1
|
Bartz C, Hirani D, Selle J, Vohlen C, Wilke R, Kuiper-Makris C, Nies C, Wagde V, Dötsch J, Alejandre Alcazar MA. Targeting IL-6 to prevent vascular and bronchial remodeling in an
experimental model of bronchopulmonary dysplasia. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754452] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C Bartz
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
| | - D Hirani
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne,
Germany
| | - J Selle
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
| | - C Vohlen
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
| | - R Wilke
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
| | - C Kuiper-Makris
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
- Department of Pediatric and Adolescent Medicine, University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne,
Germany
| | - C Nies
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
| | - V Wagde
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
| | - J Dötsch
- Department of Pediatric and Adolescent Medicine, University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne,
Germany
| | - MA Alejandre Alcazar
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne,
Germany
- Cologne Excellence Cluster on Stress Responses in Aging-associated
Diseases (CECAD), University Hospital of Cologne, University of Cologne,
Cologne, Germany
- Institute for Lung Health (ILH), Universities of Giessen and Marburg
Lung Center (UGMLC), Member of the German Center for Lung Research (DZL),
Giessen, Germany
| |
Collapse
|
2
|
Hirani D, Thielen F, Vohlen C, Danopoulos S, Mansouri S, Haznedar-Karakaya P, Mohr J, Wilke R, Koningsbruggen-Rietschel S, Al-Alam D, Savai R, Dötsch J, Alejandre Alcazar MA. CXCL10 deficiency protects from lung macrophage invasion and enables
lung growth during acute injury and recovery in experimental bronchopulmonary
dysplasia. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754519] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- D Hirani
- Institute for Lung Health (ILH), Universities of Giessen and Marburg
Lung Center (UGMLC), member of the German Center for Lung Research (DZL),
Germany, Giessen, Germany
- Center for Molecular Medicine Cologne (CMMC), University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne, Germany,
Cologne, Germany
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany, Cologne,
Germany, Cologne, Germany
| | - F Thielen
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany, Cologne,
Germany, Cologne, Germany
| | - C Vohlen
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany, Cologne,
Germany, Cologne, Germany
| | - S Danopoulos
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA
Medical Center, Torrance, CA, USA, Torrance, United States
| | - S Mansouri
- Max-Planck Institute for Heart and Lung Research, Bad Nauheim, Germany,
Bad Nauheim, Germany
| | - P Haznedar-Karakaya
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany, Cologne,
Germany, Cologne, Germany
| | - J Mohr
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany, Cologne,
Germany, Cologne, Germany
| | - R Wilke
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany, Cologne,
Germany, Cologne, Germany
| | - S Koningsbruggen-Rietschel
- Department of Pediatric and Adolescent Medicine, University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne, Germany,
Cologne, Germany
| | - D Al-Alam
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA
Medical Center, Torrance, CA, USA, Torrance, United States
| | - R Savai
- Max-Planck Institute for Heart and Lung Research, Bad Nauheim, Germany,
Bad Nauheim, Germany
| | - J Dötsch
- Department of Pediatric and Adolescent Medicine, University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne, Germany,
Cologne, Germany
| | - MA Alejandre Alcazar
- Translational Experimental Pediatrics, Experimental Pneumology,
Department of Pediatric and Adolescent Medicine, University Hospital Cologne,
Faculty of Medicine, and University of Cologne, Cologne, Germany, Cologne,
Germany, Cologne, Germany
- Institute for Lung Health (ILH), Universities of Giessen and Marburg
Lung Center (UGMLC), member of the German Center for Lung Research (DZL),
Germany, Giessen, Germany
- Center for Molecular Medicine Cologne (CMMC), University Hospital
Cologne, Faculty of Medicine, and University of Cologne, Cologne, Germany,
Cologne, Germany
- Cologne Excellence Cluster on Stress Responses in Aging-associated
Diseases (CECAD), University Hospital of Cologne, University of Cologne,
Cologne, Germany, Cologne, Germany
| |
Collapse
|
3
|
Matthaei M, Zwingelberg S, Siebelmann S, Howaldt A, Mestanoglu M, Schlereth SL, Giezelt C, Dötsch J, Fricke J, Neugebauer A, Lappas A, Dietlein T, Roters S, Bachmann BO, Cursiefen C. [Diagnostics, clinical aspects and genetics of congenital corneal opacities]. Ophthalmologe 2022; 119:443-452. [PMID: 35244750 DOI: 10.1007/s00347-022-01587-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Congenital corneal opacities are comparatively rare diseases with high amblyogenic potential. PURPOSE The present work provides an overview of the diagnostics, clinical aspects and genetics of congenital corneal opacities. METHODS A literature search was carried out to compile an overview and illustration with own clinical case examples. RESULTS Differentiated diagnostics are of high importance in the treatment of patients with congenital corneal opacities. A close cooperation between the medical departments involved and also the parents is absolutely essential. The structured classification of congenital corneal opacities provides the basis for a targeted treatment. DISCUSSION The causes and the clinical symptoms of congenital corneal opacities are manifold. The correct diagnosis should be made early and in an interdisciplinary manner. Based on this, conservative and surgical treatment measures can be planned and an impending development of amblyopia can be specifically counteracted.
