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Decker H, Schwab M, Shao S, Kaki D, Melhado C, Cuschieri J, Bongiovanni T. Screening for Intimate Partner Violence in Trauma: Results of a Quality Improvement Project. J Surg Res 2024; 295:376-384. [PMID: 38064979 DOI: 10.1016/j.jss.2023.11.044] [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: 06/01/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Intimate partner violence (IPV) is common, especially among patients presenting with traumatic injury. We implemented an IPV screening program for patients admitted after trauma. We sought to determine whether specific demographic or clinical characteristics were associated with being screened or not screened for IPV and with IPV screen results. METHODS Retrospective cohort study evaluating all patients admitted after trauma from July 2020-July 2022 in an Adult Level 1 Trauma Center. RESULTS There were 4147 admissions following traumatic injury, of which 70% were men and 30% were women. The cohort was 46% White, 20% Asian, 15% Black, and 17% other races. Twenty-three percent were Hispanic or Latino/a. Seventy-seven percent were admitted for blunt injuries and 16% for penetrating injuries. Thirteen percent (n = 559) of the cohort was successfully screened for IPV. Screening rates did not differ by gender, race, or ethnicity. After adjustment for demographic and clinical factors, patients admitted to the intensive care unit were significantly less likely to be screened. Of the screened patients, 30% (165) screened positive. These patients were more commonly Hispanic or Latino/a, insured by Medicaid and presented with a penetrating injury. There were no differences in injury severity in patients who screened positive versus those who screened negative. CONCLUSIONS There are significant barriers to universal screening for IPV, including injury acuity, in patients admitted following trauma. However, the 30% rate of positive screens for IPV in patients admitted following trauma highlights the urgent need to understand and address barriers to screening in trauma settings to enable universal screening.
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Affiliation(s)
- Hannah Decker
- Department of Surgery, University of California at San Francisco, San Francisco, California.
| | - Marisa Schwab
- Department of Surgery, University of California at San Francisco, San Francisco, California
| | - Shirley Shao
- Department of Surgery, University of California at San Francisco, San Francisco, California
| | - Dahlia Kaki
- Department of Surgery, University of California at San Francisco, San Francisco, California
| | - Caroline Melhado
- Department of Surgery, University of California at San Francisco, San Francisco, California
| | - Joseph Cuschieri
- Department of Surgery, University of California at San Francisco, San Francisco, California
| | - Tasce Bongiovanni
- Department of Surgery, University of California at San Francisco, San Francisco, California
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Kobelt D, Gürgen D, Becker M, Dahlmann M, Flechsig S, Schaeffeler E, Büttner F, Schmees C, Bohnert R, Bedke J, Schwab M, Wendler J, Schostak M, Jandrig B, Walther W, Hofmann J. Establishment and characterization of a preclinical platform of subcutaneous renal cell carcinoma (RCC) patient-derived xenograft models to evaluate novel treatment strategies. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00834-6] [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: 11/26/2022]
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3
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Schwab M, Pamminger M, Kremser C, Obmann D, Haltmeier M, Mayr A. Preliminary data on a fully automated left ventricular late gadolinium enhancement detection by a convolutional neuronal network in chronic myocardial infarction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeac141.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): FWF- Der Wissenschaftsfonds
Aim
To compare a fully automated segmentation of left ventricular late gadolinium enhancement (LGE) as evaluated by a convolutional neuronal network (CNN) with manual segmentation in chronic myocardial infarction.
Methods
Cardiac magnetic resonance imaging including two-dimensional LGE imaging was performed in 191 patients on a 1.5 T clinical scanner 12 months after ST-elevation myocardial infarction. LGE images were presented to a trained CNN for automated determination of left ventricular myocardium and consequently absolute LGE volume. Manual LGE segmentation according to the +5-SD method was used as reference standard. Image quality was assessed according to a 3-point Likert scale (2 = perfect image quality, 1 = some artifacts witout impaired LGE delineation, 0 = strong artifacts with impaired LGE delineation). Regression and Bland-Altman analysis were performed.
Results
In 191 included patients (182 male, mean age 57 years) LGE volume was 9.7 [IQR 3.6 to 16.2] ml according to manual segmentation and 8.3 [3.2 to 17.6] ml according to CNN segmentation. Bland-Altman analysis showed little average difference (-0.5 ml, p=0.257), however, limits of agreement ranged from -18.4 ml to 17.5 ml. Linear correlation was fair (0.57, p<0.001). Subgroup analysis according to image quality showed comparable performance of CNN segmentation in all three groups.
Conclusion
Our fully automated LGE segmentation based on a CNN in two-dimensional data sets provides measurements with little average difference compared to very time-consuming manual segmentations. However, dispersion is substantially and limits the current application of this approach on a per-patient basis. Image quality does not affect CNN performance.
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Affiliation(s)
- M Schwab
- Medical University of Innsbruck , Innsbruck , Austria
| | - M Pamminger
- Medical University of Innsbruck , Innsbruck , Austria
| | - C Kremser
- Medical University of Innsbruck , Innsbruck , Austria
| | - D Obmann
- University of Innsbruck, Department of Mathematics , Innsbruck , Austria
| | - M Haltmeier
- University of Innsbruck, Department of Mathematics , Innsbruck , Austria
| | - A Mayr
- Medical University of Innsbruck , Innsbruck , Austria
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Bedke J, Herrmann L, Stühler V, Winter S, Reustle A, Stenzl A, Schaeffeler E, Schwab M. Immunological markers and somatic mutations as predictors for therapy selection in metastatic renal cell carcinoma. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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5
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Staib C, Herbert S, Schwab M, Wöckel A, Häusler S. P-130 Morphokinetic analysis of early human embryo development and its relationship to endometriosis resection: a retrospective time-lapse study with the use of KIDScore D3 and D5. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.125] [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
Study question
Does complete resection of endometriosis improve embryo quality as assessed by morphokinetic parameters using time-lapse microscopy?
Summary answer
Complete resection of endometriosis in affected women undergoing assisted reproduction is shown to have a positive impact on embryo morphokinetic parameters represented in embryo quality.
What is known already
Endometriosis is one of the most common gynaecological diseases. It is characterized by the presence of cells comparable to those in the endometrium but being located outside of the uterine cavity. About 4-30% women of child-bearing age are affected by endometriosis. In vitro fertilization (IVF) studies have suggested that women with more advanced endometriosis have poor ovarian reserve, low oocyte and embryo quality and poor implantation rates. Moreover inflammatory peritoneal fluid shows a toxic effect on embryos. This might have an impact on morphokinetic timings but there is only limited data available concerning morphokinetics and endometriosis.
Study design, size, duration
246 embryos (endometriosis group: n = 85; non-endometriosis control group: n = 115; complete resection of endometriosis= 46) undergoing infertility treatment at our clinics were included in this retrospective study. Inclusion criteria were female patients aged between 18 and 45 years undergoing IVF and / or ICSI treatment. The in vitro culture was performed in a closed time-lapse incubator (EmbryoScope®, Vitrolife) up to day 3 or in a prolonged culture up to day 5.
Participants/materials, setting, methods
Patient treatment included conventional insemination or intracytoplasmatic sperm injection. IVF inseminated or ICSI injected oocytes were culturd in the TimeLapse monitoring incubator. Embryos were cultured for 3 to 5 days without media change at 6.8% CO2 and 5% O2 at 37°C. During embryo culture morphokinetic parameters and events were constantly annotated. Analysis was performed using the EmbryoViewer software and evaluated applying KIDScoreTM D3 or KIDScoreTM D5 according to the day of embryo transfer.
Main results and the role of chance
The analysis revealed a median KIDScoreTM D5 of 2.3 (on a scale from 1 to 9.9) for embryos from patients suffering from endometriosis without complete resection. The control group without endometriosis achieved a score of 7.0 (p = 0.001). The median for embryos from endometriosis patients with complete resection was 7.1 which meant a significant increase compared to embryos from patients without complete resection (p = 0.002).
Effect size according to Cohen showed a moderate up to strong biological effect (r = 0.4) for complete resection vs. no resection of endometriosis. For the three groups KIDScoreTM D3, pregnancy rates as well as abortion rates showed the same clinical trends.
Additionally, we could describe a series of four patients undergoing IVF-cycles before and after a complete resection of their endometriosis. As expected, in three out of four cases they showed a clear increase in their embryo quality after complete resection of endometriosis.
Limitations, reasons for caution
The main limitation of the study is the relative small sample size of the groups, especially the number of patients with endometriosis resection. Additionally, the study is limited to its retrospective design.
