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Roeder F, Knudsen L, Schmiedl A. The expression of the surfactant proteins SP-A and SP-B during postnatal alveolarization of the rat lung. PLoS One 2024; 19:e0297889. [PMID: 38483982 PMCID: PMC10939297 DOI: 10.1371/journal.pone.0297889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/03/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE Surfactant-specific proteins (SP) are responsible for the functional and structural integrity as well as for the stabilization of the intra-alveolar surfactant. Morphological lung maturation starts in rat lungs after birth. The aim of this study was to investigate whether the expression of the hydrophilic SP-A and the hydrophobic SP-B is associated with characteristic postnatal changes characterizing morphological lung maturation. METHODS Stereological methods were performed on the light microscope. Using immunohistochemical and molecular biological methods (Western Blot, RT-qPCR), the SP-A and SP-B of adult rat lungs and of those with different postnatal developmental stages (3, 7, 14 and 21 days after birth) were characterized. RESULTS As signs of alveolarization the total septal surface and volume increased and the septal thickness decreased. The significantly highest relative surface fraction of SP-A labeled alveolar epithelial cells type II (AEII) was found together with the highest relative SP-A gene expression before the alveolarization (3th postnatal day). With the downregulation of SP-A gene expression during and after alveolarization (between postnatal days 7 and 14), the surface fraction of the SP-A labeled AEII also decreased, so they are lowest in adult animals. The surface fraction of SP-B labeled AEII and the SP-B gene expression showed the significantly highest levels in adults, the protein expression increased also significantly at the end of morphological lung maturation. There were no alterations in the SP-B expression before and during alveolarization until postnatal day 14. The protein expression as well as the gene expression of SP-A and SP-B correlated very well with the total surface of alveolar septa independent of the postnatal age. CONCLUSION The expression of SP-A and SP-B is differentially associated with morphological lung maturation and correlates with increased septation of alveoli as indirect clue for alveolarization.
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Affiliation(s)
- Franziska Roeder
- Institute of Functional and Applied Anatomy, Medical Hannover School, Hannover, Germany
| | - Lars Knudsen
- Institute of Functional and Applied Anatomy, Medical Hannover School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Medical Hannover School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
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2
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Pabst R, Debertin AS, Todt-Brenneke M, Herden A, Schmiedl A. The postnatal development of the compartments in human lymph nodes up to 15 years of age. Ann Anat 2023; 250:152140. [PMID: 37499700 DOI: 10.1016/j.aanat.2023.152140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/22/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
The postnatal development of normal human lymph nodes (LN) is largely unknown but is of relevance for intranodal desensitization and for comparison to lymphoma. Superficial inguinal lymphoid (LN) of 25 children (newborn up to 14 years) were studied by routine histology and immunohistology for T and B lymphocytes. The LN were obtained from the legal medicine department at necropsy. The cortex and medulla were identifiable in LN of children of less than 1 month of age. Later high endothelial venules as typical structures for the T cell area are present. Secondary follicles were obvious from 3 months of age onwards in lymph nodes of adolescents also the histology of the LN was similar to adults. The structural elements for an intranodal desensitization are given in human children. The normal development of LN structure is essential to identify pathology like lymphoma in children.
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Affiliation(s)
- R Pabst
- Institute of Immunomorphology, Germany.
| | | | | | - A Herden
- Institute of Functional and Applied Anatomy, Medical School Hannover, Germany
| | - A Schmiedl
- Institute of Functional and Applied Anatomy, Medical School Hannover, Germany
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3
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Kerner AM, Biedermann U, Bräuer L, Caspers S, Doll S, Engelhardt M, Filler TJ, Ghebremedhin E, Gundlach S, Hayn-Leichsenring GU, Heermann S, Hettwer-Steeger I, Hiepe L, Hirt B, Hirtler L, Hörmann R, Kulisch C, Lange T, Leube R, Meuser AH, Müller-Gerbl M, Nassenstein C, Neckel PH, Nimtschke U, Paulsen F, Prescher A, Pretterklieber M, Schliwa S, Schmidt K, Schmiedl A, Schomerus C, Schulze-Tanzil G, Schumacher U, Schumann S, Spindler V, Streicher J, Tschernig T, Unverzagt A, Valentiner U, Viebahn C, Wedel T, Weigner J, Weninger WJ, Westermann J, Weyers I, Waschke J, Hammer N. The chemicals between us-First results of the cluster analyses on anatomy embalming procedures in the German-speaking countries. Anat Sci Educ 2023; 16:814-829. [PMID: 37183973 DOI: 10.1002/ase.2285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 05/16/2023]
Abstract
Hands-on courses utilizing preserved human tissues for educational training offer an important pathway to acquire basic anatomical knowledge. Owing to the reevaluation of formaldehyde limits by the European Commission, a joint approach was chosen by the German-speaking anatomies in Europe (Germany, Austria, Switzerland) to find commonalities among embalming protocols and infrastructure. A survey comprising 537 items was circulated to all anatomies in German-speaking Europe. Clusters were established for "ethanol"-, formaldehyde-based ("FA"), and "other" embalming procedures, depending on the chemicals considered the most relevant for each protocol. The logistical framework, volumes of chemicals, and infrastructure were found to be highly diverse between the groups and protocols. Formaldehyde quantities deployed per annum were three-fold higher in the "FA" (223 L/a) compared to the "ethanol" (71.0 L/a) group, but not for "other" (97.8 L/a), though the volumes injected per body were similar. "FA" was strongly related to table-borne air ventilation and total fixative volumes ≤1000 L. "Ethanol" was strongly related to total fixative volumes >1000 L, ceiling- and floor-borne air ventilation, and explosion-proof facilities. Air ventilation was found to be installed symmetrically in the mortuary and dissection facilities. Certain predictors exist for the interplay between the embalming used in a given infrastructure and technical measures. The here-established cluster analysis may serve as decision supportive tool when considering altering embalming protocols or establishing joint protocols between institutions, following a best practice approach to cater toward best-suited tissue characteristics for educational purposes, while simultaneously addressing future demands on exposure limits.
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Affiliation(s)
- Alexander Michael Kerner
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Uta Biedermann
- Institute of Anatomy I, University Hospital Jena, Jena, Germany
| | - Lars Bräuer
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Svenja Caspers
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sara Doll
- Department of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
| | - Maren Engelhardt
- Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Timm J Filler
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Stefanie Gundlach
- Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | | | - Stephan Heermann
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Laura Hiepe
- Institute of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Bernhard Hirt
- Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Tübingen, Germany
| | - Lena Hirtler
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Romed Hörmann
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Kulisch
- Institute of Functional Anatomy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Lange
- Institute of Anatomy I, University Hospital Jena, Jena, Germany
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rudolf Leube
- Department of Anatomy and Cell Biology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Annika Hela Meuser
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | | | | | - Peter H Neckel
- Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Tübingen, Germany
| | - Ute Nimtschke
- Institute of Anatomy, Technical University Carl Gustav Carus Dresden, Dresden, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Prescher
- Department of Anatomy and Cell Biology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Michael Pretterklieber
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Stefanie Schliwa
- Institute of Anatomy, Anatomy and Cell Biology, University of Bonn, Bonn, Germany
| | - Katja Schmidt
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Andreas Schmiedl
- Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Christof Schomerus
- Institute of Anatomy, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gundula Schulze-Tanzil
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Nuremberg, Germany
| | - Udo Schumacher
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Schumann
- Institute of Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Volker Spindler
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Johannes Streicher
- Department of Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Thomas Tschernig
- Institute of Anatomy and Cell Biology, Saarland University, Homburg, Germany
| | - Axel Unverzagt
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Ursula Valentiner
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Thilo Wedel
- Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Janet Weigner
- Institute of Veterinary Anatomy, Freie Universität Berlin, Berlin, Germany
| | - Wolfgang J Weninger
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | | | - Imke Weyers
- Institute of Anatomy, University of Lübeck, Lübeck, Germany
| | - Jens Waschke
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology Dresden, Dresden, Germany
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Dittmar JP, Schmiedl A, Bingöl A, Stögner V, Vogt PM, Krezdorn N. The Use of Plantaris Muscle Flap for Facial Reanimation: A Comprehensive Anatomical Study. Facial Plast Surg Aesthet Med 2023; 25:431-437. [PMID: 37074352 DOI: 10.1089/fpsam.2022.0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Background: Functional facial reanimation remains challenging and the quest for optimization continues. Objective: To characterize the anatomical conditions of the plantaris muscle for facial reanimation. Study Design and Methods: Forty-two plantaris muscle specimens were obtained from 23 post-mortem chemically fixed cadavers. The muscles were dissected, evaluated, and measured. Mock facial reanimation was performed on three cadaver heads. Results: The plantaris muscle was a consistently available muscle. Mean muscle belly length was 10.1 cm (standard deviation [SD] 1.4), and mean width was 1.7 cm (SD 0.4). The mean tendon length of 30.1 cm (SD 2.8) is unique in the human body. The main artery supplying the muscle had a mean length of 1.4 cm (SD 0.4). The mean nerve length was 2.2 cm (SD 0.7). Sixteen variations of vascular supply were identified. Mock facial reanimations demonstrated a good size match, and great versatility of the long tendon for oral fixation. Conclusions: The plantaris muscle as a free flap for facial reanimation could offer new possibilities in terms of oral fixation and volumetric aesthetic conditions.
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Affiliation(s)
- Jan P Dittmar
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Alperen Bingöl
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Viola Stögner
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Peter M Vogt
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Nicco Krezdorn
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
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5
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Schmiedl A, Frank S, Tschernig T, Hohlfeld JM. Ultrastructural analysis of the intracellular surfactant in lungs of healthy and ovalbumin sensitized and challenged Brown Norway rats. Exp Lung Res 2023; 49:142-151. [PMID: 37480230 DOI: 10.1080/01902148.2023.2238232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Introduction: In human and experimentally induced asthma, a dysfunction of the intra-alveolar-surface active agent (surfactant) has been demonstrated. Type II alveolar epithelial cells (AEII) synthesize, secrete and recycle surfactant. Prior to secretion, intracellular surfactant is stored in specific secretory organelles of AEII. The lamellar bodies (Lb) represent its ultrastructural correlate. The aim of this study was to investigate whether disturbances of the intra-alveolar surfactant are accompanied by alterations in the intracellular surfactant.Material and Methods: Brown-Norway rats were sensitized twice with ovalbumin (OVA) and heat killed Bordetella pertussis bacilli. During airway challenge, an aerosol of 5% ovalbumin/saline solution (0.25 l/min) was nebulized. 24 h after airway challenge, lungs were fixed by vascular perfusion. AEII and their Lb were characterized stereologically by light and electron microscopy.Results: In both groups, AEII were structurally intact. The number of AEII per lung and their number-weighted mean volume did not differ (controls: 49 × 106, 393 µm3; asthmatics: 44 × 106, 390 µm3). A mean of 90 Lb in AEII of asthmatics and of 93 Lb in AEII of controls were evaluated. The Lb mean total volume was 59 µm in asthmatics and 68 µm in controls. Values of both parameters did not reach significance. Also, the size distribution and mean volume of Lb was not influenced by asthma induction, because the volume weighted mean volume of Lb (2.18 µm in asthmatics compared to 1.87 µm in controls) and the numerical weighted mean volume (0.96 µm in asthmatics and 0.75 µm in controls) were comparable in both groups.Conclusion: The obtained results suggest that asthma-induced surfactant dysfunction is not related to disturbances in the intracellular surfactant´s ultrastructural correlates.
