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Michl M, Taverna F, Woischke C, Li P, Klauschen F, Kirchner T, Heinemann V, von Bergwelt-Baildon M, Stahler A, Herold TM, Jurinovic V, Engel J, Kumbrink J, Neumann J. Identification of a gene expression signature associated with brain metastasis in colorectal cancer. Clin Transl Oncol 2024:10.1007/s12094-024-03408-5. [PMID: 38558282 DOI: 10.1007/s12094-024-03408-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/11/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Brain metastasis (BM) in colorectal cancer (CRC) is a rare event with poor prognosis. Apart from (K)RAS status and lung and bone metastasis no biomarkers exist to identify patients at risk. This study aimed to identify a gene expression signature associated with colorectal BM. METHODS Three patient groups were formed: 1. CRC with brain metastasis (BRA), 2. exclusive liver metastasis (HEP) and, 3. non-metastatic disease (M0). RNA was extracted from primary tumors and mRNA expression was measured using a NanoString Panel (770 genes). Expression was confirmed by qPCR in a validation cohort. Statistical analyses including multivariate logistic regression followed by receiver operating characteristic (ROC) analysis were performed. RESULTS EMILIN3, MTA1, SV2B, TMPRSS6, ACVR1C, NFAT5 and SMC3 were differentially expressed in BRA and HEP/M0 groups. In the validation cohort, differential NFAT5, ACVR1C and SMC3 expressions were confirmed. BRA patients showed highest NFAT5 levels compared to HEP/M0 groups (global p = 0.02). High ACVR1C expression was observed more frequently in the BRA group (42.9%) than in HEP (0%) and M0 (7.1%) groups (global p = 0.01). High SMC3 expressions were only detectable in the BRA group (global p = 0.003). Only patients with BM showed a combined high expression of NFAT5, ACVR1C or SMC3 as well as of all three genes. ROC analysis revealed a good prediction of brain metastasis by the three genes (area under the curve (AUC) = 0.78). CONCLUSIONS The NFAT5, ACVR1C and SMC3 gene expression signature is associated with colorectal BM. Future studies should further investigate the importance of this biomarker signature.
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Affiliation(s)
- Marlies Michl
- Department of Medicine III, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Department of Haematology and Oncology, Comprehensive Cancer Center Munich, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Francesco Taverna
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Christine Woischke
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Pan Li
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Frederick Klauschen
- Department of Haematology and Oncology, Comprehensive Cancer Center Munich, Ludwig-Maximilian-University of Munich, Munich, Germany
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Thomas Kirchner
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Volker Heinemann
- Department of Medicine III, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Department of Haematology and Oncology, Comprehensive Cancer Center Munich, Ludwig-Maximilian-University of Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Michael von Bergwelt-Baildon
- Department of Medicine III, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Department of Haematology and Oncology, Comprehensive Cancer Center Munich, Ludwig-Maximilian-University of Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Arndt Stahler
- Department of Hematology, Oncology, and Tumorimmunology, Corporate Member of Freie Universitaet Berlin and Humbolt-Universitaet zu Berlin, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Tobias Marcus Herold
- Department of Medicine III, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Vindi Jurinovic
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Jörg Kumbrink
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany.
| | - Jens Neumann
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany
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Schlesinger-Raab A, Schubert-Fritschle G, Kim M, Werner J, Belka C, Wolff H, Agha A, Fuchs M, Friess H, Combs S, Häussler B, Engel J, Halfter K. Secondary Primary Cancer Risk After Radiation Therapy in Rectal Cancer: A Population-Based Cohort Study With Propensity Score Matching. Clin Colorectal Cancer 2023; 22:485-495.e3. [PMID: 37838522 DOI: 10.1016/j.clcc.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND It remains unclear whether radiation therapy (RT) has an impact on the development of secondary primary cancer (SC) in rectal cancer (RC) patients, especially within the true pelvis. AIM To examine the incidence of SC in a population-based cohort of RC after surgical treatment with or without radiation therapy (RT, NRT). PATIENTS AND METHODS The epidemiological cohort consisting of 13,919 RC patients with primary M0 stage diagnosed between 1998 and 2019 was collected from cancer registry data of Upper Bavaria. Competing risk analyses were conducted regarding the development of SC on 11 687 first malignancies, stratified by RT/NRT. A propensity score (PS) was generated by logistic regression modeling of RT to repeat competing risk analyses on a PS-matched cohort. RESULTS The median age (interquartile range) of the epidemiological cohort was 68.9 years (60.4-76.7). About 60.8%, were men, 38.7% had UICC III, 35.8% of tumors were localized lower than 8 cm, 41.3% underwent RT. Only 17.1% of patients older than 80 years at diagnosis received RT. In general, RT patients were 5 years younger than NRT patients (65.9 years [58.0-73.0] vs. 71.3 years [62.4-79.2], P < .0001). The 20-year cumulative incidence of SC was 16.5% in RT and 17.4% in NRT patients (P = .2298). Men with RT had a lower risk of prostate cancer (HR = 0.55, 95%CI [0.34-0.91], P = .0168). In the PS-matched cohort, RT patients had a significantly higher risk of bladder cancer during follow-up (10-year cumulative incidence of 1.1% vs. 0.6% in NRT). The direction of the RT effects in men and women and different tumor sites may cancel each other. CONCLUSION A protective effect of RT in rectal cancer patients on developing prostate SC by half is reproduced. Further analyses studying the long-term SC risks of RT should essentially focus on stratification by sex, and focus on more recent data.
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Affiliation(s)
- Anne Schlesinger-Raab
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany.
| | - Gabriele Schubert-Fritschle
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - Mia Kim
- Department of Surgery, Clinic Munich-Neuperlach Hospital, Munich, Germany
| | - Jens Werner
- Department of General, Visceral, and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Hendrik Wolff
- Department of Radiology, Nuclear Medicine and Radiotherapy, Radiology Munich, Munich, Germany
| | - Ayman Agha
- Department of General, Visceral, Endocrine and Minimal-Invasive Surgery, Clinic Munich-Bogenhausen, Munich, Germany
| | - Martin Fuchs
- Department of Gastroenterology, Hepatology, and Gastrointestinal-Oncology, Clinic Munich-Bogenhausen, Munich, Germany
| | - Helmut Friess
- Department of General Surgery, Klinikum rechts der Isar, Technical University Munich (TUM), School of Medicine, Munich, Germany
| | - Stefanie Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich (TUM), School of Medicine, Munich, Germany
| | | | - Jutta Engel
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - Kathrin Halfter
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
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Halfter K, Schubert-Fritschle G, Röder F, Kim M, Werner J, Belka C, Wolff H, Agha A, Fuchs M, Friess H, Combs S, Häussler B, Engel J, Schlesinger-Raab A. Advances in rectal cancer: Real-world evidence suggests limited gains in prognosis for elderly patients. Cancer Epidemiol 2023; 86:102440. [PMID: 37572415 DOI: 10.1016/j.canep.2023.102440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Rectal cancer treatment has improved considerably due to the introduction of total meso-rectal excision, radio-chemotherapy, and high-resolution imaging. The aim of this observational cohort study was to quantify the effectiveness of these advances using high-quality data from a representative cohort of patients. METHODS 20 281 non-metastasized cases retrieved from the Munich Cancer Registry database were divided into three time periods corresponding to before (1988-1997), partial (1998-2007), and full implementation (2008-2019) of clinical advances. Early-onset (<50 yrs.), middle-aged, elderly patient subgroups (> 70 yrs.) were compared. The overall effectiveness of evidence-based guideline adherence was also examined. RESULTS Median survival improved by 1.5 yrs. from the first to the last time period. Relative survival increased from 74.9% (5-yr 95%CI[73.3 - 76.6]) to 79.2% (95%CI[77.8 - 80.5]). The incidence of locoregional recurrences was reduced dramatically by more than half (5-yr 17.7% (95%CI[16.5 - 18.8]); 6.7% (95%CI[6.1 - 7.3])). Gains in 5-yr relative survival were limited to early-onset and middle-aged patients with no significant improvement seen in elderly patients (Female 68.6% [63.9 - 73.3] to 67.6% [64.0 - 71.2]; Male 71.7% [65.9 - 77.4] to 74.0% [70.8 - 77.2]). CONCLUSIONS Real-world evidence suggests that recent treatment advances have lead to an increase in prognosis for rectal cancer patients. However, more effort should be made to improve the implementation of new developments in elderly patients. Especially considering, that these cases represent a growing majority of diagnosed patients.
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Affiliation(s)
- K Halfter
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany.
| | - G Schubert-Fritschle
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - F Röder
- Department of Radiotherapy and Radiation Oncology, Paracelsus Medical University Salzburg, Landeskrankenhaus, Müller Hauptstraße 48, 5020 Salzburg, Austria
| | - M Kim
- Department of Surgery, Clinic Munich-Neuperlach Hospital, Oskar-Maria-Graf-Ring 51, 81737 Munich, Germany
| | - J Werner
- Department of General, Visceral, and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - C Belka
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - H Wolff
- Department of Radiology, Nuclear Medicine and Radiotherapy, Radiology Munich, Burgstraße 7, 80331 Munich, Germany
| | - A Agha
- Department of General, Visceral, Endocrine and Minimal-Invasive Surgery, Clinic Munich-Bogenhausen, Englschalkinger Straße 77, 81925 Munich, Germany
| | - M Fuchs
- Department of Gastroenterology, Hepatology, and Gastrointestinal-Oncology, Clinic Munich-Bogenhausen, Englschalkinger Straße 77, 81925 Munich, Germany
| | - H Friess
- Department General Surgery, Klinikum rechts der Isar, Technical University Munich (TUM) School of Medicine, Ismaninger Straße 22, 81675 Munich, Germany
| | - S Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich (TUM) School of Medicine, Ismaninger Straße 22, 81675 Munich, Germany
| | - B Häussler
- Strahlentherapie Klinikum Harlaching, Sanatoriumsplatz 2, 81545 München, Germany
| | - J Engel
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - A Schlesinger-Raab
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
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Hölzel D, Halfter K, Schubert-Fritschle G, Engel J. Expanding mammography screening for women aged 40-80 years: evidence from a modeling approach using real-world data. Sci Rep 2023; 13:16229. [PMID: 37758770 PMCID: PMC10533880 DOI: 10.1038/s41598-023-42820-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
If a mammography screening program (MS) is to be expanded, the benefit must be demonstrated for each additional age cohort. For the age interval between 40 and 80 years, the association between tumor-related and tumor-independent mortality of 21 2-year cohorts is modeled using up-to-date, valid data to determine MS outcome. Disease trajectories with and without biennial MS are extrapolated for each age cohort using the available data and knowledge on MS. The competing mortality is randomly generated for each age cohort with and without MS for a follow-up period of 20 years. Analyses of the modeled cohorts describe incremental change for each year, quantifying the changing benefits of MS. With increasing age, the proportion of tumor-independent mortality before and with metastatic disease increases and the benefit decreases. The simulations with 21 studies on the age interval 40-80 years provide four parameters to determine the benefits and costs of MS: The number of prevented deaths, required mammography screening exams (MSE) and their costs, life-years gained, and the required MSEs. If one additional MSE is offered for age groups 48/70 years, this will result in 311/320 prevented breast cancer (BC) deaths with 1742/1494 required MSEs or 8784/4168 life-years gained with 64/140 required MSEs. A rational cutoff cannot be quantified. The mortality effect of MS between 40 and 80 years is quantified in 21 steps using two metrics, number of MSEs per tumor-related mortality prevented and per life-year gained. This provides a decision support for stepwise expansions. Given this real-world evidence no rational age cutoffs for MS becomes evident. A society has to decide which MS costs, including side effects of MS for women who remain BC-free, it is willing and able to accept in order to reduce breast cancer mortality.
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Affiliation(s)
- Dieter Hölzel
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians University Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Kathrin Halfter
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians University Munich, Marchioninistraße 15, 81377, Munich, Germany.
| | - Gabriele Schubert-Fritschle
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians University Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Jutta Engel
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians University Munich, Marchioninistraße 15, 81377, Munich, Germany
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Hallsson LR, Sroczynski G, Engel J, Siebert U. Decision-analytic evaluation of the comparative effectiveness and cost-effectiveness of strategies to prevent breast and ovarian cancer in German women with BRCA-1/2 mutations. BMC Cancer 2023; 23:590. [PMID: 37365514 DOI: 10.1186/s12885-023-10956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/13/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Women with inherited mutations in the BRCA1 or BRCA2 genes have increased lifetime risks for developing breast and/or ovarian cancer and may develop these cancers around the age of 30 years. Therefore, prevention of breast and ovarian cancer in these women may need to start relatively early in life. In this study we systematically evaluate the long-term effectiveness and cost effectiveness of different prevention strategies for breast and ovarian cancer in women with BRCA-1/2 mutation in Germany. METHODS A decision-analytic Markov model simulating lifetime breast and ovarian cancer development in BRCA-1/2 carriers was developed. Different strategies including intensified surveillance (IS), prophylactic bilateral mastectomy (PBM), and prophylactic bilateral salpingo-oophorectomy (PBSO) alone or in combination at different ages were evaluated. German clinical, epidemiological, and economic (in 2022 Euro) data were used. Outcomes included cancer incidences, mortality, life years (LYs), quality-adjusted life years (QALYs), and discounted incremental cost-effectiveness ratios (ICER). We adopted the German health-care system perspective and discounted costs and health effects with 3% annually. RESULTS All intervention strategies are more effective and less costly than IS alone. Prevention with PBM plus PBSO at age 30 maximizes life expectancy with 6.3 LYs gained, whereas PBM at age 30 with delayed PBSO at age 35 improves quality of life with 11.1 QALYs gained, when compared to IS alone. A further delay of PBSO was associated with lower effectiveness. Both strategies are cost effective with ICERs significantly below 10,000 EUR/LYG or QALY. CONCLUSION Based on our results, PBM at age 30 plus PBSO between age 30 and 40 prolongs life and is cost effective in women with BRCA-1/2 mutations in Germany. Serial preventive surgeries with delayed PBSO potentially improve quality of life for women. However, delaying PBM and/or PBSO further may lead to increased mortality and reduced QALYs.
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Affiliation(s)
- Lára R Hallsson
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Eduard-Wallnoefer-Zentrum 1, Hall in Tirol, A-6060, Austria
- Division of Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria
- IBE-Institute for Medical Informatics, Biometry and Epidemiology, LMU-Ludwig-Maximilians- University, Munich, Germany
| | - Gaby Sroczynski
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Eduard-Wallnoefer-Zentrum 1, Hall in Tirol, A-6060, Austria
| | - Jutta Engel
- MCR-Munich Cancer Registry, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians Universität (LMU), Munich, Germany
| | - Uwe Siebert
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Eduard-Wallnoefer-Zentrum 1, Hall in Tirol, A-6060, Austria.
- Division of Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria.
- Center for Health Decision Science, Departments of Epidemiology and Health Policy & Management, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
- Institute for Technology Assessment, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
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Wadle SL, Schmitt TTX, Engel J, Kurt S, Hirtz JJ. Altered population activity and local tuning heterogeneity in auditory cortex of Cacna2d3-deficient mice. Biol Chem 2023; 404:607-617. [PMID: 36342370 DOI: 10.1515/hsz-2022-0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022]
Abstract
The α2δ3 auxiliary subunit of voltage-activated calcium channels is required for normal synaptic transmission and precise temporal processing of sounds in the auditory brainstem. In mice its loss additionally leads to an inability to distinguish amplitude-modulated tones. Furthermore, loss of function of α2δ3 has been associated with autism spectrum disorder in humans. To investigate possible alterations of network activity in the higher-order auditory system in α2δ3 knockout mice, we analyzed neuronal activity patterns and topography of frequency tuning within networks of the auditory cortex (AC) using two-photon Ca2+ imaging. Compared to wild-type mice we found distinct subfield-specific alterations in the primary auditory cortex, expressed in overall lower correlations between the network activity patterns in response to different sounds as well as lower reliability of these patterns upon repetitions of the same sound. Higher AC subfields did not display these alterations but showed a higher amount of well-tuned neurons along with lower local heterogeneity of the neurons' frequency tuning. Our results provide new insight into AC network activity alterations in an autism spectrum disorder-associated mouse model.
