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Kretschmer S, Pieper M, König P, Marsh LM. Title. Imaging the dynamics and interactions of granulocytes and antigen-processing cells in allergic airway inflammation by two-photon microscopy. Pneumologie 2012. [DOI: 10.1055/s-0032-1315474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Pieper M, Aman S, Hintz W, Tomas J. Optimization of a Continuous Precipitation Process to Produce Nanoscale BaSO4. Chem Eng Technol 2011. [DOI: 10.1002/ceat.201000405] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Mercado N, Moe T, Pieper M, House J, Dolla W, Seifert L, Stolker J, Lindsey J, Kennedy K, Marso S. Tissue characterisation of atherosclerotic plaque in the left main: an in vivo intravascular ultrasound radiofrequency data analysis. EUROINTERVENTION 2011; 7:347-52. [DOI: 10.4244/eijv7i3a59] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Casarosa P, Kollak I, Kiechle T, Ostermann A, Schnapp A, Kiesling R, Pieper M, Sieger P, Gantner F. Functional and biochemical rationales for the 24-hour-long duration of action of olodaterol. J Pharmacol Exp Ther 2011; 337:600-9. [PMID: 21357659 DOI: 10.1124/jpet.111.179259] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
β(2)-Adrenoceptor (β(2)-AR) agonists are powerful bronchodilators and play a pivotal role in the management of pulmonary obstructive diseases, such as asthma and chronic obstructive pulmonary disease. Although these agents first were used many years ago, progress in drug development has resulted in better tolerated, long-acting β(2)-AR agonists (LABAs), such as formoterol and salmeterol. Although LABAs have been on the market for several years, relatively little is known on the rationale(s) behind their long duration of action. In this study, we focused on olodaterol (previously known as BI1744CL), a novel inhaled LABA, which provides a bronchodilating effect lasting 24 h and is currently in Phase III clinical trials. To understand the rationale behind its long duration of action, different aspects of olodaterol were analyzed (i.e., its lipophilicity and propensity to accumulate in the lipid bilayer as well as its tight binding to the β(2)-AR). In line with its physicochemical properties, olodaterol associated moderately with lipid bilayers. Instead, kinetic as well as equilibrium binding studies indicated the presence of a stable [(3)H]olodaterol/β(2)-AR complex with a dissociation half-life of 17.8 h due to ternary complex formation. The tight binding of olodaterol to the human β(2)-AR and stabilization of the ternary complex were confirmed in functional experiments monitoring adenylyl cyclase activity after extensive washout. Taken together, binding, kinetic, and functional data support the existence of a stable complex with the β(2)-AR that, with a dissociation half-life >17 h, might indeed be a rationale for the 24-h duration of action of olodaterol.
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Fajadet J, Wijns W, Laarman GJ, Kuck KH, Ormiston J, Baldus S, Hauptmann KE, Suttorp MJ, Drzewiecki J, Pieper M, Schultheiss HP, Mauri L. Long-term follow-up of the randomised controlled trial to evaluate the safety and efficacy of the zotarolimus-eluting driver coronary stent in de novo native coronary artery lesions: five year outcomes in the ENDEAVOR II study. EUROINTERVENTION 2011; 6:562-7. [PMID: 21044908 DOI: 10.4244/eijv6i5a95] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS We report here the final 5-year follow-up results from the ENDEAVOR II trial, which was the first randomised trial evaluating the Endeavor(tm) zotarolimus-eluting stent (ZES) compared with a bare metal stent (BMS) in patients with single, de novo coronary artery lesions. METHODS AND RESULTS Eligible patients were randomised 1:1 to receive ZES or BMS and were followed by telephone or clinic visit up to five years. We evaluated TVF and its components (target vessel revascularisation [TVR], Q-wave or non Q-wave myocardial infarction, or cardiac death attributed to the target vessel) at five years. Additionally, we report rates of MACE, TLR, and stent thrombosis (protocol- and ARC-defined) through five years. ENDEAVOR II enrolled 1,197 patients (598 ZES, 599 BMS). At five years of follow-up, the rates of TVF (15.4% vs 24.4%), TVR (10.7% vs 20.1%), MACE (15.4% vs 24.6%), and TLR (7.5% vs 16.3%) remained significantly lower in ZES patients compared with BMS patients. ARC definite and probable very late (>1 year) stent thrombosis remained low (0.2% ZES and 0.3% BMS) through five years. CONCLUSIONS After five years of follow-up, ZES demonstrated significantly improved clinical outcomes with sustained safety compared with BMS in patients with obstructive coronary artery disease.
