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Wohlschlaeger J, Bertram S, Theegarten D, Hager T, Baba HA. [Coronary atherosclerosis and progression to unstable plaques : Histomorphological and molecular aspects]. Herz 2016. [PMID: 26216542 DOI: 10.1007/s00059-015-4341-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Atherosclerosis causes clinical symptoms through luminal narrowing by stenosis or by precipitating thrombi that obstruct blood flow to the myocardium (coronary artery disease), central nervous system (ischemic stroke) or lower extremities (peripheral vascular disease). The most common of these manifestations of atherosclerosis is coronary artery disease, clinically presenting as either stable angina or acute coronary syndromes. Atherosclerosis is a mainly lipoprotein-driven disease, which is associated with the formation of atherosclerotic plaques at specific sites of the vascular system through inflammation, necrosis, fibrosis and calcification. In most cases, plaque rupture of a so-called thin-cap fibroatheroma leads to contact of the necrotic core material of the underlying atherosclerotic plaque with blood, resulting in the formation of a thrombus with acute occlusion of the affected (coronary) artery. The atherosclerotic lesions that can cause acute coronary syndromes by formation of a thrombotic occlusion encompass (1) thin-cap fibroatheroma, (2) plaque erosion and (3) so-called calcified nodules in calcified and tortuous arteries of aged individuals. The underlying pathomechanisms remain incompletely understood so far. In this review, the mechanisms of atherosclerotic plaque initiation and progression are discussed.
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Bonella F, Long X, Theegarten D, Boerner E, Wessendorf T, Guzman J, Costabel U. Einfluss von Nintedanib auf die Freisetzung von angiogenetischen/angiostatischen Zytokinen von Alveolarmakrophagen (AMs) bei interstitiellen Lungenerkrankungen (ILD). Pneumologie 2016. [DOI: 10.1055/s-0036-1572293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wessendorf T, Bonella F, Theegarten D, Darwiche K, Cuyás Cortadellas M, Börner E, Costabel U. Granulomnachweis bei Sarkoidose: Welche Technik hat die höchste Trefferquote? Pneumologie 2016. [DOI: 10.1055/s-0036-1571982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Theegarten D, Bonella F, Hager T, Wessendorf T. Transmissionselektronenmikroskopische Untersuchungen der bronchoalveolären Lavage: erste Ergebnisse. Pneumologie 2016. [DOI: 10.1055/s-0036-1572016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Theegarten D, Welter S, Hager T, Krebs B. Neuroendokriner Tumor mit Quetschungsartefakten: Kleinzelliges Karzinom oder Karzinoid? Pneumologie 2016. [DOI: 10.1055/s-0036-1572281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kühl H, Theegarten D, Balzen L, Hahn S, Herbrik M, Darwiche K, Wetter A. Kombination von CT-gesteuerter Stanzbiopsie und zytologischer Sofortbefundung bei Patienten mit peripheren Lungentumoren: Diagnostische Wertigkeit der Zytologie im Vergleich zur Histologie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Walter RFH, Mairinger FD, Ting S, Vollbrecht C, Mairinger T, Theegarten D, Christoph DC, Schmid KW, Wohlschlaeger J. MDM2 is an important prognostic and predictive factor for platin-pemetrexed therapy in malignant pleural mesotheliomas and deregulation of P14/ARF (encoded by CDKN2A) seems to contribute to an MDM2-driven inactivation of P53. Br J Cancer 2015; 112:883-90. [PMID: 25668009 PMCID: PMC4453955 DOI: 10.1038/bjc.2015.27] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 01/01/2015] [Accepted: 01/12/2015] [Indexed: 12/28/2022] Open
Abstract
Background: Malignant pleural mesothelioma (MPM) is a highly aggressive tumour that is
first-line treated with a combination of cisplatin and pemetrexed. Until
now, predictive and prognostic biomarkers are lacking, making it a
non-tailored therapy regimen with unknown outcome. P53 is frequently
inactivated in MPM, but mutations are extremely rare. MDM2 and P14/ARF
are upstream regulators of P53 that may contribute to P53 inactivation. Methods: A total of 72 MPM patients were investigated. MDM2 immunoexpression was
assessed in 65 patients. MDM2 and P14/ARF mRNA
expression was analysed in 48 patients of the overall collective. The
expression results were correlated to overall survival (OS) and
progression-free survival (PFS). Results: OS and PFS correlated highly significantly with MDM2 mRNA and protein
expression, showing a dismal prognosis for patients with elevated MDM2
expression (for OS: Score (logrank) test: P⩽0.002, and for PFS:
Score (logrank) test; P<0.007). MDM2 was identified as robust
prognostic and predictive biomarker for MPM on the mRNA and protein level.