Collapse
Affiliation(s)
- M Matthaei
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - S Zwingelberg
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S Siebelmann
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - A Howaldt
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - M Mestanoglu
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S L Schlereth
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - C Giezelt
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - J Dötsch
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - J Fricke
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - A Neugebauer
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - A Lappas
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - T Dietlein
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S Roters
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - B O Bachmann
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland
| | - C Cursiefen
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinik Köln, Köln, Deutschland.,Zentrum für Molekulare Medizin Köln (ZMMK), Universität zu Köln, Köln, Deutschland
| |
Collapse
|
4
|
Dörr HG, Bettendorf M, Binder G, Dötsch J, Hauffa B, Mohnike K, Müller HL, Woelfle J. Effekte eines späten Beginns einer Therapie mit Wachstumshormon. Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-017-0267-3] [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]
|
5
|
Querfeld U, Dötsch J, Gellermann J, Hoyer P, Kemper M, Latta K, Tönshoff B, Weber LT, Rascher W. Diagnostik und Therapie des idiopathischen nephrotischen Syndroms im Kindesalter. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
6
|
Weber L, Dötsch J. Therapeutic monitoring of immunosuppressive drugs in pediatric patients: special considerations. Expert Rev Clin Pharmacol 2016; 9:1001-3. [DOI: 10.1080/17512433.2016.1193434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
7
|
Abstract
The Cologne statement resulted from both regional and nationwide controversial discussions about meaning and purpose of an initial examination for infectious diseases of refugees with respect to limited time, personnel and financial resources. Refugees per se are no increased infection risk factors for the general population as well as aiders, when the aiders comply with general hygiene rules and are vaccinated according to the recommendations of the German Standing Committee on Vaccination (STIKO). This is supported by our own data. Based on individual medical history, refugees need medical care, which is offered purposeful, economic, humanitarian and ethical. In addition to medical confidentiality, the reporting obligation according § 34 Infection Protection Act (IPA) and the examination concerning infectious pulmonary tuberculosis according to § 36 (4) IPA must be considered.
Collapse
Affiliation(s)
| | - J Dötsch
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Köln
| | - M Weiß
- Klinik für Kinder- und Jugendmedizin, Kinderkrankenhaus Amsterdamer Straße, Köln
| | - A Wiater
- Kinderklinik, Krankenhaus Porz am Rhein Köln
| | - G Fätkenheuer
- Klinische Infektiologie, Klinik I für Innere Medizin, Universitätsklinikum Köln
| | | | - A Bunte
- Gesundheitsamt der Stadt Köln
| |
Collapse
|
8
|
Nüsken E, Herrmann Y, Wohlfarth M, Goecke T, Appel S, Schneider H, Dötsch J, Nüsken K. Strong hypoxia reduces leptin synthesis in purified primary human trophoblasts. Placenta 2015; 36:427-32. [DOI: 10.1016/j.placenta.2015.01.191] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/20/2015] [Accepted: 01/24/2015] [Indexed: 12/20/2022]
|
9
|
Appel S, Turnwald EM, Alejandre-Alcazar MA, Ankerne J, Rother E, Janoschek R, Wohlfarth M, Vohlen C, Schnare M, Meißner U, Dötsch J. Leptin does not induce an inflammatory response in the murine placenta. Horm Metab Res 2014; 46:384-9. [PMID: 24591047 DOI: 10.1055/s-0034-1368710] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Leptin is described as a pro-inflammatory signal in fat tissue, which is released from adipocytes and in turn activates immune cells. Also, leptin levels are known to be increased in pregnancies complicated with enhanced inflammatory processes in the placenta. Hence, we assumed that increased leptin amounts might contribute to inducing an inflammatory response in the placenta. To test this hypothesis, pregnant mice were continuously infused with recombinant murine leptin s. c. from day g13 to g16, resulting in a 3-fold increase of maternal circulating serum leptin levels. Dissected placentas were examined for the expression of pro-inflammatory cytokines IL-6 and TNF-alpha and the anti-inflammatory cytokine IL-10 using qPCR analysis. No changes were found except for TNF-alpha, which was slightly elevated upon leptin stimulation. However, TNF-alpha protein levels were not significantly higher in placentas from leptin treated mice. Also, leukocyte infiltration in the labyrinth section of placentas was not increased. In summary, our data demonstrate for the first time that elevated leptin levels alone do not induce an inflammatory response in the placenta.
Collapse
Affiliation(s)
- S Appel
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - E-M Turnwald
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - M A Alejandre-Alcazar
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - J Ankerne
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - E Rother
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - R Janoschek
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - M Wohlfarth
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - C Vohlen
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - M Schnare
- Institute for Immunology, University of Marburg, Marburg, Germany
| | | | - J Dötsch
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| |
Collapse
|
10
|
Dötsch J, Weber L. Update - Vortrag Nephrologie und Dialyse. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0033-1354483] [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: 10/26/2022]
|
11
|
Imschinetzki D, Nüsken KD, Nüsken E, Peitz J, Koerber F, Mentzel HJ, Dötsch J. „Validation of BoneXpert™ in children with chronic renal failure“ - GPN-gestützte, retrospektive Multizenterstudie. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1352557] [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: 10/26/2022]
|
12
|
Striegel AK, Nazzal R, Fabri M, Rietschel E, Dötsch J, Mauch C, Tantcheva-Poor I. Two cases of lupus vulgaris in childhood and review of the clinical challenges. Klin Padiatr 2013; 226:40-3. [PMID: 23599230 DOI: 10.1055/s-0033-1343412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Lupus vulgaris (LV) is the most common form of cutaneous tuberculosis (TB) in Europe, nevertheless the overall incidence is low. It constitutes about 1.5% of all extra-pulmonary cases worldwide. A slight raise in TB incidence rates among children was recently registered in Germany, which can be explained by the increased immigration. PATIENTS AND METHODS We present 2 cases of immigrated children who were diagnosed with Lupus vulagris, both clinically and histopathologically. Although the symptoms and the duration of the skin lesions were very different, both patients had a non-healing skin ulceration.In our cases cultures of the skin biopsy were positive for Mycobacterium tuberculosis and the lesions showed marked improvement in response to antituberculous treatment. In the first patient, it took 6 years between occurrence of skin lesions and final diagnosis. The second patient had an extracutaneous focus, namely abdominal TB. CONCLUSION We report our experience and emphasize on recent advances in the diagnosis and treatment of paediatric skin TB.
