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Schüle S, Ostheim P, Muhtadi R, Stewart S, Kaletka G, Hermann C, Port M, Abend M. Evaluating transport conditions of conventional, widely used EDTA blood tubes for gene expression analysis in comparison to expensive, specialized PAXgene tubes in preparedness for radiological and nuclear events. Int J Radiat Biol 2023; 100:99-107. [PMID: 37676284 DOI: 10.1080/09553002.2023.2250871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/29/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Gene expression (GE) analysis of a radio-sensitive gene set (FDXR, DDB2, WNT3, POU2AF1) has been introduced in the last decade as an early and high-throughput prediction tool of later developing acute hematologic radiation syndrome (H-ARS) severity. The use of special tubes for RNA extraction from peripheral whole blood (PAXgene) represent an established standard in GE studies, although uncommonly used in clinics and not immediately available in the quantities needed in radiological/nuclear (R/N) incidents. On the other hand, EDTA blood tubes are widely utilized in clinical practice. MATERIAL AND METHODS Using blood samples from eleven healthy donors, we investigated GE changes associated with delayed processing of EDTA tubes up to 4 h at room temperature (RT) after venipuncture (simulating delays caused by daily clinical routine), followed by a subsequent transport time of 24 h at RT, 4 °C, and -20 °C. Differential gene expression (DGE) of the target genes was further examined after X-irradiation with 0 Gy and 4 Gy under optimal transport conditions. RESULTS No significant changes in DGE were observed when storing EDTA whole blood samples up to 4 h at RT and subsequently kept at 4 °C for 24 h which is in line with expected DGE. However, other storage conditions, such as -20 °C or RT, decreased RNA quality and/or (significantly) caused changes in DGE exceeding the known methodological variance of the qRT-PCR. CONCLUSION Our data indicate that the use of EDTA whole blood tubes for GE-based H-ARS severity prediction is comparable to the quality of PAXgene tubes, when processed ≤ 4 h after venipuncture and the sample is transported within 24 hours at 4 °C.
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Affiliation(s)
- Simone Schüle
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
| | - Patrick Ostheim
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
| | - Razan Muhtadi
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
| | - Samantha Stewart
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
| | - Gwendolyn Kaletka
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, affiliated to the University of Ulm, Munich, Germany
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Schüle S, Hackenbroch C, Beer M, Muhtadi R, Hermann C, Stewart S, Schwanke D, Ostheim P, Port M, Scherthan H, Abend M. Ex-vivo dose response characterization of the recently identified EDA2R gene after low level radiation exposures and comparison with FDXR gene expression and the γH2AX focus assay. Int J Radiat Biol 2023; 99:1584-1594. [PMID: 36988552 DOI: 10.1080/09553002.2023.2194402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 03/09/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE Recently, promising radiation-induced EDA2R gene expression (GE) changes after low level radiation could be shown. Stimulated by that, in this study, we intended to independently validate these findings and to further characterize dose-response relationships in comparison to FDXR and the γH2AX-DNA double-strand break (DSB) focus assay, since both assays are already widely used for biodosimetry purposes. MATERIALS AND METHODS Peripheral blood samples from six healthy human donors were irradiated ex vivo (dose: ranging from 2.6 to 49.7 mGy). Subsequently, the fold-differences relative to the sham irradiated reference group were calculated. Radiation-induced changes in GE of FDXR and EDA2R were examined using the quantitative real-time polymerase-chain-reaction (qRT-PCR). DSB foci were quantified in 100 γH2AX + 53BP1 immunostained cells employing fluorescence microscopy. Examinations were performed at single time points enabling sufficient detection of both endpoints. RESULTS A significant increase in EDA2R GE relative to the unexposed control was observed in the range of 2.6 mGy (1.6-fold, p = .045) to 5.4 mGy (2.2-fold, p = .0002), whereas the copy numbers increased linearly up to 13.1-fold at 49.7 mGy. On the contrary, FDXR upregulation (2.2-fold) became significant after a 22.6 mGy exposure (p ≤ .02) and increased linearly up to 4-fold at 49.7 mGy. A significant increase in radiation-induced foci (relative to unexposed, RIF-fd) was observed after 11.3 mGy (RIF-fd: 1.5 ± 0.5, p ≤ .03), while the foci increased linearly up to 3-fold at 49.7 mGy. From this, the FDXR and RIF-fd slopes have shown comparability, while the EDA2R slope was five times higher. Nevertheless, the coefficient of variation (CV) of EDA2R was about 30% higher than for RIF-fd. CONCLUSION Higher radiation-induced EDA2R GE changes and a lower radiation detection level compared to RIF-fd and FDXR GE changes examined under optimal conditions ex vivo on human samples appear promising. Yet, our results represent just the beginning of further studies to be conducted in animal models for further time- and dose-dependent evaluation and additional examinations on radiologically examined patients to evaluate the impact of confounder, such as age, sex, social behavior, or diseases.
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Affiliation(s)
- Simone Schüle
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Carsten Hackenbroch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Force Hospital of Ulm, Ulm, Germany
- Department of Radiology, University Hospital of Ulm, Ulm, Germany
| | - Meinrad Beer
- Department of Radiology, University Hospital of Ulm, Ulm, Germany
| | - Razan Muhtadi
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Samantha Stewart
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Daniel Schwanke
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Patrick Ostheim
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Harry Scherthan
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Affiliated to the University of Ulm, Munich, Germany
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Rump A, Hermann C, Lamkowski A, Popp T, Port M. A comparison of the chemo- and radiotoxicity of thorium and uranium at different enrichment grades. Arch Toxicol 2023; 97:1577-1598. [PMID: 37022444 PMCID: PMC10182955 DOI: 10.1007/s00204-023-03484-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/02/2023] [Indexed: 04/07/2023]
Abstract
Uranium and thorium are heavy metals, and all of their isotopes are radioactive, so it is impossible to study chemical effects entirely independent of the radiation effects. In the present study, we tried to compare the chemo- and radiotoxicity of both metals, taking into account deterministic radiation damages reflected by acute radiation sickness and stochastic radiation damages leading to long-term health impairments (e.g., tumor induction). We made at first a literature search on acute median lethal doses that may be expected to be caused by chemical effects, as even acute radiation sickness as a manifestation of acute radiotoxicity occurs with latency. By simulations based on the biokinetic models of the International Commission on Radiological Protection and using the Integrated Modules for Bioassay Analysis software, we determined the amounts of uranium at different enrichment grades and thorium-232 leading to a short-term red bone marrow equivalent dose of 3.5 Sv considered to cause 50% lethality in humans. Different intake pathways for incorporation were considered, and values were compared to the mean lethal doses by chemotoxicity. To assess stochastic radiotoxicity, we calculated the uranium and thorium amounts leading to a committed effective dose of 200 mSv that is often considered critical. Mean lethal values for uranium and thorium are in the same order of magnitude so that the data do not give evidence for substantial differences in acute chemical toxicity. When comparing radiotoxicity, the reference units (activity in Bq or weight in g) must always be taken into account. The mean lethal equivalent dose to the red bone marrow of 3.5 Sv is reached by lower activities of thorium compared to uranium in soluble compounds. However, for uranium as well as thorium-232, acute radiation sickness is expected only after incorporation of amounts exceeding the mean lethal doses by chemotoxicity. Thus, acute radiation sickness is not a relevant clinical issue for either metal. Concerning stochastic radiation damages, thorium-232 is more radiotoxic than uranium if incorporating the same activities. Using weight units for comparison show that for soluble compounds, thorium-232 is more radiotoxic than low-enriched uranium in the case of ingestion but even more toxic than high-enriched uranium after inhalation or intravenous administration. For insoluble compounds, the situation differs as the stochastic radiotoxicity of thorium-232 ranges between depleted and natural uranium. For acute effects, the chemotoxicity of uranium, even at high enrichment grades, as well as thorium-232 exceeds deterministic radiotoxicity. Simulations show that thorium-232 is more radiotoxic than uranium expressed in activity units. If the comparison is based on weight units, the rankings depend on the uranium enrichment grades and the route of intake.
