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Kaiser A, Dhar LK, Jahan I, Razia S, Talukder A, Ali MS, Nigar K. Coverage of defects over Posterior aspect of Ankle Joint and Heel with Lateral Calcaneal Artery Flap- Experience in Mymensingh Medical College Hospital. Mymensingh Med J 2024; 33:373-377. [PMID: 38557513] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Lateral calcaneal artery flap is randomly used by many Plastic Surgeons for covering any defect on the posterior aspect of heel. A prospective observational study was conducted in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2020 to June 2022, to see the outcome of the flap for coverage of defects over the posterior aspect of ankle joint and heel. A total number of 09 patients, selected by purposive sampling, were included in the study. The age of the patients ranged from 06 years to 70 years. The cause of the defects were post traumatic in 07 cases, electric burn in 01 case and pressure sore in 01 case. The defect sizes varied from 3×2 to 6×3cm. and flap size ranged from 4×2.5 to 7×4.5cm. The follow-up period ranged from 3 to 6 months. All the flaps survived completely without any complications; except in two cases. In one case, there was marginal epidermal necrolysis that healed secondarily without the need of any further surgical intervention. In the other case, there was gangrene of about 0.5 cm area at the flap tip, which was debrided and the resulting wound healed secondarily. The average operating time was 63 minutes. The results were satisfactory on the context of adequate coverage, and flap and donor site morbidity. So, the lateral calcaneal artery flap can be a good and safe option for the coverage of posterior ankle and heel defects.
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Affiliation(s)
- A Kaiser
- Dr Adnan Kaiser, Assistant Professor, Department of Burn and Plastic Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Obenhuber T, Scheier TC, Stutz T, Hug M, Fontein D, Kaiser A, Schoene S, Steiger P, Brugger SD, Zingg W, Schreiber PW. An outbreak of multi-drug-resistant Acinetobacter baumannii on a burns ICU and its control with multi-faceted containment measures. J Hosp Infect 2024; 146:102-108. [PMID: 38219836 DOI: 10.1016/j.jhin.2024.01.002] [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: 11/02/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Patients in burns centres are at high risk of acquiring multi-drug-resistant organisms (MDROs) due to the reduced skin barrier and long hospital stay. METHODS This study reports the investigation and control of an outbreak of MDR Acinetobacter baumannii in a burns centre. The 27 patients hospitalized in the centre during the outbreak were screened regularly, and a total of 132 environmental samples were analysed to identify a potential source. Fourier-transform infra-red (FT-IR) spectroscopy and multi-locus sequence typing were applied to characterize the outbreak strain. RESULTS Between August and November 2022, the outbreak affected eight patients, with 11 infections and three potentially related fatal outcomes. An interdisciplinary and multi-professional outbreak team implemented a bundle strategy with repetitive admission stops, isolation precaution measures, patient screenings, enhanced cleaning and disinfection, and staff education. FT-IR spectroscopy suggested that the outbreak started from a patient who had been repatriated 1 month previously from a country with high prevalence of MDR A. baumannii. Environmental sampling did not identify a common source. Acquisition of the outbreak strain was associated with a higher percentage of body surface area with burn lesions ≥2a [per percent increase: odds ratio (OR) 1.05, 95% confidence interval (CI) 0.99-1.12; P=0.09], and inversely associated with a higher nurse-to-patient ratio (per 0.1 increase: OR 0.34, 95% CI 0.10-1.12; P=0.06). CONCLUSIONS Burn patients with a higher percentage of body surface area with burn lesions ≥2a are at high risk of colonization and infection due to MDROs, particularly during periods of high workload. A multi-faceted containment strategy can successfully control outbreaks due to MDR A. baumannii in a burns centre.
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Affiliation(s)
- T Obenhuber
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - T C Scheier
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - T Stutz
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - M Hug
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - D Fontein
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - A Kaiser
- Institute for Anaesthesiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - S Schoene
- Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - P Steiger
- Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - S D Brugger
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - W Zingg
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - P W Schreiber
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
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Dhar LK, Jahan I, Kaiser A, Razia S, Talukder A, Alam MJ. Developments in Hand Surgery: Experience from a Tertiary Hospital of Northern Bangladesh. Mymensingh Med J 2024; 33:393-401. [PMID: 38557517] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Hand Surgery is a specialized branch of Plastic and Reconstructive surgery. There are many conditions that require hand surgery, for example, congenital deformity, electric or flame burn, mechanical or road traffic injury, and post burn or post traumatic deformity. A retrospective observational study was conducted in the department of Burn and Plastic surgery, Mymensingh Medical College Hospital, Bangladesh during a 2 years period extending from 9th September 2021 to 8th September 2023. The objective of this study was to see the hand surgery status in a tertiary hospital of Bangladesh during the post Covid pandemic period. During this period 236 hand surgery procedures were performed in 176 patients. The age of the patients ranged from 02 to 78 years (Mean 31.14±1.52). One hundred and four (59.0%) were male and 72(41.0%) were female. Thirty-four (19.32%) patients had co-morbidities e.g., Epilepsy, Diabetes Mellitus, Chronic Kidney Diseases and HBsAg +ve. Causes of surgery included, wound due to electric burn 49(27.84%), flame burn 36(20.45%), post traumatic 24(13.64%), post infective 11(06.25%), tumor excision 02(2.24%), Dupuytren's contracture 03(1.70%), congenital anomalies 06(3.41%), post burn scar contractures 41(23.29%), nerve injury 01(00.57%) and carpal tunnel syndrome 01 (00.57%). Procedures were performed: post burn scar contracture release 41(17.37%), syndactly release 06(2.54%), release of post traumatic contracture 06(2.54%), carpal tunnel release 01(00.42%), release of Dupuytren's contracture 03(01.27%), nerve repair 01(00.42%), debridement, amputation and Fillet flap 29(12.29%), split thickness skin graft 46 (19.49%), V-Y advancement flap 06(2.54%), transposition flap 18(07.63%), cross finger flap 16 (06.78%), reverse cross finger flap 02 (00.85%), first dorsal metacarpal artery (FDMA) flap 05 (02.12%), reverse FDMA flap 01 (00.42%), metacarpal artery perforator flap 08(3.39%), radial artery perforator flap 04(01.69%), posterior interosseous artery flap 05(2.12%), abdominal flap 11(04.46%) and flap division and insetting 27(11.44%). Outcome of surgery was satisfactory in 225(95.34%) and 11(04.46%) cases had complications (p value 0.453), which was not significant. So, it can be concluded that the outcome of various types of hand surgery procedures in tertiary hospital of northern Bangladesh during the post Covid period was satisfactory overall.
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Affiliation(s)
- L K Dhar
- Dr Liman Kumar Dhar, Associate Professor and Head, Department of Burn and Plastic Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Teppert K, Winter N, Herbel V, Brandes C, Lennartz S, Engert F, Kaiser A, Schaser T, Lock D. Combining CSPG4-CAR and CD20-CCR for treatment of metastatic melanoma. Front Immunol 2023; 14:1178060. [PMID: 37901209 PMCID: PMC10603253 DOI: 10.3389/fimmu.2023.1178060] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
The prognosis for patients with metastatic melanoma is poor and treatment options are limited. Genetically-engineered T cell therapy targeting chondroitin sulfate proteoglycan 4 (CSPG4), however, represents a promising treatment option, especially as both primary melanoma cells as well as metastases uniformly express CSPG4. Aiming to prevent off-tumor toxicity while maintaining a high cytolytic potential, we combined a chimeric co-stimulatory receptor (CCR) and a CSPG4-directed second-generation chimeric antigen receptor (CAR) with moderate potency. CCRs are artificial receptors similar to CARs, but lacking the CD3ζ activation element. Thus, T cells expressing solely a CCR, do not induce any cytolytic activity upon target cell binding, but are capable of boosting the CAR T cell response when both CAR and CCR engage their target antigens simultaneously. Here we demonstrate that co-expression of a CCR can significantly enhance the anti-tumor response of CSPG4-CAR T cells in vitro as well as in vivo. Importantly, this boosting effect was not dependent on co-expression of both CCR- and CAR-target on the very same tumor cell, but was also achieved upon trans activation. Finally, our data support the idea of using a CCR as a powerful tool to enhance the cytolytic potential of CAR T cells, which might open a novel therapeutic window for the treatment of metastatic melanoma.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Dominik Lock
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
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Chuong MD, McAllister N, Carvallo N, Chundru S, Herrera R, Kaiser A, Hall MD, Kotecha R, Mittauer KE, Alvarez D, McCulloch J, Bassiri-Gharb N, Gutierrez A, Extein J. Patterns of Locoregional Failure After Ablative 5-Fraction Stereotactic MR-Guided on-Table Adaptive Radiation Therapy for Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S14-S15. [PMID: 37784358 DOI: 10.1016/j.ijrobp.2023.06.231] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) SBRT for pancreatic ductal adenocarcinoma (PDAC) is routinely delivered with non-ablative dose to only gross disease resulting in locoregional failure (LRF) rates of >50%, most commonly near the celiac artery (CA) and/or superior mesenteric artery (SMA). It is unclear whether an alternative approach of prescribing ablative dose to gross disease plus elective coverage prevents and/or delays LRF. The study objective was to describe the incidence and anatomic distribution of LRF using this treatment approach. MATERIALS/METHODS A single institution retrospective analysis was performed of non-metastatic PDAC patients who received ablative stereotactic MR-guided on-table adaptive radiation therapy (A-SMART) on a 0.35T MR-Linac from 2018-2022. Median prescribed dose was 50 Gy/5 fractions. Elective coverage (EC), including a margin around the primary tumor, CA, and SMA, to 33-35 Gy/5 fractions became routine in 2019 using a simultaneous integrated boost; the porta hepatis was not routinely covered. LRFs were contoured and defined as out-of-field (OOF), marginal (M), or in-field (IF) if >80%, 20-80%, or <20% of it was outside of the most peripheral prescription isodose line. RESULTS One hundred four patients were evaluated (87% head tumors). 94% had induction chemotherapy (median 4 months), usually FOLFIRINOX (66%) or gemcitabine/nab-paclitaxel (27%). 88% received EC. Median GTV, CTV, PTVgrosstumor, and PTVelective volumes were 29 cc, 90 cc, 64 cc, and 127 cc, respectively. 16 patients (15%) had LRF after a median of 17 months (range: 2.4-30.8) from A-SMART; 13 had scans available for delineating LRF. Median follow-up from A-SMART for the entire cohort vs. LRF was 12 vs. 24 months. LRF involved the primary tumor (31%), retroperitoneal lymph nodes (25%), SMA (19%), porta hepatis (19%), and CA (6%). LRF was OOF, M, or IF in 30.8% (n = 4), 61.5% (n = 8), and 7.7% (n = 1). Distance from the 3 SMA failures to SMA origin was 10 cm (EC used), 9.3 cm (EC used), and 3 cm (no EC). The 1 CA failure involved the CA origin (no EC). Median mean, maximum, and minimum dose of the contoured LRF region on the original plan was 33.3 Gy (range: 9.7-50.3 Gy), 56 Gy (range: 44.2-71.4 Gy), and 11.4 Gy (range: 1.2-22.7 Gy), respectively. Median V20, V25, V30, V35, and V40 of the contoured LRF was 84.3% (range: 16.1-100%), 69.2% (range: 12.5-99.7%), 57.5% (range: 9.3-95.5%), 41.2% (range: 6.8-84.0%), and 32.7% (range: 4.8-71.8%). CONCLUSION This study represents the first patterns of LRF analysis after ablative 5-fraction SBRT for PDAC. Although EC is not currently endorsed by published pancreas SBRT guidelines, our low LRF incidence especially involving the CA/SMA demonstrates that EC should be considered, even when delivering ablative dose. Furthermore, given that nearly all LRF were M or OOF we have considered expanding our institutional elective volumes. While the optimal EC dose is uncertain, 33-35 Gy appears effective in limiting IF LRF and therefore has been standardized within ongoing ablative SBRT trials for PDAC at our institution.