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Kretschmer S, Pieper M, Marsh L, König P. Dynamik von Granulozyten und Antigen-prozessierenden Zellen während einer akuten allergischen Atemwegsentzündung mittels 2-Photonen Laser Scanning Mikroskopie. Pneumologie 2011. [DOI: 10.1055/s-0030-1270354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kubo T, Maehara A, Mintz GS, Doi H, Tsujita K, Choi SY, Katoh O, Nasu K, Koenig A, Pieper M, Rogers JH, Wijns W, Böse D, Margolis MP, Moses JW, Stone GW, Leon MB. The dynamic nature of coronary artery lesion morphology assessed by serial virtual histology intravascular ultrasound tissue characterization. J Am Coll Cardiol 2010; 55:1590-7. [PMID: 20378076 DOI: 10.1016/j.jacc.2009.07.078] [Citation(s) in RCA: 243] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 06/16/2009] [Accepted: 07/14/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVES We used virtual histology intravascular ultrasound (VH-IVUS) to investigate the natural history of coronary artery lesion morphology. BACKGROUND Plaque stability is related to its histological composition. METHODS We performed serial (baseline and 12-month follow-up) VH-IVUS studies and examined 216 nonculprit lesions (plaque burden >or=40%) in 99 patients. Lesions were classified into pathological intimal thickening (PIT), VH-IVUS-derived thin-capped fibroatheroma (VH-TCFA), thick-capped fibroatheroma (ThCFA), fibrotic plaque, and fibrocalcific plaque. RESULTS At baseline, 20 lesions were VH-TCFAs; during follow-up, 15 (75%) VH-TCFAs "healed," 13 became ThCFAs, 2 became fibrotic plaque, and 5 (25%) VH-TCFAs remained unchanged. Compared with VH-TCFAs that healed, VH-TCFAs that remained VH-TCFAs located more proximally (values are median [interquartile range]) (16 mm [15 to 18 mm] vs. 31 mm [22 to 47 mm], p = 0.013) and had larger lumen (9.1 mm(2) [8.2 to 10.7 mm(2)] vs. 6.9 mm(2) [6.0 to 8.2 mm(2)], p = 0.021), vessel (18.7 mm(2) [17.3 to 28.6 mm(2)] vs. 15.5 mm(2) [13.3 to 16.6 mm(2)]; p = 0.010), and plaque (9.7 mm(2) [9.6 to 15.7 mm(2)] vs. 8.4 mm(2) [7 to 9.7 mm(2)], p = 0.027) areas; however, baseline VH-IVUS plaque composition did not differ between VH-TCFAs that healed and VH-TCFAs that remained VH-TCFAs. Conversely, 12 new VH-TCFAs developed; 6 late-developing VH-TCFAs were PITs, and 6 were ThCFAs at baseline. In addition, plaque area at minimum lumen sites increased significantly in PITs (7.8 mm(2) [6.2 to 10.0 mm(2)] to 9.0 mm(2) [6.5 to 12.0 mm(2)], p < 0.001), VH-TCFAs (8.6 mm(2) [7.3 to 9.9 mm(2)] to 9.5 mm(2) [7.8 to 10.8 mm(2)], p = 0.024), and ThCFAs (8.6 mm(2) [6.8 to 10.2 mm(2)] to 8.8 mm(2) [7.1 to 11.4 mm(2)], p < 0.001) with a corresponding decrease lumen areas, but not in fibrous or fibrocalcific plaque. CONCLUSIONS Most VH-TCFAs healed during 12-month follow-up, whereas new VH-TCFAs also developed. PITs, VH-TCFAs, and ThCFAs showed significant plaque progression compared with fibrous and fibrocalcific plaque.