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Affiliation(s)
- A Rump
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany.
| | - C Hermann
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - A Lamkowski
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - T Popp
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - M Port
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
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Schüle S, Bristy EA, Muhtadi R, Kaletka G, Stewart S, Ostheim P, Hermann C, Asang C, Pleimes D, Port M, Abend M. Four Genes Predictive for the Severity of Hematological Damage Reveal a Similar Response after X Irradiation and Chemotherapy. Radiat Res 2023; 199:115-123. [PMID: 36480042 DOI: 10.1667/rade-22-00068.1] [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] [Received: 04/12/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022]
Abstract
Radiological and especially nuclear accidents and incidents pose a threat to populations. In such events, gene expression (GE) analysis of a set of 4 genes (FDXR, DDB2, POU2AF1, WNT3) is an emerging approach for early and high-throughput prediction of the later manifesting severity degrees of the hematological acute radiation syndrome (H-ARS). Validation of this gene set on radiation victims is difficult since these events are rare. However, chemotherapy (CTX) is widely used e.g., breast cancer patient treatment and pathomechanisms, as well as blood cell count changes are comparable among both exposure types. We wondered whether GE changes are similarly deregulated after CTX, which would be interpreted as a confirmation of our already identified gene set for H-ARS prediction after irradiation. We examined radiation-induced differential GE (DGE) of our gene set as a positive control using in vitro whole blood samples from ten healthy donors (6 females, 4 males, aged: 24-40 years). Blood was incubated in vitro for 8 h after X irradiation with 0 and 4 Gy (1 Gy/min). These data were compared with DGE measured in vivo in blood samples of 10 breast tumor CTX patients (10 females, aged: 39-71 years) before and 4 days after administration of cyclophosphamide and epirubicin. RNA was isolated, reverse transcribed and quantitative real-time polymerase-chain-reaction (qRT-PCR) was performed to assess DGE of FDXR, DDB2, POU2AF1 and WNT3 relative to the unexposed samples using TaqMan assays. After X irradiation, we found a significant upregulation (irrespective of sex) with mean fold changes of 21 (P < 0.001) and 7 (P < 0.001) for FDXR and DDB2 and a significant down-regulation with mean fold changes of 2.5 (P < 0.001) and 2 (P = 0.005) for POU2AF1 and WNT3, respectively. After CTX, a similar pattern was observed, although mean fold changes of up-regulated FDXR (6-fold, P < 0.001) and DDB2 (3-fold, P < 0.001) as well as down-regulated POU2AF1 (1.2-fold, P = 0.270) and WNT3 (1.3-fold, P = 0.069) appeared lower corresponding to less altered blood cell count changes observed after CTX compared to historic radiation exposure data. However, a subpopulation of CTX patients (n = 6) showed on average a significant downregulation of POU2AF1 (1.8-fold, P = 0.04) and WNT3 (2.1-fold, P = 0.008). In summary, the pattern of up-regulated GE changes observed in all CTX patients and down-regulated GE changes observed in a subgroup of CTX patients appeared comparable with an already identified gene set predictive for the radiation-induced H-ARS. This underlines the significance of in vivo GE measurements in CTX patients, employed as a surrogate model to further validate already identified radiation-induced GE changes predictive for the H-ARS.
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Affiliation(s)
- Simone Schüle
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - Effat Ara Bristy
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany
| | - Razan Muhtadi
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - Gwendolyn Kaletka
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - Samantha Stewart
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - Patrick Ostheim
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | | | | | - Matthias Port
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
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Rump A, Hermann C, Lamkowski A, Abend M, Port M. Simulations of radioiodine exposure and protective thyroid blocking in a new biokinetic model of the mother-fetus unit at different pregnancy ages. Arch Toxicol 2022; 96:2947-2965. [PMID: 35922584 PMCID: PMC9525366 DOI: 10.1007/s00204-022-03331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
In the case of nuclear incidents, radioiodine may be released. After incorporation, it accumulates in the thyroid and enhances the risk of thyroidal dysfunctions and cancer occurrence by internal irradiation. Pregnant women and children are particularly vulnerable. Therefore, thyroidal protection by administering a large dose of stable (non-radioactive) iodine, blocking radioiodide uptake into the gland, is essential in these subpopulations. However, a quantitative estimation of the protection conferred to the maternal and fetal thyroids in the different stages of pregnancy is difficult. We departed from an established biokinetic model for radioiodine in pregnancy using first-order kinetics. As the uptake of iodide into the thyroid and several other tissues is mediated by a saturable active transport, we integrated an uptake mechanism described by a Michaelis–Menten kinetic. This permits simulating the competition between stable and radioactive iodide at the membrane carrier site, one of the protective mechanisms. The Wollf–Chaikoff effect, as the other protective mechanism, was simulated by adding a total net uptake block for iodide into the thyroid, becoming active when the gland is saturated with iodine. The model’s validity was confirmed by comparing predicted values with results from other models and sparse empirical data. According to our model, in the case of radioiodine exposure without thyroid blocking, the thyroid equivalent dose in the maternal gland increases about 45% within the first weeks of pregnancy to remain in the same range until term. Beginning in the 12th pregnancy week, the equivalent dose in the fetal thyroid disproportionately increases over time and amounts to three times the dose of the maternal gland at term. The maternal and fetal glands’ protection increases concomitantly with the amount of stable iodine administered to the mother simultaneously with acute radioiodine exposure. The dose–effect curves reflecting the combined thyroidal protection by the competition at the membrane carrier site and the Wolff–Chaikoff effect in the mother are characterized by a mean effective dose (ED50) of roughly 1.5 mg all over pregnancy. In the case of the fetal thyroid, the mean effective doses for thyroid blocking, taking into account only the competition at the carrier site are numerically lower than in the mother. Taking into account additionally the Wolff–Chaikoff effect, the dose–effect curves for thyroidal protection in the fetus show a shift to the left over time, with a mean effective dose of 12.9 mg in the 12th week of pregnancy decreasing to 0.5 mg at term. In any case, according to our model, the usually recommended dose of 100 mg stable iodine given at the time of acute radioiodine exposure confers a very high level of thyroidal protection to the maternal and fetal glands over pregnancy. For ethical reasons, the possibilities of experimental studies on thyroid blocking in pregnant women are extremely limited. Furthermore, results from animal studies are associated with the uncertainties related to the translation of the data to humans. Thus model-based simulations may be a valuable tool for better insight into the efficacy of thyroidal protection and improve preparedness planning for uncommon nuclear or radiological emergencies.
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Affiliation(s)
- A Rump
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany.
| | - C Hermann
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - A Lamkowski
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - M Abend
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - M Port
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
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Rump A, Eder S, Hermann C, Lamkowski A, Kinoshita M, Yamamoto T, Take J, Abend M, Shinomiya N, Port M. Modeling principles of protective thyroid blocking. Int J Radiat Biol 2021; 98:831-842. [PMID: 34762000 DOI: 10.1080/09553002.2021.1987570] [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] [Indexed: 10/19/2022]
Abstract
PURPOSE In the case of a nuclear incident, the release of radioiodine must be expected. Radioiodine accumulates in the thyroid and by irradiation enhances the risk of cancer. Large doses of stable (non-radioactive) iodine may inhibit radioiodine accumulation and protect the thyroid ('thyroid blocking'). Protection is based on a competition at the active carrier site in the cellular membrane and an additional temporary inhibition of the organification of iodide (Wolff-Chaikoff effect). Alternatively, other agents like e.g. perchlorate that compete with iodide for the uptake into the thyrocytes may also confer thyroidal protection against radioiodine exposure.Biokinetic models for radioiodine mostly describe exchanges between compartments by first order kinetics. This leads to correct predictions only for low (radio)iodide concentrations. These models are not suited to describe the kinetics of iodine if administered at the dosages recommended for thyroid blocking and moreover does not permit to simulate either the protective competition mechanism at the membrane or the Wolff-Chaikoff effect. Models adapted for this purpose must be used. Such models may use a mathematical relation between the serum iodide concentration and a relative uptake suppression or a dependent rate constant determining total thyroidal radioiodine accumulation. Alternatively, the thyroidal uptake rate constant may be modeled as a function of the total iodine content of the gland relative to a saturation amount. Newer models integrate a carrier-mechanism described by Michalis-Menten kinetics in the membrane and in analogy to enzyme kinetics apply the rate law for monomolecular irreversible enzyme reactions with competing substrates to model the competition mechanism. An additional total iodide uptake block, independent on competition but limited in time, is used to simulate the Wolff-Chaikoff effect. CONCLUSION The selection of the best model depends on the issue to be studied. Most models cannot quantify the relative contributions of the competition mechanism at the membrane and the Wolff-Chaikoff effect. This makes it impossible or exceedingly difficult to simulate prolonged radioiodine exposure and the effect of repetitive administrations of stable iodine. The newer thyroid blocking models with a separate modeling of competition and Wolff-Chaikoff effect allow better quantitative mechanistic insights and offer the possibility to simulate complex radioiodine exposure scenarios and various protective dosage schemes of stable iodine relatively easily. Moreover, they permit to study the protective effects of other competitors at the membrane carrier site, like e.g. perchlorate, and to draw conclusions on their protective efficacy in comparison to stable iodine.
