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Wang R, Li J, Zhang X, Zhang X, Zhang X, Zhu Y, Chen C, Liu Z, Wu X, Wang D, Dongye M, Wang J, Lin H. Extracellular vesicles promote epithelial-to-mesenchymal transition of lens epithelial cells under oxidative stress. Exp Cell Res 2020; 398:112362. [PMID: 33221317 DOI: 10.1016/j.yexcr.2020.112362] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/01/2020] [Accepted: 11/03/2020] [Indexed: 12/21/2022]
Abstract
Posterior capsule opacification (PCO), resulting from residual lens epithelial cell (LEC) epithelial-mesenchymal transition (EMT), abnormal proliferation, and migration, is the most common complication of cataract surgery. A recent study determined that extracellular vesicles (EVs) and reactive oxygen species (ROS) regulate the EMT process during cutaneous wound healing and tumour metastasis. However, their underlying mechanism in PCO is unclear. In this study, we examined the secreted EVs from a scratch model in vitro. We found that the production of ROS was increased after mechanical injury, especially at the wound edge, and there was an increased viability of LECs, which can be blocked by diphenyleneiodonium, an NADPH oxidase inhibitor. Cell viability and migration were increased upon treatment with 1 μM H2O2, but significantly reduced when the concentration of H2O2 increased to 100 μM. Transwell assay showed that both post-surgery LECs and LECs treated with 1 μM H2O2 significantly induced the migration of normal LECs by EV secretion. Extraction and quantification of EVs derived from injured and H2O2-treated LECs showed a similar increase in production. Co-incubation of EVs from both injured and H2O2-treated LECs with normal LECs and organ-cultured mouse lenses activated EMT, which was attenuated by a ROS inhibitor. These results suggest that EVs participate in ROS-induced lens EMT, making EVs a potential target for treating PCO.
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Affiliation(s)
- Ruixin Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Jianbing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Xiayin Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Xulin Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Xinyu Zhang
- Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Chuan Chen
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Dongni Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Meimei Dongye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Jinghui Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
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Ongkasin K, Masmoudi Y, Tassaing T, Le-Bourdon G, Badens E. Supercritical loading of gatifloxacin into hydrophobic foldable intraocular lenses – Process control and optimization by following in situ CO2 sorption and polymer swelling. Int J Pharm 2020; 581:119247. [DOI: 10.1016/j.ijpharm.2020.119247] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022]
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Supercritical fluid technology for the development of innovative ophthalmic medical devices: Drug loaded intraocular lenses to mitigate posterior capsule opacification. Eur J Pharm Biopharm 2020; 149:248-256. [PMID: 32112896 DOI: 10.1016/j.ejpb.2020.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/17/2020] [Accepted: 02/24/2020] [Indexed: 11/21/2022]
Abstract
Supercritical impregnation technology was applied to load acrylic intraocular lenses (IOLs) with methotrexate to produce a sustained drug delivery device to mitigate posterior capsule opacification. Drug release kinetics were studied in vitro and used to determine the drug loading. Loaded IOLs and control IOLs treated under the same operating conditions, but without drug, were implanted ex vivo in human donor capsular bags. The typical cell growth was observed and immunofluorescence staining of three common fibrosis markers, fibronectin, F-actin and α-smooth muscle actin was carried out. Transparent IOLs presenting a sustained release of methotrexate for more than 80 days were produced. Drug loading varying between 0.43 and 0.75 ± 0.03 µgdrug·mg-1IOL were obtained when varying the supercritical impregnation pressure (8 and 25 MPa) and duration (30 and 240 min) at 308 K. The use of ethanol (5 mol%) as a co-solvent did not influence the impregnation efficiency and was even unfavorable at certain conditions. Even if the implantation of methotrexate loaded IOLs did not lead to a statistically significant variation in the duration required for a full cell coverage of the posterior capsule in the human capsular bag model, it was shown to reduce fibrosis by inhibiting epithelial-mesenchymal transformation. The innovative application presented has the potential to gain clinical relevance.