Wider implications of the findings
Pathogenesis of endometriosis related infertility is multifactorial and not completely understood. But knowing that endometrioid lesions produce inflammatory cytokines which are toxic for oocytes and embryos, resection of the lesions in order to reduce inflammation seems to be a plausible approach.
Trial registration number
20191007 01
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Affiliation(s)
- C Staib
- University of Würzburg, Zentrum für gynäkologische Endokrinologie und Reproduktionsmedizin , Wuerzburg, Germany
| | - S.L Herbert
- University of Würzburg, Zentrum für gynäkologische Endokrinologie und Reproduktionsmedizin , Wuerzburg, Germany
| | - M Schwab
- University of Würzburg, Zentrum für gynäkologische Endokrinologie und Reproduktionsmedizin , Wuerzburg, Germany
| | - A Wöckel
- University of Würzburg, Zentrum für gynäkologische Endokrinologie und Reproduktionsmedizin , Wuerzburg, Germany
| | - S Häusler
- Hospital St. Hedwig of The Order of St. John- University of Regensburg, University Department of Obstetrics and Gynecology , Regensburg, Germany
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Stuehler V, Herrmann L, Winter S, Bohnert R, Reustle A, Hennenlotter J, Rausch S, Stenzl A, Schwab M, Schaeffeler E, Bedke J. Immunological markers and somatic mutations as predictors for therapy selection in metastatic renal cell carcinoma. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01197-6] [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: 11/25/2022]
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7
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Stuehler V, Rausch S, Winter S, Schmees C, Maas M, Walz S, Stenzl A, Bedke J, Schwab M, Schaeffeler E. Autophagy as a new therapeutic pathway. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01192-7] [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: 11/25/2022]
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8
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Yilma M, Trang K, Schwab M, Bowman M, Sugi M, Courtier J, Baskin L, Ozgediz D. A case of prenatally diagnosed prune belly syndrome variant and congenital pouch colon in the United States: A case report. J Neonatal Surg 2021. [DOI: 10.47338/jns.v10.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Prune belly syndrome (PBS) and congenital pouch colon (CPC) are rare congenital syndromes with a low incidence in the United States (U.S.) with most CPC cases being from India. In this case report, we describe, to the best of our knowledge, the first PBS variant and CPC patient in the U.S.
Case Presentation: A 30-year-old G2P0010 woman was referred to a tertiary center after an 18-week ultrasound showed a fetal abdominal mass. A prenatal MRI showed a dilated loop of bowel containing a mixture of urine and meconium, oligohydramnios, and a protuberant abdominal wall. Born at 37 weeks, the child’s physical exam was notable for a distended abdomen with thin abdominal musculature, non-palpable bilateral testes, no anal opening, and flat buttocks. Intra-operatively, a dilated cecum/ascending colon was noted with an abrupt change in caliber at the transverse colon, bilateral enlarged ureters, a left testis at the internal ring and no visualized right testis. A colostomy and mucous fistula were created 5 cm from the sigmoid pouch.
Conclusion: While most reported cases of CPC undergo single stage repair (one operation) at 1 day of life, our patient underwent the first procedure of a staged repair at 16 hours of life given his clinical instability at the time as well as his unknown urological anatomy in the setting of urinary obstruction. This case demonstrates the importance of fetal imaging, multidisciplinary approach at a tertiary care center, and reinforces a staged repair when necessary.
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9
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Franke K, Bublak P, Hoyer D, Billiet T, Gaser C, Witte OW, Schwab M. In vivo biomarkers of structural and functional brain development and aging in humans. Neurosci Biobehav Rev 2021; 117:142-164. [PMID: 33308708 DOI: 10.1016/j.neubiorev.2017.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 05/23/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 12/25/2022]
Abstract
Brain aging is a major determinant of aging. Along with the aging population, prevalence of neurodegenerative diseases is increasing, therewith placing economic and social burden on individuals and society. Individual rates of brain aging are shaped by genetics, epigenetics, and prenatal environmental. Biomarkers of biological brain aging are needed to predict individual trajectories of aging and the risk for age-associated neurological impairments for developing early preventive and interventional measures. We review current advances of in vivo biomarkers predicting individual brain age. Telomere length and epigenetic clock, two important biomarkers that are closely related to the mechanistic aging process, have only poor deterministic and predictive accuracy regarding individual brain aging due to their high intra- and interindividual variability. Phenotype-related biomarkers of global cognitive function and brain structure provide a much closer correlation to age at the individual level. During fetal and perinatal life, autonomic activity is a unique functional marker of brain development. The cognitive and structural biomarkers also boast high diagnostic specificity for determining individual risks for neurodegenerative diseases.
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Affiliation(s)
- K Franke
- Department of Neurology, Jena University Hospital, Jena, Germany.
| | - P Bublak
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - D Hoyer
- Department of Neurology, Jena University Hospital, Jena, Germany
| | | | - C Gaser
- Department of Neurology, Jena University Hospital, Jena, Germany; Department of Psychiatry, Jena University Hospital, Jena, Germany
| | - O W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - M Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
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10
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Chambel S, Oliveira R, Ferreira A, Antunes Lopes T, Schwab M, Cruz C. Sprouting of bladder afferents following spinal cord injury is independent from the lumbosacral cord highly repulsive environment. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00405-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Chambel S, Oliveira R, Ferreira A, Vale L, Schwab M, Cruz C. Lumbosacral sprouting of bladder afferents after thoracic spinal cord injury reflects changes in levels of Nogo-A. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33032-9] [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: 10/23/2022] Open
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12
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Groga-Bada P, Heller F, Lente N, Hack L, Schaeffeler E, Winter S, Mueller K, Droppa M, Stimpfle F, Schwab M, Gawaz M, Geisler T, Rath D. P3641Matrix Metalloproteinase-2 polymorphisms are associated with prognosis of patients with symptomatic coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0498] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Matrix Metalloproteinase-2 (MMP-2) is involved in regulation and proliferation of vascular and endothelial cells and is therefore an important component of atherosclerotic vessels. Inhibition of MMP-2 activity is associated with improvement of cardiac function in animal models after myocardial infarction. MMP-2 single nucleotide polymorphisms (SNPs) might alter MMP-2 expression and therefore influence prognosis in patients with symptomatic coronary artery disease (CAD).
Methods and results
Genotyping for selected MMP-2 SNPs variants (rs2241145, rs2285053, rs2287076, rs243865, rs7201) was performed in 943 consecutive patients with symptomatic CAD. All patients were followed-up for all-cause death (ACD), myocardial infarction (MI) and ischemic stroke (IS) for 360 days. The primary combined endpoint (CE) consisted of either first occurrence of ACD, and/or MI, and/or IS. Secondary endpoints were defined as the single events of ACD or MI. Homozygous carriers of major allele (rs2241145, rs2287076) showed significantly better event-free survival than carriers of the minor allele for CE (Log rank = 0.022 and Log rank= 0.015, respectively). Furthermore, homozygous carriers of major allele (rs2241145, rs2285053, rs2287076) showed significantly better event-free survival for ACD (Log rank= 0.047, Log rank= 0.006 and Log rank= 0.023, respectively). In multivariate analysis, MMP-2 rs2241145, rs2287076 and rs2285053 were significantly and independently associated with CE and ACD.
Figure 1
Conclusions
MMP-2 rs2241145, rs2287076 and rs2285053 are associated with prognosis and might be valuable for further risk stratification in CAD patients.
Acknowledgement/Funding
DFG, KFO 274, CRC TR 240
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Affiliation(s)
- P Groga-Bada
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - F Heller
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - N Lente
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - L Hack
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - E Schaeffeler
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - S Winter
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - K Mueller
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - M Droppa
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - F Stimpfle
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - M Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - M Gawaz
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - T Geisler
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - D Rath
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
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Rath D, Altgelt K, Mueller K, Hack LP, Schaeffeler E, Winter S, Schwab M, Chatterjee M, Gawaz M, Geisler T. P3643Junctional Adhesion Molecule-A (JAM-A) polymorphisms influence serum levels of soluble JAM-A and are associated with long term prognosis in coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0500] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
Junctional adhesion molecule A (JAM-A/F11R) is a cell adhesion molecule. Membrane associated JAM-A mediates platelet aggregation, secretion, adhesion, and spreading. Plasma levels of JAM-A are elevated in hypertension and atherosclerosis. This study was designed to investigate the impact of JAM-A single nucleotide polymorphisms (SNPs) on circulatory JAM-A levels and prognosis in patients with symptomatic coronary artery disease (CAD).