P14/ARF mRNA expression reached no statistical
significance, but Kaplan–Meier curves distinguished patients with low
P14/ARF expression and hence shorter survival from patients
with higher expression and prolonged survival. Conclusions: MDM2 is a prognostic and predictive marker for a platin–pemetrexed
therapy of patients with MPMs. Downregulation of P14/ARF expression
seems to contribute to MDM2-overexpression-mediated P53 inactivation in MPM
patients.
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Reis H, Herold T, Ting S, Worm K, Huber U, Christoph DC, Eberhardt WE, Kostbade K, Kasper S, Stamatis G, Welter S, Darwiche K, Karpf-Wissel R, Theegarten D, Schmid KW, Schuler M, Wiesweg M. HER2 expression and markers of phosphoinositide-3-kinase pathway activation define a favorable subgroup of metastatic pulmonary adenocarcinomas. Lung Cancer 2015; 88:34-41. [PMID: 25708529 DOI: 10.1016/j.lungcan.2015.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 01/04/2015] [Accepted: 02/01/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Pulmonary adenocarcinomas (ADC) can be sub-grouped based on dominant oncogenic drivers. EGFR mutations define an entity of metastatic ADC with favorable prognosis and high susceptibility to EGFR tyrosine kinase inhibition. In contrast, the clinical impact of additional ERBB family members in ADC is less defined. To this end we prospectively studied HER2 expression, gene amplification, and mutation in relation to outcome of patients with advanced or metastatic ADC. MATERIALS AND METHODS Diagnostic tumor biopsies from 193 sequential patients with stage III/IV ADC were prospectively studied for HER2 expression by immunohistochemistry (IHC). Cases with IHC scores 2+ or 3+ were analyzed by HER2 chromogenic in situ hybridization (CISH), and sequencing of HER2 exons 20 and 23. Additional prospectively determined biomarkers included PTEN, cMET, pAKT, and pERK expression, KRAS, EGFR, BRAF and PIK3CA mutations, and ALK fluorescence ISH (FISH). RESULTS AND CONCLUSION HER2-IHC was feasible in 176 (91.2%) cases. Of 53 (30%) cases with IHC scores 2+/3+, 45 (85%) could be studied by CISH and 34 (64%) by sequencing. The lower number of HER2-mutational analyses resulted from exhaustion of tumor tissue and DNA following mutational analysis of KRAS, EGFR, BRAF and PIK3CA. HER2 amplification was detected in 4 cases (2.3%), while no mutation was found. HER2 expression correlated with expression of pAKT and cMET. Expression of HER2 and pAKT was associated with favorable overall survival in stage IV disease. HER2-expressing ADC more frequently harbored KRAS mutations, while HER2 expression was absent in all 4 cases with BRAF mutation. HER2-IHC was not predictive of HER2 gene amplification or mutation, which both were rare events in prospectively studied patients with advanced or metastatic ADC. Expression of HER2 and pAKT define a population of patients with stage IV ADC with a distinct disease course, who could benefit from specifically tailored pharmacotherapies.
