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Zarghooni K, Westermann L, Sobottke R, Röllinghoff M, Bredow J, Siewe J, Eysel P, Scheyerer MJ. Fracture risk of vertebral bodies after cryosurgery using a miniature cryoprobe: A biomechanical in-vitro analysis on human bones. Technol Health Care 2016; 25:343-351. [PMID: 27886022 DOI: 10.3233/thc-161277] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Due to spinal instability and compressive neurologic deficits surgical management is sometimes necessary in patients with metastatic spinal lesions. However, in some cases open surgery is not possible and minimally invasive procedures, like cryoablation, are needed. The aim of the current study was to investigate whether a miniature cryoprobe provides adequate tissue cooling in vertebrae and to evaluate the direct impact of cryosurgery on vertebral body stability. MATERIALS AND METHODS Twelve thoracic vertebral bodies were harvested from fresh cadavers. After documenting bone density cryoablation was performed in six vertebral bodies according to a standardized procedure. Afterwards temperature inside the vertebral body and maximum breaking force were measured in the control and experimental groups. RESULTS Required temperature of -50° was reached in all areas. There was a significant correlation between maximum breaking force and measured bone density (p= 0.001). Mean breaking force within the experimental group was 5047 N (SD = 2955 N) compared to 4458 N (SD = 2554 N) in the control group. There were no observable differences in maximum breaking force between both groups. CONCLUSION Miniature cryoprobe can deliver adequate tissue cooling to -50°C in vertebral bodies. The procedure does not seem to influence breaking force of the treated bones in-vitro. Therefore, using miniature probes cryosurgery may provide a valuable alternative to conventional surgical resection of neoplastic diseases as well as of benign locally aggressive bone tumors.
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Affiliation(s)
- K Zarghooni
- Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany
| | - L Westermann
- Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany
| | - R Sobottke
- Department of Orthopedics, Medical Center City Aachen GmbH, Wuerselen, Germany
| | - M Röllinghoff
- Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany.,Centre for Orthopaedics, University Medical Centre, Halle (Saale), Germany
| | - J Bredow
- Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany
| | - J Siewe
- Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany
| | - P Eysel
- Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany
| | - M J Scheyerer
- Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany
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Siewe J, Zarghooni K, Röllinghoff M, Herren C, Koy T, Eysel P, Sobottke R. [Complication analysis of spinal interventions in adult central movement disorders and scoliosis]. Z Orthop Unfall 2013; 151:454-62. [PMID: 23817804 DOI: 10.1055/s-0032-1328664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Adult central movement disorders, malpostures, and scolioses can have their cause in various neurological underlying diseases such as Morbus Parkinson, Pisa syndrome, or segmental dystonia. Important clinical characteristics are marked postural distortions such as camptocormia (bent spine) or laterocollis. In cases of these adult scolioses, surgical spine treatment puts high demands on the surgeon. Surgery in Parkinson's disease, for example, is associated with serious surgery-specific as well as general complications. The more rarely occurring Pisa syndrome is an entity primarily requiring medical therapy. PATIENTS AND METHODS A series of ten case reports of patients with Morbus Parkinson and Pisa syndrome who underwent spinal surgery is presented and discussed. From these reports, treatment recommendations have been derived and complemented by references from the literature. An extensive MEDLINE search was performed for this purpose. RESULTS AND CONCLUSION In patients suffering from Parkinson's disease, even minor surgical interventions can lead to instability of whole spine segments or even the entire spine. Implant loosening, adjacent segment instability, general perioperative complications, and progressive malposture due to disease progress can bring forth disastrous treatment courses. Spinal fixation should be performed long-segmented in combination with ventral stabilisation. Due to osteoporosis, pedicle screw cement augmentation is recommended in this collective. If the diagnosis of Pisa syndrome is established, an optimised preoperative preparation should be initiated in close cooperation with neurologists. In many cases medical therapy is sufficient and surgical interventions can be avoided.
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Affiliation(s)
- J Siewe
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universität Köln
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Alfieri A, Gazzeri R, Prell J, Röllinghoff M. The current management of lumbar spondylolisthesis. J Neurosurg Sci 2013; 57:103-113. [PMID: 23676859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Lumbar spondylolisthesis can lead to disabling low back pain and neurological deficits. This review details the clinical history, neurological examination, clinical presentation, imaging modalities, and current management standards for lumbar spondylolisthesis. Based on the available clinical trials, there is evidence that, compared with nonsurgical care, the surgical treatment of symptomatic spondylolisthesis offers a significant clinical benefit in the presence of progressive neurological deficits; cauda equina syndrome; failure of an adequate response to conservative therapy: radiographic instability with neurological symptoms; radiographic progression of subluxation to greater than grade II; symptomatic grades III, II, or spondyloptosis; and unremitting pain that affects the quality of life. Optimizing the diagnostic paths and surgical indications and standardizing both the surgical procedures as well as the outcome measurements with validated instruments should assist the spine care community in acquiring data that are essential for providing the best evidence-based treatment while reducing or eliminating procedures that lack evidence of either efficacy or value.
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Affiliation(s)
- A Alfieri
- Department of Neurosurgery, Martin Luther University, Halle, Germany.
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Gutteck N, Wohlrab D, Radetzki F, Zeh A, Röllinghoff M, Delank KS, Lebek S. Is it feasible to rely on intraoperative X ray in correcting hallux valgus? Arch Orthop Trauma Surg 2013; 133:753-5. [PMID: 23503889 DOI: 10.1007/s00402-013-1720-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The aim of the study was to prove whether the intraoperatively taken fluoroscopy pictures compared to the X rays taken 8 weeks and 3 months postoperatively picture the achieved correction reliably. METHOD In a prospective study, the pre- and postoperative standing foot X rays as well as the intraoperatively taken fluoroscopy pictures of 31 patients were analysed. The intermetatarsal angle (IMA) and the hallux valgus angle (HVA) were measured. In all cases, a tarso-metatarsal joint I arthrodesis combined with a distal soft tissue release was performed. The mean age was 54 (17-73) years. RESULTS There was no significant difference between the measured angles in intraoperative fluoroscopy and standing X rays postoperatively taken. CONCLUSIONS Despite the consideration that fluoroscopic pictures lack the loading criteria, we found reliable results in IMA and HVA.
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Affiliation(s)
- N Gutteck
- Department of Orthopaedic Surgery, Martin Luther University Halle Wittenberg, Magdeburger Straße 22, 06112, Halle (Saale), Germany.
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Röllinghoff M, Hagel A, Siewe J, Gutteck N, Delank KS, Steinmetz A, Zarghooni K. Ist eine Höhenrekonstruktion mit vergleichsweise wenig Zement für die
Radiofrequenz-Kyphoplastie über einen monopedikulären Zugang
möglich? Z Orthop Unfall 2013; 151:156-62. [DOI: 10.1055/s-0032-1328418] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hintergrund: Perkutane Zementaugmentationssysteme haben sich in den
letzten 10 Jahren als eine effektive Behandlungsmethode bei
Kompressionsfrakturen durchgesetzt. Als Sonderform ist nun seit 2009 die
Radiofrequenz-Kyphoplastie (RF) hinzugekommen, die durch applizierbare
Energie die Viskosität des Zements erhöht. Ziel dieser Studie war es,
herauszufinden, ob mit einer vergleichsweise geringen Zementmenge eine
Wirbelkörpererhöhung für osteoporotische Wirbelkörperfrakturen bei der
RF-Kyphoplastie zu erreichen ist. Material und Methode: Bei diesem
minimalinvasiven Verfahren wurde das „StabiliT® Vertebral Augmentation
System“ der Firma DFine verwendet. Im Rahmen einer retrospektiven Studie
wurden von 2011 bis Januar 2012 insgesamt 35 Patienten mit 49
osteoporotischen Wirbelkörperfrakturen versorgt. Als Parameter wurden die
Altersstruktur mit Geschlechtsverteilung sowie klinisch der Verlauf der
Schmerzintensität anhand der visuellen Analogskala (VAS0–100) ausgewertet.
