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Sonstige beteiligte Institutionen
Stimulatory or superagonistic (SA) CD28-specific monoclonal antibodies (mAbs) are potent polyclonal activators of regulatory T cells and have proven highly effective as treatment in a wide range of rodent models for autoimmune and inflammatory diseases. In these models, a preferential activation of regulatory T cells was observed by in vivo administration of CD28SA. In stark contrast, human volunteers receiving TGN1412, a humanized CD28-specific mAb, experienced a life-threatening cytokine release syndrome during the first-in-man trial. Preclinical tests employing human peripheral blood mononuclear cells (PBMC) failed to announce the rapid cytokine release measured in the human volunteers in response to TGN1412. The aim of this thesis project was to find an explanation of why standard PBMC assays failed to predict the unexpected TGN1412-induced "cytokine storm" observed in human volunteers. CD28 superagonists can activate T cells without T cell receptor (TCR) ligation. They do depend, however, on “tonic” TCR signals received by MHC scanning, signals that they amplify. PBMC do not receive these signals in the circulation. Short-term in vitro preculture of human PBMC at a high cell density (HDC) resulted in massive cytokine release during subsequent TGN1412 stimulation. Restoration of reactivity was cell-contact dependent, associated with TCR polarization and tyrosine-phosphorylation, and blocked by HLA-specific mAb. In HDC, both CD4 T cells and monocytes functionally mature in a mutually dependent fashion. However, only CD4 memory T-cells proliferate upon TGN1412 stimulation, and were identified as the main source of pro-inflammatory cytokines. Importantly, responses to other T-cell activating agents were also enhanced if PBMC were first allowed to interact under tissue-like conditions. A new in vitro protocol is provided that returns circulating T-cells to a tissue-like status where they respond to TGN1412 stimulation, and it might represent a more reliable preclinical in vitro test for both activating and inhibitory immunomodulatory drugs. Finally, the surprising observation was made that the IgG1 “sibling” of TGN1412, which is of the poorly Fc receptor-binding IgG4 isotype, has a much lower stimulatory activity. We could exclude steric hindrance as an explanation and provide evidence for removal of TGN1112 from the T-cell surface by trans-endocytosis.
Das Ziel der Studie war es, den vorbeschriebenen Befund des P50-Gating-Defizits bei Schizophrenie, insbesondere die Unterschiede zwischen den verschiedenen Subgruppen nach Leonhard zu replizieren und darüber hinaus diejenigen kortikalen Areale zu detektieren, die während Bedingungen gesteigerten sensorischen Gatings mit signifikanter Aktivierung reagieren. Ferner sollten mögliche Differenzen im Muster kortikaler Aktivierung zwischen gesunden Kontrollen und Patienten aufgedeckt werden, um das kortikale Substrat defizitären sensorischen Gatings zu ermitteln.
Von August 1997 bis Ende 2011 wurden in einem zweistufigen Neugeborenen-Hörscreening-Modell über 16994 Neugeborene mit dem MB 11 BERAphon® (MAICO, Diagnostic GmbH, Berlin) getestet. Anfangs wurde unter Verwendung des Zeitgang-BERA das Screening durchgeführt. Der akustische Reiz wurde im Laufe der Zeit verändert und optimiert. Aktuell wird mit einem breitbandigen akustischen CE-Chirp™ bei einem Screeningpegel von 35 dB-nHL gearbeitet. Von April 2008 bis September 2008 wurden im Rahmen dieser Arbeit Neugeborene mit der genannten Methode gescreent. Im Juli 2008 wurde zusätzlich eine Umfrage unter Eltern durchgeführt, deren Kinder ca. zwei Jahre zuvor in der Univ.