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Affiliation(s)
| | | | | | - S Chundru
- Department of Radiology, Baptist Health South Florida, Miami, FL
| | | | - A Kaiser
- Miami Cancer Institute, Miami, FL
| | - M D Hall
- Miami Cancer Institute, Miami, FL
| | - R Kotecha
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | | | - D Alvarez
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - J McCulloch
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | | | - A Gutierrez
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - J Extein
- Department of Radiology, Baptist Health South Florida, Miami, FL
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Chuong MD, Fellows A, Rzepczynski AE, Kaiser A, Hall MD, Kotecha R, Alvarez D, Bassiri-Gharb N, Gutierrez A, McCulloch J, Mittauer KE, McAllister N. Ablative 5-Fraction CT vs. MR-Guided Pancreatic SBRT: Evaluation of Interfraction Anatomic Changes on Dosimetric Constraints. Int J Radiat Oncol Biol Phys 2023; 117:e289. [PMID: 37785068 DOI: 10.1016/j.ijrobp.2023.06.1282] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) CT-guided SBRT for locally advanced pancreatic cancer (LAPC) is usually non-ablative (BED < 100 Gy10) to minimize grade 3+ toxicity risks given the concern of interfraction anatomic changes (IACs) in GI anatomy and imaging quality associated with kV-CBCT. Emerging data demonstrate that MR guidance facilitates 5-fraction (fx) dose escalation due to superior soft tissue contrast, continuous intrafraction imaging, automatic beam gating, and on-table adaptive replanning capability. Treatment outcomes for ablative 5-fx CT- vs. MR-guided SBRT are not well characterized, nor are differences in predicted GI OAR doses when accounting for IACs. MATERIALS/METHODS Weevaluated 40 plans (20 CT, 20 MR) for 20 LAPC patients (pts) previously treated in breath hold (BH) on a 0.35 T MR-Linac. Prescribed dose was 50 Gy (gross disease) and 33 Gy (elective) in 5 fx using a simultaneous integrated boost technique. CT plans were retrospectively created using 2-3 VMAT arcs with the same prescription dose, target volumes (assuming BH), and constraints (prioritizing OARs over target coverage) as the MR IMRT plans (∼20-40 fields). CT planners were blinded to MR plans. We compared predicted GI OAR dose of CT vs. MR plans across each of the 5 fx for all 20 patients to evaluate the dosimetric impact of IACs by coregistering CT plans to the anatomy of the day based on 0.35T MR scans acquired for GI OAR segmentation and treatment delivery. RESULTS MedianV100% of the GTV, CTV, PTV50, and PTV33 across the original CT vs. MR plans were 97.5% vs. 91.3% (p = 0.017), 99.9% vs. 98.2% (p<0.01), 86.2% vs. 79.3% (p = 0.39), and 97.2% vs. 93.0% (p<0.01), respectively. GI OAR constraints were met for all original CT/MR plans although it was predicted that 1+ GI OAR constraint would be violated (most commonly duodenum) for 88/100 CT vs. 85/100 MR fractions. Across the 88 violated CT fractions, the median predicted GI OAR doses were duodenum V35: 3.3 cc (range: 0.16-18.0cc), duodenum V40: 1.2 cc (range: 0.01-11.9cc), small bowel V35: 1.2 cc (range: 0.4-10.9cc), small bowel V40: 0.2 cc (range: 0.04-7.0cc), stomach V35: 1.5 cc (range: 0.52-6.8cc), stomach V40: 0.3 cc (range: 0.05-2.8cc). GI OAR doses across the 85 violated MR fractions were similar. Median fxs per pt with 1+ predicted GI OAR violation was 5 (range: 1-5) for both CT and MR plans. CONCLUSION This isthe first evaluation of IAC effects on predicted GI OAR dose for 5-fx CT- vs. MR-guided SBRT. Although VMAT arcs facilitated higher target coverage in the initial CT plans, GI OAR constraint violations were observed in 85-88% of CT/MR plans. Although on-table adaptive replanning is routine on MR-guided Linacs it is not commonly available on CT-guided Linacs. As such, ablative 5-fx SBRT delivered with CT guidance is expected to result in significant toxicity due to exceeding GI OAR constraints for most delivered fractions.
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Affiliation(s)
| | | | - A E Rzepczynski
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - A Kaiser
- Miami Cancer Institute, Miami, FL
| | - M D Hall
- Miami Cancer Institute, Miami, FL
| | - R Kotecha
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - D Alvarez
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | | | - A Gutierrez
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - J McCulloch
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
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Nixdorf D, Sponheimer M, Berghammer D, Engert F, Bader U, Philipp N, Kazerani M, Straub T, Rohrbacher L, Wange L, Dapa S, Atar D, Seitz CM, Brandstetter K, Linder A, von Bergwelt M, Leonhardt H, Mittelstaet J, Kaiser A, Bücklein V, Subklewe M. Adapter CAR T cells to counteract T-cell exhaustion and enable flexible targeting in AML. Leukemia 2023:10.1038/s41375-023-01905-0. [PMID: 37106163 DOI: 10.1038/s41375-023-01905-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
Although the landscape for treating acute myeloid leukemia (AML) patients has changed substantially in recent years, the majority of patients will eventually relapse and succumb to their disease. Allogeneic stem cell transplantation provides the best anti-AML treatment strategy, but is only suitable in a minority of patients. In contrast to B-cell neoplasias, chimeric antigen receptor (CAR) T-cell therapy in AML has encountered challenges in target antigen heterogeneity, safety, and T-cell dysfunction. We established a Fab-based adapter CAR (AdCAR) T-cell platform with flexibility of targeting and control of AdCAR T-cell activation. Utilizing AML cell lines and a long-term culture assay for primary AML cells, we were able to demonstrate AML-specific cytotoxicity using anti-CD33, anti-CD123, and anti-CLL1 adapter molecules in vitro and in vivo. Notably, we show for the first time the feasibility of sequential application of adapter molecules of different specificity in primary AML co-cultures. Importantly, using the AML platform, we were able to demonstrate that chronic T-cell stimulation and exhaustion can be counteracted through introduction of treatment-free intervals. As T-cell exhaustion and target antigen heterogeneity are well-known causes of resistance, the AdCAR platform might offer effective strategies to ameliorate these limitations.
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Affiliation(s)
- D Nixdorf
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - M Sponheimer
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - D Berghammer
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - F Engert
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - U Bader
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - N Philipp
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - M Kazerani
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - T Straub
- Core Facility Bioinformatics, Biomedical Center, LMU, Munich, Germany
| | - L Rohrbacher
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - L Wange
- Anthropology and Human Genomics, Faculty of Biology, LMU, Munich, Germany
| | - S Dapa
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - D Atar
- Department of General Pediatrics, Hematology and Oncology, University Children's Hospital Tuebingen, Tuebingen, Germany
| | - C M Seitz
- Department of General Pediatrics, Hematology and Oncology, University Children's Hospital Tuebingen, Tuebingen, Germany
- Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University Tuebingen, Tuebingen, Germany
| | | | - A Linder
- Gene Center and Department of Biochemistry, LMU, Munich, Germany
- Department of Medicine II, University Hospital, LMU, Munich, Germany
| | - M von Bergwelt
- Department of Medicine III, University Hospital, LMU, Munich, Germany
| | - H Leonhardt
- Department of Biology II, LMU, Munich, Germany
| | - J Mittelstaet
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - A Kaiser
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - V Bücklein
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - M Subklewe
- Department of Medicine III, University Hospital, LMU, Munich, Germany.
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany.