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Affiliation(s)
- Simon L Wadle
- Physiology of Neuronal Networks, Department of Biology, University of Kaiserslautern, Erwin-Schrödinger-Straße 13, D-67663 Kaiserslautern, Germany
| | - Tatjana T X Schmitt
- Physiology of Neuronal Networks, Department of Biology, University of Kaiserslautern, Erwin-Schrödinger-Straße 13, D-67663 Kaiserslautern, Germany
| | - Jutta Engel
- Department of Biophysics, Saarland University, School of Medicine, Center for Integrative Physiology and Molecular Medicine (CIPMM), D-66421 Homburg, Germany
| | - Simone Kurt
- Department of Biophysics, Saarland University, School of Medicine, Center for Integrative Physiology and Molecular Medicine (CIPMM), D-66421 Homburg, Germany
| | - Jan J Hirtz
- Physiology of Neuronal Networks, Department of Biology, University of Kaiserslautern, Erwin-Schrödinger-Straße 13, D-67663 Kaiserslautern, Germany
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Guenther M, Surendran SA, Haas M, Heinemann V, von Bergwelt-Baildon M, Engel J, Werner J, Boeck S, Ormanns S. TPX2 expression as a negative predictor of gemcitabine efficacy in pancreatic cancer. Br J Cancer 2023:10.1038/s41416-023-02295-x. [PMID: 37142730 DOI: 10.1038/s41416-023-02295-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Targeting protein for Xenopus kinesin-like protein 2 (TPX2) overexpression in human tumours is associated with increased malignancy. Its effect on gemcitabine resistance in pancreatic ductal adenocarcinoma (PDAC) has not been studied yet. METHODS The prognostic impact of TPX2 expression was examined in the tumour tissue of 139 patients with advanced PDAC (aPDAC) treated within the AIO-PK0104 trial or translational trials and of 400 resected PDAC (rPDAC) patients. The findings were validated using RNAseq data of 149 resected PDAC patients. RESULTS In the aPDAC cohorts, 13.7% of all samples showed high TPX2 expression, conferring significantly shorter progression-free survival (PFS, HR 5.25, P < 0.001) and overall survival times (OS, HR 4.36, P < 0.001) restricted to gemcitabine-based treated patients (n = 99). In the rPDAC cohort, 14.5% of all samples showed high TPX2 expression, conferring significantly shorter disease-free survival times (DFS, HR 2.56, P < 0.001) and OS times (HR 1.56, P = 0.04) restricted to patients treated with adjuvant gemcitabine. RNAseq data from the validation cohort confirmed the findings. CONCLUSIONS High TPX2 expression may serve as a negative predictor of gemcitabine-based palliative and adjuvant chemotherapy in PDAC and could be used to inform clinical therapy decisions. CLINICAL TRIAL REGISTRY The clinical trial registry identifier is NCT00440167.
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Affiliation(s)
- Michael Guenther
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site, Munich, Germany
| | - Sai Agash Surendran
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Michael Haas
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Volker Heinemann
- German Cancer Consortium (DKTK), Partner Site, Munich, Germany
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Michael von Bergwelt-Baildon
- German Cancer Consortium (DKTK), Partner Site, Munich, Germany
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Munich Tumor Centre (TZM), Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Jens Werner
- Department of General, Visceral and Transplant Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Stefan Boeck
- German Cancer Consortium (DKTK), Partner Site, Munich, Germany
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Steffen Ormanns
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site, Munich, Germany.
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Halfter K, Schubert-Fritschle G, Klauschen F, Werner J, Mayerle J, Weichert W, Friess H, Schmid R, Kremer M, Ruppert R, Hoelzl J, Krenz D, Nerlich A, Agha A, Fuchs M, Becker I, Nowak K, Engel J, Schlesinger-Raab A. The other colon cancer: a population-based cohort study of appendix tumour trends and prognosis. Colorectal Dis 2023; 25:943-953. [PMID: 36748436 DOI: 10.1111/codi.16510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/16/2022] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
AIM Appendiceal neoplasms are rare subtypes of colorectal tumours that mainly affect younger patients some 20 years earlier than other colon tumours. The aim of this study was to gain more insight into the histological subtypes of this rare disease and include cases previously excluded, such as mucinous neoplasia. METHOD The cohort study included 1097 patients from the Munich Cancer Registry (MCR) diagnosed between 1998 and 2020. Joinpoint analysis was used to determine trend in incidence. Baseline demographic comparisons and survival analyses using competing risk and univariate/multivariate methods were conducted according to tumour histology: adenocarcinoma (ADENO), neuroendocrine neoplasia (NEN), mixed adeno-neuroendocrine carcinoma (MANEC), and low- (LAMN) and high-grade mucinous neoplasia (HAMN). RESULTS Up to 2016 the number of cases increased significantly [annual per cent change (APC) = 6.86, p < 0.001] followed by a decline in the following years (APC = -14.82, p = 0.014; average APC = 2.5, p = 0.046). Comparison of all patients showed that NEN (48.4%) and mucinous neoplasms (11.6%) had a considerably better prognosis than ADENO (36.0%) and MANEC (3.0%, p < 0.0001). A multivariate analysis within the NEN and ADENO subgroups revealed that further histological classification was not prognostically relevant, while older age and regional tumour spread at diagnosis were associated with a poor prognosis. ADENO histology with high tumour grade and appendectomy only was also associated with poorer survival. CONCLUSION Appendiceal neoplasms are histologically heterogeneous; however, this diversity becomes less relevant compared with the marked difference from cancers of the remaining colon. The previously observed increase in cases appears to be abating; fewer cases of appendicitis and/or appendectomies or changes in histopathological assessment may be behind this trend.
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Affiliation(s)
- Kathrin Halfter
- Munich Cancer Registry (MCR) at the Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Gabriele Schubert-Fritschle
- Munich Cancer Registry (MCR) at the Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Frederick Klauschen
- Institute of Pathology, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Jens Werner
- Department of General, Visceral and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Julia Mayerle
- Department of Internal Medicine II, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Wilko Weichert
- Institute of Pathology, Technical University Munich (TUM), Munich, Germany
| | - Helmut Friess
- Department of General Surgery, Klinikum rechts der Isar, Technical University Munich (TUM) School of Medicine, Munich, Germany
| | - Roland Schmid
- Department of Internal Medicine II, University Hospital, Technical University Munich (TUM), Munich, Germany
| | - Marcus Kremer
- Institute of Pathology, Clinic Munich-Neuperlach, Munich, Germany
| | - Reinhard Ruppert
- Department of Surgery, Clinic Munich-Neuperlach Hospital, Munich, Germany
| | | | - Detlef Krenz
- Department of General, Vascular, Thyroid and Thorax Surgery, Hospital Dritter Orden, Munich, Germany
| | - Andreas Nerlich
- Institute of Pathology, Clinic Munich-Bogenhausen, Munich, Germany
| | - Ayman Agha
- Department of General, Visceral, Endocrine and Minimal-Invasive Surgery, Clinic Munich-Bogenhausen, Munich, Germany
| | - Martin Fuchs
- Department of Gastroenterology, Hepatology and Gastrointestinal-Oncology, Clinic Munich-Bogenhausen, Munich, Germany
| | | | - Kai Nowak
- Department of General, Vascular and Thorax Surgery, Clinic Rosenheim, Rosenheim, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR) at the Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Anne Schlesinger-Raab
- Munich Cancer Registry (MCR) at the Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Munich, Germany
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9
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Guenther M, Boeck S, Heinemann V, Werner J, Engel J, Ormanns S. The impact of adjuvant therapy on outcome in UICC stage I pancreatic cancer. Int J Cancer 2022; 151:914-919. [PMID: 35467760 DOI: 10.1002/ijc.34044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/01/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/06/2022]
Abstract
Adjuvant chemotherapy has become standard of care for pancreatic ductal adenocarcinoma (PDAC) as it improves patient outcome. However, its clinical meaning in early-stage, UICC I tumors remains uncertain. We examined the effect of adjuvant therapy on disease-free survival (DFS) and overall survival (OS) of UICC stage I PDAC patients treated at an academic tertiary care center between 2000 and 2016. Among 124 patients (69 male, 55 female; median age 68 years, range 41-84 years) with UICC stage I disease, adjuvant therapy improved both DFS (19.8 vs 12.8 months, HR 0.59, 95% CI: 0.37-0.94, P = .03) and OS (40.9 vs 20.3 months, HR 0.54, 95% CI: 0.35-0.84, P = .005). Multivariate analyses and propensity score matching confirmed the prognostic impact of adjuvant therapy independent of localization, differentiation and R-status. Thus, every patient with UICC I PDAC should receive adjuvant chemotherapy as it may improve outcome significantly. Our findings support the concept of PDAC as systemic disease from early stages on.
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Affiliation(s)
- Michael Guenther
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Stefan Boeck
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Volker Heinemann
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Jens Werner
- Department of General, Visceral and Transplant Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Munich Tumor Centre (TZM), Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Steffen Ormanns
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
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10
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Foersch S, Lang-Schwarz C, Eckstein M, Geppert C, Schmitt M, Konukiewitz B, Groll T, Schicktanz F, Engel J, Gleitsmann M, Westhoff CC, Frickel N, Litmeyer AS, Grass A, Jank P, Lange S, Tschurtschenthaler M, Wilhelm D, Roth W, Vieth M, Denkert C, Nagtegaal I, Weichert W, Jesinghaus M. pT3 colorectal cancer revisited: a multicentric study on the histological depth of invasion in more than 1000 pT3 carcinomas-proposal for a new pT3a/pT3b subclassification. Br J Cancer 2022; 127:1270-1278. [PMID: 35864156 PMCID: PMC9519960 DOI: 10.1038/s41416-022-01889-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background Pathological TNM staging (pTNM) is the strongest prognosticator in colorectal carcinoma (CRC) and the foundation of its post-operative clinical management. Tumours that invade pericolic/perirectal adipose tissue generally fall into the pT3 category without further subdivision. Methods The histological depth of invasion into the pericolic/perirectal fat was digitally and conventionally measured in a training cohort of 950 CRCs (Munich). We biostatistically calculated the optimal cut-off to stratify pT3 CRCs into novel pT3a (≤3 mm)/pT3b (>3 mm) subgroups, which were then validated in two independent cohorts (447 CRCs, Bayreuth/542 CRCs, Mainz). Results Compared to pT3a tumours, pT3b CRCs showed significantly worse disease-specific survival, including in pN0 vs pN+ and colonic vs. rectal cancers (DSS: P < 0.001, respectively, pooled analysis of all cohorts). Furthermore, the pT3a/pT3b subclassification remained an independent predictor of survival in multivariate analyses (e.g. DSS: P < 0.001, hazard ratio: 4.41 for pT3b, pooled analysis of all cohorts). While pT2/pT3a CRCs showed similar survival characteristics, pT3b cancers remained a distinct subgroup with dismal survival. Discussion The delineation of pT3a/pT3b subcategories of CRC based on the histological depth of adipose tissue invasion adds valuable prognostic information to the current pT3 classification and implementation into current staging practices of CRC should be considered.
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Affiliation(s)
| | - Corinna Lang-Schwarz
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
| | - Markus Eckstein
- Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - Carol Geppert
- Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - Maxime Schmitt
- Institute of Pathology, Technical University of Munich, Munich, Germany.,Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Björn Konukiewitz
- Institute of Pathology, Christian-Albrechts University, Kiel, Germany
| | - Tanja Groll
- Institute of Pathology, Technical University of Munich, Munich, Germany
| | - Felix Schicktanz
- Institute of Pathology, Technical University of Munich, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Moritz Gleitsmann
- Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Christina C Westhoff
- Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Nadine Frickel
- Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Anne-Sophie Litmeyer
- Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Albert Grass
- Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Paul Jank
- Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Sebastian Lange
- II Medizinische Klinik, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Markus Tschurtschenthaler
- II Medizinische Klinik, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.,Institute for Translational Cancer Research, German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Dirk Wilhelm
- Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Wilfried Roth
- Institute of Pathology, University Medical Center, Mainz, Germany
| | - Michael Vieth
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
| | - Carsten Denkert
- Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Iris Nagtegaal
- Department of Pathology, Radboudumc, Nijmegen, The Netherlands
| | - Wilko Weichert
- Institute of Pathology, Technical University of Munich, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.,Bavarian Cancer Center (BZKF), Munich, Germany.,Comprehensive Cancer Center Munich (CCCM), Munich, Germany
| | - Moritz Jesinghaus
- Institute of Pathology, Technical University of Munich, Munich, Germany. .,Institute of Pathology, Philipps University Marburg and University Hospital Marburg (UKGM), Marburg, Germany.
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11
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Hölzel D, Schubert-Fritschle G, Engel J. Estimation of the Risk of Progression of Breast Cancer After the COVID-19 Lockdown. Dtsch Arztebl Int 2022; 119:368-369. [PMID: 36017987 DOI: 10.3238/arztebl.m2022.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/14/2021] [Accepted: 03/10/2022] [Indexed: 06/15/2023]
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12
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Guenther M, Gil L, Surendran SA, Palm MA, Heinemann V, von Bergwelt-Baildon M, Mayerle J, Engel J, Werner J, Boeck S, Ormanns S. Bacterial Lipopolysaccharide as a Negative Predictor of Adjuvant Gemcitabine Efficacy in Pancreatic Cancer. JNCI Cancer Spectr 2022; 6:pkac039. [PMID: 35587155 PMCID: PMC9219162 DOI: 10.1093/jncics/pkac039] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/01/2022] [Accepted: 05/02/2022] [Indexed: 11/21/2022] Open
Abstract
Adjuvant gemcitabine (aGC) is one standard of care after pancreatic ductal adenocarcinoma (PDAC) resection. No biomarker for its efficacy is established. As bacteria mediate gemcitabine resistance, we analyzed whether lipopolysaccharide (LPS) as surrogate for bacterial colonization is prognostic in PDAC patients treated with aGC or without aGC adjuvant gemcitabine. We detected LPS in 86 tumors from 376 patients, which defined a specific microbiome as revealed by 16 s-rRNA-sequencing. In the 230 aGC patients, LPS conferred worse disease-free survival (8.3 vs 13.7 months; hazard ratio = 1.75, 95% confidence interval = 1.22 to 2.49; log-rank P = .002) and overall survival (21.7 vs 28.5 months; hazard ratio = 1.80, 95% confidence interval = 1.23 to 2.57; log-rank P = .001) but not in the 146 naGC patients, which was confirmed in an independent validation cohort (n = 178). LPS may serve as a negative predictor for aGC efficacy in PDAC, which suggests a role for microbiome modification to overcome bacteria-mediated chemotherapy resistance.
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Affiliation(s)
- Michael Guenther
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Lina Gil
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Sai Agash Surendran
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Melanie Alexandra Palm
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Volker Heinemann
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig- Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), partner site, Munich, Germany
| | - Michael von Bergwelt-Baildon
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig- Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), partner site, Munich, Germany
| | - Julia Mayerle
- Department of Internal Medicine II, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Munich Tumor Centre (TZM), Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Jens Werner
- Department of General, Visceral and Transplant Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Stefan Boeck
- Department of Internal Medicine III, Grosshadern University Hospital, Ludwig- Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), partner site, Munich, Germany
| | - Steffen Ormanns
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), partner site, Munich, Germany
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13
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Perera F, Baldassarre F, Eisen A, Dayes I, Engel J, Cil T, Kornecki A, George R, SenGupta S, Brackstone M. A systematic review of axillary nodal irradiation for the management of the axilla in patients with early-stage breast cancer. Surg Oncol 2022; 42:101754. [DOI: 10.1016/j.suronc.2022.101754] [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] [Received: 12/09/2021] [Revised: 02/14/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
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14
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Chin Koon Siw K, Engel J, Visva S, Mallick R, Hart A, de Buck van Overstraeten A, McCurdy J. A153 STRATEGIES TO DISTINGUISH PERIANAL FISTULAS RELATED TO CROHN’S DISEASE FROM CRYPTOGLANDULAR DISEASE: SYSTEMATIC REVIEW WITH META-ANALYSIS. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859239 DOI: 10.1093/jcag/gwab049.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Differentiating between perianal fistulas related to cryptoglandular disease (CGD) and Crohn’s disease (CD) is essential to guide disease specific management.
Aims
We aimed to assess the ability of diagnostic strategies to differentiate between CD from CGD in patients with perianal fistulas.
Methods
We performed a diagnostic accuracy systematic review and meta-analysis. Electronic databases (MEDLINE, Embase, Web of Science, CENTRAL) were systematically searched from inception through February 2021 for studies that assessed a diagnostic test’s ability to distinguish fistula types. We calculated weighted summary estimates with 95% confidence intervals for sensitivity and specificity by bivariate analysis, using fixed effects models when data was available from two or more studies. The QUADAS tool was used to assess study quality.
Results
Twenty-one studies were identified and included: clinical symptoms (2 studies; n = 154 patients), MRI characteristics (3 studies; n = 296 patients), ultrasound characteristics (7 studies; n = 1003 patients), video capsule endoscopy (2 studies; n = 44 patients), fecal calprotectin (1 study; n = 56 patients) and various biomarkers (8 studies; n = 440 patients). MRI and ultrasound characteristics had the most robust data. Rectal inflammation, multiple-branched fistula tracts and abscesses on pelvic MRI, and the Crohn’s Ultrasound Fistula Sign, fistula debris and bifurcated fistulas on pelvic ultrasonography had high specificity (range, 80–95% vs. 89–96%) but poor sensitivity (range, 17–37% vs. 31–63%), respectively. Fourteen of twenty-one studies had risk of bias on at least one of the QUADAS domains.
