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Shen Y, Schmaderer C, Ossadnik A, Hammitzsch A, Carbajo-Lozoya J, Bachmann Q, Bonell V, Braunisch MC, Heemann U, Pham D, Kemmner S, Lorenz G. Immunophenotypic Characterization of Citrate-Containing A Concentrates in Maintenance Hemodialysis: A Pre-Post Study. Int J Nephrol 2023; 2023:7772677. [PMID: 37809041 PMCID: PMC10551471 DOI: 10.1155/2023/7772677] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 06/07/2023] [Accepted: 06/21/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Due to chronic inflammation, maintenance hemodialysis (MHD) patients continue to show excess mortality. Acetate-free citrate-buffered A concentrates could be a way to improve the biocompatibility of the procedure, reduce chronic inflammation, and thus in the long term improve the prognosis of patients. Methods Using a pre-post design (3 months of acetate followed by 3 months of citrate-acidified A concentrates in standard bicarbonate-based dialysate hemodialysis, CiaHD) and linear mixed model analysis in 61 stable HD patients, we assessed the impact of CiaHD on counts and phenotypes of peripheral T cells and monocytes by flow cytometry. Results Switching to CiaHD left C-reactive protein (CRP) levels and leucocyte counts unaffected. However, CiaHD increased lymphocyte counts ex vivo. Furthermore, we found a decrease in total CD3+CD4+CD69+ ((109/L), mean ± SD: acetate, 0.04 ± 1.0 versus citrate, 0.02 ± 0.01; P = 0.02) activated cells, while the number of CD28+ T cells remained stable. No differences were noted regarding T-cell exhaustion marker expression, CD14+CD16+ monocyte counts, and PMN-MDSCs. Conclusion Compared with acetate, CiaHD has a minor impact on lymphocyte counts and CD4+T-cell activation, which was independent of systemic CRP and ionized magnesium, calcium levels, and other dialysis prescription modalities.
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Affiliation(s)
- Yuli Shen
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
- Nephrology and Rheumatology Department of the Second Affiliated Hospital, School of Medicine, The Chinese University of Hong Kong, Shenzhen & Longgang District People's Hospital of Shenzhen, Shenzhen 518172, China
| | - Christoph Schmaderer
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Andreas Ossadnik
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Arianne Hammitzsch
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Javier Carbajo-Lozoya
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Quirin Bachmann
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Vera Bonell
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Matthias Christoph Braunisch
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Uwe Heemann
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Dang Pham
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Stephan Kemmner
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
| | - Georg Lorenz
- Department of Nephrology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
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Braunisch MC, Bachmann Q, Hammitzsch A, Lorenz G, Geisler F, Schmaderer C, Heemann U, Moog P. [Prospective monitoring of a university rheumatology outpatient clinic throughout the first wave of the COVID-19 pandemic : What lessons can be learned?]. Z Rheumatol 2020; 80:408-417. [PMID: 33258019 PMCID: PMC7703502 DOI: 10.1007/s00393-020-00935-8] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 12/15/2022]
Abstract
Hintergrund Im März 2020 breitete sich die SARS-CoV-2-Pandemie initial v. a. in Bayern aus. Zu diesem Zeitpunkt war weitgehend unklar, wie mit der immunmodulatorischen Therapie bei Rheumapatienten umzugehen ist. Ziel der Arbeit Das Ziel war es, den Einfluss der Pandemie auf klinische Entscheidungen zu erfassen. Material und Methoden Es wurden zwischen dem 16.03. und 31.07.2020 Patienten eingeschlossen, die sich in der Rheumaambulanz des Klinikums rechts der Isar vorstellten. Anpassungen der Therapie erfolgten nach klinischem Ermessen und in Anlehnung an die Handlungsempfehlungen der DGRh. Ergebnisse Es wurden 322 Patienten eingeschlossen. Die häufigsten Diagnosen waren die rheumatoide Arthritis mit 17 %, die ANCA-assoziierte Vaskulitis (AAV) mit 14 % sowie der SLE mit 12 %; 262 Patienten erhielten eine DMARD-Therapie und 77 Patienten orale Glukokortikoide. Es lagen 5 SARS-CoV-2-Verdachtsfälle vor. Kein Patient erkrankte nachweislich an COVID-19. Eine Therapieänderung erfolgte aufgrund der Pandemie bei 40 Patienten. Dabei kam es bei 3 Patienten zu einem Flare der Grunderkrankung. Eine Therapiedeeskalation erfolgte am häufigsten bei AAV, IgG4-assoziierter Erkrankung sowie bei gleichzeitig bestehenden Malignomen und beim Einsatz von Rituximab. Diskussion In dieser Single-Center-Kohorte legt das gänzliche Fehlen von nachweislichen SARS-CoV-2-Infektionen in einer sonst relativ stark betroffenen Region den Schluss nahe, dass kein überproportional erhöhtes Infektionsrisiko für Patienten mit entzündlich rheumatischen Erkrankungen zu bestehen scheint. Eine Fortführung der meisten immunsuppressiven Therapien erscheint daher sinnvoll.
