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Schmid CD, Olsavszky V, Reinhart M, Weyer V, Trogisch FA, Sticht C, Winkler M, Kürschner SW, Hoffmann J, Ola R, Staniczek T, Heineke J, Straub BK, Mittler J, Schledzewski K, ten Dijke P, Richter K, Dooley S, Géraud C, Goerdt S, Koch P. ALK1 controls hepatic vessel formation, angiodiversity, and angiocrine functions in hereditary hemorrhagic telangiectasia of the liver. Hepatology 2023; 77:1211-1227. [PMID: 35776660 PMCID: PMC10026949 DOI: 10.1002/hep.32641] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS In hereditary hemorrhagic telangiectasia (HHT), severe liver vascular malformations are associated with mutations in the Activin A Receptor-Like Type 1 ( ACVRL1 ) gene encoding ALK1, the receptor for bone morphogenetic protein (BMP) 9/BMP10, which regulates blood vessel development. Here, we established an HHT mouse model with exclusive liver involvement and adequate life expectancy to investigate ALK1 signaling in liver vessel formation and metabolic function. APPROACH AND RESULTS Liver sinusoidal endothelial cell (LSEC)-selective Cre deleter line, Stab2-iCreF3 , was crossed with Acvrl1 -floxed mice to generate LSEC-specific Acvrl1 -deficient mice ( Alk1HEC-KO ). Alk1HEC-KO mice revealed hepatic vascular malformations and increased posthepatic flow, causing right ventricular volume overload. Transcriptomic analyses demonstrated induction of proangiogenic/tip cell gene sets and arterialization of hepatic vessels at the expense of LSEC and central venous identities. Loss of LSEC angiokines Wnt2 , Wnt9b , and R-spondin-3 ( Rspo3 ) led to disruption of metabolic liver zonation in Alk1HEC-KO mice and in liver specimens of patients with HHT. Furthermore, prion-like protein doppel ( Prnd ) and placental growth factor ( Pgf ) were upregulated in Alk1HEC-KO hepatic endothelial cells, representing candidates driving the organ-specific pathogenesis of HHT. In LSEC in vitro , stimulation or inhibition of ALK1 signaling counter-regulated Inhibitors of DNA binding (ID)1-3, known Alk1 transcriptional targets. Stimulation of ALK1 signaling and inhibition of ID1-3 function confirmed regulation of Wnt2 and Rspo3 by the BMP9/ALK1/ID axis. CONCLUSIONS Hepatic endothelial ALK1 signaling protects from development of vascular malformations preserving organ-specific endothelial differentiation and angiocrine signaling. The long-term surviving Alk1HEC-KO HHT model offers opportunities to develop targeted therapies for this severe disease.
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Affiliation(s)
- Christian David Schmid
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Victor Olsavszky
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Manuel Reinhart
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Vanessa Weyer
- Department of Neuroradiology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Radiation Oncology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Felix A. Trogisch
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Cardiovascular Physiology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Carsten Sticht
- Core Facility Platform Mannheim, NGS Core Facility, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Manuel Winkler
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sina W. Kürschner
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johannes Hoffmann
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Roxana Ola
- Department of Cardiovascular Pharmacology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Theresa Staniczek
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Joerg Heineke
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Cardiovascular Physiology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Beate K. Straub
- Institute of Pathology, University Medical Center of the Johannes Gutenberg‐University Mainz, Mainz, Germany
| | - Jens Mittler
- Department of General, Visceral, and Transplant Surgery, University Medical Center of the Johannes Gutenberg‐University Mainz, Mainz, Germany
| | - Kai Schledzewski
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Peter ten Dijke
- Oncode Institute, Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karsten Richter
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Steven Dooley
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Section of Clinical and Molecular Dermatology, Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Philipp‐Sebastian Koch