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Thomas S, Enders J, Kaiser A, Rovenstine L, Heslop L, Hauser W, Chadwick A, Wright D. Abnormal intraepidermal nerve fiber density in disease: A scoping review. Front Neurol 2023; 14:1161077. [PMID: 37153658 PMCID: PMC10157176 DOI: 10.3389/fneur.2023.1161077] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
Background Intraepidermal nerve fiber density (IENFD) has become an important biomarker for neuropathy diagnosis and research. The consequences of reduced IENFD can include sensory dysfunction, pain, and a significant decrease in quality of life. We examined the extent to which IENFD is being used as a tool in human and mouse models and compared the degree of fiber loss between diseases to gain a broader understanding of the existing data collected using this common technique. Methods We conducted a scoping review of publications that used IENFD as a biomarker in human and non-human research. PubMed was used to identify 1,004 initial articles that were then screened to select articles that met the criteria for inclusion. Criteria were chosen to standardize publications so they could be compared rigorously and included having a control group, measuring IENFD in a distal limb, and using protein gene product 9.5 (PGP9.5). Results We analyzed 397 articles and collected information related to publication year, the condition studied, and the percent IENFD loss. The analysis revealed that the use of IENFD as a tool has been increasing in both human and non-human research. We found that IENFD loss is prevalent in many diseases, and metabolic or diabetes-related diseases were the most studied conditions in humans and rodents. Our analysis identified 73 human diseases in which IENFD was affected, with 71 reporting IENFD loss and an overall average IENFD change of -47%. We identified 28 mouse and 21 rat conditions, with average IENFD changes of -31.6% and -34.7%, respectively. Additionally, we present data describing sub-analyses of IENFD loss according to disease characteristics in diabetes and chemotherapy treatments in humans and rodents. Interpretation Reduced IENFD occurs in a surprising number of human disease conditions. Abnormal IENFD contributes to important complications, including poor cutaneous vascularization, sensory dysfunction, and pain. Our analysis informs future rodent studies so they may better mirror human diseases impacted by reduced IENFD, highlights the breadth of diseases impacted by IENFD loss, and urges exploration of common mechanisms that lead to substantial IENFD loss as a complication in disease.
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Affiliation(s)
| | | | | | | | | | | | | | - Douglas Wright
- Sensory Nerve Disorder Lab, Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
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Thomas S, Enders JD, Rovenstine L, Kaiser A, Heslop L, Hauser W, Chadwick A, Wright D. Intraepidermal Nerve Fiber Density In Disease: A Scoping Review. The Journal of Pain 2023. [DOI: 10.1016/j.jpain.2023.02.163] [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: 04/07/2023]
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Dimachkie Nunnally A, Baczewski L, Sterrett K, Holbrook A, Kaiser A, Kasari C. Profiles and trajectories of executive functioning in young children with Down syndrome. J Intellect Disabil Res 2023; 67:254-270. [PMID: 36642763 DOI: 10.1111/jir.13008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/02/2021] [Revised: 03/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Language acquisition strongly predicts executive functioning (EF) in early childhood in typical development and in children with Down syndrome (DS). Both language and EF are critical contributors to later positive social and academic outcomes yet are often areas of concern in children with DS. Despite the wider availability of interventions targeting language development in DS, no efforts have been made to understand how these interventions may influence the development of EF in this population. METHODS This study examined secondary data from 76 preschoolers with DS collected as part of a randomised waitlist control trial of an early social communication intervention (JASPER-EMT). Children's EF skills were measured using the BRIEF-P, at three timepoints over 6 months. Linear regression was used to examine the baseline relationship between child characteristics and the three indices of the BRIEF-P: Emergent Metacognition, Flexibility and Inhibitory Self-Control. Linear mixed effects models were used to estimate change across the three indices of the BRIEF-P and whether that change was moderated by treatment. RESULTS Children in this sample exhibited an uneven profile of EF at baseline, with relative strengths in the Flexibility Index and the Inhibitory Self-Control Index, and relative weaknesses in the Emerging Metacognition Index. Chronological age was associated with all indices at baseline (all P < 0.05). Children in the intervention group exhibited improvements in the Flexibility Index from entry to exit (3 months later) compared with the control, although this treatment effect did not maintain at the follow up at 6 months. CONCLUSIONS Baseline EF profiles of children were consistent with findings of other studies with children with DS. Longitudinal findings suggest that behavioural interventions targeting language may have positive collateral effects on certain EF skills, however these effects may be transitory without ongoing support. These findings illustrate both the need for further exploration of the impact of early language interventions on EF abilities and the malleability of certain EF domains in young children with DS.
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Affiliation(s)
| | - L Baczewski
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - K Sterrett
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - A Holbrook
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - A Kaiser
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - C Kasari
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Reyes EG, Tonse R, Chuong M, Contreras J, Hall M, Gutierrez A, Kaiser A, Kotecha R, Wroe A, Kalman N. Impact of Treatment Modality on Post-Radiation Imaging in Post-Operative Head and Neck Cancers. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1361] [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: 10/31/2022]
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12
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Reyngold M, O'Reilly E, Herrera R, Kaiser A, Zinovoy M, Romesser P, Wu A, Hajj C, Cuaron J, Ucar A, de Zarraga F, Aparo S, Lu W, Mittauer K, McCulloch J, Romaguera T, Alvarez D, Gutierrez A, Crane C, Chuong M. Multi-Institutional Comparison of Ablative Radiation Therapy in 5 Versus 15-25 Fractions for Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.534] [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: 10/31/2022]
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13
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McCulloch J, Herrera R, Gutierrez A, Romaguera T, Alvarez D, Kotecha R, Kaiser A, Armas J, Abrams K, Mehta M, Chuong M, Mittauer K. Management of Cardiac Implantable Electronic Devices for Patients Receiving MR-Guided Radiotherapy: 4-Year Single Institution Experience. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.513] [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: 11/28/2022]
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14
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Kaiser A, LeGrand L, Valladares M, Chuong M, Kotecha R, Hall M, Gutierrez A, Mehta M. Feasibility and Initial Results of a Daily Wearable Patient-Tracking Device for Optimization of Radiation Machine Utilization and Timely Treatment Delivery. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.916] [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: 11/17/2022]
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Lock D, Monjezi R, Brandes C, Bates S, Lennartz S, Teppert K, Gehrke L, Karasakalidou-Seidt R, Lukic T, Schmeer M, Schleef M, Werchau N, Eyrich M, Assenmacher M, Kaiser A, Prommersberger S, Schaser T, Hudecek M. Automated, scaled, transposon-based production of CAR T cells. J Immunother Cancer 2022; 10:jitc-2022-005189. [PMID: 36096530 PMCID: PMC9472140 DOI: 10.1136/jitc-2022-005189] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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] [Accepted: 08/23/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There is an increasing demand for chimeric antigen receptor (CAR) T cell products from patients and care givers. Here, we established an automated manufacturing process for CAR T cells on the CliniMACS Prodigy platform that is scaled to provide therapeutic doses and achieves gene-transfer with virus-free Sleeping Beauty (SB) transposition. METHODS We used an advanced CliniMACS Prodigy that is connected to an electroporator unit and performed a series of small-scale development and large-scale confirmation runs with primary human T cells. Transposition was accomplished with minicircle (MC) DNA-encoded SB100X transposase and pT2 transposon encoding a CD19 CAR. RESULTS We defined a bi-pulse electroporation shock with bi-directional and unidirectional electric field, respectively, that permitted efficient MC insertion and maintained a high frequency of viable T cells. In three large scale runs, 2E8 T cells were enriched from leukapheresis product, activated, gene-engineered and expanded to yield up to 3.5E9 total T cells/1.4E9 CAR-modified T cells within 12 days (CAR-modified T cells: 28.8%±12.3%). The resulting cell product contained highly pure T cells (97.3±1.6%) with balanced CD4/CD8 ratio and a high frequency of T cells with central memory phenotype (87.5%±10.4%). The transposon copy number was 7.0, 9.4 and 6.8 in runs #1-3, respectively, and gene analyses showed a balanced expression of activation/exhaustion markers. The CD19 CAR T cell product conferred potent anti-lymphoma reactivity in pre-clinical models. Notably, the operator hands-on-time was substantially reduced compared with conventional non-automated CAR T cell manufacturing campaigns. CONCLUSIONS We report on the first automated transposon-based manufacturing process for CAR T cells that is ready for formal validation and use in clinical manufacturing campaigns. This process and platform have the potential to facilitate access of patients to CAR T cell therapy and to accelerate scaled, multiplexed manufacturing both in the academic and industry setting.
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Affiliation(s)
- Dominik Lock
- Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany
| | - Razieh Monjezi
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | - Stephan Bates
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | - Karin Teppert
- Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany
| | - Leon Gehrke
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | - Teodora Lukic
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | | | - Niels Werchau
- Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany
| | - Matthias Eyrich
- Universitätskinderklinik, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | - Andrew Kaiser
- Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany
| | | | | | - Michael Hudecek
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
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Dhar LK, Jahan I, Talukder A, Hossain MA, Kaiser A, Razia S, Sarker B, Anam S, Satter T, Ali A, Bhuiyan MH. A Comparative Study of Collagen Sheet versus 1% Silver Sulfadiazine Dressing in Superficial Partial Thickness Burns. Mymensingh Med J 2022; 31:649-655. [PMID: 35780346] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Burn injury causes a lot of suffering. The goal of burn management is to achieve rapid wound healing, pain relief, rehabilitation with minimum scars and optimal functional ability. Objective of this study was to compare the efficacy of collagen sheets and 1% silver sulfadiazine dressing (SSD) for superficial partial thickness burns. This prospective observational study was conducted among the patients of Department of Plastic surgery, Dhaka Medical College Hospital, and Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, from 1st April 2020 to 31st March 2021. Total 60 patients with superficial partial thickness burns by purposive sampling 30 patients of them were treated with collagen sheet dressing (Group A) and 30 patients with 1.0% silver sulfadiazine dressing (Group B). First case was selected by tossing a coin. Then every alternate patient was provided the same kind of dressing material (either collagen sheet or 1.0% silver sulfadiazine). Data were collected by semi structured data collection sheets. Pearson's chi-square test and student's 't' test were used for data analysis (p value was significant at <0.05). It was observed that a total of 18(60.0%) patients belonged to age <10 years in Group A and 17(56.7%) patients in Group B. The mean age was 14.9±14.2 years in Group A and 11.6±10.2 years in Group B. Good quality of healing was significantly higher in the collagen group compared to the SSD group (<0.05). The mean complete healing time in the collagen group was 10.47±2.21 days and in the 1.0% SSD group were 13.07±2.33 days. The mean healing time was significantly lower in the collagen group compared to the 1.0% SSD group (p<0.001). There was no significant difference in infection rate between the two groups (p>0.05). Considering the overall outcome, Collagen sheet dressing decreases pain, reduces the need for analgesics, aids in early healing as compared to the patients treated with 1% silver sulfadiazine.
