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Sheikh K, Daniel BL, Lee J, Tokuda J, Jerosch-Herold M, Benkert T, Bhat H, Seethamraju RT, Schmidt E, Song D. Prostate Tumor Regression during Radiation Therapy in Relation to Image Derived Estimates of Fibrosis Using Ultrashort Echo Time MRI. Int J Radiat Oncol Biol Phys 2023; 117:e715-e716. [PMID: 37786091 DOI: 10.1016/j.ijrobp.2023.06.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) An inflammatory response due to radiation injury can lead to the activation of fibroblasts and their transformation into myofibroblasts that produce organized collagen layers. We term these organized collagen layers "acute fibrosis" (FA). Small animal imaging has shown that accumulation of fibrosis is accelerated at a higher radiation dose with later remodeling of type III collagen into densely packed type I collagen structures, which later transform into what we term "chronic fibrosis" (FC). In prostate cancer (PCa) patients treated with EBRT, we evaluated image derived FA (IDFA) and FC (IDFC) estimates using non-contrast and late gadolinium contrast enhanced (LGE) IR UTE, respectively. We hypothesized that fibrosis changes during RT are associated to tumor regression. MATERIALS/METHODS Four PCa patients undergoing radiation and hormone suppression were included. 1.5T MR imaging was acquired at three time-points (TPs); pre-RT, on-RT (30-40 Gy), and post-RT (60-78 Gy). IDFA imaging: Stack of spirals dual echo (TE = 50, 2690µs, TI = 60ms) IR UTE research application. Subtracting the two echoes yielded short TE signal intensity (SI). IDFC imaging: stack of spirals dual echo IR UTE research application, TE = 50µs, TI = 200ms, acquired 15 minutes following Gadovist administration. Remnant tumor was contoured at each TP with T2, ADC, and DCE. Relative quantification; IDFA = IR UTE SI/Gluteal Muscle SI and IDFC = LGE IR UTE SI/Gluteal Muscle SI. The sum of normalized IDFA and IDFC SI within the remnant tumor at each TP was divided by the corresponding tumor volume yielding tumor intensity (TI) FA and FC accumulation estimates: TIFA and TIFC. Mean delivered dose within the treated volume to regions where post-RT IDFA and IDFC > 100% gluteal muscle SI was determined. Univariate relationships were evaluated using correlation coefficients (r). RESULTS The coefficients of variation for TIFA = 10% and TIFC = 11%. IDFA and IDFC were observed pre-RT on the prostate gland periphery, and on RT and post RT within the prostate gland. IDFA and IDFC mean doses were 74% and 85% of prescription, respectively. Tumor regression was incomplete by post-RT. Initial tumor burden was inversely correlated with pre-RT TIFC (r = -0.98, p = .01). Tumor volume change post RT was inversely correlated with larger on-RT TIFA (r = -0.76) and post-RT TIFC (r = -0.78). CONCLUSION In this small pilot study, results suggest that IDFA and IDFC may be associated with improved tumor regression. They also suggest higher delivered dose is related to regions of greater IDFC. Quantitative fibrosis may be an early marker of RT response. Caution must be taken when interpreting these results given the small sample size. Future work will include a larger cohort of patients and include post-RT imaging.
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Affiliation(s)
- K Sheikh
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - B L Daniel
- Department of Radiology, Stanford University, Stanford, CA
| | - J Lee
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - J Tokuda
- Harvard Medical School, Boston, MA
| | | | - T Benkert
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - H Bhat
- Siemens Medical Solutions, Boston, MA
| | | | - E Schmidt
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - D Song
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
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Sheikh K, Schmidt E, Daniel BL, Lee J, Tokuda J, Jerosch-Herold M, Benkert T, Bhat H, Seethamraju RT, Viswanathan AN. Image Derived Estimates of Fibrosis Using Ultrashort Echo Time MRI in Gynecologic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S67. [PMID: 37784551 DOI: 10.1016/j.ijrobp.2023.06.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Fibrosis forms during and after radiation therapy (RT) due to wound-healing and cell death. In gynecologic cancer patients treated with EBRT and HDR, we evaluated image derived (ID) acute fibrosis (IDFA) and chronic fibrosis (IDFC) estimates using non-contrast and late gadolinium contrast enhanced (LGE) inversion recovery ultrashort echo time (IR UTE) MRI, respectively. We hypothesized that that ID markers can quantify FA and FC within tumor as a result of response to RT and that fibrosis changes over the course of RT are associated with tumor regression. MATERIALS/METHODS Subjects: Three subjects with cervical squamous cell carcinoma (SCC), 1 subject with cervical adenocarcinoma, and 2 subjects with vaginal SCC undergoing RT were included. Image Acquisition & Analysis: 1.5T MR imaging at four time-points (TPs): pre-RT, on-RT, post-RT, and post 3mo RT. IDFA imaging: Stack of spirals dual echo (TE = 50, 2690µs), TI = 60ms IR UTE research application. Subtracting the two echoes yielded short TE signal intensity (SI). IDFC imaging: stack of spirals dual echo IR UTE research application, TE = 50µs, TI = 200ms, acquired 15 minutes following contrast. Remnant tumor was contoured at each TP with T2, ADC, and DCE. Relative IDFA, IDFC quantification: voxel-wise IR UTE and LGE IR UTE signal intensity (SI) normalized to gluteal muscle SI. The sum of normalized IDFA and IDFC SI within the remnant tumor at each TP was divided by the corresponding tumor volume yielding tumor intensity (TI) TIFA and TIFC fibrosis accumulation estimates. STATISTICS The coefficients of variation (COV) for TIFA and TIFC were calculated by varying tumor margins and re-computing TIFA and TIFC. Univariate relationships were evaluated using linear regression. RESULTS The COVs for TIFA = 13% and TIFC = 7%. IDFA and IDFC were observed pre-RT on the tumor periphery, on-RT and post-RT within the tumor, with IDFA potentially transforming into IDFC. Table 1 shows that a greater decrease in tumor volume post RT was correlated with a larger pre-RT TIFA (r = -0.85, p = .03). Decrease in tumor volume was correlated with a larger TIFC post-RT (r = -0.79, p = .05). Post 3 month TIFC was associated with tumor reduction (r = 0.82, n = 4). CONCLUSION In this pilot study, we developed reproducible methods to quantify IDFA and IDFC within remnant tumor. Our results suggest that IDFA and IDFC may be associated with tumor response based on tumor volume.
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Affiliation(s)
- K Sheikh
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - E Schmidt
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - B L Daniel
- Department of Radiology, Stanford University, Stanford, CA
| | - J Lee
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - J Tokuda
- Harvard Medical School, Boston, MA
| | | | - T Benkert
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - H Bhat
- Siemens Healthineers, Boston, MA
| | | | - A N Viswanathan
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
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Haug D, Schreiter R, Thesing B, Rathmann L, Lambertz C, Hofmann P, Erhard M, Bellof G, Schmidt E. Injurious pecking in organic turkey fattening-effects of husbandry and feeding on injuries and plumage damage of a slow- (Auburn) and a fast-growing (B.U.T.6) genotype. Poult Sci 2023; 102:102746. [PMID: 37327745 PMCID: PMC10404662 DOI: 10.1016/j.psj.2023.102746] [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: 02/13/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 06/18/2023] Open
Abstract
Injuries and plumage damage (PD) are important indicators of welfare. First priority in turkey fattening is to reduce injurious pecking, which includes aggressive pecking (agonistic behavior) and additionally severe feather pecking (SFP) and cannibalism with their multifactorial reasons. Still, there are few studies available evaluating different genotypes for their welfare status under organic conditions. The aim of this study was to investigate the effects of genotype and husbandry with 100% organic feeding (2 variants with different riboflavin content: V1 and V2) on injuries and PD. During rearing nonbeaktrimmed male turkeys of a slow- (Auburn, n = 256) and fast-growing (B.U.T.6, n = 128) genotype were kept in 2 indoor housing systems (without environmental enrichment (EE) = H1-, n = 144 and with EE = H2+, n = 240). During fattening 13 animals per pen of H2+ were relocated to a free-range system (H3 MS, n = 104). EE included pecking stones, elevated seating platforms and silage feeding. The study included five 4-wk feeding phases. At the end of each phase, injuries and PD were scored to assess animal welfare. Injury scores ranged from 0 (=no damage) to 3 (=severe damage) and PD from 0 to 4. Injurious pecking was observed from the 8th week onward (injuries: 16.5% and PD: 31.4%). Binary logistic regression models showed that both indicators were affected by genotype (each P < 0.001), husbandry (each P < 0.001), feeding (injuries P = 0.004; PD P = 0.003), and age (each P < 0.001). Auburn showed less injuries and PD than B.U.T.6. H1- had the fewest injuries and PD for Auburn animals compared to H2+ or H3 MS. In summary, the use of alternative genotypes (Auburn) in organic fattening improved welfare, but keeping them in free-range systems or in husbandry with EE, does not lead to a reduction of injurious pecking. Therefore, further studies are needed with more and changing enrichment materials, further management measures, changes in housing structure, and even more intensive animal care.
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Affiliation(s)
- D Haug
- Weihenstephan-Triesdorf University of Applied Sciences, 85354 Freising, Germany.
| | - R Schreiter
- Centre for Applied Research and Technology e.V. at the Dresden University of Applied Sciences, 01069 Dresden, Germany
| | - B Thesing
- Weihenstephan-Triesdorf University of Applied Sciences, 85354 Freising, Germany
| | - L Rathmann
- Bavarian State Estates, Kitzingen, Germany
| | - C Lambertz
- Research Institute of Organic Agriculture (FiBL), 37213 Witzenhausen, Germany
| | - P Hofmann
- Bavarian State Research Center for Agriculture, Kitzingen, Germany
| | - M Erhard
- Chair of Animal Welfare, Ethology, Animal Hygiene and Animal Husbandry, Department of Veterinary Sciences, LMU Munich, 80539 Munich, Germany
| | - G Bellof
- Weihenstephan-Triesdorf University of Applied Sciences, 85354 Freising, Germany
| | - E Schmidt
- Weihenstephan-Triesdorf University of Applied Sciences, 85354 Freising, Germany
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Pennitz A, Breitbart E, Clanner-Engelshofen BM, Dickel H, Eisert L, Nenoff P, Paasch U, Schmidt E, Ständer S, Zidane M, Nast A. [Current dermatology guidelines in Germany-selected recommendations from 2021 and 2022]. Dermatologie (Heidelb) 2023:10.1007/s00105-023-05154-1. [PMID: 37266595 DOI: 10.1007/s00105-023-05154-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 06/03/2023]
Abstract
Guidelines are systematically developed decision-making aids to ensure appropriate clinical care for specific medical conditions. In Germany, dermatological guidelines are developed under the aegis of the German Dermatological Society (DDG) and the Professional Association of German Dermatologists (BVDD), while European and international guidelines are published by organisations such as the European Centre for Guidelines Development (EuroGuiDerm), founded by the European Dermatology Forum (EDF) in cooperation with the Division of Evidence-Based Medicine at Charité-Universitätsmedizin Berlin. In 2021 and 2022, the German guidelines were revised or developed on topics such as the management of anticoagulation during dermatological procedures, chronic pruritus, contact dermatitis, laser therapy of the skin, psoriasis vulgaris, rosacea, extracorporeal photopheresis, onychomycosis, mucous membrane pemphigoid and prevention of skin cancer. A selection of the most important recommendations and innovations in the guidelines is summarized here.