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Manta CP, Leibing T, Friedrich M, Nolte H, Adrian M, Schledzewski K, Krzistetzko J, Kirkamm C, David Schmid C, Xi Y, Stojanovic A, Tonack S, de la Torre C, Hammad S, Offermanns S, Krüger M, Cerwenka A, Platten M, Goerdt S, Géraud C. Targeting of Scavenger Receptors Stabilin-1 and Stabilin-2 Ameliorates Atherosclerosis by a Plasma Proteome Switch Mediating Monocyte/Macrophage Suppression. Circulation 2022; 146:1783-1799. [PMID: 36325910 DOI: 10.1161/circulationaha.121.058615] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Scavenger receptors Stabilin-1 (Stab1) and Stabilin-2 (Stab2) are preferentially expressed by liver sinusoidal endothelial cells. They mediate the clearance of circulating plasma molecules controlling distant organ homeostasis. Studies suggest that Stab1 and Stab2 may affect atherosclerosis. Although subsets of tissue macrophages also express Stab1, hematopoietic Stab1 deficiency does not modulate atherogenesis. Here, we comprehensively studied how targeting Stab1 and Stab2 affects atherosclerosis. METHODS ApoE-KO mice were interbred with Stab1-KO and Stab2-KO mice and fed a Western diet. For antibody targeting, Ldlr-KO mice were also used. Unbiased plasma proteomics were performed and independently confirmed. Ligand binding studies comprised glutathione-S-transferase-pulldown and endocytosis assays. Plasma proteome effects on monocytes were studied by single-cell RNA sequencing in vivo, and by gene expression analyses of Stabilin ligand-stimulated and plasma-stimulated bone marrow-derived monocytes/macrophages in vitro. RESULTS Spontaneous and Western diet-associated atherogenesis was significantly reduced in ApoE-Stab1-KO and ApoE-Stab2-KO mice. Similarly, inhibition of Stab1 or Stab2 by monoclonal antibodies significantly reduced Western diet-associated atherosclerosis in ApoE-KO and Ldlr-KO mice. Although neither plasma lipid levels nor circulating immune cell numbers were decisively altered, plasma proteomics revealed a switch in the plasma proteome, consisting of 231 dysregulated proteins comparing wildtype with Stab1/2-single and Stab1/2-double KO, and of 41 proteins comparing ApoE-, ApoE-Stab1-, and ApoE-Stab2-KO. Among this broad spectrum of common, but also disparate scavenger receptor ligand candidates, periostin, reelin, and TGFBi (transforming growth factor, β-induced), known to modulate atherosclerosis, were independently confirmed as novel circulating ligands of Stab1/2. Single-cell RNA sequencing of circulating myeloid cells of ApoE-, ApoE-Stab1-, and ApoE-Stab2-KO mice showed transcriptomic alterations in patrolling (Ccr2-/Cx3cr1++/Ly6Clo) and inflammatory (Ccr2+/Cx3cr1+/Ly6Chi) monocytes, including downregulation of proatherogenic transcription factor Egr1. In wildtype bone marrow-derived monocytes/macrophages, ligand exposure alone did not alter Egr1 expression in vitro. However, exposure to plasma from ApoE-Stab1-KO and ApoE-Stab2-KO mice showed a reverted proatherogenic macrophage activation compared with ApoE-KO plasma, including downregulation of Egr1 in vitro. CONCLUSIONS Inhibition of Stab1/Stab2 mediates an anti-inflammatory switch in the plasma proteome, including direct Stabilin ligands. The altered plasma proteome suppresses both patrolling and inflammatory monocytes and, thus, systemically protects against atherogenesis. Altogether, anti-Stab1- and anti-Stab2-targeted therapies provide a novel approach for the future treatment of atherosclerosis.
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Affiliation(s)
- Calin-Petru Manta
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Thomas Leibing
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Section of Clinical and Molecular Dermatology (T.L., M.A., J.K., C.K., Y.X., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Mirco Friedrich
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Department of Neurology, MCTN (M.F., M.P.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,DKTK Clinical Cooperation Unit Neuroimmunology and Brain Tumor Immunology, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.F., M.P.)
| | - Hendrik Nolte
- European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Institute for Genetics and CECAD, University of Cologne, Germany (H.N., M.K.).,Max Planck Institute for Biology of Ageing, Cologne, Germany (H.N.)
| | - Monica Adrian
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Section of Clinical and Molecular Dermatology (T.L., M.A., J.K., C.K., Y.X., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Kai Schledzewski
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Jessica Krzistetzko
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Section of Clinical and Molecular Dermatology (T.L., M.A., J.K., C.K., Y.X., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Christof Kirkamm
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Section of Clinical and Molecular Dermatology (T.L., M.A., J.K., C.K., Y.X., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Christian David Schmid
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Yannick Xi
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Section of Clinical and Molecular Dermatology (T.L., M.A., J.K., C.K., Y.X., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Ana Stojanovic
- European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Department of Immunobiochemistry, Mannheim Institute for Innate Immunoscience, MI3 (A.S., A.C.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sarah Tonack
- Max Planck Institute for Heart and Lung Research, Department of Pharmacology, Bad Nauheim, Germany (S.T., S.O., M.K.)