Methods and results
JAM-A SNP analysis (JAM-A F11R rs2774276 and rs790056) was performed in 943 patients with symptomatic CAD. All patients were tracked for all-cause death (ACD), myocardial infarction (MI), and ischemic stroke (IS) for 1080 days. The primary combined endpoint (CE) was defined as a composite of ACD and/or MI and/or IS. Secondary endpoints were defined as the single events of ACD and MI. Homozygote carriers of the minor allele (F11R rs2774276 and rs790056) showed significantly worse event-free survival for MI when compared with major allele carriers (Log rank = 0.011 and log rank = 0.031, respectively). No significant differences could be shown for the CE and ACD. Of note, in multivariate analysis, both SNPs were significantly and independently associated with MI. Furthermore, serum levels of soluble JAM-A were elevated in homozygote carriers of minor allele when compared to major allele carriers. Finally, serum levels of soluble JAM-A were significantly elevated in patients with MI when compared to stable CAD (p=0.036).
Figure 1
Conclusion
JAM-A SNPs are associated with prognosis in patients with symptomatic coronary artery disease. Furthermore, JAM-A SNPs might influence serum concentration of soluble JAM-A. Finally, serum concentration of soluble JAM-A is higher in patients with myocardial infarction when compared to stable coronary artery disease. These findings suggest JAM-A as a valuable biomarker for risk stratification and tailoring therapies in patients with coronary artery disease.
Acknowledgement/Funding
DFG-KFO274, CRC/Transregio 240
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Affiliation(s)
- D Rath
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - K Altgelt
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - K Mueller
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - L P Hack
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - E Schaeffeler
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - S Winter
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - M Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - M Chatterjee
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - M Gawaz
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
| | - T Geisler
- University hospital Tuebingen, Cardiology department, Tuebingen, Germany
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Trimarchi H, Duboscq C, Genoud V, Lombi F, Muryan A, Young P, Schwab M, Castañón M, Rodríguez-Reimundes E, Forrester M, Pereyra H, Campolo-Girard V, Seminario O, Alonso M, Kordich L. Plasminogen Activator Inhibitor-1 Activity and 4G/5G Polymorphism in Hemodialysis. J Vasc Access 2018. [DOI: 10.1177/112972980800900212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Chronic insufficiency alters homeostasis, in part due to endothelial inflammation. Plasminogen activator inhibitor-1 (PAI-1) is increased in renal disease, contributing to vascular damage. We assessed PAI-1 activity and PAI-1 4G/5G polymorphism in hemodialysis (HD) subjects and any association between thrombotic vascular access (VA) events and PAI-1 polymorphism. Methods Prospective, observational study in 36 HD patients: mean age: 66.6 ± 12.5 yr, males n=26 (72%), time on HD: 28.71 ± 22.45 months. Vascular accesses: 10 polytetrafluoroethylene grafts (PTFEG), 22 arteriovenous fistulae (AVF), four dual lumen catheters (CAT). Control group (CG): 40 subjects; mean age: 60.0 ± 15 yrs, males n=30 (75%). Group A (GA): thrombotic events (n=12), and group B (GB): No events (n=24). Groups were no different according to age (69.2 ± 9.12 vs. 65.3 ± 14.5 yrs), gender (males: 7; 58.3% vs. 18; 81.8%), time on HD (26.1 ± 14.7 vs. 30.1 ± 38.7 months), causes of renal failure. Time to follow-up for access thrombosis: 12 months. Results PAI-1 levels in HD: 7.21 ± 2.13 vs. CG: 0.42 ± 0.27 U/ml (p<0.0001). PAI-1 4G/5G polymorphic variant distribution in HD: 5G/5G: 6 (17%), 4G/5G: 23 (64%); 4G/4G: 7 (19%) and in CG: 5G/5G: 14 (35%); 4G/5G: 18 (45%); 4G/4G: 8 (20%). C-reactive protein (CRP) in HD: 24.5 ± 15.2 mg/L vs. in CG 2.3 ± 0.2 mg/L (p<0.0001). PAI-1 4G/5G variants: GA: 5G/5G: 3; 4G/5G: 8; 4G/4G: 1; GB: 5G/5G: 3; 4G/5G: 15; 4G/4G: 6. Thrombosis occurred in 8/10 patients (80%) with PTFEG, 3/22 (9%) in AVF, and 1/4 (25%) in CAT. Among the eight PTFEG patients with thrombosis, seven were PAI 4G/5G. Conclusions PAI-1 levels were elevated in HD patients, independent of their polymorphic variants, 4G/5G being the most prevalent variant. Our data suggest that in patients with PTFEG the 4G/5G variant might be associated with an increased thrombosis risk.
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Affiliation(s)
- H. Trimarchi
- Nephrology Unit, British Hospital of Buenos Aires
| | - C. Duboscq
- Hematology Unit, British Hospital of Buenos Aires
| | - V. Genoud
- Hemostasis and Thrombosis Laboratory, Department of Biological Chemistry, Faculty of Exact and Natural Sciences, University of Buenos Aires
| | - F. Lombi
- Nephrology Unit, British Hospital of Buenos Aires
| | - A. Muryan
- Biochemistry Unit, British Hospital of Buenos Aires
| | - P. Young
- Clinical Medicine Unit, British Hospital of Buenos Aires, Buenos Aires - Argentina
| | - M. Schwab
- Department of Internal Medicine, Lausanne University Hospital, Lausanne - Switzerland
| | - M. Castañón
- Hemostasis and Thrombosis Laboratory, Department of Biological Chemistry, Faculty of Exact and Natural Sciences, University of Buenos Aires
| | | | - M. Forrester
- Nephrology Unit, British Hospital of Buenos Aires
| | - H. Pereyra
- Nephrology Unit, British Hospital of Buenos Aires
| | | | - O. Seminario
- Nephrology Unit, British Hospital of Buenos Aires
| | - M. Alonso
- Clinical Medicine Unit, British Hospital of Buenos Aires, Buenos Aires - Argentina
| | - L. Kordich
- Hemostasis and Thrombosis Laboratory, Department of Biological Chemistry, Faculty of Exact and Natural Sciences, University of Buenos Aires
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15
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Danesi R, Del Re M, Ciccolini J, Schellens JHM, Schwab M, van Schaik RHN, van Kuilenburg ABP. Prevention of fluoropyrimidine toxicity: do we still have to try our patient's luck? Ann Oncol 2018; 28:183. [PMID: 27687313 DOI: 10.1093/annonc/mdw448] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Danesi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Del Re
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - J Ciccolini
- Clinical Pharmacokinetics, La Timone University Hospital, Marseille, and GPCO-Unicancer, Paris, France
| | - J H M Schellens
- Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Schwab
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and Department of Clinical Pharmacology, University Hospital, Tuebingen, Germany
| | - R H N van Schaik
- IFCC Reference center - Pharmacogenetics, Department of Clinical Chemistry, Erasmus University, Rotterdam
| | - A B P van Kuilenburg
- Department of Clinical Chemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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16
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Lunkenheimer P, Emmert S, Gulich R, Köhler M, Wolf M, Schwab M, Loidl A. Electromagnetic-radiation absorption by water. Phys Rev E 2017; 96:062607. [PMID: 29347319 DOI: 10.1103/physreve.96.062607] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Indexed: 06/07/2023]
Abstract
Why does a microwave oven work? How does biological tissue absorb electromagnetic radiation? Astonishingly, we do not have a definite answer to these simple questions because the microscopic processes governing the absorption of electromagnetic waves by water are largely unclarified. This absorption can be quantified by dielectric loss spectra, which reveal a huge peak at a frequency of the exciting electric field of about 20 GHz and a gradual tailing off toward higher frequencies. The microscopic interpretation of such spectra is highly controversial and various superpositions of relaxation and resonance processes ascribed to single-molecule or molecule-cluster motions have been proposed for their analysis. By combining dielectric, microwave, THz, and far-infrared spectroscopy, here we provide nearly continuous temperature-dependent broadband spectra of water. Moreover, we find that corresponding spectra for aqueous solutions reveal the same features as pure water. However, in contrast to the latter, crystallization in these solutions can be avoided by supercooling. As different spectral contributions tend to disentangle at low temperatures, this enables us to deconvolute them when approaching the glass transition under cooling. We find that the overall spectral development, including the 20 GHz feature (employed for microwave heating), closely resembles the behavior known for common supercooled liquids. Thus water's absorption of electromagnetic waves at room temperature is not unusual but very similar to that of glass-forming liquids at elevated temperatures, deep in the low-viscosity liquid regime, and should be interpreted along similar lines.