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Affiliation(s)
- L K Dhar
- Dr Liman Kumar Dhar, Associate Professor and Head, Department of Burn & Plastic Surgery, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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Seitz CM, Mittelstaet J, Atar D, Hau J, Reiter S, Illi C, Kieble V, Engert F, Drees B, Bender G, Krahl AC, Knopf P, Schroeder S, Paulsen N, Rokhvarguer A, Scheuermann S, Rapp E, Mast AS, Rabsteyn A, Schleicher S, Grote S, Schilbach K, Kneilling M, Pichler B, Lock D, Kotter B, Dapa S, Miltenyi S, Kaiser A, Lang P, Handgretinger R, Schlegel P. Novel adapter CAR-T cell technology for precisely controllable multiplex cancer targeting. Oncoimmunology 2021; 10:2003532. [PMID: 35686214 PMCID: PMC9172918 DOI: 10.1080/2162402x.2021.2003532] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 12/24/2022] Open
Abstract
Chimeric antigen receptor (CAR)-T therapy holds great promise to sustainably improve cancer treatment. However, currently, a broad applicability of CAR-T cell therapies is hampered by limited CAR-T cell versatility and tractability and the lack of exclusive target antigens to discriminate cancerous from healthy tissues. To achieve temporal and qualitative control on CAR-T function, we engineered the Adapter CAR (AdCAR) system. AdCAR-T are redirected to surface antigens via biotin-labeled adapter molecules in the context of a specific linker structure, referred to as Linker-Label-Epitope. AdCAR-T execute highly specific and controllable effector function against a multiplicity of target antigens. In mice, AdCAR-T durably eliminate aggressive lymphoma. Importantly, AdCAR-T might prevent antigen evasion by combinatorial simultaneous or sequential targeting of multiple antigens and are capable to identify and differentially lyse cancer cells by integration of adapter molecule-mediated signals based on multiplex antigen expression profiles. In consequence the AdCAR technology enables controllable, flexible, combinatorial, and selective targeting. Adapter CAR-T cells for multiple synchronic targeting.
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Affiliation(s)
- Christian M. Seitz
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | | | - Daniel Atar
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Jana Hau
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Selina Reiter
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Clara Illi
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Verena Kieble
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Fabian Engert
- R&D Department, Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Britta Drees
- R&D Department, Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Giulia Bender
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Ann-Christin Krahl
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Philipp Knopf
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Germany
| | - Sarah Schroeder
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Nikolas Paulsen
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Alexander Rokhvarguer
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Sophia Scheuermann
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Elena Rapp
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Anna-Sophia Mast
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Armin Rabsteyn
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
- Cluster of Excellence iFIT (Exc 2180) “Image-guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Germany
| | - Sabine Schleicher
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Stefan Grote
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Karin Schilbach
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
| | - Manfred Kneilling
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Germany
- Cluster of Excellence iFIT (Exc 2180) “Image-guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Germany
| | - Bernd Pichler
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Germany
- Cluster of Excellence iFIT (Exc 2180) “Image-guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Germany
| | - Dominik Lock
- R&D Department, Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Bettina Kotter
- R&D Department, Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Sandra Dapa
- R&D Department, Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Stefan Miltenyi
- R&D Department, Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Andrew Kaiser
- R&D Department, Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Peter Lang
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
- Cluster of Excellence iFIT (Exc 2180) “Image-guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Germany
| | - Rupert Handgretinger
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
- Cluster of Excellence iFIT (Exc 2180) “Image-guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Germany
| | - Patrick Schlegel
- Department of General Pediatrics, Hematology and Oncology, University Children’s Hospital Tuebingen, Germany
- Cluster of Excellence iFIT (Exc 2180) “Image-guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Germany
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Cellular Cancer Therapeutics Unit, Children’s Medical Research Institute, Westmead, Australia
- Department of Pediatric Hematology and Oncology, Westmead Children’s Hospital, Westmead, Australia
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Autrey C, Mittauer K, Alvarez D, Chuong M, Contreras J, Gutierrez A, Kaiser A, McCulloch J, Romaguera T, Kalman N. MR-Guided Radiotherapy (MRgRT) for Laryngeal Cancer With Real-Time Visualization of Intrafraction Larynx Motion. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1446] [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: 10/20/2022]
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19
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Kutuk T, McAllister N, Rzepczynski A, Young G, Crawley M, Kaiser A, Contreras J, Kalman N. Submandibular Gland Transfer for the Prevention of Radiation Induced Xerostomia in Head and Neck Cancer — Dosimetric Impact With Intensity Modulated Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1167] [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: 10/20/2022]
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20
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Chuong M, Herrera R, Mustafayev T, Gungor G, Ugurluer G, Atalar B, Kotecha R, Hall M, Rubens M, Mittauer K, Contreras J, Gutierrez A, Kalman N, Alvarez D, Romaguera T, McCulloch J, Garcia J, Kaiser A, Mehta M, Ozyar E. Multi-Institutional Outcomes of Stereotactic Magnetic Resonance Image-Guided Adaptive Radiation Therapy (SMART) With Median Biologically Effective Dose of 100 Gy10 for Oligometastases. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1322] [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: 12/01/2022]
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21
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Walters R, Kutuk T, Williams A, Rosen E, Contreras J, Coutinho L, Gelover Reyes E, Hobson M, Kaiser A, Kalman N. Proton Therapy Specific Salivary Gland Volume Changes After Head and Neck Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1193] [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: 11/28/2022]
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22
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Sabouri P, Yam M, Yu J, Khan F, Gutierrez A, Kaiser A, Chuong M. NTCP-Driven Comparison of Proton Versus VMAT Approaches for Reducing Hematologic and Gastrointestinal Toxicities in Anal Cancer Patients Receiving Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1439] [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: 10/20/2022]
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23
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Chuong M, Herrera R, Chundru S, Gutierrez A, Romaguera T, Alvarez D, Kotecha R, Hall M, McCulloch J, Contreras J, Kaiser A, Mittauer K. Cumulative Target Volume Dose and Locoregional Failure in Pancreatic Cancer Patients With Treated With Ablative Stereotactic MR-Guided Adaptive Radiation Therapy (SMART). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.318] [Citation(s) in RCA: 1] [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: 10/20/2022]
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Gelover Reyes E, Chuong M, Contreras J, Goughenour A, Gutierrez A, Hall M, Kaiser A, Khan F, Kotecha R, Wroe A, Yam M, Kalman N. Evaluation of Biological Dose Enhancement in Mucosal Surfaces of Oropharyngeal Cancer Patients Treated With Ipsilateral Discrete Spot-Scanning Proton Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1173] [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: 11/16/2022]
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25
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Schären M, Snedec T, Riefke B, Slopianka M, Keck M, Gruendemann S, Wichard J, Brunner N, Klein S, Theinert KB, Pietsch F, Leonhardt A, Theile S, Rachidi F, Kaiser A, Köller G, Bannert E, Spilke J, Starke A. Aspects of transition cow metabolomics-Part I: Effects of a metaphylactic butaphosphan and cyanocobalamin treatment on the metabolome in liver, blood, and urine in cows with different liver metabotypes. J Dairy Sci 2021; 104:9205-9226. [PMID: 34024600 DOI: 10.3168/jds.2020-19055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/09/2020] [Accepted: 03/16/2021] [Indexed: 12/17/2022]
Abstract
Dairy cows in modern production systems are at risk to develop metabolic disorders during the transition period. Reasons for individual differences in susceptibility, as well as the underlying pathomechanisms, are still only partially understood. The development of metaphylactic treatment protocols is needed. In this context, an on-farm prospective 3-fold blinded randomized study involving 80 German Holstein cows was performed throughout 1 yr. The trial involved a thorough recording of the production and clinical traits, clinical chemistry, and liver biopsies and blood and urine sampling at d 14 (mean: 12 d, range: 1-26 d) antepartum (AP), and d 7 (7, 4-13) and 28 (28, 23-34) postpartum (PP) for metabolomics analyses. Two groups received a treatment with butaphosphan and cyanocobalamin (BCC) at either the dosage recommended by the manufacturer or the double dosage (5 or 10 mL/100 kg of body weight 10% butaphosphan and 0.005% cyanocobalamin (Catosal, Bayer Animal Health), n = 20 in each group, parity: 4.2 ± 2.0 and 3.4 ± 1.3, respectively (mean ± SD)] and one group a placebo treatment (NaCl 0.9%, n = 40, parity: 4.0 ± 1.9). The animals were treated at 6 time points (7, 6, and 5 d AP, and 1, 2, and 3 d PP) via intravenous injection. Mass spectroscopy-based targeted metabolomics analysis of blood plasma and liver samples were performed using the AbsoluteIDQ p180 kit (Biocrates Life Sciences), whereas the urine samples were analyzed by nuclear magnetic resonance spectroscopy. Statistical analysis was performed using multivariate [partial least squares discriminant analysis (PLS-DA)] and univariate methods (linear mixed model). Multivariate data analysis (PLS-DA plots) of the liver metabolome revealed 3 different metabotypes (A = medium, B = minor, C = large alterations in liver metabolome profile between AP and PP status). Metabotype B animals were characterized by higher PP lipomobilization (stronger PP body condition decrease and higher blood bilirubin, fatty acids, gamma-glutamyltransferase, and triglyceride levels) and a higher occurrence of transition cow diseases, compared with the animals in metabotype C. Analysis of the feeding data showed that the period of metabotype B animals (calving in a distinct time frame) was characterized by a decreased grass silage quality. The PP liver metabolome of the metabotype C animals was characterized by higher concentrations of AA, acylcarnitines, lysoPC and sphingomyelins compared with metabotype B. For the metaphylactic treatment with BCC a dose-dependent effect was confirmed, differing between the metabotypes. In all matrices and metabotypes at various time points significant treatment effects were observed, with different profiles in clinical chemistry and as well in metabolomics data. The most clear-cut treatment effect was observed in metabotype B in the liver at 7 d PP, characterized by an increase in several acylcarnitines and phosphatidylcholines, indicating a more efficient influx and oxidation of fatty acids in mitochondria and thereby an increase in energy supply and more efficient triglyceride export in the liver. The results from the liver metabolomics analysis support the application of an indication-based metaphylactic treatment with BCC.