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Affiliation(s)
- Alexis Rump
- Institut für Radiobiologie der Bundeswehr, München, Germany
| | - Stefan Eder
- Institut für Radiobiologie der Bundeswehr, München, Germany
| | | | | | - Manabu Kinoshita
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan
| | - Tetsuo Yamamoto
- NBC Countermeasure Medical Unit, Japan Ground Self Defense Force, Tokyo Japan
| | - Junya Take
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Japan
| | - Michael Abend
- Institut für Radiobiologie der Bundeswehr, München, Germany
| | | | - Matthias Port
- Institut für Radiobiologie der Bundeswehr, München, Germany
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Rump A, Eder S, Hermann C, Lamkowski A, Kinoshita M, Yamamoto T, Abend M, Shinomiya N, Port M. A comparison of thyroidal protection by iodine and perchlorate against radioiodine exposure in Caucasians and Japanese. Arch Toxicol 2021; 95:2335-2350. [PMID: 34003340 PMCID: PMC8241675 DOI: 10.1007/s00204-021-03065-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/28/2021] [Indexed: 11/28/2022]
Abstract
Radioactive iodine released in nuclear accidents may accumulate in the thyroid and by irradiation enhances the risk of cancer. Radioiodine uptake into the gland can be inhibited by large doses of stable iodine or perchlorate. Nutritional iodine daily intake may impact thyroid physiology, so that radiological doses absorbed by the thyroid as well as thyroid blocking efficacy may differ in Japanese with a very rich iodine diet compared to Caucasians. Based on established biokinetic-dosimetric models for the thyroid, we derived the parameters for Caucasians and Japanese to quantitatively compare the effects of radioiodine exposure and the protective efficacy of thyroid blocking by stable iodine at the officially recommended dosages (100 mg in Germany, 76 mg in Japan) or perchlorate. The maximum transport capacity for iodine uptake into the thyroid is lower in Japanese compared to Caucasians. For the same radioiodine exposure pattern, the radiological equivalent thyroid dose is substantially lower in Japanese in the absence of thyroid blocking treatments. In the case of acute radioiodine exposure, stable iodine is less potent in Japanese (ED50 = 41.6 mg) than in Caucasians (ED50 = 2.7 mg) and confers less thyroid protection at the recommended dosages because of a delayed responsiveness to iodine saturation of the gland (Wolff-Chaikoff effect). Perchlorate (ED50 = 10 mg in Caucasians) at a dose of 1000 mg has roughly the same thyroid blocking effect as 100 mg iodine in Caucasians, whereas it confers a much better protection than 76 mg iodine in Japanese. For prolonged exposures, a single dose of iodine offer substantially lower protection than after acute radioiodine exposure in both groups. Repetitive daily iodine administrations improve efficacy without reaching levels after acute radioiodine exposure and achieve only slightly better protection in Japanese than in Caucasians. However, in the case of continuous radioiodine exposure, daily doses of 1000 mg perchlorate achieve a high protective efficacy in Caucasians as well as Japanese (> 0.98). In Caucasians, iodine (100 mg) and perchlorate (1000 mg) at the recommended dosages seem alternatives in case of acute radioiodine exposure, whereas perchlorate has a higher protective efficacy in the case of longer lasting radioiodine exposures. In Japanese, considering protective efficacy, preference should be given to perchlorate in acute as well as prolonged radioiodine exposure scenarios.
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Affiliation(s)
- A Rump
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany.
| | - S Eder
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - C Hermann
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - A Lamkowski
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - M Kinoshita
- Japan Self Defense Forces National Defense Medical College Research Institute, Tokorozawa, Japan
| | - T Yamamoto
- Japan Ground Self Defense Force NBC Countermeasure Medical Unit, Tokyo, Japan
| | - M Abend
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - N Shinomiya
- Japan Self Defense Forces National Defense Medical College Research Institute, Tokorozawa, Japan
| | - M Port
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
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Ostheim P, Coker O, Schüle S, Hermann C, Combs SE, Trott KR, Atkinson M, Port M, Abend M. Identifying a Diagnostic Window for the Use of Gene Expression Profiling to Predict Acute Radiation Syndrome. Radiat Res 2021; 195:38-46. [PMID: 33181834 DOI: 10.1667/rade-20-00126.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/28/2020] [Indexed: 11/03/2022]
Abstract
In the event of a mass casualty radiological or nuclear scenario, it is important to distinguish between the unexposed (worried well), low-dose exposed individuals and those developing the hematological acute radiation syndrome (HARS) within the first three days postirradiation. In previous baboon studies, we identified altered gene expression changes after irradiation, which were predictive for the later developing HARS severity. Similar changes in the expression of four of these genes were observed using an in vitro human whole blood model. However, these studies have provided only limited information on the time frame of the changes after exposure in relationship to the development of HARS. In this study we analyzed the time-dependent changes in mRNA expression after in vitro irradiation of whole blood. Changes in the expression of informative mRNAs (FDXR, DBB2, POU2AF1 and WNT3) were determined in the blood of eight healthy donors (6 males, 2 females) after irradiation at 0 (control), 0.5, 2 and 4 Gy using qRT-PCR. FDXR expression was significantly upregulated (P < 0.001) 4 h after ≥0.5 Gy irradiation, with an 18-40-fold peak attained 4-12 h postirradiation which remained elevated (4-9-fold) at 72 h. DDB2 expression was upregulated after 4 h (fold change, 5-8, P < 0.001 at ≥ 0.5 Gy) and remained upregulated (3-4-fold) until 72 h (P < 0.001). The earliest time points showing a significant downregulation of POU2AF1 and WNT3 were 4 h (fold change = 0.4, P = 0.001, at 4 Gy) and 8 h (fold change = 0.3-0.5, P < 0.001, 2-4 Gy), respectively. These results indicate that the diagnostic window for detecting HARS-predictive changes in gene expression may be opened as early as 2 h for most (75%) and at 4 h postirradiation for all individuals examined. Depending on the RNA species studied this may continue for at least three days postirradiation.
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Affiliation(s)
- Patrick Ostheim
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Omoleye Coker
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Simone Schüle
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany.,Institute of Radiation Medicine, Department of Radiation Sciences, Helmholtz Zentrum München, Oberschleissheim, Germany.,Deutsches Konsortium für Translationale Krebsforschung, Partner Site Munich, Munich, Germany
| | - Klaus-Rüdiger Trott
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany
| | - Mike Atkinson
- Institute of Radiation Biology, Department of Radiation Sciences, Helmholtz Zentrum München, Oberschleissheim, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
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9
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Ostheim P, Don Mallawaratchy A, Müller T, Schüle S, Hermann C, Popp T, Eder S, Combs SE, Port M, Abend M. Acute radiation syndrome-related gene expression in irradiated peripheral blood cell populations. Int J Radiat Biol 2021; 97:474-484. [PMID: 33476246 DOI: 10.1080/09553002.2021.1876953] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE In a nuclear or radiological event, an early diagnostic tool is needed to distinguish the worried well from those individuals who may later develop life-threatenFing hematologic acute radiation syndrome. We examined the contribution of the peripheral blood's cell populations on radiation-induced gene expression (GE) changes. MATERIALS AND METHODS EDTA-whole-blood from six healthy donors was X-irradiated with 0 and 4Gy and T-lymphocytes, B-lymphocytes, NK-cells and granulocytes were separated using immunomagnetic methods. GE were examined in cell populations and whole blood. RESULTS The cell populations contributed to the total RNA amount with a ratio of 11.6 for T-lymphocytes, 1.2 for B-cells, 1.2 for NK-cells, 1.0 for granulocytes. To estimate the contribution of GE per cell population, the baseline (0Gy) and the radiation-induced fold-change in GE relative to unexposed was considered for each gene. The T-lymphocytes (74.8%/80.5%) contributed predominantly to the radiation-induced up-regulation observed for FDXR/DDB2 and the B-lymphocytes (97.1%/83.8%) for down-regulated POU2AF1/WNT3 with a similar effect on whole blood gene expression measurements reflecting a corresponding order of magnitude. CONCLUSIONS T- and B-lymphocytes contributed predominantly to the radiation-induced up-regulation of FDXR/DDB2 and down-regulation of POU2AF1/WNT3. This study underlines the use of FDXR/DDB2 for biodosimetry purposes and POU2AF1/WNT3 for effect prediction of acute health effects.
