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Kolorz J, Demir S, Gottschlich A, Beirith I, Ilmer M, Lüthy D, Walz C, Dorostkar MM, Magg T, Hauck F, von Schweinitz D, Kobold S, Kappler R, Berger M. The Neurokinin-1 Receptor Is a Target in Pediatric Rhabdoid Tumors. Curr Oncol 2021; 29:94-110. [PMID: 35049682 PMCID: PMC8775224 DOI: 10.3390/curroncol29010008] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 12/25/2022] Open
Abstract
Rhabdoid tumors (RT) are among the most aggressive tumors in early childhood. Overall survival remains poor, and treatment only effectively occurs at the cost of high toxicity and late adverse effects. It has been reported that the neurokinin-1 receptor/ substance P complex plays an important role in cancer and proved to be a promising target. However, its role in RT has not yet been described. This study aims to determine whether the neurokinin-1 receptor is expressed in RT and whether neurokinin-1 receptor (NK1R) antagonists can serve as a novel therapeutic approach in treating RTs. By in silico analysis using the cBio Cancer Genomics Portal we found that RTs highly express neurokinin-1 receptor. We confirmed these results by RT-PCR in both tumor cell lines and in human tissue samples of various affected organs. We demonstrated a growth inhibitory and apoptotic effect of aprepitant in viability assays and flow cytometry. Furthermore, this effect proved to remain when used in combination with the cytostatic cisplatin. Western blot analysis showed an upregulation of apoptotic signaling pathways in rhabdoid tumors when treated with aprepitant. Overall, our findings suggest that NK1R may be a promising target for the treatment of RT in combination with other anti-cancer therapies and can be targeted with the NK1R antagonist aprepitant.
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Affiliation(s)
- Julian Kolorz
- Research Laboratories, Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (S.D.); (D.L.); (D.v.S.); (R.K.)
| | - Salih Demir
- Research Laboratories, Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (S.D.); (D.L.); (D.v.S.); (R.K.)
| | - Adrian Gottschlich
- Center for Integrated Protein Science Munich (CIPSM) and Division of Clinical Pharmacology, Department of Medicine IV, University Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (A.G.); (S.K.)
| | - Iris Beirith
- Department of General, Visceral, and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (M.I.)
| | - Matthias Ilmer
- Department of General, Visceral, and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (M.I.)
- German Center for Translational Cancer Research (DKTK), Partner Site Munich, 81377 Munich, Germany
| | - Daniel Lüthy
- Research Laboratories, Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (S.D.); (D.L.); (D.v.S.); (R.K.)
| | - Christoph Walz
- Institute of Pathology, Faculty of Medicine, Ludwig Maximilians-University Munich, 80337 Munich, Germany;
| | - Mario M. Dorostkar
- Center for Neuropathology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany;
| | - Thomas Magg
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (T.M.); (F.H.)
| | - Fabian Hauck
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (T.M.); (F.H.)
| | - Dietrich von Schweinitz
- Research Laboratories, Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (S.D.); (D.L.); (D.v.S.); (R.K.)
| | - Sebastian Kobold
- Center for Integrated Protein Science Munich (CIPSM) and Division of Clinical Pharmacology, Department of Medicine IV, University Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (A.G.); (S.K.)
- German Center for Translational Cancer Research (DKTK), Partner Site Munich, 81377 Munich, Germany
- Einheit für Klinische Pharmakologie (EKLiP), Helmholtz Zentrum München, German Research Center for Environmental Health (HMGU), 85764 Neuherberg, Germany
| | - Roland Kappler
- Research Laboratories, Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (S.D.); (D.L.); (D.v.S.); (R.K.)
| | - Michael Berger
- Research Laboratories, Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (S.D.); (D.L.); (D.v.S.); (R.K.)