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Affiliation(s)
- A Pennitz
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - E Breitbart
- Arbeitsgemeinschaft Dermatologische Prävention (ADP) e. V., Buxtehude, Deutschland
| | - B M Clanner-Engelshofen
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - H Dickel
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum (UK RUB), Bochum, Deutschland
| | - L Eisert
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln/ÜBAG Vivantes MVZ Neukölln, Berlin, Deutschland
| | - P Nenoff
- Mykologie Experten - Labor Mölbis Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Rötha OT Mölbis, Deutschland
| | - U Paasch
- Hautärzte Paasch, Praxis Prof. Paasch, Jesewitz OT Gotha, Deutschland
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - E Schmidt
- Klinik für Dermatologie, Allergologie und Venerologie, UKSH, Campus Lübeck und Lübeck Institut für Experimentelle Dermatologie, Universität zu Lübeck, Lübeck, Deutschland
| | - S Ständer
- Kompetenzzentrum Chronischer Pruritus (KCP) und Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Deutschland
| | - M Zidane
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - A Nast
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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Weindl PN, Weindl PA, Schmidt E, Pleger L, Messinger D, Aulrich K, Schade B, Lehmann M, Bellof G. Photosensitisation and green egg yolks in laying hens caused by the feeding of ensiled alfalfa leaves. Br Poult Sci 2023; 64:242-251. [PMID: 36259558 DOI: 10.1080/00071668.2022.2137387] [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: 09/29/2021] [Accepted: 09/17/2022] [Indexed: 11/02/2022]
Abstract
1. The present study was carried out to determine the effects of feeding ensiled alfalfa leaves (ALS) as an alternative protein source to laying hens under the terms of an organic diet. Due to the occurrence of unexpected negative health effects and undesirable egg yolk pigmentation in the test groups the trial was prematurely stopped and further analysis was conducted to evaluate the responsible substances.2. Body weights of the test groups decreased significantly already in week 2 of the trial. Performance variables dropped. Olive green pigmented egg yolks were found in groups fed diets containing ALS. Severe comb necrosis occurred in the experimental group receiving the highest level of ALS (20%) combined with the option of free-range access and therefore natural light exposure.3. The noxious agent found in ALS, blood serum and egg yolk was the photosensitising chlorophyll derivate pheophorbid a (PPBa), deriving from a strong depletion of chlorophyll contained in the alfalfa leaves. PPBa caused the olive-green pigmentation found in yolks and led to photosensitivity in groups with the highest level of ALS in the diet in combination with light exposure.4. By aiming for high protein and amino acid levels, harvesting and processing have, unintentionally and initially unnoticed, led to a strong accumulation of phototoxic PPBa. From these results it is strongly advised not to include ensiled alfalfa leaves as a protein source in organic laying hen diets.
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Affiliation(s)
- P N Weindl
- Faculty of Sustainable Agriculture and Energy Systems, University of Applied Sciences Weihenstephan-Triesdorf, Freising, Germany
| | - P A Weindl
- Faculty of Sustainable Agriculture and Energy Systems, University of Applied Sciences Weihenstephan-Triesdorf, Freising, Germany
| | - E Schmidt
- Faculty of Sustainable Agriculture and Energy Systems, University of Applied Sciences Weihenstephan-Triesdorf, Freising, Germany
| | - L Pleger
- Faculty of Sustainable Agriculture and Energy Systems, University of Applied Sciences Weihenstephan-Triesdorf, Freising, Germany
| | - D Messinger
- Faculty of Sustainable Agriculture and Energy Systems, University of Applied Sciences Weihenstephan-Triesdorf, Freising, Germany
| | - K Aulrich
- Institute of Organic Farming, Johann Heinrich von Thünen Institute, Federal Research Institute for Rural Areas, Forestry and Fisheries, Westerau, Germany
| | - B Schade
- Department of Pathology, Bavarian Animal Health Services, Poing, Germany
| | - M Lehmann
- Department of Biology and Plant Sciences, Ludwig Maximilians-University München, Munich, Germany
| | - G Bellof
- Faculty of Sustainable Agriculture and Energy Systems, University of Applied Sciences Weihenstephan-Triesdorf, Freising, Germany
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Gambichler T, Schmidt E, Scheel CH, Chatzipantazi M. Onset of epidermolysis bullosa acquisita under therapy with ustekinumab for the treatment of Crohn disease. Clin Exp Dermatol 2023; 48:245-246. [PMID: 36763773 DOI: 10.1093/ced/llac077] [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: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 01/22/2023]
Abstract
A 32-year-old man with a long history of Crohn disease was put on ustekinumab, and after about 1 year of treatment, developed blisters and inflammatory lesions. He was diagnosed with epidermolysis bullosa acquisita and treated with dapsone.
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Affiliation(s)
- Thilo Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany; and
| | - E Schmidt
- Department of Dermatology and Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Christina H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany; and
| | - Maria Chatzipantazi
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany; and
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Schmidt E, Reinke N, Freitag M, Sonnenkalb M. Analyses of Critical Hydrogen Enrichment in PWR Containment Compartments. NUCL SCI ENG 2023. [DOI: 10.1080/00295639.2022.2146994] [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: 01/14/2023]
Affiliation(s)
- E. Schmidt
- Becker Technologies GmbH, Eschborn, Germany
| | - N. Reinke
- Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Köln, Germany
| | - M. Freitag
- Becker Technologies GmbH, Eschborn, Germany
| | - M. Sonnenkalb
- Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Köln, Germany
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Kimmeyer M, Schmidt E, Rentschler V, Graf A, Gerhardt C, Lehmann LJ, Schmalzl J. [Fracture sequelae type 2 of the proximal humerus-clinical results after arthroplasty]. Obere Extrem 2023; 18:30-36. [PMID: 36627888 PMCID: PMC9817432 DOI: 10.1007/s11678-022-00723-7] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/24/2022] [Indexed: 01/09/2023]
Abstract
Locked dislocations of the glenohumeral joint are rare but often painful and are associated with limited range of motion in the shoulder. In patients of advanced age, arthroplasty is increasingly indicated as a surgical treatment option. Preoperatively, the direction of dislocation, the presence and extent of a glenoid defect, and the soft tissue situation (rotator cuff status, joint capsule) should be analyzed in a differentiated manner. Based on the above factors, we recommend the subclassification of type 2 according to Boileau: posterior locked dislocation (2a), anterior locked dislocation without glenoid defect (2b), and anterior locked dislocation with glenoid defect (2c). In the case of dorsally locked dislocation, a good clinical result can be achieved by using an anatomical endoprosthesis. For ventrally locked dislocations, we recommend using an inverse total endoprosthesis with, if necessary, bony glenoid reconstruction and transfer of the pectoralis major muscle.Level of evidence: IV.
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Affiliation(s)
- M. Kimmeyer
- Klinik für Unfall‑, Handchirurgie und Sportmedizin, ViDia Christliche Kliniken Karlsruhe, Steinhäusserstr. 18, 76135 Karlsruhe, Deutschland
| | - E. Schmidt
- Klinik für Unfall‑, Handchirurgie und Sportmedizin, ViDia Christliche Kliniken Karlsruhe, Steinhäusserstr. 18, 76135 Karlsruhe, Deutschland
| | - V. Rentschler
- Klinik für Unfall‑, Handchirurgie und Sportmedizin, ViDia Christliche Kliniken Karlsruhe, Steinhäusserstr. 18, 76135 Karlsruhe, Deutschland
| | - A. Graf
- Klinik für Unfall‑, Handchirurgie und Sportmedizin, ViDia Christliche Kliniken Karlsruhe, Steinhäusserstr. 18, 76135 Karlsruhe, Deutschland
| | - C. Gerhardt
- Klinik für Unfall‑, Handchirurgie und Sportmedizin, ViDia Christliche Kliniken Karlsruhe, Steinhäusserstr. 18, 76135 Karlsruhe, Deutschland
| | - L. J. Lehmann
- Klinik für Unfall‑, Handchirurgie und Sportmedizin, ViDia Christliche Kliniken Karlsruhe, Steinhäusserstr. 18, 76135 Karlsruhe, Deutschland
| | - J. Schmalzl
- Klinik und Poliklinik für Unfall‑, Hand‑, Plastische und Wiederherstellungschirurgie, Uniklinikum Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Deutschland
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Hammers C, Emtenani S, Khodr El-Oueyk A, Papara C, Isken O, Tautz N, Lin C, Hundt J, Verschoor A, Zillikens D, Schmidt E, Siegel D, Stanley J. 011 Targeted inhibition of complement C3 deposition at the basement membrane zone in pemphigoid disease. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.020] [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: 11/19/2022]
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Sheikh K, Schmidt E, Lee J, Morcos M, Rezae M, Seethamraju R, Benkert T, Bhat H, Vadvala H, Daniel B, Viswanathan A. Tailoring Brachytherapy by Identification of Fibrosis vs. Tumor: Evaluating Acute and Chronic Fibrosis via UTE MRI in Gynecological Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2210] [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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Culton D, Ujiie H, Schmidt E, Murrell D, Stoykov I, Verheesen P, Borradori L, Hall R, Joly P. 311 Treatment of bullous pemphigoid by inhibiting fcrn: Pre-registration report of a phase 2/3 trial with efgartigimod. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.319] [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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Borradori L, Van Beek N, Feliciani C, Tedbirt B, Antiga E, Bergman R, Böckle BC, Caproni M, Caux F, Chandran NS, Cianchini G, Daneshpazhooh M, De D, Didona D, Di Zenzo GM, Dmochowski M, Drenovska K, Ehrchen J, Goebeler M, Groves R, Günther C, Horvath B, Hertl M, Hofmann S, Ioannides D, Itzlinger-Monshi B, Jedličková J, Kowalewski C, Kridin K, Lim YL, Marinovic B, Marzano AV, Mascaro JM, Meijer JM, Murrell D, Patsatsi K, Pincelli C, Prost C, Rappersberger K, Sárdy M, Setterfield J, Shahid M, Sprecher E, Tasanen K, Uzun S, Vassileva S, Vestergaard K, Vorobyev A, Vujic I, Wang G, Wozniak K, Yayli S, Zambruno G, Zillikens D, Schmidt E, Joly P. Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2022; 36:1689-1704. [PMID: 35766904 DOI: 10.1111/jdv.18220] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or, most frequently, generalized bullous lesions. A subset of patients only develops excoriations, prurigo-like lesions, and eczematous and/or urticarial erythematous lesions. The disease, which is significantly associated with neurological disorders, has high morbidity and severely impacts the quality of life. OBJECTIVES AND METHODOLOGY The Autoimmune blistering diseases Task Force of the European Academy of Dermatology and Venereology sought to update the guidelines for the management of BP based on new clinical information, and new evidence on diagnostic tools and interventions. The recommendations are either evidence-based or rely on expert opinion. The degree of consent among all task force members was included. RESULTS Treatment depends on the severity of BP and patients' comorbidities. High-potency topical corticosteroids are recommended as the mainstay of treatment whenever possible. Oral prednisone at a dose of 0.5 mg/kg/day is a recommended alternative. In case of contraindications or resistance to corticosteroids, immunosuppressive therapies, such as methotrexate, azathioprine, mycophenolate mofetil or mycophenolate acid, may be recommended. The use of doxycycline and dapsone is controversial. They may be recommended, in particular, in patients with contraindications to oral corticosteroids. B-cell-depleting therapy and intravenous immunoglobulins may be considered in treatment-resistant cases. Omalizumab and dupilumab have recently shown promising results. The final version of the guideline was consented to by several patient organizations. CONCLUSIONS The guidelines for the management of BP were updated. They summarize evidence- and expert-based recommendations useful in clinical practice.
