration, static and dynamic cultivation conditions, material properties, and sample treatment during staining for visualization of the biofilm. It was shown, that all tested parameters critically influence the experimental biofilm formation process. The results obtained in this study shall support material researchers in designing experimental biofilm setups. KW - biomaterials KW - biomedical engineering and bioengineering KW - regenerative medicine/tissue engineering KW - polymer sciences KW - ceramics, glass, composites, natural materials KW - surfaces and interfaces, thin films Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-309911 SN - 0957-4530 SN - 1573-4838 VL - 32 IS - 9 ER - TY - GEN A1 - Baur, Johannes A1 - Ramser, Michaela A1 - Keller, Nicola A1 - Muysoms, Filip A1 - Dörfer, Jörg A1 - Wiegering, Armin A1 - Eisner, Lukas A1 - Dietz, Ulrich A. T1 - Erratum to: Robotic hernia repair II. English version Robotic primary ventral and incisional hernia repair (rv-TAPP and r-Rives or r-TARUP). Video report and results of a series of 118 patients T2 - Der Chirurg N2 - No abstract available. KW - erratum Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-326357 VL - 92 IS - SUPPL 1 SP - S27 ER - TY - JOUR A1 - Fan, Sook-Ha A1 - Ebner, Patrick A1 - Reichert, Sebstian A1 - Hertlein, Tobias A1 - Zabel, Susanne A1 - Lankapalli, Aditya Kumar A1 - Nieselt, Kay A1 - Ohlsen, Knut A1 - Götz, Friedrich T1 - MpsAB is important for Staphylococcus aureus virulence and growth at atmospheric CO2 levels JF - Nature Communications N2 - The mechanisms behind carbon dioxide (CO2) dependency in non-autotrophic bacterial isolates are unclear. Here we show that the Staphylococcus aureus mpsAB operon, known to play a role in membrane potential generation, is crucial for growth at atmospheric CO2 levels. The genes mpsAB can complement an Escherichia coli carbonic anhydrase (CA) mutant, and CA from E. coli can complement the S. aureus delta-mpsABC mutant. In comparison with the wild type, S. aureus mps mutants produce less hemolytic toxin and are less virulent in animal models of infection. Homologs of mpsA and mpsB are widespread among bacteria and are often found adjacent to each other on the genome. We propose that MpsAB represents a dissolved inorganic carbon transporter, or bicarbonate concentrating system, possibly acting as a sodium bicarbonate cotransporter. KW - bacterial physiology KW - bacteriology KW - pathogens Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227624 VL - 10 ER - TY - JOUR A1 - Nowotny, Hanna A1 - Ahmed, S. Faisal A1 - Bensing, Sophie A1 - Beun, Johan G. A1 - Brösamle, Manuela A1 - Chifu, Irina A1 - Claahsen van der Grinten, Hedi A1 - Clemente, Maria A1 - Falhammar, Henrik A1 - Hahner, Stefanie A1 - Husebye, Eystein A1 - Kristensen, Jette A1 - Loli, Paola A1 - Lajic, Svetlana A1 - Reisch, Nicole T1 - Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis JF - Endocrine N2 - Adrenal insufficiency (AI) is a life-threatening condition requiring life-long glucocorticoid (GC) substitution therapy, as well as stress adaptation to prevent adrenal crises. The number of individuals with primary and secondary adrenal insufficiency in Europe is estimated to be 20–50/100.000. A growing number of AI cases are due to side effects of GC treatment used in different treatment strategies for cancer and to immunotherapy in cancer treatment. The benefit of hormone replacement therapy is evident but long-term adverse effects may arise due to the non-physiological GC doses and treatment regimens used. Given multiple GC replacement formulations available comprising short-acting, intermediate, long-acting and novel modified-release hydrocortisone as well as subcutaneous formulations, this review offers a concise summary on the latest therapeutic improvements for treatment of AI and prevention of adrenal crises. As availability of various glucocorticoid formulations and access to expert centers across Europe varies widely, European Reference Networks on rare endocrine conditions aim at harmonizing treatment and ensure access to specialized patient care for individual case-by-case treatment decisions. To improve the availability across Europe to cost effective oral and parenteral formulations of hydrocortisone will save lives. KW - adrenal insufficiency KW - congenital adrenal hyperplasia KW - adrenal crisis KW - glucocorticoid replacement KW - hydrocortisone KW - stress instructions Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308769 SN - 1355-008X SN - 1559-0100 VL - 71 IS - 3 ER - TY - JOUR A1 - Bliziotis, Nikolaos G. A1 - Kluijtmans, Leo A. J. A1 - Soto, Sebastian A1 - Tinnevelt, Gerjen H. A1 - Langton, Katharina A1 - Robledo, Mercedes A1 - Pamporaki, Christina A1 - Engelke, Udo F. H. A1 - Erlic, Zoran A1 - Engel, Jasper A1 - Deutschbein, Timo A1 - Nölting, Svenja A1 - Prejbisz, Aleksander A1 - Richter, Susan A1 - Prehn, Cornelia A1 - Adamski, Jerzy A1 - Januszewicz, Andrzej A1 - Reincke, Martin A1 - Fassnacht, Martin A1 - Eisenhofer, Graeme A1 - Beuschlein, Felix A1 - Kroiss, Matthias A1 - Wevers, Ron A. A1 - Jansen, Jeroen J. A1 - Deinum, Jaap A1 - Timmers, Henri J. L. M. T1 - Pre- versus post-operative untargeted plasma nuclear magnetic resonance spectroscopy metabolomics of pheochromocytoma and paraganglioma JF - Endocrine N2 - Purpose Pheochromocytomas and Paragangliomas (PPGL) result in chronic catecholamine excess and serious health complications. A recent study obtained a metabolic signature in plasma from PPGL patients; however, its targeted nature may have generated an incomplete picture and a broader approach could provide additional insights. We aimed to characterize the plasma metabolome of PPGL patients before and after surgery, using an untargeted approach, and to broaden the scope of the investigated metabolic impact of these tumors. Design A cohort of 36 PPGL patients was investigated. Blood plasma samples were collected before and after surgical tumor removal, in association with clinical and tumor characteristics. Methods Plasma samples were analyzed using untargeted nuclear magnetic resonance (NMR) spectroscopy metabolomics. The data were evaluated using a combination of uni- and multi-variate statistical methods. Results Before surgery, patients with a nonadrenergic tumor could be distinguished from those with an adrenergic tumor based on their metabolic profiles. Tyrosine levels were significantly higher in patients with high compared to those with low BMI. Comparing subgroups of pre-operative samples with their post-operative counterparts, we found a metabolic signature that included ketone bodies, glucose, organic acids, methanol, dimethyl sulfone and amino acids. Three signals with unclear identities were found to be affected. Conclusions Our study suggests that the pathways of glucose and ketone body homeostasis are affected in PPGL patients. BMI-related metabolite levels were also found to be altered, potentially linking muscle atrophy to PPGL. At baseline, patient metabolomes could be discriminated based on their catecholamine phenotype. KW - PPGL KW - metabolomics KW - NMR KW - paired KW - plasma KW - operation Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-326574 VL - 75 IS - 1 ER - TY - JOUR A1 - Adolf, Christian A1 - Braun, Leah T. A1 - Fuss, Carmina T. A1 - Hahner, Stefanie A1 - Künzel, Heike A1 - Handgriff, Laura A1 - Sturm, Lisa A1 - Heinrich, Daniel A. A1 - Schneider, Holger A1 - Bidlingmaier, Martin A1 - Reincke, Martin T1 - Spironolactone reduces biochemical markers of bone turnover in postmenopausal women with primary aldosteronism JF - Endocrine N2 - Context Primary aldosteronism (PA) is the most frequent form of endocrine hypertension. Besides its deleterious impact on cardiovascular target organ damage, PA is considered to cause osteoporosis. Patients and methods We assessed bone turnover in a subset of 36 postmenopausal women with PA. 18 patients had unilateral PA and were treated by adrenalectomy, whereas 18 patients had bilateral PA and received mineralocorticoid receptor antagonist (MRA) therapy respectively. 