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Boos A, Gahr BM, Park DD, Braun V, Bühler A, Rottbauer W, Just S. Hdac1-deficiency affects the cell cycle axis Cdc25-Cdk1 causing impaired G2/M phase progression and reduced cardiomyocyte proliferation in zebrafish. Biochem Biophys Res Commun 2023; 665:98-106. [PMID: 37149988 DOI: 10.1016/j.bbrc.2023.04.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
Zebrafish have the ability to fully regenerate their hearts after injury since cardiomyocytes subsequently dedifferentiate, re-enter cell cycle, and proliferate to replace damaged myocardial tissue. Recent research identified the reactivation of dormant developmental pathways during cardiac regeneration in adult zebrafish, suggesting pro-proliferative pathways important for developmental heart growth to be also critical for regenerative heart growth after injury. Histone deacetylase 1 (Hdac1) was recently shown to control both, embryonic as well as adult regenerative cardiomyocyte proliferation in the zebrafish model. Nevertheless, regulatory pathways controlled by Hdac1 are not defined yet. By analyzing RNA-seq-derived transcriptional profiles of the Hdac1-deficient zebrafish mutant baldrian, we here identified DNA damage response (DDR) pathways activated in baldrian mutant embryos. Surprisingly, although the DDR signaling pathway was transcriptionally activated, we found the complete loss of protein expression of the known DDR effector and cell cycle inhibitor p21. Consequently, we observed an upregulation of the p21-downstream target Cdk2, implying elevated G1/S phase transition in Hdac1-deficient zebrafish hearts. Remarkably, Cdk1, another p21-but also Cdc25-downstream target was downregulated. Here, we found the significant downregulation of Cdc25 protein expression, explaining reduced Cdk1 levels and suggesting impaired G2/M phase progression in Hdac1-deficient zebrafish embryos. To finally prove defective cell cycle progression due to Hdac1 loss, we conducted Cytometer-based cell cycle analyses in HDAC1-deficient murine HL-1 cardiomyocytes and indeed found impaired G2/M phase transition resulting in defective cardiomyocyte proliferation. In conclusion, our results suggest a critical role of Hdac1 in maintaining both, regular G1/S and G2/M phase transition in cardiomyocytes by controlling the expression of essential cell cycle regulators such as p21 and Cdc25.
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Affiliation(s)
- Alena Boos
- Molecular Cardiology, Department of Internal Medicine II, Ulm University, Ulm, Germany
| | - Bernd Martin Gahr
- Molecular Cardiology, Department of Internal Medicine II, Ulm University, Ulm, Germany
| | - Deung-Dae Park
- Molecular Cardiology, Department of Internal Medicine II, Ulm University, Ulm, Germany
| | - Verena Braun
- Molecular Cardiology, Department of Internal Medicine II, Ulm University, Ulm, Germany
| | - Anja Bühler
- Molecular Cardiology, Department of Internal Medicine II, Ulm University, Ulm, Germany
| | | | - Steffen Just
- Molecular Cardiology, Department of Internal Medicine II, Ulm University, Ulm, Germany.
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Wesemann U, Mahnke M, Polk S, Bühler A, Willmund G. Gender and occupational differences in post-terrorist mental health outcomes among emergency responders with and without crisis intervention. Eur J Public Health 2022. [PMCID: PMC9594380 DOI: 10.1093/eurpub/ckac129.338] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction After the Berlin terrorist attack at Breitscheidplatz, the gender-specific evaluation of emergency responders (ER) revealed higher perceived levels of paranoid ideation among females. The occupation-specific evaluation revealed higher hostility among police officers and a lower quality of life among firefighters. The aim of this study was to examine the outcome of crisis intervention (CI) provided for ER deployed to this terrorist attack. Methods In total, N = 55 ER were included (n = 37 with and n = 18 w/o CI). Stress, quality of life, post-traumatic stress disorder, and current psychological stress were assessed 4 months after the attack. Results ER with and w/o CI were compared. Participants with CI showed lower quality of life in psychological health (t(53)=2.01, p=.050) and higher depressive symptomatology (t(44) = 2.51, p=.016). Females with CI showed lower quality of life in social relationships (t(12)=2.46, p=.030), whereas males showed more posttraumatic stress symptoms (t(39)= .32, p=.026). Emergency responders from NGOs with CI had higher phobic anxiety (t(9.2)=2.72, p=.023). Emergency medical technicians with CI showed more somatic (t(7.5)=2.52, p=.037) and depressive (t(8)=2.30, p=.050) symptoms. Conclusions This study provides evidence for differences in the mental health burden for ER with and w/o CI, in general and for subgroups of gender and occupation. There is no conclusive explanation for why ER with CI score worse on certain measures. It is possible that CI had a harmful influence due to the reinforcement of negative emotions in some parts of measures like the Critical Incident Stress Debriefing (CISD). While it is known that ERs are vulnerable to develop mental problems, and appropriate and timely help is recommended, it is important to critical evaluate the methods used and to take also into account the identified gender and occupational differences. Further research is needed to better understand the interaction of risk factors.