Radiologisch wurde die Wirbelkörpererhöhung (Vorder-, Hinterkante, mittlere
Wirbelkörperhöhe und Kyphosewinkel) erfasst und mit dem applizierten
Zementvolumen verglichen. Ergebnisse: Alle Patienten hatten vor der
Operation eine gescheiterte konservative Behandlung mit weiterhin
bestehenden Schmerzen auf Höhe des frakturierten Wirbelkörpers. Bis zur
operativen Versorgung vergingen durchschnittlich 3,0 ± 1,3 Wochen. Die
durchschnittliche VAS reduzierte sich signifikant von 71 ± 9,2 präoperativ
auf 35 ± 6,2 postoperativ (p < 0,001) und nach 3 Monaten weiter auf
30 ± 5,7 (p < 0,001). Mit einem durchschnittlichen Zementvolumen von
2,9 ± 0,7 ml (1,8–4,1) im Thoralbereich und einem durchschnittlichen
Zementvolumen von 3,0 ± 0,7 ml (2,0–5,0) im Lumbalbereich wurde eine
statistisch signifikante Wirbelkörperaufrichtung erreicht. Die Vorderkante
und die mittlere Wirbelkörperhöhe wurden signifikant um 2,3 mm und 3,1 mm
angehoben, der Kyphosewinkel reduzierte sich ebenfalls signifikant um 2,1°
nach 3 Monaten. Bei 2 Wirbelkörpern (4,1 %) zeigte sich ein minimaler
Zementaustritt in die angrenzende Bandscheibe ohne klinische Konsequenz. Bei
2 Patienten entwickelten sich Anschlussfrakturen im kranialen Segment, die
erneut mit einer RF-Kyphoplastie behandelt wurden. Schlussfolgerung:
Mit einem durchschnittlichen Zementvolumen von 3 ml konnte mit der
RF-Kyphoplastie eine schnelle und kurzfristige Besserung der
Schmerzsymptomatik erreicht werden. Zusätzlich konnte mit diesem geringen
Zementvolumen eine signifikante Wirbelkörperaufrichtung erzeugt werden. Es
zeigte sich keine Korrelation zwischen der Wirbelkörperaufrichtung und dem
klinischen Ergebnis. Mit der ermittelten Zementleckagenrate von 4,1 % gehört
die Radiofrequenz-Kyphoplastie zu den sicheren und effektiven
minimalinvasiven perkutanen Zementaugmentationsverfahren. Unsere Daten
bestätigen die in der Literatur angegebene höhere Sicherheit für die
Kyphoplastie im Vergleich zur Vertebroplastie.
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Affiliation(s)
- M. Röllinghoff
- Klinik und Poliklinik für Orthopädie, Universität Halle-Wittenberg,
Halle (Saale)
| | - A. Hagel
- Klinik und Poliklinik für Orthopädie, Universität Halle-Wittenberg,
Halle (Saale)
| | - J. Siewe
- Klinik für Orthopädie und Unfallchirurgie, Universität zu
Köln
| | - N. Gutteck
- Klinik und Poliklinik für Orthopädie, Universität Halle-Wittenberg,
Halle (Saale)
| | - K.-S. Delank
- Klinik und Poliklinik für Orthopädie, Universität Halle-Wittenberg,
Halle (Saale)
| | - A. Steinmetz
- Klinik und Poliklinik für Orthopädie, Universität Halle-Wittenberg,
Halle (Saale)
| | - K. Zarghooni
- Klinik für Orthopädie und Unfallchirurgie, Universität zu
Köln
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Radetzki F, Mendel T, Noser H, Stoevesandt D, Röllinghoff M, Gutteck N, Delank KS, Wohlrab D. Potentialities and limitations of a database constructing three-dimensional virtual bone models. Surg Radiol Anat 2013; 35:963-8. [DOI: 10.1007/s00276-013-1118-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 04/02/2013] [Indexed: 10/27/2022]
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Siewe J, Rudat J, Röllinghoff M, Schlegel UJ, Eysel P, Michael JWP. Injuries and Overuse Syndromes in Powerlifting. Int J Sports Med 2011; 32:703-11. [DOI: 10.1055/s-0031-1277207] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sobottke R, Röllinghoff M, Siewe J, Schlegel U, Yagdiran A, Spangenberg M, Lesch R, Eysel P, Koy T. Clinical outcomes and quality of life 1 year after open microsurgical decompression or implantation of an interspinous stand-alone spacer. ACTA ACUST UNITED AC 2010; 53:179-83. [PMID: 21132610 DOI: 10.1055/s-0030-1263108] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Interspinous stand-alone implants are inserted without open decompression to treat symptomatic lumbar spinal stenosis (LSS). The insertion procedure is technically simple, low-risk, and quick. However, the question remains whether the resulting clinical outcomes compare with those of microsurgical decompression, the gold standard. MATERIAL AND METHODS This prospective, comparative study included all patients (n=36) with neurogenic intermittent claudication (NIC) secondary to LSS with symptoms improving in forward flexion treated operatively with either interspinous stand-alone spacer insertion (Aperius (®); Medtronic, Tolochenaz, Switzerland) (group 1) or microsurgical bilateral operative decompression (group 2) between February 2007 and November 2008. Data (patient data, operative data, COMI, SF-36 PCS and MCS, ODI, and walking tolerance) were collected preoperatively as well as at 6 weeks, at 3, 6, and 9 months, and at one year follow-up (FU). All patients had complete FU over 1 year. RESULTS Compared to preoperative measurements, surgery led to improvements of all parameters in the entire collective as well as both individual groups. There were no statistically relevant differences between the 2 groups over the entire course of FU. However, improvements in the ODI and SF-36 MCS were not significant in group 1, in contrast to those of group 2. Also, although in group 1 the improvements in leg pain (VAS leg) were still significant (p<0.05) at 6 months, this was no longer the case at 1 year FU. In group 1 at 1 year FU an increase in leg pain was observed, while in group 2, minimal improvements continued. Walking tolerance was significantly improved at all FU times compared to preoperatively, regardless of group (p<0.01). At no time there was a significant difference between the groups. In group 1, admission and operative times were shorter and blood loss decreased. The complication rate was 0% in group 1 and 20% in group 2, however reoperation was required by 27.3% of group 1 patients and 0% of group 2. CONCLUSION Implantation of an interspinous stand-alone spacer yields clinical success comparable to open decompression, at least within the first year of FU. The 1-year conversion rate of 27.3% is, however, decidedly too high.
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Affiliation(s)
- R Sobottke
- Department of Orthopaedic and Trauma Surgery, University of Cologne, Joseph-Stelzmann-Straße 9, Cologne, Germany.
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Röllinghoff M, Zarghooni K, Dargel J, Schlegel UJ, Siewe J, Eysel P, Sobottke R. The present role of vertebroplasty and kyphoplasty in the treatment of fresh vertebral compression fractures. MINERVA CHIR 2010; 65:429-437. [PMID: 20802431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Vertebroplasty (VP) and kyphoplasty (KP) are minimally invasive vertebral augmentation procedures for the treatment of fresh vertebral compression fractures (VCFs) associated with osteoporosis, trauma, malignant conditions, hemangiomas, and osteonecrosis. During these procedures, bone cement (e.g., polymethylmethacrylate) is percutaneously injected into the vertebral body. Systematic reviews of both procedures have shown significantly improved back pain and quality of life compared to conservative therapy. Direct comparison between VP and KP is not possible because of the lack of prospective randomized data comparing the two procedures. Both appear to improve patient functional status in most studies, although it is difficult to pool the available data because of differing measurement scales. With increasing popularity of both techniques, particularly over the past ten years, a rising number of publications have detailed potential complications secondary to cement extravasation, from compression of neural elements to venous embolism. Overall complication rates for both procedures are low. Systematic reviews have found significantly higher rates of cement leakage after VP (40%) versus KP (8%), with 3% of VP leaks being symptomatic. The evidence for increased risk of adjacent level fracture after these procedures compared to conservative treatment is inconclusive. When performed by a well-trained practitioner in appropriately selected patients, vertebroplasty and kyphoplasty are both safe and effective treatments for fresh vertebral compression fractures. Results from ongoing randomized controlled trials will provide further detailed information about both procedures in the future.
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Affiliation(s)
- M Röllinghoff
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
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Zarghooni K, Röllinghoff M, Siewe J, Fätkenheuer G, Seifert H, Eysel P, Sobottke R. [Spondylodiscitis - an interdisciplinary challenge]. Dtsch Med Wochenschr 2010; 135:1182-5. [PMID: 20514599 DOI: 10.1055/s-0030-1255128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
HISTORY AND ADMISSION FINDINGS A 21-year-old man presented with severe lumbar back pain and progressive paraparesis with clinical signs of spondylitis. Laboratory findings revealed elevated infectious parameters. Because of a positive Mantoux-Test he had been treated with quadruple tuberculostatic drugs for eight weeks without prior identification of the causative pathogen. INVESTIGATIONS Magnetic resonance imaging of the spine revealed a multisegmental spondylitis of the lumbar vertebrae (L3 - L5) with epidural empyema. Computed tomography (CT) of the abdomen confirmed large bilateral abscesses in the psoas muscles. TREATMENT AND COURSE The findings supported the diagnosis of spondylitis. The antibiotic regimen was continued. CT-guided drainage was placed in both psoas muscles. Laminectoma of L3 - 5 and dorsal spondylodesis of L2 - S1 were performed immediately. Mycobacterium tuberculosis was cultured from the intraoperative biopsies and treated according to the drug sensitivity test. After further surgical debridment and corporectomy of L4 and L5 the infection was successfully treated. Ten weeks after admission the patient was transferred to a neurologic rehabilitation unit for mobilization. CONCLUSION Spondylodiscitis treatment is complex and requires a multidisciplinary approach.