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Affiliation(s)
- Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Stefanie Frank
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Thomas Tschernig
- Institute of Anatomy and Cell Biology, Campus Homburg/Saar, Saarland University, Homburg, Saar, Germany
| | - Jens M Hohlfeld
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
- Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
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6
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Schmiedl A, Buchhorn A, Schönberger M. The relationship between the subclavian vessels and brachial plexus and the overlying clavicle: Anatomical study with application to plate osteosynthesis. Clin Anat 2023; 36:377-385. [PMID: 36104939 DOI: 10.1002/ca.23948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/05/2022]
Abstract
A subclavian artery aneurysm after clavicle fracture and plate osteosynthesis in a suspected case of a screw that was too long led us to investigate body donor cadavers. The aim was to verify clavicle variability, and the course of the neurovascular bundle in relation to the clavicle and to the osteosynthesis plate, in order to clarify safe zones for plate and screw fixation. We used one fresh frozen and 25 embalmed donors for in situ measurements: (1) length and craniocaudal thickness of the clavicle, (2) distances between the sternal end of the clavicle and the center of parts of the neurovascular bundle. The clavicle was 15.15 cm long. The mean distances from the sternal end of the clavicle were 5.62 cm to the subclavian vein, 6.75 cm to the subclavian artery and 8.42 cm to the cords of the brachial plexus. The subclavius muscle was 1 cm thick. Because of sex differences in length and distances, we recorded the distances between the sternal end and parts of the neurovascular bundle as ratios of clavicle length (at-risk area) to provide sex-independent parameters: 0.379 for the vein, 0.449 for the artery and 0.554 for the nerve. The neurovascular bundle runs below the clavicle between the medial fourth and three fifths of clavicle length. To avoid iatrogenic neurovascular injuries, special caution is necessary during drilling and screwing the osteosynthesis. We also recommend using screws shorter than 1.4 cm.
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Affiliation(s)
- Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, Germany
| | - Andreas Buchhorn
- Institute of Functional and Applied Anatomy, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, Germany
| | - Michael Schönberger
- Arbitration Board for Medical Liability Issues of the North German Medical Associations, Hannover, Germany
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Lindenberg M, Buchhorn A, Reineke C, Vonberg RP, Schmiedl A. Bacterial species-specific antimicrobial efficacies of three different body embalming solutions for anatomical studies. Lett Appl Microbiol 2023; 76:6902089. [PMID: 36688765 DOI: 10.1093/lambio/ovac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/28/2022] [Accepted: 11/25/2022] [Indexed: 01/24/2023]
Abstract
While body decompensation is mainly facilitated by bacteria, investigating the antimicrobial properties of body preservation methods is still a neglected research area. We performed microbiological sampling for potentially pathogenic bacteria species of brain, lung, liver, colon, and subcutis samples obtained from bodies perfused with embalming solutions of variable composition with emphasis on variable formaldehyde concentrations. We, thereby, identified spore-forming aerobic and anaerobic bacteria mainly in the samples obtained from the colon of ethanol- and lower-concentrated formaldehyde formulation embalmed bodies. Moreover, we could identify Enterococcus species in bodies preserved with the latter method. Tissue samples of the subcutis remained sterile. Long-term incubation of special mycobacteria growth indicator tubes revealed no growth of mycobacteria in all 60 samples analyzed. Overall, we show survival of bacterial genera known to be especially environmentally resistant but also include potentially pathogenic members. Knowledge of bactericidal capacities of embalming solutions are therefore critical to assess risk and apply appropriate disinfection routines while working with human bodies. Moreover, new formulations to reduce potentially toxic substances for embalming needs to be evaluated regarding their bactericidal capacities.
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Affiliation(s)
- Marc Lindenberg
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, 30625 Hannover, Germany
| | - Andreas Buchhorn
- Institute for Functional and Applied Anatomy, Hannover Medical School, 30625 Hannover, Germany
| | - Christiane Reineke
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, 30625 Hannover, Germany
| | - Ralf-Peter Vonberg
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, 30625 Hannover, Germany
| | - Andreas Schmiedl
- Institute for Functional and Applied Anatomy, Hannover Medical School, 30625 Hannover, Germany
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Werner J, Schipke J, Brandenberger C, Schmiedl A, Mühlfeld C. Differential temporal development of alveoli and the alveolar capillary network in the postnatal rat lung. Am J Physiol Lung Cell Mol Physiol 2022; 323:L667-L675. [DOI: 10.1152/ajplung.00273.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Quantitative data about the internal lung structure are needed to better understand normal and pathological lung development. Aberrant lung development causes deficits in alveolar and microvascular development, however, the normal temporal relationship between these processes is still not fully understood. We hypothesized that alveolar and capillary development show a differential time pattern. Lungs of rats aged 3, 7, 14, 21 days or 3 months (n = 8-10 each) were fixed by vascular perfusion and processed for light microscopy. Using design-based stereology number, surface area and volume of alveoli, septal capillaries and alveolar septa was quantified. The total number and the total volume of alveoli increased progressively during postnatal development. Interestingly, the numerical density of capillary loops was significantly higher in 14 and 21 day old rats than before or after this age, causing a duplication of the total number of capillary loops between 1 and 2 weeks of age. The mean thickness of alveolar septa started to decline slightly at the age of 14 days and more pronounced at later stages. While the septal epithelial surface area increased in proportion to alveolar number during the first 3 weeks, the capillary endothelial surface area grew only slightly compared with the number of capillaries. In conclusion, the number of elements composing alveolar capillary network expands massively during the first two postnatal weeks and exceeds the formation of alveoli. The thinning of the alveolar septa during further development suggests a reduction of the capillary network during alveolarization.
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Affiliation(s)
- Julia Werner
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Julia Schipke
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Christina Brandenberger
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
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Schulte H, Schmiedl A, Mühlfeld C, Knudsen L. Teaching gross anatomy during the Covid-19 pandemic: Effects on medical students' gain of knowledge, confidence levels and pandemic-related concerns. Ann Anat 2022; 244:151986. [PMID: 35914632 PMCID: PMC9334863 DOI: 10.1016/j.aanat.2022.151986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/10/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022]
Abstract
For medical students the dissection course is the preferred method to learn gross anatomy. However, the added value of active cadaver dissection on knowledge gain in multimodal curricula offering a diversity of e-learning resources is unknown. The Covid-19-related lockdown forced educators to replace the dissection course by e-learning resources. At the end of the summer term 2020 loosening of pandemic-related regulations allowed offering a compact, voluntary active dissection course of the head-neck region to first-year medical students at Hannover Medical School. A study was conducted comparing a dissection group (G1, n = 115) and a non-dissection group (G2, n = 23). Knowledge gain and confidence level were measured with a multiple-choice (MC-)test. The use of e-learning resources was recorded. A questionnaire measured motivation, interest and level of concern regarding Covid-19 and anatomy teaching. No differences between groups were found regarding motivation and interest in anatomy of the head-neck region. G2, however, had significantly higher concerns regarding the Covid-19 pandemic than G1. Neither before nor after the educational intervention, differences in the scores of the MC-test were found. However, after the course G1 answered more MC-questions with highest confidence level than G2 (6.7 ± 6.0 vs. 3.6 ± 4.6, p < 0.05) and demonstrated by trend an increased improvement in the scores of image-based questions (30.8 ± 18.2 % vs. 17.1 ± 14.8 %, p = 0.06). In general, frequent users of online quizzes, a part of the e-learning resources, scored significantly better in the knowledge test. Active dissection improves self-assurance to identify anatomical structures and should be re-implemented in multimodal, blended-learning-based anatomical curricula in the post-pandemic era.
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Affiliation(s)
- Henri Schulte
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Lars Knudsen
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.
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van Bömmel L, Könneker S, Sonnow L, Krezdorn N, Schmiedl A, Vogt PM. Bone Tunnel Orientation in Suspension Arthroplasty of the Thumb Carpometacarpal Joint: An Anatomical Cadaver Study. Hand (N Y) 2021; 16:804-810. [PMID: 31948284 PMCID: PMC8647332 DOI: 10.1177/1558944719897137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Ligament suspension after trapeziectomy is a common technique in patients with osteoarthrosis. In this study, we set out to determine whether the orientation of the bone tunnel in the first metacarpal base affects the intraoperative position of the first metacarpal after surgery. Methods: Trapeziectomy and Epping procedure were performed in 32 cadaver hands. A drill hole was placed in the base of the first metacarpal, leaving a radial to ulnar tunnel parallel to the joint surface or a diagonal bone tunnel from the radiodorsal surface to the ulnar joint surface of the first metacarpal. Positioning of the first metacarpal was studied via radiography. Results: The distance between the first metacarpal and the scaphoid after suspension arthroplasty was 9.5 ± 2.6 mm when using the parallel radioulnar bone tunnel and 10.9 ± 2.3 mm when using the diagonal bone tunnel. Suspension of the first metacarpal was 33% higher with the diagonal bone tunnel compared with when using the parallel bone tunnel (displacement of 2.8 ± 2.0 mm vs 4.2 ± 2.0 mm). Conclusions: Higher suspension of the first metacarpal after trapeziectomy can be significantly achieved in our cadaveric model when using ligament suspension of the flexor carpi radialis tendon passed from the ulnar joint surface to the dorsum of the metacarpal. Our results have to be determined via clinical examination. To date, we prefer the diagonal bone tunnel when performing ligament suspension arthroplasty.
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Affiliation(s)
| | - Sören Könneker
- Hannover Medical School, Germany,Sören Könneker, Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
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11
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Koop CFA, Marschollek M, Schmiedl A, Proskynitopoulos PJ, Behrends M. Does an Audiovisual Dissection Manual Improve Medical Students' Learning in the Gross Anatomy Dissection Course? Anat Sci Educ 2021; 14:615-628. [PMID: 33460300 DOI: 10.1002/ase.2012] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 06/12/2023]
Abstract
The gross anatomy dissection course is considered to be one of the most important subjects in medical school. Advancing technology facilitates the production of e-learning material that can improve the learning of topographic anatomy during the course. The purpose of this study was to examine a locally produced audiovisual dissection manual's effects on performance in dissection, formal knowledge gained, motivation, emotions, learning behavior, and learning efficiency of the medical students. The results, combined with the total effort put into the production of the manual, should support decisions on further implementation of this kind of audiovisual e-learning resource into the university's curriculum. First-year medical students (n = 279) were randomly divided into three groups for two weeks within the regular dissection course hours during the dissection of the anterior and posterior triangles of the neck. Two groups received an audiovisual dissection manual (n = 96) or an improved written manual (n = 94) as an intervention, the control group (n = 89) received the standard dissection manual. After dissection, each student filled out tests and surveys and their dissections were evaluated. The audiovisual dissection manual did not have any significant positive effects on the examined parameters. The effects of the audiovisual dissection manual on the medical students' learning experience, as observed in this study, did not support further curriculum implementation of this kind of e-learning resource. This study can serve as an orientation for further evaluation and design of e-learning resources for the gross anatomy dissection course.
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Affiliation(s)
- Christian F A Koop
- Peter L. Reichertz Institute for Medical Informatics, Hannover Medical School, Hannover, Germany
- Office of the Dean of Studies, Hannover Medical School, Hannover, Germany
| | - Michael Marschollek
- Peter L. Reichertz Institute for Medical Informatics, Hannover Medical School, Hannover, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | | | - Marianne Behrends
- Peter L. Reichertz Institute for Medical Informatics, Hannover Medical School, Hannover, Germany
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12
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Müller H, Schmiedl A, Weiss C, Ai M, Jung S, Renner M. DMBT1 is upregulated in lung epithelial cells after hypoxia and changes surfactant ultrastructure. Pediatr Pulmonol 2020; 55:2964-2969. [PMID: 32770804 DOI: 10.1002/ppul.25018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/05/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Hypoxia and asphyxia are known to induce surfactant inactivation in newborns. Deleted in Malignant Brain Tumors 1 (DMBT1) is an innate immunity protein with functions in epithelial differentiation and angiogenesis. It was detected in hyaline membranes of infants with respiratory distress syndrome. Human recombinant DMBT1 is able to increase the surface tension of exogenous surfactant preparations in a dose-dependent manner. METHODS Immunohistochemistry was performed on lung sections of infants who died due to pre-, peri- or postnatal hypoxia. The lung epithelial cell line A549 was stably transfected with a DMBT1 (DMBT1+ cells) expression plasmid or with an empty plasmid (DMBT1- cells). The cells were cultured in normoxic or hypoxic conditions, and then DMBT1 as well as HIF-1α RNA expression were analyzed by using real-time-polymerase chain reaction. Human recombinant DMBT1 was added to the modified porcine natural surfactant Curosurf to examine the effect of DMBT1 on surfactant ultrastructure with electron microscopy. RESULTS DMBT1 expression was upregulated in human lung tissue after fetal/peri-/postnatal hypoxia. In addition, in vitro experiments showed increased DMBT1 RNA expression in A549 cells after hypoxia. HIF-1α was upregulated in both DMBT1+ and DMBT1- cells in response to hypoxia. The addition of human recombinant DMBT1 to Curosurf caused an impaired surfactant ultrastructure. CONCLUSIONS DMBT1 is upregulated in response to hypoxia and there seems to be a link between hypoxia and surfactant inactivation.