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Affiliation(s)
- P Lunkenheimer
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - S Emmert
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - R Gulich
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - M Köhler
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - M Wolf
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - M Schwab
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - A Loidl
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
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17
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Schwab M, Fisel P, Schäffeler E. [Metabolomics and Cancer]. Pathologe 2017; 38:202-204. [PMID: 29138896 DOI: 10.1007/s00292-017-0374-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- M Schwab
- Dr. Margarete Fischer-Bosch-Institut für klinische Pharmakologie, und Universität Tübingen, Auerbachstr. 112, 70376, Stuttgart, Deutschland.
- Abteilung klinische Pharmakologie, Universitätsklinikum Tübingen, Eberhard-Karls Universität Tübingen, Tübingen, Deutschland.
| | - P Fisel
- Dr. Margarete Fischer-Bosch-Institut für klinische Pharmakologie, und Universität Tübingen, Auerbachstr. 112, 70376, Stuttgart, Deutschland
| | - E Schäffeler
- Dr. Margarete Fischer-Bosch-Institut für klinische Pharmakologie, und Universität Tübingen, Auerbachstr. 112, 70376, Stuttgart, Deutschland
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18
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Nikolaus S, Schreiber S, Siegmund B, Bokemeyer B, Bästlein E, Bachmann O, Görlich D, Hofmann U, Schwab M, Kruis W. Patient Education in a 14-month Randomised Trial Fails to Improve Adherence in Ulcerative Colitis: Influence of Demographic and Clinical Parameters on Non-adherence. J Crohns Colitis 2017; 11:1052-1062. [PMID: 28486634 DOI: 10.1093/ecco-jcc/jjx062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 01/17/2017] [Accepted: 05/08/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM Recent observational studies document that non-adherence to mesalamine therapy during remission is frequent. We aimed to investigate patient impact of patient education using objective assessments of adherence. METHODS A 14-month randomised, prospective clinical trial of adherence to mesalamine was conducted in 248 patients with ulcerative colitis [UC], Colitis Activity Index [CAI] ≤ 9, receiving standard care [n = 122] versus a standardised patient education programme [n = 126]. Primary endpoint was adherence at all visits (5-aminosalicylic acid [5-ASA] urine levels). Secondary endpoints included quality of life (inflammatory bowel disease questionnaise [IBDQ]), disease activity, partial adherence, and self-assessment of adherence. RESULTS Patient allocation was well balanced. Baseline non-adherence was high in quiescent/mildly active UC [52.4%] without difference between the groups (52.4% of patients in the education group versus 52.5% in the standard care group [p = 0.99]). No difference between the intervention group and standard care was seen in IBDQ, partial adherence, self-assessment of adherence, or therapy satisfaction at all visits. We suggest a model in which individual risks for non-adherence are driven by patients with young age, short disease duration, and low education levels. CONCLUSIONS Non-adherence is frequent in a population with quiescent/mildly active UC. Although more than 25% of the population was not in remission at the various time points, no relationship between disease activity and adherence was seen over the 14-month observation period. Physicians should maximise their efforts to motivate high-risk patients for adherence. Future trials should use objective exposure assessments to examine the impact of continuous education and consultations on the background of individual risks to develop non-adherence.
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Affiliation(s)
- S Nikolaus
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - S Schreiber
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - B Siegmund
- Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - B Bokemeyer
- Gastroenterologische Schwerpunktpraxis, Minden, Germany
| | | | - O Bachmann
- Medizinische Hochschule Hannover, Hannover, Germany
| | - D Görlich
- Institute of Biostatistics and Clinical Research, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - U Hofmann
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Tübingen,Germany
| | - M Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Tübingen, Germany.,Department of Clinical Pharmacology, University Hospital Tübingen, Tübingen, Germany
| | - W Kruis
- Evangelisches Krankenhaus Kalk, Köln, Germany
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19
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Blank A, Eidam A, Haag M, Hohmann N, Burhenne J, Schwab M, van de Graaf SFJ, Meyer MR, Maurer HH, Meier K, Weiss J, Bruckner T, Alexandrov A, Urban S, Mikus G, Haefeli WE. The NTCP-inhibitor Myrcludex B: Effects on Bile Acid Disposition and Tenofovir Pharmacokinetics. Clin Pharmacol Ther 2017; 103:341-348. [DOI: 10.1002/cpt.744] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/10/2017] [Accepted: 05/13/2017] [Indexed: 12/26/2022]
Affiliation(s)
- A Blank
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
| | - A Eidam
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
| | - M Haag
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology; University of Tübingen; Stuttgart Germany
- German Center for Infection Research (DZIF); Tübingen Partner Site; Tübingen Germany
| | - N Hohmann
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
| | - J Burhenne
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
| | - M Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology; University of Tübingen; Stuttgart Germany
- German Center for Infection Research (DZIF); Tübingen Partner Site; Tübingen Germany
- Department of Clinical Pharmacology; University Hospital Tübingen; Tübingen Germany
- Department of Pharmacy and Biochemistry; University of Tübingen; Tübingen Germany
| | - SFJ van de Graaf
- Tytgat Institute for Liver and Intestinal Research & Department of Gastroenterology & Hepatology; Academic Medical Center; Amsterdam The Netherlands
| | - MR Meyer
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- Experimental and Clinical Toxicology; Saarland University; Homburg Germany
| | - HH Maurer
- Experimental and Clinical Toxicology; Saarland University; Homburg Germany
| | - K Meier
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
| | - J Weiss
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
| | - T Bruckner
- Institute of Medical Biostatistics and Medical Informatics; Heidelberg University Hospital; Heidelberg Germany
| | | | - S Urban
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
- Department of Infectious Diseases, Molecular Virology; Heidelberg University Hospital; Heidelberg Germany
| | - G Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
| | - WE Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Heidelberg Germany
- German Center for Infection Research (DZIF); Heidelberg Partner Site; Heidelberg Germany
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20
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van der Wouden CH, Cambon-Thomsen A, Cecchin E, Cheung KC, Dávila-Fajardo CL, Deneer VH, Dolžan V, Ingelman-Sundberg M, Jönsson S, Karlsson MO, Kriek M, Mitropoulou C, Patrinos GP, Pirmohamed M, Samwald M, Schaeffeler E, Schwab M, Steinberger D, Stingl J, Sunder-Plassmann G, Toffoli G, Turner RM, van Rhenen MH, Swen JJ, Guchelaar HJ. CORRIGENDUM: Implementing Pharmacogenomics in Europe: Design and Implementation Strategy of the Ubiquitous Pharmacogenomics Consortium. Clin Pharmacol Ther 2017; 102:152. [PMID: 30239993 DOI: 10.1002/cpt.725] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Anegroaie P, Frasch MG, Rupprecht S, Antonow-Schlorke I, Müller T, Schubert H, Witte OW, Schwab M. Development of somatosensory-evoked potentials in foetal sheep: effects of betamethasone. Acta Physiol (Oxf) 2017; 220:137-149. [PMID: 27580709 DOI: 10.1111/apha.12795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 05/21/2016] [Revised: 06/15/2016] [Accepted: 08/30/2016] [Indexed: 11/30/2022]
Abstract
AIM Antenatal glucocorticoids are used to accelerate foetal lung maturation in babies threatened with premature labour. We examined the influence of glucocorticoids on functional and structural maturation of the central somatosensory pathway in foetal sheep. Somatosensory-evoked potentials (SEP) reflect processing of somatosensory stimuli. SEP latencies are determined by afferent stimuli transmission while SEP amplitudes reveal cerebral processing. METHODS After chronic instrumentation of foetal sheep, mothers received saline (n = 9) or three courses of betamethasone (human equivalent dose of 2 × 110 μg kg-1 betamethasone i.m. 24 h apart, n = 12) at 0.7, 0.75 and 0.8 of gestational age. Trigeminal SEP were evoked prior to, 4 and 24 h after each injection and at 0.8 of gestational age before brains were histologically processed. RESULTS Somatosensory-evoked potentials were already detectable at 0.7 of gestation age. The early and late responses N20 and N200 were the only reproducible peaks over the entire study period. With advancing gestational age, SEP latencies decreased but amplitudes remained unchanged. Acutely, betamethasone did not affect SEP latencies and amplitudes 4 and 24 h following administration. Chronically, betamethasone delayed developmental decrease in the N200 but not N20 latency by 2 weeks without affecting amplitudes. In parallel, betamethasone decreased subcortical white matter myelination but did not affect network formation and synaptic density in the somatosensory cortex. CONCLUSION Somatosensory stimuli are already processed by the foetal cerebral cortex at the beginning of the third trimester. Subsequent developmental decrease in SEP latencies suggests ongoing maturation of afferent sensory transmission. Antenatal glucocorticoids affect structural and functional development of the somatosensory system with specific effects at subcortical level.