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Affiliation(s)
- M Schären
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany.
| | - T Snedec
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - B Riefke
- Bayer AG, Pharmaceuticals, Research and Development, 13342 Berlin, Germany
| | - M Slopianka
- Bayer AG, Pharmaceuticals, Research and Development, 13342 Berlin, Germany
| | - M Keck
- Bayer AG, Pharmaceuticals, Research and Development, 13342 Berlin, Germany
| | - S Gruendemann
- Bayer AG, Pharmaceuticals, Research and Development, 13342 Berlin, Germany
| | - J Wichard
- Bayer AG, Pharmaceuticals, Research and Development, 13342 Berlin, Germany
| | - N Brunner
- Bayer Animal Health GmbH, 51373 Leverkusen, Germany
| | - S Klein
- Bayer Animal Health GmbH, 51373 Leverkusen, Germany
| | - K B Theinert
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - F Pietsch
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - A Leonhardt
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - S Theile
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - F Rachidi
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - A Kaiser
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - G Köller
- Laboratory of Large Animal Clinics, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - E Bannert
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - J Spilke
- Biometrics and Informatics in Agriculture Group, Institute of Agricultural and Nutritional Sciences, Martin-Luther University, Halle-Wittenberg, Karl-Freiherr-von-Fritsch-Str. 4, 06108 Halle (Saale), Germany
| | - A Starke
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 11, 04103 Leipzig, Germany
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Pietsch F, Schären M, Snedec T, Theinert KB, Leonhardt AS, Kaiser A, Rachidi F, Böttcher D, Scheinert J, Schoon HA, Wohlsein P, Spilke J, Haudum A, Baumgartner W, Starke A. Aspects of transition cow metabolomics-Part II: Histomorphologic changes in the liver parenchyma throughout the transition period, in cows with different liver metabotypes and effects of a metaphylactic butaphosphan and cyanocobalamin treatment. J Dairy Sci 2021; 104:9227-9244. [PMID: 34024602 DOI: 10.3168/jds.2020-19057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/09/2020] [Accepted: 03/18/2021] [Indexed: 12/13/2022]
Abstract
The aims of this study were to evaluate histopathologic changes during the transition period, describe the histopathological features of the metabotypes identified in Part I (Schären et al., 2021b), and investigate effects of a metaphylactic treatment with butaphosphan and cyanocobalamin (BCC) on the liver parenchyma. Eighty German Holstein cows (mean 305-d production: 10,957 kg, range: 6,480-15,193 kg; mean lactation number: 3.9, range: 2-9) from a commercial dairy farm in Saxony, Germany, were enrolled in a randomized, prospective, triple-blinded study. Two groups received a treatment with BCC (5 or 10 mL/100 kg of body weight 10% butaphosphan and 0.005% cyanocobalamin, Catosal, Bayer Animal Health, n = 20 each) and one group a placebo treatment (NaCl 0.9%, n = 40). Liver biopsy specimens were collected 14 d antepartum (AP) and 7, 28, and 42 d postpartum (PP), routinely processed for histologic examination, and stained with hematoxylin and eosin, Sudan III, periodic acid-Schiff, and picrosirius red stains. The sections were assessed for fat and glycogen content and degenerative, inflammatory, fibrotic, and proliferative changes. The statistical analysis included the effects of the sampling day, the lactation number, the treatment, and the metabotype (A = medium, B = minor, C = large alterations in the liver metabolome profile between AP and PP status). There was mild to moderate fat infiltration in the liver of 37% of cows in the last 2 wk AP, and moderate to severe fat infiltration in 66% of cows in the first days PP. The degree of fat infiltration increased from 2 wk AP until the end of the first week PP, and then decreased until the end of the study period, at which time about 25% of cows had moderate to severe fatty infiltration. Lipidosis was positively correlated with the severity of liver cell degeneration, and negatively correlated with the degree of glycogen deposits. Complete glycogen depletion of hepatocytes was not observed in cows, even in the presence of severe hepatic lipidosis. Moderate to severe lymphocytic hepatitis was seen in 39% of cows throughout the study period, and cows with lactation numbers 5 or greater had perisinusoidal fibrosis more often than younger cows. Severe fibrosis and cirrhosis of the liver did not occur. Metabotype B animals exhibited a higher chance of fatty infiltration, lower glycogen storage, and perisinusoidal fibrosis and for this metabotype positive correlations were calculated between increased fat deposition in the liver and marked glycogen depletion, and increased degenerative, inflammatory, fibrotic, and proliferative changes of hepatic tissue. For the treatment with BCC, no significant effect was observed. In summary, during the transition period, the liver of dairy cows is characterized by fat accumulation and glycogen depletion and histologic signs of hepatitis and hepatocyte degeneration. These histomorphologic changes were accentuated in animals exhibiting little alterations in their liver metabolome profile across the transition period (metabotype B) and support the assumption of a decreased grass silage quality as a causative factor.
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Affiliation(s)
- F Pietsch
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - M Schären
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany.
| | - T Snedec
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - K B Theinert
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - A-S Leonhardt
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - A Kaiser
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - F Rachidi
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany
| | - D Böttcher
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103 Leipzig, Germany
| | - J Scheinert
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103 Leipzig, Germany
| | - H-A Schoon
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103 Leipzig, Germany
| | - P Wohlsein
- Department of Pathology, University of Veterinary Medicine Hanover, Foundation, Bünteweg 17, 30559 Hanover, Germany
| | - J Spilke
- Biometrics and Informatics in Agriculture Group, Institute of Agricultural and Nutritional Sciences, Martin-Luther University, Halle-Wittenberg, Karl-Freiherr-von-Fritsch-Str. 4, 06108 Halle (Saale), Germany
| | - A Haudum
- Veterinary Practice, Herrnschlag 3, 4170 St. Stefan am Walde, Austria
| | - W Baumgartner
- University Clinic for Ruminants, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - A Starke
- Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 11, 04103 Leipzig, Germany
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Schäfer D, Tomiuk S, Küster LN, Rawashdeh WA, Henze J, Tischler-Höhle G, Agorku DJ, Brauner J, Linnartz C, Lock D, Kaiser A, Herbel C, Eckardt D, Lamorte M, Lenhard D, Schüler J, Ströbel P, Missbach-Guentner J, Pinkert-Leetsch D, Alves F, Bosio A, Hardt O. Identification of CD318, TSPAN8 and CD66c as target candidates for CAR T cell based immunotherapy of pancreatic adenocarcinoma. Nat Commun 2021; 12:1453. [PMID: 33674603 PMCID: PMC7935963 DOI: 10.1038/s41467-021-21774-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 02/09/2021] [Indexed: 12/17/2022] Open
Abstract
A major roadblock prohibiting effective cellular immunotherapy of pancreatic ductal adenocarcinoma (PDAC) is the lack of suitable tumor-specific antigens. To address this challenge, here we combine flow cytometry screenings, bioinformatic expression analyses and a cyclic immunofluorescence platform. We identify CLA, CD66c, CD318 and TSPAN8 as target candidates among 371 antigens and generate 32 CARs specific for these molecules. CAR T cell activity is evaluated in vitro based on target cell lysis, T cell activation and cytokine release. Promising constructs are evaluated in vivo. CAR T cells specific for CD66c, CD318 and TSPAN8 demonstrate efficacies ranging from stabilized disease to complete tumor eradication with CD318 followed by TSPAN8 being the most promising candidates for clinical translation based on functionality and predicted safety profiles. This study reveals potential target candidates for CAR T cell based immunotherapy of PDAC together with a functional set of CAR constructs specific for these molecules.
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Affiliation(s)
- Daniel Schäfer
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
- University Medical Center Göttingen, Clinic for Hematology and Medical Oncology, Göttingen, Lower Saxony, Germany
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Lower Saxony, Germany
| | - Stefan Tomiuk
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Laura N Küster
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Wa'el Al Rawashdeh
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Janina Henze
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
- University Medical Center Göttingen, Clinic for Hematology and Medical Oncology, Göttingen, Lower Saxony, Germany
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Lower Saxony, Germany
| | | | - David J Agorku
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Janina Brauner
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Cathrin Linnartz
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Dominik Lock
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Andrew Kaiser
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Christoph Herbel
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Dominik Eckardt
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Melina Lamorte
- Charles River Discovery Research Services GmbH, Freiburg, Baden-Wuerttemberg, Germany
| | - Dorothee Lenhard
- Charles River Discovery Research Services GmbH, Freiburg, Baden-Wuerttemberg, Germany
| | - Julia Schüler
- Charles River Discovery Research Services GmbH, Freiburg, Baden-Wuerttemberg, Germany
| | - Philipp Ströbel
- University Medical Center Göttingen, Institute for Pathology, Göttingen, Lower Saxony, Germany
| | - Jeannine Missbach-Guentner
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Lower Saxony, Germany
| | - Diana Pinkert-Leetsch
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Lower Saxony, Germany
- Max Planck Institute for Experimental Medicine, Translational Molecular Imaging, Göttingen, Lower Saxony, Germany
| | - Frauke Alves
- University Medical Center Göttingen, Clinic for Hematology and Medical Oncology, Göttingen, Lower Saxony, Germany
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Lower Saxony, Germany
- Max Planck Institute for Experimental Medicine, Translational Molecular Imaging, Göttingen, Lower Saxony, Germany
| | - Andreas Bosio
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany
| | - Olaf Hardt
- Miltenyi Biotec GmbH, R&D, Bergisch Gladbach, North Rhine-Westphalia, Germany.