Collapse
Affiliation(s)
- A K Striegel
- Children's Hospital, University of Cologne, Germany
| | - R Nazzal
- Children's Hospital, University of Cologne, Germany
| | - M Fabri
- Dermatology and Venerology, University of Cologne, Germany
| | - E Rietschel
- Children's Hospital, University of Cologne, Germany
| | - J Dötsch
- Children's Hospital, University of Cologne, Germany
| | - C Mauch
- Dermatology and Venerology, University of Cologne, Germany
| | | |
Collapse
|
13
|
Klaffenbach D, Friedrich D, Strick R, Strissel PL, Beckmann MW, Rascher W, Gessner A, Dötsch J, Meissner U, Schnare M. Contribution of different placental cells to the expression and stimulation of antimicrobial proteins (AMPs). Placenta 2011; 32:830-7. [PMID: 21899884 DOI: 10.1016/j.placenta.2011.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 08/08/2011] [Accepted: 08/14/2011] [Indexed: 10/17/2022]
Abstract
The placenta is a major barrier that prevents potentially infectious agents from causing fetal diseases or related complications during pregnancy. Therefore, we postulated that the placenta might express a broad repertoire of antimicrobial proteins as well as inflammatory chemokines and cytokines to combat invading microorganisms. Here we demonstrate that placental cells indeed express a wide range of AMPs (antimicrobial peptides and proteins) including bactericidal/permeability-increasing protein (BPI), secretory leukocyte protease inhibitor (SLPI), human β-defensin 2 (hBD2), acyloxyacyl hydrolase (AOAH), and cathelicidin (CAP18). In addition, these cells also secrete pro-inflammatory cytokines and chemokines upon stimulation with bacterial ligands. Notably, we show that BPI expression by placental cells could be completely attributed to granulocytes while highly purified placental trophoblasts expressed only a subset of the AMPs like SLPI. Unexpectedly, trophoblast AMPs did not exhibit inducible secretion in response to various TLR ligands and further investigations showed that the unresponsiveness of trophoblasts to lipopolysaccharide (LPS) was due to a lack of TLR4 expression. In summary, we have shown that the expression of different AMPs can be allocated to various cells in the placenta and the repertoire of the AMPs expressed by placental cells is a result of a cooperation of leukocytes as well as cells from embryonic origin.
Collapse
Affiliation(s)
- D Klaffenbach
- Department of Pediatrics, University Hospital Erlangen, Loschgestrasse 15, 91054 Erlangen, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Alejandre Alcázar MA, Böhler E, Amann K, von Hoersten S, Dötsch J. Frühe postnatale Hyperalimentation prädisponiert für Nierenfunktionsstörungen: SOCS3 als zentraler Regulator der renalen Leptin-NPY-Achse. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
15
|
Nüsken KD, Nüsken E, Birkner Y, Schneider H, Dötsch J. Dauerhaft erhöhte renale Erythropoietin-Genexpression nach intrauteriner Wachstumsrestriktion infolge experimenteller Plazentainsuffizienz. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
16
|
Benz K, Amann K, Dötsch J, Rascher W, Dittrich K. Rezidivierende interstitielle Nephritiden bei Dent's disease. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
17
|
Galiano M, Plank C, Amann K, Dötsch J, Rascher W, Dittrich K. Starker Gewichtsverlust und Hypokaliämie als Zeichen der humoralen Transplantatabstoßung. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
18
|
Liebau MC, Reddy A, Dafinger C, Benzing T, Dötsch J, Schermer B. Das ARPKD Protein Fibrozystin-ein Regulator transkriptioneller Prozesse in der Zelle? Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
19
|
Nüsken E, Nüsken KD, Birkner Y, Schneider H, Dötsch J. Renale Expression gebräuchlicher Housekeeping-Gene nach experimenteller Plazentainsuffizienz. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
20
|
Abstract
BACKGROUND Intrauterine growth restriction seems to be a risk factor for an aggravated course of secondary renal diseases in children. Catch-up growth after birth may play a critical role. We tested if there is an association between an aggravated course of nephritis in Henoch-Schönlein Purpura (PSHN) and low birth weight or early weight gain during infancy. PATIENTS We retrospectively analysed the clinical course of 34 children with PSHN. METHODS Patients were sorted according their birth weight standard deviation score (SDS) in tertiles. Early weight gain was defined as gain of weight standard deviation score >0.67 between birth and 2 years of age. RESULTS Patients with higher birth weight needed Cyclophosphamide in a higher rate than low birth weight children. In the high weight gain group (SDS gain >0.67) 9 of the 11 patients compared to 7 of 22 patients in the low weight gain group (SDS gain <0.67) presented with arterial hypertension during the initial manifestation of PSH nephritis (p=0.01). Median systolic blood pressure SDS in the high weight gain group was 1.54 (-1.39-4.71) versus 0.29 (0.52-4.05) in the low weight gain group (p=0.008). Nevertheless, other clinical parameters during first manifestation and follow-up were not relevantly different. CONCLUSION In contrast to the data of children with idiopathic nephrotic syndrome or IgA nephropathy, this study does neither provide evidence for an association between low birth weight nor early weight gain and the later course of PSHN. Interestingly, early weight gain was associated with a higher systolic blood pressure during the initial manifestation of PSHN.