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Affiliation(s)
- P. Anegroaie
- Department of Neurology; Jena University Hospital; Jena Germany
- Department of Pediatric Surgery; Jena University Hospital; Jena Germany
| | - M. G. Frasch
- Department of Obstetrics and Gynecology; University of Washington; Seattle WA USA
| | - S. Rupprecht
- Department of Neurology; Jena University Hospital; Jena Germany
| | | | - T. Müller
- Institute of Laboratory Animal Science; Jena University Hospital; Jena Germany
| | - H. Schubert
- Institute of Laboratory Animal Science; Jena University Hospital; Jena Germany
| | - O. W. Witte
- Department of Neurology; Jena University Hospital; Jena Germany
| | - M. Schwab
- Department of Neurology; Jena University Hospital; Jena Germany
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22
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Bell GC, Caudle KE, Whirl-Carrillo M, Gordon RJ, Hikino K, Prows CA, Gaedigk A, Agundez J, Sadhasivam S, Klein TE, Schwab M. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 genotype and use of ondansetron and tropisetron. Clin Pharmacol Ther 2017; 102:213-218. [PMID: 28002639 DOI: 10.1002/cpt.598] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/07/2016] [Indexed: 12/16/2022]
Affiliation(s)
- G C Bell
- Personalized Medicine Program, Mission Health, Asheville, North Carolina, USA
| | - K E Caudle
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - M Whirl-Carrillo
- Department of Genetics, Stanford University, Stanford, California, USA
| | - R J Gordon
- University of California, San Diego, Department of Anesthesiology, San Diego, California, USA
| | - K Hikino
- Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, Illinois, USA
| | - C A Prows
- Division of Human Genetics, Division of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - A Gaedigk
- Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy-Kansas City, Kansas City, Missouri, USA
| | - Jag Agundez
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.,Department of Pharmacology, University of Extremadura, Cáceres, Spain
| | - S Sadhasivam
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.,Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - T E Klein
- Department of Genetics, Stanford University, Stanford, California, USA
| | - M Schwab
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tübingen, Germany.,Department of Clinical Pharmacology, University Hospital Tübingen, Tübingen, Germany.,Department of Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany
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23
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Kuo AH, Li J, Li C, Huber HF, Schwab M, Nathanielsz PW, Clarke GD. Prenatal steroid administration leads to adult pericardial and hepatic steatosis in male baboons. Int J Obes (Lond) 2017; 41:1299-1302. [PMID: 28337030 PMCID: PMC5548625 DOI: 10.1038/ijo.2017.82] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 02/18/2017] [Accepted: 03/15/2017] [Indexed: 11/18/2022]
Abstract
Developmental programming studies indicate that glucocorticoids modify
fetal development. We hypothesized that administration of the synthetic
glucocorticoid (sGC) betamethasone to pregnant baboons at doses and stages of
fetal life equivalent to human obstetric practice to decrease premature
offspring morbidity and mortality, programs lipid metabolism. In 10-year-old
male baboons (human equivalent 40) exposed in fetal life to betamethasone or
saline, we quantified pericardial fat and hepatic lipid content with magnetic
resonance imaging and spectroscopy. sGC offspring delivered at term as do most
sGC exposed human neonates. Pericardial fat thickness (7.7 ± 3.6 mm vs.
3.1 ± 1.1 mm, M ± SD; p = 0.022; n=5) and
hepatic fatty acids (13.3 ± 11.0 % vs. 2.5 ± 2.2
%; p = 0.046; n=5) increased following sGC without birth
weight or current body morphometric differences. Our results indicate that
antenatal sGC therapy caused abnormal fat deposition and adult body composition
in mid-life primate offspring. The concern raised is that this degree of
pericardial and hepatic lipid accumulation can lead to harmful local
lipotoxicity. In summary, developmental programing by sGC produces a mid-life
metabolically obese but normal weight phenotype. Prior studies show sexually
dimorphic responses to some programming challenges thus female studies are
necessary.
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Affiliation(s)
- A H Kuo
- Department of Radiology and Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - J Li
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - C Li
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA.,Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | - H F Huber
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | - M Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - P W Nathanielsz
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA.,Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | - G D Clarke
- Department of Radiology and Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
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24
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van der Wouden CH, Cambon-Thomsen A, Cecchin E, Cheung KC, Dávila-Fajardo CL, Deneer VH, Dolžan V, Ingelman-Sundberg M, Jönsson S, Karlsson MO, Kriek M, Mitropoulou C, Patrinos GP, Pirmohamed M, Samwald M, Schaeffeler E, Schwab M, Steinberger D, Stingl J, Sunder-Plassmann G, Toffoli G, Turner RM, van Rhenen MH, Swen JJ, Guchelaar HJ. Implementing Pharmacogenomics in Europe: Design and Implementation Strategy of the Ubiquitous Pharmacogenomics Consortium. Clin Pharmacol Ther 2017; 101:341-358. [DOI: 10.1002/cpt.602] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 12/14/2022]
Affiliation(s)
- CH van der Wouden
- Department of Clinical Pharmacy and Toxicology; Leiden University Medical Center; Leiden The Netherlands
| | - A Cambon-Thomsen
- UMR Inserm U1027 and Université de Toulouse III Paul Sabatier; Toulouse France
| | - E Cecchin
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico; National Cancer Institute; Aviano Italy
| | - KC Cheung
- Royal Dutch Pharmacists Association (KNMP); The Hague The Netherlands
| | - CL Dávila-Fajardo
- Department of Clinical Pharmacy, Granada University Hospital; Institute for Biomedical Research; Granada Spain
| | - VH Deneer
- Department of Clinical Pharmacy; St Antonius Hospital; Nieuwegein The Netherlands
| | - V Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine; University of Ljubljana; Slovenia
| | - M Ingelman-Sundberg
- Department of Physiology and Pharmacology, Section of Pharmacogenetics; Karolinska Institutet; Stockholm Sweden
| | - S Jönsson
- Department of Pharmaceutical Biosciences; Uppsala University; Uppsala Sweden
| | - MO Karlsson
- Department of Pharmaceutical Biosciences; Uppsala University; Uppsala Sweden
| | - M Kriek
- Center for Clinical Genetics; Leiden University Medical Center; Leiden The Netherlands
| | | | - GP Patrinos
- University of Patras, School of Health Sciences, Department of Pharmacy; University Campus; Rion Patras Greece
| | - M Pirmohamed
- Department of Molecular and Clinical Pharmacology; Royal Liverpool University Hospital and University of Liverpool; Liverpool United Kingdom
| | - M Samwald
- Center for Medical Statistics, Informatics, and Intelligent Systems; Medical University of Vienna; Vienna Austria
| | - E Schaeffeler
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart; Germany and University of Tübingen; Tübingen Germany
| | - M Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart; Germany and University of Tübingen; Tübingen Germany
- Department of Clinical Pharmacology; University Hospital Tübingen; Tübingen Germany
- Department of Pharmacy and Biochemistry; University of Tübingen; Tübingen Germany
| | - D Steinberger
- Bio.logis Center for Human Genetics; Frankfurt am Main Germany
| | - J Stingl
- Research Division; Federal Institute for Drugs and Medical Devices; Bonn Germany
| | - G Sunder-Plassmann
- Division of Nephrology and Dialysis, Department of Internal Medicine III; Medical University of Vienna; Vienna Austria
| | - G Toffoli
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico; National Cancer Institute; Aviano Italy
| | - RM Turner
- Department of Molecular and Clinical Pharmacology; Royal Liverpool University Hospital and University of Liverpool; Liverpool United Kingdom
| | - MH van Rhenen
- Royal Dutch Pharmacists Association (KNMP); The Hague The Netherlands
| | - JJ Swen
- Department of Clinical Pharmacy and Toxicology; Leiden University Medical Center; Leiden The Netherlands
| | - H-J Guchelaar
- Department of Clinical Pharmacy and Toxicology; Leiden University Medical Center; Leiden The Netherlands
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25
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Tamm R, Mägi R, Tremmel R, Winter S, Mihailov E, Smid A, Möricke A, Klein K, Schrappe M, Stanulla M, Houlston R, Weinshilboum R, Mlinarič Raščan I, Metspalu A, Milani L, Schwab M, Schaeffeler E. Polymorphic variation in TPMT is the principal determinant of TPMT phenotype: A meta-analysis of three genome-wide association studies. Clin Pharmacol Ther 2017; 101:684-695. [PMID: 27770449 DOI: 10.1002/cpt.540] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/02/2016] [Accepted: 10/17/2016] [Indexed: 12/20/2022]
Abstract
Thiopurine-related hematotoxicity in pediatric acute lymphoblastic leukemia (ALL) and inflammatory bowel diseases has been linked to genetically defined variability in thiopurine S-methyltransferase (TPMT) activity. While gene testing of TPMT is being clinically implemented, it is unclear if additional genetic variation influences TPMT activity with consequences for thiopurine-related toxicity. To examine this possibility, we performed a genome-wide association study (GWAS) of red blood cell TPMT activity in 844 Estonian individuals and 245 pediatric ALL cases. Additionally, we correlated genome-wide genotypes to human hepatic TPMT activity in 123 samples. Only genetic variants mapping to chromosome 6, including the TPMT gene region, were significantly associated with TPMT activity (P < 5.0 × 10-8 ) in each of the three GWAS and a joint meta-analysis of 1,212 cases (top hit P = 1.2 × 10-72 ). This finding is consistent with TPMT genotype being the primary determinant of TPMT activity, reinforcing the rationale for genetic testing of TPMT alleles in routine clinical practice to individualize mercaptopurine dosage.