18 age- and BMI-matched females served as controls. To estimate bone remodeling, we measured the bone turnover markers intact procollagen 1 N-terminal propeptide, bone alkaline phosphatase, osteocalcin and tartrate resistant acid phosphatase 5b in plasma by chemiluminescent immunoassays at time of diagnosis and one year after initiation of treatment. Study design Observational longitudinal cohort study. Setting Tertiary care hospital. Results Compared with controls, patients with PA had mildly elevated osteocalcin at baseline (p = 0.013), while the other bone markers were comparable between both groups. There were no differences between the unilateral and the bilateral PA subgroup. One year after initiation of MRA treatment with spironolactone bone resorption and bone formation markers had significantly decreased in patients with bilateral PA. In contrast, patients adrenalectomized because of unilateral PA showed no significant change of bone turnover markers. Conclusion This study shows that aldosterone excess in postmenopausal women with PA is not associated with a relevant increase of bone turnover markers at baseline. However, we observed a significant decrease of bone markers in patients treated with spironolactone, but not in patients treated by adrenalectomy. KW - aldosterone KW - osteocalcin KW - osteoporosis KW - hyperparathyroidism KW - cortisol Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-315966 SN - 1355-008X SN - 1559-0100 VL - 69 IS - 3 ER - TY - JOUR A1 - Li, Minghao A1 - Pamporaki, Christina A1 - Fliedner, Stephanie M. J. A1 - Timmers, Henri J. L. M. A1 - Nölting, Svenja A1 - Beuschlein, Felix A1 - Prejbisz, Aleksander A1 - Remde, Hanna A1 - Robledo, Mercedes A1 - Bornstein, Stefan R. A1 - Lenders, Jacques W. M. A1 - Eisenhofer, Graeme A1 - Bechmann, Nicole T1 - Metastatic pheochromocytoma and paraganglioma: signs and symptoms related to catecholamine secretion JF - Discover Oncology N2 - Background The presence or future development of metastatic pheochromocytomas or paragangliomas (mPPGLs) can be difficult to diagnose or predict at initial presentation. Since production of catecholamines from mPPGLs is different from non-metastatic tumors (non-mPPGLs), this study aimed to clarify whether presenting catecholamine-related signs and symptoms (cSS) might also differ. Methods The study included 249 patients, 43 with mPPGL and 206 with non-mPPGL. Clinical data at the time of biochemical diagnosis (i.e. at entry into the study) were used to generate a cumulative score of cSS for each patient. Results Patients with mPPGL were significantly younger (43.3 ± 14 vs. 48.9 ± 16.1 years) and included a lower proportion of females (39.5% vs. 60.7%) than patients with non-mPPGLs. Frequencies of signs and symptoms did not differ between the two groups. Patients with mPPGLs had lower (P < 0.001) urinary excretion of epinephrine (3.5 (IQR, 1.9—6.5) µg/day) than those with non-mPPGLs (19.1 (IQR, 4.3—70.2) µg/day). There was no difference in urinary excretion of norepinephrine. In patients with mPPGLs a high cSS score was associated with high urinary excretion of norepinephrine and normetanephrine. In contrast, in patients with non-mPPGLs, a high cSS was associated with high urinary excretion of epinephrine and metanephrine. Conclusion Although presenting signs and symptoms were associated with production of norepinephrine in patients with mPPGLs and of epinephrine in patients with non-mPPGLs, there were no differences in signs and symptoms between the two groups. Therefore, consideration of signs and symptoms does not appear helpful for distinguishing patients with and without mPPGLs. KW - pheochromocytoma KW - paraganglioma KW - metastatic KW - signs KW - symptoms KW - catecholamines Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-309901 SN - 2730-6011 VL - 12 ER - TY - JOUR A1 - Minner, S. A1 - Schreiner, J. A1 - Saeger, W. T1 - Adrenal cancer: relevance of different grading systems and subtypes JF - Clinical and Translational Oncology N2 - Purpose The subclassification of adrenal cancers according to the WHO classification in ordinary, myxoid, oncocytic, and sarcomatoid as well as pediatric types is well established, but the criteria for each subtype are not sufficiently determined and the relative frequency of the different types of adrenal cancers has not been studied in large cohorts. Therefore, our large collection of surgically removed adrenal cancers should be reviewed o establish the criteria for the subtypes and to find out the frequency of the various types. Methods In our series of 521 adrenal cancers the scoring systems of Weiss et al., Hough et al., van Slooten et al. and the new Helsinki score system were used for the ordinary type of cancer (97% of our series) and the myxoid type (0.8%). For oncocytic carcinomas (2%), the scoring system of Bisceglia et al. was applied. Results Discrepancies between benign and malignant diagnoses from the first thee classical scoring systems are not rare (22% in our series) and could be resolved by the Helsinki score especially by Ki-67 index (more than 8% unequivocally malignant). Since all our cancer cases are positive in the Helsinki score, this system can replace the three elder systems. For identification of sarcomatoid cancer as rarest type in our series (0.2%), the scoring systems are not practical but additional immunostainings used for soft tissue tumors and in special cases molecular pathology are necessary to differentiate these cancers from adrenal sarcomas. According to the relative frequencies of the different subtypes of adrenal cancers the main type is the far most frequent (97%) followed by the oncocytic type (2%), the myxoid type (0.8%) and the very rare sarcomatoid type (0.2%). Conclusions The Helsinki score is the best for differentiating adrenal carcinomas of the main, the oncocytic, and the myxoid type in routine work. Additional scoring systems for these carcinomas are generally not any longer necessary. Signs of proliferation (mitoses and Ki-67 index) and necroses are the most important criteria for diagnosis of malignancy. KW - adrenal KW - cancer KW - cancer types KW - classification Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308479 SN - 1699-048X SN - 1699-3055 VL - 23 IS - 7 ER - TY - JOUR A1 - Danysz, Wojciech A1 - Dekundy, Andrzej A1 - Scheschonka, Astrid A1 - Riederer, Peter T1 - Amantadine: reappraisal of the timeless diamond—target updates and novel therapeutic potentials JF - Journal of Neural Transmission N2 - The aim of the current review was to provide a new, in-depth insight into possible pharmacological targets of amantadine to pave the way to extending its therapeutic use to further indications beyond Parkinson’s disease symptoms and viral infections. Considering amantadine’s affinities in vitro and the expected concentration at targets at therapeutic doses in humans, the following primary targets seem to be most plausible: aromatic amino acids decarboxylase, glial-cell derived neurotrophic factor, sigma-1 receptors, phosphodiesterases, and nicotinic receptors. Further three targets could play a role to a lesser extent: NMDA receptors, 5-HT3 receptors, and potassium channels. Based on published clinical studies, traumatic brain injury, fatigue [e.g., in multiple sclerosis (MS)], and chorea in Huntington’s disease should be regarded potential, encouraging indications. Preclinical investigations suggest amantadine’s therapeutic potential in several further indications such as: depression, recovery after spinal cord injury, neuroprotection in MS, and cutaneous pain. Query in the database http://www.clinicaltrials.gov reveals research interest in several further indications: cancer, autism, cocaine abuse, MS, diabetes, attention deficit-hyperactivity disorder, obesity, and schizophrenia. KW - Amantadine Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-330133 VL - 128 IS - 2 ER - TY - JOUR A1 - Ferreira, Manuel A. A1 - Gamazon, Eric R. A1 - Al-Ejeh, Fares A1 - Aittomäki, Kristiina A1 - Andrulis, Irene L. A1 - Anton-Culver, Hoda A1 - Arason, Adalgeir A1 - Arndt, Volker A1 - Aronson, Kristan J. A1 - Arun, Banu K. A1 - Asseryanis, Ella A1 - Azzollini, Jacopo A1 - Balmaña, Judith A1 - Barnes, Daniel R. A1 - Barrowdale, Daniel A1 - Beckmann, Matthias W. A1 - Behrens, Sabine A1 - Benitez, Javier A1 - Bermisheva, Marina A1 - Bialkowska, Katarzyna A1 - Blomqvist, Carl A1 - Bogdanova, Natalia V. A1 - Bojesen, Stig E. A1 - Bolla, Manjeet K. A1 - Borg, Ake A1 - Brauch, Hiltrud A1 - Brenner, Hermann A1 - Broeks, Annegien A1 - Burwinkel, Barbara A1 - Caldés, Trinidad A1 - Caligo, Maria A. A1 - Campa, Daniele A1 - Campbell, Ian A1 - Canzian, Federico A1 - Carter, Jonathan A1 - Carter, Brian D. A1 - Castelao, Jose E. A1 - Chang-Claude, Jenny A1 - Chanock, Stephen J. A1 - Christiansen, Hans A1 - Chung, Wendy K. A1 - Claes, Kathleen B. M. A1 - Clarke, Christine L. A1 - Couch, Fergus J. A1 - Cox, Angela A1 - Cross, Simon S. A1 - Czene, Kamila A1 - Daly, Mary B. A1 - de la Hoya, Miguel A1 - Dennis, Joe A1 - Devilee, Peter A1 - Diez, Orland A1 - Dörk, Thilo A1 - Dunning, Alison M. A1 - Dwek, Miriam A1 - Eccles, Diana M. A1 - Ejlertsen, Bent A1 - Ellberg, Carolina A1 - Engel, Christoph A1 - Eriksson, Mikael A1 - Fasching, Peter A. A1 - Fletcher, Olivia A1 - Flyger, Henrik A1 - Friedman, Eitan A1 - Frost, Debra A1 - Gabrielson, Marike A1 - Gago-Dominguez, Manuela A1 - Ganz, Patricia A. A1 - Gapstur, Susan M. A1 - Garber, Judy A1 - García-Closas, Montserrat A1 - García-Sáenz, José A. A1 - Gaudet, Mia M. A1 - Giles, Graham G. A1 - Glendon, Gord A1 - Godwin, Andrew K. A1 - Goldberg, Mark S. A1 - Goldgar, David E. A1 - González-Neira, Anna A1 - Greene, Mark H. A1 - Gronwald, Jacek A1 - Guenél, Pascal A1 - Haimann, Christopher A. A1 - Hall, Per A1 - Hamann, Ute A1 - He, Wei A1 - Heyworth, Jane A1 - Hogervorst, Frans B. L. A1 - Hollestelle, Antoinette A1 - Hoover, Robert N. A1 - Hopper, John L. A1 - Hulick, Peter J. A1 - Humphreys, Keith A1 - Imyanitov, Evgeny N. A1 - Isaacs, Claudine A1 - Jakimovska, Milena A1 - Jakubowska, Anna A1 - James, Paul A. A1 - Janavicius, Ramunas A1 - Jankowitz, Rachel C. A1 - John, Esther M. A1 - Johnson, Nichola A1 - Joseph, Vijai A1 - Karlan, Beth Y. A1 - Khusnutdinova, Elza A1 - Kiiski, Johanna I. A1 - Ko, Yon-Dschun A1 - Jones, Michael E. A1 - Konstantopoulou, Irene A1 - Kristensen, Vessela N. A1 - Laitman, Yael A1 - Lambrechts, Diether A1 - Lazaro, Conxi A1 - Leslie, Goska A1 - Lester, Jenny A1 - Lesueur, Fabienne A1 - Lindström, Sara A1 - Long, Jirong A1 - Loud, Jennifer T. A1 - Lubiński, Jan A1 - Makalic, Enes A1 - Mannermaa, Arto A1 - Manoochehri, Mehdi A1 - Margolin, Sara A1 - Maurer, Tabea A1 - Mavroudis, Dimitrios A1 - McGuffog, Lesley A1 - Meindl, Alfons A1 - Menon, Usha A1 - Michailidou, Kyriaki A1 - Miller, Austin A1 - Montagna, Marco A1 - Moreno, Fernando A1 - Moserle, Lidia A1 - Mulligan, Anna Marie A1 - Nathanson, Katherine L. A1 - Neuhausen, Susan L. A1 - Nevanlinna, Heli A1 - Nevelsteen, Ines A1 - Nielsen, Finn C. A1 - Nikitina-Zake, Liene A1 - Nussbaum, Robert L. A1 - Offit, Kenneth A1 - Olah, Edith A1 - Olopade, Olufunmilayo I. A1 - Olsson, Håkan A1 - Osorio, Ana A1 - Papp, Janos A1 - Park-Simon, Tjoung-Won A1 - Parsons, Michael T. A1 - Pedersen, Inge Sokilde A1 - Peixoto, Ana A1 - Peterlongo, Paolo A1 - Pharaoh, Paul D. P. A1 - Plaseska-Karanfilska, Dijana A1 - Poppe, Bruce A1 - Presneau, Nadege A1 - Radice, Paolo A1 - Rantala, Johanna A1 - Rennert, Gad A1 - Risch, Harvey A. A1 - Saloustros, Emmanouil A1 - Sanden, Kristin A1 - Sawyer, Elinor J. A1 - Schmidt, Marjanka K. A1 - Schmutzler, Rita K. A1 - Sharma, Priyanka A1 - Shu, Xiao-Ou A1 - Simard, Jaques A1 - Singer, Christian F. A1 - Soucy, Penny A1 - Southey, Melissa C. A1 - Spinelli, John J. A1 - Spurdle, Amanda B. A1 - Stone, Jennifer A1 - Swerdlow, Anthony J. A1 - Tapper, William J. A1 - Taylor, Jack A. A1 - Teixeira, Manuel R. A1 - Terry, Mary Beth A1 - Teulé, Alex A1 - Thomassen, Mads A1 - Thöne, Kathrin A1 - Thull, Darcy L. A1 - Tischkowitz, Marc A1 - Toland, Amanda E. A1 - Torres, Diana A1 - Truong, Thérèse A1 - Tung, Nadine A1 - Vachon, Celine M. A1 - van Asperen, Christi J. A1 - van den Ouweland, Ans M. W. A1 - van Rensburg, Elizabeth J. A1 - Vega, Ana A1 - Viel, Alexandra A1 - Wang, Qin A1 - Wappenschmidt, Barbara A1 - Weitzel, Jeffrey N. A1 - Wendt, Camilla A1 - Winqvist, Robert A1 - Yang, Xiaohong R. A1 - Yannoukakos, Drakoulis A1 - Ziogas, Argyrios A1 - Kraft, Peter A1 - Antoniou, Antonis C. A1 - Zheng, Wei A1 - Easton, Douglas F. A1 - Milne, Roger L. A1 - Beesley, Jonathan A1 - Chenevix-Trench, Georgia T1 - Genome-wide association and transcriptome studies identify target genes and risk loci for breast cancer JF - Nature Communications N2 - Genome-wide association studies (GWAS) have identified more than 170 breast cancer susceptibility loci. Here we hypothesize that some risk-associated variants might act in non-breast tissues, specifically adipose tissue and immune cells from blood and spleen. Using expression quantitative trait loci (eQTL) reported in these tissues, we identify 26 previously unreported, likely target genes of overall breast cancer risk variants, and 17 for estrogen receptor (ER)-negative breast