| | - Carolina de la Torre
- Centre for Medical Research (ZMF) (C.d.l.T.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Seddik Hammad
- Department of Medicine II (S.H.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Stefan Offermanns
- Max Planck Institute for Heart and Lung Research, Department of Pharmacology, Bad Nauheim, Germany (S.T., S.O., M.K.)
| | - Marcus Krüger
- Institute for Genetics and CECAD, University of Cologne, Germany (H.N., M.K.).,Max Planck Institute for Heart and Lung Research, Department of Pharmacology, Bad Nauheim, Germany (S.T., S.O., M.K.)
| | - Adelheid Cerwenka
- European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Department of Immunobiochemistry, Mannheim Institute for Innate Immunoscience, MI3 (A.S., A.C.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Michael Platten
- European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Department of Neurology, MCTN (M.F., M.P.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,DKTK Clinical Cooperation Unit Neuroimmunology and Brain Tumor Immunology, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.F., M.P.)
| | - Sergij Goerdt
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology, and Allergology (C.-P.M., T.L., M.A., K.S., J.K., C.K., C.D.S., Y.X., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,Section of Clinical and Molecular Dermatology (T.L., M.A., J.K., C.K., Y.X., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany.,European Center for Angioscience (ECAS) (C.-P.M., T.L., M.F., M.A., K.S., J.K., C.K., C.D.S., Y.X., A.S., A.C., M.P., S.G., C.G.), University Medical Center and Medical Faculty Mannheim, Heidelberg University, Germany
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3
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Wohlfeil SA, Häfele V, Dietsch B, Weller C, Sticht C, Jauch AS, Winkler M, Schmid CD, Irkens AL, Olsavszky A, Schledzewski K, Reiners-Koch PS, Goerdt S, Géraud C. Angiogenic and molecular diversity determine hepatic melanoma metastasis and response to anti-angiogenic treatment. J Transl Med 2022; 20:62. [PMID: 35109875 PMCID: PMC8812268 DOI: 10.1186/s12967-022-03255-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Received: 09/29/2021] [Accepted: 01/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cutaneous melanoma exhibits heterogeneous metastatic patterns and prognosis. In this regard, liver metastasis, which is detected in ~ 10-20% of stage 4 patients, came to the fore of melanoma research, as it recently evolved as decisive indicator of treatment resistance to immune checkpoint inhibition. METHODS Hepatic metastases were induced by intrasplenic injection of five different murine melanoma cell lines. The efficiencies of hepatic colonization, morphologic patterns, gene expression profiles and degree of vascularization were analyzed and Sorafenib was applied as anti-angiogenic treatment. RESULTS WT31 melanoma showed the highest efficiency of hepatic colonization, while intermediate efficiencies were observed for B16F10 and RET, and low efficiencies for D4M and HCmel12. RNAseq-based gene expression profiles of high and intermediate metastatic melanomas in comparison to low metastatic melanomas indicated that this efficiency predominantly associates with gene clusters involved in cell migration and angiogenesis. Indeed, heterogeneous vascularization patterns were found in the five models. Although the degree of vascularization of WT31 and B16F10 metastases differed, both showed a strong response to Sorafenib with a successful abrogation of the vascularization. CONCLUSION Our data indicate that molecular heterogeneity of melanomas can be associated with phenotypic and prognostic features of hepatic metastasis paving the way for organ-specific anti-angiogenic therapeutic approaches.
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Affiliation(s)
- Sebastian A Wohlfeil
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany
| | - Verena Häfele
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bianca Dietsch
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Céline Weller
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Carsten Sticht
- NGS Core Facility, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anna Sophia Jauch
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Manuel Winkler
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany
| | - Christian David Schmid
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany
| | - Anna Lena Irkens
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ana Olsavszky
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Kai Schledzewski
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany
| | - Philipp-Sebastian Reiners-Koch
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany.,European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, 68135, Mannheim, Germany. .,Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. .,European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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