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Casarosa P, Bouyssou T, Gantner F, Pieper M. Pharmakologischer Vergleich von Tiotropium mit anderen antimuskarinischen Substanzen. Pneumologie 2010. [DOI: 10.1055/s-0030-1251367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pieper M, Bouyssou T, Walland A, Pairet M. Die Zugabe eines Betamimetikums verstärkt die bronchodilatierende Wirkung von Tiotropium im experimentellen Modell. Pneumologie 2010. [DOI: 10.1055/s-0030-1251369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wollin L, Pieper M. Anti-entzündliche Wirkung von Tiotropium in einem Mausmodell für chronisch obstruktive Atemwegserkrankungen (COPD). Pneumologie 2010. [DOI: 10.1055/s-0030-1251368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Casarosa P, Kiechle T, Sieger P, Pieper M, Gantner F. The Constitutive Activity of the Human Muscarinic M3 Receptor Unmasks Differences in the Pharmacology of Anticholinergics. J Pharmacol Exp Ther 2009; 333:201-9. [DOI: 10.1124/jpet.109.163188] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kaspereit M, Sainio T, Pieper M, Seidel-Morgenstern A, Kienle A. Analyse und Auslegung chromatographischer Trennverfahren mit Rückläufen. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Weber K, Spirk D, Pieper M, Kucher N. Clinical efficacy and safety of enoxaparin in unselected Swiss patients undergoing primary or elective percutaneous coronary intervention: analysis of the RIVIERA study. Acta Cardiol 2009; 64:455-9. [PMID: 19725437 DOI: 10.2143/ac.64.4.2041609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Appropriate antithrombotic therapy during percutaneous coronary intervention (PCI) reduces major cardiovascular events and bleeding complications. The objective of the present analysis of the multinational, prospective, observational Registry on IntraVenous anticoagulation In the Elective and primary Real world of Angioplasty (RIVIERA) was to prospectively evaluate in-hospital death, myocardial infarction (MI), major and minor bleeding, and angiographic complications of enoxaparin-guided primary or elective PCI. METHODS In Switzerland, 255 consecutive patients from the Herz-Neuro-Zentrum Bodensee Kreuzlingen were enrolled in the RIVIERA study. The mean age of the patients was 64 years and 77% were men; 18% had primary PCI for acute ST-segment elevation myocardial infarction.The mean dose of intravenous enoxaparin was 1 mg/kg. RESULTS The in-hospital mortality rate was 1.2%; MI occurred in 5.5% patients, and major and minor bleeding 0.8% and 2.7%, respectively.Angiographic complications occurred in 8.6% of patients, mainly coronary dissection (3.9%) and thrombus at the treated lesion site (1.6%). CONCLUSIONS In a real-world setting, the clinical efficacy and safety of intravenous enoxaparin during acute and elective PCI in a Swiss heart centre is comparable with the results of randomized controlled trials.