cancer, several with a known immune function. We determine the directional effect of gene expression on disease risk measured based on single and multiple eQTL. In addition, using a gene-based test of association that considers eQTL from multiple tissues, we identify seven (and four) regions with variants associated with overall (and ER-negative) breast cancer risk, which were not reported in previous GWAS. Further investigation of the function of the implicated genes in breast and immune cells may provide insights into the etiology of breast cancer. KW - cancer KW - genetics Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-228024 VL - 10 ER - TY - JOUR A1 - Buchmann, J. A1 - Baumann, N. A1 - Meng, K. A1 - Semrau, J. A1 - Kuhl, J. A1 - Pfeifer, K. A1 - Vogel, H. A1 - Faller, H. T1 - Volitional Action Control and Depression in Chronic Pain: Does Action versus State Orientation Moderate the Relations of Pain-Related Cognitions to Depression? JF - Current Psychology N2 - In this study, we examined the conditional indirect and direct relations of pain-related cognitions to depression. Subjective helplessness was included as presumably mediating the relations of catastrophizing and thought suppression to depression due to motivational deficits. In addition, moderating effects of dispositional action versus state orientation were analyzed, whereby state orientation indicates volitional deficits in coping with distress. The study was based on self-report data from 536 patients with chronic non-specific low back pain at the beginning of inpatient rehabilitation. Moderated mediation analyses were performed. The indirect catastrophizing- and thought suppression-depression relations were (partially) mediated by subjective helplessness; and moderated by failure-related action versus state orientation. Moreover, action versus state orientation moderated the direct relation of thought suppression to depression. Results suggest that catastrophizing, thought suppression, and subjective helplessness do not lead to depression unless associated with self-regulatory inability (i.e., state orientation). In contrast, action-oriented patients more effectively self-regulate pain-related emotions, disengage from rumination, and distract from pain and thus better avoid the debilitating effects of negative pain-related cognitions on depression. Future research and treatment may more strongly focus on the role of motivational and volitional deficits underlying learned helplessness and depression in chronic pain. KW - chronic low back pain KW - catastrophizing KW - thought suppression KW - helplessness KW - depression KW - action versus state orientation Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308508 SN - 1046-1310 SN - 1936-4733 VL - 42 ER - TY - JOUR A1 - Naue, Jana A1 - Pfeifer, Manuel A1 - Augustin, Christa A1 - Becker, Julia A1 - Fleckhaus, Jan A1 - Grabmüller, Melanie A1 - Han, Yang A1 - Heidorn, Frank A1 - Hollaender, Olivia A1 - Klein-Unseld, Rachel A1 - Kulstein, Galina A1 - Lichtenwald, Julia A1 - Neubauer, Jacqueline A1 - Suarez, Philippe A1 - Haas, Cordula A1 - Schneider, Peter M. A1 - Vennemann, Marielle A1 - Böhme, Petra T1 - Forensische DNA-Methylierungsanalyse T1 - Forensic DNA methylation analysis : Second technical collaborative exercise by the working group on “molecular age estimation” of the German Society of Legal Medicine BT - Zweiter, technischer Ringversuch der Arbeitsgruppe „Molekulare Altersschätzung“ der Deutschen Gesellschaft für Rechtsmedizin JF - Rechtsmedizin N2 - Mit der Entdeckung altersabhängiger epigenetischer Veränderungen, der DNA-Methylierung (DNAm), hat sich eine neue Möglichkeit aufgezeigt, das Alter eines Individuums zu schätzen. Die Methode wurde intensiv erforscht und ihre Anwendung in der forensischen Fallarbeit durch die Aktualisierung des § 81e der Strafprozessordnung (StPO) in Deutschland reguliert. Zur Untersuchung des DNAm-Grades müssen neue Techniken etabliert und validiert werden. Dies macht die Prüfung der Vergleichbarkeit von Messergebnissen aus verschiedenen forensischen Laboren erforderlich. Hierzu führte die Arbeitsgruppe „Molekulare Altersschätzung“ der Deutschen Gesellschaft für Rechtsmedizin (DGRM) im Winter 2019/2020 den 2. Ringversuch (RV) zur quantitativen DNAm-Analyse mithilfe der Mini- und der Pyrosequenzierung durch. Dieser basierte auf den Erfahrungen des 1. RV 2018/2019, dessen Ergebnisse in dieser Ausgabe ebenfalls vorgestellt werden. Die aktuelle Studie umfasst Analyseergebnisse aus 12 Laboren (ingesamt 14 teilnehmende Labore), von denen einige beide Methoden angewandt haben. Zusätzlich führten 4 Labore eine Altersschätzung an den RV-Proben mit eigenen Markerkombinationen und Modellen durch. Da diese auf unterschiedlichen Referenzdaten und Markerkombinationen beruhen, erfolgte kein qualitativer Vergleich der Modelle, sondern das grundsätzliche Potenzial der Methodik wurde verdeutlicht. Ziele des RV waren die Evaluierung der Vergleichbarkeit der DNAm-Messungen und die Bewertung möglicher Einflussfaktoren, wie Extraktionsmethode und verwendetes Gerät. Die Ergebnisse zeigen, dass sich die gemessenen DNAm-Werte der untersuchten Marker sowohl zwischen Mini- und Pyrosequenzierung als auch innerhalb der jeweiligen Methode zwischen den Laboren unterscheiden können, sodass mit Schwankungen gerechnet werden muss. N2 - With the discovery of age-related epigenetic changes DNA methylation (DNAm) has shown new possibilities for the estimation of the age of an individual. The method has been intensively researched and its application in forensic casework is regulated by an amendment of § 81e of the German Code of Criminal Procedures (StPO). To investigate the degree of DNAm new techniques must be established and validated. This necessitates investigation of the comparability of measurement results from different forensic laboratories. In winter 2019/2020 the molecular age estimation working group of the German Society of Legal Medicine (DGRM) conducted a second proficiency test to investigate this comparability using minisequencing and pyrosequencing for quantitative analysis of DNAm. This was based on the experience from the first proficiency test in 2018/2019, the results of which are presented in this edition of the journal. The current study includes the results of DNAm analysis from 12 laboratories (in total 14 participating laboratories), some of which have used both methods. In addition, four laboratories performed an age estimation using their own marker combinations and models. As these are based on different reference data and marker combinations, no qualitative comparison of the models was done but the fundamental potential of the methodology was clarified. The aim of the interlaboratory comparison was to evaluate the comparability of the DNAm measurements and to assess possible influencing factors, such as the extraction method and the device used. The results showed that the measured DNAm values of the investigated markers can differ between minisequencing and pyrosequencing as well as within the respective method between laboratories, so that