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Affiliation(s)
- Patrick Ostheim
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | | | - Thomas Müller
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Simone Schüle
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Tanja Popp
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Stefan Eder
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Technical University of Munich (TUM), Munich, Germany.,Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München (HMGU), Oberschleißheim, Germany.,Deutsches Konsortium für Translationale Krebsforschung (DKTK), Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
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10
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Hermann C, Lang S, Popp T, Hafner S, Steinritz D, Rump A, Port M, Eder S. Bardoxolone-Methyl (CDDO-Me) Impairs Tumor Growth and Induces Radiosensitization of Oral Squamous Cell Carcinoma Cells. Front Pharmacol 2021; 11:607580. [PMID: 33584286 PMCID: PMC7878525 DOI: 10.3389/fphar.2020.607580] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022] Open
Abstract
Radiotherapy represents a common treatment strategy for patients suffering from oral squamous cell carcinoma (OSCC). However, application of radiotherapy is immanently limited by radio-sensitivity of normal tissue surrounding the tumor sites. In this study, we used normal human epithelial keratinocytes (NHEK) and OSCC cells (Cal-27) as models to investigate radio-modulating and anti-tumor effects of the synthetic triterpenoid 2-cyano-3,12-dioxooleana-1,9,-dien-28-oic acid methyl ester (CDDO-Me). Nanomolar CDDO-Me significantly reduced OSCC tumor xenograft-growth in-ovo applying the chick chorioallantoic membrane (CAM) assay. In the presence of CDDO-Me reactive oxygen species (ROS) were found to be reduced in NHEK when applying radiation doses of 8 Gy, whereas ROS levels in OSCC cells rose significantly even without radiation. In parallel, CDDO-Me was shown to enhance metabolic activity in malignant cells only as indicated by significant accumulation of reducing equivalents NADPH/NADH. Furthermore, antioxidative heme oxygenase-1 (HO-1) levels were only enhanced in NHEK and not in the OSCC cell line, as shown by immunoblotting. Clonogenic survival was left unchanged by CDDO-Me treatment in NHEK but revealed to be abolished almost completely in OSCC cells. Our results indicate anti-cancer and radio-sensitizing effects of CDDO-Me treatment in OSCC cells, whereas nanomolar CDDO-Me failed to provoke clear detrimental consequences in non-malignant keratinocytes. We conclude, that the observed differential aftermath of CDDO-Me treatment in malignant OSCC and non-malignant skin cells may be utilized to broaden the therapeutic range of clinical radiotherapy.
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Affiliation(s)
| | - Simon Lang
- Bundeswehr Institute of Pharmacology and Toxicology, Munich, Germany
| | - Tanja Popp
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Susanne Hafner
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, University of Ulm, Ulm, Germany
| | - Dirk Steinritz
- Bundeswehr Institute of Pharmacology and Toxicology, Munich, Germany
| | - Alexis Rump
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Stefan Eder
- Bundeswehr Institute of Radiobiology, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich (LMU), Munich, Germany
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11
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Rump A, Ostheim P, Eder S, Hermann C, Abend M, Port M. Preparing for a "dirty bomb" attack: the optimum mix of medical countermeasure resources. Mil Med Res 2021; 8:3. [PMID: 33455578 PMCID: PMC7812656 DOI: 10.1186/s40779-020-00291-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In radiological emergencies with radionuclide incorporation, decorporation treatment is particularly effective if started early. Treating all people potentially contaminated ("urgent treatment") may require large antidote stockpiles. An efficacious way to reduce antidote requirements is by using radioactivity screening equipment. We analyzed the suitability of such equipment for triage purposes and determined the most efficient mix of screening units and antidote daily doses. METHODS The committed effective doses corresponding to activities within the detection limits of monitoring portals and mobile whole-body counters were used to assess their usefulness as triage tools. To determine the optimal resource mix, we departed from a large-scale scenario (60,000 victims) and based on purchase prices of antidotes and screening equipment in Germany, we calculated efficiencies of different combinations of medical countermeasure resources by data envelopment analysis. Cost-effectiveness was expressed as the costs per life year saved and compared to risk reduction opportunities in other sectors of society as well as the values of a statistical life. RESULTS Monitoring portals are adequate instruments for a sensitive triage after cesium-137 exposure with a high screening throughput. For the detection of americium-241 whole-body counters with a lower daily screening capacity per unit are needed. Assuming that 1% of the potentially contaminated patients actually need decorporation treatment, an efficient resource mix includes 6 monitoring portals and 25 mobile whole-body counters. The optimum mix depends on price discounts and in particular the fraction of victims actually needing treatment. The cost-effectiveness of preparedness for a "dirty bomb" attack is less than for common health care, but costs for a life year saved are less than for many risk-reduction interventions in the environmental sector. CONCLUSION To achieve economic efficiency a high daily screening capacity is of major importance to substantially decrease the required amount of antidote doses. Among the determinants of the number of equipment units needed, the fraction of the potentially contaminated victims that actually needs treatment is the most difficult to assess. Judging cost-effectiveness of the preparedness for "dirty bomb" attacks is an issue of principle that must be dealt with by political leaders.
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Affiliation(s)
- Alexis Rump
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany.
| | - Patrick Ostheim
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Stefan Eder
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
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12
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Kähler J, Hafner S, Popp T, Hermann C, Rump A, Port M, Steinestel K, Eder S. Heterogeneous nuclear ribonucleoprotein K is overexpressed and contributes to radioresistance irrespective of HPV status in head and neck squamous cell carcinoma. Int J Mol Med 2020; 46:1733-1742. [PMID: 32901844 PMCID: PMC7521550 DOI: 10.3892/ijmm.2020.4718] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Radiotherapy is a major treatment option for head and neck squamous cell carcinoma (HNSCC). However, the success of radiotherapy is limited by tumor cell resistance to ionizing radiation (IR). Clinical studies have demonstrated an overall improved prognosis and higher susceptibility to radiotherapy of high‑risk human papillomavirus (HPV)‑associated HNSCC compared with classic HNSCC, as well as worse overall survival for male HNSCC patients. Overexpression of heterogeneous nuclear ribonucleoprotein (hnRNP) K has been associated with resistance to radiotherapy in melanoma and colorectal carcinoma. The aim of the present study was to analyze the impact of hnRNP K expression on the aggressiveness and radioresistance of HNSCC with respect to patient sex and HPV status. Immunohistochemical staining of HNSCC tissue specimens revealed elevated hnRNP K levels compared with those in the non‑neoplastic epithelium. Cytoplasmic hnRNP K accumulation was associated with advanced tumor stage and male sex. Exposure of HNSCC cells to IR was followed by rapid upregulation of hnRNP K at the protein level, along with re‑localization from the tumor cell nucleus to the cytoplasm. siRNA‑based knockdown of hnRNP K induced apoptosis and abolished tumor formation after xenotransplantation of HNSCC cells onto the chick egg chorioallantoic membrane (CAM). The observed effects were independent of the respective HPV status of the cell lines. These results indicated a tumorigenic and anti‑apoptotic role of hnRNP K in HNSCC, which appeared to be enhanced in male patients and contributed to the radioresistance of these tumors. However, the radioprotective effects of hnRNP K were found to be independent of the tumor's HPV status.
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Affiliation(s)
- Justus Kähler
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | - Susanne Hafner
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, University of Ulm, D‑89081 Ulm, Germany
| | - Tanja Popp
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | | | - Alexis Rump
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
| | - Konrad Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, D‑89081 Ulm, Germany
| | - Stefan Eder
- Bundeswehr Institute of Radiobiology, D‑80937 Munich, Germany
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13
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Eder S, Hermann C, Lamkowski A, Kinoshita M, Yamamoto T, Abend M, Shinomiya N, Port M, Rump A. A comparison of thyroidal protection by stable iodine or perchlorate in the case of acute or prolonged radioiodine exposure. Arch Toxicol 2020; 94:3231-3247. [PMID: 32656655 PMCID: PMC7415763 DOI: 10.1007/s00204-020-02809-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/15/2020] [Indexed: 12/14/2022]
Abstract
In the case of a nuclear power plant accident, repetitive/prolonged radioiodine release may occur. Radioiodine accumulates in the thyroid and by irradiation enhances the risk of cancer. Large doses of non-radioactive iodine may protect the thyroid by inhibiting radioiodine uptake into the gland (iodine blockade). Protection is based on a competition at the active carrier site in the cellular membrane and the Wolff-Chaikoff effect, the latter being, however, only transient (24-48 h). Perchlorate may alternatively provide protection by a carrier competition mechanism only. Perchlorate has, however, a stronger affinity to the carrier than iodide. Based on an established biokinetic-dosimetric model developed to study iodine blockade, and after its extension to describe perchlorate pharmacokinetics and the inhibition of iodine transport through the carrier, we computed the protective efficacies that can be achieved by stable iodine or perchlorate in the case of an acute or prolonged radioiodine exposure. In the case of acute radioiodine exposure, perchlorate is less potent than stable iodine considering its ED50. A dose of 100 mg stable iodine has roughly the same protective efficacy as 1000 mg perchlorate. For prolonged exposures, single doses of protective agents, whether stable iodine or perchlorate, offer substantially lower protection than after acute radioiodine exposure, and thus repetitive administrations seem necessary. In case of prolonged exposure, the higher affinity of perchlorate for the carrier in combination with the fading Wolff-Chaikoff effect of iodine confers perchlorate a higher protective efficacy compared to stable iodine. Taking into account the frequency and seriousness of adverse effects, iodine and perchlorate at equieffective dosages seem to be alternatives in case of short-term acute radioiodine exposure, whereas preference should be given to perchlorate in view of its higher protective efficacy in the case of longer lasting radioiodine exposures.