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Funke F, Fleimisch P, Kleibrink B, Firch V, Theegarten D, Weinreich G, Kamler M, Witzke O, Teschler H, Sommerwerck U. Bortezomibtherapie bei Bronchiolitis-Obliterans-Syndrom nach Lungentransplantation. Pneumologie 2015. [DOI: 10.1055/s-0035-1544821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Börner E, Wessendorf T, Theegarten D, Hetzel M, Costabel U, Bonella F. A Case with Pulmonary Alveolar Proteinosis and Sarcoidosis. Pneumologie 2015. [DOI: 10.1055/s-0035-1544750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Özkan F, Freitag L, Theegarten D, Hohenforst-Schmidt W, Khan AM, Darwiche K. EBUS-TBNA Proben lassen sich ohne Verlust der diagnostischen Genauigkeit für zytologische und molekulare Analysen teilen. Pneumologie 2015. [DOI: 10.1055/s-0035-1544642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Theegarten D, Bonella F, Welter S, Hager T, Wessendorf T. Neu aufgetretene pulmonale Verdichtungen bei einer Sarkoidose. Pneumologie 2015. [DOI: 10.1055/s-0035-1544746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Long X, Costabel U, He X, Guzman J, Theegarten D, Bonella F. Serum YKL-40 as a candidate biomarker for hypersensitivity pneumonitis. Pneumologie 2015. [DOI: 10.1055/s-0035-1544609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Oezkan F, Khan A, Zarogoulidis P, Hohenforst-Schmidt W, Theegarten D, Yasufuku K, Nakajima T, Freitag L, Darwiche K. Efficient utilization of EBUS-TBNA samples for both diagnosis and molecular analyses. Onco Targets Ther 2014; 7:2061-5. [PMID: 25419143 PMCID: PMC4234164 DOI: 10.2147/ott.s72974] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The assessment of an increasing number of molecular markers is becoming a standard requirement from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) specimens. However, it is unclear how many needle passes should be performed and the amount of lung cancer cells that should be sent for molecular analyses. The objective of this study was to determine if it is feasible to divide the material obtained by EBUS-TBNA to allow for molecular analysis without compromising the accuracy of mediastinal staging. OBJECTIVE We aimed to determine if dividing EBUS-TBNA specimens has a negative impact on either histopathological diagnosis or molecular analysis. METHODS EBUS-TBNA was performed in 249 enlarged lymph nodes. Negative or ambiguous histopathological results were confirmed by surgical means and clinical follow-up over 6 months. The tissue obtained by EBUS-TBNA was placed onto a glass slide and divided for histopathological workup and molecular analysis. The number of passes was recorded. Both the accuracy of the mediastinal lymph node staging and the applicability of the sample division for molecular analysis were assessed. RESULTS Each lymph node was punctured an average of 3.18 times and division of the obtained material for diagnosis and molecular analysis was feasible in all cases. The sensitivity and accuracy of the mediastinal lymph node staging were 96.6% and 97.6%, respectively. A cytokeratin (CK)-19-mRNA concentration-based molecular test was feasible in 74.1% of cases. CONCLUSION Dividing EBUS-TBNA samples for both histopathological diagnosis and molecular testing is feasible and does not compromise the accuracy of mediastinal staging. This method may be an alternative to taking additional needle passes for molecular analyses.