fluctuations are to be expected. KW - Epigenetik KW - Biomarker KW - Minisequenzierung KW - Pyrosequenzierung KW - Laborleistungstests KW - epigenetics KW - biomarker KW - minisequencing KW - pyrosequencing KW - laboratory proficiency testing Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307129 SN - 0937-9819 SN - 1434-5196 VL - 31 IS - 3 ER - TY - JOUR A1 - Dubail, Johanne A1 - Huber, Céline A1 - Chantepie, Sandrine A1 - Sonntag, Stephan A1 - Tüysüz, Beyhan A1 - Mihci, Ercan A1 - Gordon, Christopher T. A1 - Steichen-Gersdorf, Elisabeth A1 - Amiel, Jeanne A1 - Nur, Banu A1 - Stolte-Dijkstra, Irene A1 - van Eerde, Albertien M. A1 - van Gassen, Koen L. A1 - Breugem, Corstiaan C. A1 - Stegmann, Alexander A1 - Lekszas, Caroline A1 - Maroofian, Reza A1 - Karimiani, Ehsan Ghayoor A1 - Bruneel, Arnaud A1 - Seta, Nathalie A1 - Munnich, Arnold A1 - Papy-Garcia, Dulce A1 - De La Dure-Molla, Muriel A1 - Cormier-Daire, Valérie T1 - SLC10A7 mutations cause a skeletal dysplasia with amelogenesis imperfecta mediated by GAG biosynthesis defects JF - Nature Communications N2 - Skeletal dysplasia with multiple dislocations are severe disorders characterized by dislocations of large joints and short stature. The majority of them have been linked to pathogenic variants in genes encoding glycosyltransferases, sulfotransferases or epimerases required for glycosaminoglycan synthesis. Using exome sequencing, we identify homozygous mutations in SLC10A7 in six individuals with skeletal dysplasia with multiple dislocations and amelogenesis imperfecta. SLC10A7 encodes a 10-transmembrane-domain transporter located at the plasma membrane. Functional studies in vitro demonstrate that SLC10A7 mutations reduce SLC10A7 protein expression. We generate a Slc10a7−/− mouse model, which displays shortened long bones, growth plate disorganization and tooth enamel anomalies, recapitulating the human phenotype. Furthermore, we identify decreased heparan sulfate levels in Slc10a7−/− mouse cartilage and patient fibroblasts. Finally, we find an abnormal N-glycoprotein electrophoretic profile in patient blood samples. Together, our findings support the involvement of SLC10A7 in glycosaminoglycan synthesis and specifically in skeletal development. KW - bone development KW - disease genetics KW - medical genetics Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226377 VL - 9 ER - TY - JOUR A1 - Rolfes, Leoni A1 - Ruck, Tobias A1 - David, Christina A1 - Mencl, Stine A1 - Bock, Stefanie A1 - Schmidt, Mariella A1 - Strecker, Jan-Kolja A1 - Pfeuffer, Steffen A1 - Mecklenbeck, Andreas-Schulte A1 - Gross, Catharina A1 - Gliem, Michael A1 - Minnerup, Jens A1 - Schuhmann, Michael K. A1 - Kleinschnitz, Christoph A1 - Meuth, Sven G. T1 - Natural Killer Cells Are Present in Rag1\(^{−/−}\) Mice and Promote Tissue Damage During the Acute Phase of Ischemic Stroke JF - Translational Stroke Research N2 - Rag1\(^{−/−}\) mice, lacking functional B and T cells, have been extensively used as an adoptive transfer model to evaluate neuroinflammation in stroke research. However, it remains unknown whether natural killer (NK) cell development and functions are altered in Rag1\(^{−/−}\) mice as well. This connection has been rarely discussed in previous studies but might have important implications for data interpretation. In contrast, the NOD-Rag1\(^{null}\)IL2rg\(^{null}\) (NRG) mouse model is devoid of NK cells and might therefore eliminate this potential shortcoming. Here, we compare immune-cell frequencies as well as phenotype and effector functions of NK cells in Rag1\(^{−/−}\) and wildtype (WT) mice using flow cytometry and functional in vitro assays. Further, we investigate the effect of Rag1\(^{−/−}\) NK cells in the transient middle cerebral artery occlusion (tMCAO) model using antibody-mediated depletion of NK cells and adoptive transfer to NRG mice in vivo. NK cells in Rag1\(^{−/−}\) were comparable in number and function to those in WT mice. Rag1\(^{−/−}\) mice treated with an anti-NK1.1 antibody developed significantly smaller infarctions and improved behavioral scores. Correspondingly, NRG mice supplemented with NK cells were more susceptible to tMCAO, developing infarctions and neurological deficits similar to Rag1−/− controls. Our results indicate that NK cells from Rag1−/− mice are fully functional and should therefore be considered in the interpretation of immune-cell transfer models in experimental stroke. Fortunately, we identified the NRG mice, as a potentially better-suited transfer model to characterize individual cell subset-mediated neuroinflammation in stroke. KW - infarction KW - middle cerebral artery occlusion KW - animal model KW - inflammation KW - natural killer cells Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308924 SN - 1868-4483 SN - 1868-601X VL - 13 IS - 1 ER - TY - JOUR A1 - Potreck, Arne A1 - Mutke, Matthias A. A1 - Weyland, Charlotte S. A1 - Pfaff, Johannes A. R. A1 - Ringleb, Peter A. A1 - Mundiyanapurath, Sibu A1 - Möhlenbruch, Markus A. A1 - Heiland, Sabine A1 - Pham, Mirko A1 - Bendszus, Martin A1 - Hoffmann, Angelika T1 - Combined Perfusion and Permeability Imaging Reveals Different Pathophysiologic Tissue Responses After Successful Thrombectomy JF - Translational Stroke Research N2 - Despite successful recanalization of large-vessel occlusions in acute ischemic stroke, individual patients profit to a varying degree. Dynamic susceptibility-weighted perfusion and dynamic T1-weighted contrast-enhanced blood-brain barrier permeability imaging may help to determine secondary stroke injury and predict clinical outcome. We prospectively performed perfusion and permeability imaging in 38 patients within 24 h after successful mechanical thrombectomy of an occlusion of the middle cerebral artery M1 segment. Perfusion alterations were evaluated on cerebral blood flow maps, blood-brain barrier disruption (BBBD) visually and quantitatively on ktrans maps and hemorrhagic transformation on susceptibility-weighted images. Visual BBBD within the DWI lesion corresponded to a median ktrans elevation (IQR) of 0.77 (0.41–1.4) min−1 and was found in all 7 cases of hypoperfusion (100%), in 10 of 16 cases of hyperperfusion (63%), and in only three of 13 cases with unaffected perfusion (23%). BBBD was significantly associated with hemorrhagic transformation (p < 0.001). While BBBD alone was not a predictor of clinical outcome at 3 months (positive predictive value (PPV) = 0.8 [0.56–0.94]), hypoperfusion occurred more often in patients with unfavorable clinical outcome (PPV = 0.43 [0.10–0.82]) compared to hyperperfusion (PPV = 0.93 [0.68–1.0]) or unaffected perfusion (PPV = 1.0 [0.75–1.0]). We show that combined perfusion and permeability imaging reveals distinct infarct signatures after recanalization, indicating the severity of prior ischemic damage. It assists in predicting clinical outcome and may identify patients at risk of stroke progression. KW - permeability imaging KW - perfusion imaging KW - mechanical thrombectomy KW - secondary stroke injury KW - hyperperfusion Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308946 