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Affiliation(s)
- Stefan Eder
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Andreas Lamkowski
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Manabu Kinoshita
- Japan Self Defense Forces National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Tetsuo Yamamoto
- Japan Ground Self Defense Forces Military Medicine Research Unit and Ministry of Defense Clinic, Tokyo, Japan
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Nariyoshi Shinomiya
- Japan Self Defense Forces National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany
| | - Alexis Rump
- Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany.
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14
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Beinke C, Scherthan H, Port M, Popp T, Hermann C, Eder S. Triterpenoid CDDO-Me induces ROS generation and up-regulates cellular levels of antioxidative enzymes without induction of DSBs in human peripheral blood mononuclear cells. Radiat Environ Biophys 2020; 59:461-472. [PMID: 32409897 PMCID: PMC7369132 DOI: 10.1007/s00411-020-00847-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 04/30/2020] [Indexed: 05/11/2023]
Abstract
Ionizing radiation produces reactive oxygen species (ROS) leading to cellular DNA damage. Therefore, patients undergoing radiation therapy or first responders in radiological accident scenarios could both benefit from the identification of specifically acting pharmacological radiomitigators. The synthetic triterpenoid bardoxolone-methyl (CDDO-Me) has previously been shown to exert antioxidant, anti-inflammatory and anticancer activities in several cell lines, in part by enhancing the DNA damage response. In our study, we examined the effect of nanomolar concentrations of CDDO-Me in human peripheral blood mononuclear cells (PBMC). We observed increased cellular levels of the antioxidative enzymes heme oxygenase-1 (HO-1), NAD(P)H dehydrogenase (quinone1) and mitochondrial superoxide dismutase 2 by immunoblotting. Surprisingly, we found increased intracellular ROS-levels using imaging flow-cytometry. However, the radiation-induced DNA double-strand break (DSB) formation using the γ-H2AX + 53BP1 DSB focus assay and the cytokinesis-block micronucleus assay both revealed, that nanomolar CDDO-Me pre-treatment of PBMC for 2 h or 6 h ahead of X irradiation with 2 Gy did neither significantly affect γ-H2AX + 53BP1 DSB foci formation nor the frequency of micronuclei. CDDO-Me treatment also failed to alter the nuclear division index and the frequency of IR-induced PBMC apoptosis as investigated by Annexin V-labeled live-cell imaging. Our results indicate that pharmacologically increased cellular concentrations of antioxidative enzymes might not necessarily exert radiomitigating short-term effects in IR-exposed PBMC. However, the increase of antioxidative enzymes could also be a result of a defensive cellular mechanism towards elevated ROS levels.
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Affiliation(s)
- Christina Beinke
- Bundeswehr Institute of Radiobiology Affiliated to the University Ulm, Neuherbergstr. 11, 80937, Munich, Germany.
| | - Harry Scherthan
- Bundeswehr Institute of Radiobiology Affiliated to the University Ulm, Neuherbergstr. 11, 80937, Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology Affiliated to the University Ulm, Neuherbergstr. 11, 80937, Munich, Germany
| | - Tanja Popp
- Bundeswehr Institute of Radiobiology Affiliated to the University Ulm, Neuherbergstr. 11, 80937, Munich, Germany
| | - Cornelius Hermann
- Bundeswehr Institute of Radiobiology Affiliated to the University Ulm, Neuherbergstr. 11, 80937, Munich, Germany
| | - Stefan Eder
- Bundeswehr Institute of Radiobiology Affiliated to the University Ulm, Neuherbergstr. 11, 80937, Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich (LMU), Munich, Germany
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15
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Hasseli R, Pfeiffer S, Kappesser J, Hermann C, Richter-Bastian K, Sattler T, Tschernatsch M, Hoffmann U, Müller-Ladner U, Lange U. Modellprojekt zur interdisziplinären universitären Lehre – Studierende der Medizin und der Psychologie lernen erstmals gemeinsam. Z Rheumatol 2020; 79:200-202. [DOI: 10.1007/s00393-020-00749-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungEine interdisziplinäre Zusammenarbeit ist in der medizinischen Versorgung chronisch erkrankter Patienten mit komplexen Erkrankungen erforderlich. Vor allem im Bereich der internistischen Rheumatologie ist eine interdisziplinäre Arbeit unerlässlich, um die komplexen somatischen und psychosozialen Aspekte einer chronischen Erkrankung zu berücksichtigen. Dennoch werden die Aspekte der interprofessionellen Arbeit im Studium der Medizin und Psychologie unzureichend thematisiert. Aus diesem Grund wurde ein Modellprojekt zur interdisziplinären universitären Lehre konzipiert, welches beide Fächer miteinander vereint. Die Veranstaltung wurde im Wintersemester 2019/20 erstmalig durchgeführt und stieß bei den Teilnehmer*innen auf positive Resonanz. Das Hauptziel der Veranstaltung ist die Implementierung interprofessioneller Arbeit in die Ausbildung des medizinischen Personals. Zusätzlich konnte das Fach der internistischen Rheumatologie den Studierenden nähergebracht werden.
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16
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Danisavich T, Destro C, Diaz B, Fitzgerald S, Gallagher D, Franke W, Freshly J, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Maki G, McDonagh S, McKee B, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Trottier Y, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Visual Immunoprecipitate Assay (VIP) for Listeria monocytogenes and Related Listeria Species Detection in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.791] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Roger D Calhoon
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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17
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Destro C, Diaz B, Franke W, Gallagher D, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Trottier YL, Maki G, McDonagh S, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Assurance Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria Species in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.775] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Roger D Calhoon
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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Wollborn J, Schlueter B, Steiger C, Hermann C, Wunder C, Schmidt J, Diel P, Meinel L, Buerkle H, Goebel U, Schick MA. Extracorporeal resuscitation with carbon monoxide improves renal function by targeting inflammatory pathways in cardiac arrest in pigs. Am J Physiol Renal Physiol 2019; 317:F1572-F1581. [PMID: 31482730 DOI: 10.1152/ajprenal.00241.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Deleterious consequences like acute kidney injury frequently occur upon successful resuscitation from cardiac arrest. Extracorporeal life support is increasingly used to overcome high cardiac arrest mortality. Carbon monoxide (CO) is an endogenous gasotransmitter, capable of reducing renal injury. In our study, we hypothesized that addition of CO to extracorporeal resuscitation hampers severity of renal injury in a porcine model of cardiac arrest. Hypoxic cardiac arrest was induced in pigs. Animals were resuscitated using a conventional [cardiopulmonary resuscitation (CPR)], an extracorporeal (E-CPR), or a CO-assisted extracorporeal (CO-E-CPR) protocol. CO was applied using a membrane-controlled releasing system. Markers of renal injury were measured, and histopathological analyses were carried out. We investigated renal pathways involving inflammation as well as apoptotic cell death. No differences in serum neutrophil gelatinase-associated lipocalin (NGAL) were detected after CO treatment compared with Sham animals (Sham 71 ± 7 and CO-E-CPR 95 ± 6 ng/mL), while NGAL was increased in CPR and E-CPR groups (CPR 135 ± 11 and E-CPR 124 ± 5 ng/mL; P < 0.05). Evidence for histopathological damage was abrogated after CO application. CO increased renal heat shock protein 70 expression and reduced inducible cyclooxygenase 2 (CPR: 60 ± 8; E-CPR 56 ± 8; CO-E-CPR 31 ± 3 µg/mL; P < 0.05). Caspase 3 activity was decreased (CPR 1,469 ± 276; E-CPR 1,670 ± 225; CO-E-CPR 755 ± 83 pg/mL; P < 0.05). Furthermore, we found a reduction in renal inflammatory signaling upon CO treatment. Our data demonstrate improved renal function by extracorporeal CO treatment in a porcine model of cardiac arrest. CO reduced proinflammatory and proapoptotic signaling, characterizing beneficial aspects of a novel treatment option to overcome high mortality.