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Affiliation(s)
- U Wesemann
- Department of Psychiatry, Psychotherapy, Bundeswehr Hospital , Berlin, Germany
| | - M Mahnke
- Department of Psychiatry, Psychotherapy, Bundeswehr Hospital , Berlin, Germany
- Fire Department Berlin , Berlin, Germany
| | - S Polk
- Planck Institute for Human Development Max , Berlin, Germany
| | - A Bühler
- Department of Psychiatry, Psychotherapy, Bundeswehr Hospital , Berlin, Germany
| | - G Willmund
- Department of Psychiatry, Psychotherapy, Bundeswehr Hospital , Berlin, Germany
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Agostini C, Bühler A, Antico Calderone A, Aadepu N, Herder C, Loosli F, Carl M. Conserved and diverged asymmetric gene expression in the brain of teleosts. Front Cell Dev Biol 2022; 10:1005776. [PMID: 36211473 PMCID: PMC9532764 DOI: 10.3389/fcell.2022.1005776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
Morphological left-right brain asymmetries are universal phenomena in animals. These features have been studied for decades, but the functional relevance is often unclear. Studies from the zebrafish dorsal diencephalon on the genetics underlying the establishment and function of brain asymmetries have uncovered genes associated with the development of functional brain asymmetries. To gain further insights, comparative studies help to investigate the emergence of asymmetries and underlying genetics in connection to functional adaptation. Evolutionarily distant isogenic medaka inbred lines, that show divergence of complex traits such as morphology, physiology and behavior, are a valuable resource to investigate intra-species variations in a given trait of interest. For a detailed study of asymmetry in the medaka diencephalon we generated molecular probes of ten medaka genes that are expressed asymmetrically in the zebrafish habenulae and pineal complex. We find expression of eight genes in the corresponding brain areas of medaka with differences in the extent of left-right asymmetry compared to zebrafish. Our marker gene analysis of the diverged medaka inbred strains revealed marked inter-strain size differences of the respective expression domains in the parapineal and the habenulae, which we hypothesize may result from strain-specific gene loss. Thus, our analysis reveals both inter-species differences but also intra-species plasticity of gene expression in the teleost dorsal diencephalon. These findings are a starting point showing the potential to identify the genetics underlying the emergence and modulations of asymmetries. They are also the prerequisite to examine whether variance in habenular gene expression may cause variation of behavioral traits.
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Affiliation(s)
- Carolina Agostini
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
- Institute of Biological and Chemical Systems, Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Anja Bühler
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | | | - Narendar Aadepu
- Institute of Biological and Chemical Systems, Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology, Karlsruhe, Germany
- Centre for Organismal Studies, Heidelberg University, Heidelberg, Germany
| | - Cathrin Herder
- Institute of Biological and Chemical Systems, Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Felix Loosli
- Institute of Biological and Chemical Systems, Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology, Karlsruhe, Germany
- *Correspondence: Felix Loosli, ; Matthias Carl,
| | - Matthias Carl
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
- *Correspondence: Felix Loosli, ; Matthias Carl,
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4
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Bühler A, Gahr BM, Park DD, Bertozzi A, Boos A, Dalvoy M, Pott A, Oswald F, Kovall RA, Kühn B, Weidinger G, Rottbauer W, Just S. Histone deacetylase 1 controls cardiomyocyte proliferation during embryonic heart development and cardiac regeneration in zebrafish. PLoS Genet 2021; 17:e1009890. [PMID: 34723970 PMCID: PMC8584950 DOI: 10.1371/journal.pgen.1009890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 11/11/2020] [Revised: 11/11/2021] [Accepted: 10/18/2021] [Indexed: 12/20/2022] Open
Abstract
In contrast to mammals, the zebrafish maintains its cardiomyocyte proliferation capacity throughout adulthood. However, neither the molecular mechanisms that orchestrate the proliferation of cardiomyocytes during developmental heart growth nor in the context of regeneration in the adult are sufficiently defined yet. We identified in a forward genetic N-ethyl-N-nitrosourea (ENU) mutagenesis screen the recessive, embryonic-lethal zebrafish mutant baldrian (bal), which shows severely impaired developmental heart growth due to diminished cardiomyocyte proliferation. By positional cloning, we identified a missense mutation in the zebrafish histone deacetylase 1 (hdac1) gene leading to severe protein instability and the loss of Hdac1 function in vivo. Hdac1 inhibition significantly reduces cardiomyocyte proliferation, indicating a role of Hdac1 during developmental heart growth in zebrafish. To evaluate whether developmental and regenerative Hdac1-associated mechanisms of cardiomyocyte proliferation are conserved, we analyzed regenerative cardiomyocyte proliferation after Hdac1 inhibition at the wound border zone in cryoinjured adult zebrafish hearts and we found that Hdac1 is also essential to orchestrate regenerative cardiomyocyte proliferation in the adult vertebrate heart. In summary, our findings suggest an important and conserved role of Histone deacetylase 1 (Hdac1) in developmental and adult regenerative cardiomyocyte proliferation in the vertebrate heart. Heart disease is one of the most common causes of death in all developed countries. While zebrafish cardiomyocytes are able to proliferate throughout adulthood, mammalian cardiomyocytes lose this ability during early development, and therefore are not capable to replace and renew cardiomyocytes after injury. The underlying mechanisms of cardiomyocyte proliferation are still not completely resolved. Understanding how zebrafish cardiomyocytes preserve their proliferating state, would be a valuable information to foster cardiac regeneration, e.g. after myocardial infarction in patients. Knowledge of the signaling pathways that need to be activated, or deactivated in order to induce cardiomyocyte proliferation after acute or chronic injury will pave the way for the development of genetic and/or pharmacological treatment options. In an ENU-mutagenesis screen, we identified the zebrafish mutant baldrian, which shows reduced embryonic cardiomyocyte proliferation. As genetic cause of the observed phenotype, we identified a missense mutation in the hdac1 gene. By treatment of heart-injured adult fish with the HDAC1 inhibitor Mocetinostat, we were able to show a reduced rate of cardiomyocyte proliferation also in the adult zebrafish heart in vivo, suggesting a role of Hdac1 in embryonic heart growth and adult regenerative cardiomyocyte proliferation in zebrafish.