- Correspondence: ; Tel.: +49-89-4400-57859
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Ritz A, Froeba-Pohl A, Kolorz J, Vigodski V, Hubertus J, Ley-Zaporozhan J, von Schweinitz D, Häberle B, Schmid I, Kappler R, Lurz E, Berger M. Total Psoas Muscle Area as a Marker for Sarcopenia Is Related to Outcome in Children With Neuroblastoma. Front Surg 2021; 8:718184. [PMID: 34490339 PMCID: PMC8418308 DOI: 10.3389/fsurg.2021.718184] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 05/31/2021] [Accepted: 07/22/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Sarcopenia describes a generalized loss of skeletal muscle mass, strength, or function. Determined by measuring the total psoas muscle area (tPMA) on cross-sectional imaging, sarcopenia is an independent marker for poor post-surgical outcomes in adults and children. Children with cancer are at high risk for sarcopenia due to immobility, chemotherapy, and cachexia. We hypothesize that sarcopenic children with neuroblastoma are at higher risk for poor post-operative outcomes. Patients and Methods: Retrospective analysis of children with neuroblastoma ages 1-15 years who were treated at our hospital from 2008 to 2016 with follow-up through March 2021. Psoas muscle area (PMA) was measured from cross-sectional images, using computed tomography (CT) and magnetic resonance imaging (MRI) scans at lumbar disc levels L3-4 and L4-5. tPMA is the sum of the left and right PMA. Z-scores were calculated using age- and gender-specific reference values. Sarcopenia was defined as a tPMA z-score below -2. A correlation of tPMA z-scores and sarcopenia with clinical variables and outcome was performed. Results: One hundred and sixty-four children with workup for neuroblastoma were identified, and 101 children fulfilled inclusion criteria for further analysis, with a mean age of 3.92 years (SD 2.71 years). Mean tPMA z-score at L4-5 was -2.37 (SD 1.02). Correlation of tPMA z-score at L4-5 with weight-for-age z-score was moderate (r = 0.54; 95% CI, 0.38, 0.66). No association between sarcopenia and short-term outcome was observed. Sarcopenia had a sensitivity of 0.82 (95% CI, 0.62-0.93) and a specificity of 0.48 (95% CI 0.36-0.61) in predicting 5-year survival. In a multiple regression analysis, pre-operative sarcopenia, pre-operative chemotherapy in the NB2004 high-risk group, unfavorable tumor histology, and age at diagnosis were associated with 5-year survival after surgery, with hazard ratios of 4.18 (95% CI 1.01-17.26), 2.46 (95% CI 1.02-5.92), 2.39 (95% CI 1.03-5.54), and 1.01 (95% CI 1.00-1.03), respectively. Conclusion: In this study, the majority of children had low tPMA z-scores and sarcopenia was a risk factor for decreased 5-year survival in children with neuroblastoma. Therefore, we suggest measuring the tPMA from pre-surgical cross-sectional imaging as a biomarker for additional risk stratification in children with neuroblastoma.
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Affiliation(s)
- Annika Ritz
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Alexandra Froeba-Pohl
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Julian Kolorz
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Victor Vigodski
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Jochen Hubertus
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Julia Ley-Zaporozhan
- Department of Radiology, Pediatric Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Dietrich von Schweinitz
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Beate Häberle
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Irene Schmid
- Department of Pediatrics, Division of Hematology and Oncology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Roland Kappler
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Eberhard Lurz
- Department of Pediatrics, Division of Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Berger
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of General, Abdominal, and Transplant Surgery, Essen University Hospital, Essen, Germany
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Beirith I, Renz BW, Mudusetti S, Ring NS, Kolorz J, Koch D, Bazhin AV, Berger M, Wang J, Angele MK, D’Haese JG, Guba MO, Niess H, Andrassy J, Werner J, Ilmer M. Identification of the Neurokinin-1 Receptor as Targetable Stratification Factor for Drug Repurposing in Pancreatic Cancer. Cancers (Basel) 2021; 13:cancers13112703. [PMID: 34070805 PMCID: PMC8198055 DOI: 10.3390/cancers13112703] [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: 04/17/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 12/22/2022] Open
Abstract
The SP/NK1R-complex plays an important role in tumor proliferation. Targeting of the neurokinin-1 receptor in previous studies with its antagonist aprepitant (AP) resulted in anti-tumoral effects in colorectal cancer and hepatoblastoma. However, there is still a lack of knowledge regarding its effects on pancreatic cancer. Therefore, we treated human pancreatic ductal adenocarcinoma (PDAC) cell lines (Capan-1, DanG, HuP-T3, Panc-1, and MIA PaCa-2) and their cancer stem cell-like cells (CSCs) with AP and analyzed functional effects by MTT-, colony, and sphere formation assays, respectively; moreover, we monitored downstream mechanisms by flow cytometry. NK1R inhibition resulted in dose-dependent growth reduction in both CSCs and non-CSCs without induction of apoptosis in most PDAC cell lines. More importantly, we identified striking AP dependent cell cycle arrest in all parental cells. Furthermore, gene expression and the importance of key genes in PDAC tumorigenesis were analyzed combining RT-qPCR in eight PDAC cell lines with publicly available datasets (TCGA, GEO, CCLE). Surprisingly, we found a better overall survival in patients with high NK1R levels, while at the same time, NK1R was significantly decreased in PDAC tissue compared to normal tissue. Interestingly, there is currently no differentiation between the isoforms of NK1R (truncated and full; NK1R-tr and -fl) in any of the indicated public transcriptomic records, although many publications already emphasize on important regulatory differences between the two isoforms of NK1R in many cancer entities. In conclusion, analysis of splice variants might potentially lead to a stratification of PDAC patients for NK1R-directed therapies. Furthermore, we presume PDAC patients with high expressions of NK1R-tr might benefit from treatment with AP to improve chemoresistance. Therefore, analysis of splice variants might potentially lead to a stratification of PDAC patients for NK1R-directed therapies.