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Wertheimer C, Kueres A, Siedlecki J, Braun C, Kassumeh S, Wolf A, Mayer W, Priglinger C, Priglinger S, Eibl-Lindner K. The intraocular lens as a drug delivery device for an epidermal growth factor-Receptor inhibitor for prophylaxis of posterior capsule opacification. Acta Ophthalmol 2018; 96:e874-e882. [PMID: 29855160 DOI: 10.1111/aos.13759] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 02/12/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Posterior capsule opacification (PCO) occurs as a common complication after cataract surgery. Erlotinib is an inhibitor of the epidermal growth factor-Receptor and reduces critical cellular events leading to PCO. In this in vitro study, Erlotinib-modified intraocular lenses (IOLs) employed as a drug delivery device have been evaluated for PCO prevention. METHODS The IC50 concentration of Erlotinib was determined by using FHL-124 cells. For the human capsular bag model, 40 cadaver eyes underwent sham cataract surgery. Sixteen capsular bags were exposed to the IC50 of Erlotinib. Intraocular lens (IOL) of three different materials was pharmacologically modified and tested in the anterior segment model and implanted into 24 capsular bags. To test for corneal toxicity, pairs of human cornea were exposed to high concentrations of Erlotinib and corneal endothelial cells (CEC) were exposed to the modified IOL. Release kinetics of Erlotinib from the IOL was measured. RESULTS IC50 of Erlotinib was determined to be 10 μm. Erlotinib alone (p = 0.002) and when soaked into IOLs (p < 0.001) significantly increased the number of days needed until total cell coverage of the capsular bags in comparison with the control. Modified IOLs mitigated cell growth in the anterior segment model (p < 0.001). No short-term corneal toxicity was observed up to a concentration of 100 μm, and IOLs did not show toxicity on CEC. Erlotinib was released constantly from IOL. CONCLUSION Erlotinib might be of clinical relevance in PCO prophylaxis, as its short-term application induces a long-term deceleration of cellular growth. Erlotinib can be introduced into the eye via soaked IOLs.
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Affiliation(s)
| | - Alexander Kueres
- Department of Ophthalmology; Ludwig-Maximilians-University; Munich Germany
| | - Jakob Siedlecki
- Department of Ophthalmology; Ludwig-Maximilians-University; Munich Germany
| | - Christian Braun
- Institute for Forensic Medicine; Ludwig-Maximilians-University; Munich Germany
| | - Stefan Kassumeh
- Department of Ophthalmology; Ludwig-Maximilians-University; Munich Germany
| | - Armin Wolf
- Department of Ophthalmology; Ludwig-Maximilians-University; Munich Germany
| | - Wolfgang Mayer
- Department of Ophthalmology; Ludwig-Maximilians-University; Munich Germany
| | - Claudia Priglinger
- Department of Ophthalmology; Ludwig-Maximilians-University; Munich Germany
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Vounotrypidis E, Lackerbauer C, Kook D, Dirisamer M, Priglinger S, Mayer WJ. Influence of total intraocular lens diameter on efficacy and safety for in the bag cataract surgery. Oman J Ophthalmol 2018; 11:144-149. [PMID: 29930449 PMCID: PMC5991056 DOI: 10.4103/ojo.ojo_143_2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Intraocular lenses with variable total diameter are supposed to fit better in the capsular bag and lead to fewer complications. AIMS This study aims to investigate the efficacy and the safety of an intraocular lens model with variable total diameter. SETTINGS AND DESIGN Prospective randomized intraindividual study. SUBJECTS AND METHODS Thirty-two eyes of sixteen patients with bilateral age-related cataract received standard cataract surgery with implantation of an intraocular lens with a standard diameter in one eye (Quatrix®, Group A) and with a variable total diameter in the fellow eye (Quatrix Evolutive®, Group B). Primary study endpoints included evaluation of refraction stability and posterior capsule opacification (PCO) over a follow-up period of 6 months. STATISTICAL ANALYSIS USED SPSS (Version 19.0) was used for statistical analysis. RESULTS Uncorrected and corrected distant visual acuity after 6 months were 0.24 and 0.1 LogMAR in Group A and 0.23 and 0.09 LogMAR in Group B, respectively. The objective and manifest spherical equivalent (OSE, MSE) 6 months postoperatively were + 0.65 D and + 0.62 D in Group A compared to + 0.33 D and + 0.33 D in Group B respectively (P = 0.665 for OSE, P = 0.208 for MSE). PCO-index increased statistically significant in both groups (P = 0.004 in Group A, P = 0.046 in Group B), but the difference of PCO-index between both groups was not statistically significant (P = 0.569). CONCLUSIONS An intraocular lens with a variable total diameter shows good visual outcomes and safety performance as well as same outcomes concerning postoperative refractive stability and development of PCO compared to an intraocular lens with standard total diameter.