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Lüscher TF, Pieper M, Tendera M, Vrolix M, Rutsch W, van den Branden F, Gil R, Bischoff KO, Haude M, Fischer D, Meinertz T, Münzel T. A randomized placebo-controlled study on the effect of nifedipine on coronary endothelial function and plaque formation in patients with coronary artery disease: the ENCORE II study. Eur Heart J 2009; 30:1590-7. [PMID: 19474053 PMCID: PMC3295238 DOI: 10.1093/eurheartj/ehp151] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Revised: 03/16/2009] [Accepted: 03/17/2009] [Indexed: 11/13/2022] Open
Abstract
AIMS Endothelial dysfunction and plaque formation are features of atherosclerosis. Inhibition of L-type calcium channels or HMG-CoA pathway improves endothelial function and reduces plaque size. Thus, we investigated in stable coronary artery disease (CAD) the effects of a calcium antagonist on coronary endothelial function and plaque size. METHODS AND RESULTS In 454 patients undergoing PCI, acetylcholine (10(-6) to 10(-4) M) was infused in a coronary segment without significant CAD. Changes in coronary diameter were measured and an intravascular ultrasound examination (IVUS) was performed. On top of statin therapy, patients were randomized in a double-blind fashion to placebo or nifedipine GITS 30-60 mg/day and followed for 18-24 months. Blood pressure was lower on nifedipine than on placebo by 5.8/2.1 mmHg (P < 0.001) as was total and LDL cholesterol (4.8 mg/dL; P = 0.495), while HDL was higher (3.6 mg/dL; P = 0.026). In the most constricting segment, nifedipine reduced vasoconstriction to acetylcholine (14.0% vs. placebo 7.7%; P < 0.0088). The percentage change in plaque volume with nifedipine and placebo, respectively, was 1.0 and 1.9%, ns. CONCLUSION The ENCORE II trial demonstrates in a multi-centre setting that calcium channel blockade with nifedipine for up to 2 years improves coronary endothelial function on top of statin treatment, but did not show an effect of nifedipine on plaque volume.
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Casarosa P, Bouyssou T, Germeyer S, Schnapp A, Gantner F, Pieper M. Preclinical Evaluation of Long-Acting Muscarinic Antagonists: Comparison of Tiotropium and Investigational Drugs. J Pharmacol Exp Ther 2009; 330:660-8. [DOI: 10.1124/jpet.109.152470] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Vacca G, Gillissen A, Dück K, Dück R, Pieper M. Reduzierung der makrophageninduzierten Chemotaxis bei COPD Patienten durch M-Rezeptor Inhibierung. Pneumologie 2009. [DOI: 10.1055/s-0029-1214053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pieper M. Gründung eines technologieorientierten Unternehmens als Hochschulabsolvent - Ein persönlicher Erfahrungsbericht. CHEM-ING-TECH 2008. [DOI: 10.1002/cite.200750612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hofer M, Pieper M, Sadlo M, Reipen J, Heussen N. [Performance-related middle management in medical teaching. Attractiveness of incentive tools from the perspective of the teachers]. Dtsch Med Wochenschr 2008; 133:1615-20. [PMID: 18546087 DOI: 10.1055/s-2008-1081141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE German medical schools are increasingly challenged by the competition for public funds and talented students. Therefore. many curriculum planners, deans and school administrators plan to implement a systematic and comprehensive awarding system for good teaching. The OBJECTIVE of this study was to elaborate which specific incentives would be most effective to increase the motivation and enthusiasm for teaching among basic scientists as well as residents and attendings involved in medical education. In addition, a cost-effective model should be developed, which could be used as an adjustable blue-print for an awarding system. METHODS Based on literature search, existing approaches to rewards and incentives for medical teachers were analysed by an interdisciplinary committee in coordination with the members' department heads. According to german teaching methods and available resources, a catalogue of specific incentives has been designed and ranked by a representative sample of 200 medical teachers / faculty at two universities. Thus, a variety of favourite rewarding instruments could be elaborated, which were preferred by teachers in theoretical versus clinical disciplines. RESULTS The majority of the medical teachers prefer heterogeneously monetary incentives and additional protected time, followed by career-effective incentives (tenure & promotion). The discussion reflects on a transferable catalogue of different rewarding instruments, including a cost-/benefit-analysis and prerequisite students' evaluation data. CONCLUSION A single alteration of departmental teaching budgets does not seem to be sufficient. It seems rather advisable, also to strive for a variety of different incentives on a level that predominantly affects individual teaching personnel. Even with comparatively small amounts of money, significant effects on teachers' motivation can be achieved.