Conclusions
Limited high-quality evidence suggest that imaging characteristics may help discriminate CD from CGD in patients with perianal fistulas. Larger, prospective studies are needed to confirm these findings and to evaluate if combining multiple diagnostic tests can improve diagnostic sensitivity.
Funding Agencies
None
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Affiliation(s)
- K Chin Koon Siw
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - J Engel
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - S Visva
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - R Mallick
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - A Hart
- IBD Unit, St Mark’s Hospital, Harrow, London, United Kingdom
| | | | - J McCurdy
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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15
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Icheva V, Ebert J, Budde U, Wiegand G, Schober S, Engel J, Kumpf M, Jaschonek K, Neunhoeffer F, Michel J, Schlensak C, Hofbeck M, Magunia H. Acquired von Willebrand's Syndrome in Congenital Heart Disease. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- V. Icheva
- Universtiy Childrens' Hospital Tübingen, Tübingen, Deutschland
| | - J. Ebert
- Faculty of Medicine, Eberhard Karls University, Tübingen, Deutschland
| | - U. Budde
- cMEDILYS Coagulation Lab mbH, Hamburg, Deutschland
| | - G. Wiegand
- Department of Pediatric Cardiology, University of Tuebingen, Tuebingen, Deutschland
| | - S. Schober
- Universtiy Childrens' Hospital Tübingen, Tübingen, Deutschland
| | - J. Engel
- Department of Pediatric Cardiology, University Childrens' Hospital Tübingen, Tuebingen, Deutschland
| | - M. Kumpf
- Department of Pediatric Cardiology, University of Tuebingen, Tuebingen, Deutschland
| | - K. Jaschonek
- Department of Medical Oncology and Pneumology (Internal Medicine VIII), University Hospital Tübingen, Tuebingen, Deutschland
| | - F. Neunhoeffer
- Abteilung für Kinderkardiologie, Pulmologie, Intensivmedizin, Tübingen, Deutschland
| | - J. Michel
- Department of Pediatric Cardiology, University Childrens' Hospital Tübingen, Tuebingen, Deutschland
| | | | - M. Hofbeck
- Hoppe-Seyler-Str. 1, Tübingen, Deutschland
| | - H. Magunia
- Department of Anesthesiology and Intensive Care Medicine, Tübingen, Germany
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16
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Abstract
In the Dutch nursing context, work remains in strengthening the voice of nurses serving as frontline health care providers and board members alike. Conceptual clarity of Public Opinion Leadership (POL) in nursing practice is needed to provide attributes, antecedents and consequences for nurses and nurse leaders so they can contribute in the public debate and policy making processes. Using Rodgers’ method of evolutionary concept analysis and the key words “POL,” “lobbying” and “public affairs,” we searched PubMed (including MEDLINE), CINAHL, PsycINFO and Cochrane Library for articles written in English, published between January 1999 and May 2020, which resulted in a final selection of seven studies. In addition, transcripts of an expert panel discussion regarding POL were analyzed. Attributes of POL are credibility, accessibility, altruism, dynamic networking and sense of systemness. Antecedents are a clinical background, authentic authority, policy and political awareness and strategic skills. The main consequences of POL entail influencing those who are involved in policy making processes, a new generation of public opinion leaders, and the raising of bottom-up political leaders. POL is a relatively new concept for nursing, with increasing interest given the need to ensure quality of care by increasing the use of evidence in clinical practice. POL in nursing practice is defined as the action of influencing public debate regarding policy making processes by maintaining dynamic (social) networks, having a high sense of systemness, and being (clinically) credible, altruistic and accessible to peers and a wide variety of stakeholders.
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Affiliation(s)
- M van Wijk
- 8119HU University of Applied Sciences, Utrecht, The Netherlands
| | - P C B Lalleman
- 3158University of Alberta, Edmonton, Canada.,3158Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | | | - J Engel
- 8119HU University of Applied Sciences, Utrecht, The Netherlands
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17
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Hallsson LR, Sroczynski G, Engel J, Siebert U. Prevention of breast&ovarian cancer in women with BRCA-1/2 mutations - A decision-analytic evaluation. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Women who have inherited BRCA-1/2 mutations have substantially elevated lifetime risks for developing breast and/or ovarian cancer and may develop these cancers around age 30. Therefore, breast and ovarian cancer prevention should be administered relatively early in life for those women. We systematically evaluate the long-term effectiveness and cost-effectiveness of different breast and ovarian cancer prevention strategies in women with BRCA-1/2 mutations in Germany.
Methods
A decision-analytic Markov model simulating lifetime breast and ovarian cancer development in BRCA-1/2 carriers was developed to evaluate different strategies including intensified surveillance (IS), prophylactic bilateral mastectomy (PBM), and prophylactic bilateral oophorectomy (PBSO) alone or in combination at different ages. German clinical, epidemiological and cost (in 2018 Euro) data were used. Outcomes included cancer incidences, mortality, life years (LYs), quality-adjusted life years (QALYs), and discounted incremental cost-effectiveness ratios (ICER).
Results
All intervention strategies are more effective and less costly than IS alone. Prevention with PBM plus PBSO at age 30 maximizes life expectancy with 6.3 LYs gained, whereas PBM at age 30 with delayed PBSO at age 35 improves quality of life with 11.1 QALYs gained, when compared to IS alone. Both strategies are cost effective with ICER significantly below 10,000 EUR/LY or QALY gained.
Conclusions
Based on our results, PBM at age 30 plus PBSO between age 30 and 40 prolongs life and is cost effective in women with BRCA-1/2 mutations in Germany. Serial preventive surgeries with delayed PBSO potentially improve quality of life for women. We therefore suggest that efforts should be directed to carefully and thoroughly inform women with BRCA-1/2 mutations about their options to prevent breast and ovarian cancer.
Key messages
Prophylactic mastectomy at age 30 combined with prophylactic oophorectomy between age 30 and 40 may prolong lives and be cost effective in German women with BRCA- 1/2 mutations. Women’s quality of life might be improved by a delayed prophylactic oophorectomy after a prophylactic mastectomy.
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Affiliation(s)
- LR Hallsson
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Division of Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria
- IBE-Institute for Medical Informatics, Biometry and Epidemiology, LMU-Ludwig-Maximilians-University, Munich, Germany
| | - G Sroczynski
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - J Engel
- MCR-Munich Cancer Registry of the TZM-Munich Tumour Centre at the IBE-Institute for Medical Information Processing, Biometry and Epidemiology, LMU-Ludwig-Maximilians-University, Munich, Germany
| | - U Siebert
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Harvard Chan School of Public Health, Center for Health Decision Science, Departments of Epidemiology and Health Policy & Management, Boston, MA, USA
- Harvard Medical School, Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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18
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Schrodi S, Braun M, Andrulat A, Harbeck N, Mahner S, Kiechle M, Klein E, Schnelzer A, Schindlbeck C, Bauerfeind I, Schubert-Fritschle G, Nekljudova V, Mayr D, Weichert W, Denkert C, Loibl S, Engel J. Outcome of breast cancer patients with low hormone receptor positivity: analysis of a 15-year population-based cohort. Ann Oncol 2021; 32:1410-1424. [PMID: 34419555 DOI: 10.1016/j.annonc.2021.08.1988] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/08/2021] [Accepted: 08/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Guideline recommendations for the treatment of breast cancer with low hormone receptor (HR) expression (1%-9%) are ambiguous and several studies showed more similarities with HR-negative tumors than with HR strongly positive tumors (≥10%). We used a population-based 15-year cohort to compare patient characteristics and outcome of HR low positive tumors with HR-negative and HR strongly positive tumors, respectively. PATIENTS AND METHODS A total of 38 560 women diagnosed with early invasive breast cancer between 2004 and 2018 within the scope of the Munich Cancer Registry with 4.9 million inhabitants were included. Descriptive analyses of prognostic factors, treatment, and outcome analyses using the Kaplan-Meier method; cumulative incidence in consideration of competing risks; and multivariate analyses (Cox regression and Fine-Gray model) were conducted. Endpoints were time to local recurrence (TTLR), time to lymph node recurrence (TTLNR), time to metastasis (TTM), overall survival (OS), and relative survival (RS). RESULTS A total of 861 patients (2%) had HR low positive, 4862 (13%) HR-negative, and 32 837 (85%) HR strongly positive tumors. Within the HER2-negative cohort (n = 33 366), survival of HR low positive tumors was significantly worse than that of HR strongly positive tumors [OS hazard ratio 0.66 (95% confidence interval 0.55-0.78)], whereas between HR low positive and HR-negative tumors no significant survival difference could be detected [OS hazard ratio 0.93 (95% confidence interval 0.78-1.11)]. TTLR, TTLNR, and TTM showed similar results. By contrast, within the HER2-positive cohort (n = 5194), no statistically significant differences between the three HR groups could be detected in multivariate analyses. CONCLUSION Current definitions for HR positivity and its clinical relevance should be reconsidered. Patients with HR low positive/HER2-negative tumors could be regarded and treated similar to patients with triple-negative tumors.
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Affiliation(s)
- S Schrodi
- Munich Cancer Registry (MCR) at the Institute of Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Bavarian Cancer Registry - Regional Centre Munich, Bavarian Health and Food Safety Authority (LGL), Munich, Germany.
| | - M Braun
- Department of Gynecology and Obstetrics, Breast Centre, Red Cross Hospital, Munich, Germany
| | - A Andrulat
- Department of Gynecology and Obstetrics, Breast Centre, Red Cross Hospital, Munich, Germany
| | - N Harbeck
- Department of Obstetrics and Gynecology and Breast Centre, University Hospital, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - S Mahner
- Department of Obstetrics and Gynecology and Breast Centre, University Hospital, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - M Kiechle
- Department of Gynecology and Obstetrics, Breast Centre, University Hospital, Technical University Munich (TUM), Munich, Germany
| | - E Klein
- Department of Gynecology and Obstetrics, Breast Centre, University Hospital, Technical University Munich (TUM), Munich, Germany
| | - A Schnelzer
- Department of Obstetrics and Gynecology, Breast Centre, RoMed Kliniken, Rosenheim, Germany
| | - C Schindlbeck
- Department of Obstetrics and Gynecology and Breast Centre, University Hospital, Ludwig-Maximilians-University Munich (LMU), Munich, Germany; Department of Gynecology and Obstetrics, Breast Centre, Klinikum Traunstein, Traunstein, Germany
| | - I Bauerfeind
- Department of Gynecology and Obstetrics, Breast Centre, Klinikum Landshut, Landshut, Germany
| | - G Schubert-Fritschle
- Munich Cancer Registry (MCR) at the Institute of Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Bavarian Cancer Registry - Regional Centre Munich, Bavarian Health and Food Safety Authority (LGL), Munich, Germany
| | - V Nekljudova
- German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany
| | - D Mayr
- Department of Pathology, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - W Weichert
- Institute of Pathology, Technical University Munich (TUM), Munich, Germany
| | - C Denkert
- Department of Pathology, University Hospital Marburg (UKGM), Philipps-University Marburg, Marburg, Germany
| | - S Loibl
- German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; Centre for Haematology and Oncology Bethanien, Frankfurt, Germany
| | - J Engel
- Munich Cancer Registry (MCR) at the Institute of Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Bavarian Cancer Registry - Regional Centre Munich, Bavarian Health and Food Safety Authority (LGL), Munich, Germany
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19
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Novario S, Gysbers P, Engel J, Hagen G, Jansen GR, Morris TD, Navrátil P, Papenbrock T, Quaglioni S. Coupled-Cluster Calculations of Neutrinoless Double-β Decay in ^{48}Ca. Phys Rev Lett 2021; 126:182502. [PMID: 34018796 DOI: 10.1103/physrevlett.126.182502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/15/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
We use coupled-cluster theory and nuclear interactions from chiral effective field theory to compute the nuclear matrix element for the neutrinoless double-β decay of ^{48}Ca. Benchmarks with the no-core shell model in several light nuclei inform us about the accuracy of our approach. For ^{48}Ca we find a relatively small matrix element. We also compute the nuclear matrix element for the two-neutrino double-β decay of ^{48}Ca with a quenching factor deduced from two-body currents in recent ab initio calculation of the Ikeda sum rule in ^{48}Ca [Gysbers et al., Nat. Phys. 15, 428 (2019)NPAHAX1745-247310.1038/s41567-019-0450-7].
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Affiliation(s)
- S Novario
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - P Gysbers
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - J Engel
- Department of Physics, University of North Carolina, Chapel Hill, North Carolina 27514, USA
| | - G Hagen
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - G R Jansen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - T D Morris
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - P Navrátil
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - T Papenbrock
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S Quaglioni
- Lawrence Livermore National Laboratory, P.O. Box 808, L-414, Livermore, California 94551, USA
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20
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Villegas SL, Nekljudova V, Pfarr N, Engel J, Untch M, Schrodi S, Holms F, Ulmer HU, Fasching PA, Weber KE, Albig C, Heinrichs C, Marmé F, Hartmann A, Hanusch C, Schmitt WD, Huober J, Lederer B, van Mackelenbergh M, Tesch H, Jackisch C, Rezai M, Sinn P, Sinn BV, Hackmann J, Kiechle M, Schneeweiss A, Weichert W, Denkert C, Loibl S. Therapy response and prognosis of patients with early breast cancer with low positivity for hormone receptors - An analysis of 2765 patients from neoadjuvant clinical trials. Eur J Cancer 2021; 148:159-170. [PMID: 33743484 DOI: 10.1016/j.ejca.2021.02.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/08/2021] [Accepted: 02/13/2021] [Indexed: 12/11/2022]
Abstract
AIM To evaluate HER2-negative breast cancer (BC) with a low hormone receptor (HR) expression, with regard to pathological complete response (pCR) and survival, in comparison to triple-negative BC (TNBC) and strong HR-positive BC. METHODS We compared negative [oestrogen (ER) and progesterone receptor (PR) <1%], low-positive (ER and/or PR 1-9%) and strong-positive (ER or PR 10-100%) HR-expression in neoadjuvant clinical trial cohorts (n = 2765) of BC patients. End-points were disease-free survival (DFS), distant-disease free survival (DDFS) and overall survival (OS). We performed RNA sequencing on available tumour tissue samples from patients with low-HR expression (n = 38). RESULTS Ninety-four (3.4%) patients had low HR-positive tumours, 1769 (64.0%) had strong HR-positive tumours, and 902 (32.6%) had TNBC. There were no significant differences in pCR rates between women with low HR-positive tumours (27.7%) and women with TNBC (35.5%). DFS and DDFS were also not different [for DFS, hazard ratio 1.26, 95%-CI (confidence interval) : 0.87-1.83, log-rank test p = 0.951; for DDFS, hazard ratio 1.17, 95%-CI: 0.78-1.76, log-rank test p = 0.774]. Patients with strong HR-positive tumours had a significantly lower pCR rate (pCR 9.4%; odds ratio 0.38, 95%-CI: 0.23-0.63), but better DFS (hazard ratio 0.48, 95%-CI: 0.33-0.70) and DDFS (hazard ratio 0.49, 95%-CI: 0.33-0.74) than patients with low HR-positive tumours. Molecular subtyping (RNA sequencing) of low HR-positive tumours classified these predominantly into a basal subtype (86.8%). CONCLUSION Low HR-positive, HER2-negative tumours have a similar clinical behaviour to TNBC showing high pCR rates and poor survival and also a basal-like gene expression signature. Patients with low HR-positive tumours should be regarded as candidates for therapy strategies targeting TNBC.
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Affiliation(s)
- Sonia L Villegas
- Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | | | - Nicole Pfarr
- Institute of General and Surgical Pathology of the Technical University of Munich, Technische Universität München, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Bavarian Cancer Registry - Regional Centre Munich (LGL) at the University Hospital of Munich, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Michael Untch
- Breast Cancer Center, HELIOS Klinikum, Berlin, Germany
| | - Simone Schrodi
- Munich Cancer Registry (MCR), Bavarian Cancer Registry - Regional Centre Munich (LGL) at the University Hospital of Munich, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Munich, Germany
| | | | | | - Peter A Fasching
- Department of Gynecology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Karsten E Weber
- German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany
| | - Christian Albig
- Institute of General and Surgical Pathology of the Technical University of Munich, Technische Universität München, Munich, Germany
| | | | - Frederik Marmé
- Department of Gynecology, University Hospital Mannheim, Mannheim, Germany
| | - Arndt Hartmann
- Institute of Pathology, University of Erlangen-Nürnberg, Erlangen, Germany
| | | | - Wolfgang D Schmitt
- Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Jens Huober
- Department of Gynecology, University of Ulm, Ulm, Germany
| | - Bianca Lederer
- German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany
| | | | - Hans Tesch
- Oncology Practice at Bethanien Hospital Frankfurt, Frankfurt, Germany
| | | | | | - Peter Sinn
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Bruno V Sinn
- Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - John Hackmann
- Department of Gynecology, Marien Hospital Witten, Witten, Germany
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Munich (CCCM), Klinikum Rechts der Isar, Technical University Munich (TUM), Munich, Germany
| | - Andreas Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Universität Heidelberg, Heidelberg, Germany
| | - Wilko Weichert
- Institute of General and Surgical Pathology of the Technical University of Munich, Technische Universität München, Munich, Germany
| | - Carsten Denkert
- Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany; Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Sibylle Loibl
- German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany.