-Frauenklinik Würzburg nach Hörstörungen untersucht worden waren. Das Ziel dieser Arbeit ist, die Qualität des Neugeborenen-Hörscreening-Modells zu überprüfen und somit auch die Ermittlung der Sensitivität und Spezifität des MB 11 BERAphons®. In dieser Studie werden Ergebnisse von 583 gescreenten Neugeborenen (1166 Ohren) dargestellt. Die mittlere Messzeit betrug 42,5s (SD = ± 34,24s). Die Messzeiten lagen zwischen 16s und 178s, im Median dauerte eine Messung 28s. Die Pass-Rate nach Stufe I betrug 97,69 % und nach Stufe II, bzw. nach den Kontrollscreenings 98,95 %. Eine pädaudiologische Diagnostik und Therapie fand bei 11 Ohren (8 Kinder) statt. Es wurden somit 0,94% der Ohren richtig-positiv ermittelt. Die falsch-positiv-Rate betrug 2,41 %. 0,69 % der Kinder gelten als Drop-outs. Insgesamt wurden 96,31% als richtig-negativ eingeordnet. Eine Spezifität von 97,57 % wurde erreicht. Im zweiten Teil der Arbeit wurde eine Umfrage unter 500 Elternpaaren durchgeführt. Zur Informationsermittlung wurde ein selbst entworfener Würzburger Fragebogen sowie der LittlEARS-Fragebogen der Firma MED-EL Medical Electronics verwendet. Der Würzburger Fragebogen erwies sich als sehr gut geeignet für die Sensitivitätsstudie. Es wurde eine Rücklaufquote von 71,57 % erreicht. Die durchschnittliche Antwortdauer war 16,3 Tage. Im Median dauerte eine Antwort 6 Tage. Die aus den Umfrageergebnissen ermittelte Sensitivität beträgt 100 %. Die bereits genannten Ziele dieser Arbeit wurden erreicht. Die in Würzburg angewandte Screeningmethode erwies sich als effizient und übertrifft damit die Anforderungen an eine vom G-BA geforderte Screening-Einrichtung.
Superoxidanionen (O2˙‾) sind eine von mehreren sogenannten reaktiven Sauerstoffspezies, die im menschlichen Körper intra-, aber auch extrazellulär vorkommen. Verschiedene Enzyme, z.B. in der mitochondrialen Atmungskette, die NADPH-Oxidase oder endotheliale NO-Synthasen bilden O2˙‾. Da es sich um eine sehr reaktive Substanz handelt, die mit der DNA sowie mit Proteinen und Lipiden interagiert und diese schädigen kann, spielt sie bei kardiovaskulären Erkrankungen wie etwa der chronischen Herzinsuffizienz, Hypertonie oder Arteriosklerose eine große Rolle, ist aber auch an vielen anderen Erkrankungen wie z.B. dem Diabetes mellitus pathophysiologisch beteiligt. Dies macht verständlich, dass es für die Forschung von entscheidender Bedeutung ist, Methoden zu entwickeln, die zur Erkennung und Quantifizierung von O2˙‾ geeignet sind. Bereits heute gibt es verschiedene Methoden, O2˙‾ nachzuweisen. Jede dieser Methoden hat jedoch ihre ganz spezifischen Vor- aber auch Nachteile. Wir haben eine neue, einfache, sehr schnelle und sensitive HPLC-Methode mit einem internen Standard entwickelt, mit der die O2˙‾-Produktion in Endothelzellen und aortalem Gewebe gut zu messen ist. Sie beruht auf der Tatsache, dass Dihydroethidium (DHE) mit O2.- zu 2-Hydroxyethidium (2-OH-E+) reagiert. Nach Trennung mittels HPLC wurde die Menge an entstandenem 2-OH-E+ durch einen elektrochemischen Detektor gemessen. Die Proben wurden durch isokrate Elution aufgetrennt, was bisher bei der Detektion von 2-OH-E+, DHE und O2˙‾ mit vielen Nachteilen verbunden war. Durch eine spezielle mobile Phase, die ein Ionen-Paar-Reagens enthielt, konnte diese Form der Elution nun auch zur Erkennung von O2˙‾ angewandt werden. DHE und seine Reaktionsprodukte konnten nicht nur eindeutig aufgetrennt werden, sondern die Auftrennung erfolgte auch sehr schnell in nur etwa 15min, was gegenüber älteren Methoden einen eindeutigen Zeitvorteil bringt. Anstatt zwei benötigten wir darüber hinaus nur eine Pumpe, was ebenfalls ein Vorteil der isokraten Elution ist. Wir erreichten auch über längere Messreihen stabile Bedingungen, da für die isokrate Elution die mobile