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Dück K, Vacca G, Dück R, Pieper M, Gillissen A. Tiotropiumbromide reduces macrophage induced chemotaxis of neutrophils. Pneumologie 2008. [DOI: 10.1055/s-2008-1074354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dück K, Vacca G, Dück R, Pieper M, Gillissen A. Antiinflammatory properties of tiotropium bromide: Reduction of macrophage induced chemotaxis in vitro. Pneumologie 2008. [DOI: 10.1055/s-2008-1074352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dück K, Vacca G, Dück R, Pieper M, Gillissen A. Antiinflammatory properties of tiotropium bromide: Reduction of macrophage induced chemotaxis in vitro. Pneumologie 2007. [DOI: 10.1055/s-2007-1032287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pieper M, Scheffold C, Duwe S, Rossig C, Bisping G, Stelljes M, Tedder TF, Jurgens H, Berdel WE, Kienast J. Immunotherapy of B-cell malignancies with genetically engineered human CD8+ natural killer T cells. Leukemia 2006; 20:729-32. [PMID: 16437143 DOI: 10.1038/sj.leu.2404114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gebauer M, Saas J, Sohler F, Haag J, Söder S, Pieper M, Bartnik E, Beninga J, Zimmer R, Aigner T. Comparison of the chondrosarcoma cell line SW1353 with primary human adult articular chondrocytes with regard to their gene expression profile and reactivity to IL-1beta. Osteoarthritis Cartilage 2005; 13:697-708. [PMID: 15950496 DOI: 10.1016/j.joca.2005.04.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2004] [Accepted: 04/12/2005] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In this study, the human chondrosarcoma cell line SW1353 was investigated by gene expression analysis in order to validate it as an in vitro model for primary human (adult articular) chondrocytes (PHCs). METHODS PHCs and SW1353 cells were cultured as high density monolayer cultures with and without 1ng/ml interleukin-1beta (IL-1beta). RNA was isolated and assayed using a custom-made oligonucleotide microarray representing 312 chondrocyte-relevant genes. The expression levels of selected genes were confirmed by real-time polymerase chain reaction and the gene expression profiles of the two cell types, both with and without IL-1beta treatment, were compared. RESULTS Overall, gene expression profiling showed only very limited similarities between SW1353 cells and PHCs at the transcriptional level. Similarities were predominantly seen with respect to catabolic effects after IL-1beta treatment. In both cell systems matrix metalloproteinase-1 (MMP-1), MMP-3 and MMP-13 were strongly induced by IL-1beta, without significant induction of MMP-2. IL-6 was also found to be up-regulated by IL-1beta in both cellular models. On the other hand, intercellular mediators such as leukemia inhibitory factor (LIF) and bone morphogenetic protein-2 (BMP-2) were not induced by IL-1beta in SW1353 cells, but significantly up-regulated in PHCs. Bioinformatical analysis identified nuclear factor kappa-B (NFkappaB) as a common transcriptional regulator of IL-1beta induced genes in both SW1353 cells and PHCs, whereas other transcription factors were only found to be relevant for individual cell systems. CONCLUSION Our data characterize SW1353 cells as a cell line with only a very limited potential to mimic PHCs, though SW1353 cells can be of value to study the induction of protease expression within cells, a phenomenon also seen in chondrocytes.