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Affiliation(s)
- Iris Beirith
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Bernhard W. Renz
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
- German Center for Translations Cancer Research (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Shristee Mudusetti
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Natalja Sergejewna Ring
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Julian Kolorz
- Department of Pediatric Surgery, Research Laboratories, von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (M.B.)
| | - Dominik Koch
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Alexandr V. Bazhin
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
- German Center for Translations Cancer Research (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Michael Berger
- Department of Pediatric Surgery, Research Laboratories, von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany; (J.K.); (M.B.)
- Department of General, Abdominal and Transplant Surgery, Essen University Hospital, 45417 Essen, Germany
| | - Jing Wang
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
- Department of General Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, China
| | - Martin K. Angele
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Jan G. D’Haese
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Markus O. Guba
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Hanno Niess
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Joachim Andrassy
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
| | - Jens Werner
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
- German Center for Translations Cancer Research (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Matthias Ilmer
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University Munich, 81377 Munich, Germany; (I.B.); (B.W.R.); (S.M.); (N.S.R.); (D.K.); (A.V.B.); (J.W.); (M.K.A.); (J.G.D.); (M.O.G.); (H.N.); (J.A.); (J.W.)
- German Center for Translations Cancer Research (DKTK), Partner Site Munich, 80336 Munich, Germany
- Correspondence: ; Tel.: +49-089-4400-711218
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Ritz A, Kolorz J, Hubertus J, Ley-Zaporozhan J, von Schweinitz D, Koletzko S, Häberle B, Schmid I, Kappler R, Berger M, Lurz E. Sarcopenia is a prognostic outcome marker in children with high-risk hepatoblastoma. Pediatr Blood Cancer 2021; 68:e28862. [PMID: 33438330 DOI: 10.1002/pbc.28862] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Children with hepatoblastoma (HB) are at risk of sarcopenia due to immobility, chemotherapy, and malnutrition. We hypothesized that children with HB have a low preoperative total psoas muscle area (tPMA), reflecting sarcopenia, which negatively impacts outcome. PROCEDURE Retrospective study of children (1-10 years) with hepatoblastoma treated at a large university children's hospital from 2009 to 2018. tPMA was measured as the sum of the right and left psoas muscle area (PMA) at intervertebral disc levels L3-4 and L4-5. z-Scores were calculated using age- and gender-specific reference values and were compared to anthropometric measurements, clinical variables, and outcomes. Sarcopenia was defined as a tPMA z-score below -2. RESULTS Thirty-three children were included. Mean tPMA z-score was -2.18 ± 1.08, and 52% were sarcopenic. A poor correlation between tPMA and weight was seen (r = 0.35; confidence interval [CI] 0.01, 0.62; P = .045), and most children had weights within the normal range (mean z-score -0.55 ± 1.39). All children categorized as high risk with relapse (n = 5/12) were sarcopenic before surgery. Relapse was significantly higher in the high-risk sarcopenic group compared to the nonsarcopenic group (P = .008). The change in tPMA z-score 1-4 months after surgery did not improve in patients with relapse, but did improve in 75% of children without relapse. CONCLUSIONS The majority of children with HB were sarcopenic prior to surgery. Especially in children with high-risk hepatoblastoma, sarcopenia is an additional risk factor for relapse. Large multicenter studies are needed to confirm these preliminary results.
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Affiliation(s)
- Annika Ritz
- Department of Pediatric Surgery, Research Laboratories, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Julian Kolorz
- Department of Pediatric Surgery, Research Laboratories, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Jochen Hubertus
- Department of Pediatric Surgery, Research Laboratories, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Julia Ley-Zaporozhan
- Department of Radiology, Pediatric Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Dietrich von Schweinitz
- Department of Pediatric Surgery, Research Laboratories, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Sibylle Koletzko
- Department of Pediatrics, Division of Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.,Department of Pediatric Gastroenterology and Nutrition, School of Medicine Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland
| | - Beate Häberle
- Department of Pediatric Surgery, Research Laboratories, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Irene Schmid
- Department of Pediatric Hematology and Oncology, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Roland Kappler
- Department of Pediatric Surgery, Research Laboratories, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Michael Berger
- Department of Pediatric Surgery, Research Laboratories, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Eberhard Lurz
- Department of Pediatrics, Division of Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
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