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Affiliation(s)
- Anja Bühler
- Molecular Cardiology, Department of Internal Medicine II, University of Ulm, Ulm, Germany
| | - Bernd M Gahr
- Molecular Cardiology, Department of Internal Medicine II, University of Ulm, Ulm, Germany
| | - Deung-Dae Park
- Molecular Cardiology, Department of Internal Medicine II, University of Ulm, Ulm, Germany
| | - Alberto Bertozzi
- Institute of Biochemistry and Molecular Biology, University of Ulm, Ulm, Germany
| | - Alena Boos
- Molecular Cardiology, Department of Internal Medicine II, University of Ulm, Ulm, Germany
| | - Mohankrishna Dalvoy
- Institute of Biochemistry and Molecular Biology, University of Ulm, Ulm, Germany
| | - Alexander Pott
- Molecular Cardiology, Department of Internal Medicine II, University of Ulm, Ulm, Germany.,Department of Internal Medicine II, University of Ulm, Ulm, Germany
| | - Franz Oswald
- Department of Internal Medicine I, University of Ulm, Ulm, Germany
| | - Rhett A Kovall
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Bernhard Kühn
- Department of Pediatrics, University of Pittsburgh, and Richard King Mellon Institute for Pediatric Research and Division of Pediatric Cardiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States of America
| | - Gilbert Weidinger
- Institute of Biochemistry and Molecular Biology, University of Ulm, Ulm, Germany
| | | | - Steffen Just
- Molecular Cardiology, Department of Internal Medicine II, University of Ulm, Ulm, Germany
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5
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Bühler A, Carl M. Zebrafish Tools for Deciphering Habenular Network-Linked Mental Disorders. Biomolecules 2021; 11:biom11020324. [PMID: 33672636 PMCID: PMC7924194 DOI: 10.3390/biom11020324] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Everything that we think, feel or do depends on the function of neural networks in the brain. These are highly complex structures made of cells (neurons) and their interconnections (axons), which develop dependent on precisely coordinated interactions of genes. Any gene mutation can result in unwanted alterations in neural network formation and concomitant brain disorders. The habenula neural network is one of these important circuits, which has been linked to autism, schizophrenia, depression and bipolar disorder. Studies using the zebrafish have uncovered genes involved in the development of this network. Intriguingly, some of these genes have also been identified as risk genes of human brain disorders highlighting the power of this animal model to link risk genes and the affected network to human disease. But can we use the advantages of this model to identify new targets and compounds with ameliorating effects on brain dysfunction? In this review, we summarise the current knowledge on techniques to manipulate the habenula neural network to study the consequences on behavior. Moreover, we give an overview of existing behavioral test to mimic aspects of mental disorders and critically discuss the applicability of the zebrafish model in this field of research. Abstract The prevalence of patients suffering from mental disorders is substantially increasing in recent years and represents a major burden to society. The underlying causes and neuronal circuits affected are complex and difficult to unravel. Frequent disorders such as depression, schizophrenia, autism, and bipolar disorder share links to the habenular neural circuit. This conserved neurotransmitter system relays cognitive information between different brain areas steering behaviors ranging from fear and anxiety to reward, sleep, and social behaviors. Advances in the field using the zebrafish model organism have uncovered major genetic mechanisms underlying the formation of the habenular neural circuit. Some of the identified genes involved in regulating Wnt/beta-catenin signaling have previously been suggested as risk genes of human mental disorders. Hence, these studies on habenular genetics contribute to a better understanding of brain diseases. We are here summarizing how the gained knowledge on the mechanisms underlying habenular neural circuit development can be used to introduce defined manipulations into the system to study the functional behavioral consequences. We further give an overview of existing behavior assays to address phenotypes related to mental disorders and critically discuss the power but also the limits of the zebrafish model for identifying suitable targets to develop therapies.
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Affiliation(s)
- Anja Bühler
- Correspondence: (A.B.); (M.C.); Tel.: +39-0461-282745 (A.B.); +39-0461-283931 (M.C.)
| | - Matthias Carl
- Correspondence: (A.B.); (M.C.); Tel.: +39-0461-282745 (A.B.); +39-0461-283931 (M.C.)
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6
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Guglielmi L, Bühler A, Moro E, Argenton F, Poggi L, Carl M. Temporal control of Wnt signaling is required for habenular neuron diversity and brain asymmetry. Development 2020; 147:147/6/dev182865. [PMID: 32179574 DOI: 10.1242/dev.182865] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 07/18/2019] [Accepted: 02/11/2020] [Indexed: 12/31/2022]
Abstract
Precise temporal coordination of signaling processes is pivotal for cellular differentiation during embryonic development. A vast number of secreted molecules are produced and released by cells and tissues, and travel in the extracellular space. Whether they induce a signaling pathway and instruct cell fate, however, depends on a complex network of regulatory mechanisms, which are often not well understood. The conserved bilateral left-right asymmetrically formed habenulae of the zebrafish are an excellent model for investigating how signaling control facilitates the generation of defined neuronal populations. Wnt signaling is required for habenular neuron type specification, asymmetry and axonal connectivity. The temporal regulation of this pathway and the players involved have, however, have remained unclear. We find that tightly regulated temporal restriction of Wnt signaling activity in habenular precursor cells is crucial for the diversity and asymmetry of habenular neuron populations. We suggest a feedback mechanism whereby the tumor suppressor Wnt inhibitory factor Wif1 controls the Wnt dynamics in the environment of habenular precursor cells. This mechanism might be common to other cell types, including tumor cells.