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Affiliation(s)
- K Zarghooni
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie der Universität zu Köln.
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Schlueter-Brust K, Bontemps G, Sobottke R, Röllinghoff M, Michael JWP, Siewe J, Eysel P. The future of surgical orthopaedics of the knee. Proc Inst Mech Eng H 2010; 224:729-34. [DOI: 10.1243/09544119jeim754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Over the past two decades, orthopaedics has gone through major changes, principally in the surgical treatment options for articular defects of the knee. This paper explores the advantages and shortcomings of the current surgical treatment modalities for cartilaginous defects in the knee. Emphasis is placed on current techniques in knee arthroplasty, including a view on the future of orthopaedic knee surgery.
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Affiliation(s)
- K Schlueter-Brust
- Klinikum der Universität zu Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Cologne, Germany
| | - G Bontemps
- Fabricius Klinik, Abteilung für Orthopädische Chirurgie, Remscheid, Germany
| | - R Sobottke
- Klinikum der Universität zu Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Cologne, Germany
| | - M Röllinghoff
- Klinikum der Universität zu Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Cologne, Germany
| | - J W-P Michael
- Klinikum der Universität zu Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Cologne, Germany
| | - J Siewe
- Klinikum der Universität zu Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Cologne, Germany
| | - P Eysel
- Klinikum der Universität zu Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Cologne, Germany
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Röllinghoff M, Siewe J, Zarghooni K, Sobottke R, Alparslan Y, Eysel P, Delank KS. Effectiveness, Security and Height Restoration on Fresh Compression Fractures – A Comparative Prospective Study of Vertebroplasty and Kyphoplasty. ACTA ACUST UNITED AC 2010; 52:233-7. [DOI: 10.1055/s-0029-1243631] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zilkens G, Röllinghoff M, Sobottke R, Eysel P, Delank KS. [Cage assisted fusion operation of the spine]. Z Orthop Unfall 2009; 147:751-60; quiz 761-2. [PMID: 19998223 DOI: 10.1055/s-0029-1240614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- G Zilkens
- Klinik für Orthopädie und Unfallchirurgie der Universität zu Köln.
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Röllinghoff M, Koriller M, Sobottke R, Delank KS, Eysel P. Dorsal corporectomy in a Ewing sarcoma situated in the pedicle of the L5 vertebral body. Zentralbl Neurochir 2008; 69:200-3. [PMID: 18949684 DOI: 10.1055/s-2008-1080938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The clinical case of a 34-year-old patient is presented who was diagnosed with Ewing sarcoma in the right pedicle of the L5 vertebral body on the basis of persisting dorsolumbar pain. Staging examinations including CT scan of the thorax and abdomen as well as bone scintigraphy were inconspicuous. The patient underwent 6 cycles of neoadjuvant chemotherapy (VIDE, similar to Euro Ewing 99). Presurgically, embolisation of the L4 and L5 vertebral bodies was performed on both sides. The tumour was removed via a dorsal approach with corporectomy of L5 and resection of the right nerve root of L5. The defect was bridged by a titanium cage filled with bone cement; a dorsal L4-S1 instrumentation was performed. Early postoperative X-rays showed a screw dislocation in S1, making a revision intervention and screw replacement necessary. For additional fixation, S2 was instrumented. Histopathology classified the tissue samples as containing no active tumour cells. Surgery was followed by additional chemotherapy. The patient has remained free of recurrence until now. The aim of this case report is to call attention to the unusual site of the Ewing sarcoma as well as to discuss therapy options, especially dorsal corporectomy, and the prognosis together with a review of the most current literature.
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Affiliation(s)
- M Röllinghoff
- Department of Orthopedic Surgery, Universitiy of Cologne, Köln, Germany.
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Abstract
Cytotoxic T lymphocytes specific for immune alloantigens controlled by alleles of the Ly system have been induced in vivo. These results were obtained either in a secondary type of response or by treating mice before immunization with a single dose of cyclophosphamide (80 mg/kg).
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Röllinghoff M, Sobottke R, Koy T, Delank KS, Eysel P. Minimalinvasive Operationen an der Lendenwirbelsäule. Teil 2. Z Orthop Unfall 2008; 146:395-408. [DOI: 10.1055/s-2008-1038546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Röllinghoff M, Delank KS, Haupt WF, Eysel P. [Erysipel at the lower leg combined with a peripheral peroneus nerve palsy--an unusual occurrence]. ACTA ACUST UNITED AC 2006; 144:639-42. [PMID: 17187341 DOI: 10.1055/s-2006-955187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We present the clinical case of a fifty-year-old man who presented two times with a foot elevator paresis and an erysipel first on the right and after two months on the left side. Afterwards, we carried out a thorough case history with the help of clinical, radiological and magnetic resonance imaging. Even so the clinical pathology of the foot elevator paresis could not be manifested. A compartment syndrome could be discounted. In the context of the second stay during a neurology examination on both legs electromyography was performed and the nerve speed was tested. A peripheral peroneus paresis of unknown level and of unknown aetiology was demonstrated. The erysipel regressed rapidly under intravenous ampicillin antibiotics while the peroneus paresis was unchanged. The patent was released with a peroneus splint on both sides. With this case report we would like to point out the causes of peripheral peroneus paresis with regard to an additional erysipel. This case report is discussed regarding the possible aetiopathology and the current literature.
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Affiliation(s)
- M Röllinghoff
- Universitätsklinikum zu Köln, Orthopädische Klinik, Germany.
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18
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Stenger S, Liu P, Meinken C, Ganz T, Bals R, Zügel U, Steinmeyer A, Ficker J, Modlin R, Röllinghoff M, Wagner M. Toll-like Rezeptoren induzieren einen Vitamin D abhängigen Abwehrmechanismus gegen Mycobacterium tuberculosis in Alveolarmakrophagen. Pneumologie 2006. [DOI: 10.1055/s-2006-933856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Stenger S, Böhmer G, Leistner RD, Gilleron M, Puzo G, DeLibero G, Habich G, Röllinghoff M, Ficker JH, Wagner M. Sulfoglykolipid (Ac2SGL) als neuer Impfstoff gegen Tuberkulose. Pneumologie 2004. [DOI: 10.1055/s-2004-819495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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20
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Taylor BN, Harrer T, Pscheidl E, Schweizer A, Röllinghoff M, Schröppel K. Surveillance of nosocomial transmission of Candida albicans in an intensive care unit by DNA fingerprinting. J Hosp Infect 2004; 55:283-9. [PMID: 14629972 DOI: 10.1016/s0195-6701(03)00295-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The frequency of nosocomial transmission of the opportunistic fungal pathogen Candida albicans in an intensive care unit was tested by DNA fingerprinting of 91 isolates from 32 hospitalized patients with the mid-repetitive Ca3 DNA probe. This showed that serial isolates of C. albicans from individual patients belonged to genetically distinct strains. In comparison with nosocomial bacterial pathogens, the transmission of C. albicans in an intensive care unit occurred at a much lower frequency. In conclusion, the threat of C. albicans infection does not lie within the hospital, but in commensal isolates. These findings are relevant for infection control practices.
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Affiliation(s)
- B N Taylor
- Institute of Clinical Microbiology, Immunology and Hygiene, Faculty of Medicine, Friedrich-Alexander University Erlangen-Nürnberg, Wasserturmstrasse 3/5, Erlangen, Germany
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21
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Berger TG, Schoerner C, Schell H, Simon M, Schuler G, Röllinghoff M, Gessner A. Two unusual cases of diffuse acrodermatitis chronica atrophicans seronegative for Lyme borreliosis. Eur J Clin Microbiol Infect Dis 2003; 22:392-5. [PMID: 12783283 DOI: 10.1007/s10096-003-0943-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- T G Berger
- Dermatologische Klinik der Universität Erlangen-Nürnberg, Erlangen, Germany
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22
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Von Loewenich FD, Stumpf G, Baumgarten BU, Röllinghoff M, Dumler JS, Bogdan C. A case of equine granulocytic ehrlichiosis provides molecular evidence for the presence of pathogenic anaplasma phagocytophilum (HGE agent) in Germany. Eur J Clin Microbiol Infect Dis 2003; 22:303-5. [PMID: 12740667 DOI: 10.1007/s10096-003-0935-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Based on seroprevalence studies and tick infection rates, tick-borne human granulocytic ehrlichiosis (HGE) is thought to occur in Germany, but to date no clinical case has been detected. Reported here are the first ehrlichial sequences derived from a German horse that fell ill with granulocytic ehrlichiosis. The analysis of three different genes (16S rRNA gene, groESL, and ankA) revealed up to 100% identity with ehrlichial sequences derived from patients with HGE in other countries or from infected ticks in Germany. Thus, the current lack of clinical cases of HGE in Germany is unlikely to result from the absence of pathogenic granulocytic ehrlichiae strains in German ticks.