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Affiliation(s)
- L Borradori
- Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - N Van Beek
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - C Feliciani
- Dermatology Unit, Department of Medicine and Surgery, University Hospital, University of Parma, Italy
| | - B Tedbirt
- Department of Dermatology, Rouen University Hospital, Referral Center for Autoimmune Bullous Diseases, Referral Center for Autoimmune Bullous Diseases, Rouen University Hospital, INSERM U1234, Normandie University, Rouen, France
| | - E Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - R Bergman
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - B C Böckle
- Department of Dermatology, Venereology & Allergology, Innsbruck Medical University, Innsbruck, Austria
| | - M Caproni
- Department of Health Sciences, Section of Dermatology, AUSL Toscana Centro, Rare Diseases Unit, European Reference Network-Skin Member, University of Florence, Italy
| | - F Caux
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and University Paris 13, Bobigny, France
| | - N S Chandran
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - G Cianchini
- Department of Dermatology, Ospedale Classificato Cristo Re, Rome, Italy
| | - M Daneshpazhooh
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - D De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D Didona
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - G M Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - M Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - K Drenovska
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - J Ehrchen
- Department of Dermatology, University of Münster, Münster, Germany
| | - M Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - R Groves
- St. John's Institute of Dermatology, Viapath Analytics LLP, St. Thomas' Hospital, London, UK.,Division of Genetics and Molecular Medicine, King's College London, Guy's Hospital, London, UK
| | - C Günther
- Department of Dermatology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - B Horvath
- Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M Hertl
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - S Hofmann
- Department of Dermatology, Allergy and Dermatosurgery, Helios University Hospital Wuppertal, University Witten, Herdecke, Germany
| | - D Ioannides
- 1st Department of Dermatology-Venereology, Hospital of Skin and Venereal Diseases, Aristotle University Medical School, Thessaloniki, Greece
| | - B Itzlinger-Monshi
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria
| | - J Jedličková
- Department of Dermatovenereology, Masaryk University, University Hospital St. Anna, Brno.,Department of Dermatovenereology, University Hospital Brno, Brno, Czech Republic
| | - C Kowalewski
- Department Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland
| | - K Kridin
- National Skin Centre, Singapore, Singapore
| | - Y L Lim
- Department of Dermatology and Venereology, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
| | - B Marinovic
- Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - J-M Mascaro
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J M Meijer
- Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - D Murrell
- Department of Dermatology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia
| | - K Patsatsi
- 2nd Department of Dermatology, Autoimmune Bullous Diseases Unit, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece
| | - C Pincelli
- DermoLab, Institute of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Prost
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and University Paris 13, Bobigny, France
| | - K Rappersberger
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria.,Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Austria
| | - M Sárdy
- Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany.,Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - J Setterfield
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Shahid
- Department of Dermatology, Medical University, Sofia, Bulgaria
| | - E Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center and Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Tasanen
- Department of Dermatology, the PEDEGO Research Unit, University of Oulu and Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - S Uzun
- Department of Dermatology and Venereology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - S Vassileva
- Department of Dermatology, Medical University, Sofia, Bulgaria
| | - K Vestergaard
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - A Vorobyev
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - I Vujic
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria
| | - G Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - K Wozniak
- National Skin Centre, Singapore, Singapore
| | - S Yayli
- Department of Dermatology, School of Medicine, Koç University, Istanbul, Turkey
| | - G Zambruno
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Referral Center for Autoimmune Bullous Diseases, Referral Center for Autoimmune Bullous Diseases, Rouen University Hospital, INSERM U1234, Normandie University, Rouen, France
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13
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Liu F, Ryan S, Fahnoe K, Morgan J, Bieber K, Schmidt E, Verschoor A, Ludwig R, Salant D, Thurman J, Holers V, Violette S, WAWERSIK S. POS-042 C3d-Directed Factor H Targeting Delivers Potent and Durable Complement Inhibition and Disease-Modifying Efficacy In Kidney and Skin Without Inhibiting Systemic Complement. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.04.064] [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: 11/26/2022] Open
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14
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Schluessel V, Kreuter N, Gosemann IM, Schmidt E. Cichlids and stingrays can add and subtract 'one' in the number space from one to five. Sci Rep 2022; 12:3894. [PMID: 35361791 PMCID: PMC8971382 DOI: 10.1038/s41598-022-07552-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 10/09/2021] [Accepted: 02/21/2022] [Indexed: 12/02/2022] Open
Abstract
The numerical understanding of cichlids and stingrays was examined regarding addition and subtraction abilities within the number space of one to five. Experiments were conducted as two-alternative forced-choice experiments, using a delayed matching to sample technique. On each trial, fish had to perform either an addition or subtraction, based on the presentation of two-dimensional objects in two distinct colors, with the color signaling a particular arithmetic process. Six cichlids and four stingrays successfully completed training and recognized specific colors as symbols for addition and subtraction. Cichlids needed more sessions than stingrays to reach the learning criterion. Transfer tests showed that learning was independent of straightforward symbol memorization. Individuals did not just learn to pick the highest or lowest number presented based on the respective color; instead, learning was specific to adding or subtracting ‘one’. Although group results were significant for both species in all tests, individual results varied. Addition was learned more easily than subtraction by both species. While cichlids learned faster than stingrays, and more cichlids than stingrays learned the task, individual performance of stingrays exceeded that of cichlids. Previous studies have provided ample evidence that fish have numerical abilities on par with those of other vertebrate and invertebrate species tested, a result that is further supported by the findings of the current study.
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Affiliation(s)
- V Schluessel
- Institute of Zoology, University of Bonn, Meckenheimer Allee 169, Poppelsdorfer Schloss, 53115, Bonn, Germany.
| | - N Kreuter
- Institute of Zoology, University of Bonn, Meckenheimer Allee 169, Poppelsdorfer Schloss, 53115, Bonn, Germany
| | - I M Gosemann
- Institute of Zoology, University of Bonn, Meckenheimer Allee 169, Poppelsdorfer Schloss, 53115, Bonn, Germany
| | - E Schmidt
- Institute of Zoology, University of Bonn, Meckenheimer Allee 169, Poppelsdorfer Schloss, 53115, Bonn, Germany
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15
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Nsiah‐Dosu S, Scholz C, Orinska Z, Sadik CD, Ludwig RJ, Schmidt E, Zillikens D, Hartmann K. Mast cell‐deficient mice
Mcpt5Cre/Dicer
fl/fl
redefine the role of mast cells in experimental bullous pemphigoid. Skin Health and Disease 2022; 2:e70. [PMID: 35665207 PMCID: PMC9060025 DOI: 10.1002/ski2.70] [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] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022]
Abstract
Background Bullous pemphigoid (BP) is the most frequent autoimmune blistering disease of the skin affecting the elderly. BP is immunopathologically characterized by autoantibodies against BP180 and BP230. With the growing evidence of cell‐mediated autoimmunity in the pathogenesis of BP, it still remains unclear whether mast cells (MCs) are involved, due to conflicting data obtained from Kit‐dependent MC‐deficient mouse models. Objectives To clarify the role of MCs in experimental BP; the dynamics in cutaneous MC numbers, associated immune cells and the development of disease in Kit‐independent MC‐deficient mouse model. Methods Employing a recently established murine adult passive transfer model of BP induced by the transfer of pathogenic immunoglobulin G (IgG), lesional skin biopsies were investigated histologically and immunohistochemically for the time‐dependent MC accumulation and dermal infiltration. Results The numbers of cutaneous MCs increased following the induction of BP, in part, maintained by MC proliferation. Numbers of T cells, neutrophils and eosinophils in the skin also increased after BP induction, with eosinophils showing a preferential co‐localization with MCs. Furthermore, clinical disease manifestation in MC‐deficient Mcpt5Cre/Dicerfl/fl mice remained unchanged compared to MC‐sufficient Dicerfl/fl mice. The composition of the immune cell infiltration including as T cells, neutrophils and eosinophils was largely unaffected by the absence of MCs. Conclusion MCs do not play a pivotal role in the pathogenesis of passive IgG‐transfer mediated BP model. Their increase in number may be a bystander effect following tissue injury. We therefore suggest caution regarding the selection of MCs as sole targets for the development of novel drugs for BP.
