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Seo EJ, Khelifi D, Fayez S, Feineis D, Bringmann G, Efferth T, Dawood M. Molecular determinants of the response of cancer cells towards geldanamycin and its derivatives. Chem Biol Interact 2023; 383:110677. [PMID: 37586545 DOI: 10.1016/j.cbi.2023.110677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/13/2023] [Indexed: 08/18/2023]
Abstract
Geldanamycin is an ansamycin-derivative of a benzoquinone isolated from Streptomyces hygroscopicus. It inhibits tyrosine kinases and heat shock protein 90 (HSP90). Geldanamycin and 11 derivatives were subjected to molecular docking to HSP90, and 17-desmethoxy-17-N,N-dimethylamino-geldanamycin (17-DMAG) was the compound with the highest binding affinity (-7.73 ± 0.12 kcal/mol) and the lowest inhibition constant (2.16 ± 0.49 μM). Therefore, 17-DMAG was selected for further experiments in comparison to geldanamycin. Multidrug resistance (MDR) represents a major problem for successful cancer therapy. We tested geldanamycin and 17-DMAG against various drug-resistant cancer cell lines. Although geldanamycin and 17-DMAG inhibited the proliferation in all cell lines tested, multidrug-resistant P-glycoprotein-overexpressing CEM/ADR5000 cells were cross-resistant, ΔEGFR-overexpressing tumor cells and p53 knockout cells were sensitive to these two compounds. COMPARE and hierarchical cluster analyses were performed, and 60 genes were identified to predict the sensitivity or resistance of 59 NCI tumor cell lines towards geldanamycin and 17-DMAG. The distribution of cell lines according to their mRNA expression profiles indicated sensitivity or resistance to both compounds with statistical significance. Moreover, bioinformatic tools were used to study possible mechanisms of action of geldanamycin and 17-DMAG. Galaxy Cistrome analyses were carried out to predict transcription factor binding motifs in the promoter regions of the candidate genes. Interestingly, the NF-ĸB DNA binding motif (Rel) was identified as the top transcription factor. Furthermore, these 60 genes were subjected to Ingenuity Pathway Analysis (IPA) to study the signaling pathway interactions of these genes. Interestingly, IPA also revealed the NF-ĸB pathway as the top network among these genes. Finally, NF-ĸB reporter assays confirmed the bioinformatic prediction, and both geldanamycin and 17-DMAG significantly inhibited NF-κB activity after exposure for 24 h. In conclusion, geldanamycin and 17-DMAG exhibited cytotoxic activity against different tumor cell lines. Their activity was not restricted to HSP90 but indicated an involvement of the NF-KB pathway.
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Affiliation(s)
- Ean-Jeong Seo
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Staudinger Weg 5, 55128, Mainz, Germany
| | - Daycem Khelifi
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Staudinger Weg 5, 55128, Mainz, Germany
| | - Shaimaa Fayez
- Institute of Organic Chemistry, University of Würzburg, Germany; Department of Pharmacognosy, Ain-Shams University, Cairo, Egypt
| | - Doris Feineis
- Institute of Organic Chemistry, University of Würzburg, Germany
| | | | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Staudinger Weg 5, 55128, Mainz, Germany
| | - Mona Dawood
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Staudinger Weg 5, 55128, Mainz, Germany; Department of Molecular Biology, Al-Neelain University, Khartoum, Sudan.
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Abstract
The chaperone system (CS) of an organism is composed of molecular chaperones, chaperone co-factors, co-chaperones, and chaperone receptors and interactors. It is present throughout the body but with distinctive features for each cell and tissue type. Previous studies pertaining to the CS of the salivary glands have determined the quantitative and distribution patterns for several members, the chaperones, in normal and diseased glands, focusing on tumors. Chaperones are cytoprotective, but can also be etiopathogenic agents causing diseases, the chaperonopathies. Some chaperones such as Hsp90 potentiate tumor growth, proliferation, and metastasization. Quantitative data available on this chaperone in salivary gland tissue with inflammation, and benign and malignant tumors suggest that assessing tissue Hsp90 levels and distribution patterns is useful for differential diagnosis-prognostication, and patient follow up. This, in turn, will reveal clues for developing specific treatment centered on the chaperone, for instance by inhibiting its pro-carcinogenic functions (negative chaperonotherapy). Here, we review data on the carcinogenic mechanisms of Hsp90 and their inhibitors. Hsp90 is the master regulator of the PI3K-Akt-NF-kB axis that promotes tumor cell proliferation and metastasization. We discuss pathways and interactions involving these molecular complexes in tumorigenesis and review Hsp90 inhibitors that have been tested in search of an efficacious anti-cancer agent. This targeted therapy deserves extensive investigation in view of its theoretical potential and some positive practical results and considering the need of novel treatments for tumors of the salivary glands as well as other tissues.