Collapse
Affiliation(s)
- C Plank
- Department of Pediatrics, University Hospital Erlangen, Germany
| | | | | | | |
Collapse
|
21
|
Meas T, Carreira E, Wang Y, Rauh M, Poitou C, Clément K, Dötsch J, Lévy-Marchal C. 11beta-hydroxysteroid dehydrogenase type 1 of the subcutaneous adipose tissue is dysregulated but not associated with metabolic disorders in adults born small for gestational age. J Clin Endocrinol Metab 2010; 95:3949-54. [PMID: 20519348 DOI: 10.1210/jc.2010-0254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
INTRODUCTION The mechanisms relating being born small for gestational age (SGA) and the later risk of metabolic disorders are not yet fully understood. Adipose 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) activity and expression have been positively associated with metabolic syndrome. In humans, no in vivo studies have explored 11beta-HSD1 activity and gene expression in sc adipose tissue of SGA subjects. SUBJECTS AND METHODS Thirty-nine subjects SGA (birth weight<10th percentile) were matched on gender and age with 36 subjects born appropriate for gestational age (AGA) (25th percentile<birth weight<75th percentile); the two groups were stratified according to body fat content into low-fat-mass (20 SGA and 18 AGA) and high-fat-mass (19 SGA and 18 AGA) subjects. Basal and stimulated activities of the 11beta-HSD1 enzyme were assessed in the effluent of microdialysis performed in the abdominal sc wall in vivo. mRNA expression was measured by real-time quantitative PCR. RESULTS Basal 11beta-HSD1 activity was comparable in both groups, whereas stimulated activity was lower in SGA subjects. A significant effect of body fat content on the stimulated 11beta-HSD1 activity was found in AGA but not in SGA subjects. 11beta-HSD1 expression was associated with body fat but not with birth weight. CONCLUSION The in vivo stimulated 11beta-HSD1 activity was decreased in subjects born SGA as compared with adults born AGA. 11beta-HSD1 gene expression was not associated with birth weight. It is therefore unlikely that local glucocorticoid metabolism in sc fat plays a major role in the development of the metabolic complications associated with being born SGA.
Collapse
Affiliation(s)
- T Meas
- Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 690, Hôpital Robert Debré, Université Paris 7 Denis Diderot, 48 Boulevard Sérurier, Paris FR-75019, France.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Richter M, Plank C, Lang T, Behrens R, Carbon RT, Dötsch J, Köhler H. [Benefits and risks of tube feeding via gastrostoma in infants and children with peritoneal dialysis]. Z Gastroenterol 2010; 48:673-7. [PMID: 20517804 DOI: 10.1055/s-0028-1109931] [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: 10/19/2022]
Abstract
BACKGROUND Nutrition of children with end-stage renal disease and peritoneal dialysis (PD) is often difficult. Tube feeding via a gastrostoma is discussed controversially, and some authors consider this as a contraindication because of the risk of peritonitis. METHODS In our centre 16 infants and children with end-stage renal disease were treated with PD and tube feeding over a gastrostoma in the last 12 years. The patients showed dystrophy (mean BMI -1.73 SDS) and were too small (mean body length -4.56 SDS). Seven of them (median age 11 months) received a gastrostoma before insertion of a Tenkhoff-catheter and start of PD. Nine children (median age 5 months) had PD primarily before insertion of the gastrostoma and start of tube feeding. RESULTS Patients with start of PD while a gastrostoma was already inserted had 15 events with peritonitis in the observation time of 91 months (1.98 per patient year). Patients with primary start of PD had 12 events with peritonitis in a total time of 43 month (3.34 per patient year), after insertion while PD was already running the number of events fell significantly to 25 peritonitis events in a total of 271 months (1.11 per patient year, p < 0.01). The children had a benefit from tube feeding via a gastrostoma in regard of body weight (BMI + 1.61 SDS, p < 0.01) as well as growth (body height + 2.29 SDS, p < 0.05). CONCLUSION Tube feeding via a gastrostoma is a good and safe option for alimentation, even under peritoneal dialysis. A decrease of PD-associated peritonitis under tube feeding was observed while physical development was positively influenced.
Collapse
Affiliation(s)
- M Richter
- Kinder- und Jugendklinik, Universitätsklinikum, Erlangen
| | | | | | | | | | | | | |
Collapse
|
23
|
Dötsch J. Tierexperimentelle Modelle intrauteriner Wachstumsstörungen. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
24
|
Nüsken E, Dittrich K, Carbon R, Dötsch J. Considering laparoscopic salvage options--is pre-emptive omentectomy necessary in paediatric peritoneal patients? Klin Padiatr 2010; 222:252-4. [PMID: 20306383 DOI: 10.1055/s-0030-1247509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In paediatric peritoneal dialysis patients, pre-emptive omentectomy is discussed controversially and literature provides only little data concerning this issue. Our aim was to evaluate the rate of omentum-majus-related problems in our patients, in whom omentectomy was generally not performed. Furthermore, we were interested in the success rates of laparoscopic adhesiolysis. PATIENTS AND METHODS Between 09/2006 and 03/2008, we regularly saw 18 peritoneal dialysis patients in whom we retrospectively analysed medical records to determine the rate of catheter-related complications. In addition, we evaluated the success rates of laparoscopic adhesiolysis. RESULTS During 355 dialysis months in 18 patients, we observed 7 omentum-majus-related obstructions in 6 patients (1/50.7 PM). The median age of the patients affected was 9 years, median filling volume at the time of the obstruction was 671 ml/m (2). Laparoscopic adhesiolysis was successful in 4 out of 7 episodes. In 3 cases, the catheter lumen was plugged by necrotic portions of the omentum and the catheters had to be replaced. CONCLUSION Our data confirm omentum-majus-related catheter obstruction as a major cause of catheter dysfunction. However, in comparison to literature, it remains unclear to which extent omentectomy can reduce the incidence of catheter obstruction in general (including e. g. obstruction due to coagulation). Thus, the decision to perform an omentectomy should be taken individually after careful consideration. In case of omentum-majus-associated obstruction, early but not late laparoscopic intervention proved to be a successful, minimally invasive technique to restore catheter function.