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Affiliation(s)
- S. Nsiah‐Dosu
- Department of Dermatology University of Luebeck Luebeck Germany
| | - C. Scholz
- Department of Dermatology University of Luebeck Luebeck Germany
- Department of Infectious Diseases and Microbiology University of Luebeck Luebeck Germany
| | - Z. Orinska
- Division of Experimental Pneumology Research Center Borstel Leibniz Lung Center Borstel Germany
- Division of Experimental Pneumology, Research Center Borstel, Leibniz Lungenzentrum Airway Research Center North (ARCN) German Center for Lung Research (DZL) Borstel Germany
| | - C. D. Sadik
- Department of Dermatology University of Luebeck Luebeck Germany
| | - R. J. Ludwig
- Luebeck Institute of Experimental Dermatology (LIED) University of Luebeck Luebeck Germany
| | - E. Schmidt
- Department of Dermatology University of Luebeck Luebeck Germany
- Luebeck Institute of Experimental Dermatology (LIED) University of Luebeck Luebeck Germany
| | - D. Zillikens
- Department of Dermatology University of Luebeck Luebeck Germany
| | - K. Hartmann
- Department of Dermatology University of Luebeck Luebeck Germany
- Division of Allergy Department of Dermatology University of Basel Basel Switzerland
- Department of Biomedicine University of Basel Basel Switzerland
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16
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Goebeler M, Bata-Csörgő Z, De Simone C, Didona B, Remenyik E, Reznichenko N, Stoevesandt J, Ward ES, Parys W, de Haard H, Dupuy P, Verheesen P, Schmidt E, Joly P. Treatment of pemphigus vulgaris and foliaceus with efgartigimod, a neonatal Fc receptor inhibitor: a phase II multicentre, open-label feasibility trial. Br J Dermatol 2021; 186:429-439. [PMID: 34608631 DOI: 10.1111/bjd.20782] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Pemphigus vulgaris and pemphigus foliaceus are potentially life-threatening autoimmune disorders triggered by IgG autoantibodies against mucosal and epidermal desmogleins. There is an unmet need for fast-acting drugs that enable patients to achieve early sustained remission with reduced corticosteroid reliance. OBJECTIVES To investigate efgartigimod, an engineered Fc fragment that inhibits the activity of the neonatal Fc receptor, thereby reducing serum IgG levels, for treating pemphigus. METHODS Thirty-four patients with mild-to-moderate pemphigus vulgaris or foliaceus were enrolled in an open-label phase II adaptive trial. In sequential cohorts, efgartigimod was dosed at 10 or 25 mg kg-1 intravenously with various dosing frequencies, as monotherapy or as add-on therapy to low-dose oral prednisone. Safety endpoints comprised the primary outcome. The study is registered at ClinicalTrials.gov (identifier NCT03334058). RESULTS Adverse events were mostly mild and were reported by 16 of 19 (84%) patients receiving efgartigimod 10 mg kg-1 and 13 of 15 (87%) patients receiving 25 mg kg-1 , with similar adverse event profiles between dose groups. A major decrease in serum total IgG and anti-desmoglein autoantibodies was observed and correlated with improved Pemphigus Disease Area Index scores. Efgartigimod, as monotherapy or combined with prednisone, demonstrated early disease control in 28 of 31 (90%) patients after a median of 17 days. Optimized, prolonged treatment with efgartigimod in combination with a median dose of prednisone 0·26 mg kg-1 per day (range 0·06-0·48) led to complete clinical remission in 14 of 22 (64%) patients within 2-41 weeks. CONCLUSIONS Efgartigimod was well tolerated and exhibited an early effect on disease activity and outcome parameters, providing support for further evaluation as a therapy for pemphigus.
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Affiliation(s)
- M Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Policlinic A. Gemelli, Rome, Italy
| | - B Didona
- Dermatopathic Institute of the Immaculate, Rome, Italy
| | - E Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N Reznichenko
- Zaporizhzhya State Medical University, Zaporizhzhya, Ukraine
| | - J Stoevesandt
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - E S Ward
- Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | | | | | | | | | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Rouen, France
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Vicari E, Haeberle S, Bolduan V, Ramcke T, Vorobyev A, Goletz S, Iwata H, Ludwig R, Schmidt E, Enk A, Hadaschik E. 006 Pathogenic autoantibody derived from Treg-deficient scurfy mice targets Type VII Collagen and induces Epidermolysis bullosa acquisita-like blistering disease. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.007] [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: 11/26/2022]
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18
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Schmidt E, Rashid H, Marzano A, Lamberts A, Di Zenzo G, Diercks G, Alberti‐Violetti S, Barry R, Borradori L, Caproni M, Carey B, Carrozzo M, Cianchini G, Corrà A, Dikkers F, Feliciani C, Geerling G, Genovese G, Hertl M, Joly P, Meijer J, Mercadante V, Murrell D, Ormond M, Pas H, Patsatsi A, Rauz S, van Rhijn B, Roth M, Setterfield J, Zillikens D, C.Prost, Zambruno G, Horváth B, Caux F. European Guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology - Part II. J Eur Acad Dermatol Venereol 2021; 35:1926-1948. [PMID: 34309078 PMCID: PMC8518905 DOI: 10.1111/jdv.17395] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/24/2021] [Indexed: 01/21/2023]
Abstract
This guideline has been initiated by the task force Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology, including physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline that systematically reviewed the literature on mucous membrane pemphigoid (MMP) in the MEDLINE and EMBASE databases until June 2019, with no limitations on language. While the first part of this guideline addressed methodology, as well as epidemiology, terminology, aetiology, clinical presentation and outcome measures in MMP, the second part presents the diagnostics and management of MMP. MMP should be suspected in cases with predominant mucosal lesions. Direct immunofluorescence microscopy to detect tissue-bound IgG, IgA and/or complement C3, combined with serological testing for circulating autoantibodies are recommended. In most patients, serum autoantibodies are present only in low levels and in variable proportions, depending on the clinical sites involved. Circulating autoantibodies are determined by indirect IF assays using tissue substrates, or ELISA using different recombinant forms of the target antigens or immunoblotting using different substrates. The major target antigen in MMP is type XVII collagen (BP180), although in 10-25% of patients laminin 332 is recognized. In 25-30% of MMP patients with anti-laminin 332 reactivity, malignancies have been associated. As first-line treatment of mild/moderate MMP, dapsone, methotrexate or tetracyclines and/or topical corticosteroids are recommended. For severe MMP, dapsone and oral or intravenous cyclophosphamide and/or oral corticosteroids are recommended as first-line regimens. Additional recommendations are given, tailored to treatment of single-site MMP such as oral, ocular, laryngeal, oesophageal and genital MMP, as well as the diagnosis of ocular MMP. Treatment recommendations are limited by the complete lack of high-quality randomized controlled trials.
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19
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Emtenani S, Ghorbanalipoor S, Parker M, Kamaguchi M, Osterloh C, Pigors M, Patzelt S, Chakievska L, Bieber K, Osman I, Izumi K, Smith P, Schmidt E, Ludwig R. 018 Cutaneous kinase activity correlates with treatment outcomes following PI3K delta inhibition in mice with experimental pemphigoid diseases. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.019] [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: 11/15/2022]
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20
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Rashid H, Lamberts A, Borradori L, Alberti‐Violetti S, Barry R, Caproni M, Carey B, Carrozzo M, Caux F, Cianchini G, Corrà A, Diercks G, Dikkers F, Di Zenzo G, Feliciani C, Geerling G, Genovese G, Hertl M, Joly P, Marzano A, Meijer J, Mercadante V, Murrell D, Ormond M, Pas H, Patsatsi A, Prost C, Rauz S, van Rhijn B, Roth M, Schmidt E, Setterfield J, Zambruno G, Zillikens D, Horváth B. European guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology - Part I. J Eur Acad Dermatol Venereol 2021; 35:1750-1764. [PMID: 34245180 PMCID: PMC8457055 DOI: 10.1111/jdv.17397] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022]
Abstract
This guideline on mucous membrane pemphigoid (MMP) has been elaborated by the Task Force for Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology (EADV) with a contribution of physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline encompassing a systematic review of the literature until June 2019 in the MEDLINE and EMBASE databases. This first part covers methodology, the clinical definition of MMP, epidemiology, MMP subtypes, immunopathological characteristics, disease assessment and outcome scores. MMP describes a group of autoimmune skin and mucous membrane blistering diseases, characterized by a chronic course and by predominant involvement of the mucous membranes, such as the oral, ocular, nasal, nasopharyngeal, anogenital, laryngeal and oesophageal mucosa. MMP patients may present with mono- or multisite involvement. Patients' autoantibodies have been shown to be predominantly directed against BP180 (also called BPAG2, type XVII collagen), BP230, laminin 332 and type VII collagen, components of junctional adhesion complexes promoting epithelial stromal attachment in stratified epithelia. Various disease assessment scores are available, including the Mucous Membrane Pemphigoid Disease Area Index (MMPDAI), the Autoimmune Bullous Skin disorder Intensity Score (ABSIS), the 'Cicatrising Conjunctivitis Assessment Tool' and the Oral Disease Severity Score (ODSS). Patient-reported outcome measurements (PROMs), including DLQI, ABQOL and TABQOL, can be used for assessment of quality of life to evaluate the effectiveness of therapeutic interventions and monitor disease course.
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21
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Goebeler M, Bata-Csörgo Z, de Simone C, Didona B, Remenyik E, Reznichenko N, Schmidt E, Stoevesandt J, Ward E, Parys W, de Haard H, Dupuy P, Verheesen P, Joly P. LB773 Treating pemphigus vulgaris (PV) and foliaceus (PF) by inhibiting the neonatal Fc receptor: Phase 2 multicentre open-label trial with efgartigimod. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Hébert V, Bastos S, Drenovska K, Meijer J, Ingen-Housz-Oro S, Bedane C, Lunardon L, Debarbieux S, Jedlickova H, Caux F, Chaby G, D'Incan M, Feliciani C, Boulard C, Schumacher N, Schmidt E, Roussel A, Richard MA, Gottlieb J, Ferranti V, Guérin O, Bénichou J, Joly P. International multicentre observational study to assess the efficacy and safety of a 0·5 mg kg -1 per day starting dose of oral corticosteroids to treat bullous pemphigoid. Br J Dermatol 2021; 185:1232-1239. [PMID: 34173243 DOI: 10.1111/bjd.20593] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND European guidelines propose a 0·5 mg kg-1 per day dose of oral prednisone as initial treatment for bullous pemphigoid (BP). We assessed the safety and efficacy of this regimen depending on BP extent and general condition of the patients. METHODS In a prospective international study, we consecutively included all patients diagnosed with BP. Patients received a 0·5 mg kg-1 per day dose of prednisone, which was then gradually tapered 15 days after disease control, with the aim of stopping prednisone or maintaining minimal treatment (0·1 mg kg-1 per day) within 6 months after the start of treatment. The two coprimary endpoints were control of disease activity at day 21 and 1-year overall survival. Disease severity was assessed according to the Bullous Pemphigoid Disease Area Index (BPDAI) score. RESULTS In total, 198 patients were included between 2015 and 2017. The final analysis comprised 190 patients with a mean age of 80·9 (SD 9·1) years. Control of disease activity was achieved at day 21 in 119 patients [62·6%, 95% confidence interval (CI) 55·3-69.5]; 18 of 24 patients (75%, 95% CI 53·3-90·2), 75 of 110 patients (68·8%, 95% CI 59·2-77·3) and 26 of 56 patients (46.4%, 95% CI 33·0-60·3) had mild, moderate and severe BP, respectively (P = 0·0218). A total of 30 patients died during the study. The overall Kaplan-Meier 1-year survival was 82·6% (95% CI 76·3-87·4) corresponding to 90·9%, 83·0% and 80·0% rates in patients with mild, moderate and severe BP, respectively (P = 0·5). Thresholds of 49 points for BPDAI score and 70 points for Karnofsky score yielded maximal Youden index values with respect to disease control at day 21 and 1-year survival, respectively. CONCLUSIONS A 0·5 mg kg-1 per day dose of prednisone is a valuable therapeutic option in patients with mild or moderate BP whose general condition allows them to be autonomous.