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Affiliation(s)
- F D Von Loewenich
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen, Wasserturmstrasse 3-5, 91054, Erlangen, Germany
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23
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Abstract
Drosophila, the toll gene controls a powerful innate defense system against bacteria and fungi. Conserved through evolution, the mammalian innate immune system retains a family of homologous Toll-like receptors (TLRs) that are activated by microbial ligands to release cytokines that instruct the adaptive immune responses. Here we show that TLR2 activation leads to killing of intracellular Mycobacterium (M.) tuberculosis in both mouse and human macrophages. In mouse macrophages, bacterial lipoprotein activation of TLR2 leads to a nitric oxide-dependent killing of intracellular tubercle bacilli. In human monocytes and alveolar macrophages, bacterial lipoproteins similarly activated TLR2 to kill intracellular M. tuberculosis, however by an antimicrobial pathway that is nitric oxide independent. TLR2+CD14+CD68+ macrophages were detected in human lesions of tuberculous lymphadenitis within granulomas and surrounding foci of necrosis. These data provide evidence that mammalian TLRs have retained not only the structural features of Drosophila Toll that allow them to respond to microbial ligands, but also the ability directly to activate antimicrobial effector pathways at the site of infection.
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Affiliation(s)
- S Stenger
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich-Alexander Universität Erlangen-Nürnberg, Germany.
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24
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Affiliation(s)
- S Stenger
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universität Erlangen, Germany.
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25
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Matzer SP, Baumann T, Lukacs NW, Röllinghoff M, Beuscher HU. Constitutive expression of macrophage-inflammatory protein 2 (MIP-2) mRNA in bone marrow gives rise to peripheral neutrophils with preformed MIP-2 protein. J Immunol 2001; 167:4635-43. [PMID: 11591793 DOI: 10.4049/jimmunol.167.8.4635] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Macrophage-inflammatory protein 2 (MIP-2) is a major CXC chemokine involved in the migration of polymorphonuclear neutrophils (PMNs) to sites of inflammation. Although cell culture experiments have identified different cell types that can produce MIP-2, the cellular sources in vivo are not clearly defined. By using immunohistochemical staining and analysis of chemokine mRNA expression, the present study aimed to localize cells producing MIP-2 in tissues of normal mice and mice challenged with Yersinia enterocolitica. The results showed a constitutive expression of MIP-2 mRNA in bone marrow (BM) of normal mice, but not in other organs such as spleen, lung, or liver. MIP-2 protein was found in all organs tested but it was exclusively associated with PMNs that stained positive with the cell surface marker Gr-1. Bacterial infection caused a 5-fold increase in the number of MIP-2-positive PMNs recruited to spleens concomitant with a strong increase of splenic MIP-2 mRNA. This correlated well with a 3-fold loss of MIP-2-producing cells in BM. Because MIP-2 mRNA expression in PMNs was increased after stimulation with TNF, the results indicate that newly recruited PMNs can supplement their MIP-2 content through TNF-stimulated transcription. Together, the data imply a constitutive production of MIP-2 by a subset of PMNs in BM and argue for the possibility of a rapid mobilization of MIP-2 through its storage in circulating PMNs.
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Affiliation(s)
- S P Matzer
- Institute for Clinical Microbiology, Immunology, and Hygiene, University of Erlangen, Erlangen, Germany
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26
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Geissdörfer W, Wittmann I, Röllinghoff M, Schoerner C, Bogdan C. Detection of a new 16S-23S rRNA spacer sequence variant (type 7) of Tropheryma whippelii in a patient with prosthetic aortic valve endocarditis. Eur J Clin Microbiol Infect Dis 2001; 20:762-3. [PMID: 11757986 DOI: 10.1007/s100960100588] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- W Geissdörfer
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Erlangen, Germany.
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27
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Sommer F, Faller G, Röllinghoff M, Kirchner T, Mak TW, Lohoff M. Lack of gastritis and of an adaptive immune response in interferon regulatory factor-1-deficient mice infected with Helicobacter pylori. Eur J Immunol 2001. [PMID: 11180103 DOI: 10.1002/1521-4141(200102)31:2<396::aid-immu396>3.0.co;2-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To study the role of T cell responses in Helicobacter pylori gastritis, C57BL/6 wild-type and interferon regulatory factor-1-deficient (IRF-1(-/-)) mice were infected with the mouse-adapted H. pylori Sydney strain. Mice lacking the transcription factor IRF-1 are defective in Th1 development and are therefore biased to mount a Th2-type response. After 4 months of infection, C57BL/6 mice developed severe gastritis and atrophy and mounted a Th1-type response towards H. pylori. The Th1 response was abrogated in IRF-1(-/-) mice. This defective Th1 response was associated with the total lack of gastritis and atrophy in IRF-1(-/-) mice despite severe colonization with H. pylori. In addition, IRF-1(-/-) mice did also not develop a Th2 reaction, since they failed to generate H. pylori-specific antibodies and to produce IL-4 in response to H. pylori antigens in vitro. Thus, the transcription factor IRF-1 is necessary for the development of gastritis and atrophy in H. pylori-infected wild-type mice, suggesting a role of Th1 cells in the pathogenesis of H. pylori-associated diseases.
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Affiliation(s)
- F Sommer
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, University of Erlangen, Erlangen, Germany.
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28
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Wilhelm P, Ritter U, Labbow S, Donhauser N, Röllinghoff M, Bogdan C, Körner H. Rapidly fatal leishmaniasis in resistant C57BL/6 mice lacking TNF. J Immunol 2001; 166:4012-9. [PMID: 11238648 DOI: 10.4049/jimmunol.166.6.4012] [Citation(s) in RCA: 150] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The resolution of infections with the protozoan parasite Leishmania major in mice requires a Th1 response that is closely associated with the expression of IL-12, IFN-gamma, and inducible NO synthase. Previous Ab neutralization studies or the use of mice deficient for both TNF receptors suggested that TNF plays only a limited role in the control of parasite replication in vivo. In this study we demonstrate that resistant C57BL/6 (B6.WT) mice locally infected with L. major rapidly succumb to progressive visceral leishmaniasis after deletion of the TNF gene by homologous recombination. A reduction of the parasite inoculum to 3000 promastigotes did not prevent the fatal outcome of the disease. An influence of the altered morphology of secondary lymphoid organs in C57BL/6-TNF(-/-) (B6.TNF(-/-)) mice on the course of disease could be excluded by the generation of reciprocal bone marrow chimeras. Although infected B6.TNF(-/-) mice mounted an L. major-specific IFN-gamma response and expressed IL-12, the onset of the immune reaction was delayed. After in vitro stimulation, B6.TNF(-/-) inflammatory macrophages released 10-fold less NO in response to IFN-gamma than B6.WT cells. However, in the presence of a costimulus, e.g., L. major infection or LPS, the production of NO by B6.WT and B6.TNF(-/-) macrophages was comparable. In vivo, inducible NO synthase protein was readily detectable in skin lesions and draining lymph nodes of B6.TNF(-/-) mice, but its expression was more disperse and less focal in the absence of TNF. These are the first data to demonstrate that TNF is essential for the in vivo control of L. major.
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MESH Headings
- Animals
- Antibodies, Protozoan/biosynthesis
- Antibodies, Protozoan/blood
- Bone Marrow Transplantation/immunology
- Disease Progression
- Dose-Response Relationship, Immunologic
- Genetic Predisposition to Disease
- Hypersensitivity, Delayed/genetics
- Hypersensitivity, Delayed/immunology
- Hypersensitivity, Delayed/parasitology
- Immunity, Cellular/genetics
- Immunity, Innate/genetics
- Immunoglobulin G/biosynthesis
- Immunoglobulin G/blood
- Immunohistochemistry
- Leishmania major/growth & development
- Leishmania major/immunology
- Leishmaniasis, Visceral/enzymology
- Leishmaniasis, Visceral/genetics
- Leishmaniasis, Visceral/immunology
- Leishmaniasis, Visceral/mortality
- Mice
- Mice, Congenic
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mice, Knockout
- Nitric Oxide Synthase/biosynthesis
- Nitric Oxide Synthase/metabolism
- Nitric Oxide Synthase Type II
- Radiation Chimera/immunology
- Survival Rate
- Tumor Necrosis Factor-alpha/deficiency
- Tumor Necrosis Factor-alpha/genetics
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Affiliation(s)
- P Wilhelm
- Institut für Klinische Mikrobiologie, Immunologie, Universität Erlangen-Nürnberg, Erlangen, Germany
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29
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Schröppel K, Kryk M, Herrmann M, Leberer E, Röllinghoff M, Bogdan C. Suppression of type 2 NO-synthase activity in macrophages by Candida albicans. Int J Med Microbiol 2001; 290:659-68. [PMID: 11310444 DOI: 10.1016/s1438-4221(01)80003-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Macrophages (Mphi) are important for the defence against experimental disseminated candidiasis. Nitric oxide (NO) generated by the inducible isoform of NO-synthase (iNOS or NOS2) is thought to contribute to candidacidal effector functions by activated Mphi. In vitro, however, Mphi cannot control the growth and hyphal formation of Candida (C.) albicans. Using mouse peritoneal exudate Mphi stimulated with IFN-gamma and LPS, we examined the effect of C. albicans on NO synthesis, NOS2 enzyme activity and macrophage survival. C. albicans effectively inhibited the production of NO via suppression of total NOS2 protein and enzyme activity. Hyphal formation of C. albicans and direct interaction with host cells was required for maximum inhibition of NO production, whereas non-filamentous C. albicans mutants released soluble products that effected only partial inhibition. Ultimately, Mphi underwent apoptotic cell death after infection with C. albicans wild-type strains capable of hyphal formation, indicated by loss of the mitochondrial membrane potential and onset of chromatin degradation. NO suppression and Mphi killing are potent activities of C. albicans that may augment virulence of C. albicans.