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Samanta S, Damron P, Poirier Y, Mao S, Lamichhane N, Dahiya S, Yared J, Rapoport A, Hardy N, Molitoris J, Kaiser A, Yi B, Mohindra P. Dose To Lungs And Kidneys During Total Body Irradiation: Are We Delivering The Expected Dose? Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.190] [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: 10/23/2022]
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Chiat D, Sun K, Guelde E, D'Adamo C, Bentzen S, Kaiser A. Median Household Income Remains Strongly Associated With Integrative Therapy Utilization During Radiation Treatment Despite Program Subsidization. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2493] [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: 10/23/2022]
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Scheiling E, Kertscher C, Kaiser A, Schleußner E. Analyse der Sectio-Raten Bayerns, Hessens, Sachsens und Thüringens unter Nutzung der Robson-Klassifikation. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Scheiling
- Klinik für Geburtsmedizin, Universitätsklinikum Jena
| | - C Kertscher
- Landesgeschäftsstelle für Qualitätssicherung Thüringen
| | - A Kaiser
- LÄK Sachsen, Projektgeschäftsstelle Qualitätssicherung
| | - E Schleußner
- Klinik für Geburtsmedizin, Universitätsklinikum Jena
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Grote S, Mittelstaet J, Baden C, Chan KCH, Seitz C, Schlegel P, Kaiser A, Handgretinger R, Schleicher S. Adapter chimeric antigen receptor (AdCAR)-engineered NK-92 cells: an off-the-shelf cellular therapeutic for universal tumor targeting. Oncoimmunology 2020; 9:1825177. [PMID: 33457105 PMCID: PMC7781805 DOI: 10.1080/2162402x.2020.1825177] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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] [Indexed: 12/14/2022] Open
Abstract
Despite the recent success of CAR T cells targeting CD19 and CD22 in hematological malignancies, the production of CAR T cells still requires an extensive manufacturing process. The well-established NK-92 cell line provides a promising alternative to produce CAR-modified effector cells in a GMP-compliant, cost-effective way. NK-92 can be redirected against a variety of surface antigens by our adapter CAR (AdCAR) system utilizing biotinylated antibodies (bAb) as adapter molecules. Selected bAb were capable of inducing significant AdCAR NK-92-mediated lysis of non-Hodgkin lymphoma (NHL) and mantle-cell lymphoma (MCL) cell lines as well as primary MCL and chronic lymphocytic leukemia (CLL) cells. AdCAR specificity was proven using a JeKo-1 CD19/CD20 knockout antigen-loss model. Moreover, through combinations of bAb, AdCAR NK-92 cells are capable of combatting tumor antigen evasion mechanisms. In conclusion, we successfully generated the AdCAR NK-92 cell line which can be manufactured as an “off-the-shelf, on-demand” product allowing universal and tunable tumor targeting.
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Affiliation(s)
- Stefan Grote
- Department of Hematology and Oncology, University Hospital Tuebingen, Children's Hospital, Tuebingen, Germany
| | | | - Caroline Baden
- Department of Hematology and Oncology, University Hospital Tuebingen, Children's Hospital, Tuebingen, Germany
| | - Kenneth Chun-Ho Chan
- Department of Hematology and Oncology, University Hospital Tuebingen, Children's Hospital, Tuebingen, Germany
| | - Christian Seitz
- Department of Hematology and Oncology, University Hospital Tuebingen, Children's Hospital, Tuebingen, Germany
| | - Patrick Schlegel
- Department of Hematology and Oncology, University Hospital Tuebingen, Children's Hospital, Tuebingen, Germany
| | | | - Rupert Handgretinger
- Department of Hematology and Oncology, University Hospital Tuebingen, Children's Hospital, Tuebingen, Germany
| | - Sabine Schleicher
- Department of Hematology and Oncology, University Hospital Tuebingen, Children's Hospital, Tuebingen, Germany
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Lennartz S, Lock D, Kolbe C, Winkels G, Assenmacher M, Kaiser A. StraightFrom®MicroBeads: Fast T cell isolation for CAR T cell manufacturing without density gradient centrifugation. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.86.28] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
In recent years, CAR T cell mediated immunotherapy has shown clinical efficacy in the fight against cancer. Increased research efforts to address several challenges associated with CAR T cell therapy for solid tumor treatment for instance, such as poor efficacy and unwanted side effects, are required to progress current approaches. Fast, efficient and flexible CAR T workflows can offer the opportunity to progress such research.
At Miltenyi Biotec we have established an optimized CAR T cell research workflow, combining cell isolation, culture and analysis tailored for CAR T cell generation that can be transferred into clinical setting.
Using our StraightFrom® MicroBeads, the fundamental step of isolating high quality T cells as starting material to generate functional CAR T cells, can be performed directly from whole blood, buffy coat and blood products without density gradient centrifugation. Thereby, experimental procedure is accelerated and allows for automation on platforms such as the MultiMACS™ Cell24 Separator Plus and the MultiMACS™ X, whilst maintaining the quality, functionality and downstream compatibility of the isolated T cells, resulting in an ideal starting population for the generation of fully functional CAR T cells.
In conclusion, our innovative tools can reduce experimental time and increase the reproducibility and quality of data obtained in your CAR T cell research efforts in immuno-oncology and immunotherapy.
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Dhar LK, Razia S, Kaiser A, Talukder A. Crane Principle in Plastic Surgery- Experience in Mymensingh Medical College Hospital. Mymensingh Med J 2020; 29:457-459. [PMID: 32506105] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The crane principle is a Plastic surgical technique whereby, a pedicled flap can be used as an engineering crane to lift and transport subcutaneous tissue from one area and deposit it in another. The flap can be returned later to its original bed. It takes only one week for the conveyance. Here we present a case of 25 year old female patient with degloving injury of scalp with exposed skull bone was initially managed with transposition flap for coverage of the scalp defect in Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh on 07 December 2017. After 8 months the scalp flap was returned to its original site following the crane principle and the new wound was covered by split-thickness skin graft. The flap survived completely and patient was satisfied.
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Affiliation(s)
- L K Dhar
- Dr Liman Kumar Dhar, Assistant Professor and Head, Department of Burn & Plastic Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Hernández-Triana LM, Brugman VA, Pramual P, Barrero E, Nikolova NI, Ruiz-Arrondo I, Kaiser A, Krüger A, Lumley S, Osório HC, Ignjatović-Ćupina A, Petrić D, Laure Setier-Rio M, Bødker R, Johnson N. Genetic diversity and population structure of Culex modestus across Europe: does recent appearance in the United Kingdom reveal a tendency for geographical spread? Med Vet Entomol 2020; 34:86-96. [PMID: 31603254 DOI: 10.1111/mve.12412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 06/21/2019] [Revised: 09/15/2019] [Accepted: 09/20/2019] [Indexed: 06/10/2023]
Abstract
In mainland Europe, the mosquito species Culex modestus Ficalbi (1890) is a bridge vector for West Nile virus (WNV) from its natural bird-mosquito cycle to mammals. The present study assessed the genetic diversity of Cx. modestus, as well as related Culex species, using the mitochondrial COI DNA barcoding region and compared this with the population structure across Europe. A haplotype network was mapped to determine genealogical relationships among specimens. The intraspecific genetic diversity within individual Culex species was below 2%, whereas the interspecific genetic divergence varied from 2.99% to 13.74%. In total, 76 haplotypes were identified among 198 sequences. A median-joining network determined from 198 COI sequences identified two major lineages that were separated by at least four mutation steps. A high level of intraspecific genetic diversity was not detected in Cx. modestus in samples submitted from different European populations, which indicates that morphologically identified specimens represent a single species and not a species complex. Therefore, it is deduced that different populations of Cx. modestus will show a similar potential to transmit WNV, lending support to concerns that the population present in southeast England represents a risk of transmission to humans.
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Affiliation(s)
| | - V A Brugman
- Vecotech Ltd, London, U.K
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, U.K
| | - P Pramual
- Department of Biology and Biodiversity and Traditional Knowledge Research Unit, Faculty of Science, Mahasarakham University, Kantharawichai District, Maha Sarakham, Thailand
| | - E Barrero
- Animal and Plant Health Agency, Addlestone, U.K
| | - N I Nikolova
- Biodiversity Institute of Ontario, University of Guelph, Guelph, Ontario, Canada
| | - I Ruiz-Arrondo
- Center for Rickettsiosis and Arthropod-Borne Diseases, CIBIR, Logroño, La Rioja, Spain
| | - A Kaiser
- German Mosquito Control Association (KABS), Institute for Dipterology, Speyer, Rhineland-Palatinate, Germany
| | - A Krüger
- Bundeswehr Hospital Hamburg, Section Tropical Microbiology & Entomology, Hamburg, Germany
| | - S Lumley
- The Pirbright Institute, Pirbright, Woking, U.K
| | - H C Osório
- Centre for Vectors and Infectious Diseases Research, National Institute of Health Dr. Ricardo Jorge, Águas de Moura, Portugal
| | - A Ignjatović-Ćupina
- Faculty of Agriculture, University of Novi Sad, Novi Sad, Vojvodina Province, Serbia
| | - D Petrić
- Direction Recherche et Dèvelopment, Montpellier, Cedex, France
| | | | - R Bødker
- Technical University of Denmark, National Veterinary Institute, Frederiksberg C, Denmark
| | - N Johnson
- Animal and Plant Health Agency, Addlestone, U.K
- Faculty of Health and Medical Science, University of Surrey, Guildford, U.K
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Mohindra P, Mossahebi S, Moreau J, Buttion M, Molitoris J, Eblan M, Kaiser A, Langen K, Simone C. First Clinical Experience of Gated Voluntary Breath-Hold Intensity Modulated Proton Therapy for Thoracic Malignancies. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Koroulakis A, Molitoris J, Kaiser A, Hanna N, Jiang Y, Regine W. Re-Irradiation for Rectal Cancer: A Single Institution Experience Utilizing Photons and Protons. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2146] [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: 11/29/2022]
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Remick J, Sabouri P, Zhu M, Kwok Y, Bentzen S, Kaiser A. Simulation of an HDR Prostate Boost with Stereotactic Intensity-Modulated Proton Versus Photon Radiation Therapy: A Dosimetric Comparison Study. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.719] [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: 10/26/2022]
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Alagboso FI, Budak M, Sommer U, Ray S, Kaiser A, Kampschulte M, Henss A, Dürselen L, Biehl C, Lips KS, Heiss C, Thormann U, Alt V. Establishment of a clinically relevant large animal model to assess the healing of metaphyseal bone. Eur Cell Mater 2019; 37:444-466. [PMID: 31219613 DOI: 10.22203/ecm.v037a27] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Despite the high incidence of metaphyseal bone fractures in patients, the mechanisms underlying the healing processes are poorly understood due to the lack of suitable experimental animal models. Hence, the present study was conducted to establish and characterise a clinically relevant large-animal model for metaphyseal bone healing. Six female adult Merino sheep underwent full wedge-shaped osteotomy at the distal left femur metaphysis. The osteotomy was stabilised internally with a customised anatomical locking titanium plate that allowed immediate post-operative full-weight bearing. Bone healing was evaluated at 12 weeks post-fracture relative to the untouched right femur. Histological and quantitative micro-computed tomography results revealed an increased mineralised bone mass with a rich bone microarchitecture. New trabeculae healed by direct intramembranous ossification, without callus and cartilaginous tissue formation. Stiffness at the cortical and trabecular regions was comparable in both groups. Functional morphological analysis of the osteocyte lacunae revealed regularly arranged spherically shaped lacunae along with the canalicular network. Bone surface biochemical analysis using time-of-flight secondary-ion mass spectrometry showed high and homogeneously distributed levels of calcium and collagenous components. Ultrastructure imaging of the new trabeculae revealed a characteristic parallel arrangement of the collagen fibrils, evenly mineralised by the dense mineral substance. The specialised bone cells were also characterised by their unique structural features. Bone remodelling in the fractured femur was evident in the higher expression levels of prominent bone formation and resorption genes. In conclusion, the novel metaphyseal fracture model is beneficial for studying healing and treatment options for the enhancement of metaphyseal bone defects.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - V Alt
- Department of Trauma Surgery, University Medical Centre, Regensburg,
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Dhar LK, Talukder A, Kaiser A, Razia S, Jahan I, Islam MS. Posterior Tibial Artery Perforator Based Propeller Flap for Lower Leg and Ankle Defect Coverage: A Prospective Observational Study. Mymensingh Med J 2019; 28:311-316. [PMID: 31086144] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Reconstruction of lower leg and ankle defect with exposed bone or tendon is a challenging task for a Plastic Surgeon. There are various options, among them perforator based propeller flap is a very good option though this is a microsurgical procedure but no need of microvascular anastomosis. This study was designed to see the clinical results of Posterior tibial artery perforator based propeller flap for lower leg and ankle defect coverage. The study was a prospective observational study. It was conducted in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2017 to June 2018. Sample size was 9. Sampling was carried out purposively. Postoperative follow up period was up to 6 weeks. Among the 9 cases, 8 flaps completely survived, 1 case developed marginal necrosis which was secondarily healed. There were total 2 complications among 9 cases i.e. transient venous congestion and superficial epidermonecrolysis which were resolved spontaneously. Regarding the cause of the defect, maximum cases were post traumatic wound (66.7%), others were post infective, post malignancy excision and post electric burn wound. Defect size was 2cm×2cm to 7cm×5cm. Maximum dimension of the flap was 19cm×6cm and minimum size was 7cm×3cm. Posterior tibial artery perforator location was 4cm to 9cm from lowest level of medial malleolous (mean 6.2±1.6cm). Rotation of the flap was 145°-180° (mean 163°±1.39°). In all cases donor site was covered with split thickness skin graft. Operation time was 120 minutes to 180 minutes; mean operative time was 143.3±2.38 minutes. After operation hospital stay was 10 days to 21 days, mean 11.44±3.64 days. So, posterior tibial artery perforator based propeller flap for lower leg and ankle defect coverage is a very good option.