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Affiliation(s)
- Jakob Wollborn
- Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bjoern Schlueter
- Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Steiger
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts.,Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Wuerzburg, Germany
| | - Cornelius Hermann
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Wuerzburg, Germany
| | - Christian Wunder
- Department of Anesthesiology and Critical Care, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Johannes Schmidt
- Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Patric Diel
- Department of Cardiovascular Surgery, University Heart Center, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lorenz Meinel
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Wuerzburg, Germany
| | - Hartmut Buerkle
- Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ulrich Goebel
- Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martin A Schick
- Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Rump A, Eder S, Lamkowski A, Hermann C, Abend M, Port M. A quantitative comparison of the chemo- and radiotoxicity of uranium at different enrichment grades. Toxicol Lett 2019; 313:159-168. [PMID: 31276769 DOI: 10.1016/j.toxlet.2019.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The radiotoxic effects of uranium are often in the focus of the public fears but the chemical toxic effects of uranium are reported to surpass radiation effects. As there is no uranium isotope that is not radioactive, it is not possible to study chemical effects fully independently from radiation effects. In order to quantitate and compare radio- and chemotoxicity, we determined the median lethal doses of uranium due to its chemical toxicity and calculated the absorbed radiological doses resulting from the ingestion or inhalation of corresponding amounts depending on the isotopic enrichment grade. Committed effective doses over 50 years are related to the stochastic health effects like cancer occurrence and can be converted to a loss of statistical life time (mean loss 0.4 day / mSv). The equivalent doses absorbed within a short time frame permits conclusion on the induction of deterministic effects (e.g. acute radiation sickness). METHOD Simulations were based on the biokinetic models of the International Commission for Radioprotection and performed using Integrated Modules for Bioassay Analysis software. Results were compared with the doses given by the calculator of the WISE uranium project. The fractions of the total doses absorbed within different time periods were derived from the respective areas under the activity-time curves in the whole body. RESULTS The distribution of the total dose on the organs and tissues depends on the invasion pathway and the solubility of the compound. In the case of inhalation, the absorption of the total dose is more protracted than after ingestion. The incorporation of depleted or natural uranium in lethal amounts due to nephrotoxicity does not lead to deterministic radiation effects and is associated with committed effective doses reaching at most about 200 mSv (proposed possible threshold for therapeutic interventions after accidental radionuclide incorporation). The inhalation of low enriched uranium leads to higher effective doses up to 690 mSv, but they are still insufficient to cause acute deterministic effects. Even highly enriched uranium seems not to induce radiation nephropathy, but deterministic effects on the hematopoetic system cannot be excluded in particularly sensitive patients. But the equivalent doses to the lungs associated with the inhalation of poorly soluble compounds of highly enriched uranium are in a range that may induce radiation pneumonitis. CONCLUSION Our findings give clear evidence that for depleted and natural uranium chemical toxicity is much more marked than radiotoxicity. However, this conclusion must not be drawn for enriched and in particular highly enriched compounds that besides stochastic effects may even cause deterministic radiation effects.
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Affiliation(s)
- A Rump
- Bundeswehr Institute of Radiobiology, Munich, Germany.
| | - S Eder
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - A Lamkowski
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - C Hermann
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - M Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - M Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
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Wollborn J, Hermann C, Goebel U, Merget B, Wunder C, Maier S, Schäfer T, Heuler D, Müller-Buschbaum K, Buerkle H, Meinel L, Schick MA, Steiger C. Overcoming safety challenges in CO therapy - Extracorporeal CO delivery under precise feedback control of systemic carboxyhemoglobin levels. J Control Release 2018; 279:336-344. [PMID: 29655987 DOI: 10.1016/j.jconrel.2018.04.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 01/14/2018] [Revised: 04/04/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
Abstract
Carbon monoxide (CO) has demonstrated therapeutic potential in multiple inflammatory conditions including intensive care applications such as organ transplantation or sepsis. Approaches to translate these findings into future therapies, however, have been challenged by multiple hurdles including handling and toxicity issues associated with systemic CO delivery. Here, we describe a membrane-controlled Extracorporeal Carbon Monoxide Release System (ECCORS) for easy implementation into Extracorporeal Membrane Oxygenation (ECMO) setups, which are being used to treat cardiac and respiratory diseases in various intensive care applications. Functionalities of the ECCORS were investigated in a pig model of veno-arterial ECMO. By precisely controlling CO generation and delivery as a function of systemic carboxyhemoglobin levels, the system allows for an immediate onset of therapeutic CO-levels while preventing CO-toxicity. Systemic carboxyhemoglobin levels were profiled in real-time by monitoring exhaled CO levels as well as by pulse oximetry, enabling self-contained and automatic feedback control of CO generation within ECCORS. Machine learning based mathematical modeling was performed to increase the predictive power of this approach, laying foundation for high precision systemic CO delivery concepts of tomorrow.
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Affiliation(s)
- Jakob Wollborn
- Department of Anesthesiology and Critical Care, Medical Center, University of Freiburg, Faculty of Medicine, Germany
| | - Cornelius Hermann
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Germany
| | - Ulrich Goebel
- Department of Anesthesiology and Critical Care, Medical Center, University of Freiburg, Faculty of Medicine, Germany
| | - Benjamin Merget
- Computational Chemistry and Biology, BASF SE, Ludwigshafen, Germany
| | - Christian Wunder
- Department of Anesthesiology and Critical Care, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Sven Maier
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany
| | - Thomas Schäfer
- Institute for Inorganic Chemistry, University of Würzburg, Germany
| | - Dominik Heuler
- Institute for Inorganic Chemistry, University of Würzburg, Germany
| | | | - Hartmut Buerkle
- Department of Anesthesiology and Critical Care, Medical Center, University of Freiburg, Faculty of Medicine, Germany
| | - Lorenz Meinel
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Germany
| | - Martin A Schick
- Department of Anesthesiology and Critical Care, Medical Center, University of Freiburg, Faculty of Medicine, Germany
| | - Christoph Steiger
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Germany.
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21
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Schneider O, Scharf HP, Stein T, Knapstein S, Hermann C, Flechtenmacher J. [Incidence of knee injuries : Numbers for outpatient and inpatient care in Germany]. Orthopade 2017; 45:1015-1026. [PMID: 27518117 DOI: 10.1007/s00132-016-3301-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Musculoskeletal illnesses and injuries are among the most common ailments in the Federal Republic of Germany. In 2008 they generated costs of nearly 29 billion euros. Figures about their incidence and prevalence are necessary for a demand-oriented planning of future patient-centred care. METHOD Pseudonymised data of 3.8 million people insured by AOK Baden-Württemberg between 2008 and 2013 were evaluated. The diagnoses were assigned to nine injury groups. For outpatient care confirmed diagnoses were considered, and for inpatient care both primary and secondary diagnoses were considered. For all patients with structural knee injuries, it was evaluated whether they made use of one of five eligible treatment paradigms either in the quarter in which they were injured or in the following quarter. RESULTS 418,257 patients were treated in 2013 for at least one new-onset injury (10.9 % of all insurees); 86,783 insurees (2.3 % of all insurees) had a newly occurring knee injury. The vast majority of the patients were treated by specialist doctors. While magnetic resonance imaging clearly increased during the observation period, the incidence of surgical therapy did not change. Striking are the different age distributions regarding the types of injuries, with a high injury incidence amongst young men and a significant increase in injuries between 2008 and 2013, especially amongst women. CONCLUSION For the first time, the data quantify the knee injury incidences of a large cohort in Germany. They show which inpatient and outpatient health care services have been claimed and that an age- and gender-adapted prevention and an increased awareness are needed.
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Affiliation(s)
- O Schneider
- AOK Baden-Württemberg, Presselstraße 19, 70191, Stuttgart, Deutschland
| | - H-P Scharf
- Orthopädisch-Unfallchirurgisches Zentrum, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - T Stein
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, BioMotion Center, Engler-Bunte-Ring 15, 76131, Karlsruhe, Deutschland
| | - S Knapstein
- AOK Baden-Württemberg, Presselstraße 19, 70191, Stuttgart, Deutschland
| | - C Hermann
- AOK Baden-Württemberg, Presselstraße 19, 70191, Stuttgart, Deutschland
| | - J Flechtenmacher
- Ortho-Zentrum - Orthopädische Gemeinschaftspraxis am Ludwigplatz, Waldstr. 67, 76133, Karlsruhe, Deutschland.
- Berufsverband für Orthopädie und Unfallchirurgie, Straße des 17. Juni 106-108, 10623, Berlin, Deutschland.