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Affiliation(s)
- K Schröppel
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen, Germany.
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30
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Schindler H, Lutz MB, Röllinghoff M, Bogdan C. The production of IFN-gamma by IL-12/IL-18-activated macrophages requires STAT4 signaling and is inhibited by IL-4. J Immunol 2001; 166:3075-82. [PMID: 11207258 DOI: 10.4049/jimmunol.166.5.3075] [Citation(s) in RCA: 145] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Macrophages release IFN-gamma on combined stimulation with IL-12 and IL-18, but the signaling requirements of this process and its regulation by other cytokines are unknown. Here, we demonstrate that STAT4 is indispensable for IL-12/IL-18-induced production of IFN-gamma by mouse peritoneal macrophages. Type 2 NO synthase (NOS2), which we previously found to be a prerequisite for IL-12-induced IFN-gamma production in NK cells, was not required for IFN-gamma production by these macrophages. IL-12 alone already induced the expression of IFN-gamma mRNA, but nuclear translocation of STAT4, the release of IFN-gamma protein, and the subsequent production of NO was strictly dependent on the simultaneous presence of IL-18. NF-kappa B, which mediates IL-18 effects in T cells, was only weakly activated by IL-12 and/or IL-18 in macrophages. Known inhibitors of macrophage functions (e.g., IL-4 and TGF-beta) also suppressed macrophage IFN-gamma production and the subsequent production of NOS2-derived NO. The inhibitory effect of IL-4 was paralleled by nuclear translocation of STAT6, which in EMSAs was able to bind to the same DNA oligonucleotide as STAT4. These results further define the production of IFN-gamma by macrophages and point to a diversity in the signals required for IFN-gamma production by various cell types.
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MESH Headings
- Active Transport, Cell Nucleus/genetics
- Active Transport, Cell Nucleus/immunology
- Animals
- Ascitic Fluid/immunology
- Binding, Competitive/genetics
- Binding, Competitive/immunology
- Cells, Cultured
- DNA-Binding Proteins/deficiency
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- DNA-Binding Proteins/physiology
- Drug Synergism
- Female
- Interferon Inducers/pharmacology
- Interferon-gamma/antagonists & inhibitors
- Interferon-gamma/biosynthesis
- Interferon-gamma/genetics
- Interferon-gamma/metabolism
- Interleukin-12/metabolism
- Interleukin-12/physiology
- Interleukin-18/metabolism
- Interleukin-18/physiology
- Interleukin-18 Receptor alpha Subunit
- Interleukin-4/physiology
- Macrophage Activation
- Macrophages, Peritoneal/enzymology
- Macrophages, Peritoneal/immunology
- Macrophages, Peritoneal/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- NF-kappa B/metabolism
- Nitric Oxide/biosynthesis
- Nitric Oxide Synthase/biosynthesis
- Nitric Oxide Synthase/genetics
- Nitric Oxide Synthase/physiology
- Nitric Oxide Synthase Type II
- Oligonucleotides/metabolism
- RNA, Messenger/biosynthesis
- Receptors, Interleukin/biosynthesis
- Receptors, Interleukin/genetics
- Receptors, Interleukin-12
- Receptors, Interleukin-18
- STAT4 Transcription Factor
- STAT6 Transcription Factor
- Signal Transduction/genetics
- Signal Transduction/immunology
- Trans-Activators/deficiency
- Trans-Activators/genetics
- Trans-Activators/metabolism
- Trans-Activators/physiology
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Affiliation(s)
- H Schindler
- Institute of Clinical Microbiology, Immunology, and Hygiene, University of Erlangen, Erlangen, Germany
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31
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Körner H, Winkler TH, Sedgwick JD, Röllinghoff M, Basten A, Cook MC. Recirculating and marginal zone B cell populations can be established and maintained independently of primary and secondary follicles. Immunol Cell Biol 2001; 79:54-61. [PMID: 11168624 DOI: 10.1046/j.1440-1711.2001.00984.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In normal spleen, most recirculating naïve IgM+IgDhi B cells are located within primary follicles and mantle zones of secondary follicles. By contrast, the marginal zone contains a heterogeneous population of IgMhiIgDlo/- B cells that are mostly non-recirculating. Although these are dynamic populations they are maintained at a constant size, the fundamental homeostatic mechanisms remain uncertain. One possibility is that the presence and turnover of each of the B cell populations is dependent on their location within discrete splenic compartments. To investigate this, we have characterized immature, non-recirculating, mature recirculating, marginal zone and B-1 cell populations in TNF-/- and TNF/lymphotoxin(LT)-alpha-/- mice that have disorganized splenic architecture. Labelling with 5-bromo-2'-deoxyuridine revealed that turnover of B cells in TNF-/- mice is normal, but is diminished in TNF/LT-alpha-/- mice. The recirculating B cell populations in both mutant strains are normal in proportion and phenotype. Marginal zone B cells are not seen in TNF/LT-alpha-/- mice, but this population appears normal in TNF-/- mice, even though they lack germinal centres. These findings indicate that peripheral B cell subsets can be established and maintained independently of normal follicular architecture.
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Affiliation(s)
- H Körner
- IZKF Nachwuchsgruppe 1 der Universität Erlangen-Nürnberg, Germany
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32
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Sommer F, Faller G, Röllinghoff M, Kirchner T, Mak TW, Lohoff M. Lack of gastritis and of an adaptive immune response in interferon regulatory factor-1-deficient mice infected with Helicobacter pylori. Eur J Immunol 2001; 31:396-402. [PMID: 11180103 DOI: 10.1002/1521-4141(200102)31:2<396::aid-immu396>3.0.co;2-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To study the role of T cell responses in Helicobacter pylori gastritis, C57BL/6 wild-type and interferon regulatory factor-1-deficient (IRF-1(-/-)) mice were infected with the mouse-adapted H. pylori Sydney strain. Mice lacking the transcription factor IRF-1 are defective in Th1 development and are therefore biased to mount a Th2-type response. After 4 months of infection, C57BL/6 mice developed severe gastritis and atrophy and mounted a Th1-type response towards H. pylori. The Th1 response was abrogated in IRF-1(-/-) mice. This defective Th1 response was associated with the total lack of gastritis and atrophy in IRF-1(-/-) mice despite severe colonization with H. pylori. In addition, IRF-1(-/-) mice did also not develop a Th2 reaction, since they failed to generate H. pylori-specific antibodies and to produce IL-4 in response to H. pylori antigens in vitro. Thus, the transcription factor IRF-1 is necessary for the development of gastritis and atrophy in H. pylori-infected wild-type mice, suggesting a role of Th1 cells in the pathogenesis of H. pylori-associated diseases.
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Affiliation(s)
- F Sommer
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, University of Erlangen, Erlangen, Germany.
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33
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Bogdan C, Schönian G, Bañuls AL, Hide M, Pratlong F, Lorenz E, Röllinghoff M, Mertens R. Visceral leishmaniasis in a German child who had never entered a known endemic area: case report and review of the literature. Clin Infect Dis 2001; 32:302-6. [PMID: 11170923 DOI: 10.1086/318476] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/1999] [Revised: 05/02/2000] [Indexed: 11/04/2022] Open
Abstract
We describe a case of visceral leishmaniasis in a 15-month-old German child. Diagnosis was significantly delayed because the patient had no history of travel to known endemic areas. Congenital or blood transfusion-associated leishmaniasis was ruled out. Possible modes of transmission (including a potential new autochthonous focus of the disease in central Europe) are discussed.