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Affiliation(s)
- V Hébert
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
| | - S Bastos
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
| | - K Drenovska
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - J Meijer
- Center for Blistering Diseases, Department of Dermatology, University Medical Center Groningen, Groningen, the Netherlands
| | - S Ingen-Housz-Oro
- Department of Dermatology, Henri Mondor University Hospital, (AP-HP), Creteil, France
| | - C Bedane
- Department of Dermatology, Limoges University Hospital, Limoges, France
| | - L Lunardon
- Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Debarbieux
- Department of Dermatology, Hospices Civils de Lyon, Lyon, France
| | - H Jedlickova
- Department of Dermatology, St. Anne's Faculty Hospital, Brno, Czech Republic
| | - F Caux
- Department of Dermatology, Avicenne Hospital, University Paris 13, Bobigny, France
| | - G Chaby
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | - M D'Incan
- Department of Dermatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - C Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Boulard
- Department of Dermatology, Monod General Hospital, le Havre, France
| | - N Schumacher
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - A Roussel
- Department of Dermatology, Orleans Hospital, Orléans, France
| | - M A Richard
- Department of Dermatology, Hôpital la Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - J Gottlieb
- Department of Dermatology, Saint Louis Hospital, (AP-HP), Paris, France
| | - V Ferranti
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - O Guérin
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - J Bénichou
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
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23
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Kridin K, Hübner F, Recke A, Linder R, Schmidt E. The burden of neurological comorbidities in six autoimmune bullous diseases: a population-based study. J Eur Acad Dermatol Venereol 2021; 35:2074-2078. [PMID: 34153122 DOI: 10.1111/jdv.17465] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/08/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Apart from bullous pemphigoid (BP), the association of other autoimmune bullous diseases (AIBDs) with neurological conditions is poorly understood. OBJECTIVE To estimate the association between a wide array of AIBDs and neurological conditions. METHODS A retrospective cross-sectional study recruited patients with BP, mucous membrane pemphigoid (MMP), epidermolysis bullosa acquisita (EBA), pemphigoid gestationis (PG), pemphigus vulgaris (PV) and pemphigus foliaceus (PF). These patients were compared with their age- and sex-matched control subjects with regard to the lifetime prevalence of Parkinson's disease (PD), Alzheimer's disease (AD), stroke, epilepsy and multiple sclerosis (MS). Logistic regression was used to calculate OR for specified neurological disorders. RESULTS The current study included 1743, 251, 106, 126, 860 and 103 patients diagnosed with BP, MMP, EBA, PG, PV and PF, respectively. These patients were compared with 10 141, 1386, 606, 933, 5142 and 588 matched controls, respectively. Out of the investigated neurological conditions, PD associated with BP (OR, 2.71; 95% CI, 2.19-3.35); AD with BP (OR, 2.11; 95% CI, 1.73-2.57), MMP (OR, 2.37; 95% CI, 1.03-5.47), EBA (OR, 6.00; 95% CI, 1.90-18.97) and PV (OR, 2.24; 95% CI, 1.40-3.60); stroke with BP (OR, 1.84; 95% CI, 1.55-2.19) and EBA (OR, 2.79; 95% CI, 1.11-7.01); and epilepsy with BP (OR, 2.18; 95% CI, 1.72-2.77) and PV (OR, 1.80; 95% CI, 1.19-2.73). MS did not significantly cluster with any of the six AIBDs. CONCLUSION In addition to BP, EBA and PV were found to cluster with neurological comorbidities. Patients with these AIBDs with compatible symptoms may be carefully assessed for comorbid neurological disorders.
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Affiliation(s)
- K Kridin
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Unit of Dermatology and Skin Research Laboratory, Baruch Padeh Poria Medical Center, Tiberias, Israel
| | - F Hübner
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - A Recke
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - R Linder
- Techniker Krankenkasse, Corporate Development, Analytics and Insights, Hamburg, Germany
| | - E Schmidt
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Department of Dermatology, University of Lübeck, Lübeck, Germany
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24
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Ständer S, Hammers CM, Vorobyev A, Schmidt E, Zillikens D, Ghorbanalipoor S, Bieber K, Ludwig RJ, Kridin K. The impact of lesional inflammatory cellular infiltrate on the phenotype of bullous pemphigoid. J Eur Acad Dermatol Venereol 2021; 35:1702-1711. [PMID: 33896060 DOI: 10.1111/jdv.17303] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/10/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND The influence of cutaneous cellular infiltration on the phenotype of bullous pemphigoid (BP) remains to be established. OBJECTIVES To evaluate the main histopathological characteristics of patients with BP and to assess the association between the composition of lesional inflammatory infiltrate and the various clinical, immunological and immunopathological aspects of the disease. METHODS Retrospective study encompassing patients diagnosed with BP throughout the years 2009-2020 in a specialized tertiary referral centre. RESULTS The study encompassed 136 patients with BP, of whom 27 (19.9%) demonstrated a cell-poor inflammatory infiltrate in lesional skin specimens. Overall, 78 (57.4%), 71 (52.2%) and 5 (3.7%) specimens were found to include eosinophil-predominant, lymphocyte-predominant and neutrophil-predominant inflammatory infiltrates, respectively. Relative to the remaining patients with BP, those with an eosinophil-predominant inflammatory infiltrate had higher (90.8% vs. 77.2%; P = 0.030) whilst those with a cell-poor inflammatory infiltrate lower (70.3% vs. 88.7%; P = 0.017) seropositivity of anti-BP180 NC16A IgG. The latter subgroup presented with higher prevalence of mucosal involvement (25.9% vs. 8.3%; P = 0.011) and a non-inflammatory clinical phenotype (50.0% vs. 17.1%; P = 0.041). Patients with lymphocyte-predominant inflammatory infiltrate manifested with higher severity BPDAI scores and a lower frequency of the non-inflammatory subtype (11.1% vs. 36.4%; P = 0.035), whilst those with a neutrophilic infiltrate presented with lower mean (SD) levels of anti-BP180 NC16A IgG [269.3 (227.6) vs. 722.7 (1499.6) U/mL; P = 0.003]. CONCLUSIONS Eosinophil-predominance and high cellularity in the lesional inflammatory infiltrate of BP skin are associated with increased seropositivity of anti-BP180 NC16A IgG. Lymphocyte-predominant infiltrates predict a more severe phenotype, pointing towards a pathogenic role of autoreactive lymphocytes.
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Affiliation(s)
- S Ständer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - C M Hammers
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - A Vorobyev
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - S Ghorbanalipoor
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - K Bieber
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - R J Ludwig
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - K Kridin
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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25
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Schmitt T, Egu DT, Walter E, Sigmund AM, Eichkorn R, Yazdi A, Schmidt E, Sárdy M, Eming R, Goebeler M, Waschke J. Ca 2+ signalling is critical for autoantibody-induced blistering of human epidermis in pemphigus. Br J Dermatol 2021; 185:595-604. [PMID: 33792909 DOI: 10.1111/bjd.20091] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pemphigus is a severe bullous autoimmune skin disease. Pemphigus foliaceus (PF) is characterized by antidesmoglein (Dsg) 1 IgG causing epidermal blistering; mucosal pemphigus vulgaris (mPV) by anti-Dsg3 IgG inducing erosions in the mucosa; and mucocutaneous pemphigus vulgaris (PV) by affecting both, with autoantibodies targeting Dsg1 and Dsg3. OBJECTIVES To characterize the Ca2+ flux pathway and delineate its importance in pemphigus pathogenesis and clinical phenotypes caused by different antibody profiles. METHODS Immunoprecipitation, Ca2+ flux analysis, Western blotting, immunofluorescence staining, dissociation assays and a human skin ex vivo model were used. RESULTS PV IgG and PF IgG, but neither Dsg3-specific monoclonal antibody (AK23) nor mPV IgG, caused Ca2+ influx in primary human keratinocytes. Phosphatidylinositol 4-kinase α interacts with Dsg1 but not with Dsg3. Its downstream target - phospholipase-C-γ1 (PLC) - was activated by PV IgG and PF IgG but not AK23 or mPV IgG. PLC releases inositol 1,4,5-trisphosphate (IP3) causing IP3 receptor (IP3R) activation and Ca2+ flux from the endoplasmic reticulum into the cytosol, which stimulates Ca2+ release-activated channels (CRAC)-mediated Ca2+ influx. Inhibitors against PLC, IP3R and CRAC effectively blocked PV IgG and PF IgG-induced Ca2+ influx; ameliorated alterations of Dsg1 and Dsg3 localization, and reorganization of keratin and actin filaments; and inhibited loss of cell adhesion in vitro. Finally, inhibiting PLC or IP3R was protective against PV IgG-induced blister formation and redistribution of Dsg1 and Dsg3 in human skin ex vivo. CONCLUSIONS Ca2+ -mediated signalling is important for epidermal blistering and dependent on the autoantibody profile, which indicates different roles for signalling complexes organized by Dsg1 and Dsg3. Interfering with PLC and Ca2+ signalling may be a promising approach to treat epidermal manifestations of pemphigus.
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Affiliation(s)
- T Schmitt
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - D T Egu
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - E Walter
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - A M Sigmund
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
| | - R Eichkorn
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls-University, Tübingen, Germany
| | - A Yazdi
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls-University, Tübingen, Germany.,Department of Dermatology, RWTH Aachen, Aachen, Germany
| | - E Schmidt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, 23562, Germany.,Department of Dermatology, University of Lübeck, Lübeck, 23562, Germany
| | - M Sárdy
- Clinic for Dermatology, Semmelweis University, Budapest, Hungary
| | - R Eming
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - M Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, 97080, Germany
| | - J Waschke
- Ludwig-Maximilian-Universität München, Anatomische Anstalt, Lehrstuhl Anatomie I - Vegetative Anatomie, Pettenkoferstraße 11, München, D-80336, Germany
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26
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Görög A, Antiga E, Caproni M, Cianchini G, De D, Dmochowski M, Dolinsek J, Drenovska K, Feliciani C, Hervonen K, Lakos Jukic I, Kinyó Á, Koltai T, Korponay-Szabó I, Marzano AV, Patsatsi A, Rose C, Salmi T, Schmidt E, Setterfield J, Shahid M, Sitaru C, Uzun S, Valitutti F, Vassileva S, Yayli S, Sárdy M. S2k guidelines (consensus statement) for diagnosis and therapy of dermatitis herpetiformis initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2021; 35:1251-1277. [PMID: 34004067 DOI: 10.1111/jdv.17183] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/14/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Dermatitis herpetiformis (DH) is a chronic, pruritic, gluten-induced skin disorder characterized by subepidermal granular IgA deposition and a variable degree of enteropathy identical to that seen in coeliac disease. So far, there has been no European consensus about the management of DH. METHODS The guidelines were created by small subgroups of a guideline committee consisting of 26 specialists from various medical fields and one patients' representative. The members of the committee then discussed the guidelines and voted for the final version at two consensus meetings. The guidelines were developed under the support of the European Academy of Dermatology and Venereology (EADV) and in collaboration with the European Dermatology Forum (EDF). RESULTS The guidelines summarize evidence-based and expert-based recommendations (S2 level) for the management of DH (see Appendix). CONCLUSION These guidelines will improve the quality of management of DH and support dermatologists in their diagnostic and therapeutic decisions.