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Affiliation(s)
- Hanna Müller
- Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Christel Weiss
- Department for Medical Statistics and Biomathematics, University Hospital Mannheim, Mannheim, Germany
| | - Maria Ai
- Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Susan Jung
- Department of Pediatrics, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Marcus Renner
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
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13
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Yazicioglu T, Mühlfeld C, Autilio C, Huang CK, Bär C, Dittrich-Breiholz O, Thum T, Pérez-Gil J, Schmiedl A, Brandenberger C. Aging impairs alveolar epithelial type II cell function in acute lung injury. Am J Physiol Lung Cell Mol Physiol 2020; 319:L755-L769. [DOI: 10.1152/ajplung.00093.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Morbidity and mortality rates in acute lung injury (ALI) increase with age. As alveolar epithelial type II cells (AE2) are crucial for lung function and repair, we hypothesized that aging promotes senescence in AE2 and contributes to the severity and impaired regeneration in ALI. ALI was induced with 2.5 μg lipopolysaccharide/g body weight in young (3 mo) and old (18 mo) mice that were euthanized 24 h, 72 h, and 10 days later. Lung function, pulmonary surfactant activity, stereology, cell senescence, and single-cell RNA sequencing analyses were performed to investigate AE2 function in aging and ALI. In old mice, surfactant activity was severely impaired. A 60% mortality rate and lung function decline were observed in old, but not in young, mice with ALI. AE2 of young mice adapted to injury by increasing intracellular surfactant volume and proliferation rate. In old mice, however, this adaptive response was compromised, and AE2 of old mice showed signs of cell senescence, increased inflammatory signaling, and impaired surfactant metabolism in ALI. These findings provide evidence that ALI promotes a limited proliferation rate, increased inflammatory response, and surfactant dysfunction in old, but not in young, mice, supporting an impaired regenerative capacity and reduced survival rate in ALI with advancing age.
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Affiliation(s)
- Tolga Yazicioglu
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Chiara Autilio
- Department of Biochemistry and Molecular Biology, Faculty of Biology, and Research Institute “Hospital 12 de Octubre (imas12)”, Complutense University, Madrid, Spain
| | - Cheng-Kai Huang
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany
- REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | | | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany
- REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Jesús Pérez-Gil
- Department of Biochemistry and Molecular Biology, Faculty of Biology, and Research Institute “Hospital 12 de Octubre (imas12)”, Complutense University, Madrid, Spain
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Christina Brandenberger
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
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14
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Ahrendt N, Steingrüber T, Rajces A, Lopez-Rodriguez E, Eisenberg T, Magnes C, Madeo F, Sedej S, Schmiedl A, Ochs M, Mühlfeld C, Schipke J. Spermidine supplementation and voluntary activity differentially affect obesity-related structural changes in the mouse lung. Am J Physiol Lung Cell Mol Physiol 2020; 319:L312-L324. [PMID: 32521164 DOI: 10.1152/ajplung.00423.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Obesity is associated with lung function impairment and respiratory diseases; however, the underlying pathophysiological mechanisms are still elusive, and therapeutic options are limited. This study examined the effects of prolonged excess fat intake on lung mechanics and microstructure and tested spermidine supplementation and physical activity as intervention strategies. C57BL/6N mice fed control diet (10% fat) or high-fat diet (HFD; 60% fat) were left untreated or were supplemented with 3 mM spermidine, had access to running wheels for voluntary activity, or a combination of both. After 30 wk, lung mechanics was assessed, and left lungs were analyzed by design-based stereology. HFD exerted minor effects on lung mechanics and resulted in higher body weight and elevated lung, air, and septal volumes. The number of alveoli was higher in HFD-fed animals. This was accompanied by an increase in epithelial, but not endothelial, surface area. Moreover, air-blood barrier and endothelium were significantly thicker. Neither treatment affected HFD-related body weights. Spermidine lowered lung volumes as well as endothelial and air-blood barrier thicknesses toward control levels and substantially increased the endothelial surface area under HFD. Activity resulted in decreased volumes of lung, septa, and septal compartments but did not affect vascular changes in HFD-fed mice. The combination treatment showed no additive effect. In conclusion, excess fat consumption induced alveolar capillary remodeling indicative of impaired perfusion and gas diffusion. Spermidine alleviated obesity-related endothelial alterations, indicating a beneficial effect, whereas physical activity reduced lung volumes apparently by other, possibly systemic effects.
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Affiliation(s)
- Nancy Ahrendt
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Tobias Steingrüber
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Alexandra Rajces
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Elena Lopez-Rodriguez
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany.,Institute of Vegetative Anatomy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Eisenberg
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, Graz, Austria.,BioTechMed-Graz, Graz, Austria
| | - Christoph Magnes
- Joanneum Research, HEALTH-Institute for Biomedicine and Health Sciences, Graz, Austria
| | - Frank Madeo
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, Graz, Austria.,BioTechMed-Graz, Graz, Austria
| | - Simon Sedej
- Department of Cardiology, Medical University of Graz, Graz, Austria.,BioTechMed-Graz, Graz, Austria
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence REBIRTH (From Regenerative Biology to Reconstructive Therapy), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
| | - Matthias Ochs
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence REBIRTH (From Regenerative Biology to Reconstructive Therapy), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany.,Institute of Vegetative Anatomy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence REBIRTH (From Regenerative Biology to Reconstructive Therapy), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
| | - Julia Schipke
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence REBIRTH (From Regenerative Biology to Reconstructive Therapy), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
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15
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Schmiedl A, Bokel K, Huhn V, Ionescu L, Zscheppang K, Dammann CEL. Bone marrow stem cells accelerate lung maturation and prevent the LPS-induced delay of morphological and functional fetal lung development in the presence of ErbB4. Cell Tissue Res 2020; 380:547-564. [PMID: 32055958 DOI: 10.1007/s00441-019-03145-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/18/2019] [Indexed: 12/28/2022]
Abstract
ErbB4 is a regulator in lung development and disease. Prenatal infection is an important risk factor for the delay of morphologic lung development, while promoting the maturation of the surfactant system. Bone marrow-derived mesenchymal stem cells (BMSCs) have the potential to prevent lung injury. We hypothesized that BMSCs in comparison with hematopoietic control stem cells (HPSCs) minimize the lipopolysaccharide (LPS)-induced lung injury only when functional ErbB4 receptor is present. We injected LPS and/or murine green fluorescent protein-labeled BMSCs or HPSCs into the amniotic cavity of transgenic ErbB4heart mothers at gestational day 17. Fetal lungs were analyzed 24 h later. BMSCs minimized significantly LPS-induced delay in morphological lung maturation consisting of a stereologically measured increase in mesenchyme and septal thickness and a decrease of future airspace and septal surface. This effect was more prominent and significant in the ErbB4heart+/- lungs, suggesting that the presence of functioning ErbB4 signaling is required. BMSC also diminished the LPS induced increase in surfactant protein (Sftp)a mRNA and decrease in Sftpc mRNA is only seen if ErbB4 is present. The reduction of morphological delay of lung development and of levels of immune-modulating Sftp was more pronounced in the presence of the ErbB4 receptor. Thus, ErbB4 may be required for the protective signaling of BMSCs.
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Affiliation(s)
- Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center of Lung Research (DZL), Hannover, Germany.
| | - Kyra Bokel
- Institute of Functional and Applied Anatomy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Verena Huhn
- Department of Pediatric Pulmonology and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Lavinia Ionescu
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Katja Zscheppang
- Department of Pediatric Pulmonology and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Christiane E L Dammann
- Department of Pediatric Pulmonology and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA
- Graduate School for Biomedical Sciences, Tufts University, Boston, MA, USA
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16
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Wagener I, Jungen M, von Hörsten S, Stephan M, Schmiedl A. Postnatal morphological lung development of wild type and CD26/DPP4 deficient rat pups in dependency of LPS exposure. Ann Anat 2019; 229:151423. [PMID: 31654734 DOI: 10.1016/j.aanat.2019.151423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Rodents are born with morphological immature lungs and an intact surfactant system. CD26/DPP4 is a multifactorial transmembrane integral type II protein, which is involved in physiological and pathophysiological processes and is already expressed during development. CD26/DPP4, called CD26 in the following, is able to enhance or dampen differently triggered inflammation. LPS exposure often used to simulate perinatal infection delays lung development. OBJECTIVE A perinatal LPS rat model was used to test the hypothesis that CD26 deficiency modulates LPS-induced retardation in morphological lung development. METHODS New born Fischer CD26 positive (CD26+) and deficient (CD26-) rats were exposed to LPS on postnatal day (day post partum, dpp) 3 and 5. Morphological parameters of lung development were determined stereologically. Lung development was analysed in 7, 10 14 and 21day old rats. RESULTS Compared to controls LPS application resulted (1) in a mild inflammation independent of the strain, (2) in significantly lower total surface and volume of alveolar septa combined with significantly higher total volume of airspaces and alveolar size on dpp 7 in both substrains. However, compared to controls in LPS treated CD26- rats significant lower values of total septal surface and volume combined with higher values of total parenchymal airspaces and alveolar size were found until the end of classical alveolarization (dpp14). In LPS treated CD26+ rat pups the retardation was abolished already on dpp 10. CONCLUSION In absence of CD26, LPS enhances the delay of morphological lung development. Morphological recovery was slower after the end of LPS exposure in CD26 deficient lungs.
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Affiliation(s)
- Inga Wagener
- Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.
| | - Meike Jungen
- Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.
| | - Stephan von Hörsten
- Franz-Penzoldt-Centre, Experimental Therapy, Friedrich-Alexander-University of Erlangen, Germany.
| | - Michael Stephan
- Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany; Clinic for Psychosomatics and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany.
| | - Andreas Schmiedl
- Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.
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17
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Neuhaus M, Munder A, Schipke J, Schmiedl A. Lung infection caused by Pseudomonas aeruginosa in a CD26/DPP4 deficient F344 rat model. Inflamm Res 2019; 68:529-544. [PMID: 31089745 PMCID: PMC7079754 DOI: 10.1007/s00011-019-01236-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 03/27/2019] [Accepted: 04/16/2019] [Indexed: 01/21/2023] Open
Abstract
Background Pseudomonas aeruginosa (PA) is the most important opportunistic pathogen in causing nosocomial infections and, furthermore, poses a permanent threat for severe chronic infections in patients with cystic fibrosis or COPD. The transmembrane protein CD26 with dipeptidyl peptidase-4 (DPP4) activity shows an increased expression in inflamed tissue. We tested whether CD26/DPP4 deficiency leads to reduced inflammation and decreased structural damage when infected with PA. Methods CD26/DPP4+ and CD26/DPP4− rats were instilled intratracheally with NaCl (controls) or with PA. Six hours later, bacterial distribution was detected with the in vivo imaging system 200 (IVIS). Lungs were then processed for molecular biology, light and electron microscopy and analyzed qualitatively, quantitatively and stereologically. Bacterial numbers were determined in homogenized lungs. Results Compared to saline treated controls, in both infected groups (1) the acinar airspace was significantly increased, (2) the volume density of the alveolar epithelium was significantly decreased, (3) the septal thickness was significantly reduced, (4) more than 40% of the alveolar epithelial surface was damaged, and up to 36% of the epithelial surface was covered with edema. In infected CD26− rats, the increase in lung weight was significantly less pronounced, the portion of edematous alveolar airspace was significantly lower and the part of edema interspersed with PA was decreased significantly. Conclusions CD26/DPP4 deficiency resulted in reduced pulmonary edema under sublethal PA infection, implicating a role for CD26 in infection progression. The partly pronounced structural damage may mask further possible influences of CD26 on the inflammatory response.
