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Faust I, Weile J, Fujita B, Kandolf R, Hendig D, Vollmer T, Stan AC, Kellner U, Kuhn J, Gummert JF, Knabbe C. Heart Transplantation in Systemic Sclerosis: New Impulses for Conventional Scleroderma Transplantation Regimen and Scleroderma Diagnostic Monitoring: 2 Case Reports. Transplant Proc 2019; 51:865-870. [PMID: 30979477 DOI: 10.1016/j.transproceed.2019.01.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 01/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although low (but increasing) rates of lung/lung-heart transplantations of scleroderma (systemic sclerosis [SSc]) patients have been reported, exclusive heart transplantation is a rare approach for treatment of heart failure due to SSc. CASES We report on 2 cases of SSc patients receiving a heart transplantation (HTx) due to severe and progressive right heart failure without pulmonary artery hypertension. One patient received a hepatitis C virus (HCV)-positive donor heart and recovered excellently from viral transmission after administration of a direct-acting antiviral (DAA) regimen. This is the first published case of an SSc patient who underwent HTx using an HCV-positive donor heart. The clinical course of both patients was monitored by different serum SSc biomarkers. Only xylosyltransferase activity proved to be a promising biomarker for disease stage determination and therapeutic monitoring, precisely reflecting fibrotic remodeling and successful organ recovery. CONCLUSIONS Successful implementation of the 2 cases described here demonstrates that HTx is a safe and effective therapeutic option for defined SSc sub-patient groups despite the progressive character of the underlying disease. In the future, xylosyltransferase activity might be conducive to simplify the identification of patients with low systemic involvement but a strong indication for single heart transplantation. Finally, we demonstrate that treatment of HCV viral transmission from HCV-positive donor to organ recipient using DAA gives us new opportunities to consider HCV-positive donor organs for HTx and might reveal new possibilities to ease the lack of donor organs.
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Affiliation(s)
- I Faust
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany.
| | - J Weile
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - B Fujita
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - R Kandolf
- Abteilung für Molekulare Pathologie, Institut für Pathologie und Neuropathologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - D Hendig
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - T Vollmer
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - A-C Stan
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - U Kellner
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - J Kuhn
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - J F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - C Knabbe
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
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Meneghini O, Shiraiwa S, Faust I, Parker RR, Schmidt A, Wallace G. Fullwave Simulations of Lower Hybrid Waves Coupled to 3D Fokker-Planck Solver: Comparison with Alcator C-Mod Experiment. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a12403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- O. Meneghini
- MIT Plasma Science and Fusion Center, Cambridge MA, USA
| | - S. Shiraiwa
- MIT Plasma Science and Fusion Center, Cambridge MA, USA
| | - I. Faust
- MIT Plasma Science and Fusion Center, Cambridge MA, USA
| | - R. R. Parker
- MIT Plasma Science and Fusion Center, Cambridge MA, USA
| | - A. Schmidt
- MIT Plasma Science and Fusion Center, Cambridge MA, USA
| | - G. Wallace
- MIT Plasma Science and Fusion Center, Cambridge MA, USA
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LaBombard B, Kuang A, Brunner D, Faust I, Mumgaard R, Reinke M, Terry J, Hughes J, Walk J, Chilenski M, Lin Y, Marmar E, Wallace G, Whyte D, Wolfe S, Wukitch S. High-field side scrape-off layer investigation: Plasma profiles and impurity screening behavior in near-double-null configurations. Nuclear Materials and Energy 2017. [DOI: 10.1016/j.nme.2016.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Faust I, Delgado-Aparicio L, Bell RE, Tritz K, Diallo A, Gerhardt SP, LeBlanc B, Kozub TA, Parker RR, Stratton BC. Two-dimensional AXUV-based radiated power density diagnostics on NSTX-U. Rev Sci Instrum 2014; 85:11D856. [PMID: 25430269 DOI: 10.1063/1.4890254] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A new set of radiated-power-density diagnostics for the National Spherical Torus Experiment Upgrade (NSTX-U) tokamak have been designed to measure the two-dimensional poloidal structure of the total photon emissivity profile in order to perform power balance, impurity transport, and magnetohydrodynamic studies. Multiple AXUV-diode based pinhole cameras will be installed in the same toroidal angle at various poloidal locations. The local emissivity will be obtained from several types of tomographic reconstructions. The layout and response expected for the new radially viewing poloidal arrays will be shown for different impurity concentrations to characterize the diagnostic sensitivity. The radiated power profile inverted from the array data will also be used for estimates of power losses during transitions from various divertor configurations in NSTX-U. The effect of in-out and top/bottom asymmetries in the core radiation from high-Z impurities will be addressed.