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Affiliation(s)
- C Bogdan
- Institute for Clinical Microbiology, Immunology and Hygiene, University of Erlangen, Germany.
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34
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Baar S, Schörner C, Röllinghoff M, Radespiel-Tröger M, Hümmer HP, Carbon RT. Collagen patches impregnated with antimicrobial agents have high local antimicrobial efficacy and achieve effective tissue gluing. Infection 2001; 29:27-31. [PMID: 11261754 DOI: 10.1007/s15010-001-0073-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Local antimicrobial systems have gained importance, as illustrated by current research on drug delivery systems (DDS). We aimed to develop materials that combine hemostatic and antimicrobial efficacy as well as adhesiveness for use in surgical tissue management. MATERIALS AND METHODS Materials were evaluated by in vitro studies employing microbiological and technological methods. RESULTS Antimicrobial impregnation of a collagen fleece, which is a pre-coated fibrinogen-based adhesive and therefore ready-to-use (TachoComb), is significantly more efficient--both in terms of the antimicrobial efficacy (p < 0.001) as well as the adhesive strength (p = 0.03) -than coating an antibiotic-containing collagen fleece "on-site" with fibrin glue. CONCLUSION Due to ease of practical handling and favorable pharmacoeconomics, this DDS is recommended for both open and minimally invasive surgery.
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Affiliation(s)
- S Baar
- Dept. of Anesthesiology, Friedrich-Alexander University, Erlangen, Germany.
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35
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Meissner U, Blum H, Schnare M, Röllinghoff M, Gessner A. A soluble form of the murine common gamma chain is present at high concentrations in vivo and suppresses cytokine signaling. Blood 2001; 97:183-91. [PMID: 11133759 DOI: 10.1182/blood.v97.1.183] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The common gamma-chain (gammac) is a component of the receptors for IL-2, IL-4, IL-7, IL-9, and IL-15 and is essential for their signal transduction. Western blotting and a newly established enzyme-linked immunosorbent assay detected substantial constitutive levels (50-250 ng/mL) of soluble gammac (sgammac) in sera of murine inbred strains. It was demonstrated that purified immune cells, such as T, B, and natural killer cells, and macrophages released this protein after activation. Transfection experiments with cDNA encoding the full-length gammac showed that shedding of the transmembrane receptor led to the release of sgammac. The shedding enzymes, however, appeared to be distinct from those cleaving other cytokine receptors because inhibitors of metalloproteases (eg, TAPI) did not influence sgammac release. In vivo, superantigen-induced stimulation of T cells enhanced sgammac serum concentrations up to 10-fold within 6 hours. Because these findings demonstrated regulated expression of a yet unknown molecule in the immune response, further experiments were performed to assess the possible function(s) of sgammac. A physiological role of sgammac was indicated by its capacity to specifically inhibit cell growth induced by gammac-dependent cytokines. Mutational analysis revealed that the C-terminus and the WSKWS motif are essential for the cytokine inhibitory effect of the sgammac and for binding of the molecule to cytokine receptor-expressing cells. Thus, competitive displacement of the transmembrane gammac by excess sgammac is the most likely mechanism of cell growth inhibition. It was implied that naturally produced sgammac is a negative modulator of gammac-dependent cytokines.
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MESH Headings
- Amino Acid Motifs
- Animals
- Blotting, Western
- Cell Division/drug effects
- Cytokines/drug effects
- Cytokines/pharmacology
- Cytokines/physiology
- Depression, Chemical
- Female
- Interleukin Receptor Common gamma Subunit
- Lymphocyte Activation
- Lymphocyte Subsets/metabolism
- Male
- Metalloendopeptidases
- Mice
- Mice, Inbred Strains/metabolism
- Mice, Mutant Strains/metabolism
- Mice, SCID/metabolism
- Mutagenesis, Site-Directed
- Peptide Hydrolases/metabolism
- Protein Structure, Tertiary
- Protein Subunits
- Receptors, Interleukin/blood
- Receptors, Interleukin/genetics
- Receptors, Interleukin/metabolism
- Receptors, Interleukin-7/physiology
- Signal Transduction/drug effects
- Solubility
- Tumor Cells, Cultured
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Affiliation(s)
- U Meissner
- Institute for Clinical Microbiology, Immunology and Hygiene, University of Erlangen-Nuremberg, Erlangen, Germany
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36
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Geissdörfer W, Wittmann I, Seitz G, Cesnjevar R, Röllinghoff M, Schoerner C, Bogdan C. A case of aortic valve disease associated with Tropheryma whippelii infection in the absence of other signs of Whipple's disease. Infection 2001; 29:44-7. [PMID: 11261759 DOI: 10.1007/s15010-001-0135-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A case of endocarditis caused by Tropheryma whippelii is reported. The 69-year-old patient was diagnosed as suffering from severe aortic regurgitation requiring aortic valve replacement, but showed no other symptoms of Whipple's disease. T. whippelii was detected in the explanted aortic valve by broad-range PCR amplification of the 16S rDNA and subsequent sequence analysis of the product. The etiologic agent was classified as a type 2A sequence variant based on the 16S-23S intergenic spacer and the 23S rDNA (domain III) sequences. The histological examination of the aortic valve was compatible with Whipple's disease. A duodenal biopsy revealed an infection with Giardia lamblia, but T. whippelii and histological signs of Whipple's disease were not detectable.
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Affiliation(s)
- W Geissdörfer
- Institute of Clinical Microbiology, Immunology and Hygiene, Friedrich-Alexander University of Erlangen-Nürnberg, Germany.
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37
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Schleicher U, Röllinghoff M, Gessner A. A stable marker for specific T-cells: a TCR alpha/green fluorescent protein (GFP) fusionprotein reconstitutes a functionally active TCR complex. J Immunol Methods 2000; 246:165-74. [PMID: 11121557 DOI: 10.1016/s0022-1759(00)00298-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The detection of antigen specific clonal T-cell populations in vivo during T-cell selection and an immune responses is often hampered due to the lack of suitable clonotype specific monoclonal antibodies. In order to determine the potential usefulness of green fluorescent protein (GFP) to follow specific T-cells in vivo, we decided to express and analyze the function of a T-cell receptor (TCR) alpha chain-GFP fusionprotein. The TCRalpha and beta chain cDNAs of a Leishmania major-specific murine T helper 2 cell clone were cloned and inserted into the pHSE3' expression vector. Simultaneously, a TCRalpha expression vector was constructed containing a C-terminal in frame fusion with the open reading frame of the enhanced GFP (EGFP). TCRalpha/TCRbeta or TCRalpha-EGFP/TCRbeta constructs were expressed in T-cell hybridoma cells 58alpha(-)beta(-) which lack an endogenous TCR but still express CD3 components. The TCRalpha-EGFP fusionprotein was detected with the expected molecular weight by immunoprecipitation and Western Blot analysis. Surface staining of TCR components was detected in transfectants expressing the wild type TCR heterodimer and, with only a slight reduction in intensity, also in those expressing the TCR-EGFP complex. Hence, expression and transport to the outer cell membrane is possible despite the 27 kD C-terminal extension of the TCRalpha. Most importantly, the EGFP-tagged TCR was functional since the transfectants produced IL-2 in response to stimulation via their TCR. Thus, TCR-EGFP constructs represent attractive tools to study posttranslational regulation of TCR expression and ligand-induced TCR clustering as well as the fate of antigen specific T-cells during tolerance induction and immunity in transgenic mouse models.
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MESH Headings
- Animals
- Biomarkers/analysis
- Cell Membrane/metabolism
- Clone Cells
- Epitopes, T-Lymphocyte/immunology
- Green Fluorescent Proteins
- Humans
- Luminescent Proteins/genetics
- Luminescent Proteins/immunology
- Luminescent Proteins/physiology
- Mice
- Mice, Inbred BALB C
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Receptors, Antigen, T-Cell, alpha-beta/physiology
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/immunology
- Recombinant Fusion Proteins/physiology
- Reverse Transcriptase Polymerase Chain Reaction
- Signal Transduction/physiology
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Th2 Cells/immunology
- Th2 Cells/metabolism
- Transfection
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Affiliation(s)
- U Schleicher
- Clinical Microbiology, Immunology and Hygiene, University of Erlangen-Nürnberg, Wasserturmstrasse 3, 91054, Erlangen, Germany
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38
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Schröppel K, Sprösser K, Whiteway M, Thomas DY, Röllinghoff M, Csank C. Repression of hyphal proteinase expression by the mitogen-activated protein (MAP) kinase phosphatase Cpp1p of Candida albicans is independent of the MAP kinase Cek1p. Infect Immun 2000; 68:7159-61. [PMID: 11083847 PMCID: PMC97832 DOI: 10.1128/iai.68.12.7159-7161.2000] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cpp1p is a putative mitogen-activated protein (MAP) kinase phosphatase that suppresses Candida albicans hyphal formation at 25 degrees C through its probable substrate, the Cek1p filamentation MAP kinase. Here we report that expression of the serum-induced genes SAP4-6 and HYR1 increased several fold in hyphal forms of a cpp1/cpp1 null mutant, while the rate and extent of hyphal development up to 5 h were normal. Therefore, we provide evidence that Cpp1p represses hyphal gene expression by acting through a Cek1p-independent mechanism. SAP4-6 and HYR1 transcripts were undetectable in a null mutant of another key regulator of filamentation, Efg1p; thus, Efg1p and Cpp1p oppose each other during the expression of these genes in hyphal forms.