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Affiliation(s)
- R Tamm
- Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia.,Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - R Mägi
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - R Tremmel
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tuebingen, Germany
| | - S Winter
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tuebingen, Germany
| | - E Mihailov
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - A Smid
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - A Möricke
- Department of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - K Klein
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tuebingen, Germany
| | - M Schrappe
- Department of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Stanulla
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - R Houlston
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - R Weinshilboum
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | | | - A Metspalu
- Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia.,Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - L Milani
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - M Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tuebingen, Germany.,Department of Clinical Pharmacology, University Hospital Tuebingen, Tuebingen, Germany.,Department of Pharmacy and Biochemistry, University of Tuebingen, Tuebingen, Germany
| | - E Schaeffeler
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tuebingen, Germany
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Dietl A, Farthmann J, Schwab M, Zollner U. Schwangerschafts- und geburtshilfliches Outcome bei fortgeschrittenem maternalen Alter. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Matthaei J, Tzvetkov MV, Strube J, Sehrt D, Sachse-Seeboth C, Hjelmborg JB, Möller S, Halekoh U, Hofmann U, Schwab M, Kerb R, Brockmöller J. Heritability of Caffeine Metabolism: Environmental Effects Masking Genetic Effects on CYP1A2 Activity but Not on NAT2. Clin Pharmacol Ther 2016; 100:606-616. [DOI: 10.1002/cpt.444] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/27/2016] [Accepted: 07/29/2016] [Indexed: 12/24/2022]
Affiliation(s)
- J Matthaei
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - MV Tzvetkov
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - J Strube
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - D Sehrt
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - C Sachse-Seeboth
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - JB Hjelmborg
- Department of Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - S Möller
- Department of Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - U Halekoh
- Department of Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - U Hofmann
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tübingen; Stuttgart Germany
| | - M Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tübingen; Stuttgart Germany
- Department of Clinical Pharmacology; University Hospital Tübingen; Tübingen Germany
- Department of Pharmacy and Biochemistry; University of Tübingen; Tübingen Germany
| | - R Kerb
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tübingen; Stuttgart Germany
| | - J Brockmöller
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
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Peters S, Schwab M, Faller H, Meng K. Wie sind die Voraussetzungen und Erwartungen von Hausärzten und Therapeuten hinsichtlich eines Schulungsangebots zur Bewegungsförderung. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586551] [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: 10/21/2022]
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29
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Fisel P, Schaeffeler E, Schwab M. DNA Methylation of ADME Genes. Clin Pharmacol Ther 2016; 99:512-27. [PMID: 27061006 DOI: 10.1002/cpt.343] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 12/13/2022]
Abstract
The epigenetic regulation of expression of genes involved in the absorption, distribution, metabolism, and excretion (ADME) of drugs contributes to interindividual variability in drug response. Epigenetic mechanisms include DNA methylation, histone modifications, and miRNAs. This review systematically outlines the influence of DNA methylation on ADME gene expression and highlights the consequences for interindividual variability in drug response or drug-induced toxicity and the implications for personalized medicine.
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Affiliation(s)
- P Fisel
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - E Schaeffeler
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - M Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,Department of Clinical Pharmacology, University Hospital Tübingen, Tübingen, Germany.,Department of Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany
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Dahms C, Guenther A, Schwab M, Schultze T, Nowack S, Hoyer D, Ehrhardt J, Witte OW, Mayer G, Rupprecht S. Dysautonomia in prodromal α-synucleinopathy: peripheral versus central autonomic degeneration. Eur J Neurol 2016; 23:878-90. [PMID: 26842960 DOI: 10.1111/ene.12957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/04/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE There is an urgent need for early predictive markers for the course of disease in prodromal α-synucleinopathies such as idiopathic rapid eye movement (REM) sleep behaviour disorder. Autonomic cardiac/vascular dysfunction is a prominent feature in advanced α-synucleinopathies, but its diagnostic value as an early neurodegenerative marker remains unclear. The latter may be complicated since synuclein-mediated neurodegeneration may involve central and peripheral components of the autonomic nervous system. METHODS The diagnostic value of autonomic symptoms and central and peripheral autonomic markers of blood pressure and heart rate regulation were prospectively evaluated in 20 subjects with idiopathic REM sleep behaviour disorder and 20 age-matched healthy controls. RESULTS Although subjects with REM sleep behaviour disorder showed no clinical autonomic symptoms, blood pressure (P ≤ 0.035) and heart rate response (P ≤ 0.065) were slightly diminished during orthostatic challenge. Autonomic dysregulation was distinctively reflected in lower resting heart rate (all components, P ≤ 0.05) and blood pressure variability (low frequency component, P ≤ 0.024) indicating peripheral cardiac/vascular denervation. In contrast, baroreflex sensitivity and central cardiac autonomic outflow (sympathovagal balance) were well preserved indicating intact central autonomic regulation. Heart rate variability [very low frequency component, receiver operating characteristic (ROC) area under the curve (AUC) 0.80, P ≤ 0.001] and blood pressure variability (low frequency component ROC AUC 0.73, P ≤ 0.01) but not baroreflex sensitivity and sympathovagal balance showed an excellent diagnostic accuracy in identifying subjects with REM sleep behaviour disorder and healthy controls. CONCLUSIONS Cardiac/vascular dysfunction in prodromal α-synucleinopathy arises from peripheral rather than from central autonomic degeneration. Autonomic indices encoded in heart rate and blood pressure variability are precise functional markers of early synuclein-mediated neurodegeneration.
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Affiliation(s)
- C Dahms
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - A Guenther
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - M Schwab
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - T Schultze
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - S Nowack
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - D Hoyer
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - J Ehrhardt
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - O W Witte
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - G Mayer
- Hephata Hospital, Schwalmstadt-Treysa, Germany
| | - S Rupprecht
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
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Schroth W, Winter S, Büttner F, Goletz S, Faißt S, Brinkmann F, Saladores P, Heidemann E, Ott G, Gerteis A, Alscher MD, Dippon J, Schwab M, Brauch H, Fritz P. Clinical outcome and global gene expression data support the existence of the estrogen receptor-negative/progesterone receptor-positive invasive breast cancer phenotype. Breast Cancer Res Treat 2015; 155:85-97. [DOI: 10.1007/s10549-015-3651-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/26/2015] [Indexed: 01/08/2023]
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Matthaei J, Brockmöller J, Tzvetkov MV, Sehrt D, Sachse-Seeboth C, Hjelmborg JB, Möller S, Halekoh U, Hofmann U, Schwab M, Kerb R. Heritability of metoprolol and torsemide pharmacokinetics. Clin Pharmacol Ther 2015; 98:611-21. [DOI: 10.1002/cpt.258] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 09/02/2015] [Indexed: 12/22/2022]
Affiliation(s)
- J Matthaei
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - J Brockmöller
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - MV Tzvetkov
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - D Sehrt
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - C Sachse-Seeboth
- Institute for Clinical Pharmacology, University Medical Center, Göttingen; Georg-August University; Göttingen Germany
| | - JB Hjelmborg
- Department of Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - S Möller
- Department of Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - U Halekoh
- Department of Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - U Hofmann
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and Department of Clinical Pharmacology; University of Tübingen; Stuttgart Germany
| | - M Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and Department of Clinical Pharmacology; University of Tübingen; Stuttgart Germany
- Department of Clinical Pharmacology; University Hospital Tübingen; Tübingen Germany
| | - R Kerb
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and Department of Clinical Pharmacology; University of Tübingen; Stuttgart Germany
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Kramer K, Wolf S, Mayer B, Schmidt SA, Agaimy A, Henne-Bruns D, Knippschild U, Schwab M, Schmieder M. Frequence, spectrum and prognostic impact of additional malignancies in patients with gastrointestinal stromal tumors. Neoplasia 2015; 17:134-40. [PMID: 25622906 PMCID: PMC4309732 DOI: 10.1016/j.neo.2014.12.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 09/20/2014] [Accepted: 12/04/2014] [Indexed: 02/08/2023] Open
Abstract
Currently available data on prognostic implication of additional neoplasms in GIST miss comprehensive information on patient outcome with regard to overall or disease specific and disease free survival. Registry data of GIST patients with and without additional neoplasm were compared in retrospective case series. We investigated a total of 836 patients from the multi-center Ulmer GIST registry. Additionally, a second cohort encompassing 143 consecutively recruited patients of a single oncology center were analyzed. The frequency of additional malignant neoplasms in GIST patients was 31.9% and 42.0% in both cohorts with a mean follow-up time of 54 and 65 months (median 48 and 60 months), respectively. The spectrum of additional neoplasms in both cohorts encompasses gastrointestinal tumors (43.5%), uro-genital and breast cancers (34.1%), hematological malignancies (7.3%), skin cancer (7.3%) and others. Additional neoplasms have had a significant impact on patient outcome. The five year overall survival in GIST with additional malignant neoplasms (n = 267) was 62.8% compared to 83.4% in patients without other tumors (n = 569) (P < .001, HR=0.397, 95% CI: 0.298-0.530). Five-year disease specific survival was not different between both groups (90.8% versus 90.9%). 34.2% of all deaths (n = 66 of n = 193) were GIST-related. The presented data suggest a close association between the duration of follow-up and the rate of additional malignancies in GIST patients. Moreover the data indicate a strong impact of additional malignant neoplasms in GIST on patient outcome. A comprehensive follow-up strategy of GIST patients appears to be warranted.