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21
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Thurmaier J, Heinemann V, Engel J, Schubert-Fritschle G, Wiedemann M, Nüssler NC, Ruppert R, Kleeff J, Schepp W, Löhe F, Karthaus M, Neumann J, Kumbrink J, Taverna F, Stahler A, Heinrich K, Westphalen CB, Holch JW, Kirchner T, Michl M. Patients with colorectal cancer and brain metastasis: The relevance of extracranial metastatic patterns predicting time intervals to first occurrence of intracranial metastasis and survival. Int J Cancer 2020; 148:1919-1927. [PMID: 33113215 DOI: 10.1002/ijc.33364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/15/2020] [Accepted: 09/22/2020] [Indexed: 01/20/2023]
Abstract
The aim of the study was to investigate the predictive impact of extracranial metastatic patterns on course of disease and survival in patients with colorectal cancer (CRC) and brain metastasis (BM). A total of 228 patients (134 male [59%], 94 female [41%]) with histologically proven CRC and BM were classified into different groups according to extracranial metastatic patterns. Time intervals to metastatic events and survival times from initial CRC diagnosis, extracranial and intracranial metastasis were analyzed. Extracranial organs mostly affected were liver (102 of 228 [44.7%]) and lung (96 of 228 [42.1%]). Liver and lung metastases were detected in 31 patients (13.6%). Calculated over the entire course of disease, patients with lung metastasis showed longer overall survival (OS) than patients with liver metastasis or patients without lung metastasis (43.9 vs 34.6 [P = .002] vs 35.0 months [P = .002]). From the date of initial CRC diagnosis, lung metastasis occurred later in CRC history than liver metastasis (24.3 vs 7.5 months). Once lung metastasis was diagnosed, BM occurred faster than in patients with liver metastasis (15.8 vs 26.0 months; Δ 10.2 months). Accordingly, OS from the diagnosis of liver metastasis was longer than from lung metastasis (27.1 vs 19.6 months [P = .08]). Once BM was present, patients with lung metastasis lived longer than patients with liver metastasis (3.8 vs 1.1 months [P = .028]). Shortest survival times in all survival categories analyzed revealed patients with concurrent liver and lung metastasis. Patients with CRC and BM form a heterogeneous cohort where extracranial metastasis to liver or lungs predicts survival.
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Affiliation(s)
- Johannes Thurmaier
- Department of General Pediatrics, Ostschweizer Kinderspital, St. Gallen, Switzerland
| | - Volker Heinemann
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Ludwig-Maximilians-University of Munich, Munich, Germany.,Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University of Munich, Germany
| | - Gabriele Schubert-Fritschle
- Munich Cancer Registry (MCR), Ludwig-Maximilians-University of Munich, Munich, Germany.,Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University of Munich, Germany
| | - Max Wiedemann
- Munich Cancer Registry (MCR), Ludwig-Maximilians-University of Munich, Munich, Germany.,Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University of Munich, Germany
| | | | - Reinhard Ruppert
- Department of Surgery, München Klinik Neuperlach, Munich, Germany
| | - Jörg Kleeff
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Germany
| | - Wolfgang Schepp
- Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, München Klinik Bogenhausen, Munich, Germany
| | - Florian Löhe
- Department of Surgery, Klinikum Landshut, Landshut, Germany
| | - Meinolf Karthaus
- Department of Hematology, Oncology and Palliative Care, München Klinik Harlaching and Neuperlach, Munich, Germany
| | - Jens Neumann
- German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany.,Institute of Pathology, Ludwig-Maximilians-University of Munich, Germany
| | - Jörg Kumbrink
- German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany.,Institute of Pathology, Ludwig-Maximilians-University of Munich, Germany
| | - Francesco Taverna
- Institute of Pathology, Ludwig-Maximilians-University of Munich, Germany
| | - Arndt Stahler
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Kathrin Heinrich
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Christoph Benedikt Westphalen
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Julian W Holch
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Thomas Kirchner
- German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany.,Institute of Pathology, Ludwig-Maximilians-University of Munich, Germany
| | - Marlies Michl
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK); German Cancer Research Centre (DKFZ), Heidelberg, Germany
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22
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Gambacurta D, Grasso M, Engel J. Gamow-Teller Strength in ^{48}Ca and ^{78}Ni with the Charge-Exchange Subtracted Second Random-Phase Approximation. Phys Rev Lett 2020; 125:212501. [PMID: 33274967 DOI: 10.1103/physrevlett.125.212501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/29/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
We develop a fully self-consistent subtracted second random-phase approximation for charge-exchange processes with Skyrme energy-density functionals. As a first application, we study Gamow-Teller excitations in the doubly magic nucleus ^{48}Ca, the lightest double-β emitter that could be used in an experiment, and in ^{78}Ni, the single-beta-decay rate of which is known. The amount of Gamow-Teller strength below 20 or 30 MeV is considerably smaller than in other energy-density-functional calculations and agrees better with experiment in ^{48}Ca, as does the beta-decay rate in ^{78}Ni. These important results, obtained without ad hoc quenching factors, are due to the presence of two-particle-two-hole configurations. Their density progressively increases with excitation energy, leading to a long high-energy tail in the spectrum, a fact that may have implications for the computation of nuclear matrix elements for neutrinoless double-β decay in the same framework.
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Affiliation(s)
- D Gambacurta
- INFN-LNS, Laboratori Nazionali del Sud, 95123 Catania, Italy
| | - M Grasso
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - J Engel
- Department of Physics and Astronomy, CB 3255, University of North Carolina, Chapel Hill, North Carolina 27599-3255, USA
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23
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Yao JM, Bally B, Engel J, Wirth R, Rodríguez TR, Hergert H. Ab Initio Treatment of Collective Correlations and the Neutrinoless Double Beta Decay of ^{48}Ca. Phys Rev Lett 2020; 124:232501. [PMID: 32603157 DOI: 10.1103/physrevlett.124.232501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/04/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
Working with Hamiltonians from chiral effective field theory, we develop a novel framework for describing arbitrary deformed medium-mass nuclei by combining the in-medium similarity renormalization group with the generator coordinate method. The approach leverages the ability of the first method to capture dynamic correlations and the second to include collective correlations without violating symmetries. We use our scheme to compute the matrix element that governs the neutrinoless double beta decay of ^{48}Ca to ^{48}Ti, and find it to have the value 0.61, near or below the predictions of most phenomenological methods. The result opens the door to ab initio calculations of the matrix elements for the decay of heavier nuclei such as ^{76}Ge, ^{130}Te, and ^{136}Xe.
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Affiliation(s)
- J M Yao
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - B Bally
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27516-3255, USA
| | - J Engel
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27516-3255, USA
| | - R Wirth
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - T R Rodríguez
- Departamento de Física Teórica y Centro de Investigación Avanzada en Física Fundamental, Universidad Autónoma de Madrid, E-28049 Madrid, Spain
| | - H Hergert
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824-1321, USA
- Department of Physics & Astronomy, Michigan State University, East Lansing, Michigan 48824-1321, USA
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24
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Ditsch N, Heublein S, Jeschke U, Sattler C, Kuhn C, Hester A, Czogalla B, Trillsch F, Mahner S, Engel J, Mayr D, Schmoeckel E. Cytoplasmic versus nuclear THR alpha expression determines survival of ovarian cancer patients. J Cancer Res Clin Oncol 2020; 146:1923-1932. [PMID: 32533406 PMCID: PMC7324415 DOI: 10.1007/s00432-020-03241-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/02/2020] [Accepted: 05/01/2020] [Indexed: 12/16/2022]
Abstract
Purpose
Thyroid hormone receptors (THR) have manifold functions and are involved in the carcinogenesis of several tumor types. Within this study, we aimed to investigate the expression pattern (nuclear versus cytoplasmic) of the THR alpha and its impact on patients survival in ovarian cancer (OvCa). Methods The presence of the thyroid hormone receptors THRα, THRα1 and − 2 was investigated in 156 ovarian cancer samples using immunohistochemistry (IHC) using semi-quantitative immunoreactivity (IR) scores and correlated with clinical, pathological data, subtype of ovarian cancer, clinical data, staining of 20 already described OvCa marker proteins and overall survival (OS). Results Among all subtypes of OvCa, clear cell carcinomas showed the highest THRα expression. Furthermore, nuclear THRα was associated with a reduced survival in this subtype. However, nuclear expressed THRα1 turned out to be a positive prognosticator for all subtypes of OvCa patients. Nuclear THRα2 is a positive prognosticator for OvCa patients of the serous subtype. In contrast, cytoplasmic expression THRα2 was associated with a reduced OS in all subtypes of OvCa patients; while, cytoplasmic expression of THRα1 is associated with reduced OS in mucinous OvCa patients only. In addition, THRα expression correlates with gonadotropin receptors, steroid hormone receptors, TA-MUC1 and glycodelin. Conclusion Depending on nuclear or cytoplasmic expression, our study shows that THRα and its isoforms 1 and 2 provide different prognostic information for ovarian cancer patients. Further investigations should analyze if THRs may represent new endocrine targets for the treatment of ovarian cancer. Electronic supplementary material The online version of this article (10.1007/s00432-020-03241-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nina Ditsch
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Sabine Heublein
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, 69120 Heidelberg, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Cornelia Sattler
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
| | - Anna Hester
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
| | - Bastian Czogalla
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
| | - Fabian Trillsch
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Marchioninistr. 15, 81377 Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Bavarian Cancer Registry—Regional Centre Munich (LGL), Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Doris Mayr
- Department of Pathology, LMU Munich, Thalkirchner Str. 36, 80337 Munich, Germany
| | - Elisa Schmoeckel
- Department of Pathology, LMU Munich, Thalkirchner Str. 36, 80337 Munich, Germany
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Sinke C, Engel J, Veit M, Hartmann U, Hillemacher T, Kneer J, Kruger THC. Sexual cues alter working memory performance and brain processing in men with compulsive sexual behavior. Neuroimage Clin 2020; 27:102308. [PMID: 32599553 PMCID: PMC7327301 DOI: 10.1016/j.nicl.2020.102308] [Citation(s) in RCA: 4] [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: 01/02/2020] [Revised: 05/29/2020] [Accepted: 06/07/2020] [Indexed: 02/06/2023]
Abstract
Pornography has been repeatedly at the centre of public attention and has been controversially discussed for a long time. However, little is known about the connection between pornographic stimuli and individual (neuronal) processing of attention and memory. Here, the impact and neural underpinnings of pornographic pictures on working memory processes in a sample of subjects with compulsive sexual behaviour was investigated. Therefore, whilst using functional magnetic resonance imaging (fMRI), a letter n-back task with neutral or pornographic pictures in the background was employed in 38 patients and 31 healthy controls. On the behavioural level, patients were slowed down by pornographic material depending on their pornography consumption in the last week, which was reflected by a higher activation in the lingual gyrus. In addition, the lingual gyrus showed a higher functional connectivity to the insula during processing of pornographic stimuli in the patient group. In contrast, healthy subjects showed faster responses when confronted with pornographic pictures only with high cognitive load. Also, patients showed a better memory for pornographic pictures in a surprise recognition task compared to controls, speaking for a higher relevance of pornographic material in the patient group. These findings are in line with the incentive salience theory of addiction, especially the higher functional connectivity to the salience network with the insula as a key hub and the higher lingual activity during processing of pornographic pictures depending on recent pornography consumption.
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Affiliation(s)
- C Sinke
- Hannover Medical School, Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany.
| | - J Engel
- Hannover Medical School, Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - M Veit
- Hannover Medical School, Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - U Hartmann
- Hannover Medical School, Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - T Hillemacher
- Department for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Prof. Ernst-Nathan-Str. 1, 90419 Nürnberg, Germany; Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - J Kneer
- Hannover Medical School, Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - T H C Kruger
- Hannover Medical School, Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
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Engel J, Schubert-Fritschle G, Emeny R, Hölzel D. Breast cancer: are long-term and intermittent endocrine therapies equally effective? J Cancer Res Clin Oncol 2020; 146:2041-2049. [PMID: 32472445 PMCID: PMC7324413 DOI: 10.1007/s00432-020-03264-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/03/2020] [Accepted: 05/14/2020] [Indexed: 12/29/2022]
Abstract
Purpose In breast cancer (BC), the duration of endocrine adjuvant therapies (AT) has been extended continuously up to 10 years. We present an alternative explanation for the effect, which could enable shorter treatments. Method The relevant literature on chemoprevention and (neo-)adjuvant therapy was reviewed. Data for initiation and growth of primary and contralateral BCs and their metastases (MET) were considered. Also, population-based data from the Munich Cancer Registry for MET-free survival, time trends of MET patterns, and survival achieved by improved ATs are used to estimate all events in the long-term follow-up. Results Extended ATs (EAT) that continue after 1, 2, or 5 years reduce mortality only slightly. The effect is delayed, occurring more than 5 years after extension. EATs does not affect the prognosis of 1stBCs, they preventively eradicate contralateral 2ndBCs and thus their future life-threatening METs. Because chemoprevention can eradicate BCs from the smallest clusters to almost detectable BCs, ATs can be temporarily suspended without imposing harm. Results equal to EATs can be achieved by short-term ATs of the 1stBC and by repeated neo-ATs targeted at the indefinitely developing 2ndBCs. Considering this potential in de-escalation, a 70–80% reduction of overtreatment seems possible. Conclusion Knowledge of initiation and growth of tumors with known effects of neo-ATs suggest that intermittent endocrine ATs may achieve the same results as EATs but with improved quality of life and survival because of fewer side effects and better compliance. The challenge for developments of repeated ATs becomes: how short is short enough.
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Affiliation(s)
- Jutta Engel
- Munich Cancer Registry (MCR), Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), 81377, Munich, Germany
| | - Gabriele Schubert-Fritschle
- Munich Cancer Registry (MCR), Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), 81377, Munich, Germany
| | - Rebecca Emeny
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03756, USA
| | - Dieter Hölzel
- Munich Cancer Registry (MCR), Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University (LMU), 81377, Munich, Germany.
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Marchetta P, Möhrle D, Eckert P, Reimann K, Wolter S, Tolone A, Lang I, Wolters M, Feil R, Engel J, Paquet-Durand F, Kuhn M, Knipper M, Rüttiger L. Guanylyl Cyclase A/cGMP Signaling Slows Hidden, Age- and Acoustic Trauma-Induced Hearing Loss. Front Aging Neurosci 2020; 12:83. [PMID: 32327991 PMCID: PMC7160671 DOI: 10.3389/fnagi.2020.00083] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 11/18/2019] [Accepted: 03/10/2020] [Indexed: 12/24/2022] Open
Abstract
In the inner ear, cyclic guanosine monophosphate (cGMP) signaling has been described as facilitating otoprotection, which was previously observed through elevated cGMP levels achieved by phosphodiesterase 5 inhibition. However, to date, the upstream guanylyl cyclase (GC) subtype eliciting cGMP production is unknown. Here, we show that mice with a genetic disruption of the gene encoding the cGMP generator GC-A, the receptor for atrial and B-type natriuretic peptides, display a greater vulnerability of hair cells to hidden hearing loss and noise- and age-dependent hearing loss. This vulnerability was associated with GC-A expression in spiral ganglia and outer hair cells (OHCs) but not in inner hair cells (IHCs). GC-A knockout mice exhibited elevated hearing thresholds, most pronounced for the detection of high-frequency tones. Deficits in OHC input–output functions in high-frequency regions were already present in young GC-A-deficient mice, with no signs of an accelerated progression of age-related hearing loss or higher vulnerability to acoustic trauma. OHCs in these frequency regions in young GC-A knockout mice exhibited diminished levels of KCNQ4 expression, which is the dominant K+ channel in OHCs, and decreased activation of poly (ADP-ribose) polymerase-1, an enzyme involved in DNA repair. Further, GC-A knockout mice had IHC synapse impairments and reduced amplitudes of auditory brainstem responses that progressed with age and with acoustic trauma, in contrast to OHCs, when compared to GC-A wild-type littermates. We conclude that GC-A/cGMP-dependent signaling pathways have otoprotective functions and GC-A gene disruption differentially contributes to hair-cell damage in a healthy, aged, or injured system. Thus, augmentation of natriuretic peptide GC-A signaling likely has potential to overcome hidden and noise-induced hearing loss, as well as presbycusis.