SN - 1868-4483 SN - 1868-601X VL - 12 IS - 5 ER - TY - THES A1 - Choi, Jihyoung T1 - Development of an Add-On Electrode for Non-Invasive Monitoring in Bioreactor Cultures and Medical Devices T1 - Entwicklung einer Zusatzelektrode für das nicht-invasive Monitoring von Bioreaktorkulturen und Medizinprodukten N2 - Electrochemical impedance spectroscopy (EIS) is a valuable technique analyzing electrochemical behavior of biological systems such as electrical characterization of cells and biomolecules, drug screening, and biomaterials in biomedical field. In EIS, an alternating current (AC) power signal is applied to the biological system, and the impedance of the system is measured over a range of frequencies. In vitro culture models of endothelial or epithelial barrier tissue can be achieved by culturing barrier tissue on scaffolds made with synthetic or biological materials that provide separate compartments (apical and basal sides), allowing for further studies on drug transport. EIS is a great candidate for non-invasive and real-time monitoring of the electrical properties that correlate with barrier integrity during the tissue modeling. Although commercially available transendothelial/transepithelial electrical resistance (TEER) measurement devices are widely used, their use is particularly common in static transwell culture. EIS is considered more suitable than TEER measurement devices in bioreactor cultures that involve dynamic fluid flow to obtain accurate and reliable measurements. Furthermore, while TEER measurement devices can only assess resistance at a single frequency, EIS measurements can capture both resistance and capacitance properties of cells, providing additional information about the cellular barrier's characteristics across various frequencies. Incorporating EIS into a bioreactor system requires the careful optimization of electrode integration within the bioreactor setup and measurement parameters to ensure accurate EIS measurements. Since bioreactors vary in size and design depending on the purpose of the study, most studies have reported using an electrode system specifically designed for a particular bioreactor. The aim of this work was to produce multi-applicable electrodes and established methods for automated non-invasive and real-time monitoring using the EIS technique in bioreactor cultures. Key to the electrode material, titanium nitride (TiN) coating was fabricated on different substrates (materials and shape) using physical vapor deposition (PVD) and housed in a polydimethylsiloxane (PDMS) structure to allow the electrodes to function as independent units. Various electrode designs were evaluated for double-layer capacitance and morphology using EIS and scanning electron microscopy (SEM), respectively. The TiN-coated tube electrode was identified as the optimal choice. Furthermore, EIS measurements were performed to examine the impact of influential parameters related to culture conditions on the TiN-coated electrode system. In order to demonstrate the versatility of the electrodes, these electrodes were then integrated into in different types of perfusion bioreactors for monitoring barrier cells. Blood-brain barrier (BBB) cells were cultured in the newly developed dynamic flow bioreactor, while human umblical vascular endothelial cells (HUVECs) and Caco-2 cells were cultured in the miniature hollow fiber bioreactor (HFBR). As a result, the TiN-coated tube electrode system enabled investigation of BBB barrier integrity in long-term bioreactor culture. While EIS measurement could not detect HUVECs electrical properties in miniature HFBR culture, there was the possibility of measuring the barrier integrity of Caco-2 cells, indicating potential usefulness for evaluating their barrier function. Following the bioreactor cultures, the application of the TiN-coated tube electrode was expanded to hemofiltration, based on the hypothesis that the EIS system may be used to monitor clotting or clogging phenomena in hemofiltration. The findings suggest that the EIS monitoring system can track changes in ion concentration of blood before and after hemofiltration in real-time, which may serve as an indicator of clogging of filter membranes. Overall, our research demonstrates the potential of TiN-coated tube electrodes for sensitive and versatile non-invasive monitoring in bioreactor cultures and medical devices. N2 - Die elektrochemische Impedanzspektroskopie (EIS) ist eine nützliche Methode, um das elektrochemische Verhalten von biologischen Systemen zu analysieren, wie z.B. die elektrische Charakterisierung von Zellen und Biomolekülen, Drug Screening und Biomaterialien im biomedizinischen Bereich. Für die EIS wird ein Wechselstrom an das biologische System angeschlossen und die Impedanz des Systems über einen Frequenzbereich gemessen. In vitro-Modelle von Gewebekulturen epithelialer Barrieren können mithilfe künstlicher oder biologischer Materialien, die über unterschiedliche Kompartimente (apikale und basolaterale Seite) verfügen, hergestellt werden und ermöglichen weitere Untersuchungen zum Transport von Arzneistoffen. Die EIS bietet dabei eine hervorragende Methode für das nicht-invasive Echtzeit-Monitoring der elektrischen Eigenschaften, die mit der Barriere-Integrität während der Gewebeentwicklung korreliert. Obwohl kommerziell erhältliche Geräte zur Messung des transendothelialen/transepithelialen elektrischen Widerstands (TEER) umfangreich verwendet werden, ist ihre Verwendung besonders bei statischen Transwell-Kulturen verbreitet. Durch die EIS kann im Gegensatz zur TEER-Messung für Bioreaktor-Kulturen, die einen dynamischen Medienfluss aufweisen, genauere und verlässliche Messungen erhalten werden. Zudem können EIS-Messungen anders als die TEER-Messung, die nur den Widerstand einer einzelnen Frequenz misst, gleichzeitig den elektrischen Widerstand und die Kapazität von Zellen erfassen und damit zusätzliche Informationen über die zellulären Barriereeigenschaften über verschiedene Frequenzen hinweg liefern. Der EIS-Einbau in ein Bioreaktor-System bedarf einer sorgfältigen Optimierung der Elektrodenintegration in das Bioreaktor-Setup und der Messparameter, um akkurate EIS-Messungen durchführen zu können. Da Bioreaktoren abhängig vom Untersuchungszweck in ihrer Größe und ihrem Design variieren, verwenden die meisten Studien speziell entwickelte Elektrodensysteme für einzelne Bioreaktoren. Das Ziel dieser Arbeit war die Herstellung von vielseitig anwendbaren Elektroden und etablierten Methoden für das automatisierte nicht-invasive Echtzeit-Monitoring von Bioreaktor-Kulturen mithilfe der EIS. Entscheidend für das Elektrodenmaterial war die Titannitrid (TiN)-Beschichtung, die auf verschiedenen Substraten (Materialien und Formen) durch Physical Vapor Deposition (PVD) hergestellt und in einer Polydimethylsiloxan (PDMS)-Struktur untergebracht wurde, damit die Elektroden unabhängig voneinander arbeiten können. Verschiedene Elektrodendesigns wurden auf Doppelschicht-Kapazität mithilfe der EIS bzw. auf die Morphologie mit Rasterelektronenmikroskopie untersucht. Die