Phase nicht verändert werden muss. Des Weiteren haben wir 3,4-Dihydroxyzimtsäure als internen Standard eingeführt, der sich hinsichtlich seiner Retentionszeit als sehr geeignet erwies und mit einem elektrochemischen Detektor klar und eindeutig nachweisbar war. Dies bietet große Vorteile gegenüber Methoden ohne internen Standard. Veränderungen der Konzentrationen von DHE, 2-OH-E+ und Ethidium aufgrund von Verdampfen des Lösungsmittels Methanol können ebenso erkannt werden wie Ungenauigkeiten während der Präparation sowie Schwankungen im HPLC-System, wie sie etwa bei langen Messreihen durch Auswaschungs-Effekte oder Verunreinigungen auftreten können. Da sich die Konzentration des internen Standards 3,4-Dihydroxyzimtsäure stets mitverändert, können die Messwerte normalisiert werden und somit die Verfälschungen aufgehoben werden. Dem zu Folge sind Messungen mit einem internen Standard gegenüber solchen ohne internen Standard deutlich valider. Sowohl die Stimulation von humanen aortalen Endothelzellen (HAEC) mit Glukose bzw. Tumornekrosefaktor α, als auch die Infusion von Angiotensin II bei männlichen Mäusen mit anschließender Untersuchung der Aorta führt bekanntermaßen zu einem Anstieg von O2˙‾. Dieser Effekt konnte nun auch mit unserer neu etablierten HPLC-Methode nachgewiesen werden. Ebenfalls war ein Anstieg des aortalen O2˙‾-Spiegels bei Ratten nach induziertem Myokardinfarkt bereits in mehreren früheren Arbeiten beschrieben worden. Dieser lag auch bei Messung mit unserer neu etablierten HPLC-Methode eindeutig vor. Die Signale waren hierbei für die untersuchten Substanzen 2-OH-E+, DHE sowie für den internen Standard 3,4-Dihydroxyzimtsäure eindeutig und gut voneinander getrennt. Zusammenfassend konnte somit gezeigt werden, dass sich anhand mehrerer etablierter in vitro und in vivo Modelle erhöhter Sauerstoffradikal-Produktion der Anstieg von O2˙‾ auch mit unserer neuen Variante der HPLC mit isokrater Elution, internem Standard und Messung mittels elektrochemischem Detektor nachweisen ließ. Es handelt sich um eine zuverlässige und sensitive Methode, die zusätzliche Vorteile für die Messung von O2˙‾ mit sich bringt.
Background: Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis. Differential diagnosis with cystic echinococcosis (CE) caused by E. granulosus and AE is challenging. We aimed at improving diagnosis of AE on paraffin sections of infected human tissue by immunohistochemical testing of a specific antibody.
Methodology/Principal Findings: We have analysed 96 paraffin archived specimens, including 6 cutting needle biopsies and 3 fine needle aspirates, from patients with suspected AE or CE with the monoclonal antibody (mAb) Em2G11 specific for the Em2 antigen of E. multilocularis metacestodes. In human tissue, staining with mAb Em2G11 is highly specific for E. multilocularis metacestodes while no staining is detected in CE lesions. In addition, the antibody detects small particles of E. multilocularis (spems) of less than 1 mm outside the main lesion in necrotic tissue, liver sinusoids and lymphatic tissue most probably caused by shedding of parasitic material. The conventional histological diagnosis based on haematoxylin and eosin and PAS stainings were in accordance with the immunohistological diagnosis using mAb Em2G11 in 90 of 96 samples. In 6 samples conventional subtype diagnosis of echinococcosis had to be adjusted when revised by immunohistology with mAb Em2G11.
Conclusions/Significance: Immunohistochemistry with the mAb Em2G11 is a new, highly specific and sensitive diagnostic tool for AE. The staining of small particles of E. multilocularis (spems) outside the main lesion including immunocompetent tissue, such as lymph nodes, suggests a systemic effect on the host.