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Affiliation(s)
- Luca Guglielmi
- Heidelberg University, Medical Faculty Mannheim, Department of Cell and Molecular Biology, 68167 Mannheim, Germany.
| | - Anja Bühler
- University of Trento, Department of Cellular, Computational and Integrative Biology (CIBIO), 38123 Trento, Italy.
| | - Enrico Moro
- University of Padova, Department of Molecular Medicine, 35121 Padova, Italy
| | | | - Lucia Poggi
- University of Trento, Department of Cellular, Computational and Integrative Biology (CIBIO), 38123 Trento, Italy.
| | - Matthias Carl
- Heidelberg University, Medical Faculty Mannheim, Department of Cell and Molecular Biology, 68167 Mannheim, Germany. ,University of Trento, Department of Cellular, Computational and Integrative Biology (CIBIO), 38123 Trento, Italy.
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7
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Cakir B, Reich M, Lang SJ, Bühler A, Stahl A, Böhringer D, Agostini H, Lange C. [Possibilities and Limitations of OCT-Angiography in Patients with Central Serous Chorioretinopathy]. Klin Monbl Augenheilkd 2017; 234:1161-1168. [PMID: 28514814 DOI: 10.1055/s-0043-102576] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Purpose Central serous chorioretinopathy (CSC) is a commonly acquired maculopathy characterized by the accumulation of subretinal fluid at the posterior pole. This study aims to analyze optical coherence tomography angiography (OCTA) findings in patients with acute and chronic CSC and to compare them to conventional imaging methods. Methods A series of 43 consecutive eyes of 29 patients diagnosed with CSC and 18 eyes of 9 healthy control subjects were included in this retrospective study. The OCTA images were assessed and compared to conventional fluorescence (FAG) and indocyanine green angiography (ICG). Results All CSC patients demonstrated abnormal areas of focal hypo- and hyperperfusion in the choriocapillaris. These were particularly evident in patients with chronic atrophic CSC. FAG and ICG imaging revealed leakage points in 10 of 43 eyes and choroidal neovascularization (CNV) in 3 of 43 eyes. OCTA imaging confirmed leakage points in 4 out of 10 cases and choroidal neovascularization in 2 out of 3 cases. In one case, OCTA demonstrated a CNV which was not detectable by FAG/ICG. Conclusion OCTA reveals areas of focal hypo- and hyperperfusion in the choriocapillaris in patients with CSC. Due to the inability to detect plasma flow, OCTA is not suitable to detect leakage points in CSC with confidence. However, OCTA reliably detects CNV in CSC even in the absence of exudative activity and may, therefore, represent an important supplement in the diagnosis of CSC.
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Affiliation(s)
- B Cakir
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - M Reich
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - S J Lang
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - A Bühler
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - A Stahl
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - D Böhringer
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - H Agostini
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - C Lange
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
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8
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Just S, Raphel L, Berger IM, Bühler A, Keßler M, Rottbauer W. Tbx20 Is an Essential Regulator of Embryonic Heart Growth in Zebrafish. PLoS One 2016; 11:e0167306. [PMID: 27907103 PMCID: PMC5132222 DOI: 10.1371/journal.pone.0167306] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/13/2016] [Indexed: 01/06/2023] Open
Abstract
The molecular mechanisms that regulate cardiomyocyte proliferation during embryonic heart growth are not completely deciphered yet. In a forward genetic N-ethyl-N-nitrosourea (ENU) mutagenesis screen, we identified the recessive embryonic-lethal zebrafish mutant line weiches herz (whz). Homozygous mutant whz embryos display impaired heart growth due to diminished embryonic cardiomyocyte proliferation resulting in cardiac hypoplasia and weak cardiac contraction. By positional cloning, we found in whz mutant zebrafish a missense mutation within the T-box 20 (Tbx20) transcription factor gene leading to destabilization of Tbx20 protein. Morpholino-mediated knock-down of Tbx20 in wild-type zebrafish embryos phenocopies whz, indicating that the whz phenotype is due to loss of Tbx20 function, thereby leading to significantly reduced cardiomyocyte numbers by impaired proliferation of heart muscle cells. Ectopic overexpression of wild-type Tbx20 in whz mutant embryos restored cardiomyocyte proliferation and heart growth. Interestingly, ectopic overexpression of Tbx20 in wild-type zebrafish embryos resulted, similar to the situation in the embryonic mouse heart, in significantly reduced proliferation rates of ventricular cardiomyocytes, suggesting that Tbx20 activity needs to be tightly fine-tuned to guarantee regular cardiomyocyte proliferation and embryonic heart growth in vivo.