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Affiliation(s)
- L K Dhar
- Dr Liman Kumar Dhar, Assistant Professor and Head, Department of Burn & Plastic Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail: limandhar@ yahoo.com
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Henneresse T, Kaiser A, Wesselingh RA, Tyteca D. Variability in space and time: contrasting fruit distribution patterns in the deceptive orchid Orchis militaris. Plant Biol (Stuttg) 2019; 21:259-266. [PMID: 30388306 DOI: 10.1111/plb.12932] [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: 10/02/2018] [Accepted: 10/31/2018] [Indexed: 06/08/2023]
Abstract
In angiosperms, a decrease in fruit production towards the apex of individual inflorescences is usually observed. Orchids are thought to be primarily pollination-limited species, and non-uniform pollination could cause this decrease pattern in several species. Fruit production was investigated in relation to flower position and floral display size in Orchis militaris (Orchidaceae), a deceptive species. Over 2 years, eight populations of O. militaris were studied and fruit position along the inflorescence was recorded. Generalised linear models were performed to examine the effect of population, year, flower position and floral display size on fruit production. The dominant pattern was characterised by a higher fruit set in the middle part of the inflorescence (parabolic pattern). A non-directional pattern of fruit production was also detected in some populations. Within a given population, patterns were generally consistent among years. In one of the two study years and in one of the eight populations specifically, the proximal-to-distal decrease in fruit production was dramatic in plants with a large floral display but weak or absent in small displays. Our study demonstrates the intraspecific diversity of fruit distribution patterns in O. militaris. Non-uniform pollination along the inflorescence is likely to be responsible for the parabolic pattern, while irregular visitation could explain the non-directional pattern of fruit production. Pattern variation among years and between populations could arise from spatiotemporal variation in pollinator assemblages. Resource competition effects could explain the interaction effect between display size and flower position.
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Affiliation(s)
- T Henneresse
- Biodiversity Research Centre, Earth and Life Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - A Kaiser
- Biodiversity Research Centre, Earth and Life Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - R A Wesselingh
- Biodiversity Research Centre, Earth and Life Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - D Tyteca
- Biodiversity Research Centre, Earth and Life Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Aleksandrova K, Leise J, Priesner C, Melk A, Kubaink F, Abken H, Hombach A, Aktas M, Essl M, Bürger I, Kaiser A, Rauser G, Jurk M, Goudeva L, Glienke W, Arseniev L, Esser R, Köhl U. Functionality and Cell Senescence of CD4/ CD8-Selected CD20 CAR T Cells Manufactured Using the Automated CliniMACS Prodigy® Platform. Transfus Med Hemother 2019; 46:47-54. [PMID: 31244581 DOI: 10.1159/000495772] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 07/18/2018] [Accepted: 11/23/2018] [Indexed: 12/28/2022] Open
Abstract
Clinical studies using autologous CAR T cells have achieved spectacular remissions in refractory CD19+ B cell leukaemia, however some of the patient treatments with CAR T cells failed. Beside the heterogeneity of leukaemia, the distribution and senescence of the autologous cells from heavily pretreated patients might be further reasons for this. We performed six consecutive large-scale manufacturing processes for CD20 CAR T cells from healthy donor leukapheresis using the automated CliniMACS Prodigy® platform. Starting with a CD4/CD8-positive selection, a high purity of a median of 97% T cells with a median 65-fold cell expansion was achieved. Interestingly, the transduction rate was significantly higher for CD4+ compared to CD8+ T cells and reached in a median of 23%. CD20 CAR T cells showed a good specific IFN-γ secretion after cocultivation with CD20+ target cells which correlated with good cytotoxic activity. Most importantly, 3 out of 5 CAR T cell products showed an increase in telomere length during the manufacturing process, while telomere length remained consistent in one and decreased in another process. In conclusion, this shows for the first time that beside heterogeneity among healthy donors, CAR T cell products also differ regarding cell senescence, even for cells manufactured in a standardised automated process.
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Affiliation(s)
- Krasimira Aleksandrova
- Cellular Therapy Centre, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany
| | - Jana Leise
- Cellular Therapy Centre, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany
| | - Christoph Priesner
- Cellular Therapy Centre, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany
| | - Anette Melk
- Clinic for Paediatric Nephrology, Hepatology and Metabolic Disorders, Hannover Medical School (MHH), Hanover, Germany
| | - Fanni Kubaink
- Clinic for Paediatric Nephrology, Hepatology and Metabolic Disorders, Hannover Medical School (MHH), Hanover, Germany
| | - Hinrich Abken
- Center for Molecular Medicine Cologne, University of Cologne, and Dept I Internal Medicine, University Hospital Cologne, Cologne, Germany.,RCI, Chair Gene-Immunotherapy, University Hospital Regensburg, Regensburg, Germany
| | - Andreas Hombach
- Center for Molecular Medicine Cologne, University of Cologne, and Dept I Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - Murat Aktas
- Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Mike Essl
- Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Iris Bürger
- Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | | | - Georg Rauser
- Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Marion Jurk
- Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Lilia Goudeva
- Institute for Transfusion Medicine, Hannover Medical School (MHH), Hanover, Germany
| | - Wolfgang Glienke
- ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany
| | - Lubomir Arseniev
- Cellular Therapy Centre, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany
| | - Ruth Esser
- ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany
| | - Ulrike Köhl
- Cellular Therapy Centre, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany.,ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Hannover Medical School (MHH), Hanover, Germany.,Institute of Clinical Immunology, University Hospital and Medical Faculty, University of Leipzig, Leipzig, Germany.,Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
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Heemskerk B, Maeder C, Criado-Moronati E, Boettcher L, Kaiser A, Assenmacher M, Dzionek A. Abstract B016: Automated ex vivo expansion of low numbers of tumor-reactive T-cells on the CliniMACS Prodigy®. Cancer Immunol Res 2019. [DOI: 10.1158/2326-6074.cricimteatiaacr18-b016] [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: 11/16/2022]
Abstract
Abstract
Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TILs) has shown remarkable results in patients with metastatic melanoma. However, only a small fraction within the TIL population reacts against the tumor. Therefore, the pre-enrichment of tumor-specific T-cells and subsequent ex vivo expansion may improve the efficiency of ACT therapies. In addition, tumor-reactive T lymphocytes circulating in the blood (TRLs) have been found in low frequencies, which represents a challenge for their isolation, but also an advantage over TIL therapy since blood is a more reliable and accessible source than tumor excisions. Another impediment to the widespread application of ACT is the conventional rapid expansion protocol (REP) that constitutes a laborious and extensive process with frequent culture manipulations, and thus requires specialized personell and equipment. Our aim is to develop a fully automated large scale ex vivo T-cell isolation and expansion procedure in the CliniMACS Prodigy in order to simplify the manufacturing of tumor-reactive T-cells for ACT. The CliniMACS Prodigy instrument is a controlled system that integrates a series of cell processes, from magnetic cell separation and cell culture to final product formulation, under GMP conditions in a closed system. This process focuses on the optimization of the REP procedure on the CliniMACS Prodigy for TILs and TRLs. As a proof of concept, we used both cryopreserved outgrown TILs and magnetically isolated virus-specific T-cells from healthy donor leukapheresis via CD137 upregulation upon in vitro antigen stimulation. The first results show expansions ranging from 3,000-15,000 fold, both for TILs and CD137-expressing T-cells. From low cell numbers (2x10e5 - 1x10e6 cells) and after 14 days of cell culture in TexMACS medium and in the presence of high amounts of IL-2 and irradiated feeder cells, we were able to obtain around 3-4x10e9 cells. We also compared two different stimulation reagents, anti-CD3 antibody (OKT3) and TransAct (a soluble polymeric nanomatrix conjugated to humanized CD3 and CD28 agonist), which resulted in comparable expansion rates. Furthermore, small-scale experiments showed no differences between TexMACS and the conventional TIL culture medium (50% RPMI/50% AIM-V medium). The phenotype and reactivity of the expanded T-cells were also assessed by flow cytometry. Currently, higher starting cell numbers up to 1x10e7 cells are being assessed and first results are promising when shaking and media exchange are commenced earlier in the process. In summary, these data provide proof of concept for the expansion of low numbers of TILs and virus-specific T-cells from peripheral blood in a closed, automated manner in the CliniMACS Prodigy. In the future, this expansion process will be combined with a tumor-reactive T-cell enrichment process (e.g., via CD137-conjugated magnetic beads) to achieve the desired efficiency, simplicity and automated production of ACT therapies against cancer.