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Affiliation(s)
- M Neuhaus
- Institute of Functional and Applied Anatomy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.,Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - A Munder
- Clinic of Pediatric Pneumology, Allergology and Neonatology Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover Medical School, Hannover, Germany
| | - J Schipke
- Institute of Functional and Applied Anatomy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover Medical School, Hannover, Germany.,REBIRTH Cluster of Excellence, Hannover Medical School, Hannover, Germany
| | - A Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany. .,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover Medical School, Hannover, Germany. .,REBIRTH Cluster of Excellence, Hannover Medical School, Hannover, Germany.
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18
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Zientara A, Stephan M, von Hörsten S, Schmiedl A. Differential severity of LPS-induced lung injury in CD26/DPP4 positive and deficient F344 rats. Histol Histopathol 2019; 34:1151-1171. [PMID: 30977110 DOI: 10.14670/hh-18-117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Lipopolysaccharide (LPS) induced inflammation often leads to lung injury, in which pulmonary recruitment of neutrophils plays a pivotal role. Inflammatory processes are influenced by CD26/DPP4, highly expressed in lungs. Asthma induced CD26/DPP4 deficient (CD26/DPP4⁻) Fischer (F) 344 rats suffering from a transport block in the rER caused by a point mutation showed reduced pulmonary inflammation and reduced expression of immunomodulating surfactant proteins (SP). The degree of LPS induced lung injury in CD26/DPP4 deficient rats has not been investigated so far. OBJECTIVE We hypothesize that LPS induced lung injury leads not only to an attenuated inflammation but also to a reduced SP expression and decreased structural damage in CD26/DPP4⁻ rats. METHODS Both genotypes were intratracheally instilled with 250 µl LPS or with 250 µl 0.9% NaCl. Nine hours later animals were killed and either bronchoalveolar lavage was carried out to determine inflammatory cells and surface tension or lung blocks were removed and processed for histology, immunohistochemistry, electron microscopy or qRt-PCR analyses and Western Blot analyses. RESULTS Signs of acute lung injury, such as structural damage of the blood gas barrier occurred only sporadically in both genotypes. LPS-induced CD26/DPP4⁻ rats showed decreased gene expression of SP-A and SP-D and reduced signs of lung inflammation associated with a reduced alveolar influx of macrophages and neutrophils. CONCLUSIONS Less pulmonary inflammation combined with less structural alterations and minor expression of immunomodulating SP may be an indication of the critical role of CD26/DPP4 in regulating lung inflammation.
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Affiliation(s)
- Alicja Zientara
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,Department of Cardiac Surgery, Stadtspital Triemli, Zürich, Switzerland
| | - Michael Stephan
- Clinic for Psychosomatics and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stephan von Hörsten
- Department for Experimental Therapy, Universitätsklinikum Erlangen (UKEr), Preclinical Experimental Center (PETZ), Friedrich-Alexander-Universität Nürnberg-Erlangen (FAU), Erlangen, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage und Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.,REBIRTH Cluster of Excellence, Hannover Medical School, Hannover, Germany.
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19
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Knudsen L, Nawrotzki R, Schmiedl A, Mühlfeld C, Kruschinski C, Ochs M. Hands-on or no hands-on training in ultrasound imaging: A randomized trial to evaluate learning outcomes and speed of recall of topographic anatomy. Anat Sci Educ 2018; 11:575-591. [PMID: 29683560 DOI: 10.1002/ase.1792] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 05/14/2023]
Abstract
Medical students have difficulties in interpreting two-dimensional (2D) topographic anatomy on sectional images. Hands-on and no hands-on training in ultrasound imaging facilitate learning topographic anatomy. Hands-on training is linked with active search for patterns of anatomical structures and might train pattern recognition for image interpretation better although the added value on learning outcomes is unclear. This study explores first year medical students' knowledge in topographic anatomy of the upper abdomen after attending hands-on or no hands-on training in ultrasound in a randomized trial. While students in the hands-on ultrasound group (N = 21) generated and interpreted standardized planes of ultrasound imaging, students in the no hands-on seminar group (N = 22) interpreted provided ultrasound images by correlation to three-dimensional (3D) anatomical prosections. Afterwards knowledge in topographic anatomy was measured repetitively by text and ultrasound image-based multiple choice (MC) examinations. As surrogate for pattern recognition, students rated whether answers were known after reflection or instantly. While intrinsic motivation was higher in the ultrasound group, no differences in the MC-examination score were found between ultrasound and seminar group instantly (66.5 ±10.9% vs. 64.5% ±11.0%, P = 0.551) or six weeks (62.9% ±12.3% vs. 61.5% ±11.0%, P = 0.718) after training. In both groups scores in text-based questions declined (P < 0.001) while scores in image-based questions remained stable (P = 0.895) with time. After six weeks more image-based questions were instantly known in the hands-on ultrasound compared to seminar-group (28% ±17.3% vs. 16% ±13.5%, P = 0.047). Hands-on ultrasound-training is linked with faster interpreting of ultrasound images without loss in accuracy. The added value of hands-on training might be facilitation of pattern recognition.
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Affiliation(s)
- Lars Knudsen
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
| | - Ralph Nawrotzki
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
| | | | - Matthias Ochs
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
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Jörger A, Acevedo C, Busley D, Ganter M, Schmiedl A, Humann-Ziehank E. Stereological and biophysical characteristics of the ovine surfactant system and its changes caused by ovine pulmonary adenocarcinoma. Res Vet Sci 2017. [DOI: 10.1016/j.rvsc.2017.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lerner A, Arleevskaya M, Schmiedl A, Matthias T. Microbes and Viruses Are Bugging the Gut in Celiac Disease. Are They Friends or Foes? Front Microbiol 2017; 8:1392. [PMID: 28824555 PMCID: PMC5539691 DOI: 10.3389/fmicb.2017.01392] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/10/2017] [Indexed: 12/17/2022] Open
Abstract
The links between microorganisms/viruses and autoimmunity are complex and multidirectional. A huge number of studies demonstrated the triggering impact of microbes and viruses as the major environmental factors on the autoimmune and inflammatory diseases. However, growing evidences suggest that infectious agents can also play a protective role or even abrogate these processes. This protective crosstalk between microbes/viruses and us might represent a mutual beneficial equilibrium relationship between two cohabiting ecosystems. The protective pathways might involve post-translational modification of proteins, decreased intestinal permeability, Th1 to Th2 immune shift, induction of apoptosis, auto-aggressive cells relocation from the target organ, immunosuppressive extracellular vesicles and down regulation of auto-reactive cells by the microbial derived proteins. Our analysis demonstrates that the interaction of the microorganisms/viruses and celiac disease (CD) is always a set of multidirectional processes. A deeper inquiry into the CD interplay with Herpes viruses and Helicobacter pylori demonstrates that the role of these infections, suggested to be potential CD protectors, is not as controversial as for the other infectious agents. The outcome of these interactions might be due to a balance between these multidirectional processes.
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Affiliation(s)
- Aaron Lerner
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of TechnologyHaifa, Israel.,Department of Research, AESKU.KIPP InstituteWendelsheim, Germany
| | - Marina Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy KazanKazan, Russia
| | - Andreas Schmiedl
- Department of Research, AESKU.KIPP InstituteWendelsheim, Germany
| | - Torsten Matthias
- Department of Research, AESKU.KIPP InstituteWendelsheim, Germany
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Schmiedl A, Roolfs T, Tutdibi E, Gortner L, Monz D. Influence of prenatal hypoxia and postnatal hyperoxia on morphologic lung maturation in mice. PLoS One 2017; 12:e0175804. [PMID: 28426693 PMCID: PMC5398543 DOI: 10.1371/journal.pone.0175804] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 03/31/2017] [Indexed: 01/15/2023] Open
Abstract
Background Oxygen supply as a lifesaving intervention is frequently used to treat preterm infants suffering additionally from possible prenatal or perinatal pathogen features. The impact of oxygen and/or physical lung injury may influence the morphological lung development, leading to a chronic postnatal lung disease called bronchopulmonary dysplasia (BPD). At present different experimental BPD models are used. However, there are no systematic comparative studies regarding different influences of oxygen on morphological lung maturation. Objective We investigated the influence of prenatal hypoxia and/or postnatal hyperoxia on morphological lung maturation based on stereological parameters, to find out which model best reflects morphological changes in lung development comparable with alterations found in BPD. Methods Pregnant mice were exposed to normoxia, the offspring to normoxia (No/No) or to hyperoxia (No/Hyper). Furthermore, pregnant mice were exposed to hypoxia and the offspring to normoxia (Hypo/No) or to hyperoxia (Hypo/Hyper). Stereological investigations were performed on all pups at 14 days after birth. Results Compared to controls (No/No) 1) the lung volume was significantly reduced in the No/Hyper and Hypo/Hyper groups, 2) the volume weighted mean volume of the parenchymal airspaces was significantly higher in the Hypo/Hyper group, 3) the total air space volume was significantly lower in the No/Hyper and Hypo/Hyper groups, 4) the total septal surface showed significantly lower values in the No/Hyper and Hypo/Hyper groups, 5) the wall thickness of septa showed the highest values in the Hypo/Hyper group without reaching significance, 6) the volume density and the volume weighted mean volume of lamellar bodies in alveolar epithelial cells type II (AEII) were significantly lower in the Hypo/Hyper group. Conclusion Prenatal hypoxia and postnatal hyperoxia differentially influence the maturation of lung parenchyma. In 14 day old mice a significant retardation of morphological lung development leading to BPD-like alterations indicated by different parameters was only seen after hypoxia and hyperoxia.
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Affiliation(s)
- Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage und Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
- REBIRTH Cluster of Excellence, Hannover Medical School, Hannover, Germany
| | - Torge Roolfs
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Erol Tutdibi
- Department of Pediatrics and Neonatology, Saarland University, Homburg/Saar, Germany
| | - Ludwig Gortner
- Department of Pediatrics and Neonatology, Saarland University, Homburg/Saar, Germany
| | - Dominik Monz
- Department of Pediatrics and Neonatology, Saarland University, Homburg/Saar, Germany
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Plaass C, Claassen L, Daniilidis K, Fumy M, Stukenborg-Colsman C, Schmiedl A, Ettinger S. Placement of Plantar Plates for Lapidus Arthrodesis: Anatomical Considerations. Foot Ankle Int 2016; 37:427-32. [PMID: 26635414 DOI: 10.1177/1071100715619607] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The modified Lapidus procedure is an accepted treatment option for patients with moderate to severe hallux valgus. Placing a plate plantar on the tension side of the arthrodesis has been shown to be biomechanically superior and has provided good clinical results. There is some concern about interference of the plantar placed plates on the tendon insertions. The purpose of this study was to determine a "safe zone" for plantar plate placement without irritation of the tendons. METHODS Twenty-nine embalmed right feet were used for this study. The anatomy of the insertion of the peroneus longus (PL) tendon and tibialis anterior (TA) tendon on the medial cuneiform and first metatarsal were analyzed. Six different plate designs for plantar plating of the first tarsometatarsal fusion were included. The fit to the bone and contact to tendon insertion were analyzed. RESULTS The PL showed a main insertion to the first metatarsal and a lesser insertion to the medial cuneiform. The TA inserted onto the medial cuneiform and first metatarsal in all cases in our series. There was a "safe zone" between the TA and PL insertion areas for plate placement. Straight, Y- and U-shaped plates could be placed without compromising the tendon insertion. Depending on the design, even preshaped plates may have to be bent to allow a good fit to the plantar side of the first tarsometatarsal joint. CONCLUSION Plantar plating for modified Lapidus arthrodesis can be safely performed, without damaging the plantar tendon insertion area of the PL and TA. CLINICAL RELEVANCE The exact knowledge of the anatomy of the plantar region of the tarsometatarsal joint can help to improve plate placement.