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22
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Kind A, Gilmore-Bykovskyi A, Schmitz E, Mineau J, Troller P, Hermann C, Brenny-Fitzpatrick M. FACILITATING PARTICIPATION BY PERSONS WITH DEMENTIA AND THEIR CARERS IN A TRANSITIONAL CARE RCT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A.J. Kind
- William S Middleton Memorial VA Hospital, Madison, Wisconsin,
- University of Wisconsin-Madison, Madison, Wisconsin,
| | - A. Gilmore-Bykovskyi
- William S Middleton Memorial VA Hospital, Madison, Wisconsin,
- University of Wisconsin-Madison, Madison, Wisconsin,
| | - E. Schmitz
- University of Wisconsin-Madison, Madison, Wisconsin,
| | - J. Mineau
- University of Wisconsin-Madison, Madison, Wisconsin,
| | - P. Troller
- University of Wisconsin Hospitals and Clinics, Madison, Wisconsin
| | - C. Hermann
- University of Wisconsin-Madison, Madison, Wisconsin,
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Abstract
The heme oxygenase (HO)/carbon monoxide (CO) system is a physiological feedback loop orchestrating various cell-protective effects in response to cellular stress. The therapeutic use of CO is impeded by safety challenges as a result of high CO-Hemoglobin formation following non-targeted, systemic administration jeopardizing successful CO therapies as of this biological barrier. Another caveat is the use of CO-Releasing Molecules containing toxicologically critical transition metals. An emerging number of local delivery approaches addressing these issues have recently been introduced and provide exciting new starting points for translating the fascinating preclinical potential of CO into a clinical setting. This review will discuss these approaches and link to future delivery strategies aiming at establishing CO as a safe and effective medication of tomorrow.
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Affiliation(s)
- Christoph Steiger
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
| | - Cornelius Hermann
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
| | - Lorenz Meinel
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany.
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Steiger C, Uchiyama K, Takagi T, Mizushima K, Higashimura Y, Gutmann M, Hermann C, Botov S, Schmalz HG, Naito Y, Meinel L. Prevention of colitis by controlled oral drug delivery of carbon monoxide. J Control Release 2016; 239:128-36. [PMID: 27578097 DOI: 10.1016/j.jconrel.2016.08.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 01/03/2023]
Abstract
Carbon monoxide (CO) is an endogenous signal transmitter involved in numerous physiological processes including the gastrointestinal (GI) homeostasis. CO has been recognized as potential new therapeutic agent for motility related and inflammatory disorders of the GI tract. A therapeutic use, however, is challenged by inappropriate drug delivery modes. Here we describe a micro scale Oral Carbon Monoxide Release System (M-OCORS) designed for localized and controlled exposure of the GI tract with in situ generated CO. M-OCORS allowed for controlled release profiles lasting for several minutes or up to almost one day. These in vitro release profiles translated into a large pharmacokinetic design space following oral administration in mice and measured as CO-hemoglobin (CO-Hb) formation. M-OCORS with a release profile featuring exposure of the intestine was profiled in two independently performed studies demonstrating preventive effects in chemically induced colitis. M-OCORS significantly reduced damage scores and prevented upregulation of colitis biomarkers.
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Affiliation(s)
- Christoph Steiger
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany
| | - Kazuhiko Uchiyama
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomohisa Takagi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Katsura Mizushima
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yasuki Higashimura
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Marcus Gutmann
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany
| | - Cornelius Hermann
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany
| | - Svetlana Botov
- Department of Chemistry, University of Cologne, Greinstrasse 4, 50939 Koeln, Germany
| | - Hans-Günther Schmalz
- Department of Chemistry, University of Cologne, Greinstrasse 4, 50939 Koeln, Germany
| | - Yuji Naito
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Lorenz Meinel
- Institute for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany.
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Lenk J, Hermann C, Matthé E, Pillunat LE, Sandner D. [Methotrexate in Atypical Non-Arteritic Ischemic Optic Neuropathy]. Klin Monbl Augenheilkd 2016; 234:924-929. [PMID: 27508886 DOI: 10.1055/s-0042-107948] [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: 10/21/2022]
Abstract
Background: Optic nerve disease can occur from a variety of different causes, with vascular, inflammatory or toxic pathologies. In such cases, it is hardly possible to clarify the aetiology. These diseases of the optic nerve are usually accompanied by progressive loss of visual field and visual impairment. Patient: We report a case of a 74-year-old woman complaining of loss of visual acuity, visual and blurred vision in the left eye in 2010. We made the diagnosis of non-arteritic ischemic optic neuropathy (NAION). With steroid therapy, there was an improvement in both visual acuity and visual field defects. But if an attempt was made to reduce steroids, her condition progressed. Except for a very small optic disk and arterial hypotension, there were no typical risk factors for NAION. We started treatment with methotrexate (MTX), with a starting dose of 10 mg per week, and observed the patient over two years. Results: Using MTX therapy, the swelling of the optic nerve head and visual field loss were reversible, so we increased the dose of MTX up to 15 mg/week. Steroid therapy could be stopped and the patient's visual acuity and visual field have now been stable for two years. There was no visible pallor in the optic nerve head, as normally occurs after AION, so we considered different underlying pathologies, including autoimmune disease. There were no adverse events with MTX therapy. Conclusion: If the course of the disease is atypical, the pathology may include an autoimmune component. Immunosuppressive MTX therapy may be started in order to avoid long-term steroid use. It may then be possible to maintain a stable visual field and prevent remitting episodes.
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Affiliation(s)
- J Lenk
- Augenklinik, Universitätsklinikum Carl Gustav Carus, TU Dresden
| | - C Hermann
- Augenklinik, Universitätsklinikum Carl Gustav Carus, TU Dresden
| | - E Matthé
- Augenklinik, Universitätsklinikum Carl Gustav Carus, TU Dresden
| | - L E Pillunat
- Augenklinik, Universitätsklinikum Carl Gustav Carus, TU Dresden
| | - D Sandner
- Augenklinik, Universitätsklinikum Carl Gustav Carus, TU Dresden
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Abstract
In order to provide specificity for T cell responses against pathogens and tumours, major histocompatibility complex (MHC) class I molecules present high-affinity peptides at the cell surface to T cells. A key player for peptide loading is the MHC class I-dedicated chaperone tapasin. Recently we discovered a second MHC class I-dedicated chaperone, the tapasin-related protein TAPBPR. Here, we review the major steps in the MHC class I pathway and the TAPBPR data. We discuss the potential function of TAPBPR in the MHC class I pathway and the involvement of this previously uncharacterised protein in human health and disease.
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Affiliation(s)
- C Hermann
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK
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Cordel N, Hermann C, Claudéon J, Turolien Y, Hue K, Tressières B. Prévalence et distribution génotypique des infections génitales à HPV oncogènes chez les transplantées du rein afro-caribéennes (Guadeloupe). Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.482] [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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Moyret-Lalle C, Vitton-Méa B, Ruiz E, Hermann C, Lam E, Puisieux A. 164: Interplay between EMT-inducers and miRNAs during breast tumorigenesis. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50137-2] [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: 11/30/2022]
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Juluru K, Shih JC, Raj A, Comunale JP, Delaney H, Greenberg ED, Hermann C, Liu YB, Hoelscher A, Al-Khori N, Sanelli PC. Effects of increased image noise on image quality and quantitative interpretation in brain CT perfusion. AJNR Am J Neuroradiol 2013; 34:1506-12. [PMID: 23557960 DOI: 10.3174/ajnr.a3448] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is a desire within many institutions to reduce the radiation dose in CTP examinations. The purpose of this study was to simulate dose reduction through the addition of noise in brain CT perfusion examinations and to determine the subsequent effects on quality and quantitative interpretation. MATERIALS AND METHODS A total of 22 consecutive reference CTP scans were identified from an institutional review board-approved prospective clinical trial, all performed at 80 keV and 190 mAs. Lower-dose scans at 188, 177, 167, 127, and 44 mAs were generated through the addition of spatially correlated noise to the reference scans. A standard software package was used to generate CBF, CBV, and MTT maps. Six blinded radiologists determined quality scores of simulated scans on a Likert scale. Quantitative differences were calculated. RESULTS For qualitative analysis, the correlation coefficients for CBF (-0.34; P < .0001), CBV (-0.35; P < .0001), and MTT (-0.44; P < .0001) were statistically significant. Interobserver agreements in quality for the simulated 188-, 177-, 167-, 127-, and 44-mAs scans for CBF were 0.95, 0.98, 0.98, 0.95, and 0.52, respectively. Interobserver agreements in quality for the simulated CBV were 1, 1, 1, 1, and 0.83, respectively. For MTT, the interobserver agreements were 0.83, 0.86, 0.88, 0.74, and 0.05, respectively. For quantitative analysis, only the lowest simulated dose of 44 mAs showed statistically significant differences from the reference scan values for CBF (-1.8; P = .04), CBV (0.07; P < .0001), and MTT (0.46; P < .0001). CONCLUSIONS From a reference CTP study performed at 80 keV and 190 mAs, this simulation study demonstrates the potential of a 33% reduction in tube current and dose while maintaining image quality and quantitative interpretations. This work can be used to inform future studies by using true, nonsimulated scans.