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Affiliation(s)
- K Kramer
- Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm Germany.
| | - S Wolf
- Department of Surgery, District-Hospital St. Gallen, Rorschacher Strasse 95, 9007 St.Gallen, Switzerland.
| | - B Mayer
- Institute of Epidemiology and Medical Biometry, Schwabstr. 13, University of Ulm, 89075 Ulm, Germany.
| | - S A Schmidt
- Department of Diagnostic and Interventional Radiology, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
| | - A Agaimy
- Institute of Pathology, University of Erlangen, Krankenhausstr. 8-10, 91054 Erlangen Germany.
| | - D Henne-Bruns
- Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm Germany.
| | - U Knippschild
- Department of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm Germany.
| | - M Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Auerbachstraße 112, 70376 Stuttgart, Germany; Department of Clinical Pharmacology, University Hospital, Wilhelmstraße 56, 72074 Tübingen, Germany.
| | - M Schmieder
- Department of Internal Medicine, Alb-Fils-Kliniken, Eichertstr. 3, 73035 Goeppingen, Germany.
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Wöckel A, Schwab M. Einladung. 1. Franken Fortbildung Frauengesundheit in Würzburg. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1557930] [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: 10/23/2022] Open
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Dietl A, Cupisti S, Beckmann MW, Schwab M, Zollner U. Pregnancy and Obstetrical Outcomes in Women Over 40 Years of Age. Geburtshilfe Frauenheilkd 2015; 75:827-832. [PMID: 26366002 DOI: 10.1055/s-0035-1546109] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 12/07/2014] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 12/20/2022] Open
Abstract
Introduction: Delayed childbearing is increasing, and advanced maternal age has been associated with an increased risk of obstetrical complications. The purpose of this study was to evaluate pregnancy outcomes in women with advanced maternal age (≥ 40 years). Methods: Maternal and obstetrical data were collected from the Department of Obstetrics and Gynecology of the University of Wuerzburg for the period from 2006 to 2011. In this retrospective analysis we compared the outcomes for women aged ≥ 40 years (n = 405) with those of three younger subgroups (I: < 30 y; II: 30-34 y; III: 35-39 y). Results: Pregnant women older than 40 years had more chronic diseases such as hypertension, needed medical treatment more frequently and had a higher thrombosis risk. Pregnancy-induced diseases such as gestational diabetes, preeclampsia and pregnancy-associated hypertension occurred more often in women ≥ 40 years of age. Compared to mothers who were younger than 30 years, primiparous women ≥ 40 years had a more than four times higher overall cesarean section rate and four times higher elective cesarean section rate. Furthermore, they required longer hospital stays, both after cesarean section and after vaginal delivery. The preterm birth rate (≤ 32 weeks of gestation) was similar across the different age groups. Conclusions: The outcomes of pregnancy and childbirth and for newborns born to women ≥ 40 years did not vary significantly from those of younger women if the following conditions were met: a) pre-existing chronic diseases were treated medically and dietetically; b) pregnancy-induced morbidity was monitored regularly and controlled medically; c) women attended regular prenatal check-ups; d) a healthy lifestyle was adhered to during pregnancy, and e) delivery occurred in a perinatal center.
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Affiliation(s)
- A Dietl
- Department of Obstetrics and Gynecology, University of Freiburg i. Br., Freiburg i. Br
| | - S Cupisti
- Department of Obstetrics and Gynecology, University of Erlangen, Erlangen
| | - M W Beckmann
- Department of Obstetrics and Gynecology, University of Erlangen, Erlangen
| | - M Schwab
- Department of Obstetrics and Gynecology, University of Würzburg, Würzburg
| | - U Zollner
- Department of Obstetrics and Gynecology, University of Würzburg, Würzburg
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Tremmel R, Fehr S, Battke F, Klein K, Schaeffeler E, Schwab M, Biskup S, Zanger U.. Adme-wide analysis of Copy Number Variation using Targeted exome resequencing and their functional relevance in Human Liver. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.300] [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: 11/26/2022]
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Klein K, Fehr S, Tremmel R, Schaeffeler E, Winter S, Schwab M, Biskup S, Zanger U. Targeted Exome Resequencing: Adme Pharmacogenetics In Human Liver. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.213] [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: 11/17/2022]
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38
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Walker B, Schmid E, Russo A, Schmidt EM, Burk O, Münzer P, Velic A, Macek B, Schaller M, Schwab M, Seabra MC, Gawaz M, Lang F, Borst O. Impact of the serum- and glucocorticoid-inducible kinase 1 on platelet dense granule biogenesis and secretion. J Thromb Haemost 2015; 13:1325-34. [PMID: 25944668 DOI: 10.1111/jth.12998] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Platelet secretion is critical to development of acute thrombotic occlusion. Platelet dense granules contain a variety of important hemostatically active substances. Nevertheless, biogenesis of platelet granules is poorly understood. OBJECTIVES Serum- and glucocorticoid-inducible kinase 1 (SGK1) has been shown to be highly expressed in platelets and megakaryocytes, but its role in the regulation of platelet granule biogenesis and its impact on thrombosis has not been investigated so far. METHODS AND RESULTS Electron microscopy analysis of the platelet ultrastructure revealed a significant reduction in the number and packing of dense granules in platelets lacking SGK1 (sgk1(-/-) ). In sgk1(-/-) platelets serotonin content was significantly reduced and activation-dependent secretion of ATP, serotonin and CD63 significantly impaired. In vivo adhesion after carotis ligation was significantly decreased in platelets lacking SGK1 and occlusive thrombus formation after FeCl3 -induced vascular injury was significantly diminished in sgk1(-/-) mice. Transcript levels and protein abundance of dense granule biogenesis regulating GTPase Rab27b were significantly reduced in sgk1(-/-) platelets without affecting Rab27b mRNA stability. In MEG-01 cells transfection with constitutively active (S422) (D) SGK1 but not with inactive (K127) (N) SGK1 significantly enhanced Rab27b mRNA levels. Sgk1(-/-) megakaryocytes show significantly reduced expression of Rab27b and serotonin/CD63 levels compared with sgk1(+/+) megakaryocytes. Proteome analysis identified nine further vesicular transport proteins regulated by SGK1, which may have an impact on impaired platelet granule biogenesis in sgk1(-/-) platelets independent of Rab27b. CONCLUSIONS The present observations identify SGK1 as a novel powerful regulator of platelet dense granule biogenesis, platelet secretion and thrombus formation. SGK1 is at least partially effective because it regulates transcription of Rab27b in megakaryocytes.