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Steinhoff M, Alam M, Ahmad A, Uddin S, Buddenkotte J. Targeting oncogenic transcription factors in skin malignancies: An update on cancer stemness and therapeutic outcomes. Semin Cancer Biol 2022; 87:98-116. [PMID: 36372325 DOI: 10.1016/j.semcancer.2022.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/29/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
The skin is the largest organ of the human body and prone to various diseases, including cancer; thus, provides the first line of defense against exogenous biological and non-biological agents. Skin cancer, a complex and heterogenic process, with steep incidence rate often metastasizes due to poor understanding of the underlying mechanisms of pathogenesis and clinical challenges. Indeed, accumulating evidence indicates that deregulation of transcription factors (TFs) due to genetic, epigenetic and signaling distortions plays essential role in the development of cutaneous malignancies and therapeutic challenges including cancer stemness features and reprogramming. This review highlights the recent developments exploring underlying mechanisms how deregulated TFs (e.g., NF-κB, AP-1, STAT etc.,) orchestrates cutaneous onco-pathogenesis, reprogramming, stemness and poor clinical outcomes. Along this line, bioactive drugs, and their derivatives from natural and or synthetic origin has gained attention due to their multitargeting potential, potentially safer and effective therapeutic outcome for human malignancies. We also discussed therapeutic importance of targeting aberrantly expressed TFs in skin cancers with bioactive natural products and or synthetic agents.
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Affiliation(s)
- Martin Steinhoff
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar; Department of Medicine, Weill Cornell Medicine Qatar, Qatar Foundation-Education City, Doha 24144, Qatar; Department of Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA; College of Medicine, Qatar University, Doha 2713, Qatar.
| | - Majid Alam
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar
| | - Aamir Ahmad
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar
| | - Shahab Uddin
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar; Laboratory Animal Center, Qatar University, Doha, Qatar
| | - Joerg Buddenkotte
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar
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4
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Basset CA, Rappa F, Barone R, Florena AM, Porcasi R, Conway de Macario E, Macario AJL, Leone A. The Chaperone System in Salivary Glands: Hsp90 Prospects for Differential Diagnosis and Treatment of Malignant Tumors. Int J Mol Sci 2022; 23:ijms23169317. [PMID: 36012578 PMCID: PMC9409185 DOI: 10.3390/ijms23169317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/11/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022] Open
Abstract
Salivary gland tumors represent a serious medical problem and new tools for differential diagnosis and patient monitoring are needed. Here, we present data and discuss the potential of molecular chaperones as biomarkers and therapeutic targets, focusing on Hsp10 and Hsp90. The salivary glands are key physiological elements but, unfortunately, the information and the means available for the management of their pathologies, including cancer, are scarce. Progress in the study of carcinogenesis has occurred on various fronts lately, one of which has been the identification of the chaperone system (CS) as a physiological system with presence in all cells and tissues (including the salivary glands) that plays a role in tumor-cell biology. The chief components of the CS are the molecular chaperones, some of which belong to families of evolutionarily related molecules named heat shock protein (Hsp). We are quantifying and mapping these molecular chaperones in salivary glands to determine their possible role in the carcinogenetic mechanisms in these glands and to assess their potential as diagnostic biomarkers and therapeutic targets. Here, we report recent findings on Hsp10 and Hsp90 and show that the quantitative and topographic patterns of tissue Hsp90 are distinctive of malignant tumors and differentiate benign from malignant lesions. The Hsp90 results show a correlation between quantity of chaperone and tumor progression, which in turn calls for negative chaperonotherapy, namely, elimination/inhibition of the chaperone to stop the tumor. We found that in vitro, the Hsp90 inhibitor Ganetespib is cytotoxic for the salivary gland UM-HACC-2A cell line. The drug, by interfering with the pro-survival NF-κB pathway, hampers cellular proliferation and migration, and favors apoptosis, and can, therefore, be considered a suitable candidate for future experimentation to develop a treatment for salivary gland tumors.