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Affiliation(s)
| | - Carlo Lackerbauer
- Department of Ophthalmology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Daniel Kook
- Department of Ophthalmology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Martin Dirisamer
- Department of Ophthalmology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Siegfried Priglinger
- Department of Ophthalmology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Wolfgang J. Mayer
- Department of Ophthalmology, Ludwig Maximilians University of Munich, Munich, Germany
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Kassumeh SA, Wertheimer CM, von Studnitz A, Hillenmayer A, Priglinger C, Wolf A, Mayer WJ, Teupser D, Holdt LM, Priglinger SG, Eibl-Lindner KH. Poly(lactic-co-glycolic) Acid as a Slow-Release Drug-Carrying Matrix for Methotrexate Coated onto Intraocular Lenses to Conquer Posterior Capsule Opacification. Curr Eye Res 2018; 43:702-708. [PMID: 29451997 DOI: 10.1080/02713683.2018.1437455] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Posterior capsule opacification (PCO) still represents the main long-term complication of cataract surgery. Research into pharmacologic PCO prophylaxis is extensive. One promising candidate drug is methotrexate (MTX). Our aim is to determine the in vitro feasibility of MTX-loaded poly(lactic-co-glycolic) (PLGA) biomatrices sprayed on intraocular lenses (IOLs) as a drug-delivery implant. METHODS Hydrophilic and hydrophobic acrylic IOLs were spray-coated with MTX-loaded PLGA. Unsprayed, solvent only, and solvent-PLGA-sprayed IOLs served as controls. All IOLs were evaluated for their growth-inhibiting properties in an in vitro anterior segment model and the ex vivo human capsular bag. The release kinetics of MTX from the IOLs was determined. The toxicity of MTX on corneal endothelial cells was evaluated by using a dye reduction colorimetric assay. MTX was also used in a scratch assay. RESULTS MTX-PLGA-IOL showed a significant difference in cell proliferation and migration compared with all controls in the anterior segment model (p < 0.001) and in the human capsular bag model (p = 0.04). No difference in viability was observed on corneal endothelial cells (p = 0.43; p = 0.61). MTX significantly inhibited cells in the scratch assay (p = 0.02). At all measured points, the released MTX dose remained above EC50 and below the toxic dose for the endothelium. CONCLUSIONS In view of the strong inhibition of PCO in vitro with the lack of toxic effects on a corneal cell line, MTX encapsulating microspheres seem to be a promising method for modifying IOL.
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Affiliation(s)
- Stefan A Kassumeh
- a Department of ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | | | - Annabel von Studnitz
- a Department of ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Anna Hillenmayer
- a Department of ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Claudia Priglinger
- a Department of ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Armin Wolf
- a Department of ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Wolfgang J Mayer
- a Department of ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Daniel Teupser
- b Institute of Laboratory Medicine , Ludwig-Maximilians-University Munich , Munich , Germany
| | - Lesca M Holdt
- b Institute of Laboratory Medicine , Ludwig-Maximilians-University Munich , Munich , Germany
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Viveiros MMH, Soares RT, Omodei MS, Rainho CA, Padovani CR, Cruz N, Schellini SA, Rodrigues ACL. Adhesion study of cultured human lens capsule cells on hydrophilic intraocular lenses coated with polyethylene glycol. J Cataract Refract Surg 2015. [PMID: 26210051 DOI: 10.1016/j.jcrs.2014.11.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the adhesion of human lens capsule cells on hydrophilic acrylic intraocular lenses (IOLs) coated with polyethylene glycol (PEG). SETTING Department of Ophthalmology, Faculty of Medicine, Universidade Estadual Paulista-Botucatu, São Paulo, Brazil. DESIGN Experimental study. METHODS Human anterior lens capsules obtained during cataract surgery were cultured and seeded (200 cells/IOLs) in triplicates on the surface of a copolymer comprising hydroxyethyl methacrylate, ethyl methacrylate, and methyl methacrylate IOLs (Loflex) treated or not treated with PEG. After 26 hours, the number of viable adherent cells was estimated by counting in a hemocytometer. RESULTS The coating of hydrophilic acrylic IOLs with PEG was effective in inhibiting cell adhesion (P < .05). Cells showing 2 distinct morphologic patterns-epithelial and dendritic-like-were observed during the in vitro establishment of the cultures. A tendency toward greater adhesion of dendritic-like cells was observed in untreated IOLs compared with treated IOLs (P = .095). CONCLUSION Coating hydrophilic acrylic IOLs with PEG was effective in inhibiting cell adhesion. This treatment might play a role in posterior capsule opacification prevention. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Magda Massae Hata Viveiros
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil.