Collapse
Affiliation(s)
- E Nüsken
- Paediatric Nephrology, University of Erlangen-Nuremberg, Loschgestrasse 15, Erlangen, Germany.
| | | | | | | |
Collapse
|
25
|
Alejandre Alcázar MA, Lendzian L, Hartner A, Plank C, Dötsch J. Prädisposition für Atemwegserkrankung nach intrauteriner Wachstumsrestriktion. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1251044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
26
|
Galiano M, Plank C, Dittrich K, Beck B, Hoppe B, Dötsch J. Terminales Nierenversagen in den ersten Lebensmonaten als Erstmanifestation einer Hyperoxalurie Typ I. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1251049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
27
|
Plank C, Gores H, Hartner A, Amann K, Dötsch J. Wurfgröße bestimmt Nephronanzahl und spätere Nierenschädigung nach intrauteriner Wachstumsrestriktion in der Ratte. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1251051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
28
|
Nüsken EC, Dittrich K, Plank C, Amann K, Dötsch J. Parvovirus B19-assoziierte FSGS-Rekurrenz nach Nierentransplantation? Klin Padiatr 2010. [DOI: 10.1055/s-0030-1251063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
29
|
Dittrich K, Plank C, Amann K, Dötsch J, Fehrenbach H, Kemper M, Konrad M, Pohl M, Weber L. Beeinflusst die Art der Behandlung das Outcome der IgA-Nephropathie bei Kindern? Klin Padiatr 2010. [DOI: 10.1055/s-0030-1251047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
30
|
Struwe E, Berzl G, Schild R, Blessing H, Drexel L, Hauck B, Tzschoppe A, Weidinger M, Sachs M, Scheler C, Schleussner E, Dötsch J. Microarray analysis of placental tissue in intrauterine growth restriction. Clin Endocrinol (Oxf) 2010; 72:241-7. [PMID: 19548955 DOI: 10.1111/j.1365-2265.2009.03659.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Besides foetal or maternal disorders, placental dysfunction is a major cause of intrauterine growth restriction (IUGR). Although numerous macro- and histopathological changes have been described, little is known about the precise aetiology and the contribution of foetal/placental genes in this disorder. DESIGN Placental tissues of 20 IUGR and control neonates were analysed by microarray technique. Four of the regulated genes with possible relevance in the pathogenesis of IUGR and its consequences were further studied in placentas of 27 IUGR and 35 control newborns. RESULTS Elevated gene expression of leptin, corticotrophin-releasing hormone (CRH), and IGF-binding protein-1 (IGFBP-1) in IUGR placentas could be confirmed in the larger group by real-time PCR, whereas prolactin showed no significant difference. Accordingly, protein expression of leptin and IGFBP-1 depicted by Western blot was elevated in IUGR, prolactin was not different. Birthweight standard deviation score (SDS) correlated negatively to leptin, IGFBP-1, and CRH, whereas placental weight correlated only to IGFBP-1. Leptin correlated negatively to gestational age of IUGR patients and positively to placental score, a marker of severity of impaired foeto-placental circulation. CONCLUSIONS As confirmed in a large group of IUGR and control samples, the up-regulated factors leptin, IGFBP-1, and CRH may serve as candidate genes for the prediction of subsequent metabolic consequences in IUGR newborns. These three factors may not only influence growth of the foetus, but might also interact with programming of its metabolic functions, which has to be determined in an ongoing study.
Collapse
Affiliation(s)
- E Struwe
- Departments of Pediatrics, University of Erlangen, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Tzschoppe AA, Struwe E, Dörr HG, Goecke TW, Beckmann MW, Schild RL, Dötsch J. Differences in gene expression dependent on sampling site in placental tissue of fetuses with intrauterine growth restriction. Placenta 2010; 31:178-85. [PMID: 20045557 DOI: 10.1016/j.placenta.2009.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Revised: 11/21/2009] [Accepted: 12/03/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The human placenta as part of the feto-placental unit may influence fetal endocrine systems and may therefore represent a very important link between intrauterine growth restriction (IUGR) and metabolic disorders in later life. We aimed to analyze the effect of sample origin on gene expression of placental factors potentially involved in fetal programming in IUGR versus appropriate for gestational age growth (AGA) to standardize sample collection procedure for a multicenter approach. DESIGN Placental gene expression of insulin-like growth factor-binding protein (IGFBP)-1, prolactin, corticotropin releasing hormone (CRH) and leptin was measured and compared between proximal, intermediate and peripheral region of the placenta in 22 IUGR (proven by anomalous placental Doppler velocimetry) and 19 AGA neonates. RESULTS Whereas no difference in gene expression was seen in the proximal portion, in the intermediate placental region mRNA expression of IGFBP-1 (p = 0.01), prolactin (p = 0.04), CRH (p = 0.01) and leptin (p = 0.04) was increased in IUGR samples compared to controls. At the placental periphery, gene expression of these placental transcripts showed a higher expression level in IUGR placentas without statistical significance, except for leptin (p = 0.03). CONCLUSION Placental sampling site seems to be relevant for detecting differences in gene expression between IUGR and AGA neonates.