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Affiliation(s)
- A Görög
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - E Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - M Caproni
- Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, USL Toscana Centro, European Reference Network-Skin Member, University of Florence, Florence, Italy
| | - G Cianchini
- Department of Dermatology, Cristo Re Hospital, Rome, Italy
| | - D De
- Department of Dermatology, Postgraduate Institute of Medical Education Research, Chandigarh, India
| | - M Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
| | - J Dolinsek
- Gastroenterology Unit, Department of Pediatrics, University Medical Center Maribor, Maribor, Slovenia.,Medical Faculty, University of Maribor, Maribor, Slovenia
| | - K Drenovska
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - C Feliciani
- Dermatology Unit Azienda Ospedaliero - Universitaria, Università di Parma, Parma, Italy
| | - K Hervonen
- Coeliac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - I Lakos Jukic
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Pécs, Hungary
| | - T Koltai
- Association of European Coeliac Societies, Brussels, Belgium.,Hungarian Coeliac Society, Budapest, Hungary
| | - I Korponay-Szabó
- Coeliac Disease Centre, Heim Pál National Paediatric Institute, Budapest, Hungary.,Faculty of Medicine, Institute of Paediatrics, University of Debrecen, Debrecen, Hungary
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - A Patsatsi
- Autoimmune Bullous Diseases Unit, 2nd Dermatology Department, Aristotle University School of Medicine, Thessaloniki, Greece
| | - C Rose
- Dermatopathology Laboratory, Lübeck, Germany.,German Coeliac Disease Society e. V., Stuttgart, Germany
| | - T Salmi
- Coeliac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - J Setterfield
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre for Host Microbiome Interactions, Faculty of Dentistry Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Shahid
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - C Sitaru
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.,BIOSS Centre for Biological Signalling, University of Freiburg, Freiburg, Germany
| | - S Uzun
- Department of Dermatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - F Valitutti
- Pediatric Unit, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - S Vassileva
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - S Yayli
- Department of Dermatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.,Department of Dermatology and Allergy, University Hospital of LMU, Munich, Germany
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Blum D, Seiler A, Schmidt E, Pavic M, Strasser F. Patterns of integrating palliative care into standard oncology in an early ESMO designated center: a 10-year experience. ESMO Open 2021; 6:100147. [PMID: 33984671 PMCID: PMC8134655 DOI: 10.1016/j.esmoop.2021.100147] [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: 02/01/2021] [Revised: 03/26/2021] [Accepted: 04/09/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Integration of specialist palliative care (PC) into standard oncology care is recommended. This study investigated how integration at the Cantonal Hospital St. Gallen (KSSG) was manifested 10 years after initial accreditation as a European Society for Medical Oncology (ESMO) Designated Center (ESMO-DC) of Integrated Oncology and Palliative Care. METHODS A chart review covering the years 2006-2009 and 2016 was carried out in patients with an incurable malignancy receiving PC. Visual graphic analysis was utilized to identify patterns of integration of PC into oncology based on the number and nature of medical consultations recorded for both specialties. A follow-up cohort collected 10 years later was analyzed and changes in patterns of integrating specialist PC into oncology were compared. RESULTS Three hundred and forty-five patients from 2006 to 2009 and 64 patients from 2016 were included into analyses. Four distinct patterns were identified using visual graphic analysis. The 'specialist PC-led pattern' (44.9%) and the 'oncology-led pattern' (20.3%) represent disciplines that took primary responsibility for managing patients, with occasional and limited involvement from other disciplines. Patients in the 'concurrent integrated care pattern' (18.3%) had medical consultations that frequently bounced between specialist PC and oncology. In the 'segmented integrated care pattern' (16.5%), patients had sequences of continuous consultations provided by one discipline before alternating to a stretch of consultations provided by the other specialty. In the 2016 follow-up, while the 'oncology-led pattern' occurred significantly less frequently relative to the 'specialist PC-led pattern' and the 'segmented integrated care pattern', the 'concurrent integrated care pattern' emerged more frequently when compared with the 2006-2009 follow-up. CONCLUSION The 'specialist PC-led pattern' was the most prominent pattern in this data. The 2016 follow-up showed that a growing number of patients received a collaborative pattern of care, indicating that integration of specialist PC into standard oncology can manifest as either segmented or concurrent care pathways. Our data suggest a closer, more dynamic and flexible collaboration between oncology and specialist PC early in the disease course of patients with advanced cancer and concurrent with active treatment.
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Affiliation(s)
- D. Blum
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland,Correspondence to: Dr David Blum, Competence Center Palliative Care, Department of Radiation Oncology, University Hospital Zurich (USZ), Rämistrasse 100, CH-8091 Zürich, Switzerland. Tel: +044-255-37-42; Mob: +079-154-87-47
| | - A. Seiler
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland,Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - E. Schmidt
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland,Oncological Palliative Medicine, Clinic Oncology/Hematology, Cantonal Hospital St. Gallen, Switzerland
| | - M. Pavic
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - F. Strasser
- Oncological Palliative Medicine, Clinic Oncology/Hematology, Cantonal Hospital St. Gallen, Switzerland
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28
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Ständer S, Hammers CM, Vorobyev A, Schmidt E, Hundt JE, Sadik CD, Lange T, Zillikens D, Ludwig RJ, Kridin K. Coexistence of bullous pemphigoid with neuropsychiatric comorbidities is associated with anti-BP230 seropositivity. J Eur Acad Dermatol Venereol 2021; 35:2067-2073. [PMID: 33896070 DOI: 10.1111/jdv.17304] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND While clustering of bullous pemphigoid (BP) with neuropsychiatric diseases is well-established, the clinical and immunological profile of BP patients with this comorbidity remains to be decisively determined. OBJECTIVES To evaluate the burden of neurological and psychiatric comorbidities among patients with BP and to elucidate the clinical, immunological and immunopathological features of patients with BP and comorbid neuropsychiatric conditions. METHODS We performed a retrospective study encompassing patients diagnosed with BP throughout the years 2009-2020 in a specialized tertiary referral centre. Multivariate logistic regression model was used to identify predictors of neuropsychiatric conditions among patients with BP. RESULTS The study included 273 patients with BP, of whom 123 (45.1%) presented with comorbid neuropsychiatric disease. Compared to the remaining patients with BP (n = 150), those with pre-existing neuropsychiatric diseases demonstrated older mean [standard deviation (SD)] age [81.7 (9.1) vs. 76.9 (10.1); P < 0.001], female preponderance (65.0% vs. 49.3%; P = 0.009), higher seropositivity rate of anti-BP230 (67.7% vs. 36.5%; P = 0.006) and higher levels of anti-BP180 NC16A IgG [651.3 (1279.6) vs. 370.4 (818.6) U/mL; P = 0.039]. In multivariate analysis, anti-BP230 seropositivity was independently associated with coexistence of BP with neuropsychiatric conditions [adjusted odds ratio (OR), 3.43; 95% CI, 1.24-9.52; P = 0.018]. In a sensitivity analysis confined to patients with neurological diseases (n = 103), older age [82.1 (8.4) vs. 77.2 (10.3); P < 0.001] and increased anti-BP230 seropositivity (68.0% vs. 39.7%; P = 0.018) were identified. CONCLUSIONS The coexistence of BP with neuropsychiatric diseases is independently associated with the generation of anti-BP230 antibodies.
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Affiliation(s)
- S Ständer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - C M Hammers
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - A Vorobyev
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - J E Hundt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - C D Sadik
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - T Lange
- Department of Rheumatology & Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - R J Ludwig
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - K Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Kasperkiewicz M, Schmidt E, Amagai M, Fairley JA, Joly P, Murrell DF, Payne AS, Yale ML, Zillikens D, Woodley DT. Updated international expert recommendations for the management of autoimmune bullous diseases during the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2021; 35:e412-e414. [PMID: 33655539 PMCID: PMC8013840 DOI: 10.1111/jdv.17207] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Affiliation(s)
- M Kasperkiewicz
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - M Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - J A Fairley
- Department of Dermatology, University of Iowa, Iowa City, IA, USA
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Rouen, France
| | - D F Murrell
- Department of Dermatology, St George Hospital, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - A S Payne
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - M L Yale
- International Pemphigus and Pemphigoid Foundation, Sacramento, CA, USA
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D T Woodley
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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30
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De D, Kaushik A, Handa S, Mahajan R, Schmidt E. Omalizumab: an underutilized treatment option in bullous pemphigoid patients with co-morbidities. J Eur Acad Dermatol Venereol 2021; 35:e469-e472. [PMID: 33725360 DOI: 10.1111/jdv.17229] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Affiliation(s)
- D De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kaushik
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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31
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Krebs M, Helland Å, Carcereny Costa E, Arriola Aperribay E, Dómine Gómez M, Trigo Pérez J, Thompson J, Strauss J, Ortega Granados A, Felip E, Schmidt E, Chisamore M, Madeleine N, Rayford A, Lorens K, Siddiqui A, Gabra H, Nautiyal J, Micklem D, Lorens J, Spicer J. OA01.07 A Phase II Study of the Oral Selective AXL Inhibitor Bemcentinib with Pembrolizumab in Patients with Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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32
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van Beek N, Weidinger A, Schneider SW, Kleinheinz A, Gläser R, Holtsche MM, von Georg A, Hammers CM, Hübner F, Lima AL, Gola D, Sadik CD, Zillikens D, Katalinic A, Schmidt E, König IR. Incidence of pemphigoid diseases in Northern Germany in 2016 - first data from the Schleswig-Holstein Registry of Autoimmune Bullous Diseases. J Eur Acad Dermatol Venereol 2021; 35:1197-1202. [PMID: 33428263 DOI: 10.1111/jdv.17107] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Autoimmune bullous diseases (AIBD) are rare disorders characterized by autoantibody formation against components of adhesion molecules; in pemphigoid diseases (PD), these are proteins of hemidesmosomes and basement membrane, important for cell-matrix adhesion in skin and/or mucous membranes. Incidences of these diseases vary considerably between different populations. OBJECTIVES To establish a registry prospectively recruiting all AIBD patients in a geographically well-defined region in Northern Germany (Schleswig-Holstein). METHODS Only patients with verified disease (by clinical presentation, histology, direct and/or indirect immunofluorescence and /or ELISA) living in Schleswig-Holstein were included. Incidences of PD were estimated based on the total number of inhabitants in Schleswig-Holstein, stratified by birth year and sex. RESULTS Of 67 patients with PD [35 male, 32 female, mean age 75 (standard deviation 14.3 years)], 83% were patients with bullous pemphigoid [n = 56, 28 male, 28 female, mean age 78 (SD 9.9)]. The resulting crude incidences were 23.4 patients/million/year for all pemphigoid patients, 19.6 patients/million/year for bullous pemphigoid (age-standardized 16.9 patients/million/year) with a strong increase in bullous pemphigoid patients in the age group of 85-90 years with 262 patients/million/year. Incidences for bullous pemphigoid were higher in urban compared to rural areas. Other PD (mucous membrane pemphigoid, linear IgA disease, anti-p200 pemphigoid) were less frequent with crude incidences of 2.1, 1.0 and 0.7 patients/million/year, respectively. CONCLUSIONS This study prospectively analyses the incidence of PD in a carefully defined geographical area. The highest incidence among PD patients was found for bullous pemphigoid. The incidence of bullous pemphigoid is considerably increased compared to previous reports and reveals regional differences. Further studies are needed in order to clarify these findings.