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Mairinger F, Walter R, Werner R, Vollbrecht C, Ting S, Theegarten D, Christoph D, Schmid K, Wohlschlaeger J. 548: mRNA biomarker screening in pulmonary tumors showing neuroendocrine differentiation via NanoString nCounter. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50489-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Theegarten D, Tötsch M, Worm K, Darwiche K, Anhenn O, Wohlschläger J. [Diagnosis of pulmonary tuberculosis using Ziehl-Neelsen stain and polymerase chain reaction]. DER PATHOLOGE 2014; 34:305-9. [PMID: 23503854 DOI: 10.1007/s00292-013-1759-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Definitive diagnosis of unclear pulmonary lesions is mainly based on morphological methods. In addition to a neoplasm, inflammatory reactions, in particular tuberculosis (TB), have to be considered in most cases. Therefore, the aim of this work was to determine whether established methods used in general pathology can be efficiently used with cytological material. MATERIALS AND METHODS An established polymerase chain reaction (PCR) protocol for the detection of Mycobacterium tuberculosis complex (Mtc) DNA in fixed specimens was conducted on fixed material available as an assay for liquid-based cytology (LBC). CytoLyt®-fixed material of 45 patients with clinically suspected TB or other mycobacteriosis were selected and were initially tested cytologically. In cases of absent tumor cells, PCR for detection of Mtc DNA and Ziehl-Neelsen stain (ZN) were performed. RESULTS In 9 patients (20 %), Mtc DNA was found by PCR. The following methods were used to obtain material: catheter biopsy (5), needle biopsy (2), transbronchial needle aspiration (1), and bronchoalveolar lavage (1). Cytologically an inflammatory reaction was observed in all cases. In 2 patients, a history of TB, in 2 further cases either silicosis or a posttransplant situation was known. In cases with a positive PCR, 7 patients (78 %) were positive in ZN and 3 patients (33.3 %) in TB culture (15.5 % vs. 6.7 % of the total cohort); however, the material used for investigation was not always from identical sources, respectively. In 36 out of 45 patients, both PCR and ZN were negative for the detection of Mtc DNA. CONCLUSION The material intended for LBC can be used for detection of TB with ZN and Mtc PCR.
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Sonnen S, Sonnen PC, Welter S, Klein-Hitpass L, Bonella F, Theegarten D. Unterschiedliche Expression von microRNAs in Lungen- und Lymphknotengewebe bei der Sarkoidose. Pneumologie 2014. [DOI: 10.1055/s-0034-1367902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Özkan F, Zarogoulidis P, Theegarten D, Freitag L, Darwiche K. Carcinoma in situ auf dem Boden einer Tracheomalazie. Pneumologie 2014. [DOI: 10.1055/s-0034-1367812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hagmeyer L, Theegarten D, Wohlschläger J, Priegnitz C, Randerath WJ. Transbronchiale Kryobiopsie und offene Lungenbiopsie bei interstitiellen Lungenerkrankungen: Vergleich zweier Verfahren. Pneumologie 2014. [DOI: 10.1055/s-0034-1367819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Franke KJ, Nilius G, Hein M, Rühle KH, Theegarten D. Transbronchiale Katheteraspiration im Vergleich zur transbronchialen Nadelaspiration in der Diagnostik des peripheren Lungenherdes. Pneumologie 2014. [DOI: 10.1055/s-0034-1367817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sonnen PC, Sonnen S, Welter S, Klein-Hitpass L, Theegarten D, Bonella F. MicroRNA-Profile in mediastinalen Lymphknoten von Patienten mit Anthrakosilikose. Pneumologie 2014. [DOI: 10.1055/s-0034-1367901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Theegarten D, Szatmári V, Griese M, Bonella F. Erstbeschreibung und Charakterisierung einer pulmonalen Alveolarproteinose bei einer Katze. Pneumologie 2014. [DOI: 10.1055/s-0034-1367912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hartmann D, Theegarten D, Kamler M, Dührsen U, Teschler H, Sommerwerck U. Ist eine maligne Grunderkrankung immer eine absolute Kontraindikation für eine Lungentransplantationslistung? Eine Fallvorstellung. Pneumologie 2014. [DOI: 10.1055/s-0034-1368014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Börner E, Bonella F, Theegarten D, Wessendorf T, Guzman J, Costabel U. Pleuroparenchymal fibroelastosis – a new diagnostic and therapeutic challenge for pneumologists. Pneumologie 2014. [DOI: 10.1055/s-0034-1367971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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50
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Reis H, Hager T, Witzke O, Theegarten D. Kavernöse pulmonale Zygomykose mit letaler Gefäßarrosion nach Nierentransplantation. Pneumologie 2014. [DOI: 10.1055/s-0034-1367852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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