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Affiliation(s)
- Philine Marchetta
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre, Department of Otolaryngology, University of Tübingen, Tübingen, Germany
| | - Dorit Möhrle
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre, Department of Otolaryngology, University of Tübingen, Tübingen, Germany.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Philipp Eckert
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre, Department of Otolaryngology, University of Tübingen, Tübingen, Germany
| | - Katrin Reimann
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre, Department of Otolaryngology, University of Tübingen, Tübingen, Germany
| | - Steffen Wolter
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre, Department of Otolaryngology, University of Tübingen, Tübingen, Germany
| | - Arianna Tolone
- Cell Death Mechanisms Group, Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Isabelle Lang
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine, Hearing Research, Saarland University, Homburg, Germany
| | - Markus Wolters
- Signal Transduction and Transgenic Models, Interfaculty Institute of Biochemistry, University of Tübingen, Tübingen, Germany
| | - Robert Feil
- Signal Transduction and Transgenic Models, Interfaculty Institute of Biochemistry, University of Tübingen, Tübingen, Germany
| | - Jutta Engel
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine, Hearing Research, Saarland University, Homburg, Germany
| | - François Paquet-Durand
- Cell Death Mechanisms Group, Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Michaela Kuhn
- Institute of Physiology, University of Würzburg, Würzburg, Germany
| | - Marlies Knipper
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre, Department of Otolaryngology, University of Tübingen, Tübingen, Germany
| | - Lukas Rüttiger
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre, Department of Otolaryngology, University of Tübingen, Tübingen, Germany
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28
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Schade-Mann T, Münkner S, Eckrich T, Engel J. Calcium signaling in interdental cells during the critical developmental period of the mouse cochlea. Hear Res 2020; 389:107913. [PMID: 32120242 DOI: 10.1016/j.heares.2020.107913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 11/18/2022]
Abstract
The tectorial membrane (TM), a complex acellular structure that covers part of the organ of Corti and excites outer hair cells, is required for normal hearing. It consists of collagen fibrils and various glycoproteins, which are synthesized in embryonic and postnatal development by different cochlear cell types including the interdental cells (IDCs). At its modiolar side, the TM is fixed to the apical surfaces of IDCs, which form the covering epithelium of the spiral limbus. We performed confocal membrane imaging and Ca2+ imaging in IDCs of the developing mouse cochlea from birth to postnatal day 18 (P18). Using the fluorescent membrane markers FM 4-64 and CellMask™ Deep Red on explanted whole-mount cochlear epithelium, we identified the morphology of IDCs at different z-levels of the spiral limbus. Ca2+ imaging of Fluo-8 AM-loaded cochlear epithelia revealed spontaneous intracellular Ca2+ transients in IDCs at P0/1, P4/5, and P18. Their relative frequency was lowest on P0/1, increased by a factor of 12.5 on P4/5 and decreased to twice the initial value on P18. At all three ages, stimulation of IDCs with the trinucleotides ATP and UTP at 1 and 10 μM elicited Ca2+ transients of varying amplitude and shape. Before the onset of hearing, IDCs responded with robust Ca2+ oscillations. At P18, after the onset of hearing, ATP stimulation either caused Ca2+ oscillations or an initial Ca2+ peak followed by a plateau while the UTP response was unchanged from that at pre-hearing stage. Parameters of spontaneous and nucleotide-evoked Ca2+ transients such as amplitude, decay time and duration were markedly reduced during cochlear development, whereas the kinetics of the Ca2+ rise did not show relevant changes. Whether low-frequency spontaneous Ca2+ transients are necessary for the formation and maintenance of the tectorial membrane e.g. by regulating gene transcription needs to be elucidated in further studies.
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Affiliation(s)
- Thore Schade-Mann
- Dept. of Biophysics & CIPMM, Hearing Research, Saarland University, Homburg, Germany; Department of Otolaryngology, Head and Neck Surgery, Tübingen University Medical Centre, Germany
| | - Stefan Münkner
- Dept. of Biophysics & CIPMM, Hearing Research, Saarland University, Homburg, Germany
| | - Tobias Eckrich
- Dept. of Biophysics & CIPMM, Hearing Research, Saarland University, Homburg, Germany
| | - Jutta Engel
- Dept. of Biophysics & CIPMM, Hearing Research, Saarland University, Homburg, Germany.
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29
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Albertsmeier M, Riedl K, Stephan AJ, Drefs M, Schiergens TS, Engel J, Angele MK, Werner J, Guba M. Improved survival after resection of colorectal liver metastases in patients with unresectable lung metastases. HPB (Oxford) 2020; 22:368-375. [PMID: 31399325 DOI: 10.1016/j.hpb.2019.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/19/2019] [Accepted: 07/09/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Modern systemic therapies considerably improve tumour control and thus open the possibility of new surgical approaches in metastatic colorectal cancer. In this retrospective clinical cohort with a comparison group, we investigated whether liver resection in a combined liver-lung-metastasised stage is justified if pulmonary disease is not resected. METHODS From 283 patients treated in our institution between 2000 and 2014 for combined colorectal liver- and lung metastases, 35 patients had their pulmonary metastases left in situ while they were eligible for both treatment options: resection versus non-resection of liver metastases. Effectively, 15 of these patients received whereas 20 did not receive a liver resection. In these patients, we compared overall survival and determined risk factors that are associated with poor survival, applying a Cox-Proportional Hazards model. RESULTS Patients whose liver metastases were resected showed significantly longer median survival compared to patients who did not undergo hepatic surgery (median 2.6 vs 1.5 years, P = 0.0182). The Cox-Proportional Hazards model revealed hepatic metastasectomy to be the strongest determinant of patient survival (HR 5.27; CI: (1.89, 14.65)). CONCLUSION Our results suggest that surgical removal of liver metastases may be beneficial in selected patients even if concomitant lung metastases cannot be resected.
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Affiliation(s)
- Markus Albertsmeier
- Department of General, Visceral and Transplantation Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany.
| | - Kathrin Riedl
- Department of General, Visceral and Transplantation Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Anna-Janina Stephan
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Moritz Drefs
- Department of General, Visceral and Transplantation Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Tobias S Schiergens
- Department of General, Visceral and Transplantation Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Bavarian Cancer Registry - Regional Centre Munich (LGL) at the University Hospital of Munich, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Martin K Angele
- Department of General, Visceral and Transplantation Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Jens Werner
- Department of General, Visceral and Transplantation Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
| | - Markus Guba
- Department of General, Visceral and Transplantation Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377 Munich, Germany
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30
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De Toni EN, Schlesinger-Raab A, Fuchs M, Schepp W, Ehmer U, Geisler F, Ricke J, Paprottka P, Friess H, Werner J, Gerbes AL, Mayerle J, Engel J. Age independent survival benefit for patients with hepatocellular carcinoma (HCC) without metastases at diagnosis: a population-based study. Gut 2020; 69:168-176. [PMID: 30878947 PMCID: PMC6943246 DOI: 10.1136/gutjnl-2018-318193] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/12/2019] [Accepted: 02/21/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Hepatocellular carcinoma (HCC) is a major cause of death worldwide and its incidence is expected to increase globally. Aim of this study was to assess whether the implementation of screening policies and the improvement of treatment options translated into a real-world survival benefit in HCC patients. DESIGN 4078 patients diagnosed with HCC between 1998 and 2016 from the Munich Cancer Registry were analysed. Tumour characteristics and outcome were analysed by time period and according to age and presence of metastases at diagnosis. Overall survival (OS) was analysed using Kaplan-Meier method and relative survival (RS) was computed for cancer-specific survival. Cox proportional hazard models were conducted to control for prognostic variables. RESULTS While incidence of HCC remained substantially stable, tumours were diagnosed at increasingly earlier stages, although the median age at diagnosis increased. The 3 years RS in HCC improved from 19.8% in 1998-2002, 22.4% in 2003-2007, 30.6% in 2008-2012 up to 31.0% in 2013-2016. Median OS increased from 6 months in 1998-2002 to 12 months in 2008-2016. However, analysis according to the metastatic status showed that survival improved only in patients without metastases at diagnosis whereas the prognosis of patients with metastatic disease remained unchanged. CONCLUSION These real-world data show that, in contrast to the current assumptions, the incidence of HCC did not increase in a representative German region. Earlier diagnosis, likely related to the implementation of screening programmes, translated into an increasing employment of effective therapeutic options and a clear survival benefit in patients without metastases at diagnosis, irrespective of age.
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Affiliation(s)
- Enrico N De Toni
- Department of Medicine II, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Anne Schlesinger-Raab
- Munich Cancer Registry, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Martin Fuchs
- Department of Gastroenterology, Hepatology and GI-Oncology, Hospital Bogenhausen, Munich, Germany
| | - Wolfgang Schepp
- Department of Gastroenterology, Hepatology and GI-Oncology, Hospital Bogenhausen, Munich, Germany
| | - Ursula Ehmer
- Department of Internal Medicine II, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Fabian Geisler
- Department of Internal Medicine II, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Jens Ricke
- Department of Clinical Radiology, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Philipp Paprottka
- Department of Interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Helmut Friess
- Department of Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Jens Werner
- Department of General, Visceral, Vascular and Transplant Surgery, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Alexander L Gerbes
- Department of Medicine II, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Julia Mayerle
- Department of Medicine II, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University (LMU), Munich, Germany
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Ortner NJ, Pinggera A, Hofer NT, Siller A, Brandt N, Raffeiner A, Vilusic K, Lang I, Blum K, Obermair GJ, Stefan E, Engel J, Striessnig J. RBP2 stabilizes slow Cav1.3 Ca 2+ channel inactivation properties of cochlear inner hair cells. Pflugers Arch 2019; 472:3-25. [PMID: 31848688 PMCID: PMC6960213 DOI: 10.1007/s00424-019-02338-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 07/23/2019] [Revised: 10/18/2019] [Accepted: 12/04/2019] [Indexed: 01/31/2023]
Abstract
Cav1.3 L-type Ca2+ channels (LTCCs) in cochlear inner hair cells (IHCs) are essential for hearing as they convert sound-induced graded receptor potentials into tonic postsynaptic glutamate release. To enable fast and indefatigable presynaptic Ca2+ signaling, IHC Cav1.3 channels exhibit a negative activation voltage range and uniquely slow inactivation kinetics. Interaction with CaM-like Ca2+-binding proteins inhibits Ca2+-dependent inactivation, while the mechanisms underlying slow voltage-dependent inactivation (VDI) are not completely understood. Here we studied if the complex formation of Cav1.3 LTCCs with the presynaptic active zone proteins RIM2α and RIM-binding protein 2 (RBP2) can stabilize slow VDI. We detected both RIM2α and RBP isoforms in adult mouse IHCs, where they co-localized with Cav1.3 and synaptic ribbons. Using whole-cell patch-clamp recordings (tsA-201 cells), we assessed their effect on the VDI of the C-terminal full-length Cav1.3 (Cav1.3L) and a short splice variant (Cav1.342A) that lacks the C-terminal RBP2 interaction site. When co-expressed with the auxiliary β3 subunit, RIM2α alone (Cav1.342A) or RIM2α/RBP2 (Cav1.3L) reduced Cav1.3 VDI to a similar extent as observed in IHCs. Membrane-anchored β2 variants (β2a, β2e) that inhibit inactivation on their own allowed no further modulation of inactivation kinetics by RIM2α/RBP2. Moreover, association with RIM2α and/or RBP2 consolidated the negative Cav1.3 voltage operating range by shifting the channel's activation threshold toward more hyperpolarized potentials. Taken together, the association with "slow" β subunits (β2a, β2e) or presynaptic scaffolding proteins such as RIM2α and RBP2 stabilizes physiological gating properties of IHC Cav1.3 LTCCs in a splice variant-dependent manner ensuring proper IHC function.
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Affiliation(s)
- Nadine J Ortner
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria.
| | - Alexandra Pinggera
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Nadja T Hofer
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Anita Siller
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Niels Brandt
- Department of Biophysics and CIPMM, Saarland University, Homburg, Germany
| | - Andrea Raffeiner
- Institute of Biochemistry, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Kristina Vilusic
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Isabelle Lang
- Department of Biophysics and CIPMM, Saarland University, Homburg, Germany
| | - Kerstin Blum
- Department of Biophysics and CIPMM, Saarland University, Homburg, Germany
| | - Gerald J Obermair
- Division of Physiology, Medical University Innsbruck, Innsbruck, Austria.,Division Physiology, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Eduard Stefan
- Institute of Biochemistry, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Jutta Engel
- Department of Biophysics and CIPMM, Saarland University, Homburg, Germany
| | - Jörg Striessnig
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria.
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Engel J, Weichert W, Jung A, Emeny R, Hölzel D. Lymph node infiltration, parallel metastasis and treatment success in breast cancer. Breast 2019; 48:1-6. [DOI: 10.1016/j.breast.2019.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/28/2019] [Accepted: 07/31/2019] [Indexed: 02/05/2023] Open
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Elmasry M, Brandl L, Engel J, Jung A, Kirchner T, Horst D. RBP7 is a clinically prognostic biomarker and linked to tumor invasion and EMT in colon cancer. J Cancer 2019; 10:4883-4891. [PMID: 31598160 PMCID: PMC6775517 DOI: 10.7150/jca.35180] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 03/24/2019] [Accepted: 07/22/2019] [Indexed: 01/17/2023] Open
Abstract
RBP7 is a member of the cellular retinol-binding protein (CRBP) family and previous data suggested a link between CRBPs and the malignant transformation of colon cancer cells. Here, we investigated the potential of RBP7 as a predictive biomarker for patients with colon cancer and determined its functional relevance for tumor progression. We analyzed RBP7 protein and mRNA expression in independent tissue collections of colon cancers with recorded follow-up data, including data from TCGA. We used gene set enrichment analyses to characterize its functional role. Effects of RBP7 on migration and invasion were determined in transwell assays. High expression of RBP7 was an independent biomarker of poor cancer specific survival in early and late stage colon cancer, and linked to colon cancer progression. Gene set enrichment analysis revealed a strong association of RBP7, colon cancer invasion and epithelial mesenchymal transition (EMT). Ectopic expression of RBP7 increased migration and invasion of colon cancer cells. Our findings demonstrate that RBP7 is a strong prognostic biomarker in colon cancer that functionally contributes to the malignant phenotype of colon cancer cells. This may aid in risk stratification for the therapeutic management of patients with colorectal cancer.
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Affiliation(s)
- Manal Elmasry
- Institute of Pathology, Ludwig-Maximilians-Universität München, Munich, Germany.,Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Lydia Brandl
- Institute of Pathology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Department of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Andreas Jung
- Institute of Pathology, Ludwig-Maximilians-Universität München, Munich, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Kirchner
- Institute of Pathology, Ludwig-Maximilians-Universität München, Munich, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David Horst
- German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Beggs MR, Lee JJ, Busch K, Raza A, Dimke H, Weissgerber P, Engel J, Flockerzi V, Alexander RT. TRPV6 and Ca v1.3 Mediate Distal Small Intestine Calcium Absorption Before Weaning. Cell Mol Gastroenterol Hepatol 2019; 8:625-642. [PMID: 31398491 PMCID: PMC6889763 DOI: 10.1016/j.jcmgh.2019.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Intestinal Ca2+ absorption early in life is vital to achieving optimal bone mineralization. The molecular details of intestinal Ca2+ absorption have been defined in adults after peak bone mass is obtained, but they are largely unexplored during development. We sought to delineate the molecular details of transcellular Ca2+ absorption during this critical period. METHODS Expression of small intestinal and renal calcium transport genes was assessed by using quantitative polymerase chain reaction. Net calcium flux across small intestinal segments was measured in Ussing chambers, including after pharmacologic inhibition or genetic manipulation of TRPV6 or Cav1.3 calcium channels. Femurs were analyzed by using micro-computed tomography and histology. RESULTS Net TRPV6-mediated Ca2+ flux across the duodenum was absent in pre-weaned (P14) mice but present after weaning. In contrast, we found significant transcellular Ca2+ absorption in the jejunum at 2 weeks but not 2 months of age. Net jejunal Ca2+ absorption observed at P14 was not present in either Trpv6 mutant (D541A) mice or Cav1.3 knockout mice. We observed significant nifedipine-sensitive transcellular absorption across the ileum at P14 but not 2 months. Cav1.3 knockout pups exhibited delayed bone mineral accrual, compensatory nifedipine-insensitive Ca2+ absorption in the ileum, and increased expression of renal Ca2+ reabsorption mediators at P14. Moreover, weaning pups at 2 weeks reduced jejunal and ileal Cav1.3 expression. CONCLUSIONS We have detailed novel pathways contributing to transcellular Ca2+ transport across the distal small intestine of mice during development, highlighting the complexity of the multiple mechanisms involved in achieving a positive Ca2+ balance early in life.
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Affiliation(s)
- Megan R. Beggs
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada,The Women’s & Children’s Health Research Institute, Edmonton, Alberta, Canada
| | - Justin J. Lee
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada,The Women’s & Children’s Health Research Institute, Edmonton, Alberta, Canada
| | - Kai Busch
- Experimentelle und Klinische Pharmakologie und Toxikologie, Saarland University, Homburg, Germany
| | - Ahsan Raza
- Experimentelle und Klinische Pharmakologie und Toxikologie, Saarland University, Homburg, Germany
| | - Henrik Dimke
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Petra Weissgerber
- Experimentelle und Klinische Pharmakologie und Toxikologie, Saarland University, Homburg, Germany
| | - Jutta Engel
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, School of Medicine, Homburg, Germany
| | - Veit Flockerzi
- Experimentelle und Klinische Pharmakologie und Toxikologie, Saarland University, Homburg, Germany
| | - R. Todd Alexander
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada,The Women’s & Children’s Health Research Institute, Edmonton, Alberta, Canada,Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada,Correspondence Address correspondence to: R. Todd Alexander, MD, PhD, Department of Pediatrics, 4-585 Edmonton Clinic Health Academy, 11405 – 87 Avenue, University of Alberta, Edmonton, Alberta T6G 2R7, Canada. fax: (780) 248-5556.