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Affiliation(s)
- K Juluru
- Department of Radiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY 10065, USA.
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Bunk S, Trbic A, Winkler A, Weber A, Schwarz H, Reipert B, Hermann C. Intravenous Immunoglobulins Suppress Antibody-Dependent Effector Functions of Human Peripheral Blood Cells. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Delgado E, Fuentes GA, Hermann C, Kunzmann G, Knözinger H. Site Characterization on Reduced and on Sulfided Mo/Al2O3 Catalysis by Adsorption of Probe Molecules. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bscb.19840930815] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Boehm B, Hoberg R, Hermann C, Graf J, Knappstein S, Köppel R, Mannuß J, Hauner H, Boehme MWJ. Prävalenz des Diabetes mellitus Typ 1 und Typ 2 in Baden-Württemberg: Eine Analyse der Versicherten der AOK Baden-Württemberg 2006–2008. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1255187] [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: 10/19/2022]
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Stienen MN, Hermann C, Breuer T, Gautschi OP. [Pott's puffy tumor - severe course of a sinusitis]. Praxis (Bern 1994) 2010; 99:555-560. [PMID: 20449824 DOI: 10.1024/1661-8157/a000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The disease pattern <<Pott's puffy tumour>> describes a local frontal-bone osteomyelitis that arises from an external infection with consecutive sub-periostal expansion. Symptoms may develop slowly or not at all with a mostly indolent protuberance on the patient's forehead. Symptomatic illness often indicates secondary morbidities. Here, we present a complicated case with intracranial dissemination.
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Affiliation(s)
- M N Stienen
- Klinik für Neurochirurgie, Kantonsspital St. Gallen
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Hermann C, Ilas J, Olas K, Teschner W, Schwarz H, Reipert B. Analysis of Fc-Receptor-Mediated Activities of New IgG Products Using a Novel THP-1 Cell-based Assay. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.311] [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: 10/19/2022]
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Goubert L, Macfarlane G, Hermann C, Vervoort T. 59 Topical Seminar Summary: CHRONIC PAIN AND DISABILITY IN CHILDHOOD. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60062-8] [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: 10/20/2022]
Affiliation(s)
| | - G.J. Macfarlane
- Aberdeen Pain Research Collaboration, University of Aberdeen, Aberdeen, United Kingdom
| | - C. Hermann
- Justus‐Liebig‐Universität Gieβen, Gieβen, Germany
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Kertai MD, Tiszai-Szûcs T, Varga KS, Hermann C, Acsády G, Gal J. Intraoperative use of packed red blood cell transfusion and mortality in patients undergoing abdominal or thoracoabdominal aortic aneurysm surgery. J Cardiovasc Surg (Torino) 2009; 50:501-508. [PMID: 19339959] [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: 05/27/2023]
Abstract
AIM A direct association between intraoperative use of red blood cell (RBC) transfusion and perioperative mortality in patients undergoing aortic aneurysm surgery has not been studied before. METHODS One thousand patients (mean age, 69.0 +/- 10.0 years; males 810) who underwent acute or elective abdominal or thoracoabdominal aortic aneurysm surgery between January 1999 and April 2007 at Semmelweis Medical University (Budapest, Hungary), were studied. Patients were evaluated for clinical risk factors, chronic medication use and surgical characteristics. Propensity score analysis was used to adjust for the potential bias in the intraoperative use of RBC transfusion. Multivariable logistic regression analyses were applied to study the association between the likelihood of intraoperative use of RBC transfusion and mortality occurring within 30 days of surgery. RESULTS Perioperative mortality occurred in 85 (8.5%) patients. Thirty-day mortality was significantly higher in patients who received intraoperative RBC transfusion compared to patients who did not receive it (1 or 2 units of RBCs, crude odds ratio [OR]: 6.2, 95% confidence interval [CI]: 1.8-21.0; P = 0.003; 3 or more units, OR: 35.7, 95% CI: 11.1-115.4; P < 0.0001). Even after correction for other baseline covariates and propensity for RBC transfusion intraoperative use of RBC transfusion was associated with increased 30-day mortality (1 or 2 units of RBCs, OR: 4.6, 95% CI: 1.1-18.5; P = 0.03; 3 or more units, OR: 4.0, 95% CI: 1.0-16.0; P = 0.05). CONCLUSIONS Intraoperative use of RBC transfusion in patients with acute or elective aortic aneurysm surgery is independently associated with an increased incidence of perioperative mortality.
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Affiliation(s)
- M D Kertai
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.
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Koller M, Bona R, Hermann C, Horvat P, Martinz J, Neto J, Pereira L, Varila P, Braunegg G. Biotechnological production of poly(3-hydroxybutyrate) withWautersia eutrophaby application of green grass juice and silage juice as additional complex substrates. BIOCATAL BIOTRANSFOR 2009. [DOI: 10.1080/10242420500292252] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hermann C, Gautschi OP, Hildebrandt G, Fournier JY. [Web based audiovisual patient information system--a pilot study of the preoperative patient information]. Praxis (Bern 1994) 2009; 98:695-701. [PMID: 19551654 DOI: 10.1024/1661-8157.98.13.695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A considerable part of the medical clinical daily routine incorporates the information of patients about medical diagnosis and especially about the scheduled operative intervention. The disease pattern, the course in the hospital before and after surgery and the operation itself will be discussed during these conversations. The patient has to be informed about all potential complications from a medico legal point of view. To optimise information delivery, auxiliary materials like charts, pictures, X-rays and models are used. Unfortunately, only a small percentage of the presented information is assimilated by the patient after strict verbal information. To inform patients better and earlier about medical details and internal processes before the operation, we developed a web-based audiovisual patient information system with a combination of pictures, text, tone and video about surgical interventions. The patient satisfaction could be markedly improved by the application of this patient information system in the informed consent process. Furthermore, the use of the web-based multimedia information portal may leads to an essential time saving for the medical staff.
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Affiliation(s)
- C Hermann
- Klinik für Neurochirurgie, Kantonsspital St. Gallen, St. Gallen.
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Küster O, Simon P, Mittelbronn M, Tabatabai G, Hermann C, Strik H, Dietz K, Roser F, Meyermann R, Schittenhelm J. Erythropoietin receptor is expressed in meningiomas and lower levels are associated with tumour recurrence. Neuropathol Appl Neurobiol 2009; 35:555-65. [PMID: 19298633 DOI: 10.1111/j.1365-2990.2009.01021.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS The Epo-EpoR pathway plays a role in tumour growth, metastasis and treatment resistance and is a potential target in oncological treatment. As the EpoR status in human meningiomas is unknown, our aim was to characterize EpoR expression in these tumours. METHODS We examined 131 meningioma samples of all WHO grades from 116 patients by immunohistochemistry for EpoR. Among these, 25 meningiomas showed brain invasion and 29 patients had a further tumour recurrence. A group of 20 patients without tumour recurrence served as controls. In 12 cases we were able to compare both the primary and the following recurrent tumours. The presence of EpoR in meningiomas was confirmed by RT-PCR and Western blot. RESULTS EpoR was expressed in all meningiomas. Statistical analysis revealed that the mean expression levels of EpoR were significantly lower in primary tumours with known recurrence compared with a recurrence-free control group. Additional matched pair analysis in individual cases showed no significant differences between primary and recurrent tumours. No significant correlation between EpoR expression and WHO grade, age, sex or brain invasion was detected. Using specific primer pairs for RT-PCR, we were able to detect all three known isoforms of EpoR: the full-length isoform EpoR-F, the truncated isoform EpoR-T and the soluble isoform EpoR-S. CONCLUSIONS Our results demonstrate the expression of EpoR in meningiomas. Lower EpoR mean levels might be a useful marker for a higher recurrence risk, but further studies are needed to clarify the influence of EpoR on recurrences and the role of the different isoforms.
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Affiliation(s)
- O Küster
- Institute of Brain Research, University of Tübingen, Germany
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Scholz C, Hermann C, Toth B, Kainer F, Friese K, Jeschke U. Fetomaternale Transfusion bei Chorioamnionitis und Präekklampsie – Beteiligung der Entzündungsreaktion an einer Fetomaternalen Transfusion. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Scholz C, Hermann C, Kachler A, Kainer F, Friese K. Antikörperbasierte, durchflusszytometrische Evaluierug der Feto-Maternalen Transfusion. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983569] [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: 10/21/2022] Open
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Goelz R, Bevot A, Rauscher-Lacher H, Jotzo M, Drescher F, Hamprecht K, Meisner C, Hermann C, Krägeloh-Mann I, Poets C. Kognitives Langzeitoutcome >4 Jahre von Frühgeborenen mit postnataler CMV-Infektion durch Muttermilch. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983086] [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: 10/21/2022]
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