Lymph node metastases associated with prostate cancer (PCa) has been shown to be a poor prognostic factor. The role of pelvic lymph node dissection (PLND) itself in relation to survival remains unclear, however. A Medline search was conducted to address this issue. The following conclusions were drawn. Only recently, improved survival due to completion of radical prostatectomy (RP) (compared to abandoning RP) in known or presumed lymph-node-positive patients has been shown. Lymph node sampling can only be considered representative if an adequate number of nodes is removed. While several authors have suggested that a therapeutic benefit in patients undergoing RP is not provided by PLND, the reliability of these studies is uncertain. Contrary to this, several studies have indicated the possibility of long-term survival even in the presence of limited lymph node metastases. The role and timing of initiation of adjuvant androgen deprivation therapy (ADT) in patients who have node-positive disease after RP is controversial. Recent studies suggest that delaying ADT may not adversely impact survival.
Secondary Prevention after Minor Stroke and TIA - Usual Care and Development of a Support Program
(2012)
Background: Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program.
Methods: Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU). Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed.
Results: 168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP): 155/84 mmHg) and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg) were assessed at 6 months. Proportions of patients with BP according to guidelines were 50% in usual-care and 77% in the support program (p<0.01). LDL<100 mg/dl was measured in 62 versus 71% (p = 0.12). Proportions of patients who stopped smoking were 50 versus 79% (p<0.01). 72 versus 89% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09).
Conclusions: Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-)vascular recurrence rates are going to be assessed in a multicenter randomized trial.
Measuring and estimating biodiversity patterns is a fundamental task of the scientist working to support conservation and informmanagement decisions.Most biodiversity studies in temperate regions were often carried out over a very short period of time (e.g., a single season) and it is often—at least tacitly—assumed that these short-termfindings are representative of long-termgeneral patterns.However, should the studied biodiversity pattern in fact contain significant temporal dynamics, perhaps leading to contradictory conclusions. Here, we studied the seasonal diversity dynamics of arboreal spider communities dwelling in 216 European beeches (Fagus sylvatica L.) to assess the spider community composition in the following seasons: two cold seasons (I:November 2005–January 2006; II: February–April) and two warm seasons (III: May–July; IV: August–October). We show that the usually measured diversity of the warmseason community (IV: 58 estimated species) alone did not deliver a reliable image of the overall diversity present in these trees, and therefore, we recommend it should not be used for sampling protocols aimed at providing a full picture of a forest’s biodiversity in the temperate zones. In particular, when the additional samplings of other seasons (I, II, III) were included, the estimated species richness nearly doubled (108). Community I possessed the lowest diversity and evenness due to the harsh winter conditions: this community was comprised of one dominant species together with several species low in abundance. Similarity was lowest (38.6%) between seasonal communities I and III, indicating a significant species turnover due to recolonization, so that community III had the highest diversity. Finally, using nonparametric estimators, we found that further sampling in late winter (February–April) is most needed to complete our inventory. Our study clearly demonstrates that seasonal dynamics of communities should be taken into account when studying biodiversity patterns of spiders, and probably forest arthropods in general.
This letter reports the results of a search for top and bottom squarks from gluino pair production in 4.7 fb\(^{−1}\) of pp collisions at √s=7 TeV using the ATLAS detector at the LHC. The search is performed in events with large missing transverse momentum and at least three jets identified as originating from a b-quark. Exclusion limits are presented for a variety of gluino-mediated models with gluino masses up to 1 TeV excluded.
A search for the Standard Model Higgs boson in the H→WW(⋆)→ℓνℓνH→WW(⋆)→ℓνℓν (ℓ=e,μℓ=e,μ) decay mode is presented. The search is performed using proton–proton collision data corresponding to an integrated luminosity of 4.7 fb\(^{−1}\) at a centre-of-mass energy of 7 TeV collected during 2011 with the ATLAS detector at the Large Hadron Collider. No significant excess of events over the expected background is observed. An upper bound is placed on the Higgs boson production cross section as a function of its mass. A Standard Model Higgs boson with mass in the range between 133 GeV and 261 GeV is excluded at 95% confidence level, while the expected exclusion range is from 127 GeV to 233 GeV.