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Affiliation(s)
- Christian Plaass
- Department of Orthopedic Surgery, Hannover Medical School, Hanover, Germany
| | - Leif Claassen
- Department of Orthopedic Surgery, Hannover Medical School, Hanover, Germany
| | | | - Mariesol Fumy
- Department of Functional Anatomy, Hannover Medical School, Hanover, Germany
| | | | - Andreas Schmiedl
- Department of Functional Anatomy, Hannover Medical School, Hanover, Germany
| | - Sarah Ettinger
- Department of Orthopedic Surgery, Hannover Medical School, Hanover, Germany
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Hawi N, Reinhold A, Suero EM, Liodakis E, Przyklenk S, Brandes J, Schmiedl A, Krettek C, Meller R. The Anatomic Basis for the Arthroscopic Latarjet Procedure: A Cadaveric Study. Am J Sports Med 2016; 44:497-503. [PMID: 26657260 DOI: 10.1177/0363546515614320] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The Latarjet technique is a reliable treatment option for recurrent anterior shoulder instability. However, the complication rate has been reported to be as high as 30%, with 1.6% of patients suffering a nerve injury. The all-arthroscopic Latarjet procedure has been gaining popularity, even as it has introduced its own challenges. Given that the surgeon is not able to palpate the nerves, their localization and protection can be difficult. Additionally, the use of different instruments can lead to distinct nerve injury mechanisms. PURPOSE To describe the anatomic trajectory of the musculocutaneous, axillary, and suprascapular nerves in relation to the arthroscopic Latarjet approach. Using this information, guidance is provided for reducing nerve injuries during instrumentation and screw insertion. STUDY DESIGN Descriptive laboratory study. METHODS A total of 50 cadaveric shoulders from 25 whole-body specimens were examined. The specimens were placed in the beach-chair position, and the deltopectoral and dorsal approaches were used to expose the relevant structures. A subscapularis muscle split was performed between the inferior and middle thirds of the tendon. Digital caliper measurements were taken between various points of the trajectories of the nerves and surrounding anatomic landmarks. The location of the nerves relative to the split was recorded. RESULTS The musculocutaneous nerve lay within the split in 66% of the shoulders (n = 33); it was medial to the split in 28% (n = 14); it was found lateral to split in 2% (n = 1); and it was not identified in 4% of shoulders (n = 2). The mean length of the axillary nerve was 4.0 cm (95% CI, 3.7-4.2) from the exit of the plexus to the quadrangular space. The axillary nerve was found to be within the split in 50% of the shoulders (n = 25) and medial to the split in the remaining 50% (n = 25). The suprascapular nerve at the level of the supraspinatous fossa passed 3.3 cm (95% CI, 3.1-3.5) medial to the superior rim of the posterior glenoid. The nerve curves around the root of the spine at the spinoglenoid notch level, approximating the glenoid rim to a distance of 2.1 cm (95% CI, 2.0-2.2). Finally, the nerve runs medially again before branching out into smaller fibers to innervate the infraspinatus muscle at a distance of 2.9 cm (95% CI, 2.7-3.1) from the inferior glenoid rim. Based on these findings, there is an approximately 2 cm-wide safe zone from the edge of the glenoid rim for the insertion of graft-fixing screws. CONCLUSION When performing a subscapularis split in the arthroscopic Latarjet procedure, the risk of injuries to the musculocutaneous and axillary nerves could be reduced by aiming the switching stick inserted through the posterior portal toward the lateral edge of the intended location of the split. Injuries to the suprascapular nerve could be prevented by aiming the graft-fixing screws laterally toward the edge of the glenoid rim. CLINICAL RELEVANCE This study clarifies the location of the nerves relevant to the arthroscopic Latarjet technique and provides anatomic information that could help the surgeon reduce the risk of injuries to the musculocutaneous, axillary, and suprascapular nerves.
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Affiliation(s)
- Nael Hawi
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - Aja Reinhold
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - Eduardo M Suero
- Trauma Department, Hannover Medical School, Hannover, Germany
| | | | | | - Julia Brandes
- Trauma Department, Hannover Medical School, Hannover, Germany
| | | | | | - Rupert Meller
- Trauma Department, Hannover Medical School, Hannover, Germany
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Busley D, Ochs M, Hoeltig D, Ganter M, Acevedo C, Schmiedl A, Hennig-Pauka I. Characterization of surfactant alterations in pigs infected withActinobacillus pleuropneumoniae. Exp Lung Res 2016; 42:1-13. [DOI: 10.3109/01902148.2015.1123327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Katsirntaki K, Mauritz C, Olmer R, Schmeckebier S, Sgodda M, Puppe V, Eggenschwiler R, Duerr J, Schubert SC, Schmiedl A, Ochs M, Cantz T, Salwig I, Szibor M, Braun T, Rathert C, Martens A, Mall MA, Martin U. Bronchoalveolar sublineage specification of pluripotent stem cells: effect of dexamethasone plus cAMP-elevating agents and keratinocyte growth factor. Tissue Eng Part A 2014; 21:669-82. [PMID: 25316003 DOI: 10.1089/ten.tea.2014.0097] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Respiratory progenitors can be efficiently generated from pluripotent stem cells (PSCs). However, further targeted differentiation into bronchoalveolar sublineages is still in its infancy, and distinct specifying effects of key differentiation factors are not well explored. Focusing on airway epithelial Clara cell generation, we analyzed the effect of the glucocorticoid dexamethasone plus cAMP-elevating agents (DCI) on the differentiation of murine embryonic and induced pluripotent stem cells (iPSCs) into bronchoalveolar epithelial lineages, and whether keratinocyte growth factor (KGF) might further influence lineage decisions. We demonstrate that DCI strongly induce expression of the Clara cell marker Clara cell secretory protein (CCSP). While KGF synergistically supports the inducing effect of DCI on alveolar markers with increased expression of surfactant protein (SP)-C and SP-B, an inhibitory effect on CCSP expression was shown. In contrast, neither KGF nor DCI seem to have an inducing effect on ciliated cell markers. Furthermore, the use of iPSCs from transgenic mice with CCSP promoter-dependent lacZ expression or a knockin of a YFP reporter cassette in the CCSP locus enabled detection of derivatives with Clara cell typical features. Collectively, DCI was shown to support bronchoalveolar specification of mouse PSCs, in particular Clara-like cells, and KGF to inhibit bronchial epithelial differentiation. The targeted in vitro generation of Clara cells with their important function in airway protection and regeneration will enable the evaluation of innovative cellular therapies in animal models of lung diseases.
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Affiliation(s)
- Katherina Katsirntaki
- 1 Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School , Hannover, Germany
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Schmiedl A, Grützner D, Hoffmann T, von Hörsten S, Stephan M. DPP4 inhibitors increase differentially the expression of surfactant proteins in Fischer 344 rats. Acta Physiol (Oxf) 2014; 212:248-61. [PMID: 25069535 DOI: 10.1111/apha.12350] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/17/2014] [Accepted: 07/19/2014] [Indexed: 01/21/2023]
Abstract
AIM Intact surface active agent (surfactant) composed of surfactant-associated proteins (SPs) and lipids is necessary for respiration and prevents alveoli from collapsing. CD26, a transmembrane glycoprotein exerting dipeptidyl peptidase activity (DPP4), highly expressed in lung parenchyma, is involved in inflammatory processes. A pharmacological inhibition of DPP4 influenced not only the inflammation but also elevated the SPs. Thus, DPP4 inhibitors may be a novel drug for treatment of diseases with surfactant deficiency. Therefore, we tested firstly the hypothesis that DPP4 inhibitors increase the expression of SPs in healthy rats. METHODS SP mRNA and protein expression were determined different times after nebulization of aerosolized DPP4 inhibitors [L-isoleucine-thiazolidide (L-Ile-Thia), L-valine-pyrrolidide (L-Val-Pyrr)], budesonide, saline or stereoisomers. RESULTS Compared with negative controls (1) L-Ile-Thia as well as budesonide led to a significant higher and L-Val-Pyrr had the tendency to a significant higher expression of SP-A mRNA 6 h after nebulization, (2) the expression of SP-D mRNA increased significantly 6 h after nebulization with L-Ile-Thia and 3 and 6 h after nebulization with Val-pyrr, (3) SP-B mRNA levels showed significantly higher values 3 and 6 h after nebulization with L-Val-Pyrr, (4) protein levels of SP-A, SP-B and SP-C were elevated significantly 6 h after nebulization with L-Val-Pyrr as well as with budesonide, and (5) phospholipids were also increased in response to DPP4 inhibition; the minimal surface tension was comparable. CONCLUSION DPP4 inhibition influence differently the expression of surfactant proteins in healthy rats and may be suitable to elevate surfactant synthesis in different diseases accompanied with surfactant deficiencies.
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Affiliation(s)
- A. Schmiedl
- Institute of Functional and Applied Anatomy; Hannover Medical School; Hannover Germany
| | - D. Grützner
- Institute of Functional and Applied Anatomy; Hannover Medical School; Hannover Germany
| | | | - S. von Hörsten
- Department for Experimental Therapy; Franz-Penzoldt-Center; Friedrich-Alexander-University Erlangen-Nürnberg; Erlangen Germany
| | - M. Stephan
- Clinic for Psychosomatics and Psychotherapy; Hannover Medical School; Hannover Germany
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Tasic T, Stephan M, von Hörsten S, Pabst R, Schmiedl A. Differential OVA-induced pulmonary inflammation and unspecific reaction in Dark Agouti (DA) rats contingent on CD26/DPPIV deficiency. Immunobiology 2014; 219:888-900. [PMID: 25108564 DOI: 10.1016/j.imbio.2014.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 06/20/2014] [Accepted: 07/15/2014] [Indexed: 12/17/2022]
Abstract
Many disease models have shown that, within the species rat, different strains are differentially susceptible to asthma-induced inflammation depending on the genetic background. Likewise, CD26/DPPIV-deficiency in asthmatic F344 rats has been shown to result in a less pronounced inflammation and in increased Treg cell influx into the lung compared to wild-types. The aim of the present study was to investigate whether the genetic background of the animals interferes with CD26/DPPIV-deficiency in a model of allergic-like inflammation, or whether the deficiency per se is the predominant regulator of the inflammation. Therefore, we hypothesised that CD26/DPPIV-deficient Dark Agouti (DA) rats also exhibit a less pronounced ovalbumin (OVA)-induced inflammation compared to wild-types. After sensitisation with OVA, Al(OH)3 and heat-killed Bordetella pertussis bacilli, animals were challenged three times with 5% aerosolized OVA at intervals of 24h, i.e., on three consecutive days. 24h after the third challenge, animals were sacrificed and examined. In both wild-type and CD26/DPPIV-deficient rat groups, asthma induction led to (1) lung inflammation, (2) significantly increased eosinophil infiltration in the BALF, (3) significantly increased IgE serum levels, (4) a significant increase of inflammatory cytokines, (5) a significant increase of different T cell populations in the lungs and in their draining lymph nodes, as well as to (6) a significantly higher number of all T lymphocyte subtypes in the blood. Thus, the degree of the OVA-induced Th2-driven pulmonary inflammation was similarly pronounced in both wild-type and CD26/DPPIV-deficient DA rats.
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Affiliation(s)
- Tihana Tasic
- Institute of Functional and Applied Anatomy, Hannover Medical School, Germany
| | - Michael Stephan
- Clinic for Psychosomatics and Psychotherapy, Hannover Medical School, Germany
| | - Stephan von Hörsten
- Department for Experimental Therapy, Franz-Penzoldt-Center, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Reinhard Pabst
- Institute of Immunomorphology, Hannover Medical School, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Germany.
