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Nikam SP, Nikam VS, Becker S, Fehrenbach H, Seeger W, Voswinckel R. Quantitative lung morphology in a regenerative lung model. Pneumologie 2009. [DOI: 10.1055/s-0029-1202464] [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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77
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Sel S, Rost BR, Yildirim AÖ, Sel B, Kalwa H, Fehrenbach H, Renz H, Gudermann T, Dietrich A. Loss of classical transient receptor potential 6 channel reduces allergic airway response. Clin Exp Allergy 2008; 38:1548-58. [DOI: 10.1111/j.1365-2222.2008.03043.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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78
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Yildirim AO, Veith M, Rausch T, Müller B, Kilb P, Van Winkle LS, Fehrenbach H. Keratinocyte growth factor protects against Clara cell injury induced by naphthalene. Eur Respir J 2008; 32:694-704. [PMID: 18385170 DOI: 10.1183/09031936.00155107] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Airway epithelial cells are exposed to environmental toxicants that result in airway injury. Naphthalene (NA) causes site-selective damage to Clara cells in mouse distal airways. N-terminally truncated recombinant human keratinocyte growth factor (DeltaN23-KGF) protects against acute lung injury. The present study investigated whether or not DeltaN23-KGF protects against NA-induced acute Clara cell damage by measuring airway responses specifically and in order to identify underlying molecular mechanisms. Mice were treated with DeltaN23-KGF or PBS 33 h prior to injection of 200 mg.kg body weight(-1) NA. Lung function was analysed by head-out body plethysmography. Distal airways isolated by microdissection were assessed for cell permeability using ethidium homodimer-1. Immunohistochemistry of Clara cell-specific protein in conjunction with a physical dissector was used to quantify Clara cell numbers. RNA was isolated from frozen airways in order to analyse gene expression using quantitative RT-PCR. DeltaN23-KGF prevented NA-induced airflow limitation and Clara cell permeability, and resulted in twice as many Clara cells compared with PBS pre-treatment. DeltaN23-KGF-pre-treated mice exhibited increased expression of proliferating cell nuclear antigen mRNA. Cytochrome P(450) isoform 2F2, which converts NA into its toxic metabolite, was reduced by approximately 50%. The present results demonstrate that pre-treatment with N-terminally truncated recombinant human keratinocyte growth factor protects against naphthalene-induced injury. This suggests that N-terminally truncated recombinant human keratinocyte growth factor exerts its beneficial effect through a decrease in the expression of cytochrome P(450) isoform 2F2.
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Fehrenbach H, Voswinckel R, Michl V, Mehling T, Fehrenbach A, Seeger W, Nyengaard JR. Neoalveolarisation contributes to compensatory lung growth following pneumonectomy in mice. Eur Respir J 2008; 31:515-22. [DOI: 10.1183/09031936.00109407] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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80
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Sadovski J, Kuchenbuch T, Ruppert C, Fehrenbach A, Hirschburger M, Padberg W, Günther A, Hohlfeld JM, Fehrenbach H, Grau V. Keratinocyte growth factor prevents intra-alveolar oedema in experimental lung isografts. Eur Respir J 2007; 31:21-8. [PMID: 17928308 DOI: 10.1183/09031936.00011707] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Primary graft dysfunction, characterised by intra-alveolar oedema, is a major obstacle in pulmonary transplantation. The present study evaluates the potential of keratinocyte growth factor (palmiferin; DeltaN23-KGF) for the prevention of oedema in lung transplants. Intratracheal instillation of 5 mg x kg(-1) DeltaN23-KGF was performed in Lewis rats on days 3 and 2 before explantation. Control animals obtained an equivalent volume of vehicle. Left lungs were isogeneically transplanted and the graft recipients were sacrificed 1 day later for stereological analysis of intra-alveolar oedema and bronchoalveolar lavage. The total protein and phospholipid content, as well as surfactant proteins, were measured. Surfactant activity was analysed with a pulsating bubble surfactometer. In grafts from control treated donors, the fraction of intra-alveolar oedema amounted to 3.4+/-1.1% of the total parenchymal volume. Treatment of donor lungs with DeltaN23-KGF reduced oedema to a fraction of 1.6+/-0.8%. In the lavage fluid of pulmonary grafts from DeltaN23-KGF-treated donors, the total protein content was decreased compared with vehicle-treated lung transplants, whereas phospholipids did not differ. The protein fraction contained increased amounts of surfactant protein-C after DeltaN23-KGF treatment and surfactant function was improved. Treatment of donor lungs with palifermin protects against intra-alveolar oedema formation upon transplantation. This effect appears to be mediated by an improved surfactant homeostasis.