A search for supersymmetry (SUSY) in events with large missing transverse momentum, jets, and at least one hadronically decaying τ lepton, with zero or one additional light lepton (e/μ), has been performed using 4.7 fb\(^{−1}\) of proton-proton collision data at \(\sqrt s\)=7TeV recorded with the ATLAS detector at the Large Hadron Collider. No excess above the Standard Model background expectation is observed and a 95 % confidence level visible cross-section upper limit for new phenomena is set. In the framework of gauge-mediated SUSY-breaking models, lower limits on the mass scale Λ are set at 54 TeV in the regions where the \(\tilde τ_1\) is the next-to-lightest SUSY particle (tanβ>20). These limits provide the most stringent tests to date of GMSB models in a large part of the parameter space considered.
Search for second generation scalar leptoquarks in pp collisions at √s=7 TeV with the ATLAS detector
(2012)
The results of a search for the production of second generation scalar leptoquarks are presented for final states consisting of either two muons and at least two jets or a muon plus missing transverse momentum and at least two jets. A total of 1.03 fb\(^{−1}\) integrated luminosity of proton-proton collision data produced by the Large Hadron Collider at s√=7 TeV and recorded by the ATLAS detector is used for the search. The event yields in the signal regions are found to be consistent with the Standard Model background expectations. The production of second generation leptoquarks is excluded for a leptoquark mass m\(_{LQ}\)<594 (685) GeV at 95 % confidence level, for a branching ratio of 0.5 (1.0) for leptoquark decay to a muon and a quark.
A search is presented for same-sign top-quark production and down-type heavy quarks of charge −1/3 in events with two isolated leptons (e or μ) that have the same electric charge, at least two jets and large missing transverse momentum. The data are selected from pp collisions at √s=7TeV recorded by the ATLAS detector and correspond to an integrated luminosity of 1.04 fb\(^{−1}\). The observed data are consistent with expectations from Standard Model processes. Upper limits are set at 95 % confidence level on the cross section of new sources of same-sign top-quark pair production of 1.4-2.0 pb depending on the assumed mediator mass. Upper limits are also set on the pair-production cross-section for new heavy down-type quarks; a lower limit of 450 GeV is set at 95 % confidence level on the mass of heavy down-type quarks under the assumption that they decay 100 % of the time to W t.
A search for new phenomena in final states with four or more leptons (electrons or muons) is presented. The analysis is based on 4.7 fb\(^{−1}\) of √s=7 TeV proton-proton collisions delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in two signal regions: one that requires moderate values of missing transverse momentum and another that requires large effective mass. The results are interpreted in a simplified model of R-parity-violating supersymmetry in which a 95% CL exclusion region is set for charged wino masses up to 540 GeV. In an R-parity-violating MSUGRA/CMSSM model, values of m 1/2 up to 820 GeV are excluded for 10 < tan β < 40.
A search is conducted for hadronic three-body decays of a new massive coloured particle in √s=7TeV pp collisions at the LHC using an integrated luminosity of 4.6 fb\(^{−1}\) collected by the ATLAS detector. Supersymmetric gluino pair production in the context of a model with R-parity violation is used as a benchmark scenario. The analysis is divided into two search channels, each optimised separately for their sensitivity to high-mass and low-mass gluino production. The first search channel uses a stringent selection on the transverse momentum of the six leading jets and is performed as a counting experiment. The second search channel focuses on low-mass gluinos produced with a large boost. Large-radius jets are selected and the invariant mass of each of the two leading jets is used as a discriminant between the signal and the background. The results are found to be consistent with Standard Model expectations and limits are set on the allowed gluino mass.