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Katsirntaki K, Mauritz C, Schmeckebier S, Sgodda M, Puppe V, Eggenschwiler R, Duerr J, Schuber SC, Schmiedl A, Ochs M, Salwig I, Szibor M, Braus T, Cantz T, Mall MA, Martin U. Generation of Clara cells from murine pluripotent stem cells – a new tool to explore airway epithelial regeneration. Pneumologie 2014. [DOI: 10.1055/s-0034-1376846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bang C, Batkai S, Dangwal S, Gupta SK, Foinquinos A, Holzmann A, Just A, Remke J, Zimmer K, Zeug A, Ponimaskin E, Schmiedl A, Yin X, Mayr M, Halder R, Fischer A, Engelhardt S, Wei Y, Schober A, Fiedler J, Thum T. Cardiac fibroblast-derived microRNA passenger strand-enriched exosomes mediate cardiomyocyte hypertrophy. J Clin Invest 2014; 124:2136-46. [PMID: 24743145 DOI: 10.1172/jci70577] [Citation(s) in RCA: 737] [Impact Index Per Article: 73.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 02/20/2014] [Indexed: 12/20/2022] Open
Abstract
In response to stress, the heart undergoes extensive cardiac remodeling that results in cardiac fibrosis and pathological growth of cardiomyocytes (hypertrophy), which contribute to heart failure. Alterations in microRNA (miRNA) levels are associated with dysfunctional gene expression profiles associated with many cardiovascular disease conditions; however, miRNAs have emerged recently as paracrine signaling mediators. Thus, we investigated a potential paracrine miRNA crosstalk between cardiac fibroblasts and cardiomyocytes and found that cardiac fibroblasts secrete miRNA-enriched exosomes. Surprisingly, evaluation of the miRNA content of cardiac fibroblast-derived exosomes revealed a relatively high abundance of many miRNA passenger strands ("star" miRNAs), which normally undergo intracellular degradation. Using confocal imaging and coculture assays, we identified fibroblast exosomal-derived miR-21_3p (miR-21*) as a potent paracrine-acting RNA molecule that induces cardiomyocyte hypertrophy. Proteome profiling identified sorbin and SH3 domain-containing protein 2 (SORBS2) and PDZ and LIM domain 5 (PDLIM5) as miR-21* targets, and silencing SORBS2 or PDLIM5 in cardiomyocytes induced hypertrophy. Pharmacological inhibition of miR-21* in a mouse model of Ang II-induced cardiac hypertrophy attenuated pathology. These findings demonstrate that cardiac fibroblasts secrete star miRNA-enriched exosomes and identify fibroblast-derived miR-21* as a paracrine signaling mediator of cardiomyocyte hypertrophy that has potential as a therapeutic target.
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Hupa KL, Schmiedl A, Pabst R, Von Hörsten S, Stephan M. Maternal Deprivation Decelerates Postnatal Morphological Lung Development of F344 Rats. Anat Rec (Hoboken) 2013; 297:317-26. [DOI: 10.1002/ar.22848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 11/07/2013] [Indexed: 01/02/2023]
Affiliation(s)
- Katharina Luise Hupa
- Institute of Functional and Applied Anatomy; Hannover Medical School; Hannover Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy; Hannover Medical School; Hannover Germany
| | - Reinhard Pabst
- Institute of Immunomorphology; Hannover Medical School; Hannover Germany
| | - Stephan Von Hörsten
- Department for Experimental Therapy; Franz-Penzoldt-Center, Friedrich-Alexander-University Erlangen-Nürnberg; Erlangen Germany
| | - Michael Stephan
- Clinic for Psychosomatics and Psychotherapy; Hannover Medical School; Hannover Germany
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Plaass C, Abuharbid G, Waizy H, Ochs M, Stukenborg-Colsman C, Schmiedl A. Anatomical variations of the flexor hallucis longus and flexor digitorum longus in the chiasma plantare. Foot Ankle Int 2013; 34:1580-7. [PMID: 23788233 DOI: 10.1177/1071100713494780] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendon are routinely used in reconstructive foot and ankle surgery. The tendons cross in the chiasma plantare and show variable interconnections. This can complicate harvesting of the tendons. Previous anatomical studies were inconclusive and did not reference the connections to surgically relevant landmarks. The purpose of this study was to integrate these conflicting results, introduce a thorough classification system, and analyze the position of the interconnections relative to the surgically relevant bone landmarks. METHODS Sixty embalmed feet of 30 cadavers were analyzed anatomically with respect to the individual cross-links in the planta pedis. All feet were photo documented. The interconnections were classified in a modified classification system and distances to surgically relevant anatomic landmarks measured. RESULTS A proximal to distal connection from the FHL to the FDL was found in 95% of the feet (types I and III), in 3% there was a proximal to distal connection from the FDL to the FHL (type II) tendon only, and in 30% a crossed connection (type III) was found. The average point of branching of the FHL and FDL tendon was 5.3 and 4.6 cm distal to the medial malleolus, respectively. CONCLUSION Our modified classification system accommodated all found variations. In over 90% of the feet, a proximal to distal connection from the FHL to the FDL was found, which might contribute to the residual function of the lesser toes after FDL transfer. CLINICAL RELEVANCE The exact knowledge of the anatomy of the crossing of FDL and FHL in the plantar foot is essential to facilitate tendon harvesting, reduce morbidity and explain possible postoperative functional loss.
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Affiliation(s)
- Christian Plaass
- Department for Orthopedic Surgery, Hannover Medical School, Hannover, Germany
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Stephan M, Suhling H, Schade J, Wittlake M, Tasic T, Klemann C, Pabst R, Jurawitz MC, Raber KA, Hoymann HG, Braun A, Glaab T, Hoffmann T, Schmiedl A, von Hörsten S. Effects of dipeptidyl peptidase-4 inhibition in an animal model of experimental asthma: a matter of dose, route, and time. Physiol Rep 2013; 1:e00095. [PMID: 24303167 PMCID: PMC3841031 DOI: 10.1002/phy2.95] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/20/2013] [Accepted: 08/27/2013] [Indexed: 12/23/2022] Open
Abstract
The CD26-associated enzymatic activity of dipeptidyl peptidase-4 (DPP4) as well as the recruitment of CD26(+) T cells increase under allergic airway inflammation. Furthermore, genetic deficiency of CD26/DPP4 exerts protective effects in experimental asthma. Therefore, CD26/DPP4 might represent a novel therapeutic target in asthma. To study the effects of pharmacological inhibition of DPP4 on allergic airway inflammation the DPP4-inhibitor isoleucine thiazolidide was tested using different doses at different time points (at sensitization, immediately before and simultaneously with the allergen challenge, as well as continuously via drinking water), and different routes (intraperitoneal, oral, and by inhalation). Allergic-like airway inflammation was induced in Fischer 344 rats (Charles River) sensitized against ovalbumin (OVA) using OVA aerosols. Intraperitoneal application of the DPP4 inhibitor showed effects neither at sensitization nor at challenge, whereas a continuous application via drinking water using high doses of the inhibitor led to an aggravation of the histomorphological signs of airway inflammation. In contrast, aerosolization of the DPP4 inhibitor simultaneously with the allergen significantly reduced airway hyperresponsiveness and ameliorated histopathological signs compared to controls. In addition, this treatment resulted in increased mRNA levels of surfactant proteins, suggesting an involvement of DPP4 inhibitors in surfactant metabolism in OVA-challenged rats. Continuous systemic inhibition of DPP4 via the oral route aggravates allergic airway inflammation. In contrast, topical inhibition of DPP4 exerts potential protective effects, and further research in humans is needed.
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Affiliation(s)
- Michael Stephan
- Institute of Functional and Applied Anatomy, Hannover Medical School Hannover, Germany ; Clinic of Psychosomatics and Psychotherapy, Hannover Medical School Hannover, Germany
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Dettmer S, Schmiedl A, Meyer S, Giesemann A, Pabst R, Weidemann J, Wacker FK, Kirchhoff T. Radiological anatomy - evaluation of integrative education in radiology. ROFO-FORTSCHR RONTG 2013; 185:838-43. [PMID: 23888474 DOI: 10.1055/s-0033-1335048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Evaluation and analysis of the integrative course "Radiological Anatomy" established since 2007 at the Medical School Hannover (MHH) in comparison with conventional education. MATERIALS AND METHODS Anatomy and radiology are usually taught separately with a considerable time lag. Interdisciplinary teaching of these associated subjects seems logical for several reasons. Therefore, the integrative course "Radiological Anatomy" was established in the second year of medical education, combining these two closely related subjects. This interdisciplinary course was retrospectively evaluated by consideration of a student questionnaire and staff observations. The advantages and disadvantages of integrative teaching in medical education are discussed. RESULTS The course ratings were excellent (median 1; mean 1.3 on a scale of 1 to 6). This is significantly (p < 0.001) better than the average of all evaluated courses in the respective term (grade 2.8). The course improved the anatomical comprehension (90 %) and the students stated that the topics were relevant for their future medical education (90 %). Furthermore, interest in the subject's anatomy and radiology increased during the course (88 %). According to the students' suggestions the course was enhanced by a visitation in the Department of Radiology and the additional topic central nervous system. CONCLUSION Integrative teaching of anatomy and radiology was well received by the students. Both, anatomical and radiological comprehension and the motivation to learn were improved. However, it should be considered, that the amount of work and time required by the teaching staff is considerably increased compared to traditional teaching.
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Affiliation(s)
- S Dettmer
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Germany.
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Bader A, Brodarac A, Hetzer R, Kurtz A, Stamm C, Baraki H, Kensah G, Asch S, Rojas S, Martens A, Gruh I, Haverich A, Kutschka I, Cortes-Dericks L, Froment L, Kocher G, Schmid RA, Delyagina E, Schade A, Scharfenberg D, Skorska A, Lux C, Li W, Steinhoff G, Drey F, Lepperhof V, Neef K, Fatima A, Wittwer T, Wahlers T, Saric T, Choi YH, Fehrenbach D, Lehner A, Herrmann F, Hollweck T, Pfeifer S, Wintermantel E, Kozlik-Feldmann R, Hagl C, Akra B, Gyongyosi M, Zimmermann M, Pavo N, Mildner M, Lichtenauer M, Maurer G, Ankersmit J, Hacker S, Mittermayr R, Mildner M, Haider T, Nickl S, Zimmermann M, Beer L, Lebherz-Eichinger D, Schweiger T, Mitterbauer A, Keibl C, Werba G, Frey M, Ankersmit HJ, Herrmann S, Lux CA, Steinhoff G, Holfeld J, Tepekoylu C, Wang FS, Kozaryn R, Schaden W, Grimm M, Wang CJ, Holfeld J, Tepekoylu C, Kozaryn R, Urbschat A, Zacharowski K, Grimm M, Paulus P, Avaca MJ, Kempf H, Malan D, Sasse P, Fleischmann B, Palecek J, Drager G, Kirschning A, Zweigerdt R, Martin U, Katsirntaki K, Haller R, Ulrich S, Sgodda M, Puppe V, Duerr J, Schmiedl A, Ochs M, Cantz T, Mall M, Martin U, Mauritz C, Kensah G, Lara AR, Dahlmann J, Zweigerdt R, Schwanke K, Hegermann J, Skvorc D, Gawol A, Azizian A, Wagner S, Krause A, Drager G, Ochs M, Haverich A, Gruh I, Martin U, Klopsch C, Gaebel R, Kaminski A, Chichkov B, Jockenhoevel S, Steinhoff G, Klose K, Roy R, Brodarac A, Kang KS, Bieback K, Nasseri B, Choi YH, Kurtz A, Stamm C, Lepperhof V, Polchynska O, Kruttwig K, Bruggemann C, Xu G, Drey F, Neef K, Saric T, Lichtenauer M, Werba G, Mildner M, Baumgartner A, Hasun M, Nickl S, Beer L, Mitterbauer A, Zimmermann M, Gyongyosi M, Podesser BK, Ankersmit HJ, Ludwig M, Tolk A, Skorska A, Noack T, Steinhoff G, Margaryan R, Assanta N, Menciassi A, Burchielli S, Matteucci M, Lionetti V, Luchi C, Cariati E, Coceani F, Murzi B, Martens A, Rojas SV, Kensah G, Rotarmel A, Baraki H, Haverich A, Martin U, Gruh I, Kutschka I, Nasseri BA, Klose K, Ebell W, Dandel M, Kukucka M, Gebker R, Choi YH, Hetzer R, Stamm C, Paulus P, Holfeld J, Urbschat A, Mutlak H, Ockelmann P, Tacke S, Zacharowski K, Scheller B, Pereszlenyi A, Rojas SV, Martens A, Baraki H, Schwanke K, Zweigerdt R, Martin U, Haverich A, Kutschka I, Rojas SV, Martens A, Meier M, Baraki H, Schecker N, Rathert C, Zweigerdt R, Martin U, Haverich A, Kutschka I, Roy R, Brodarac A, Kukucka M, Kurtz A, Becher PM, Choi YH, Drori-Carmi N, Bercovich N, Zahavi-Goldstein E, Jack M, Netzer N, Pinzur L, Chajut A, Tschope C, Stamm C, Ruch U, Kaminski A, Strauer BE, Tiedemann G, Steinhoff G, Schade A, Delyagina E, Scharfenberg D, Lux C, Steinhoff G, Schlegel F, Dhein S, Akhavuz O, Mohr FW, Dohmen PM, Schlegel F, Salameh A, Oelmann K, Kiefer P, Dhein S, Mohr FW, Dohmen PM, Schwanke K, Merkert S, Templin C, Jara-Avaca M, Muller S, Haverich A, Martin U, Zweigerdt R, Skorska A, von Haehling S, Ludwig M, Slavic S, Curato C, Altarche-Xifro W, Unger T, Steinhoff G, Li J, Zhang Y, Li WZ, Ou L, Lux CA, Ma N, Steinhoff G, Haase A, Alt R, Schwanke K, Martin U. 3rd EACTS Meeting on Cardiac and Pulmonary Regeneration Berlin-Brandenburgische Akademie, Berlin, Germany, 14-15 December 2012. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivs561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schmeckebier S, Mauritz C, Katsirntaki K, Sgodda M, Puppe V, Duerr J, Schubert SC, Schmiedl A, Lin Q, Paleček J, Draeger G, Ochs M, Zenke M, Cantz T, Mall MA, Martin U. Keratinocyte growth factor and dexamethasone plus elevated cAMP levels synergistically support pluripotent stem cell differentiation into alveolar epithelial type II cells. Tissue Eng Part A 2013; 19:938-51. [PMID: 23176317 DOI: 10.1089/ten.tea.2012.0066] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Alveolar epithelial type II (ATII)-like cells can be generated from murine embryonic stem cells (ESCs), although to date, no robust protocols applying specific differentiation factors are established. We hypothesized that the keratinocyte growth factor (KGF), an important mediator of lung organogenesis and primary ATII cell maturation and proliferation, together with dexamethasone, 8-bromoadenosine-cAMP, and isobutylmethylxanthine (DCI), which induce maturation of primary fetal ATII cells, also support the alveolar differentiation of murine ESCs. Here we demonstrate that the above stimuli synergistically potentiate the alveolar differentiation of ESCs as indicated by increased expression of the surfactant proteins (SP-) C and SP-B. This effect is most profound if KGF is supplied not only in the late stage, but at least also during the intermediate stage of differentiation. Our results indicate that KGF most likely does not enhance the generation of (mes)endodermal or NK2 homeobox 1 (Nkx2.1) expressing progenitor cells but rather, supported by DCI, accelerates further differentiation/maturation of respiratory progeny in the intermediate phase and maturation/proliferation of emerging ATII cells in the late stage of differentiation. Ultrastructural analyses confirmed the presence of ATII-like cells with intracellular composite and lamellar bodies. Finally, induced pluripotent stem cells (iPSCs) were generated from transgenic mice with ATII cell-specific lacZ reporter expression. Again, KGF and DCI synergistically increased SP-C and SP-B expression in iPSC cultures, and lacZ expressing ATII-like cells developed. In conclusion, ATII cell-specific reporter expression enabled the first reliable proof for the generation of murine iPSC-derived ATII cells. In addition, we have shown KGF and DCI to synergistically support the generation of ATII-like cells from ESCs and iPSCs. Combined application of these factors will facilitate more efficient generation of stem cell-derived ATII cells for future basic research and potential therapeutic application.