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Fehrenbach H. Die Entwicklung des pulmonalen Surfactantsystems. Pneumologie 2007; 61:488-9. [PMID: 17566961 DOI: 10.1055/s-2007-959227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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83
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Jungraithmayr TC, Wiesmayr S, Staskewitz A, Kirste G, Bulla M, Fehrenbach H, Dippell J, Greiner C, Griebel M, Helmchen U, Klaus G, Leichter HE, Mihatsch MJ, Michalk DV, Misselwitz J, Plank C, Tönshoff B, Weber LT, Zimmerhackl LB. Five-Year Outcome in Pediatric Patients With Mycophenolate Mofetil-Based Renal Transplantation. Transplantation 2007; 83:900-5. [PMID: 17460560 DOI: 10.1097/01.tp.0000258587.70166.87] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mycophenolate mofetil (MMF) based immunosuppression after renal transplantation has proven to be safe and beneficial for children and adolescents. However, long-term analysis, in particular of pediatric patients, is scarce. PATIENTS Data of 140 patients receiving MMF versus azathioprine (AZA) in combination with cyclosporine A (CsA) and prednisone without induction were analyzed with a main focus on survival and renal function in long-term follow-up. RESULTS After 5 years of follow-up, 44 MMF and 20 AZA patients were still on study. Graft survival of intent to treat (ITT) groups was 90.7% for MMF and 68.5% for AZA patients (P<0.001). Cumulative rejection free survival was 51.2% in MMF versus 37.0% in AZA patients (P<0.05). In association with early acute rejections (ARE), projected half-life was 14.4/4.5 years in patients with and 18.7/14.5 years without rejection in the MMF/AZA group, respectively. CONCLUSIONS MMF based protocols improved long-term graft survival without an increase in side effects. Early ARE were associated with worse half-life of the graft, although more stressed in the AZA group. Thus, to improve quality of life in children for very long-term outcome, ARE should be further decreased and renal function should be better preserved.
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Vogelmeier C, Koczulla R, Fehrenbach H, Bals R. [Pathogenesis of chronic obstructive pulmonary disease]. Internist (Berl) 2007; 47:885-6, 888-90, 892-4. [PMID: 16845536 DOI: 10.1007/s00108-006-1691-y] [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: 12/01/2022]
Abstract
It is currently believed that the most important factor in the pathogenesis of chronic obstructive pulmonary disease (COPD) is inflammation of the small airways caused by inhaled particles and gases. In this context, a disturbance of the physiological balance between proteases and antiproteases develops that may cause lung emphysema. Moreover, oxidative stress seems to be important, as it may enhance the inflammatory reaction. The development of emphysema may also involve a loss of alveolar cells by apoptosis. Finally, several studies have indicated that a systemic inflammation is induced by COPD that may be of relevance to the development of systemic components that are observed in COPD patients.