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Affiliation(s)
- Steffen Just
- Molecular Cardiology, Department of Medicine II, University of Ulm, Ulm, Germany
- * E-mail: (SJ); (WR)
| | - Linda Raphel
- Department of Medicine II, University of Ulm, Ulm, Germany
| | - Ina M. Berger
- Molecular Cardiology, Department of Medicine II, University of Ulm, Ulm, Germany
| | - Anja Bühler
- Molecular Cardiology, Department of Medicine II, University of Ulm, Ulm, Germany
| | - Mirjam Keßler
- Department of Medicine II, University of Ulm, Ulm, Germany
| | - Wolfgang Rottbauer
- Molecular Cardiology, Department of Medicine II, University of Ulm, Ulm, Germany
- Department of Medicine II, University of Ulm, Ulm, Germany
- * E-mail: (SJ); (WR)
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Bühler A, Wendtner CM, Kipps TJ, Rassenti L, Fraser GAM, Michallet AS, Hillmen P, Dürig J, Gregory SA, Kalaycio M, Aurran-Schleinitz T, Trentin L, Gribben JG, Chanan-Khan A, Purse B, Zhang J, De Bedout S, Mei J, Hallek M, Stilgenbauer S. Lenalidomide treatment and prognostic markers in relapsed or refractory chronic lymphocytic leukemia: data from the prospective, multicenter phase-II CLL-009 trial. Blood Cancer J 2016; 6:e404. [PMID: 26967821 PMCID: PMC4817104 DOI: 10.1038/bcj.2016.9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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] [Received: 01/17/2016] [Accepted: 02/02/2016] [Indexed: 11/09/2022] Open
Abstract
Efficacy of lenalidomide was investigated in 103 patients with relapsed/refractory chronic lymphocytic leukemia (CLL) treated on the prospective, multicenter randomized phase-II CLL-009 trial. Interphase cytogenetic and mutational analyses identified TP53 mutations, unmutated IGHV, or del(17p) in 36/96 (37.5%), 68/88 (77.3%) or 22/92 (23.9%) patients. The overall response rate (ORR) was 40.4% (42/104). ORRs were similar irrespective of TP53 mutation (36.1% (13/36) vs 43.3% (26/60) for patients with vs without mutation) or IGHV mutation status (45.0% (9/20) vs 39.1% (27/68)); however, patients with del(17p) had lower ORRs than those without del(17p) (21.7% (5/22) vs 47.1% (33/70); P=0.049). No significant differences in progression-free survival and overall survival (OS) were observed when comparing subgroups defined by the presence or absence of high-risk genetic characteristics. In multivariate analyses, only multiple prior therapies (⩾3 lines) significantly impacted outcomes (median OS: 21.2 months vs not reached; P=0.019). This analysis indicates that lenalidomide is active in patients with relapsed/refractory CLL with unfavorable genetic profiles, including TP53 inactivation or unmutated IGHV. (ClinicalTrials.gov identifier: NCT00963105).
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Affiliation(s)
- A Bühler
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - C-M Wendtner
- Klinikum Schwabing, Academic Teaching Hospital of University of Munich, Munich, Germany.,Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - T J Kipps
- University of California San Diego Moores Cancer Center, La Jolla, CA, USA
| | - L Rassenti
- University of California San Diego Moores Cancer Center, La Jolla, CA, USA
| | - G A M Fraser
- McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada
| | - A-S Michallet
- Hospices civils de Lyon, Centre Hospitalier Lyon Sud, Lyon, France
| | - P Hillmen
- St James's Institute of Oncology, Leeds, UK
| | - J Dürig
- University Hospital Essen, Essen, Germany
| | - S A Gregory
- Rush University Medical Center, Chicago, IL, USA
| | | | | | - L Trentin
- Padua University School of Medicine, Padua, Italy
| | - J G Gribben
- Barts Cancer Institute, Queen Mary, University of London, London, UK
| | | | - B Purse
- Celgene Corporation, Summit NJ, USA
| | - J Zhang
- Celgene Corporation, Summit NJ, USA
| | | | - J Mei
- Celgene Corporation, Summit NJ, USA
| | - M Hallek
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress Responses in Aging-associated Diseases (CECAD), Cologne, Germany
| | - S Stilgenbauer
- Department of Internal Medicine III, Ulm University, Ulm, Germany
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10
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Hirth S, Bühler A, Bührdel JB, Rudeck S, Dahme T, Rottbauer W, Just S. Paxillin and Focal Adhesion Kinase (FAK) Regulate Cardiac Contractility in the Zebrafish Heart. PLoS One 2016; 11:e0150323. [PMID: 26954676 PMCID: PMC4782988 DOI: 10.1371/journal.pone.0150323] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/11/2016] [Indexed: 01/28/2023] Open
Abstract
An orchestrated interplay of adaptor and signaling proteins at mechano-sensitive sites is essential to maintain cardiac contractility and when defective leads to heart failure. We recently showed that Integrin-linked Kinase (ILK), ß-Parvin and PINCH form the IPP-complex to grant tuned Protein Kinase B (PKB) signaling in the heart. Loss of one of the IPP-complex components results in destabilization of the whole complex, defective PKB signaling and finally heart failure. Two components of IPP, ILK and ß-Parvin directly bind to Paxillin; however, the impact of this direct interaction on the maintenance of heart function is not known yet. Here, we show that targeted gene inactivation of Paxillin results in progressive decrease of cardiac contractility and heart failure in zebrafish without affecting IPP-complex stability and PKB phosphorylation. However, we found that Paxillin deficiency leads to the destabilization of its known binding partner Focal Adhesion Kinase (FAK) and vice versa resulting in degradation of Vinculin and thereby heart failure. Our findings highlight an essential role of Paxillin and FAK in controlling cardiac contractility via the recruitment of Vinculin to mechano-sensitive sites in cardiomyocytes.