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Serruys PW, IJsselmuiden S, Hout BV, Vermeersch P, Bramucci E, Legrand V, Pieper M, Antoniucci D, Gomes RS, Macaya C, Boekstegers P, Lindeboom W. Direct stenting with the Bx VELOCITY balloon-expandable stent mounted on the Raptor rapid exchange delivery system versus predilatation in a European randomized Trial: the VELVET trial. INTERNATIONAL JOURNAL OF CARDIOVASCULAR INTERVENTIONS 2003; 5:17-26. [PMID: 12623561 DOI: 10.1080/14628840304607] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIMS This study examined the six-month angiographic results of direct coronary stenting, and compared the nine-month safety, efficacy and cost of this strategy versus stenting after balloon predilatation. METHODS In phase I of VELVET, 122 patients (mean age = 62.3 +/- 10.1 years, 77% male, 11% with diabetes) with angina pectoris or myocardial ischemia resulting from a single de novo 51% to 95% coronary stenosis underwent direct stenting. The endpoints of phase I included angiographic findings and rates of major adverse cardiac events up to six months of follow-up. In phase II, 401 patients (mean age = 61.3 +/- 10.8 years, 79% male, 16% with diabetes) with angina pectoris or documented myocardial ischemia resulting from single or multiple, de novo or restenotic, coronary lesions were randomized between direct stenting and stenting after predilatation. The immediate angiographic results, and clinical outcomes and costs associated with the two treatment strategies up to nine months of follow-up were compared. RESULTS In phase I the mean diameter stenosis immediately before and after the procedure, and at six months was 61.7+/-9.4%, 13.5+/-6.3%, and 33.6+/-16.2%, respectively. The six-month binary restenosis rate was 11%. The overall rate of major adverse cardiac events, including two non-cardiac deaths, was 9.8%. In phase II, the success rates of the intended delivery strategies were 87.9% and 97.9% for direct stenting and predilatation, respectively (p < 0.001), while the procedural success rates were similar (93.9% vs 96.5%). Over a follow-up period of nine months, major adverse cardiac events rates were 12.0% and 10.9% in patients randomized to direct stenting and predilatation, respectively (non-significant). Analyses of the costs incurred up to nine months in each treatment group revealed a mean saving of e362 per patient in favor of the direct stenting strategy (non-significant). CONCLUSIONS Compared with a strategy of stenting preceded by balloon dilatation, direct stenting was associated with an equivalent procedural success rate, equivalent clinical results up to nine months of follow-up, and a reduction in procedural and in-hospital costs (p < 0.0001 and p < 0.001, respectively), that was no longer significant after nine months.
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Gioia M, Fasciglione GF, Marini S, D'Alessio S, De Sanctis G, Diekmann O, Pieper M, Politi V, Tschesche H, Coletta M. Modulation of the catalytic activity of neutrophil collagenase MMP-8 on bovine collagen I. Role of the activation cleavage and of the hemopexin-like domain. J Biol Chem 2002; 277:23123-30. [PMID: 11953425 DOI: 10.1074/jbc.m110873200] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The cleavage of bovine collagen I by neutrophil collagenase MMP-8 has been followed at pH 7.4, 37 degrees C. The behavior of the whole enzyme molecule (whMMP-8), displaying both the catalytic domain and the hemopexin-like domain, has been compared under the same experimental conditions with that of the catalytic domain only. The main observation is that whMMP-8 cleaves bovine collagen I only at a single specific site, as already reported by many others (Mallya, S. K., Mookhtiar, K. A., Gao, Y., Brew, K., Dioszegi, M., Birkedal-Hansen, H., and van Wart, H. E. (1990) Biochemistry 29, 10628-10634; Knäuper, V., Osthues, A., DeClerk, Y. A., Langley, K. A., Bläser, J., and Tschesche, H. (1993) Biochem. J. 291, 847-854; Marini, S., Fasciglione, G. F., De Sanctis, G., D'Alessio, S., Politi, V., and Coletta, M. (2000) J. Biol. Chem. 275, 18657-18663), whereas the catalytic domain lacks this specificity and cleaves the collagen molecule at multiple sites. Furthermore, a meaningful difference is observed for the cleavage features displayed by two forms of the catalytic domain, which differ for the N terminus resulting from the activation process (i.e. the former Met(80) of the proenzyme (MetMMP-8) and the former Phe(79) of the proenzyme (PheMMP-8)). Thus, the PheMMP-8 species is characterized by a much faster k(cat)/K(m), fully attributable to a lower K(m), suggesting that the conformation of the catalytic domain, induced by the insertion of this N-terminal residue in a specific pocket (Reinemer, P., Grams, F., Huber, R., Kleine, T., Schnierer, S., Piper, M., Tschesche, H., and Bode, W. (1994) FEBS Lett. 338, 227-233), brings about a better, although less discriminatory, recognition process of cleavage site(s) on bovine collagen I.
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