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Affiliation(s)
- Sabrina Schmeckebier
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
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Tutdibi E, Monz D, Hert L, Tschernig T, Laschke MW, Schmiedl A, Gortner L. Vitamin A as a growth factor for the lung – data from neonatal mice. Klin Padiatr 2012. [DOI: 10.1055/s-0032-1330785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Monz D, Tutdibi E, Mildau CF, Shen J, Kasoha M, Laschke MW, Tschernig T, Roolfs T, Schmiedl A, Gortner L. Experimental BPD – cells from human umbilical cord blood improve lung development in a double-hit mouse model. Klin Padiatr 2012. [DOI: 10.1055/s-0032-1330782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mauritz C, Schmeckebier S, Katsirntaki K, Sgodda M, Puppe V, Duerr J, Schubert S, Schmiedl A, Ochs M, Cantz T, Mall M, Martin U. Key factors for the differentiation of embryonic and induced pluripotent stem cells into respiratory epithelial cells. Pneumologie 2012. [DOI: 10.1055/s-0032-1315507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Steinwede K, Maus R, Bohling J, Voedisch S, Braun A, Ochs M, Schmiedl A, Länger F, Gauthier F, Roes J, Welte T, Bange FC, Niederweis M, Bühling F, Maus UA. Cathepsin G and neutrophil elastase contribute to lung-protective immunity against mycobacterial infections in mice. J Immunol 2012; 188:4476-87. [PMID: 22461690 DOI: 10.4049/jimmunol.1103346] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The neutrophil serine proteases cathepsin G (CG) and neutrophil elastase (NE) are involved in immune-regulatory processes and exert antibacterial activity against various pathogens. To date, their role and their therapeutic potential in pulmonary host defense against mycobacterial infections are poorly defined. In this work, we studied the roles of CG and NE in the pulmonary resistance against Mycobacterium bovis bacillus Calmette-Guérin (BCG). CG-deficient mice and even more pronounced CG/NE-deficient mice showed significantly impaired pathogen elimination to infection with M. bovis BCG in comparison to wild-type mice. Moreover, granuloma formation was more pronounced in M. bovis BCG-infected CG/NE-deficient mice in comparison to CG-deficient and wild-type mice. A close examination of professional phagocyte subsets revealed that exclusively neutrophils shuttled CG and NE into the bronchoalveolar space of M. bovis BCG-infected mice. Accordingly, chimeric wild-type mice with a CG/NE-deficient hematopoietic system displayed significantly increased lung bacterial loads in response to M. bovis BCG infection. Therapeutically applied human CG/NE encapsulated in liposomes colocalized with mycobacteria in alveolar macrophages, as assessed by laser scanning and electron microscopy. Importantly, therapy with CG/NE-loaded liposomes significantly reduced mycobacterial loads in the lungs of mice. Together, neutrophil-derived CG and NE critically contribute to deceleration of pathogen replication during the early phase of antimycobacterial responses. In addition, to our knowledge, we show for the first time that liposomal encapsulated CG/NE exhibit therapeutic potential against pulmonary mycobacterial infections. These findings may be relevant for novel adjuvant approaches in the treatment of tuberculosis in humans.
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Affiliation(s)
- Kathrin Steinwede
- Department of Experimental Pneumology, Hannover Medical School, Hannover 30625, Germany
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Neuhaus M, Munder A, Tschernig T, Hörsten SV, Ochs M, Schmiedl A. Einfluss einer CD26-Defizienz auf die Lungeninfektion mit Pseudomonas Aeruginosa in einem F344 Rattenmodell. Pneumologie 2011. [DOI: 10.1055/s-0031-1296130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Schwille PO, Schmiedl A, Manoharan M, Wipplinger J. Idiopathic Recurrent Calcium Urolithiasis (IRCU): pathophysiology evaluated in light of oxidative metabolism, without and with variation of several biomarkers in fasting urine and plasma--a comparison of stone-free and -bearing male patients, emphasizing mineral, acid-base, blood pressure and protein status. Eur J Med Res 2011; 16:349-66. [PMID: 21813378 PMCID: PMC3351987 DOI: 10.1186/2047-783x-16-8-349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND IRCU is traditionally considered as life?style disease (associations with, among others, overweight, obesity, hypertension, type-2 diabetes), arising from excess, in 24 h urine, of calcium (Ca) salts (calcium oxalate (CaOx), calcium phosphate (CaPi)), supersaturation of, and crystallization in, tubular fluid and urine, causing crystal-induced epithelial cell damage, proteinuria, crystal aggregation and uroliths. METHODS Another picture emerges from the present uncontrolled study of 154 male adult IRCU patients (75 stone-bearing (SB) and 79 age-matched stone-free (SF)), in whom stone-forming and other parameters in fasting urine and plasma were contrasted with five biomarkers (see footnote) of oxidative metabolism (OM), without and with variation of markers. RESULTS 1) In SB vs. SF unstratified OM biomarkers were statistically unchanged, but the majority of patients was overweight; despite, in SB vs. SF urine pH, total and non-albumin protein concentration were elevated, fractional urinary uric acid excretion and blood bicarbonate decreased, whereas urine volume, sodium, supersaturation with CaOx and CaPi (as hydroxyapatite) were unchanged; 2) upon variation of OM markers (strata below and above median) numerous stone parameters differed significantly, among others urine volume, total protein, Ca/Pi ratio, pH, sodium, potassium, plasma Ca/Pi ratio and parathyroid hormone, blood pressure, renal excretion of non-albumin protein and other substances; 3) a significant shift from SF to SB patients occurred with increase of urine pH, decrease of blood bicarbonate, and increase of diastolic blood pressure, whereas increase of plasma uric acid impacted only marginally; 4) in both SF and SB patients a strong curvilinear relationship links a rise of urine Ca/Pi to urine Ca/Pi divided by plasma Ca/Pi, but in SB urine Ca/Pi failed to correlate significantly with urine hydroxyapatite supersaturation; 5) also in SB, plasma Ca/Pi and urinary nitrate were negatively correlated, whereas in SF plasma Ca/Pi ratio, PTH and body mass index correlated positively; 6) multivariate regression analysis revealed that PTH, body mass index and nitrate together could explain 22 (p = 0.002) and only 7 (p = 0.06) per cent of variation of plasma Ca/Pi in SF and SB, respectively. CONCLUSIONS In IRCU a) numerous constituents of fasting urine, plasma, blood and blood pressure change in response to variation of OM biomarkers, suggesting involvement of OM imbalance as factor in functional deterioration of tissue; b) in the majority of patients a positive exponential relationship links urine Ca/Pi to urine Ca/Pi divided by plasma Ca/Pi, presumably to accumulate Ca outside tubular lumen, thereby minimizing intratubular and urinary Ca salt crystallization; c) alteration of interactions of low urine nitrate, PTH and Ca/Pi in plasma may be of importance in formation of new Ca stone and co-regulation of dynamics of blood vasculature; d) overweight, combined with OM-modified renal interstitial environment appears to facilitate these processes, carrying the risk that CaPi mineral develops within or/and close to blood vessel tissue, and spreads towards urothelium. - For future research focussing on IRCU pathogenesis studies are recommended on the role of affluent lifestyle mediated renal ischemia, mild hypertensive nephropathy, rise of uric acid precursor oxypurines and uricemia, clarifying also why loss of significance of interrelationships of OM biomarkers with traditional Ca stone risk factors is characteristic for SB patients.
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Heine J, Schmiedl A, Cebotari S, Karck M, Mertsching H, Haverich A, Kallenbach K. Tissue engineering human small-caliber autologous vessels using a xenogenous decellularized connective tissue matrix approach: preclinical comparative biomechanical studies. Artif Organs 2011; 35:930-40. [PMID: 21732955 DOI: 10.1111/j.1525-1594.2010.01199.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Suggesting that bioartificial vascular scaffolds cannot but tissue-engineered vessels can withstand biomechanical stress, we developed in vitro methods for preclinical biological material testings. The aim of the study was to evaluate the influence of revitalization of xenogenous scaffolds on biomechanical stability of tissue-engineered vessels. For measurement of radial distensibility, a salt-solution inflation method was used. The longitudinal tensile strength test (DIN 50145) was applied on bone-shaped specimen: tensile/tear strength (SigmaB/R), elongation at maximum yield stress/rupture (DeltaB/R), and modulus of elasticity were determined of native (NAs; n = 6), decellularized (DAs; n = 6), and decellularized carotid arteries reseeded with human vascular smooth muscle cells and human vascular endothelial cells (RAs; n = 7). Radial distensibility of DAs was significantly lower (113%) than for NAs (135%) (P < 0.001) or RAs (127%) (P = 0.018). At levels of 120 mm Hg and more, decellularized matrices burst (120, 160 [n = 2] and 200 mm Hg). Although RAs withstood levels up to 300 mm Hg, ANOVA revealed a significant difference from NA (P = 0.018). Compared with native vessels (NAs), SigmaB/R values were lower in DAs (44%; 57%) (P = 0.014 and P = 0.002, respectively) and were significantly higher in RAs (71%; 83%) (both P < 0.001). Similarly, DeltaB/R values were much higher in DAs compared with NAs (94%; 88%) (P < 0.001) and RAs (87%; 103%) (P < 0.001), but equivalent in NAs and RAs. Modulus of elasticity (2.6/1.1/3.7 to 16.6 N/mm(2)) of NAs, DAs, RAs was comparable (P = 0.088). Using newly developed in vitro methods for small-caliber vascular graft testing, this study proved that revitalization of decellularized connective tissue scaffolds led to vascular graft stability able to withstand biomechanical stress mimicking the human circulation. This tissue engineering approach provides a sufficiently stable autologized graft.