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Affiliation(s)
- M C Braunisch
- Sektion Rheumatologie, Abteilung für Nephrologie, II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Q Bachmann
- Sektion Rheumatologie, Abteilung für Nephrologie, II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - A Hammitzsch
- Sektion Rheumatologie, Abteilung für Nephrologie, II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - G Lorenz
- Sektion Rheumatologie, Abteilung für Nephrologie, II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - F Geisler
- II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, München, Deutschland
| | - C Schmaderer
- Sektion Rheumatologie, Abteilung für Nephrologie, II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - U Heemann
- Sektion Rheumatologie, Abteilung für Nephrologie, II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - P Moog
- Sektion Rheumatologie, Abteilung für Nephrologie, II. Medizinische Klinik, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
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Chen L, Al-Mossawi MH, Ridley A, Sekine T, Hammitzsch A, de Wit J, Simone D, Shi H, Penkava F, Kurowska-Stolarska M, Pulyakhina I, Knight JC, Kim TJ, Bowness P. miR-10b-5p is a novel Th17 regulator present in Th17 cells from ankylosing spondylitis. Ann Rheum Dis 2016; 76:620-625. [PMID: 28039186 DOI: 10.1136/annrheumdis-2016-210175] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 07/05/2016] [Revised: 11/28/2016] [Accepted: 12/03/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To determine the microRNA (miR) signature in ankylosing spondylitis (AS) T helper (Th)17 cells. METHODS Interleukin (IL)-17A-producing CD4+ T cells from patients with AS and healthy controls were FACS-sorted for miR sequencing and qPCR validation. miR-10b function was determined by miR mimic expression followed by cytokine measurement, transcriptome analysis, qPCR and luciferase assays. RESULTS AS Th17 cells exhibited a miR signature characterised by upregulation of miR-155-5p, miR-210-3p and miR-10b. miR-10b has not been described previously in Th17 cells and was selected for further characterisation. miR-10b is transiently induced in in vitro differentiated Th17 cells. Transcriptome, qPCR and luciferase assays suggest that MAP3K7 is targeted by miR-10b. Both miR-10b overexpression and MAP3K7 silencing inhibited production of IL-17A by both total CD4 and differentiating Th17 cells. CONCLUSIONS AS Th17 cells have a specific miR signature and upregulate miR-10b in vitro. Our data suggest that miR-10b is upregulated by proinflammatory cytokines and may act as a feedback loop to suppress IL-17A by targeting MAP3K7. miR-10b is a potential therapeutic candidate to suppress pathogenic Th17 cell function in patients with AS.
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Affiliation(s)
- L Chen
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - M H Al-Mossawi
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - A Ridley
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - T Sekine
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - A Hammitzsch
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Department of Nephrology, Klinikum rechts der lsar, Technical University of Munich, Munich, Germany
| | - J de Wit
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - D Simone
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - H Shi
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - F Penkava
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - M Kurowska-Stolarska
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - I Pulyakhina
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - J C Knight
- Nuffield Department of Medicine, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - T J Kim
- Department of Rheumatology, Medical School and Hospital, Chonnam National University, Gwangju, Republic of Korea
| | - P Bowness
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,National Institute for Health Research Oxford Musculoskeletal Biomedical Research Unit, Oxford, UK
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Hammitzsch A, Chen L, Al-Mossawi H, Simone D, Ridley A, Bowness P. OP0156 Deciphering The in Vitro Therapeutic Potential of JAK Inhibitors in Ankylosing Spondylitis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Neumann C, Proft F, Hammitzsch A, Gruenke M, Schulze-Koops H. THU0515 Hypogammaglobulinemia is a Frequent Finding in Patients Under Immunosuppressive Therapy but Does not Correlate with Susceptibility to Infections. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1043] [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: 11/04/2022]
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