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Affiliation(s)
- Sofia Hirth
- Molecular Cardiology, University of Ulm, Ulm, Germany
| | - Anja Bühler
- Molecular Cardiology, University of Ulm, Ulm, Germany
| | | | - Steven Rudeck
- Molecular Cardiology, University of Ulm, Ulm, Germany
| | - Tillman Dahme
- Department of Medicine II, University of Ulm, Ulm, Germany
| | - Wolfgang Rottbauer
- Department of Medicine II, University of Ulm, Ulm, Germany
- * E-mail: (SJ); (WR)
| | - Steffen Just
- Molecular Cardiology, University of Ulm, Ulm, Germany
- * E-mail: (SJ); (WR)
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11
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Rustler C, Scheifhacken S, Bühler A, Schulze K, Bonse-Rohmann M, Schweizer I. Strategien zur Implementierung eines Programmes zur Prävention und Reduktion des Tabakkonsums in der Pflegeausbildung. Pneumologie 2016. [DOI: 10.1055/s-0036-1572046] [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: 10/22/2022]
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12
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Bühler A, Kustermann M, Bummer T, Rottbauer W, Sandri M, Just S. Atrogin-1 Deficiency Leads to Myopathy and Heart Failure in Zebrafish. Int J Mol Sci 2016; 17:ijms17020187. [PMID: 26840306 PMCID: PMC4783921 DOI: 10.3390/ijms17020187] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 11/30/2015] [Revised: 01/13/2016] [Accepted: 01/18/2016] [Indexed: 12/21/2022] Open
Abstract
Orchestrated protein synthesis and degradation is fundamental for proper cell function. In muscle, impairment of proteostasis often leads to severe cellular defects finally interfering with contractile function. Here, we analyze for the first time the role of Atrogin-1, a muscle-specific E3 ubiquitin ligase known to be involved in the regulation of protein degradation via the ubiquitin proteasome and the autophagy/lysosome systems, in the in vivo model system zebrafish (Danio rerio). We found that targeted inactivation of zebrafish Atrogin-1 leads to progressive impairment of heart and skeletal muscle function and disruption of muscle structure without affecting early cardiogenesis and skeletal muscle development. Autophagy is severely impaired in Atrogin-1-deficient zebrafish embryos resulting in the disturbance of the cytoarchitecture of cardiomyocytes and skeletal muscle cells. These observations are consistent with molecular and ultrastructural findings in an Atrogin-1 knockout mouse and demonstrate that the zebrafish is a suitable vertebrate model to study the molecular mechanisms of Atrogin-1-mediated autophagic muscle pathologies and to screen for novel therapeutically active substances in high-throughput in vivo small compound screens (SCS).
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Affiliation(s)
- Anja Bühler
- Molecular Cardiology, University of Ulm, 89081 Ulm, Germany.
| | | | - Tiziana Bummer
- Molecular Cardiology, University of Ulm, 89081 Ulm, Germany.
| | - Wolfgang Rottbauer
- Department of Internal Medicine II, University of Ulm, 89081 Ulm, Germany.
| | - Marco Sandri
- Department of Biomedical Sciences, University of Padova, 35129 Padova, Italy.
| | - Steffen Just
- Molecular Cardiology, University of Ulm, 89081 Ulm, Germany.
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13
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Rustler C, Scheifhacken S, Bühler A, Schulze K, Bonse-Rohmann M, Schweizer I. Mit dem astra-Programm rauchfrei durch die Pflegeausbildung. Pneumologie 2015. [DOI: 10.1055/s-0035-1544680] [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: 10/24/2022]
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14
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Bühler A, Piontek D. [Development of a Checklist to Assess School Smoking Policy]. Gesundheitswesen 2014; 77 Suppl 1:S112-3. [PMID: 24671887 DOI: 10.1055/s-0032-1330027] [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: 10/25/2022]
Abstract
The school system is an established setting for behavioural and environmental tobacco prevention activities. Most research on the effectiveness of tobacco prevention has been conducted with regard to behavioural approaches, knowledge about school smoking policy is lacking. This research project aimed at developing a psychometrically sound instrument to assess school smoking policy. The checklist presented here contains five scales with a total of 15 items. Its reliability was tested with 42 Bavarian schools and 607 schools from Hesse. The checklist allows to measure school smoking policy in a reliable and action-oriented manner.
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Affiliation(s)
- A Bühler
- IFT Institut für Therapieforschung, München
| | - D Piontek
- IFT Institut für Therapieforschung, München
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Thrul J, Bühler A, Ferguson S. Die Nutzung von Internet und Mobiltelefonen im Rahmen einer Ecological Momentary Assessment Studie mit jungen erwachsenen Rauchenden. Suchttherapie 2013. [DOI: 10.1055/s-0033-1351600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Fink AM, Böttcher S, Ritgen M, Fischer K, Pflug N, Eichhorst B, Wendtner CM, Winkler D, Bühler A, Zenz T, Staib P, Mayer J, Hensel M, Hopfinger G, Wenger M, Fingerle-Rowson G, Döhner H, Kneba M, Stilgenbauer S, Busch R, Hallek M. Prediction of poor outcome in CLL patients following first-line treatment with fludarabine, cyclophosphamide and rituximab. Leukemia 2013; 27:1949-52. [PMID: 23787395 PMCID: PMC3768112 DOI: 10.1038/leu.2013.190] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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17
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Bühler A. Der Kindergarten als Zugangsweg für selektive familienorientierte Prävention von Übergewicht. Gesundheitswesen 2013; 77 Suppl 1:S25-6. [DOI: 10.1055/s-0033-1333712] [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: 10/26/2022]
Affiliation(s)
- A. Bühler
- IFT Institut für Therapieforschung, München
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Bühler A, Kötter C, Stemmler M, Jaursch S, Lösel F. [EFFEKT-E: Effectiveness of a Prevention Programme for Children and their Depressed Mothers]. Gesundheitswesen 2013; 77 Suppl 1:S64-5. [PMID: 23572470 DOI: 10.1055/s-0032-1333244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to develop an effective selective preventive programme for the risk group of children of depressed mothers. A universal parent and child training concept was adapted to the target group and to mother-child rehabilitation clinic conditions. A quasi-experimental design was implemented with 13 clinics. Evaluation of the results reveals that EFFEKT-E is an accepted, feasible selective programme which has the potential to enhance maternal competence and prevent children's emotional disruption.