Collapse
Affiliation(s)
- A A Tzschoppe
- Department of Pediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | | | | | | | | | | |
Collapse
|
32
|
Dittrich K, Ross S, Benz K, Amann K, Dötsch J. Experience with Mycophenolate Mofetil as Maintenance Therapy in five Pediatric Patients with Severe Systemic Lupus Erythematosus. Klin Padiatr 2009; 221:425-9. [DOI: 10.1055/s-0029-1234130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
33
|
Utsch B, Brun-Heath I, Staatz G, Gravou-Apostolatou C, Karle S, Jacobs U, Ludwig M, Zenker M, Dörr HG, Rascher W, Mornet E, Dötsch J. Infantile Hypophosphatasia due to a New Compound Heterozygous TNSALP Mutation – Functional Evidence for a Hydrophobic Side-Chain? Exp Clin Endocrinol Diabetes 2008; 117:28-33. [DOI: 10.1055/s-2008-1073157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
34
|
Meissner U, Scharf J, Dötsch J, Schroth M. Very early extubation after open-heart surgery in children does not influence cardiac function. Pediatr Cardiol 2008; 29:317-20. [PMID: 17676368 DOI: 10.1007/s00246-007-9023-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2007] [Accepted: 06/13/2007] [Indexed: 10/23/2022]
Abstract
The objective of our study was to evaluate hemodynamic effects and the cardiac function after very early extubation within the first 6 hours after open-heart surgery in children. During a 12-month period, we performed a retrospective study of 50 children (ages 3 months to 7 years) admitted to the pediatric intensive care unit immediately after minor cardiac surgery. All children were extubated within the first 6 hours after their arrival. Arterial blood and central venous pressure were monitored, and arterial blood gas analysis was performed. Cardiac index, stroke volume index, systemic vascular resistance index, and extravascular lung water index were measured by thermodilution. Early extubation of children after minor open-heart surgery with cardiopulmonary bypass is safe and does not affect cardiac functions. A slight decrease of arterial oxygen tension not resulting in respiratory or metabolic acidosis or reintubation was noted. Very early extubation in children after open-heart surgery does not promote cardiodepressive effects. It is a safe procedure that helps to reduce the unnecessary and prolonged mechanical ventilation of children after cardiopulmonary bypass surgery.
Collapse
Affiliation(s)
- U Meissner
- Department of Pediatrics, Leopoldina Hospital, D-97422, Schweinfurth, Germany
| | | | | | | |
Collapse
|
35
|
Sauerstein K, Schroth M, Amann K, Hoyer J, Singer H, Rauch A, Dötsch J. Pulmonary embolism--a rare complication of Schimke immunoosseous dysplasia. Eur J Pediatr 2007; 166:1285-8. [PMID: 17195070 DOI: 10.1007/s00431-006-0383-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2006] [Revised: 11/17/2006] [Accepted: 11/20/2006] [Indexed: 11/24/2022]
Affiliation(s)
- K Sauerstein
- Pediatric Clinic, Friedrich-Alexander University of Erlangen-Nuernberg, Loschgestr. 15, 91054 Erlangen, Germany.
| | | | | | | | | | | | | |
Collapse
|
36
|
Sauerstein K, Zimmermann B, Benz K, Dittrich K, Rascher W, Dötsch J. Encouraging survival of infants with terminal renal failure combining dialysis and succeeding early transplantation. Klin Padiatr 2007; 219:288-91. [PMID: 17763295 DOI: 10.1055/s-2007-972568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Dialysis in newborns and infants is a very challenging field in pediatric nephrology and still associated with high mortality. This article is designed for pediatricians who advise parents of newborns with renal failure. It aims to provide information about the difficulties during the period of dialysis and outcome after successful transplantation. We report upon five patients who proceeded to end-stage renal failure within the first year of life. All patients received peritoneal dialysis; however, two had to be switched to hemodialysis for several months. Four patients received percutaneous endoscopic gastric tubes (PEG) to enable high caloric diet. At the age of 1.5 to 5 years all children were successfully transplanted achieving good renal function. With regard to severe complications, hospitalisation time and somatic development all patients showed a substantial improvement after renal transplantation. Growth velocity increased to above SDS +2 after transplantation and all children reached the milestones of development in due time. In conclusion, after renal replacement therapy is initialised in infants with end-stage renal failure, sufficient nutrition to improve weight gain and to achieve the earliest possible transplantation is mandatory. Early transplantation results in a catch-up of developmental delay in short time.
Collapse
Affiliation(s)
- K Sauerstein
- Department of Pediatrics, University of Erlangen-Nürnberg
| | | | | | | | | | | |
Collapse
|
37
|
Abstract
Smoking in young men may trigger anti-GBM disease manifesting with hemoptysis. We present a male adolescent in whom hemoptysis was mistaken to be a sign of airway infection for several months and who later on underwent an unusual antibody-negative relapse. The 16-year-old patient had a history of smoking and therapy-refractant hemoptysis and, later, acute macrohematuria with renal insufficiency necessitating hemodialysis (initial creatinine 4.2 mg/ dl). Chest X-ray showed diffuse lung infiltration. Renal biopsy revealed linear IgG deposits along the glomerular basement membrane (GBM) and cellular crescents in 13/16 glomeruli, simultaneously increased anti-GBM antibodies were detected. Thus, anti-GBM glomerulonephritis was diagnosed. After treatment with prednisone, oral cyclophosphamide and plasmapheresis, chest X-ray and hemoptysis improved, but renal failure persisted. Anti-GBM antibodies were negative. 4 weeks later, the patient presented again with a clinical relapse of severe hemoptysis and respiratory insufficiency after smoke exposition. Despite negative anti-GBM antibodies, he was treated similarly to a relapse and after the second course of plasmapheresis the patients' general condition improved and hemoptysis subsided. During the next 10 months the patient was stable with negative antibodies. He was under intermittent hemodialysis until laboratory measurements showed improved renal function. Now, 30 months after the acute episode, the patient is off dialysis for 17 months with stable creatinine values of 1.9 - 2.4 mg/dl, and is currently being treated with antihypertensive medicaments, calcitriol, calciumacetate, natriumhydrogencarbonate and allopurinol. The prognosis of anti-GBM glomerulonephritis depends on serum creatinine and the need of dialysis at initial presentation. In these patients, one-year survival rate is 67% and 5% for kidney function. Of note, despite the unfavorable prognosis in our patient, renal function recovered after 1 year of hemodialysis treatment. It is important to consider that in patients with anti-GBM disease antibody-negative relapses are possible.