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Affiliation(s)
- Jörg Heine
- Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Germany.
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Schmiedl A, Behrens J, Zscheppang K, Purevdorj E, von Mayersbach D, Liese A, Dammann CEL. Lipopolysaccharide-induced injury is more pronounced in fetal transgenic ErbB4-deleted lungs. Am J Physiol Lung Cell Mol Physiol 2011; 301:L490-9. [PMID: 21724861 DOI: 10.1152/ajplung.00131.2010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pulmonary ErbB4 deletion leads to a delay in fetal lung development, alveolar simplification, and lung function disturbances in adult mice. We generated a model of intrauterine infection in ErbB4 transgenic mice to study the additive effects of antenatal LPS administration and ErbB4 deletion during fetal lung development. Pregnant mice were treated intra-amniotically with an LPS dose of 4 μg at E17 of gestation. Lungs were analyzed 24 h later. A significant influx of inflammatory cells was seen in all LPS-treated lungs. In heterozygote control lungs, LPS treatment resulted in a delay of lung morphogenesis characterized by a significant increase in the fraction of mesenchyme, a decrease in gas exchange area, and disorganization of elastic fibers. Surfactant protein (Sftp)b and Sftpc were upregulated, but mRNA of Sftpb and Sftpc was downregulated compared with non-LPS-treated controls. The mRNA of Sftpa1 and Sftpd was upregulated. In ErbB4-deleted lungs, the LPS effects were more pronounced, resulting in a further delay in morphological development, a more pronounced inflammation in the parenchyma, and a significant higher increase in all Sftp. The effect on Sftpb and Sftpc mRNA was somewhat different, resulting in a significant increase. These results imply a major role of ErbB4 in LPS-induced signaling in structural and functional lung development.
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Affiliation(s)
- Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
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Tasic T, Bäumer W, Schmiedl A, Schwichtenhövel F, Pabst R, Raap U, von Hörsten S, Stephan M. Dipeptidyl peptidase IV (DPP4) deficiency increases Th1-driven allergic contact dermatitis. Clin Exp Allergy 2011; 41:1098-107. [PMID: 21672052 DOI: 10.1111/j.1365-2222.2011.03778.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND CD26 or dipeptidyl peptidase IV (DPP4) is known to be involved in several immunological processes and has recently been reported to play a crucial role in the allergic responses of the lungs. OBJECTIVES To explore the impact of DPP4 on the allergic response of the skin. METHODS Skin biopsies from patients suffering from atopic dermatitis (AD) and healthy controls were investigated for the expression of CD26/DPP4. Furthermore, the functional impact of CD26 was investigated in two models of contact hypersensitivity using CD26/DPP4-deficient and wild-type rats. Dinitrochlorobenzene (DNCB) was used to induce a T helper type 1 (Th1)-dominated inflammation and toluene-2,3-diisocyanate for a Th2-pronounced inflammation. The inflammatory responses were determined by histological quantification, flow cytometry [fluorescence-activated cell sorting (FACS)], and an enzyme-linked immunosorbant assay (ELISA). RESULTS CD26/DPP4-expression was up-regulated in the lesional skin biopsies of patients compared with healthy controls as well as in both models of contact hypersensitivity. However, in the more Th2-driven model, a reduced inflammatory skin response was found in CD26/DPP4-deficient rats, analogous to the effects observed recently in a rat model of asthma. In partial contrast, there was an aggravation of local skin inflammation in CD26/DPP4-deficient rats under conditions of Th1-like skin inflammation. CONCLUSION AND CLINICAL RELEVANCE The up-regulation of CD26 in atopic dermatitis represents a new finding, which has also been seen in other inflammatory skin diseases. However, tissue expression of CD26/DPP4 in immunological skin response can either be beneficial or aggravating, depending on a possible Th1/Th2 shift. This might have consequences for humans suffering from diabetes mellitus treated by DPP4 inhibitors, who have eczematous skin diseases as a co-morbidity.
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Affiliation(s)
- T Tasic
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
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Heine J, Schmiedl A, Cebotari S, Mertsching H, Karck M, Haverich A, Kallenbach K. Preclinical Assessment of a Tissue-Engineered Vasomotive Human Small-Calibered Vessel Based on a Decellularized Xenogenic Matrix: Histological and Functional Characterization. Tissue Eng Part A 2011; 17:1253-61. [DOI: 10.1089/ten.tea.2010.0375] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Jörg Heine
- Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Hannover, Germany
- Leibniz Research Laboratory for Biotechnology and Artificial Organs (LEBAO), Hannover, Germany
- Oral- and Craniomaxillofacial and Facial Plastic Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Andreas Schmiedl
- Department of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Serghei Cebotari
- Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Hannover, Germany
- Leibniz Research Laboratory for Biotechnology and Artificial Organs (LEBAO), Hannover, Germany
| | - Heike Mertsching
- Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Hannover, Germany
- Leibniz Research Laboratory for Biotechnology and Artificial Organs (LEBAO), Hannover, Germany
- Fraunhofer IGB Stuttgart, Stuttgart, Germany
| | - Matthias Karck
- Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Hannover, Germany
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Axel Haverich
- Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Hannover, Germany
- Leibniz Research Laboratory for Biotechnology and Artificial Organs (LEBAO), Hannover, Germany
| | - Klaus Kallenbach
- Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Hannover, Germany
- Leibniz Research Laboratory for Biotechnology and Artificial Organs (LEBAO), Hannover, Germany
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Kerber-Momot T, Munder A, Schmiedl A, Leemhuis D, Herden A, Ochs M. MK2-/--Mäuse zeigen eine beeinträchtigte Immunantwort nach einer Infektion mit virulenten Pseudomonas aeruginosa in der Lunge. Pneumologie 2011. [DOI: 10.1055/s-0031-1272013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schmiedl A, Krainski J, Schwichtenhövel F, Schade J, Klemann C, Raber KA, Zscheppang K, Beekmann T, Acevedo C, Glaab T, Wedekind D, Pabst R, von Hörsten S, Stephan M. Reduced airway inflammation in CD26/DPP4-deficient F344 rats is associated with altered recruitment patterns of regulatory T cells and expression of pulmonary surfactant proteins. Clin Exp Allergy 2011; 40:1794-808. [PMID: 20560982 DOI: 10.1111/j.1365-2222.2010.03547.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION CD26 is highly expressed on lung epithelial cells as well as on immune cells. Ovalbumin (OVA)-induced airway inflammation induces a further increase of CD26 expression. CD26-deficient rat strains exhibit blunted clinical courses in models of experimental asthma. OBJECTIVE (1) To investigate the involvement of regulatory T cells (Tregs) and the surfactant system in a rat model of genetic CD26 deficiency. (2) To investigate regulatory mechanisms dependent on the endogenous CD26 expression. (3) To investigate the impact of CD26 on surfactant protein (SP)-levels under inflammatory conditions. METHODS Wild-type and CD26-deficient F344 rats were sensitized to and challenged with OVA. Subsequently, airway inflammation, SP levels as well as surface tension of the bronchoalveolar lavage (BAL) fluid were evaluated. RESULTS CD26 deficiency led to decreased airway inflammation, e.g. reduced numbers of eosinophils and activated T cells in the BAL. Remarkably, the CD26-deficient rats exhibited a significantly increased influx of FoxP3(+) Tregs into the lungs and increased IL-10-secretion/production by draining lymph node cells in culture experiments. Furthermore, in OVA-challenged CD26-deficient rats, the increase of the expression of the collectins SP-A and SP-D as well as of the surface tension-active SP-B was significantly less pronounced than in the CD26-positive strain. Only in the wild-type rats, functional alterations of the surfactant system, e.g. the increased surface tension were obvious after OVA challenge. CONCLUSION Reduced airway inflammation in CD26-deficient F344 rats appear to be mediated by differences in the recruitment and activity of Tregs. This altered inflammation is associated with differences in the SP expression as well as function.
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Affiliation(s)
- A Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.
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Zscheppang K, Dörk T, Schmiedl A, Jones FE, Dammann CEL. Neuregulin receptor ErbB4 functions as a transcriptional cofactor for the expression of surfactant protein B in the fetal lung. Am J Respir Cell Mol Biol 2011; 45:761-7. [PMID: 21317380 DOI: 10.1165/rcmb.2010-0179oc] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Sufficient pulmonary surfactant production is required for the fetal-neonatal transition, especially in preterm infants. Neuregulin (NRG) and its transmembrane receptor ErbB4 positively regulate the onset of fetal surfactant synthesis. Details of this signaling process remain to be elucidated. ErbB4 is known to regulate gene expression in the mammary gland, where the receptor associates with the signal transducer and activator of transcription Stat5a to transactivate the β-casein gene promoter. We hypothesized that in the fetal lung, ErbB4 functions as a transcriptional regulator for surfactant protein B (Sftpb), the most critical surfactant protein gene. Re-expressing full-length ErbB4 in primary fetal ErbB4-depleted Type II epithelial cells led to an increased expression of Sftpb mRNA. This stimulatory effect required the nuclear translocation of ErbB4 and association with Stat5a, with the resultant binding to and activation of the Sftpb promoter. We conclude that ErbB4 directly regulates important aspects of fetal lung maturation that help prepare for the fetal-neonatal transition.
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Affiliation(s)
- Katja Zscheppang
- Department of Pediatrics, Hannover Medical School, Hannover, Germany
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Müller HC, Hellwig K, Rosseau S, Tschernig T, Schmiedl A, Gutbier B, Schmeck B, Hippenstiel S, Peters H, Morawietz L, Suttorp N, Witzenrath M. Simvastatin attenuates ventilator-induced lung injury in mice. Crit Care 2010; 14:R143. [PMID: 20673352 PMCID: PMC2945124 DOI: 10.1186/cc9209] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 05/13/2010] [Accepted: 07/30/2010] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Mechanical ventilation (MV) is a life saving intervention in acute respiratory failure without alternative. However, particularly in pre-injured lungs, even protective ventilation strategies may evoke ventilator-induced lung injury (VILI), which is characterized by pulmonary inflammation and vascular leakage. Adjuvant pharmacologic strategies in addition to lung protective ventilation to attenuate VILI are lacking. Simvastatin exhibited anti-inflammatory and endothelial barrier stabilizing properties in vitro and in vivo. METHODS Mice were ventilated (12 ml/kg; six hours) and subjected to simvastatin (20 mg/kg) or sham treatment. Pulmonary microvascular leakage, oxygenation, pulmonary and systemic neutrophil and monocyte counts and cytokine release in lung and blood plasma were assessed. Further, lung tissue was analyzed by electron microscopy. RESULTS Mechanical ventilation induced VILI, displayed by increased pulmonary microvascular leakage and endothelial injury, pulmonary recruitment of neutrophils and Gr-1high monocytes, and by liberation of inflammatory cytokines in the lungs. Further, VILI associated systemic inflammation characterized by blood leukocytosis and elevated plasma cytokines was observed. Simvastatin treatment limited pulmonary endothelial injury, attenuated pulmonary hyperpermeability, prevented the recruitment of leukocytes to the lung, reduced pulmonary cytokine levels and improved oxygenation in mechanically ventilated mice. CONCLUSIONS High-dose simvastatin attenuated VILI in mice by reducing MV-induced pulmonary inflammation and hyperpermeability.
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Affiliation(s)
- Holger C Müller
- Department of Infectious Diseases and Pulmonary Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
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