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Lang I, Jung M, Niemeyer BA, Ruth P, Engel J. Expression of the LRRC52 γ subunit (γ2) may provide Ca 2+-independent activation of BK currents in mouse inner hair cells. FASEB J 2019; 33:11721-11734. [PMID: 31348683 DOI: 10.1096/fj.201900701rr] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Mammalian inner hair cells (IHCs) transduce sound into depolarization and transmitter release. Big conductance and voltage- and Ca2+-activated K+ (BK) channels are responsible for fast membrane repolarization and small time constants of mature IHCs. For unknown reasons, they activate at around -75 mV with a voltage of half-maximum activation (Vhalf) of -50 mV although being largely insensitive to Ca2+ influx. Ca2+-independent activation of BK channels was observed by others in heterologous expression systems if γ subunits leucine-rich repeat-containing protein (LRRC)26 (γ1) and LRRC52 (γ2) were coexpressed with the pore-forming BKα subunit, which shifted Vhalf by -140 and -100 mV, respectively. Using nested PCR, we consistently detected transcripts for LRRC52 but not for LRRC26 in IHCs of 3-wk-old mice. Confocal immunohistochemistry showed synchronous up-regulation of LRRC52 protein with BKα at the onset of hearing. Colocalization of LRRC52 protein and BKα at the IHC neck within ≤40 nm was specified using an in situ proximity ligation assay. Mice deficient for the voltage-gated Cav1.3 Ca2+ channel encoded by Cacna1d do not express BKα protein. LRRC52 protein was neither expressed in IHCs of BKα nor in IHCs of Cav1.3 knockout mice. Together, LRRC52 is a γ2 subunit of BK channel complexes and is a strong candidate for causing the Ca2+-independent activation of BK currents at negative membrane potentials in mouse IHCs.-Lang, I., Jung, M., Niemeyer, B. A., Ruth, P., Engel, J. Expression of the LRRC52 γ subunit (γ2) may provide Ca2+-independent activation of BK currents in mouse inner hair cells.
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Affiliation(s)
- Isabelle Lang
- Hearing Research, Department of Biophysics and Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, Homburg, Germany
| | - Martin Jung
- Department of Biochemistry and Molecular Biology, Saarland University, Homburg, Germany
| | - Barbara A Niemeyer
- Molecular Biophysics, Department of Biophysics and Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, Homburg, Germany
| | - Peter Ruth
- Institute of Pharmacy, Department of Pharmacology, Toxicology and Clinical Pharmacy, University of Tübingen, Tübingen, Germany
| | - Jutta Engel
- Hearing Research, Department of Biophysics and Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, Homburg, Germany
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Stephani F, Scheuer V, Eckrich T, Blum K, Wang W, Obermair GJ, Engel J. Deletion of the Ca 2+ Channel Subunit α 2δ3 Differentially Affects Ca v2.1 and Ca v2.2 Currents in Cultured Spiral Ganglion Neurons Before and After the Onset of Hearing. Front Cell Neurosci 2019; 13:278. [PMID: 31293392 PMCID: PMC6606706 DOI: 10.3389/fncel.2019.00278] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/07/2019] [Indexed: 12/14/2022] Open
Abstract
Voltage-gated Ca2+ channels are composed of a pore-forming α1 subunit and auxiliary β and α2δ subunits, which modulate Ca2+ current properties and channel trafficking. So far, the partial redundancy and specificity of α1 for α2δ subunits in the CNS have remained largely elusive. Mature spiral ganglion (SG) neurons express α2δ subunit isoforms 1, 2, and 3 and multiple Ca2+ channel subtypes. Differentiation and in vivo functions of their endbulb of Held synapses, which rely on presynaptic P/Q channels (Lin et al., 2011), require the α2δ3 subunit (Pirone et al., 2014). This led us to hypothesize that P/Q channels may preferentially co-assemble with α2δ3. Using a dissociated primary culture, we analyzed the effects of α2δ3 deletion on somatic Ca2+ currents (ICa) of SG neurons isolated at postnatal day 20 (P20), when the cochlea is regarded to be mature. P/Q currents were the dominating steady-state Ca2+ currents (54% of total) followed by T-type, L-type, N-type, and R-type currents. Deletion of α2δ3 reduced P/Q- and R-type currents by 60 and 38%, respectively, whereas L-type, N-type, and T-type currents were not altered. A subset of ICa types was also analyzed in SG neurons isolated at P5, i.e., before the onset of hearing (P12). Both L-type and N-type current amplitudes of wildtype SG neurons were larger at P5 compared with P20. Deletion of α2δ3 reduced L-type and N-type currents by 23 and 44%, respectively. In contrast, small P/Q currents, which were just being up-regulated at P5, were unaffected by the lack of α2δ3. In summary, α2δ3 regulates amplitudes of L- and N-type currents of immature cultured SG neurons, whereas it regulates P/Q- and R-type currents at P20. Our data indicate a developmental switch from dominating somatic N- to P/Q-type currents in cultured SG neurons. A switch from N- to P/Q-type channels, which has been observed at several central synapses, may also occur at developing endbulbs of Held. In this case, reduction of both neonatal N- (P5) and more mature P/Q-type currents (around/after hearing onset) may contribute to the impaired morphology and function of endbulb synapses in α2δ3-deficient mice.
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Affiliation(s)
- Friederike Stephani
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine, School of Medicine, Saarland University, Homburg, Germany
| | - Veronika Scheuer
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine, School of Medicine, Saarland University, Homburg, Germany
| | - Tobias Eckrich
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine, School of Medicine, Saarland University, Homburg, Germany
| | - Kerstin Blum
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine, School of Medicine, Saarland University, Homburg, Germany
| | - Wenying Wang
- Department of Physiology, School of Medicine, University of Nevada, Reno, NV, United States
| | - Gerald J Obermair
- Department of Physiology and Medical Physics, Medical University Innsbruck, Innsbruck, Austria.,Division Physiology, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Jutta Engel
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine, School of Medicine, Saarland University, Homburg, Germany
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Eckrich S, Hecker D, Sorg K, Blum K, Fischer K, Münkner S, Wenzel G, Schick B, Engel J. Cochlea-Specific Deletion of Ca v1.3 Calcium Channels Arrests Inner Hair Cell Differentiation and Unravels Pitfalls of Conditional Mouse Models. Front Cell Neurosci 2019; 13:225. [PMID: 31178698 PMCID: PMC6538774 DOI: 10.3389/fncel.2019.00225] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 03/07/2019] [Accepted: 05/03/2019] [Indexed: 12/29/2022] Open
Abstract
Inner hair cell (IHC) Cav1.3 Ca2+ channels are multifunctional channels mediating Ca2+ influx for exocytosis at ribbon synapses, the generation of Ca2+ action potentials in pre-hearing IHCs and gene expression. IHCs of deaf systemic Cav1.3-deficient (Cav1.3-/-) mice stay immature because they fail to up-regulate voltage- and Ca2+-activated K+ (BK) channels but persistently express small conductance Ca2+-activated K+ (SK2) channels. In pre-hearing wildtype mice, cholinergic neurons from the superior olivary complex (SOC) exert efferent inhibition onto spontaneously active immature IHCs by activating their SK2 channels. Because Cav1.3 plays an important role for survival, health and function of SOC neurons, SK2 channel persistence and lack of BK channels in systemic Cav1.3-/- IHCs may result from malfunctioning neurons of the SOC. Here we analyze cochlea-specific Cav1.3 knockout mice with green fluorescent protein (GFP) switch reporter function, Pax2::cre;Cacna1d-eGFPflex/flexand Pax2::cre;Cacna1d-eGFPflex/-. Profound hearing loss, lack of BK channels and persistence of SK2 channels in Pax2::cre;Cacna1d-eGFPflex/- mice recapitulated the phenotype of systemic Cav1.3-/- mice, indicating that in wildtype mice, regulation of SK2 and BK channel expression is independent of Cav1.3 expression in SOC neurons. In addition, we noticed dose-dependent GFP toxicity leading to death of basal coil IHCs of Pax2::cre;Cacna1d-eGFPflex/flex mice, likely because of high GFP concentration and small repair capacity. This and the slower time course of Pax2-driven Cre recombinase in switching two rather than one Cacna1d-eGFPflex allele lead us to study Pax2::cre;Cacna1d-eGFPflex/- mice. Notably, control Cacna1d-eGFPflex/- IHCs showed a significant reduction in Cav1.3 channel cluster sizes and currents, suggesting that the intronic construct interfered with gene translation or splicing. These pitfalls are likely to be a frequent problem of many genetically modified mice with complex or multiple gene-targeting constructs or fluorescent proteins. Great caution and appropriate controls are therefore required.
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Affiliation(s)
- Stephanie Eckrich
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Dietmar Hecker
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Katharina Sorg
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Kerstin Blum
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Kerstin Fischer
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Stefan Münkner
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Gentiana Wenzel
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Jutta Engel
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
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Beggs M, Lee J, Busch K, Raza A, Dimke H, Weissgerber P, Engel J, Flockerzi V, Alexander RT. The Jejunum and Ileum Mediate Increased Calcium Absorption for Bone Mineralization During Postnatal Development via TRPV6 and Cav1.3 (OR26-07-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz033.or26-07-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Intestinal Ca2+ absorption early in life is vital to achieving optimal bone mineralization. The molecular details of intestinal Ca2+ absorption have been defined in adults, after peak bone mass has been reached, but are largely unexplored during development. We sought to delineate the molecular details of transcellular Ca2+ absorption across the small intestine which facilitate a positive calcium balance during growth.
Methods
We used wildtype, Cav1.3 knockout and Trpv6 mutant mice. Expression of small intestinal and renal calcium transport genes was assessed using quantitative PCR. Net transcellular 45-calcium flux across intestinal segments was measured in Ussing chambers. Femurs we analyzed using micro-CT and histology.
Results
Significant TRPV6 mediated Ca2+ flux across the duodenum was absent in pre-weaned (P14) mice but occurred post-weaning. In contrast, we found significant transcellular Ca2+ absorption in the jejunum and ileum at P14 but not 2 months. TRPV6 and Cav1.3 are necessary for this jejunal absorption and Cav1.3 appears to mediate absorption across the ileum although compensation is present in knockout pups. Knockout of Cav1.3 induces a compensatory increase in renal Ca2+ reabsorption in P14 mice although these pups have increased growth plate thickness suggesting delayed bone mineralization.
Conclusions
This work provides molecular details of how the small intestine facilitates increased demand for Ca2+ early in life to meet the requirements of growth and highlights the complexity of the multiple mechanisms involved in achieving a positive Ca2+ balance.
Funding Sources
This work is funded by grants from the Women and Children's Health Research Institute, supported by the Stollery Children's Hospital Foundation, and the National Sciences and Engineering Research Council to RTA, who is the Canada Research Chair in Renal Epithelial Transport Physiology. MRB is supported by a Vanier Canada Graduate Scholarship, Alberta Innovates Clinician Fellowship and an NSERC Michael Smith Foreign Study Supplement. H. Dimke is funded by the Danish Medical Research Council. Work at UdS was funded by Deutsche Forschungsgemeinschaft (DFG) by IRTG1830 (to JE, VF), Sonderforschungsbereich (SFB) 894 (to JE, PW) and SFB TRR152 (to VF).
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Ceriani F, Hendry A, Jeng JY, Johnson SL, Stephani F, Olt J, Holley MC, Mammano F, Engel J, Kros CJ, Simmons DD, Marcotti W. Coordinated calcium signalling in cochlear sensory and non-sensory cells refines afferent innervation of outer hair cells. EMBO J 2019; 38:embj.201899839. [PMID: 30804003 PMCID: PMC6484507 DOI: 10.15252/embj.201899839] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [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: 05/16/2018] [Revised: 12/11/2018] [Accepted: 01/18/2019] [Indexed: 12/12/2022] Open
Abstract
Outer hair cells (OHCs) are highly specialized sensory cells conferring the fine‐tuning and high sensitivity of the mammalian cochlea to acoustic stimuli. Here, by genetically manipulating spontaneous Ca2+ signalling in mice in vivo, through a period of early postnatal development, we find that the refinement of OHC afferent innervation is regulated by complementary spontaneous Ca2+ signals originating in OHCs and non‐sensory cells. OHCs fire spontaneous Ca2+ action potentials during a narrow period of neonatal development. Simultaneously, waves of Ca2+ activity in the non‐sensory cells of the greater epithelial ridge cause, via ATP‐induced activation of P2X3 receptors, the increase and synchronization of the Ca2+ activity in nearby OHCs. This synchronization is required for the refinement of their immature afferent innervation. In the absence of connexin channels, Ca2+ waves are impaired, leading to a reduction in the number of ribbon synapses and afferent fibres on OHCs. We propose that the correct maturation of the afferent connectivity of OHCs requires experience‐independent Ca2+ signals from sensory and non‐sensory cells.
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Affiliation(s)
- Federico Ceriani
- Department of Biomedical Science, University of Sheffield, Sheffield, UK
| | - Aenea Hendry
- Department of Biomedical Science, University of Sheffield, Sheffield, UK
| | - Jing-Yi Jeng
- Department of Biomedical Science, University of Sheffield, Sheffield, UK
| | - Stuart L Johnson
- Department of Biomedical Science, University of Sheffield, Sheffield, UK
| | - Friederike Stephani
- Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, Homburg, Germany
| | - Jennifer Olt
- Department of Biomedical Science, University of Sheffield, Sheffield, UK
| | - Matthew C Holley
- Department of Biomedical Science, University of Sheffield, Sheffield, UK
| | - Fabio Mammano
- Department of Physics and Astronomy "G. Galilei", University of Padua, Padova, Italy.,Department of Biomedical Sciences, Institute of Cell Biology and Neurobiology, Italian National Research Council, Monterotondo, Italy
| | - Jutta Engel
- Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, Homburg, Germany
| | - Corné J Kros
- School of Life Sciences, University of Sussex, Brighton, UK
| | | | - Walter Marcotti
- Department of Biomedical Science, University of Sheffield, Sheffield, UK
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40
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Koeman M, Engel J, Jansen J, Buydens L. Critical comparison of methods for fault diagnosis in metabolomics data. Sci Rep 2019; 9:1123. [PMID: 30718783 PMCID: PMC6362212 DOI: 10.1038/s41598-018-37494-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/20/2018] [Indexed: 11/09/2022] Open
Abstract
Platforms like metabolomics provide an unprecedented view on the chemical versatility in biomedical samples. Many diseases reflect themselves as perturbations in specific metabolite combinations. Multivariate analyses are essential to detect such combinations and associate them to specific diseases. For this, usually targeted discriminations of samples associated to a specific disease from non-diseased control samples are used. Such targeted data interpretation may not respect the heterogeneity of metabolic responses, both between diseases and within diseases. Here we show that multivariate methods that find any set of perturbed metabolites in a single patient, may be employed in combination with data collected with a single metabolomics technology to simultaneously investigate a large array of diseases. Several such untargeted data analysis approaches have been already proposed in other fields to find both expected and unexpected perturbations, e.g. in Statistical Process Control. We have critically compared several of these approaches for their sensitivity and their correct identification of the specifically perturbed metabolites. Also a new approach is introduced for this purpose. The newly introduced Sparse Mean approach, which we find here as most sensitive and best able to identify the specifically perturbed metabolites, turns metabolomics into an untargeted diagnostic platform. Aside from metabolomics, the proposed approach may greatly benefit fault diagnosis with untargeted analyses in many other fields, such as Industrial Process Control, food Adulteration Detection, and Intrusion Detection.