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Kilic A, Sonar S, Hahn C, Schwinge D, Yildirim A, Achenbach S, Fehrenbach H, Renz H, Nockher W, Abram M, Fokuhl V, Luger E, Radbruch A, Wegmann M, Reuter S, Heinz A, Sieren M, Wiewrodt R, Stassen M, Buhl R, Taube C, Hausding M, Karwot R, Scholtes P, Lehr H, Blumberg R, Sternemann K, Finotto S, Maxeiner J, Caucig P, Dinges S, Teschner D, von Stebut E, Darcan Y, Haberland A, Hegend O, Spohn S, Krokowski M, Henke W, Hamelmann E, Dicke T, Sel S, Garn H, Gupta S, Fuchs B, Schulz-Maronde S, Heitland A, Escher S, Tillmann H, Braun A, Forssmann WF, Elsner J, Jaudszus A, Jahreis G, Möckel P. Atemwege. ALLERGO JOURNAL 2007. [DOI: 10.1007/bf03370557] [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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86
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Sonar S, Schwinge D, Kilic A, Yildirim A, Achenbach S, Fehrenbach H, Nockher A, Renz H. Ngf (nerve Growth Factor): A Key Player In Events Ensuing Lung Epithelium Injury And Repair. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.12.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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87
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Yildirim AÖ, Veith M, Van Winkle L, Plopper C, Fehrenbach H. Molekulare Mechanismen des Schutzes vor einer Naphthalin-induzierten Schädigung des Atemwegepithels der Maus durch Keratinocyte Growth Factor in vivo. Pneumologie 2007. [DOI: 10.1055/s-2007-973132] [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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88
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Plagens A, Muyal J, Yildirim A, Mühlhofer S, Fehrenbach H, Vogelmeier C, Seifart C. MMP und TIMP Expression in Alveolarmakrophagen beim Lungenemphysem der Ratte. Pneumologie 2007. [DOI: 10.1055/s-2007-973274] [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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89
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Kilic A, Sonar S, Schwinge D, Yildirim A, Achenbach S, Fehrenbach H, Nockher A, Renz H. Ngf (Nerve Growth Factor) Regulates Collagen Deposition Independent Of Tgf-ß. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.12.521] [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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90
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Plagens A, Muyal J, Yildirim A, Mühlhofer S, Fehrenbach H, Vogelmeier C, Seifart C. Modulation der Surfactantproteine A, B und D durch ATRA beim elastaseinduzierten Lungenemphysem der Ratte. Pneumologie 2007. [DOI: 10.1055/s-2007-973275] [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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91
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Plagens A, Muyal J, Yildirim AÖ, Seifart C, Fehrenbach H. Modulation der Surfactantproteine A und D durch die Gabe von ATRA beim elastase-induzierten Lungenemphysem der Ratte. Pneumologie 2007. [DOI: 10.1055/s-2007-967235] [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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92
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Yildirim AÖ, Wegmann M, Garn H, Renz H, Fehrenbach H. Mikrodissektion der Atemwege der Maus zur Identifizierung regions-spezifischer Genexpression beim akuten allergischen Asthmamodell. Pneumologie 2007. [DOI: 10.1055/s-2007-967223] [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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93
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Fehrenbach H. There is no rationale to still rely on outdated, biased tools for quantitative morphology in pulmonary research. Eur Respir Rev 2006. [DOI: 10.1183/09059180.00010100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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94
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95
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Voswinckel R, Ahlbrecht K, Wolff JC, Weissmann N, Fehrenbach H, Yildirim AO, Grimminger F, Seeger W. [Pulmonary tissue regeneration -- a hope for the future]. Dtsch Med Wochenschr 2006; 131:865-8. [PMID: 16625478 DOI: 10.1055/s-2006-939859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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96
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Michl V, Voswinckel R, Fehrenbach A, Seeger W, Nyengaard J, Gundersen H, Fehrenbach H. Kompensatorisches Lungenwachstum nach Pneumonektomie bei der Maus wird partiell durch die Neubildung von Alveolen erzielt. Pneumologie 2006. [DOI: 10.1055/s-2006-933781] [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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97
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Fehrenbach H, Fehrenbach A, Erpenbeck V, Blöcher S, Prinz R, Krug N, Hohlfeld J. 2D Morphometrie überschätzt große gegenüber kleinen Entzündungszellen in humanen Bronchialbiopsien. Pneumologie 2006. [DOI: 10.1055/s-2006-934008] [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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98