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Affiliation(s)
- N van Beek
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany
| | - A Weidinger
- Department of Dermatology, Venereology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - S W Schneider
- Department of Dermatology and Venerology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - A Kleinheinz
- Department of Dermatology, Elbe Medical Center, Buxtehude, Germany
| | - R Gläser
- Department of Dermatology, Venereology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M M Holtsche
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany
| | - A von Georg
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany
| | - C M Hammers
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - F Hübner
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany
| | - A-L Lima
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany
| | - D Gola
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - C D Sadik
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany
| | - A Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, Allergology, and Venereology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - I R König
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
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33
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Daneshpazhooh M, Fazlolahi S, Mahmoudi H, Atefi I, van Beek N, Balighi K, Taghizadeh Fazli J, Kamyab K, Zillikens D, Schmidt E. Epidermolysis bullosa acquisita: the most frequent pemphigoid disease in patients with dermal binding autoantibodies by indirect immunofluorescence microscopy on human salt-split skin in Tehran, Iran. J Eur Acad Dermatol Venereol 2021; 35:e370-e372. [PMID: 33497481 DOI: 10.1111/jdv.17137] [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] [Received: 12/18/2020] [Accepted: 01/14/2021] [Indexed: 11/28/2022]
Affiliation(s)
- M Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - S Fazlolahi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - H Mahmoudi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - I Atefi
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - N van Beek
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - K Balighi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - J Taghizadeh Fazli
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - K Kamyab
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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34
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Verma VB, Korzh B, Walter AB, Lita AE, Briggs RM, Colangelo M, Zhai Y, Wollman EE, Beyer AD, Allmaras JP, Vora H, Zhu D, Schmidt E, Kozorezov AG, Berggren KK, Mirin RP, Nam SW, Shaw MD. Single-photon detection in the mid-infrared up to 10 μm wavelength using tungsten silicide superconducting nanowire detectors. APL Photonics 2021; 6:10.1063/5.0048049. [PMID: 37621960 PMCID: PMC10448953 DOI: 10.1063/5.0048049] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
We developed superconducting nanowire single-photon detectors based on tungsten silicide, which show saturated internal detection efficiency up to a wavelength of 10 μm. These detectors are promising for applications in the mid-infrared requiring sub-nanosecond timing, ultra-high gain stability, low dark counts, and high efficiency, such as chemical sensing, LIDAR, dark matter searches, and exoplanet spectroscopy.
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Affiliation(s)
- V. B. Verma
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - B. Korzh
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
| | - A. B. Walter
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
| | - A. E. Lita
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - R. M. Briggs
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
| | - M. Colangelo
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y. Zhai
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - E. E. Wollman
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
| | - A. D. Beyer
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
| | - J. P. Allmaras
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
| | - H. Vora
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - D. Zhu
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - E. Schmidt
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
| | - A. G. Kozorezov
- Department of Physics, Lancaster University, Lancaster, United Kingdom
| | - K. K. Berggren
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R. P. Mirin
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - S. W. Nam
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - M. D. Shaw
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, California 91109, USA
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35
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Ständer S, Schmidt E, Zillikens D, Thaçi D, Ludwig RJ, Kridin K. Patients with bullous pemphigoid and comorbid psoriasis present with less blisters and lower serum levels of anti-BP180 autoantibodies. J Eur Acad Dermatol Venereol 2020; 35:981-987. [PMID: 33098720 DOI: 10.1111/jdv.17013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/09/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Although the association of bullous pemphigoid (BP) and psoriasis is well-established, the clinical and immunological features of patients with coexisting BP and psoriasis are yet to be investigated. OBJECTIVE We aimed to estimate the prevalence of psoriasis amongst patients with BP and to elucidate the clinical and immunological characteristics of BP patients with comorbid psoriasis. METHODS A retrospective cohort study including all consecutive patients diagnosed with BP throughout the years 2009-2019 in a tertiary referral centre. RESULTS The study encompassed 273 patients with BP, of whom 11 (4.0%; 95% CI, 2.3-7.1%) had comorbid psoriasis. The onset of psoriasis preceded that of BP in 81.8% of patients by a median (range) latency of 26.5 (5.0-34.0) years. Compared to BP patients without psoriasis, those with BP and comorbid psoriasis were significantly younger at the onset of BP [71.8 (9.3) vs. 79.4 (9.8) years; P = 0.023], had a milder erosive phenotype [erosion/blister BPDAI mean (SD)score; 5 (4.1) vs. 22.3 (15.2); P = 0.025], lower levels of anti-BP180 NC16A serum autoantibodies [236.6 (266.3) vs. 556.2 (1323.6) U/mL; P = 0.008] and a higher prevalence of isolated linear C3 deposits (36.4% vs. 14.1%; P = 0.043) and a lower prevalence of linear immunoglobulin G deposits (36.4% vs. 68.7%; P = 0.025) along the dermal-epidermal junction by direct immunofluorescence microscopy. CONCLUSIONS Patients with BP and comorbid psoriasis present at a younger age with milder erosive phenotype and lower levels of pathogenic autoantibodies.
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Affiliation(s)
- S Ständer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D Thaçi
- Research Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - R J Ludwig
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - K Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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36
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Makker V, Rasco D, Vogelzang N, Brose M, Cohn A, Mier J, DiSimone C, Hyman D, Stepan D, Dutcus C, Schmidt E, Guo M, Sachdev P, Shumaker R, Aghajanian C, Taylor M. Lenvatinib plus pembrolizumab in patients with advanced endometrial cancer: Final analysis of a multicentre, open-label, single-arm, phase 2 trial. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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37
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Charuhas Macris P, Rasmussen M, Schmidt E, Buono L, McDonnell P, McMillen K. Providing Evidence-Based Diet Recommendations for Immunocompromised Oncology Patients. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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38
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Lee CH, Shah A, Hsieh J, Rao A, Pinto A, Bilen M, Cohn A, Di Simone C, Shaffer D, Girones Sarrio R, Gunnestad Ribe S, Wu J, Schmidt E, Kubiak P, Okpara C, Smith A, Motzer R. 710P Phase II trial of lenvatinib (LEN) + pembrolizumab (PEMBRO) for progressive disease after PD-1/PD-L1 immune checkpoint inhibitor (ICI) in metastatic clear cell (mcc) renal cell carcinoma (RCC): Results by independent imaging review and subgroup analyses. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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39
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Joly P, Horvath B, Patsatsi Α, Uzun S, Bech R, Beissert S, Bergman R, Bernard P, Borradori L, Caproni M, Caux F, Cianchini G, Daneshpazhooh M, De D, Dmochowski M, Drenovska K, Ehrchen J, Feliciani C, Goebeler M, Groves R, Guenther C, Hofmann S, Ioannides D, Kowalewski C, Ludwig R, Lim Y, Marinovic B, Marzano A, Mascaró J, Mimouni D, Murrell D, Pincelli C, Squarcioni C, Sárdy M, Setterfield J, Sprecher E, Vassileva S, Wozniak K, Yayli S, Zambruno G, Zillikens D, Hertl M, Schmidt E. Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the european academy of dermatology and venereology (EADV). J Eur Acad Dermatol Venereol 2020; 34:1900-1913. [DOI: 10.1111/jdv.16752] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/29/2020] [Indexed: 01/21/2023]
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40
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Ernst N, Friedrich M, Bieber K, Kasperkiewicz M, Gross N, Sadik C, Zillikens D, Schmidt E, Ludwig R, Hartmann K. Expression of PD‐1 and Tim‐3 is increased in skin of patients with bullous pemphigoid and pemphigus vulgaris. J Eur Acad Dermatol Venereol 2020; 35:486-492. [DOI: 10.1111/jdv.16780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022]
Affiliation(s)
- N. Ernst
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - M. Friedrich
- Department of Dermatology University of Luebeck Luebeck Germany
- Laboratory of Emerging Infections Bernhard Nocht Institute for Tropical Medicine Hamburg Germany
| | - K. Bieber
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
| | - M. Kasperkiewicz
- Department of Dermatology University of Luebeck Luebeck Germany
- Department of Dermatology Keck School of Medicine University of Southern California Los Angeles CA USA
| | - N. Gross
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - C.D. Sadik
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - D. Zillikens
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - E. Schmidt
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - R.J. Ludwig
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
| | - K. Hartmann
- Department of Dermatology University of Luebeck Luebeck Germany
- Division of Allergy Department of Dermatology University of Basel Basel Switzerland
- Department of Biomedicine University of Basel Basel Switzerland
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41
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Shimanovich I, Baumann T, Schmidt E, Zillikens D, Hammers CM. Long-term outcomes of rituximab therapy in pemphigus. J Eur Acad Dermatol Venereol 2020; 34:2884-2889. [PMID: 32367562 DOI: 10.1111/jdv.16561] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/15/2020] [Accepted: 04/07/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rituximab induces a rapid remission in most patients with pemphigus. OBJECTIVE Our aim was to assess the long-term efficacy of rituximab in this disease. METHOD We conducted a retrospective study of 59 patients with pemphigus treated with rituximab and observed over a median period of 104 months. RESULTS The rate of complete remission off therapy (CRoff) after the first rituximab cycle was 39%, increasing to 61% with additional rituximab courses. Long-term CRoff was achieved in 27% of patients. The recurrence rate after the first rituximab cycle was 63%, decreasing to approximately 40% with subsequent rituximab cycles. Median time to relapse after the first and subsequent rituximab cycles was 25 months. Renewed rituximab therapy reinduced complete remission in 94% of cases. Baseline anti-desmoglein antibody levels of ≤250 U/mL were significantly associated with the outcome of CRoff. In paired serum samples obtained before the first and six months after the last rituximab therapy, significant reductions of desmoglein-specific autoantibodies were observed. Patients relapsing after a complete remission induced by the first rituximab cycle were more likely to achieve CRoff than patients relapsing after a less favourable outcome and non-responders. There was no significant difference in age, sex, pemphigus subtype, rituximab dosing and disease duration between patients achieving CRoff and those not meeting this end point. CONCLUSIONS Lower desmoglein-specific antibody levels at baseline were predictive of CRoff. In patients receiving multiple rituximab cycles, complete remission after the first cycle was associated with a favourable long-term outcome. Repeated rituximab courses were highly effective for relapsed disease and improved the overall outcome.