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Affiliation(s)
- M Koeman
- Radboud University, Institute for Molecules and Materials (IMM) Heyendaalseweg 135, 6525, AJ Nijmegen, The Netherlands
| | - J Engel
- Radboud University, Institute for Molecules and Materials (IMM) Heyendaalseweg 135, 6525, AJ Nijmegen, The Netherlands.,Biometris, Wageningen UR, Droevendaalsesteeg 1, 6708, PB Wageningen, The Netherlands
| | - J Jansen
- Radboud University, Institute for Molecules and Materials (IMM) Heyendaalseweg 135, 6525, AJ Nijmegen, The Netherlands.
| | - L Buydens
- Radboud University, Institute for Molecules and Materials (IMM) Heyendaalseweg 135, 6525, AJ Nijmegen, The Netherlands
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Nicolai N, Biasoni D, Catanzaro MA, Colecchia M, Trama A, Hackl M, Eycken EV, Henau K, Dimitrova N, Sekerija M, Dušek L, Mägi M, Malila N, Leinonen M, Velten M, Troussard X, Bouvier V, Guizard AV, Bouvier AM, Arveux P, Maynadié M, Woronoff AS, Robaszkiewic M, Baldi I, Monnereau A, Tretarre B, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Stabenow R, Luttmann S, Nennecke A, Engel J, Schubert-Fritschle G, Heidrich J, Holleczek B, Jónasson JG, Clough-Gorr K, Comber H, Mazzoleni G, Giacomin A, Sutera Sardo A, Barchielli A, Serraino D, De Angelis R, Mallone S, Tavilla A, Pierannunzio D, Rossi S, Santaquilani M, Knijn A, Pannozzo F, Gennaro V, Benfatto L, Ricci P, Autelitano M, Spagnoli G, Fusco M, Usala M, Vitale F, Michiara M, Tumino R, Mangone L, Falcini F, Ferretti S, Filiberti RA, Marani E, Iannelli A, Sensi F, Piffer S, Gentilini M, Madeddu A, Ziino A, Maspero S, Candela P, Stracci F, Tagliabue G, Rugge M, Trama A, Gatta G, Botta L, Capocaccia R, Pildava S, Smailyte G, Calleja N, Johannesen TB, Rachtan J, Góźdź S, Błaszczyk J, Kępska K, de Lacerda GF, Bento MJ, Miranda A, Diba CS, Almar E, Larrañaga N, de Munain AL, Torrella-Ramos A, Díaz García JM, Marcos-Gragera R, Sanchez MJ, Navarro C, Salmeron D, Moreno-Iribas C, Galceran J, Carulla M, Mousavi M, Bouchardy C, M. Ess S, Bordoni A, Konzelmann I, Rashbass J, Gavin A, Brewster DH, Huws DW, Visser O, Bielska-Lasota M, Primic-Zakelj M, Kunkler I, Benhamou E. Testicular germ-cell tumours and penile squamous cell carcinoma: Appropriate management makes the difference. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.02.006] [Citation(s) in RCA: 2] [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: 12/17/2022] Open
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Imbimbo M, Maury JM, Garassino M, Girard N, Hackl M, Eycken EV, Henau K, Dimitrova N, Sekerija M, Dušek L, Mägi M, Malila N, Leinonen M, Velten M, Troussard X, Bouvier V, Guizard AV, Bouvier AM, Arveux P, Maynadié M, Woronoff AS, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Stabenow R, Luttmann S, Nennecke A, Engel J, Schubert-Fritschle G, Heidrich J, Holleczek B, Jónasson JG, Clough-Gorr K, Comber H, Mazzoleni G, Giacomin A, Sardo AS, Barchielli A, Serraino D, De Angelis R, Mallone S, Tavilla A, Pierannunzio D, Rossi S, Santaquilani M, Knijn A, Pannozzo F, Gennaro V, Benfatto L, Ricci P, Autelitano M, Spagnoli G, Fusco M, Usala M, Vitale F, Michiara M, Tumino R, Mangone L, Falcini F, Ferretti S, Angela Filiberti R, Marani E, Iannelli A, Sensi F, Piffer S, Gentilini M, Madeddu A, Ziino A, Maspero S, Candela P, Stracci F, Tagliabue G, Rugge M, Trama A, Gatta G, Botta L, Capocaccia R, Pildava S, Smailyte G, Calleja N, Johannesen TB, Rachtan J, Góźdź S, Błaszczyk J, Kępska K, de Lacerda GF, Bento MJ, Miranda A, Diba CS, Almar E, Larrañaga N, de Munain AL, Torrella-Ramos A, Díaz García JM, Marcos-Gragera R, Sanchez MJ, Navarro C, Salmeron D, Moreno-Iribas C, Galceran J, Carulla M, Mousavi M, Bouchardy C, Ess SM, Bordoni A, Konzelmann I, Rashbass J, Gavin A, Brewster DH, Huws DW, Visser O, Bielska-Lasota M, Primic-Zakelj M, Kunkler I, Benhamou E. Mesothelioma and thymic tumors: Treatment challenges in (outside) a network setting. Eur J Surg Oncol 2019; 45:75-80. [DOI: 10.1016/j.ejso.2018.01.078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/02/2018] [Accepted: 01/07/2018] [Indexed: 10/18/2022] Open
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Wöckel A, Festl J, Stüber T, Brust K, Krockenberger M, Heuschmann PU, Jírů-Hillmann S, Albert US, Budach W, Follmann M, Janni W, Kopp I, Kreienberg R, Kühn T, Langer T, Nothacker M, Scharl A, Schreer I, Link H, Engel J, Fehm T, Weis J, Welt A, Steckelberg A, Feyer P, König K, Hahne A, Baumgartner T, Kreipe HH, Knoefel WT, Denkinger M, Brucker S, Lüftner D, Kubisch C, Gerlach C, Lebeau A, Siedentopf F, Petersen C, Bartsch HH, Schulz-Wendtland R, Hahn M, Hanf V, Müller-Schimpfle M, Henscher U, Roncarati R, Katalinic A, Heitmann C, Honegger C, Paradies K, Bjelic-Radisic V, Degenhardt F, Wenz F, Rick O, Hölzel D, Zaiss M, Kemper G, Budach V, Denkert C, Gerber B, Tesch H, Hirsmüller S, Sinn HP, Dunst J, Münstedt K, Bick U, Fallenberg E, Tholen R, Hung R, Baumann F, Beckmann MW, Blohmer J, Fasching P, Lux MP, Harbeck N, Hadji P, Hauner H, Heywang-Köbrunner S, Huober J, Hübner J, Jackisch C, Loibl S, Lück HJ, von Minckwitz G, Möbus V, Müller V, Nöthlings U, Schmidt M, Schmutzler R, Schneeweiss A, Schütz F, Stickeler E, Thomssen C, Untch M, Wesselmann S, Bücker A, Buck A, Stangl S. Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 2 with Recommendations for the Therapy of Primary, Recurrent and Advanced Breast Cancer. Geburtshilfe Frauenheilkd 2018; 78:1056-1088. [PMID: 30581198 PMCID: PMC6261741 DOI: 10.1055/a-0646-4630] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 12/29/2022] Open
Abstract
Purpose The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer. Method The process of updating the S3 guideline published in 2012 was based on the adaptation of identified source guidelines. They were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and with the results of a systematic search of literature databases followed by the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point and used them to develop suggestions for recommendations and statements, which were then modified and graded in a structured consensus process procedure. Recommendations Part 2 of this short version of the guideline presents recommendations for the therapy of primary, recurrent and metastatic breast cancer. Loco-regional therapies are de-escalated in the current guideline. In addition to reducing the safety margins for surgical procedures, the guideline also recommends reducing the radicality of axillary surgery. The choice and extent of systemic therapy depends on the respective tumor biology. New substances are becoming available, particularly to treat metastatic breast cancer.
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Affiliation(s)
- Achim Wöckel
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | - Jasmin Festl
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | - Tanja Stüber
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | - Katharina Brust
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | | | - Peter U. Heuschmann
- Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
| | - Steffi Jírů-Hillmann
- Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
| | | | - Wilfried Budach
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | | | - Ina Kopp
- AWMF-Institut für Medizinisches Wissensmanagement, Marburg, Germany
| | | | - Thorsten Kühn
- Frauenklinik, Klinikum Esslingen, Esslingen, Germany
| | - Thomas Langer
- Office des Leitlinienprogrammes Onkologie, Berlin, Germany
| | - Monika Nothacker
- AWMF-Institut für Medizinisches Wissensmanagement, Marburg, Germany
| | - Anton Scharl
- Frauenklinik, Klinikum St. Marien Amberg, Amberg, Germany
| | | | - Hartmut Link
- Praxis für Hämatologie und Onkologie, Kaiserslautern, Germany
| | - Jutta Engel
- Tumorregister München, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, München, Germany
| | - Tanja Fehm
- Universitätsfrauenklinik Düsseldorf, Düsseldorf, Germany
| | - Joachim Weis
- Stiftungsprofessur Selbsthilfeforschung, Tumorzentrum/CCC Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Anja Welt
- Innere Klinik (Tumorforschung), Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Germany
| | | | - Petra Feyer
- Klinik für Strahlentherapie und Radioonkologie, Vivantes Klinikum, Neukölln Berlin, Germany
| | - Klaus König
- Berufsverband der Frauenärzte, Steinbach, Germany
| | | | | | - Hans H. Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Wolfram Trudo Knoefel
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Michael Denkinger
- AGAPLESION Bethesda Klinik, Geriatrie der Universität Ulm, Ulm, Germany
| | - Sara Brucker
- Universitätsfrauenklinik Tübingen, Tübingen, Germany
| | - Diana Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Campus Benjamin Franklin, Universitätsklinikum Charité, Berlin, Germany
| | - Christian Kubisch
- Institut für Humangenetik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Gerlach
- III. Medizinische Klinik und Poliklinik, uct, Interdisziplinäre Abteilung für Palliativmedizin, Universitätsmedizin der Johannes Gutenberg Universität, Mainz, Germany
| | - Annette Lebeau
- Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | | | - Cordula Petersen
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Markus Hahn
- Universitätsfrauenklinik Tübingen, Tübingen, Germany
| | - Volker Hanf
- Frauenklinik Nathanstift, Klinikum Fürth, Fürth, Germany
| | | | | | - Renza Roncarati
- Frauenselbsthilfe nach Krebs – Bundesverband e. V., Bonn, Germany
| | - Alexander Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Christoph Heitmann
- Ästhetisch plastische und rekonstruktive Chirurgie, Camparihaus München, München, Germany
| | | | - Kerstin Paradies
- Konferenz Onkologischer Kranken- und Kinderkrankenpflege, Hamburg, Germany
| | - Vesna Bjelic-Radisic
- Universitätsfrauenklinik, Abteilung für Gynäkologie, Medizinische Universität Graz, Graz, Austria
| | - Friedrich Degenhardt
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover, Hannover, Germany
| | - Frederik Wenz
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Mannheim, Mannheim, Germany
| | - Oliver Rick
- Klinik Reinhardshöhe Bad Wildungen, Bad Wildungen, Germany
| | - Dieter Hölzel
- Tumorregister München, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, München, Germany
| | - Matthias Zaiss
- Praxis für interdisziplinäre Onkologie & Hämatologie, Freiburg, Germany
| | | | - Volker Budach
- Klinik für Radioonkologie und Strahlentherapie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Denkert
- Institut für Pathologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Gerber
- Universitätsfrauenklinik am Klinikum Südstadt, Rostock, Germany
| | - Hans Tesch
- Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany
| | | | - Hans-Peter Sinn
- Pathologisches Institut, Universität Heidelberg, Heidelberg, Germany
| | - Jürgen Dunst
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Karsten Münstedt
- Frauenklinik Offenburg, Ortenau Klinikum Offenburg-Gengenbach, Offenburg, Germany
| | - Ulrich Bick
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Eva Fallenberg
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Reina Tholen
- Deutscher Verband für Physiotherapie, Referat Bildung und Wissenschaft, Köln, Germany
| | - Roswita Hung
- Frauenselbsthilfe nach Krebs, Wolfsburg, Germany
| | - Freerk Baumann
- Centrum für Integrierte Onkologie Köln, Uniklinik Köln, Köln, Germany
| | - Matthias W. Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jens Blohmer
- Klinik für Gynäkologie incl. Brustzentrum, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Peter Fasching
- Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael P. Lux
- Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nadia Harbeck
- Brustzentrum, Frauenklinik, Universität München (LMU), München, Germany
| | - Peyman Hadji
- Klinik für Gynäkologie und Geburtshilfe, Krankenhaus Nordwest, Frankfurt, Germany
| | - Hans Hauner
- Lehrstuhl für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | | | | | - Jutta Hübner
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach, Offenbach, Germany
| | | | | | | | - Volker Möbus
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany
| | - Volkmar Müller
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Ute Nöthlings
- Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany
| | - Marcus Schmidt
- Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Universitätsmedizin der Johannes Gutenberg-Universität Mai, Germany nz, Mainz
| | - Rita Schmutzler
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Köln, Germany
| | - Andreas Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Florian Schütz
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Elmar Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Uniklinik RWTH Aachen, Aachen, Germany
| | | | - Michael Untch
- Klinik für Geburtshilfe und Gynäkologie, Helios Klinikum Berlin-Buch, Berlin, Germany
| | | | - Arno Bücker
- Klinik für Diagnostische und Interventionelle Radiologie am UKS, Universität des Saarlandes, Homburg, Germany
| | - Andreas Buck
- Nuklearmedizinische Klinik und Poliklinik des Universitätsklinikums Würzburg, Würzburg, Germany
| | - Stephanie Stangl
- Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
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Reimer T, Engel J, Schmidt M, Offersen BV, Smidt ML, Gentilini OD. Is Axillary Sentinel Lymph Node Biopsy Required in Patients Who Undergo Primary Breast Surgery? Breast Care (Basel) 2018; 13:324-330. [PMID: 30498416 PMCID: PMC6257084 DOI: 10.1159/000491703] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Local treatment of the axilla in clinically node-negative (cN0) early breast cancer patients with routine sentinel lymph node biopsy (SLNB) is debated for various reasons: i) pN staging information may not be necessary for the postoperative treatment decision regarding adjuvant systemic therapy in the great majority of patients; ii) the SLNB-positive rate is declining below 20% in specialized breast centers; iii) albeit being a minimally invasive procedure, SLNB causes a significant reduction in quality of life in 23% of patients; and iv) previous randomized trials from the pre-SLNB era did not show a disadvantage for patients without axillary surgery with regard to overall survival. These data support the hypothesis that avoiding axillary treatment in patients with clinically and sonographically unsuspicious lymph nodes seems to be a safe option, although omitting axillary surgery may increase the risk of locoregional recurrence. Currently, the information regarding node-positive status is essential to guide postoperative treatment such as systemic or radiation therapies in a non-negligible minority of patients. Three ongoing prospective European trials (SOUND, INSEMA, BOOG 2013-08) with axillary observation alone versus SLNB in cN0 patients and primary breast-conserving surgery have the objective to evaluate oncologic safety when omitting SLNB.
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Affiliation(s)
- Toralf Reimer
- Department of Obstetrics and Gynecology, University of Rostock, Rostock, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilians-University (LMU), Munich, Germany
| | - Marcus Schmidt
- Division of Molecular Medicine, Department of Obstetrics and Gynecology, Comprehensive Cancer Center, University Medical Center Mainz, Mainz, Germany
| | - Birgitte Vrou Offersen
- Department of Experimental Clinical Oncology and Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Marjolein L. Smidt
- Division of Surgical Oncology, Maastricht University Medical Centre, Maastricht, Netherlands
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45
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Wöckel A, Festl J, Stüber T, Brust K, Stangl S, Heuschmann PU, Albert US, Budach W, Follmann M, Janni W, Kopp I, Kreienberg R, Kühn T, Langer T, Nothacker M, Scharl A, Schreer I, Link H, Engel J, Fehm T, Weis J, Welt A, Steckelberg A, Feyer P, König K, Hahne A, Kreipe HH, Knoefel WT, Denkinger M, Brucker S, Lüftner D, Kubisch C, Gerlach C, Lebeau A, Siedentopf F, Petersen C, Bartsch HH, Schulz-Wendtland R, Hahn M, Hanf V, Müller-Schimpfle M, Henscher U, Roncarati R, Katalinic A, Heitmann C, Honegger C, Paradies K, Bjelic-Radisic V, Degenhardt F, Wenz F, Rick O, Hölzel D, Zaiss M, Kemper G, Budach V, Denkert C, Gerber B, Tesch H, Hirsmüller S, Sinn HP, Dunst J, Münstedt K, Bick U, Fallenberg E, Tholen R, Hung R, Baumann F, Beckmann MW, Blohmer J, Fasching PA, Lux MP, Harbeck N, Hadji P, Hauner H, Heywang-Köbrunner S, Huober J, Hübner J, Jackisch C, Loibl S, Lück HJ, von Minckwitz G, Möbus V, Müller V, Nöthlings U, Schmidt M, Schmutzler R, Schneeweiss A, Schütz F, Stickeler E, Thomssen C, Untch M, Wesselmann S, Bücker A, Krockenberger M. Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 1 with Recommendations for the Screening, Diagnosis and Therapy of Breast Cancer. Geburtshilfe Frauenheilkd 2018; 78:927-948. [PMID: 30369626 PMCID: PMC6202580 DOI: 10.1055/a-0646-4522] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 01/04/2023] Open
Abstract
Purpose The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer. Methods The process of updating the S3 guideline dating from 2012 was based on the adaptation of identified source guidelines which were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and the results of a systematic search of literature databases and the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point to develop recommendations and statements which were modified and graded in a structured consensus procedure. Recommendations Part 1 of this short version of the guideline presents recommendations for the screening, diagnosis and follow-up care of breast cancer. The importance of mammography for screening is confirmed in this updated version of the guideline and forms the basis for all screening. In addition to the conventional methods used to diagnose breast cancer, computed tomography (CT) is recommended for staging in women with a higher risk of recurrence. The follow-up concept includes suggested intervals between physical, ultrasound and mammography examinations, additional high-tech diagnostic procedures, and the determination of tumor markers for the evaluation of metastatic disease.