A search is presented for the pair production of light scalar top quarks in √s=7 TeV proton–proton collisions recorded with the ATLAS detector at the Large Hadron Collider. This analysis uses the full data sample collected during 2011 running that corresponds to a total integrated luminosity of 4.7 fb\(^{−1}\). Light scalar top quarks are searched for in events with two opposite-sign leptons (e, μ), large missing transverse momentum and at least one jet in the final state. No excess over Standard Model expectations is found, and the results are interpreted under the assumption that the light scalar top decays to a b-quark in addition to an on-shell chargino whose decay occurs through a virtual W boson. If the chargino mass is 106 GeV, light scalar top-quark masses up to 130 GeV are excluded for neutralino masses below 70 GeV.
This paper presents a search for the t-channel exchange of an R-parity violating scalar top quark ( \(\tilde{t}\) ) in the e\(^±\) μ\(^∓\) continuum using 2.1 fb\(^{−1}\) of data collected by the ATLAS detector in √s=7 TeV pp collisions at the Large Hadron Collider. Data are found to be consistent with the expectation from the Standard Model backgrounds. Limits on R-parity-violating couplings at 95 % C.L. are calculated as a function of the scalar top mass (m\(_\tilde{t}\)). The upper limits on the production cross section for pp→eμX, through the t-channel exchange of a scalar top quark, ranges from 170 fb for m\(_\tilde{t}\)=95 GeV to 30 fb for m\(_\tilde{t}\)=1000 GeV.
The ATLAS detector at the Large Hadron Collider is used to search for high-mass resonances decaying to an electron-positron pair or a muon-antimuon pair. The search is sensitive to heavy neutral Z′ gauge bosons, Randall-Sundrum gravitons, Z* bosons, techni-mesons, Kaluza-Klein Z/γ bosons, and bosons predicted by Torsion models. Results are presented based on an analysis of pp collisions at a center-of-mass energy of 7 TeV corresponding to an integrated luminosity of 4.9 fb\(^{−1}\) in the e\(^+\)e\(^−\) channel and 5.0 fb\(^{−1}\) in the μ\(^+\)μ\(^−\)channel. A Z′ boson with Standard Model-like couplings is excluded at 95 % confidence level for masses below 2.22 TeV. A Randall-Sundrum graviton with coupling k/\(\overline M_{Pl}\)=0.1 is excluded at 95 % confidence level for masses below 2.16 TeV. Limits on the other models are also presented, including Technicolor and Minimal Z′ Models.
This letter reports on a search for hypothetical heavy neutrinos, N, and right-handed gauge bosons, W R, in events with high transverse momentum objects which include two reconstructed leptons and at least one hadronic jet. The results were obtained from data corresponding to an integrated luminosity of 2.1 fb\(^{−1}\) collected in proton–proton collisions at √s=7 TeV with the ATLAS detector at the CERN Large Hadron Collider. No excess above the Standard Model background expectation is observed. Excluded mass regions for Majorana and Dirac neutrinos are presented using two approaches for interactions that violate lepton and lepton-flavor numbers. One approach uses an effective operator framework, the other approach is guided by the Left–Right Symmetric Model. The results described in this letter represent the most stringent limits to date on the masses of heavy neutrinos and W\(_R\) bosons obtained in direct searches.
A search for doubly charged Higgs bosons decaying to pairs of electrons and/or muons is presented. The search is performed using a data sample corresponding to an integrated luminosity of 4.7 fb\(^{−1}\) of pp collisions at √s = 7 TeV collected by the ATLAS detector at the LHC. Pairs of prompt, isolated, high-p\(_T\) leptons with the same electric charge (\(e^±e^±, e^±μ^±, μ^±μ^±\)) are selected, and their invariant mass distribution is searched for a narrow resonance. No significant excess over Standard Model background expectations is observed, and limits are placed on the cross section times branching ratio for pair production of doubly charged Higgs bosons. The masses of doubly charged Higgs bosons are constrained depending on the branching ratio into these leptonic final states. Assuming pair production, coupling to left-handed fermions, and a branching ratio of 100 % for each final state, masses below 409 GeV, 375 GeV, and 398 GeV are excluded for \(e^±e^±, e^±μ^±\), and \(μ^±μ^±\), respectively.