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Affiliation(s)
- A Bühler
- IFT Institut für Therapieforschung, München
| | - C Kötter
- IFT Institut für Therapieforschung, München
| | - M Stemmler
- IFT Institut für Therapieforschung, München
| | - S Jaursch
- IFT Institut für Therapieforschung, München
| | - F Lösel
- IFT Institut für Therapieforschung, München
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19
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Elter T, James R, Busch R, Winkler D, Ritgen M, Böttcher S, Kahl C, Gassmann W, Stauch M, Hasan I, Staib P, Fischer K, Fink AM, Bahlo J, Bühler A, Döhner H, Wendtner CM, Stilgenbauer S, Engert A, Hallek M. Fludarabine and cyclophosphamide in combination with alemtuzumab in patients with primary high-risk, relapsed or refractory chronic lymphocytic leukemia. Leukemia 2012; 26:2549-52. [DOI: 10.1038/leu.2012.129] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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20
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Hallek M, Fischer K, Fingerle-Rowson G, Fink AM, Busch R, Mayer J, Hensel M, Hopfinger G, Hess G, von Grünhagen U, Bergmann M, Catalano J, Zinzani PL, Caligaris-Cappio F, Seymour JF, Berrebi A, Jäger U, Cazin B, Trneny M, Westermann A, Wendtner CM, Eichhorst BF, Staib P, Bühler A, Winkler D, Zenz T, Böttcher S, Ritgen M, Mendila M, Kneba M, Döhner H, Stilgenbauer S. Addition of rituximab to fludarabine and cyclophosphamide in patients with chronic lymphocytic leukaemia: a randomised, open-label, phase 3 trial. Lancet 2010; 376:1164-74. [PMID: 20888994 DOI: 10.1016/s0140-6736(10)61381-5] [Citation(s) in RCA: 1269] [Impact Index Per Article: 90.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND On the basis of promising results that were reported in several phase 2 trials, we investigated whether the addition of the monoclonal antibody rituximab to first-line chemotherapy with fludarabine and cyclophosphamide would improve the outcome of patients with chronic lymphocytic leukaemia. METHODS Treatment-naive, physically fit patients (aged 30-81 years) with CD20-positive chronic lymphocytic leukaemia were randomly assigned in a one-to-one ratio to receive six courses of intravenous fludarabine (25 mg/m(2) per day) and cyclophosphamide (250 mg/m(2) per day) for the first 3 days of each 28-day treatment course with or without rituximab (375 mg/m(2) on day 0 of first course, and 500 mg/m(2) on day 1 of second to sixth courses) in 190 centres in 11 countries. Investigators and patients were not masked to the computer-generated treatment assignment. The primary endpoint was progression-free survival (PFS). Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00281918. FINDINGS 408 patients were assigned to fludarabine, cyclophosphamide, and rituximab (chemoimmunotherapy group) and 409 to fludarabine and cyclophosphamide (chemotherapy group); all patients were analysed. At 3 years after randomisation, 65% of patients in the chemoimmunotherapy group were free of progression compared with 45% in the chemotherapy group (hazard ratio 0·56 [95% CI 0·46-0·69], p<0·0001); 87% were alive versus 83%, respectively (0·67 [0·48-0·92]; p=0·01). Chemoimmunotherapy was more frequently associated with grade 3 and 4 neutropenia (136 [34%] of 404 vs 83 [21%] of 396; p<0·0001) and leucocytopenia (97 [24%] vs 48 [12%]; p<0·0001). Other side-effects, including severe infections, were not increased. There were eight (2%) treatment-related deaths in the chemoimmunotherapy group compared with ten (3%) in the chemotherapy group. INTERPRETATION Chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab improves progression-free survival and overall survival in patients with chronic lymphocytic leukaemia. Moreover, the results suggest that the choice of a specific first-line treatment changes the natural course of chronic lymphocytic leukaemia. FUNDING F Hoffmann-La Roche.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cyclophosphamide/administration & dosage
- Disease Progression
- Disease-Free Survival
- Drug Administration Schedule
- Female
- Humans
- Immunologic Factors/administration & dosage
- Incidence
- Kaplan-Meier Estimate
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukopenia/chemically induced
- Male
- Middle Aged
- Neutropenia/chemically induced
- Rituximab
- Severity of Illness Index
- Treatment Outcome
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
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Affiliation(s)
- M Hallek
- Department I of Internal Medicine and Centre for Integrated Oncology, University of Cologne, Cologne, Germany.
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Affiliation(s)
- A Bühler
- IFT Institut für Therapieforschung, München.
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Bühler A, Heer O. Beziehungen zwischen Zahnkaries und relativer Azidität des Speichels und des Harns. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0028-1144295] [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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Grau AJ, Buggle F, Ziegler C, Schwarz W, Meuser J, Tasman AJ, Bühler A, Benesch C, Becher H, Hacke W. Association between acute cerebrovascular ischemia and chronic and recurrent infection. Stroke 1997; 28:1724-9. [PMID: 9303015 DOI: 10.1161/01.str.28.9.1724] [Citation(s) in RCA: 176] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE We performed a case-control study to investigate whether chronic or recurrent respiratory, ear-nose-throat (ENT), and dental infections are risk factors for cerebrovascular ischemia. METHODS Using a standardized questionnaire we investigated past infectious diseases in 166 consecutive patients with acute cerebrovascular ischemia and in 166 age- and sex-matched nonstroke neurological patient controls. In subgroups, we performed standardized ENT (69 patients, 66 control subjects) and dental examinations including orthopantomography (66 patients, 60 control subjects). Dental status was determined by a total dental index (TDI) that reflects caries, periapical lesions, periodontitis, and other dental lesions and by an orthopantomography index (OPGI) that was assessed blinded. RESULTS Frequent (> or = 2 episodes in each of the 2 preceding years) or chronic bronchitis was associated with cerebrovascular ischemia in age-adjusted multiple logistic regression analysis (odds ratio, OR, 2.2; 95% confidence interval, CI, 1.04 to 4.6). Groups were not different in ENT examination. Patients tended to have a worse dental status (TDI: P = .070; OPGI: P = .062) and had more severe periodontitis (P = .047) and periapical lesions (P = .027) than control subjects. In age-adjusted multiple logistic regression analysis with social status and established vascular risk factors, poor dental status (TDI) was independently associated with cerebrovascular ischemia (OR, 2.6; 95% CI, 1.18 to 5.7). CONCLUSION Recurrent or chronic bronchial infection and poor dental status, mainly resulting from chronic dental infection, may be associated with an increased risk for cerebrovascular ischemia.