TiN-beschichteten Elektroden in Röhrenform erwiesen sich als optimal. Weiterhin wurden EIS-Messungen durchgeführt, um die Auswirkung von beeinflussenden Parametern auf die Kulturbedingungen durch das TiN-beschichtete Elektrodensystem zu untersuchen. Um die Vielseitigkeit der Elektroden aufzuzeigen, wurden diese anschließend zum Monitoring von Barriere-bildenden Zellen in unterschiedliche Perfusionsbioreaktoren integriert. Zellen der Blut-Hirn-Schranke (BHS) wurden im neu entwickelten dynamischen Flussreaktor kultiviert, wohingegen humane umbilikale vaskuläre Endothelzellen (HUVEC) und Caco-2-Zellen in Hohlfaserbioreaktoren (HFBR) in Miniaturform kultiviert wurden. Das TiN-beschichtete Röhrenelektrodensystem ermöglichte die Untersuchung der BHS-Barrieren-Integrität in einer Langzeit-Bioreaktorkultur. Während die EIS-Messung in der Miniaturform-HFBR-Kultur keine elektrischen Eigenschaften der HUVECs detektieren konnte, war es möglich, eine Barriere-Integrität der Caco-2-Zellen zu messen, die den potentiellen Nutzen für die Evaluierung deren Barrierefunktion aufzeigt. Nach den Bioreaktorkulturen wurde die Anwendung der TiN-beschichteten Röhrenelektrode auf die Hämofiltration erweitert, auf Grundlage der Hypothese, dass das EIS-System ein Gerinnen oder Verstopfen während der Hämofiltration überwachen könnte. Die Ergebnisse zeigen, dass das EIS-Monitoring-System Veränderungen in der Ionenkonzentration des Blutes vor und nach Hämofiltration in Echtzeit verfolgen kann, welches eventuell als Messgröße für ein Verstopfen der Filtermembranen genutzt werden kann. Insgesamt weisen TiN-beschichtete Röhrenelektroden unseren Forschungen zufolge ein großes Potential für ein empfindliches und vielfältiges nicht-invasives Monitoring von Bioreaktorkulturen und Medizingeräte auf. KW - Monitoring KW - Tissue Engineering KW - Electrode KW - Perfusion Bioreactor KW - Hemofiltration KW - Medizinprodukt KW - Electrochemical Impedance Spectroscopy Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-358232 ER - TY - THES A1 - Kutschka, Ilona T1 - Activation of the integrated stress response induces remodeling of cardiac metabolism in Barth Syndrome T1 - Aktivierung der "Integrated Stress Response" führt zur Umstellung des kardialen Metabolismus im Barth Syndrom N2 - Barth Syndrome (BTHS) is an inherited X-chromosomal linked disorder, characterized by early development of cardiomyopathy, immune system defects, skeletal muscle myopathy and growth retardation. The disease displays a wide variety of symptoms including heart failure, exercise intolerance and fatigue due to the muscle weakness. The cause of the disease are mutations in the gene encoding for the mitochondrial transacylase Tafazzin (TAZ), which is important for remodeling of the phospholipid cardiolipin (CL). All mutations result in a pronounced decrease of the functional enzyme leading to an increase of monolysocardiolipin (MLCL), the precursor of mature CL, and a decrease in mature CL itself. CL is a hallmark phospholipid of mitochondrial membranes, highly enriched in the inner mitochondrial membrane (IMM). It is not only important for the formation of the cristae structures, but also for the function of different protein complexes associated with the mitochondrial membrane. Reduced levels of mature CL cause remodeling of the respiratory chain supercomplexes, impaired respiration, defects in the Krebs cycle and a loss of mitochondrial calcium uniporter (MCU) protein. The defective Ca2+ handling causes impaired redox homeostasis and energy metabolism resulting in cellular arrhythmias and defective electrical conduction. In an uncompensated situation, blunting mitochondrial Ca2+ uptake provokes increased mitochondrial emission of H2O2 during workload transitions, related to oxidation of NADPH, which is required to regenerate anti-oxidative enzymes. However, in the hearts and cardiac myocytes of mice with a global knock-down of the Taz gene (Taz-KD), no increase in mitochondrial ROS was observed, suggesting that other metabolic pathways may have compensated for reduced Krebs cycle activation. The healthy heart produces most of its energy by consuming fatty acids. In this study, the fatty acid uptake into mitochondria and their further degradation was investigated, which showed a switch of the metabolism in general in the Taz-KD mouse model. In vivo studies revealed an increase of glucose uptake into the heart and decreased fatty acid uptake and oxidation. Disturbed energy conversion resulted in activation of retrograde signaling pathways, implicating overall changes in the cell metabolism. Upregulated integrated stress response (ISR) was confirmed by increased levels of the downstream target, i.e., the activating transcription factor 4 (ATF4). A Tafazzin knockout mouse embryonal fibroblast cell model (TazKO) was used to inhibit the ISR using siRNA transfection or pharmaceutical inhibition. This verified the central role of II the ISR in regulating the metabolism in BTHS. Moreover, an increased metabolic flux into glutathione biosynthesis was observed, which supports redox homeostasis. In vivo PET-CT scans depicted elevated activity of the xCT system in the BTHS mouse heart, which transports essential amino acids for the biosynthesis of glutathione precursors. Furthermore, the stress induced signaling pathway also affected the glutamate metabolism, which fuels into the Krebs cycle via -ketoglutarate and therefore supports energy converting pathways. In summary, this thesis provides novel insights into the energy metabolism and redox homeostasis in Barth syndrome cardiomyopathy and its regulation by the integrated stress response, which plays a central role in the metabolic alterations. The aim of the thesis was to improve the understanding of these metabolic changes and to identify novel targets, which can provide new possibilities for therapeutic intervention in Barth syndrome. N2 - Barth Syndrome (BTHS) ist eine X-chromosomal vererbbare Erkrankung, welche sich in der frühen Entstehung von Kardiomyopathie, Störungen des Immunsystems, Skelettmuskelschwäche und Wachstumsverzögerungen manifestiert. Das Krankheitsbild ist sehr variabel mit milden Symptomen bis hin zu sehr schwerwiegenden Fällen, bei denen die schnelle Verschlechterung der Kardiomyopathie bereits in jungen Jahren eine Herztransplantation erfordern kann. Betroffenen Patienten zeigen eine deutliche Intoleranz gegenüber körperlicher Anstrengung, welche mit schneller Müdigkeit einhergeht. Die Krankheit wird durch verschiedene Mutationen auf dem Gen für die mitochondriale Transacylase Tafazzin (TAZ) ausgelöst. Die Mutationen führen zu einem Funktionsverlust des Enzyms, welches in der Biosynthese des Phospholipids Cardiolipin (CL) eine entscheidende Rolle spielt. Die Vorstufe des Lipids, das sogenannte Monolysocardiolipin (MLCL), reichert sich dadurch an, wohingegen die Menge an reifem CL entscheidend verringert ist. CL ist ein bedeutendes Phospholipid in den Mitochondrien, wo es vor allem in der inneren Mitochondrien Membran vorkommt. CL ist einerseits wichtig für die Ausbildung der Cristae Strukturen der inneren