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Affiliation(s)
- Achim Wöckel
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | - Jasmin Festl
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | - Tanja Stüber
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | - Katharina Brust
- Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
| | - Stephanie Stangl
- Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
| | - Peter U. Heuschmann
- Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
| | | | - Wilfried Budach
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | | | - Ina Kopp
- AWMF-Institut für Medizinisches Wissensmanagement, Marburg, Germany
| | | | - Thorsten Kühn
- Frauenklinik, Klinikum Esslingen, Esslingen, Germany
| | - Thomas Langer
- Office des Leitlinienprogrammes Onkologie, Berlin, Germany
| | - Monika Nothacker
- AWMF-Institut für Medizinisches Wissensmanagement, Marburg, Germany
| | - Anton Scharl
- Frauenklinik, Klinikum St. Marien Amberg, Amberg, Germany
| | | | - Hartmut Link
- Praxis für Hämatologie und Onkologie, Kaiserslautern, Germany
| | - Jutta Engel
- Tumorregister München, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, München, Germany
| | - Tanja Fehm
- Universitätsfrauenklinik Düsseldorf, Düsseldorf, Germany
| | - Joachim Weis
- Stiftungsprofessur Selbsthilfeforschung, Tumorzentrum/CCC Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Anja Welt
- Innere Klinik (Tumorforschung), Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Germany
| | | | - Petra Feyer
- Klinik für Strahlentherapie und Radioonkologie, Vivantes Klinikum, Neukölln Berlin, Germany
| | - Klaus König
- Berufsverband der Frauenärzte, Steinbach, Germany
| | | | - Hans H. Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Wolfram Trudo Knoefel
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Michael Denkinger
- AGAPLESION Bethesda Klinik, Geriatrie der Universität Ulm, Ulm, Germany
| | - Sara Brucker
- Universitätsfrauenklinik Tübingen, Tübingen, Germany
| | - Diana Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Campus Benjamin Franklin, Universitätsklinikum Charité, Berlin, Germany
| | - Christian Kubisch
- Institut für Humangenetik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Gerlach
- III. Medizinische Klinik und Poliklinik, uct, Interdisziplinäre Abteilung für Palliativmedizin, Universitätsmedizin der Johannes Gutenberg Universität, Mainz, Germany
| | - Annette Lebeau
- Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | | | - Cordula Petersen
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Markus Hahn
- Universitätsfrauenklinik Tübingen, Tübingen, Germany
| | - Volker Hanf
- Frauenklinik Nathanstift, Klinikum Fürth, Fürth, Germany
| | | | | | - Renza Roncarati
- Frauenselbsthilfe nach Krebs – Bundesverband e. V., Bonn, Germany
| | - Alexander Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Christoph Heitmann
- Ästhetisch plastische und rekonstruktive Chirurgie, Camparihaus München, München, Germany
| | | | - Kerstin Paradies
- Konferenz Onkologischer Kranken- und Kinderkrankenpflege, Hamburg, Germany
| | - Vesna Bjelic-Radisic
- Universitätsfrauenklinik, Abteilung für Gynäkologie, Medizinische Universität Graz, Graz, Austria
| | - Friedrich Degenhardt
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover, Hannover, Germany
| | - Frederik Wenz
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Mannheim, Mannheim, Germany
| | - Oliver Rick
- Klinik Reinhardshöhe Bad Wildungen, Bad Wildungen, Germany
| | - Dieter Hölzel
- Tumorregister München, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, München, Germany
| | - Matthias Zaiss
- Praxis für interdisziplinäre Onkologie & Hämatologie, Freiburg, Germany
| | | | - Volker Budach
- Klinik für Radioonkologie und Strahlentherapie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Denkert
- Institut für Pathologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Gerber
- Universitätsfrauenklinik am Klinikum Südstadt, Rostock, Germany
| | - Hans Tesch
- Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany
| | | | - Hans-Peter Sinn
- Pathologisches Institut, Universität Heidelberg, Heidelberg, Germany
| | - Jürgen Dunst
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Karsten Münstedt
- Frauenklinik Offenburg, Ortenau Klinikum Offenburg-Gengenbach, Offenburg, Germany
| | - Ulrich Bick
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Eva Fallenberg
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Reina Tholen
- Deutscher Verband für Physiotherapie, Referat Bildung und Wissenschaft, Köln, Germany
| | - Roswita Hung
- Frauenselbsthilfe nach Krebs, Wolfsburg, Germany
| | - Freerk Baumann
- Centrum für Integrierte Onkologie Köln, Uniklinik Köln, Köln, Germany
| | - Matthias W. Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jens Blohmer
- Klinik für Gynäkologie incl. Brustzentrum, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Peter A. Fasching
- Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael P. Lux
- Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nadia Harbeck
- Brustzentrum, Frauenklinik, Universität München (LMU), München, Germany
| | - Peyman Hadji
- Klinik für Gynäkologie und Geburtshilfe, Krankenhaus Nordwest, Frankfurt, Germany
| | - Hans Hauner
- Lehrstuhl für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | | | | | - Jutta Hübner
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach, Offenbach, Germany
| | | | | | | | - Volker Möbus
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany
| | - Volkmar Müller
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Ute Nöthlings
- Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany
| | - Marcus Schmidt
- Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Rita Schmutzler
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Köln, Germany
| | - Andreas Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Florian Schütz
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Elmar Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Uniklinik RWTH Aachen, Aachen, Germany
| | | | - Michael Untch
- Klinik für Geburtshilfe und Gynäkologie, Helios Klinikum Berlin-Buch, Berlin, Germany
| | | | - Arno Bücker
- Klinik für Diagnostische und Interventionelle Radiologie am UKS, Universität des Saarlandes, Homburg, Germany
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Sonntag M, Blosa M, Schmidt S, Reimann K, Blum K, Eckrich T, Seeger G, Hecker D, Schick B, Arendt T, Engel J, Morawski M. Synaptic coupling of inner ear sensory cells is controlled by brevican-based extracellular matrix baskets resembling perineuronal nets. BMC Biol 2018; 16:99. [PMID: 30253762 PMCID: PMC6156866 DOI: 10.1186/s12915-018-0566-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 04/09/2018] [Accepted: 08/15/2018] [Indexed: 02/08/2023] Open
Abstract
Background Perineuronal nets (PNNs) are specialized aggregations of extracellular matrix (ECM) molecules surrounding specific neurons in the central nervous system (CNS). PNNs are supposed to control synaptic transmission and are frequently associated with neurons firing at high rates, including principal neurons of auditory brainstem nuclei. The origin of high-frequency activity of auditory brainstem neurons is the indefatigable sound-driven transmitter release of inner hair cells (IHCs) in the cochlea. Results Here, we show that synaptic poles of IHCs are ensheathed by basket-like ECM complexes formed by the same molecules that constitute PNNs of neurons in the CNS, including brevican, aggreccan, neurocan, hyaluronan, and proteoglycan link proteins 1 and 4 and tenascin-R. Genetic deletion of brevican, one of the main components, resulted in a massive degradation of ECM baskets at IHCs, a significant impairment in spatial coupling of pre- and postsynaptic elements and mild impairment of hearing. Conclusions These ECM baskets potentially contribute to control of synaptic transmission at IHCs and might be functionally related to PNNs of neurons in the CNS. Electronic supplementary material The online version of this article (10.1186/s12915-018-0566-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mandy Sonntag
- Paul-Flechsig-Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Maren Blosa
- Paul-Flechsig-Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sophie Schmidt
- Paul-Flechsig-Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Katja Reimann
- Paul-Flechsig-Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Kerstin Blum
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Tobias Eckrich
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Gudrun Seeger
- Paul-Flechsig-Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Dietmar Hecker
- Department of Otorhinolaryngology, School of Medicine, Saarland University, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, School of Medicine, Saarland University, Homburg, Germany
| | - Thomas Arendt
- Paul-Flechsig-Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Jutta Engel
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Markus Morawski
- Paul-Flechsig-Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany.
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de Boniface J, Schmidt M, Engel J, Smidt ML, Offersen BV, Reimer T. What Is the Best Management of cN0pN1(sn) Breast Cancer Patients? Breast Care (Basel) 2018; 13:331-336. [PMID: 30498417 DOI: 10.1159/000491704] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although the majority of breast cancer patients are clinically node-negative (cN0) at diagnosis, 15-20% will have a metastatic sentinel lymph node (SLN, pN1(sn)). While a less radical approach regarding axillary surgery in cN0 patients with a positive SLN biopsy is advocated, the limitations of 5 published trials on axillary management in pN1(sn) are discussed intensely in the literature and support the performance of ongoing validation and extension trials, especially considering the lack of data in the setting of mastectomy. As locoregional radiotherapy has a significant effect on both recurrence and survival, a standardization of locoregional radiotherapy in the situation of SLN biopsy alone in pN1(sn) patients has to be defined in the future, and de-escalation trials should embrace a truly multidisciplinary approach. This is also of utmost importance considering the fact that high-volume nodal disease requires an intensified adjuvant chemotherapy strategy to which patients omitting axillary dissection cannot be stratified. Finally, there is mounting evidence that the therapeutic role of extensive axillary surgery in low-volume nodal disease is negligible, and multidisciplinary and translational efforts must be undertaken to individualize treatment in order to gain a reasonable balance between necessary staging information and unnecessary treatment-related morbidity.
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Affiliation(s)
- Jana de Boniface
- Department of Surgery, Capio St. Göran's Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Schmidt
- Division of Molecular Medicine, Department of Obstetrics and Gynecology, Comprehensive Cancer Center, University Medical Center Mainz, Mainz, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR), Institute for Medical Information Processing, Biometry and Epidemiology (IBE) at the University Hospital of Munich, Ludwig Maximilians-University (LMU), Munich, Germany
| | - Marjolein L Smidt
- Division of Surgical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Birgitte Vrou Offersen
- Department of Experimental Clinical Oncology & Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Toralf Reimer
- Department of Obstetrics and Gynecology, University of Rostock, Rostock, Germany
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Eckrich T, Blum K, Milenkovic I, Engel J. Fast Ca 2+ Transients of Inner Hair Cells Arise Coupled and Uncoupled to Ca 2+ Waves of Inner Supporting Cells in the Developing Mouse Cochlea. Front Mol Neurosci 2018; 11:264. [PMID: 30104958 PMCID: PMC6077211 DOI: 10.3389/fnmol.2018.00264] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 03/23/2018] [Accepted: 07/12/2018] [Indexed: 01/29/2023] Open
Abstract
Before the onset of hearing, which occurs around postnatal day 12 (P12) in mice, inner hair cells (IHCs) of the immature cochlea generate sound-independent Ca2+ action potentials (APs), which stimulate the auditory pathway and guide maturation of neuronal circuits. During these early postnatal days, intercellular propagating Ca2+ waves elicited by ATP-induced ATP release are found in inner supporting cells (ISCs). It is debated whether IHCs are able to fire Ca2+ APs independently or require a trigger by an ISC Ca2+ wave. To identify the Ca2+ transients of IHCs underlying Ca2+ APs and to analyze their dependence on ISC Ca2+ waves, we performed fast Ca2+ imaging of Fluo-8 AM-loaded organs of Corti at P4/P5. Fast Ca2+ transients (fCaTs) generated by IHCs were simultaneously imaged with Ca2+ waves in ISCs. ISC Ca2+ waves frequently evoked bursts consisting of >5 fCaTs in multiple adjacent IHCs. Although Ca2+ elevations of small amplitude appeared to be triggered by ISC Ca2+ waves in IHCs of Cav1.3 knockout mice we never observed fCaTs, indicating their requirement for Ca2+ influx through Cav1.3 channels. The Ca2+ wave-triggered Ca2+ upstroke in wildtype IHCs occurred 0.52 ± 0.27 s later than the rise of the Ca2+ signal in the adjacent ISCs. In comparison, superfusion of 1 μM ATP elicited bursts of fCaTs in IHCs starting 0.99 ± 0.34 s prior to Ca2+ elevations in adjacent ISCs. PPADS irreversibly abolished Ca2+ waves in ISCs and reversibly reduced fCaTs in IHCs indicating differential involvement of P2 receptors. IHC and ISC Ca2+ signals were however unaltered in P2X2R/P2X3R double knockout or in P2X7R knockout mice. Together, our data revealed a fairly similar occurrence of fCaTs within a burst (56.5%) compared with 43.5% as isolated single fCaTs or in groups of 2–5 fCaTs (minibursts). We provide evidence that IHCs autonomously generate single fCaTs and minibursts whereas bursts synchronized between neighboring IHCs were mostly triggered by ISC Ca2+ waves. Neonatal IHCs thus spontaneously generate electrical and Ca2+ activity, which is enhanced and largely synchronized by activity of ISCs of Kölliker’s organ indicating two sources of spontaneous activity in the developing auditory system.
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Affiliation(s)
- Tobias Eckrich
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, School of Medicine, Homburg, Germany
| | - Kerstin Blum
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, School of Medicine, Homburg, Germany
| | - Ivan Milenkovic
- Carl-Ludwig-Institute for Physiology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Jutta Engel
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, School of Medicine, Homburg, Germany
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Sixou S, Müller K, Jalaguier S, Kuhn C, Harbeck N, Mayr D, Engel J, Jeschke U, Ditsch N, Cavaillès V. Importance of RIP140 and LCoR Sub-Cellular Localization for Their Association With Breast Cancer Aggressiveness and Patient Survival. Transl Oncol 2018; 11:1090-1096. [PMID: 30007204 PMCID: PMC6070698 DOI: 10.1016/j.tranon.2018.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 11/29/2022] Open
Abstract
New markers are needed to improve diagnosis and to personalize treatments for patients with breast cancer (BC). Receptor-interacting protein of 140 kDa (RIP140) and ligand-dependent corepressor (LCoR), two transcriptional co-regulators of estrogen receptors, strongly interact in BC cells. Although their role in cancer progression has been outlined in the last few years, their function in BC has not been elucidated yet. In this study, we investigated RIP140 and LCoR localization (cytoplasm vs nucleus) in BC samples from a well-characterized cohort of patients (n = 320). RIP140 and LCoR were expressed in more than 80% of tumors, (predominantly in the cytoplasm), and the two markers were highly correlated. Expression of RIP140 and LCoR in the nucleus was negatively correlated with tumor size. Conversely, RIP140 and LCoR cytoplasmic expression strongly correlated with expression of two tumor aggressiveness markers: N-cadherin and CD133 (epithelial mesenchymal transition and cancer stem cell markers, respectively). Finally, high RIP140 nuclear expression was significantly correlated with longer overall survival, whereas high total or cytoplasmic expression of RIP140 was associated with shorter disease-free survival. Our study strongly suggests that the role of RIP140 and LCoR in BC progression could vary according to their prevalent sub-cellular localization, with opposite prognostic values for nuclear and cytoplasmic expression. The involvement in BC progression/invasiveness of cytoplasmic RIP140 could be balanced by the anti-tumor action of nuclear RIP140, thus explaining the previous contradictory findings about its role in BC.
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Affiliation(s)
- Sophie Sixou
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistrasse 11, D-80337 München, Germany; Université Paul Sabatier Toulouse III, Faculté des Sciences Pharmaceutiques, F-31062 Toulouse cedex 09, France.
| | - Katharina Müller
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistrasse 11, D-80337 München, Germany.
| | - Stéphan Jalaguier
- IRCM - Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, Parc Euromédecine, 208 rue des Apothicaires, F-34298 Montpellier Cedex 5, France.
| | - Christina Kuhn
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistrasse 11, D-80337 München, Germany.
| | - Nadia Harbeck
- Brustzentrum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität, Maistrasse 11, D-80337 München, Germany.
| | - Doris Mayr
- Department of Pathology, Campus Innenstadt, Ludwig-Maximilians-University Hospital, Thalkirchner Str. 36, D-80337 Munich, Germany.
| | - Jutta Engel
- Tumorregister München (TRM) des Tumorzentrums München (TZM) am Klinikum der Universität München (KUM), Marchionistraße 15, 81377 Munich, Germany.
| | - Udo Jeschke
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistrasse 11, D-80337 München, Germany.
| | - Nina Ditsch
- Department of Obstetrics and Gynaecology, Campus Großhadern, Ludwig-Maximilians-University Hospital, Marchionistraße 15, 81377 Munich, Germany.
| | - Vincent Cavaillès
- IRCM - Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, Parc Euromédecine, 208 rue des Apothicaires, F-34298 Montpellier Cedex 5, France.
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Kneer J, Engel J, Veit M, Ponseti J, Walter M, Beier K, Walter H, Schiffer B, Schiltz K, Krueger T. 201 Neural mechanisms underlying pedophilia and sexual offending against children - first results of a multicenter study. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.169] [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: 10/28/2022]
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