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Wegmann M, Fehrenbach H, Fehrenbach A, Held T, Schramm C, Garn H, Renz H. Involvement of distal airways in a chronic model of experimental asthma. Clin Exp Allergy 2006; 35:1263-71. [PMID: 16238784 DOI: 10.1111/j.1365-2222.2005.02306.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bronchial asthma is characterized by chronic airway inflammation and airway remodelling which occurs in both proximal and distal airways. These changes are associated with development of airway hyper-responsiveness and airflow limitation. OBJECTIVE This study was aimed to analyse whether chronic inhalative allergen challenges in mice lead to morphological and physiological changes comparable with this phenotype. METHODS For this purpose, BALB/c mice were systemically sensitized to ovalbumin (OVA) followed by aerosol allergen challenges on 2 consecutive days per week for 12 weeks. RESULTS In chronically challenged mice, tissue inflammation in proximal as well as distal airways was observed with a predominance of lymphocytes within the cellular infiltrate. In contrast, inflammation in the airway lumen decreased over time. These changes were associated by a shift in bronchoalveolar lavage-cytokine levels from IL-4, IL-5 and TNF-alpha production (during the acute phase) towards markedly increased levels of TGF-beta during the chronic phase. Goblet cell hyperplasia and subepithelial fibrosis occurred throughout the airway tree. In terms of lung function, chronically challenged mice developed persistent bronchial hyper-responsiveness and progressive airflow limitation. Six weeks after OVA aerosol discontinuation, airway inflammation still persisted although lung function was normalized. CONCLUSION These data indicate that our model of chronic aerosol allergen challenges leads to a phenotype of experimental asthma with participation of distal airways and persistence of inflammation thereby resembling many morphological and physiological aspects of human bronchial asthma.
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Grau V, Garn H, Holler J, Rose F, Blöcher S, Hirschburger M, Fehrenbach H, Padberg W. Epidermal Fatty Acid-Binding Protein (E-FABP) is increased in rat lungs following in vivo treatment with Keratinocyte Growth Factor (KGF). Pneumologie 2006. [DOI: 10.1055/s-2005-925498] [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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100
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von Schnakenburg C, Feneberg R, Plank C, Zimmering M, Arbeiter K, Bald M, Fehrenbach H, Griebel M, Licht C, Konrad M, Timmermann K, Kemper MJ. Percutaneous endoscopic gastrostomy in children on peritoneal dialysis. Perit Dial Int 2006; 26:69-77. [PMID: 16538878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVE Insertion of percutaneous endoscopic gastrostomies (PEG) in patients on chronic peritoneal dialysis (PD) has been reported to be contraindicated due to an increased risk of morbidity and mortality. However, no systematic survey on this topic has yet been published. DESIGN Retrospective multicenter study. SETTING 23 pediatric dialysis units associated with the working group Arbeitsgemeinschaft für Pädiatrische Nephrologie (APN). DATA SOURCE A structured questionnaire on clinical details of PD patients who had undergone PEG insertion or open gastrostomy (OG) since 1994 was distributed to all pediatric dialysis units of the APN. RESULTS 27 PD patients (20 males) from 12 centers in whom PEG insertion was performed after Tenckhoff catheter introduction were evaluated. Age at intervention ranged from 0.25 to 10.9 years (median 1.3 years). Most patients were malnourished, with standard deviation score (SDS) for body weight between -4.2 and -0.6 (median -2.2). Major complications were early peritonitis < 7 days after PEG in 10/27 (37%) patients, episodes of fungal peritonitis in 7/27 (26%) patients, 4 cessations of PD and change to hemodialysis, and 2 associated deaths. However, in 14 patients, no such problems were encountered and, in 4 patients, early peritonitis effectively treated with intraperitoneal antibiotics was the only major complication. Thus, in 18/27 (67%) patients, PD was successfully reinitiated shortly after PEG insertion. Among all participating centers, only two OG procedures were reported during the study period, illustrating a clear preference for the PEG over the OG procedure among members of the APN. CONCLUSION PEG insertion following PD initiation carries a high risk for fungal peritonitis and potential PD failure; however, complication rates in this largest reported series were lower than previously described. Antibiotic and antifungal prophylaxis, withholding PD for 2 - 3 days, and gastrostomy placement by an experienced endoscopy team are suggested precautions for lowering the risk of associated complications. When gastrostomy placement does not occur prior to or at the time of initiating PD, the risks and benefits of percutaneous versus open placement must be carefully weighed.
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