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Affiliation(s)
- K Schröppel
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen, 91054 Erlangen, Germany.
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39
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Schweizer A, Rupp S, Taylor BN, Röllinghoff M, Schröppel K. The TEA/ATTS transcription factor CaTec1p regulates hyphal development and virulence in Candida albicans. Mol Microbiol 2000; 38:435-45. [PMID: 11069668 DOI: 10.1046/j.1365-2958.2000.02132.x] [Citation(s) in RCA: 184] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The temporal and spatial expression of stage-specific genes during morphological development of fungi and higher eukaryotes is controlled by transcription factors. In this study, we report the cloning and functional analysis of the Candida albicans TEC1 (CaTEC1) gene, a new member of the TEA/ATTS family of transcription factors that regulates C. albicans virulence. The promoters of the type 4, 5 and 6 proteinase isogenes (SAP4-6) contain repetitive TEA/ATTS consensus sequence motifs. This finding suggests a possible role for a homologue of Saccharomyces cerevisiae TEC1 during the activation of proteinase gene expression in C. albicans. CaTEC1 is predominantly expressed in the hyphal form of C. albicans. In vitro, serum-induced hyphal formation as well as evasion from MPhi after phagocytosis is suppressed in catec1/catec1 mutant cells. Furthermore, expression of the proteinase isogenes SAP4-6 is no longer inducible in these mutant cells. The deletion of the CaTEC1 gene attenuates virulence of C. albicans in a systemic model of murine candidiasis, although both mutant and revertant cells that were prepared from infected tissues or the vaginal mucosa grew in a hyphal morphology in vivo. CaTEC1 complements the pseudohyphal and invasive growth defect of haploid and diploid S. cerevisiae tec1/tec1 mutant cells and strongly activates the promoter of FLO11, a gene required for pseudohyphal growth. This study provides the first evidence pointing to an essential role for a member of the TEA/ATTS transcription factor family that had so far only been ascribed to function during development as a virulence regulator in microbial pathogenesis.
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Affiliation(s)
- A Schweizer
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen, Wasserturmstrasse 3, 91054 Erlangen, Germany
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40
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Abstract
Helicobacter pylori is now considered to be the main cause for most stomach diseases including ulcer, MALT lymphoma, adenocarcinoma and gastritis. The infection with this bacterium is chronic despite a local and systemic immune response towards it. Among the cellular infiltrate that arises during H. pylori-mediated gastritis, there is a considerable frequency of CD4+ Th1 cells producing IFNgamma, but not of Th2 cells producing IL-4. Since IFNgamma may induce binding of H. pylori to gastric epithelial cells followed by apoptosis of these cells, one may speculate that H. pylori-mediated diseases are in part autoimmune diseases initiated by H. pylori-specific Th1 cells infiltrating the gastric mucosa. Recent support for this hypothesis comes from an animal model in which mice are infected with H. pylori and display strongly reduced gastritis in the absence of IFNgamma.
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Affiliation(s)
- M Lohoff
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Wasserturmstr. 3, 91054, Erlangen, Germany.
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41
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Mattner J, Schindler H, Diefenbach A, Röllinghoff M, Gresser I, Bogdan C. Regulation of type 2 nitric oxide synthase by type 1 interferons in macrophages infected with Leishmania major. Eur J Immunol 2000; 30:2257-67. [PMID: 10940917 DOI: 10.1002/1521-4141(2000)30:8<2257::aid-immu2257>3.0.co;2-u] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We recently reported that the infection of macrophages with Leishmania major led to the release of type 1 interferons (IFN-alpha /beta ). Moreover, at day 1 of infection of mice with L. major, IFN-alpha /beta was required for the expression of type 2 (inducible) NO synthase (NOS2 or iNOS) which, however, was restricted to a few macrophages in the dermis. Here, we further characterized the regulation of NOS2 by IFN-alpha /beta. Macrophages that were either simultaneously or sequentially exposed to L. major promastigotes and IFN-alpha /beta expressed NOS2 and anti-leishmanial activity. In contrast, when high amounts of IFN-alpha /beta were used or when IFN-alpha /beta was added to the macrophages 2 h prior to the parasites, almost no induction of NOS2 was observed. After pretreatment with IFN-alpha /beta, tyrosine phosphorylation and nuclear DNA binding of Stat1alpha, the degradation of the NF-kappaB inhibitor (IkappaBalpha and beta), and the nuclear translocation of NF-kappaB were strongly impaired compared with macrophages exposed to IFN-alpha /beta and L. major simultaneously. Thus, IFN-alpha /beta exerts agonistic or antagonistic effects on the expression of NOS2 in macrophages infected with a microbial pathogen, depending on the sequence of the stimuli and the amount of IFN-alpha /beta added. The limited number of NOS2-positive macrophages at day 1 of infection in vivo might result from a blockage of non-infected macrophages by IFN-alpha /beta that is released by neighboring infected cells.
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Affiliation(s)
- J Mattner
- Institute of Clinical Microbiology, Immunology, and Hygiene, University of Erlangen, Erlangen, Germany
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42
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Förtsch D, Röllinghoff M, Stenger S. IL-10 converts human dendritic cells into macrophage-like cells with increased antibacterial activity against virulent Mycobacterium tuberculosis. J Immunol 2000; 165:978-87. [PMID: 10878374 DOI: 10.4049/jimmunol.165.2.978] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Dendritic cells (DC) are unique in their ability to initiate a primary immune response by the presentation of soluble Ags to T cells. Recent studies have shown that DC also phagocytose particulate Ags including the intracellular pathogen Mycobacterium tuberculosis. However, it is not known whether DC contain the growth of intracellular organisms or allow unlimited replication. To address this question, we infected human DC with a virulent strain of M. tuberculosis and monitored the intracellular growth. The bacteria grew two orders of magnitude within 7 days of culture. Among cytokines known to modulate mycobacterial growth particularly in murine macrophages (TNF-alpha, IFN-gamma, TGF-beta, IL-4), only IL-10 modulated the growth in human DC. This effect was specific for immature dendritic cells, as IL-10 did not induce growth inhibition in human macrophages. In searching for the mechanism of growth inhibition, we found that IL-10 induces the down-regulation of the DC marker CD1, while the macrophage marker CD14 was up-regulated. Functionally, IL-10-treated cells had a reduced capacity to induce an alloresponse, but phagocytic uptake of M. tuberculosis was more efficient. We also show that DC are inferior to macrophages in containing mycobacterial growth. These findings show that IL-10 converts DC into macrophage-like cells, thereby inducing the growth inhibition of an intracellular pathogen. At the site of a local immune response, such as a tuberculous granuloma, IL-10 might therefore participate in the composition of the cellular microenvironment by affecting the maturity and function of DC.
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Affiliation(s)
- D Förtsch
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene der Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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43
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Bogdan C, Donhauser N, Döring R, Röllinghoff M, Diefenbach A, Rittig MG. Fibroblasts as host cells in latent leishmaniosis. J Exp Med 2000; 191:2121-30. [PMID: 10859337 PMCID: PMC2193203 DOI: 10.1084/jem.191.12.2121] [Citation(s) in RCA: 160] [Impact Index Per Article: 6.7] [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: 03/31/2000] [Accepted: 04/14/2000] [Indexed: 12/14/2022] Open
Abstract
Intracellular parasites are known to persist lifelong in mammalian hosts after the clinical cure of the disease, but the mechanisms of persistence are poorly understood. Here, we show by confocal laser microscopy that in the draining lymph nodes of mice that had healed a cutaneous infection with Leishmania major, 40% of the persisting parasites were associated with fibroblasts forming the reticular meshwork of the lymph nodes. In vitro, both promastigotes and amastigotes of L. major infected primary skin or lymph node fibroblasts. Compared with macrophages, cytokine-activated fibroblasts had a reduced ability to express type 2 nitric oxide synthase and to kill intracellular L. major. These data identify fibroblasts as an important host cell for Leishmania during the chronic phase of infection and suggest that they might serve as safe targets for the parasites in clinically latent disease.