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Affiliation(s)
- I Faust
- MIT - Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | | | - R E Bell
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - K Tritz
- The Johns Hopkins University, Baltimore, Maryland 21209, USA
| | - A Diallo
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - S P Gerhardt
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - B LeBlanc
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - T A Kozub
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - R R Parker
- MIT - Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - B C Stratton
- MIT - Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
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Delgado-Aparicio L, Bell RE, Faust I, Tritz K, Diallo A, Gerhardt SP, Kozub TA, LeBlanc BP, Stratton BC. High-resolution tangential absolute extreme ultraviolet arrays for radiated power density measurements on NSTX-U. Rev Sci Instrum 2014; 85:11D859. [PMID: 25430272 DOI: 10.1063/1.4894835] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The radiated-power-density diagnostic on the equatorial midplane for the NSTX-U tokamak will be upgraded to measure the radial structure of the photon emissivity profile with an improved radial resolution. This diagnostic will enhance the characterization and studies of power balance, impurity transport, and MHD. The layout and response expected of the new system is shown for different plasma conditions and impurity concentrations. The effect of toroidal rotation driving poloidal asymmetries in the core radiation from high-Z impurities is also addressed.
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Affiliation(s)
| | - R E Bell
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - I Faust
- MIT Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - K Tritz
- The Johns Hopkins University, Baltimore, Maryland 21209, USA
| | - A Diallo
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - S P Gerhardt
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - T A Kozub
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - B P LeBlanc
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - B C Stratton
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
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Faust I, Roch C, Kuhn J, Prante C, Knabbe C, Hendig D. Human xylosyltransferase-I - a new marker for myofibroblast differentiation in skin fibrosis. Biochem Biophys Res Commun 2013; 436:449-54. [PMID: 23747722 DOI: 10.1016/j.bbrc.2013.05.125] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 05/27/2013] [Accepted: 05/29/2013] [Indexed: 01/09/2023]
Abstract
Skin fibrosis is a severe type of fibrotic disorder emerging in terms of hypertrophic scars or systemic sclerosis. Key event of fibrogenesis is the transition of fibroblasts to matrix-producing myofibroblasts. In the presence of fibrotic triggers, for instance secretion of profibrotic growth factors like transforming growth factor-β1 (TGF-β1) or mechanical strain, myofibroblasts persist. Current research focuses on discovering innovative myofibroblast biomarkers which are regulated in fibrotic development and accessible for antifibrotic inhibition. Here, we consider the suitability of xylosyltransferase-I (XT-I) as a myofibroblast biomarker in skin fibrosis. XT-I catalyzes the initial step of glycosaminoglycan biosynthesis. Its increase in enzymatic activity is known to refer only to manifested diseases which are characterized by an abnormal rate of proteoglycan biosynthesis. In this study, treatment of normal human dermal fibroblasts (NHDF) with TGF-β1 was followed by increased relative XYLT1 mRNA expression. Remarkably, this upregulation was strongly dependent on myofibroblast content, increasing during fibrogenesis. Moreover, XT activity increased time-dependently in response to progressive myofibroblast transformation. XYLT1 expression was inhibited by TGF-β receptor I (ALK5) inhibitor SB431542. In contrast, XYLT2 expression was only marginally affected by TGF-β1 as well as ALK5 inhibition. Our results strengthen the significance of XT expression and activity in fibrotic remodeling. Therefore, we propose XT activity, in addition to α-SMA expression, as a new biomarker for myofibroblast differentiation and fibrotic development. Further studies are now needed to evaluate the option to control and inhibit fibrotic remodeling by interfering with XT expression.
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Affiliation(s)
- I Faust
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
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