Mitochondrien Membran. Darüber hinaus ist es notwendig für die Struktur und Funktion verschiedenster Proteinkomplexe in der Membran, welche dadurch erst ihre volle Funktionsfähigkeit erhalten. Es wurde bereits gezeigt, dass der Verlust von reifem CL in BTHS zu einer Dissoziation der Superkomplexe der Atmungskette führt, welche dadurch in ihrer Funktion beeinträchtigt ist. Zusätzlich sind Störungen im Krebs Zyklus und der Kalziumaufnahme durch den mitochondriellen Kalzium (Ca2+) -Uniporter (MCU) Komplex bekannt. Die beeinträchtigte mitochondriale Ca2+ Aufnahme beeinflusst sowohl die Redox Homöostase als auch den Energie Metabolismus, was zu Arrhythmien und einer Störung der elektrischen Weiterleitung im Herzen führt. Im gesunden Herzen gewinnen die Herzmuskelzellen den Hauptanteil ihrer Energie aus dem Abbau von Fettsäuren. In dieser Studie wurde durch die Untersuchung des Fettsäurestoffwechsels im Taz knockdown Mausmodell (Taz-KD) gezeigt, dass eine deutliche Reduktion in Proteinen vorliegt, welche für die Aufnahme und die Verstoffwechselung der Fettsäuren in den Mitochondrien verantwortlich sind. Diese Veränderungen führten in vivo zu einer verringerten Aufnahme und Verstoffwechselung von Fettsäuren und einer Erhöhten Aufnahme von Glucose. Dysfunktionale Mitochondrien aktivieren retrograde Signalwege, welche eine generelle IV Umstellung des Metabolismus zur Folge haben. Eine erhöhte Menge des Transkriptionsfaktors ATF4, welcher sowohl Fettsäure- als auch Aminosäuremetabolismus beeinflusst, zeigte die Aktivierung der sogenannten „Integrated stress response“ (ISR). Ein Zellmodel embryonaler Fibroblasten aus der Maus mit einem Taz knockout (TazKO) wurde verwendet um die ISR durch siRNA Transfektion oder einem pharmakologischen Inhibitor zu blockieren. Dadurch konnte die zentrale Rolle der ISR in der Umstellung des Metabolismus bestätigt werden. Zusätzlich konnte eine erhöhte metabolische Aktivität in Richtung der Glutathion Biosynthese beobachtet werden, welche für die Redox Homöostase in den Mitochondrien von Bedeutung ist. In vivo PET-CT Untersuchungen zeigten eine erhöhte Aktivität des xCT Systems im Herzen des BTHS Mausmodells auf. Dies dient der Aufnahme von Aminosäuren, welche für die Glutathion Biosynthese benötigt werden. Hinzu kommt, dass die Aktivierung des Stresssignalweges den Glutamat Stoffwechsel in der Zelle beeinflusste. Über -Ketoglutarat trägt Glutamat so vermehrt zur Energiegewinnung bei. Das Ziel dieser Doktorarbeit war es, die metabolischen Veränderungen in BTHS zu untersuchen, um die veränderten Vorgänge besser zu verstehen und so neue mögliche Angriffspunkte für Therapiemöglichkeiten zu identifizieren. KW - Herzmuskelkrankheit KW - Mitochondrium KW - Stoffwechsel KW - Barth Syndrome Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-358186 ER - TY - THES A1 - Wilhelmi, Kai Alexander T1 - Untersuchung von Veränderungen der myelinisierten Nervenfasern durch Entmarkung in Haut- und Nervenbiopsien von Patienten mit Polyneuropathie T1 - Examination of changes in myelinated nerve fibers due to demyelination in skin and nerve biopsies of patients with polyneuropathy N2 - In dieser Arbeit wurde durch das immunhistochemische Anfärben von nodalen (Natriumkanäle, NF), paranodalen (Caspr, NF) und internodalen (MBP) Proteinen der in Fingerhautbiopsien vorhanden Nervenfasern untersucht, ob eine Veränderung der typischen Verteilungsmuster dieser Proteine, eine demyelinisierende Polyneuropathie anzeigen kann. Dazu wurden am Universitätsklinikum Würzburg prospektiv 93 Polyneuropathie-Patienten und 25 Kontrollpersonen rekrutiert. Bei allen Patienten wurden Hautstanzbiospien am Zeigefinger durchgeführt. Bei 35 Patienten mit schweren oder unklaren Verläufen, wurden konsiliarisch Nervus suralis Biopsien durchgeführt. Aus einem Abschnitt von 27 dieser Biopsien, konnten im Rahmen dieser Arbeit Zupfnervenpräparate angefertigt und analog zu den Hautbiopsien ausgewertet werden. Aus der Routinediagnostik der Klinik flossen weiterhin die Ergebnisse der elektrophysiologischen Routinediagnostik und der Histologiebefund der Nervus suralis Biopsien in die Auswertung ein. Zusammenfassend kamen veränderte Natriumkanalbanden in Fingerhautbiopsien signifikant häufiger bei Patienten mit elektrophysiologisch als demyelinisierend befundeten Polyneuropathien, als bei Patienten mit elektrophysiologisch als axonal befundeten Polyneuropathien vor. Vielfach fanden sich veränderte Natriumkanalbanden inmitten para- und internodal unauffälliger Schnürringe und umgekehrt. Diese Beobachtung stützt die bereits in Vorarbeiten vorgeschlagene und in der aktuellen Leitlinie zur Diagnostik für Polyneuropathien aufgegriffene Entität der Paranodopathien (Uncini, Susuki, & Yuki, 2013). Möglich wäre, dass eine veränderte Verteilung der Natriumkanäle die schnelle Leitfähigkeit beeinträchtigen und somit trotz intakter Bemarkung, elektrophysiologisch das Bild einer demyelinisierenden Neuropathie vermittelt. Ein direkter Zusammenhang zwischen dem Auftreten von doppelten und verlängerten Natriumkanalbanden und einzelnen Messwerten (z.B. Amplituden und Latenzzeiten) fand sich nicht. Auch in den Zupfnervenpräparaten der Nervus suralis Biopsien, konnten o.g. Verteilungsmuster untersucht werden. Deren Vorkommen zeigte sich als unabhängig vom elektrophysiologischen und histologischen Befund, von der Ätiologie der PNP und von den gefundenen Veränderungen in den Hautbiopsien des betreffenden Patienten. N2 - Myelinated nerve fibers in finger skin biopsies and sural nerve biopsies were examined using immunohistochemical staining to detect changes in the typical distribution patterns of nodal (voltage-gated sodium channels, neurofascin 186), paranodal (Caspr, neurofascin 155), and internodal (myelin basic protein) proteins, aiming to identify indicators for demyelinating polyneuropathies. A total of 93 polyneuropathy patients and 25 control subjects were prospectively recruited from the University Hospital Würzburg. Skin punch biopsies were conducted on all patients and control subjects. Additionally, sural nerve biopsies were performed on a consultative basis for 35 patients. Teased nerve fiber preparations were made from a section of 27 of these biopsies and evaluated similarly to the skin biopsies. In summary, altered sodium channel bands in myelinated nerve fibers from finger skin biopsies were significantly more prevalent in patients electrophysiologically diagnosed with demyelinating polyneuropathies. However, there was no significant difference in the means of individual electrophysiological measurements between patients with and without changes in the immunohistochemical stainings. Each of the investigated changes was significantly more common in the polyneuropathy group than in the control group. Further correlations, particularly in the comparison of results from skin and sural nerve biopsies, were not found KW - Polyneuropathie KW - Ranvier-Schnürring KW - Entmarkung KW - Elektrophysiologie KW - Caspr KW - Neurofascin KW - MBP KW - spannungsgesteuerter Natriumkanal Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-360046 ER -