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Affiliation(s)
- Charbel A. Basset
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, 90133 Palermo, Italy
| | - Francesca Rappa
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, 90133 Palermo, Italy
| | - Rosario Barone
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, 90133 Palermo, Italy
| | - Ada Maria Florena
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy
| | - Rossana Porcasi
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy
| | - Everly Conway de Macario
- Euro-Mediterranean Institute of Science and Technology (IEMEST), 90139 Palermo, Italy
- Department of Microbiology and Immunology, School of Medicine, University of Maryland at Baltimore-Institute of Marine and Environmental Technology (IMET), Baltimore, MD 21202, USA
| | - Alberto J. L. Macario
- Euro-Mediterranean Institute of Science and Technology (IEMEST), 90139 Palermo, Italy
- Department of Microbiology and Immunology, School of Medicine, University of Maryland at Baltimore-Institute of Marine and Environmental Technology (IMET), Baltimore, MD 21202, USA
| | - Angelo Leone
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, 90133 Palermo, Italy
- Correspondence:
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Wang W, Chen Y, Kuo C, Tsai J, Hsu F, Chung J, Pan P. DNA
damage and
NF‐κB
inactivation implicate glycyrrhizic acid‐induced
G
1
phase arrest in hepatocellular carcinoma cells. J Food Biochem 2022; 46:e14128. [DOI: 10.1111/jfbc.14128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Wei‐Shu Wang
- Department of Medicine National Yang Ming Chiao Tung University Hospital Yilan Taiwan
- School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Yu‐Shan Chen
- Department of Radiation Oncology Show Chwan Memorial Hospital Changhua Taiwan
| | - Chen‐Yu Kuo
- Division of Gastroenterology, Department of Medicine National Yang Ming Chiao Tung University Hospital Yilan Taiwan
| | - Jai‐Jen Tsai
- School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
- Division of Gastroenterology, Department of Medicine National Yang Ming Chiao Tung University Hospital Yilan Taiwan
- Department of Nursing Cardinal Tien Junior College of Healthcare and Management New Taipei City Taiwan
| | - Fei‐Ting Hsu
- Department of Biological Science and Technology China Medical University Taichung Taiwan
| | - Jing‐Gung Chung
- Department of Biological Science and Technology China Medical University Taichung Taiwan
- Department of Medical Laboratory and Biotechnology Asia University Taichung Taiwan
| | - Po‐Jung Pan
- School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
- Department of Physical Medicine and Rehabilitation National Yang Ming Chiao Tung University Hospital Yilan Taiwan
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Li L, Ji Y, Zhang L, Cai H, Ji Z, Gu L, Yang S. Wogonin inhibits the growth of HT144 melanoma via regulating hedgehog signaling-mediated inflammation and glycolysis. Int Immunopharmacol 2021; 101:108222. [PMID: 34688155 DOI: 10.1016/j.intimp.2021.108222] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/11/2022]
Abstract
Hedgehog (Hh) signaling has been proved to be closely associated with the occurrence of melanoma. Wogonin is one of the active components of flavonoids that extracts from Scutellariae radix. Previous studies showed that wogonin could inhibit the invasion and migration of B16F10 cells, and suppress the synthesis of melanin in A375 melanoma cells. However, the regulatory effects of Hh signaling in wogonin against melanoma and its potential mechanisms remain largely unknown. The present study aimed to investigate the effect of wogonin on the growth of HT144 melanoma, and to elucidate the role of Hh signaling in wogonin-induced antitumor effects by focusing on inflammation and glycolysis regulation. Wogonin inhibited the proliferation, colony formation and tumor growth of HT144 melanoma cells. Wogonin showed strong anti-inflammatory effect in HT144 melanoma, as shown by the decreased levels of pro-inflammatory factors, the increased level of anti-inflammatory factor and the decreased expression of inflammatory cytokines. Wogonin decreased the glucose consumption and the production of lactic acid and ATP, and decreased the activities of hexokinase (HK), phosphofructokinase(PFK) and pyruvate kinase (PK), and further inhibited the expression of monocarboxylate transporter 1 (MCT-1), MCT-4 and glucosecotransporter-1 (GLUT1), showing potent anti-glycolysis effect against HT144 melanoma. Wogonin inhibited the patched and Smo expression while increased Hhip expression in HT144 cells, suggesting that wogonin blocked the Hh signaling in HT144 cells. The Hh signaling inhibitor cyclopamine, like wogonin, inhibited the colony formation of HT144 cells, however, the inhibitory effect of wogonin on colony formation of HT144 cells was abrogated by the Hh signaling agonist SAG. In addition, SAG abrogated the inhibitory effect of wogonin on the secretion of inflammatory factors and the expression of inflammatory cytokines. Furthermore, SAG abrogated the inhibitory effect of wogonin on several key molecules controlling glycolysis. Overall, these findings suggested that the anti-tumor effect of wogonin can be attributed to the inhibition of Hh signaling-mediated regulation of inflammation and glycolysis in HT144 melanoma.