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Affiliation(s)
- I Shimanovich
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - T Baumann
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - C M Hammers
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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Hübner F, König IR, Holtsche MM, Zillikens D, Linder R, Schmidt E. Prevalence and age distribution of pemphigus and pemphigoid diseases among paediatric patients in Germany. J Eur Acad Dermatol Venereol 2020; 34:2600-2605. [PMID: 32289873 DOI: 10.1111/jdv.16467] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/10/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Autoimmune bullous diseases are rare and mostly occur in adults. Several cases and small case series have been described in children, but no systematic study about the prevalence of autoimmune bullous diseases (AIBD) in children is available. PATIENTS AND METHODS We analysed data of 1.7 million children insured in the largest German health insurance company based on the ICD-10-GM classification for the year 2015. Data were adjusted to the general German population based on the data of the Federal Statistical Office for the year 2015. RESULTS The prevalence of AIBD was calculated to 101.1/million children in 2015, resulting in about 1351 patients below the age of 18 years in Germany. The highest prevalence of all AIBD was seen for pemphigus vulgaris (30.5/million children) followed by linear IgA disease (24.5/million children) and bullous pemphigoid (4.9/million children). CONCLUSION Autoimmune bullous diseases in minors are scarce but should be taken into consideration in patients with pruritus and/or blisters and erosions on the skin and/or mucous membranes. Treatment is challenging, and due to the rarity of AIBD in minors, the management of these disorders in this patient population is best performed in specialized centres in a multidisciplinary approach, including paediatric dermatologists or dermatologists and paediatricians.
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Affiliation(s)
- F Hübner
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - I R König
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - M M Holtsche
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - R Linder
- Techniker Krankenkasse, Analytics & Insights, Hamburg, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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Kasperkiewicz M, Schmidt E, Fairley JA, Joly P, Payne AS, Yale ML, Zillikens D, Woodley DT. Expert recommendations for the management of autoimmune bullous diseases during the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2020; 34:e302-e303. [PMID: 32333823 PMCID: PMC7267551 DOI: 10.1111/jdv.16525] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 12/16/2022]
Affiliation(s)
- M Kasperkiewicz
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - J A Fairley
- Department of Dermatology, University of Iowa, Iowa City, IA, USA
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Rouen, France
| | - A S Payne
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - M L Yale
- International Pemphigus and Pemphigoid Foundation, Sacramento, CA, USA
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D T Woodley
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Pérez A, Schmidt E, Kourtzi Z, Tsimpli I. Multimodal semantic revision during inferential processing: The role of inhibitory control in text and picture comprehension. Neuropsychologia 2020; 138:107313. [PMID: 31904356 DOI: 10.1016/j.neuropsychologia.2019.107313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 12/08/2019] [Accepted: 12/17/2019] [Indexed: 11/22/2022]
Abstract
Although language comprehension usually requires multimodal information, no study to date has investigated how comprehenders deal with the revision of a text's interpretation when different modalities are involved. Twenty-four young adults listened to a story prompting an inference (e.g., polar bear), and then saw a picture that was either consistent (polar bear) or inconsistent but still plausible (penguin). Larger negativity (N400) in the inconsistent picture indicated successful inferential monitoring. Subsequently, a sentence carried the disambiguating word which was either expected ("bear") or unexpected ("penguin") in relation to the auditory-verbal information. Larger negativity in the unexpected word coming from the consistent picture suggested that comprehenders had difficulties selecting the unexpected concept when previous information was contradictory. More importantly, this effect was modulated by inhibitory control, where a higher resistance to distractor interference (flanker task) was associated with a better ability to suppress pictorial information, therefore preventing semantic competition. Similarly, accuracy measured in a final comprehension question demonstrated that higher inhibitory control was related to a more efficient ability to revise the situation model across modalities. Our findings speak to a relationship between story comprehension and mental flexibility during multimodal processing.
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Affiliation(s)
- A Pérez
- Theoretical and Applied Linguistics, UK; Dept. of Experimental Psychology, University of Granada, Spain.
| | - E Schmidt
- Theoretical and Applied Linguistics, UK; Cambridge Assessment English, University of Cambridge, UK
| | - Z Kourtzi
- Dept. of Psychology, University of Cambridge, UK
| | - I Tsimpli
- Theoretical and Applied Linguistics, UK
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Anemüller W, Busch H, Fleischer M, Hundt JE, Ibrahim S, Kahle B, Ludwig RJ, Recke A, Recke AL, Rose E, Sadik CD, Schmidt E, Schumacher N, Thaçi D, Terheyden P, Wolff HH, Zillikens D. Klinik für Dermatologie, Allergologie und Venerologie der Universität zu Lübeck: Interaktion von Forschung und klinischer Versorgung. Akt Dermatol 2020. [DOI: 10.1055/a-1066-5392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungDie Ursprünge der Lübecker Universitäts-Hautklinik reichen in die 30er-Jahre des letzten Jahrhunderts zurück. Die Klinik hat in den letzten Jahrzehnten eine konsequente bauliche und inhaltliche Weiterentwicklung erfahren und verfügt heute über 85 Betten auf 2 Stationen und in einer Tagesklinik. Ein modernes Weiterbildungsprogramm, das auf einem Rotationsprinzip durch 5 verschiedene stationäre und ambulante Teams beruht, vermittelt alle wesentlichen Lerninhalte der Dermatologie. Die Erweiterung der Klinik in den letzten Jahren beruhte auf einer engen Interaktion von Grundlagenforschung und klinischer Tätigkeit, insbesondere auf dem Gebiet kutaner Autoimmunerkrankungen und entzündlicher Dermatosen. Die wissenschaftliche Entwicklung der Hautklinik profitierte seit 2007 insbesondere von der Förderung durch die Exzellenzinitiative des Bundes (Exzellenzcluster Inflammation at Interfaces). Daneben wurde durch die Deutsche Forschungsgemeinschaft (DFG) seit 2011 unter Federführung der Hautklinik ein Graduiertenkolleg Modulation of Autoimmunity gefördert, das zur Entwicklung des wissenschaftlichen Nachwuchses und zur Ausbildung zahlreicher naturwissenschaftlicher und medizinischer Doktoranden/Doktorandinnen1 beitrug. Seit 2015 besteht an der Klinik auch eine Klinische Forschungsgruppe der DFG zum Thema Pemphigoid Diseases – Molecular Pathways and their Therapeutic Potential. Im Jahr 2018 haben Mitarbeiter der Klinik wesentlich zur Einwerbung eines Clinician Scientist-Programms der DFG beigetragen, das die wissenschaftliche Ausbildung forschender Kliniker verbessern soll. In den letzten Jahren haben sich aus der Lübecker Hautklinik heraus 2 eigenständige Institute neu etabliert. Hierzu zählen das Institut für Entzündungsmedizin unter der Leitung von Prof. Diamant Thaçi, in dem klinische Studien zu entzündlichen Hauterkrankungen initiiert und koordiniert werden und die Versorgung von Patienten mit entzündlichen Dermatosen stattfindet. Daneben ist aus der Hautklinik heraus das Lübecker Institut für Experimentelle Dermatologie (LIED) entstanden, in dem derzeit 5 Professoren mit ihren jeweiligen Arbeitsgruppen zu unterschiedlichen Themen der Entzündung an der Haut forschen. Die interdisziplinären wissenschaftlichen Aktivitäten zur Entzündung an der Haut am Lübecker Campus werden seit 2015 in einem Center for Research on Inflammation of the Skin (CRIS) gebündelt. CRIS erhielt kürzlich die Zusage für ein eigenständiges Forschungsgebäude, das nach § 91 Grundgesetz durch Bund und Land finanziert wird und derzeit im Zentrum des Lübecker Campus entsteht. Der Ausbau der Forschungsstrukturen der Klinik ging mit der Einrichtung von Spezialambulanzen für verschiedene entzündliche Hauterkrankungen, aber auch für die Versorgung von Hautkrebs und chronischen Wunden einher. Die Klinik verfügt über ein zertifiziertes Hautkrebszentrum und ist Teil der Lübecker universitären Gefäß- und Krebszentren. Weitere wichtige Pfeiler der klinischen Versorgung sind zertifizierte diagnostische Einsendelabore für Dermato-Histopathologie und kutane Autoimmunerkrankungen.
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Affiliation(s)
- W. Anemüller
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - H. Busch
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - M. Fleischer
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - J. E. Hundt
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - S. Ibrahim
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - B. Kahle
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. J. Ludwig
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Recke
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. L. Recke
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - E. Rose
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - C. D. Sadik
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - E. Schmidt
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - N. Schumacher
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - D. Thaçi
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - P. Terheyden
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - H. H. Wolff
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - D. Zillikens
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
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Vallet A, Del Campo N, Hoogendijk EO, Lokossou A, Balédent O, Czosnyka Z, Balardy L, Payoux P, Swider P, Lorthois S, Schmidt E. Biomechanical response of the CNS is associated with frailty in NPH-suspected patients. J Neurol 2020; 267:1389-1400. [DOI: 10.1007/s00415-019-09689-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 12/29/2022]
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Schmidt E, Fauteux D, Therrien J, Gauthier G, Seyer Y. Improving diet assessment of Arctic terrestrial predators with the size of rodent mandibles. J Zool (1987) 2020. [DOI: 10.1111/jzo.12756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. Schmidt
- Canadian Museum of Nature Ottawa ON Canada
| | - D. Fauteux
- Canadian Museum of Nature Ottawa ON Canada
- Department of Biology Centre d’Études Nordiques Université Laval Québec QC Canada
| | - J.‐F. Therrien
- Acopian Center for Conservation Learning Hawk Mountain Sanctuary Orwigsburg PA USA
| | - G. Gauthier
- Department of Biology Centre d’Études Nordiques Université Laval Québec QC Canada
| | - Y. Seyer
- Department of Biology Centre d’Études Nordiques Université Laval Québec QC Canada
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Ständer S, Färber B, Radeke S, Schmidt E, Zillikens D, Ludwig RJ. Assessment of healthcare costs for patients with pemphigus and bullous pemphigoid in an academic centre in Germany. Br J Dermatol 2020; 182:1296-1297. [PMID: 31749141 DOI: 10.1111/bjd.18731] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- S Ständer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - B Färber
- Department of Strategic Controlling, University of Lübeck, Lübeck, Germany
| | - S Radeke
- Department of Strategic Controlling, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - R J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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Felip E, Brunsvig P, Helland Å, Viñolas N, Aix S, Carcereny E, Gomez MD, Perez JT, Arriola E, Campelo RG, Spicer J, Thompson J, Granados AO, Holt R, Smethurst D, Lorens J, Shoaib M, Siddiqui A, Schoelermann J, Lorens K, Schmidt E, Chisamore M, Krebs M. MA03.06 Efficacy Results of Selective AXL Inhibitor Bemcentinib with Pembrolizumab Following Chemotherapy in Patients with NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.515] [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: 10/25/2022]
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Krebs M, Brunsvig P, Helland Å, Viñolas N, Aix S, Carcereny E, Gomez MD, Perez JT, Arriola E, Campelo RG, Spicer J, Thompson J, Granados AO, Holt R, Smethurst D, Lorens J, Shoaib M, Siddiqui A, Schoelermann J, Lorens K, Schmidt E, Chisamore M, Felip E. P1.01-72 A Phase II Study of Selective AXL Inhibitor Bemcentinib and Pembrolizumab in Patients with NSCLC Refractory to Anti-PD(L)1. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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