Collapse
Affiliation(s)
- K Benz
- Kinder- und Jugendklinik, Universität Erlangen-Nürnberg.
| | | | | | | | | | | |
Collapse
|
38
|
Nüsken KD, Petrasch M, Rauh M, Stöhr W, Nüsken E, Schneider H, Dötsch J. Reduced plasma visfatin in end-stage renal disease is associated with reduced body fat mass and elevated serum insulin. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
39
|
Weigel C, Rauh M, Dörr HG, Dötsch J, Rascher W, Knerr I. Selenium and parameters of thyroid function in patients with type 1 diabetes, autoimmune thyroiditis or nutritional and metabolic risk of thyroid disease due to phenylketonuria. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972426] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
40
|
Linnemann K, Anders C, May K, Müller C, Trollmann R, Dötsch J, Straube W, Fusch C. Plazentare Ghrelin-Freisetzung im dualen in vitro Plazentaperfusionsmodell. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
41
|
Schroth M, Plank C, Meißner U, Eberle K, Cesnjevar R, Dötsch J, Rascher W. Hypertonic-Hyperoncotic Solutions Improve Cardiac Function in Children after Open Heart Surgery. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
42
|
Schroth M, Scharf J, Dötsch J, Rascher W. Very Early Extubation After Open Heart Surgery In Children Does Not Influence Cardiac Function. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
43
|
Plank C, Ostreicher I, Hartner A, Marek I, Struwe FG, Amann K, Hilgers KF, Rascher W, Dötsch J. Intrauterine growth retardation aggravates the course of acute mesangioproliferative glomerulonephritis in the rat. Kidney Int 2006; 70:1974-82. [PMID: 17051140 DOI: 10.1038/sj.ki.5001966] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Intrauterine growth retardation (IUGR) aggravates the course of acute mesangioproliferative glomerulonephritis (GN) in the rat. Observational studies in children suggest that IUGR may be associated with a severe course of kidney diseases such as IgA nephropathy. We tested the hypothesis that IUGR leads to aggravation of acute mesangioproliferative GN in former IUGR rats. IUGR was induced in Wistar rats by isocaloric protein restriction in pregnant dams. Litter size was reduced to six male neonates in low protein animals (LP) and normal protein animals (NP). At 8 weeks GN was induced by injection of an anti-Thy-1.1 antibody. Rats were killed on days 4 and 14 after induction of GN and kidneys were investigated for inflammation and sclerosis using real-time polymerase chain reaction and histological methods. On day 4 after induction of GN, LP animals showed more glomerulosclerosis and tubulointerstitial lesions. On day 14, inflammatory markers (expression of monocyte chemoattractant protein 1, osteopontin, tumor necrosis factor and interleukin-6), extracellular matrix accumulation and markers of sclerosis (plasminogen activator inhibitor-1 expression, transforming growth factor-beta1 expression, score for glomerulosclerosis, glomerular deposition of collagen I and collagen IV) were more severe in LP animals. Some degree of induction of inflammatory and profibrotic markers was also present in non-nephritic LP animals. However, these rats did not display marked glomerulosclerosis or interstitial fibrosis. We conclude that after IUGR inflammatory damage is aggravated and the reparation of the kidney is impaired during the course of acute mesangioproliferative GN, leading to more sclerotic lesions.
Collapse
Affiliation(s)
- C Plank
- Department of Pediatrics and Adolescent Medicine, University Erlangen-Nuremberg, Erlangen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Kratzsch J, Knerr I, Galler A, Kapellen T, Raile K, Körner A, Thiery J, Dötsch J, Kiess W. Metabolic decompensation in children with type 1 diabetes mellitus associated with increased serum levels of the soluble leptin receptor. Eur J Endocrinol 2006; 155:609-14. [PMID: 16990661 DOI: 10.1530/eje.1.02261] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Type 1 diabetes mellitus (T1DM) leads to increased serum levels of the soluble leptin receptor (sOB-R) by an as yet unknown cellular mechanism. The aim of our study was to investigate potential metabolic factors that may be associated with the induction of the sOB-R release from its membrane receptor. MATERIALS AND METHODS Twenty-five children (aged between 1.5 and 17.0 years) were studied at the onset of T1DM. Blood samples were collected before (n = 25), during the first 18 h (mean +/- S.D. 11.1 +/- 4.3 h, n = 16) and 92 h (47.5 +/- 22.5 h; n = 14) after beginning insulin therapy. Serum sOB-R and leptin levels were determined by in-house immunoassays. RESULTS The sOBR-level and the molar sOB-R/leptin ratio were significantly higher before than after starting insulin treatment (P < 0.05). In contrast, leptin levels were significantly lower (P < 0.05) before insulin therapy. The correlation between sOB-R and blood glucose (r = 0.49; P < 0.05), as well as sOB-R with parameters of ketoacidosis, such as pH (r = -0.72), base excess (r = -0.70), and bicarbonate (r = -0.69) (P < 0.0001) at diagnosis of T1DM remained significant during the first 18 h of insulin treatment. Multiple regression analysis revealed that base excess predicted 41.0% (P < 0.001), age 16.4% (P < 0.05), and height SDS 13.9% (P < 0.01) of the sOB-R variance. CONCLUSIONS Metabolic decompensation in children with new onset T1DM is associated with dramatic changes of the leptin axis; serum levels of sOB-R are elevated and of leptin are reduced. The molar excess of sOB-R over leptin (median 11.3) in this condition may contribute to leptin insensitivity. Upregulation of the soluble leptin receptor appears to be a basic mechanism to compensate for intracellular substrate deficiency and energy-deprivation state.