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Affiliation(s)
- Ling Li
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China; Yancheng No.1 People's Hospital, Yancheng 224001, China
| | - Yanting Ji
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Lili Zhang
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Hengji Cai
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Zhoujing Ji
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Lixiong Gu
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Shengju Yang
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China.
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7
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Štorkánová H, Štorkánová L, Navrátilová A, Bečvář V, Hulejová H, Oreská S, Heřmánková B, Špiritović M, Bečvář R, Pavelka K, Vencovský J, Distler JHW, Šenolt L, Tomčík M. Inhibition of Hsp90 Counteracts the Established Experimental Dermal Fibrosis Induced by Bleomycin. Biomedicines 2021; 9:650. [PMID: 34200311 PMCID: PMC8226767 DOI: 10.3390/biomedicines9060650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022] Open
Abstract
Our previous study demonstrated that heat shock protein 90 (Hsp90) is overexpressed in the involved skin of patients with systemic sclerosis (SSc) and in experimental dermal fibrosis. Pharmacological inhibition of Hsp90 prevented the stimulatory effects of transforming growth factor-beta on collagen synthesis and the development of dermal fibrosis in three preclinical models of SSc. In the next step of the preclinical analysis, herein, we aimed to evaluate the efficacy of an Hsp90 inhibitor, 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG), in the treatment of established experimental dermal fibrosis induced by bleomycin. Treatment with 17-DMAG demonstrated potent antifibrotic and anti-inflammatory properties: it decreased dermal thickening, collagen content, myofibroblast count, expression of transforming growth factor beta receptors, and pSmad3-positive cell counts, as well as leukocyte infiltration and systemic levels of crucial cytokines/chemokines involved in the pathogenesis of SSc, compared to vehicle-treated mice. 17-DMAG effectively prevented further progression and may induce regression of established bleomycin-induced dermal fibrosis to an extent comparable to nintedanib. These findings provide further evidence of the vital role of Hsp90 in the pathophysiology of SSc and characterize it as a potential target for the treatment of fibrosis with translational implications due to the availability of several Hsp90 inhibitors in clinical trials for other indications.
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Affiliation(s)
- Hana Štorkánová
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Lenka Štorkánová
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
| | - Adéla Navrátilová
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Viktor Bečvář
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
| | - Hana Hulejová
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
| | - Sabína Oreská
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Barbora Heřmánková
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, 16252 Prague, Czech Republic;
| | - Maja Špiritović
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, 16252 Prague, Czech Republic;
| | - Radim Bečvář
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Karel Pavelka
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Jiří Vencovský
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Jörg H. W. Distler
- Department of Internal Medicine III and Institute for Clinical Immunology, University of Erlangen-Nuremberg, 91054 Erlangen, Germany;
| | - Ladislav Šenolt
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Michal Tomčík
- Institute of Rheumatology, 12800 Prague, Czech Republic; (H.Š.); (L.Š.); (A.N.); (V.B.); (H.H.); (S.O.); (M.Š.); (R.B.); (K.P.); (J.V.); (L.Š.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
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