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Affiliation(s)
- A J Grau
- Department of Neurology, University of Heidelberg, Germany.
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Hege-Scheuing G, Michaelsen K, Bühler A, Kustermann J, Seeling W. [Analgesia with intra-articular morphine following knee joint arthroscopy? A double-blind, randomized study with patient-controlled analgesia]. Anaesthesist 1995; 44:351-8. [PMID: 7611583 DOI: 10.1007/s001010050164] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
UNLABELLED Previous studies investigating the peripheral action of locally instilled morphine after arthroscopic knee surgery found evidence for an analgesic effect. Follow-up studies have lead to conflicting results. We used patient-controlled analgesia (PCA) to test the analgesic potency of intraarticular morphine. METHODS. Patients undergoing arthroscopic knee surgery under general anaesthesia received, after written informed consent and in double-blind and randomised manner, 1 mg morphine diluted in 10 ml saline either intraarticularly or intravenously at the end of the surgical procedure. A control injection of 10 ml saline was given at the other site. The pain intensity on a visual analogue scale (VAS) and the cumulative morphine consumption were recorded at 1, 2, 3, 4, 6, 8 and 24 h after the end of general anaesthesia. STATISTICS Wilcoxon rank sum test with P < 0.05. RESULTS. A total of 59 patients were included in the study; 29 received morphine intraarticularly (verum group), 30 intravenously (control group). There was no difference in gender, age, duration of arthroscopy or anaesthesia. There were more than 60% diagnostic arthroscopies in both groups; other types of surgery were comparable, with the exception of cruciate band repair procedures only in the control group. We found no difference in morphine consumption or pain intensity between the two groups throughout the study period. Median overall consumption of morphine after 24 h was 14 mg in the verum group and 15 mg in the control group, with wide interindividual variation. Pain intensities were remarkably low. The peak pain intensity of both groups was found at 1 h postoperatively, with median 16/100 on the VAS in both groups. Blinding was robust. CONCLUSION. We found no reduction in postoperative morphine supplementation after 1 mg morphine intraarticularly compared to 1 mg intravenously given at the end of knee arthroscopies. There were also no differences in pain intensities on a VAS. We conclude that titration of postoperative pain with a morphine-filled PCA pump was unable to show a difference in analgesic potency between intraarticular and intravenous morphine.
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Affiliation(s)
- G Hege-Scheuing
- Sektion Schmerztherapie, Universitätsklinik für Anästhesiologie Ulm
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Ehrsam RE, Bühler A, Müller P, Mauli D, Schumacher PM, Howald H, Imhof PR. [Weaning of young smokers using a transdermal nicotine patch]. Schweiz Rundsch Med Prax 1991; 80:145-50. [PMID: 2008547] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To assess efficacy and tolerance of a transdermal nicotine system (TNS) as adjuvant to tobacco withdrawal, 112 young, nicotine-dependent cigarette smokers were treated for nine weeks with TNS (n = 56) or placebo (n = 56). Initial doses of nicotine (21 or 14 mg/24 h) were based on previous smoking habits and stepwise reduced to 7 mg/24 h if abstinence was achieved during medication. After treatment, 39.3% of the TNS users were abstinent versus 19.6% on placebo (p less than 0.05). The craving for cigarettes diminished steadily, but not more significantly on TNS medication. Tenseness, difficulty in concentration and feelings of hunger were consistently and in part significantly lessened in the TNS group. The other withdrawal symptoms were not influenced by TNS treatment. Nine-month follow-up cotinine-verified abstinence rates were 12.5% in the TNS and 3.6% in the placebo group (n. s.). Transient mild or moderate erythema at the application site appeared in 20% of the TNS and 6.3% of the placebo group, and 7.1% of the TNS users dropped out because of severe localized erythema. Other mild, transient, systemic side effects reported by 33.9% of the TNS and 26.8% of the placebo users (n. s.) did not lead to drop-outs.
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Affiliation(s)
- R E Ehrsam
- Institut für Sport der Med. Fakultät, Universität Basel
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Schläpfer HU, Nüesch HJ, Kobler E, Bonetti A, Bühler A, Sulser H, Deyhle P. [Nonspecific ulcer of the colon: a report on 12 endoscopically diagnosed cases]. Schweiz Med Wochenschr 1979; 109:609-10. [PMID: 432591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Report on 12 patients with nonspecific ulcers of the colon diagnosed by colonscopy and biopsy. In 10 patients the course was favorable with conservative management. In 2 patients the symptoms were aggravated; in both patients this was due to a penetrating malignant tumour diagnosed at laparotomy a few weeks later. It is proposed that nonspecific ulcers of the colon should be managed conservatively. Further investigations and laparotomy are indicated only when symptoms progress.
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Bühler A, Bünning E. [Peroidic luminescence in Omphalia flavida]. Arch Mikrobiol 1965; 52:80-2. [PMID: 5895106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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