Citation Format: Bianca Heemskerk, Christina Maeder, Elvira Criado-Moronati, Lisa Boettcher, Andrew Kaiser, Mario Assenmacher, Andrzej Dzionek. Automated ex vivo expansion of low numbers of tumor-reactive T-cells on the CliniMACS Prodigy® [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr B016.
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Talukder A, Dhar LK, Rouf S, Kaiser A. Fetomaternal Outcome in Eclampsia in Relationship with Gravidity. Mymensingh Med J 2019; 28:44-48. [PMID: 30755549] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Eclampsia is a well-recognized major cause of maternal and perinatal morbidity and mortality. Patient's age, occupational status, socioeconomic status, educational status, regular ANC (antenatal care) and gravidity may affect the outcome of mother and foetus. The purpose of this study is to see the fetomaternal outcome in eclampsia in relationship with gravidity. This prospective observational cross-sectional study carried out among the alternate cases of primigravid and multigravid eclamptic patients. Total number of patients was 100 eclamptic patients among them, 50 patients were primigravida and 50 patients were multigravida. The study was conducted in Eclampsia unit of Department of Gynaecology and Obstetrics, Dhaka Medical College Hospital, Dhaka, Bangladesh from 21 November 2011 to 20 May 2012. In this study, it was observed that ARF (acute renal failure) occurred in 6%, of these 4 cases of multigravida and 2 cases of primigravida. Cerebro vascular accident (CVA) was reported in 16 patients and 26% in multigravida and 6% in primigravid patients. HELLP (Haemolysis, Elevated liver enzymes and low platelets) syndrome developed in 25 cases of multigravida and 6 cases of primigravida. Heart failure occurred in 7% cases, out of these 6 cases were multigravida and 1 case was primigravida. Pulmonary edema was observed in 41%, among were 21 cases of multigravida and 20 cases of primigravida. Incidence of DIC (disseminated intravascular coagulation) was noted in 2 cases of multigravida and 1 case of primigravida. PPH (postpartum haemorrhage) occurred in 10 cases of multigravida and 3 cases of primigravid patients. Puerperal psychosis was reported in 8% of multigravida and 4% of primigravida. Total 4% of patients expired, among them 3 cases were multigravida and 1 case was primigravida. Perinatal mortality was 21 cases in multigravida and 8 cases in primigravida. The incidence of live birth, in case of multigravida was 39 cases and primigravida 45 cases. Data were analyzed by paired student's 't' test. There was no statistically significant difference between primi and multigravida in feto-maternal outcome. This study reveals that gravidity does not alter the feto-maternal outcome in eclampsia.
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Affiliation(s)
- A Talukder
- Dr Anonya Talukder, Junior Consultant, Department of Obs. and Gynae, Mymensingh Medical College Hospital, Mymensingh, Bangladesh
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Brackett A, Kaiser A, Kwok Y, Zhu M. Using Robust Treatment Planning of Intensity Modulated Proton Therapy to Address Rectal Volume Uncertainty in High Risk Prostate Cancer Patients. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1481] [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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Quach L, Gagnon D, Kaiser A, Nguyen U. FALLS AMONG OLDER AMERICAN MEN: THE ROLE OF PAIN AND MILITARY EXPERIENCES IN THE HEALTH AND RETIREMENT STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - U Nguyen
- University of Massachusetts Medical School
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Kaiser A, Davenport MS, Frey KA, Greenspan B, Brown RKJ. Management of Diabetes Mellitus Before 18F-Fluorodeoxyglucose PET/CT: A Nationwide Patient-Centered Assessment of Approaches to Examination Preparation. J Am Coll Radiol 2018; 16:804-809. [PMID: 30348616 DOI: 10.1016/j.jacr.2018.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/06/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE The aim of this study was to perform, from the patient's point of view, a nationwide assessment of nuclear medicine practices regarding diabetic management before 18F-fluorodeoxyglucose (FDG) PET/CT for oncologic indications. METHODS This prospective observational study was exempt from institutional review board oversight. Sixty-five nuclear medicine scheduling lines (33 academic, 32 private practice, 12-17 in each of the five US regions) were called using a prewritten script under the guise of a nonexpert patient's family member about scheduling a patient with diabetes with "cancer" for FDG PET/CT. Each center was called three times on three different days. The following data were collected: (1) blood glucose threshold for rescheduling an examination, (2) when or if to stop various medications, (3) fasting requirements, and (4) time-of-day scheduling preferences. Withheld information was not specifically requested. Descriptive statistics were calculated. RESULTS There were 195 phone calls (mean duration, 2.9 min; range, 2-6 min). Relevant information was often withheld; withholding rates were as follows: blood glucose threshold, 71% (138 of 195); short-acting insulin instructions, 30% (59 of 195); long-acting insulin instructions, 99% (193 of 195); metformin instructions, 88% (179 of 195); fasting duration, 37% (72 of 195); and time-of-day scheduling preference, 91% (177 of 195). Mean provided data were as follows: blood glucose threshold, 195 mg/dL (range, 150-210 mg/dL); short-acting insulin withholding, 4.9 hours (range, 4-8 hours); long-acting insulin withholding, 12 hours (range, 12-24 hours); fasting duration, 5 hours (range, 4-8 hours); and preferred examination time, 91% (177 of 195). When specified (n = 18), morning scheduling was preferred (8% [15 of 195] versus 2% [3 of 195]). CONCLUSIONS Diabetes-specific information is commonly withheld by nuclear medicine call centers throughout the United States when discussing oncologic FDG PET/CT despite local and national policies indicating its importance.
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Affiliation(s)
- Andrew Kaiser
- Department of Radiology, University of Michigan, Ann Arbor, Michigan.
| | | | - Kirk A Frey
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Bennett Greenspan
- Department of Radiology, Medical College of Georgia, Augusta, Georgia
| | - Richard K J Brown
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
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Apostolidis L, Nientiedt C, Winkler E, Berger A, Kratochwil C, Kaiser A, Jäger D, Hohenfellner M, Hüttenbrink C, Pahernik S, Distler F, Grüllich C. Clinical characteristics, treatment outcomes and potential novel therapeutic options for patients with neuroendocrine carcinoma of the prostate (NEPC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.063] [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: 11/12/2022] Open
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Chen L, Sukuba I, Probst M, Kaiser A. Beryllium, tungsten and their alloys Be2W and Be12W: Surface defect energetics from density functional theory calculations. Nuclear Materials and Energy 2018. [DOI: 10.1016/j.nme.2018.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lock D, Mockel-Tenbrinck N, Drechsel K, Barth C, Mauer D, Schaser T, Kolbe C, Al Rawashdeh W, Brauner J, Hardt O, Pflug N, Holtick U, Borchmann P, Assenmacher M, Kaiser A. Automated Manufacturing of Potent CD20-Directed Chimeric Antigen Receptor T Cells for Clinical Use. Hum Gene Ther 2018; 28:914-925. [PMID: 28847167 DOI: 10.1089/hum.2017.111] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [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: 12/26/2022] Open
Abstract
The clinical success of gene-engineered T cells expressing a chimeric antigen receptor (CAR), as manifested in several clinical trials for the treatment of B cell malignancies, warrants the development of a simple and robust manufacturing procedure capable of reducing to a minimum the challenges associated with its complexity. Conventional protocols comprise many open handling steps, are labor intensive, and are difficult to upscale for large numbers of patients. Furthermore, extensive training of personnel is required to avoid operator variations. An automated current Good Manufacturing Practice-compliant process has therefore been developed for the generation of gene-engineered T cells. Upon installation of the closed, single-use tubing set on the CliniMACS Prodigy™, sterile welding of the starting cell product, and sterile connection of the required reagents, T cells are magnetically enriched, stimulated, transduced using lentiviral vectors, expanded, and formulated. Starting from healthy donor (HD) or lymphoma or melanoma patient material (PM), the robustness and reproducibility of the manufacturing of anti-CD20 specific CAR T cells were verified. Independent of the starting material, operator, or device, the process consistently yielded a therapeutic dose of highly viable CAR T cells. Interestingly, the formulated product obtained with PM was comparable to that of HD with respect to cell composition, phenotype, and function, even though the starting material differed significantly. Potent antitumor reactivity of the produced anti-CD20 CAR T cells was shown in vitro as well as in vivo. In summary, the automated T cell transduction process meets the requirements for clinical manufacturing that the authors intend to use in two separate clinical trials for the treatment of melanoma and B cell lymphoma.
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Affiliation(s)
- Dominik Lock
- 1 Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | | | | | - Carola Barth
- 1 Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | | | | | | | | | | | - Olaf Hardt
- 1 Miltenyi Biotec GmbH, Bergisch Gladbach, Germany
| | - Natali Pflug
- 2 Department I of Internal Medicine, University Hospital Cologne , Cologne, Germany
| | - Udo Holtick
- 2 Department I of Internal Medicine, University Hospital Cologne , Cologne, Germany
| | - Peter Borchmann
- 2 Department I of Internal Medicine, University Hospital Cologne , Cologne, Germany
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Taylor-Cousar J, Tullis E, Derichs N, Davies J, Nazareth D, Downey D, Rosenbluth D, Fajac I, Malfroot A, Saunders C, Short C, Jensen R, Solomon G, Vermeulen F, Willmann S, Saleh S, Langer S, Kaiser A, Hoffmann A, Rowe S, Ratjen F. P028 Riociguat for the treatment of adult Phe508del homozygous cystic fibrosis: efficacy data from the Phase II Rio-CF study. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30325-4] [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: 10/14/2022]
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