Collapse
Affiliation(s)
- J Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Struwe E, Beckmann MW, Blessing H, Dötsch J, Drexel L, Frenzel J, Goecke T, Hauck B, Kirschbaum M, Meurer B, Möller J, Plank C, Scheler C, Schild RL, Schleussner E, Stuppy A, Weidinger M, Winzer H. Die FIPS-Studie (Fetale Programmierung–Intrauterine Wachstumsrestriktion–Plazentare Marker–Studie). Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952743] [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] Open
|
46
|
Berzl G, Struwe E, Schild RL, Beckmann MW, Doerr HG, Rascher W, Dötsch J. Reduzierte Genexpression der beiden Cortisol metabolisierenden Enzyme 11ß-Hydroxysteroiddehydrogenase Typ 1 und Typ 2 in Plazenten von hypotrophen Neugeborenen. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952735] [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] Open
|
47
|
Struwe E, Krammer K, Dötsch J, Metzler M, Dörr HG, Cesnjevar R, Rascher W, Koch A. No evidence for angiotensin type 2 receptor gene polymorphism in intron 1 in patients with coarctation of the aorta and Ullrich-Turner syndrome. Pediatr Cardiol 2006; 27:636-9. [PMID: 16944335 DOI: 10.1007/s00246-005-1049-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2005] [Accepted: 08/24/2005] [Indexed: 01/09/2023]
Abstract
In male patients with congenital anomalies of the kidney and urinary tract, an increased incidence of a polymorphism in the angiotensin type 2 receptor gene (AT2R) has been identified. The AT2R has been shown to be involved in apoptosis, particularly during embryogenesis. The aim of this study was to examine the A-->1675G transition polymorphism in intron 1 of the AT2R gene that is located on the X chromosome in patients with coarctation of the aorta (CoA) with and without Ullrich-Turner syndrome (UTS). Screening of DNA samples was performed with restriction fragment length polymorphism analysis. Ninety-seven patients with CoA, 28 girls with UTS, 10 girls with UTS and CoA, and 96 control individuals were studied. There was no significant difference in the distribution of A and G-genotypes in any of the patient groups compared to controls. An A-->1675G transition in the AT2R gene seems not to be involved in the pathogenesis of aortic coarctation.
Collapse
Affiliation(s)
- E Struwe
- Children's Hospital, University of Erlangen-Nürnberg, Loschgestrasse 15, D-91045 Erlangen, Germany
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Riepe FG, Krone N, Krüger SN, Sweep FCGJ, Lenders JWM, Dötsch J, Mönig H, Sippell WG, Partsch CJ. Absence of exercise-induced leptin suppression associated with insufficient epinephrine reserve in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Exp Clin Endocrinol Diabetes 2006; 114:105-10. [PMID: 16636975 DOI: 10.1055/s-2005-865836] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency suffer from glucocorticoid and mineralocorticoid deficiency. They have insufficient epinephrine reserves and increased basal leptin levels and are often insulin resistant. In healthy subjects, an inhibitory effect of acute catecholamine elevation on the leptin plasma concentrations has been reported. However, it is not yet known how leptin levels respond to exercise in CAH patients. METHODS We performed a cycle ergometer test in six CAH patients to measure the response of plasma leptin, glucose and the catecholamines, epinephrine (E) and norepinephrine (N), as well as their respective metabolites, metanephrine (M) and normetanephrine (NM), to intense exercise. RESULTS Baseline leptin concentrations in CAH patients were not different from those of controls. Leptin levels decreased significantly with exercise in healthy controls, whereas they remained unchanged in CAH patients. In contrast to controls, CAH patients showed no rise of plasma glucose. Basal and stimulated E and M levels were significantly lower in CAH patients compared to controls. Baseline and stimulated N and NM levels were comparable, showing a significant rise after exercise. Peak systolic blood pressure and peak heart rate in both groups were comparable. CONCLUSION CAH patients do not manifest exercise-induced leptin suppression. The most probable reason for this is their severely impaired epinephrine stress response. In addition, epinephrine deficiency is leading to secondary changes in various catecholamine dependent metabolic pathways, e. g., energy balance. Although obvious clinical sequelae are so far unknown, the catecholamine-deficient state and the resulting hyperleptinemia might contribute to the severity of the disease in CAH.
Collapse
Affiliation(s)
- F G Riepe
- Division of Pediatric Endocrinology, Department of Pediatrics, Christian-Albrechts-Universität Kiel, Kiel, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Schneider H, Mühle A, Schild R, Rauh M, Dötsch J. Hypernatremia in twin lambs is a time-limited phenomenon and correlates with rapid catch-up growth. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
50
|
Schroth M, Scharf J, Dötsch J, Rascher W. Very Early Extubation After Open Heart Surgery In Children Does Not Influence Cardiac Function. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|