| | - Ricardo Torres Soares
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil
| | - Michelle Sako Omodei
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil
| | - Cláudia Aparecida Rainho
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil
| | - Carlos Roberto Padovani
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil
| | - Nilson Cruz
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil
| | - Silvana Artioli Schellini
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil
| | - Antonio Carlos Lottelli Rodrigues
- From the Graduate Program in General Basis of Surgery (Viveiros), Botucatu Medical School (Omodei), the Department of Genetics (Rainho), and the Department of Biostatistics (Padovani), Biosciences Institute, and the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (Schellini, Rodrigues), Universidade Estadual Paulista, Botucatu, and the Department of Control and Automation Engineering (Soares, Cruz), Universidade Estadual Paulista, Sorocaba, São Paulo, Brazil
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Wertheimer C, Brandlhuber U, Kook D, Mayer WJ, Laubichler P, Wolf A, Kampik A, Eibl-Lindner K. Erufosine, a phosphoinositide-3-kinase inhibitor, to mitigate posterior capsule opacification in the human capsular bag model. J Cataract Refract Surg 2015. [DOI: 10.1016/j.jcrs.2015.02.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wertheimer C, Siedlecki J, Kook D, Mayer WJ, Wolf A, Klingenstein A, Kampik A, Eibl-Lindner K. EGFR inhibitor Gefitinib attenuates posterior capsule opacification in vitro and in the ex vivo human capsular bag model. Graefes Arch Clin Exp Ophthalmol 2014; 253:409-17. [PMID: 25471020 DOI: 10.1007/s00417-014-2875-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/07/2014] [Accepted: 11/19/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Posterior capsule opacification (PCO) occurs as a common complication after cataract surgery. Gefitinib is a selective inhibitor of the epidermal growth factor receptor (EGFR) which represents a potential pharmacological target for PCO prevention. In this in vitro study, we assessed the effect and biocompatibility of Gefitinib in PCO prophylaxis. METHODS The effect of Gefitinib on the key pathological features of PCO was assessed in vitro. We determined growth in the human capsular bag model, prepared from sixteen cadaver eyes that underwent sham cataract surgery. Furthermore, two lens epithelial cell lines, HLE-B3 and FHL-124, were used to determine concentration-based effects on cell proliferation. In addition, cell-migration, matrix-contraction, and cell spreading were investigated. To exclude toxic concentrations, Gefitinib was assessed for its biocompatibility on six different human ocular cell types from the anterior and posterior segment of the eye. RESULTS Gefitinib significantly increased the time until confluence of the capsular bag compared to controls (p < 0.001)). In both human lens epithelial cell lines (HLE-B3 and FHL-124), proliferation decreased significantly and as equally strong after incubation with Gefitinib (p < 0.001), as did chemotactic migration (p = 0.004), matrix contraction (p = 0.001), and cell-spreading (p = 0.001). At the IC50 concentration, Gefitinib was well tolerated by six different human ocular cell types of the anterior and posterior segment. CONCLUSION The specific EGFR inhibitor Gefitinib might become of clinical relevance in PCO prophylaxis as it attenuated cellular growth and other pathological PCO factors in the ex vivo human capsular bag model and in two human lens epithelial cell lines, while showing good biocompatibility in vitro.
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Affiliation(s)
- Christian Wertheimer
- Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany,
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