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Affiliation(s)
- C Bogdan
- Institute of Clinical Microbiology, Department of Anatomy, University of Erlangen, D-91054 Erlangen, Germany.
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44
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Abstract
Type 2 nitric oxide synthase (iNOS or NOS2) was originally described as an enzyme that is expressed in activated macrophages, generates nitric oxide (NO) from the amino acid L-arginine, and thereby contributes to the control of replication or killing of intracellular microbial pathogens. Since interferon (IFN)-gamma is the key cytokine for the induction of NOS2 in macrophages and the prototypic product of type 1 T-helper cells, high-level expression of NOS2 has been regarded to be mostly restricted to the adaptive phase of the immune response. In this review, we summarize data that demonstrate a prominent role of NOS2/NO also during innate immunity. During the early phase of infection with the intracellular pathogen Leishmania major, focally expressed NOS2/NO not only exerts antimicrobial activities but also controls the function of natural killer cells and the expression of cytokines such as IFN-gamma or transforming growth factor-beta. Some of these effects result from the function of NOS2/NO as an indispensable co-factor for the activation of Tyk2 kinase and, thus, for interleukin-12 and IFN-alpha/beta signaling in natural killer cells.
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Affiliation(s)
- C Bogdan
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen, Germany.
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45
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Abstract
Nitric oxide, nitric oxide derivatives and reactive oxygen intermediates are toxic molecules of the immune system which contribute to the control of microbial pathogens and tumors. There is recent evidence for additional functions of these oxygen metabolites in innate and adaptive immunity; these functions include the modulation of the cytokine response of lymphocytes and the regulation of immune cell apoptosis, as well as immunodeviating effects. Components of several signal transduction pathways have been identified as intracellular targets for reactive nitrogen and oxygen intermediates.
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Affiliation(s)
- C Bogdan
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen, Erlangen, D-91054, Germany.
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46
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Körner H, Cretney E, Wilhelm P, Kelly JM, Röllinghoff M, Sedgwick JD, Smyth MJ. Tumor necrosis factor sustains the generalized lymphoproliferative disorder (gld) phenotype. J Exp Med 2000; 191:89-96. [PMID: 10620607 PMCID: PMC2195803 DOI: 10.1084/jem.191.1.89] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [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] [Indexed: 12/29/2022] Open
Abstract
Tumor necrosis factor (TNF) and Fas ligand (FasL) play major roles in the homeostasis of the peripheral immune system. This becomes dramatically obvious in the absence of a functional FasL. Mice with such a deficiency develop a profound lymphadenopathy, splenomegaly, hypergammaglobulinemia, and strain-dependent systemic autoimmune disease, and succumb to premature death. It is consequently termed generalized lymphoproliferative disorder (gld). By contrast, TNF deficiency alone does not result in a striking phenotype. Thus, we sought to determine what role TNF might play in contributing to the gld phenotype by creating C57BL/6.gld.TNF(-/-) mice. Contrary to the expected outcome, mice deficient for both FasL and TNF had a substantially milder gld phenotype with regard to mortality, lymphoaccumulation, germinal center formation, and hypergammaglobulinemia. To confirm these data in a strain highly permissive for the phenotype, C3H/HeJ.gld and C3H.HeJ.lpr mice were treated with a TNF-specific monoclonal antibody. This transient neutralization of TNF also resulted in a significantly attenuated lymphoproliferative phenotype. We conclude that TNF is necessary for the full manifestation of the lymphoproliferative disorder, in particular playing a critical role in lymphoaccumulation. Most importantly, absence of TNF protects gld mice against premature death.
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Affiliation(s)
- H Körner
- Interdisziplinäres Zentrum für Klinische Forschung der Universität Erlangen-Nürnberg, D-91054 Erlangen, Germany.
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47
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Abstract
IL-4 is a pleiotropic cytokine which plays a pivotal role in shaping immune responses. The effects of IL-4 are mediated after binding to high affinity receptor complexes present on hematopoietic as well as non-hematopoietic cells. This review will summarize the current knowledge on the molecular structure of the different types of IL-4 receptor (IL-4R) complexes as well as the signal transduction mechanisms induced by IL-4 leading to cellular proliferation and / or gene activation. IL-4 effects are modulated by soluble forms of the respective receptor molecules which are produced by several immune cells in a regulated manner. The biological impact of recently described IL-4R allotypes of mice and humans as well as the results of studies with IL-4R knockout mice will be particularly emphasized.
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Affiliation(s)
- A Gessner
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen-Nürnberg, Germany.
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48
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Baumgarten BU, Röllinghoff M, Bogdan C. Prevalence of Borrelia burgdorferi and granulocytic and monocytic ehrlichiae in Ixodes ricinus ticks from southern Germany. J Clin Microbiol 1999; 37:3448-51. [PMID: 10523532 PMCID: PMC85664 DOI: 10.1128/jcm.37.11.3448-3451.1999] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A total of 287 adult Ixodes ricinus ticks, collected in two regions of southern Germany (Frankonia and Baden-Württemberg) where Borrelia burgdorferi infections are known to be endemic, were examined for the presence of 16S ribosomal DNA specific for the Ehrlichia phagocytophila genogroup, E. chaffeensis, E. canis, and B. burgdorferi by nested PCR. Totals of 2.2% (6 of 275) and 21.8% (65 of 275) of the ticks were positive for the E. phagocytophila genogroup and B. burgdorferi, respectively. Two ticks (0.7%) were coinfected with both bacteria. Of 12 engorged I. ricinus ticks collected from two deer, 8 (67%) were positive for the E. phagocytophila genogroup and one (8%) was positive for B. burgdorferi. There was no evidence of infection with E. canis or E. chaffeensis in the investigated tick population. The nucleotide sequences of the 546-bp Ehrlichia PCR products differed at one or two positions from the original sequence of the human granulocytic ehrlichiosis (HGE) agent (S.-M. Chen, J. S. Dumler, J. S. Bakken, and D. H. Walker, J. Clin. Microbiol. 32:589-595, 1994). Three groups of sequence variants were detected; two of these were known to occur in other areas in Europe or the United States, whereas one has not been reported before. Thus, in the German I. ricinus tick population closely related granulocytic ehrlichiae are prevalent, which might represent variants of E. phagocytophila or the HGE agent.
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Affiliation(s)
- B U Baumgarten
- Institute of Clinical Microbiology, Immunology and Hygiene, University of Erlangen, Erlangen, Germany
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49
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Abstract
Currently, no easy and reliable methods allowing for the quantification of Borrelia burgdorferi in tissues of infected humans or animals are available. Due to the lack of suitable assays to detect B. burgdorferi CFU and the qualitative nature of the currently performed PCR assays, we decided to exploit the recently developed real-time PCR. This technology measures the release of fluorescent oligonucleotides during the PCR. Flagellin of B. burgdorferi was chosen as the target sequence. A linear quantitative detection range of 5 logs with a calculated detection limit of one to three spirochetes per assay reaction mixture was observed. The fact that no signals were obtained with closely related organisms such as Borrelia hermsii argues for a high specificity of this newly developed method. A similar method was developed to quantify mouse actin genomic sequences to allow for the standardization of spirochete load. The specificity and sensitivity of the B. burgdorferi and the actin real-time PCR were not altered when samples were spiked with mouse cells or spirochetes, respectively. To evaluate the applicability of the real-time PCR, we used the mouse model of Lyme disease. The fate of B. burgdorferi was monitored in different tissues from inbred mice and from mice treated with antibiotics. Susceptible C3H/HeJ mice had markedly higher burdens of bacterial DNA than resistant BALB/c mice, and penicillin G treatment significantly reduced the numbers of spirochetes. Since these results show a close correlation between clinical symptoms and bacterial burden of tissues, we are currently analyzing human biopsy specimens to evaluate the real-time PCR in a diagnostic setting.
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Affiliation(s)
- A Pahl
- Institute of Pharmacology and Toxicology, Immunology and Hygiene, University of Erlangen-Nürnberg, D-91054 Erlangen, Germany
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50
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Abstract
Interleukin-12 (IL-12) and type 2 NO synthase (NOS2) are crucial for defense against bacterial and parasitic pathogens, but their relationship in innate immunity is unknown. In the absence of NOS2 activity, IL-12 was unable to prevent spreading of Leishmania parasites, did not stimulate natural killer (NK) cells for cytotoxicity or interferon-gamma (IFN-gamma) release, and failed to activate Tyk2 kinase and to tyrosine phosphorylate Stat4 (the central signal transducer of IL-12) in NK cells. Activation of Tyk2 in NK cells by IFN-alpha/beta also required NOS2. Thus, NOS2-derived NO is a prerequisite for cytokine signaling and function in innate immunity.
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Affiliation(s)
- A Diefenbach
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universität Erlangen, Wasserturmstrasse 3, D-91054 Erlangen, Germany
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