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Affiliation(s)
- B Walker
- Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Tübingen, Germany
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - E Schmid
- Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tübingen, Tübingen, Germany
| | - A Russo
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - E-M Schmidt
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - O Burk
- Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - P Münzer
- Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Tübingen, Germany
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - A Velic
- Proteom Center Tübingen, University of Tübingen, Tübingen, Germany
| | - B Macek
- Proteom Center Tübingen, University of Tübingen, Tübingen, Germany
| | - M Schaller
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
| | - M Schwab
- Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- Department of Clinical Pharmacology, University Hospital, Tübingen, Germany
| | - M C Seabra
- Molecular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - M Gawaz
- Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Tübingen, Germany
| | - F Lang
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - O Borst
- Department of Cardiology and Cardiovascular Medicine, University of Tübingen, Tübingen, Germany
- Department of Physiology, University of Tübingen, Tübingen, Germany
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Rath D, Chatterjee M, Borst O, Müller K, Langer H, Mack AF, Schwab M, Winter S, Gawaz M, Geisler T. Platelet surface expression of stromal cell-derived factor-1 receptors CXCR4 and CXCR7 is associated with clinical outcomes in patients with coronary artery disease. J Thromb Haemost 2015; 13:719-28. [PMID: 25660395 DOI: 10.1111/jth.12870] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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: 08/05/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Surface expression of stromal cell-derived factor-1 (SDF-1, CXCL12) on platelets is enhanced during ischemic events and plays an important role in peripheral homing of stem cells and myocardial repair mechanisms. SDF-1 effects are mediated through CXCR4 and CXCR7. Both CXCR4 and CXCR7 are surface expressed on human platelets and to a higher degree in patients with coronary artery disease (CAD) compared with healthy controls. In this study, we investigated the prognostic role of platelet CXCR4- and CXCR7 surface expression in patients with symptomatic CAD. METHODS AND RESULTS In a cohort study, platelet surface expression of CXCR4 and CXCR7 was measured by using flow cytometry in 284 patients with symptomatic CAD at the time of percutaneous coronary intervention (PCI). The primary combined end point was defined as all-cause death and/or myocardial infarction (MI) during 12-month follow-up. Secondary end points were defined as the single events of all-cause death and MI. We found significant differences of CXCR4 values in patients who developed a combined end point compared with event-free patients (mean MFIAUTHOR: Please define MFI at first use. 3.17 vs. 3.44, 95% confidence interval [CI] 0.09-0.45) and in patients who subsequently died (mean MFI 3.10 vs. 3.42, 95% CI 0.09-0.56). In multivariate Cox regression analysis, lower platelet CXCR4 levels were independently and significantly associated with all-cause mortality (hazard ratio 0.24, 95% CI 0.07-0.87) and the primary combined end point of all-cause death and/or MI (hazard ratio 0.30, 95% CI 0.13-0.72). CONCLUSION These findings highlight a potential prognostic value of platelet expression CXCR4 on clinical outcomes in patients with CAD.
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Affiliation(s)
- D Rath
- Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, University Tübingen, Tübingen, Germany
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Arlanov R, Lang T, Jedlitschky G, Schaeffeler E, Ishikawa T, Schwab M, Nies AT. Functional characterization of common protein variants in the efflux transporter ABCC11 and identification of T546M as functionally damaging variant. Pharmacogenomics J 2015; 16:193-201. [PMID: 25896536 DOI: 10.1038/tpj.2015.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 02/23/2015] [Accepted: 03/02/2015] [Indexed: 11/09/2022]
Abstract
Multidrug resistance protein 8 (ABCC11) is an efflux transporter for anionic lipophilic compounds, conferring resistance to antiviral and anticancer agents like 5-fluorouracil (5-FU). ABCC11 missense variants may contribute to variability in drug response but functional consequences, except for the 'earwax variant' c.538G>A, are unknown. Using the 'Screen and Insert' technology, we generated human embryonic kidney 293 cells stably expressing ABCC11 missense variants frequently occurring in different ethnic populations: c.57G>A, c.538G>A, c.950C>A, c.1637C>T, c.1942G>A, c.4032A>G. A series of in silico prediction analyses and in vitro plasma membrane vesicle uptake, immunoblotting and immunolocalization experiments were undertaken to investigate functional consequences. We identified c.1637C>T (T546M), previously associated with 5-FU-related toxicity, as a novel functionally damaging ABCC11 variant exhibiting markedly reduced transport function of 5-FdUMP, the active cytotoxic metabolite of 5-FU. Detailed analysis of 14 subpopulations revealed highest allele frequencies of c.1637C>T in Europeans and Americans (up to 11%) compared with Africans and Asians (up to 3%).
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Affiliation(s)
- R Arlanov
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Stuttgart, Germany
| | - T Lang
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Stuttgart, Germany
| | - G Jedlitschky
- Department of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine of Greifswald, Greifswald, Germany
| | - E Schaeffeler
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Stuttgart, Germany
| | - T Ishikawa
- RIKEN Center for Life Science Technologies, Yokohama, Japan
| | - M Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Stuttgart, Germany.,Department of Clinical Pharmacology, Institute of Experimental and Clinical Pharmacology and Toxicology, University Hospital of Tübingen, Tübingen, Germany
| | - A T Nies
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Stuttgart, Germany
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41
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Saladores P, Mürdter T, Eccles D, Chowbay B, Zgheib NK, Winter S, Ganchev B, Eccles B, Gerty S, Tfayli A, Lim JSL, Yap YS, Ng RCH, Wong NS, Dent R, Habbal MZ, Schaeffeler E, Eichelbaum M, Schroth W, Schwab M, Brauch H. Tamoxifen metabolism predicts drug concentrations and outcome in premenopausal patients with early breast cancer. Pharmacogenomics J 2015; 15:84-94. [PMID: 25091503 PMCID: PMC4308646 DOI: 10.1038/tpj.2014.34] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/30/2014] [Accepted: 06/04/2014] [Indexed: 12/11/2022]
Abstract
Tamoxifen is the standard-of-care treatment for estrogen receptor-positive premenopausal breast cancer. We examined tamoxifen metabolism via blood metabolite concentrations and germline variations of CYP3A5, CYP2C9, CYP2C19 and CYP2D6 in 587 premenopausal patients (Asians, Middle Eastern Arabs, Caucasian-UK; median age 39 years) and clinical outcome in 306 patients. N-desmethyltamoxifen (DM-Tam)/(Z)-endoxifen and CYP2D6 phenotype significantly correlated across ethnicities (R(2): 53%, P<10(-77)). CYP2C19 and CYP2C9 correlated with norendoxifen and (Z)-4-hydroxytamoxifen concentrations, respectively (P<0.001). DM-Tam was influenced by body mass index (P<0.001). Improved distant relapse-free survival (DRFS) was associated with decreasing DM-Tam/(Z)-endoxifen (P=0.036) and increasing CYP2D6 activity score (hazard ratio (HR)=0.62; 95% confidence interval (CI), 0.43-0.91; P=0.013). Low (<14 nM) compared with high (>35 nM) endoxifen concentrations were associated with shorter DRFS (univariate P=0.03; multivariate HR=1.94; 95% CI, 1.04-4.14; P=0.064). Our data indicate that endoxifen formation in premenopausal women depends on CYP2D6 irrespective of ethnicity. Low endoxifen concentration/formation and decreased CYP2D6 activity predict shorter DRFS.
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Affiliation(s)
- P Saladores
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - T Mürdter
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - D Eccles
- Faculty of Medicine, Cancer Sciences Academic Unit and University of Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - B Chowbay
- Clinical Pharmacology Laboratory, Division of Medical Sciences, Humphrey Oei Institute of Cancer Research, National Cancer Centre Singapore, Singapore, Singapore
- Academic Medicine Research Institute, Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, Singapore, Singapore
- SingHealth Clinical Pharmacology Core, Academia, Singapore Health Services, Singapore, Singapore
| | - N K Zgheib
- Faculty of Medicine, Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
| | - S Winter
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - B Ganchev
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - B Eccles
- Faculty of Medicine, Cancer Sciences Academic Unit and University of Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S Gerty
- Faculty of Medicine, Cancer Sciences Academic Unit and University of Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Tfayli
- Hematology-Oncology Division, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - J S L Lim
- Clinical Pharmacology Laboratory, Division of Medical Sciences, Humphrey Oei Institute of Cancer Research, National Cancer Centre Singapore, Singapore, Singapore
| | - Y S Yap
- Department of Medical Oncology, Humphrey Oei Institute of Cancer Research, National Cancer Centre Singapore, Singapore, Singapore
| | - R C H Ng
- Department of Medical Oncology, Humphrey Oei Institute of Cancer Research, National Cancer Centre Singapore, Singapore, Singapore
| | - N S Wong
- Department of Medical Oncology, Humphrey Oei Institute of Cancer Research, National Cancer Centre Singapore, Singapore, Singapore
| | - R Dent
- Department of Medical Oncology, Humphrey Oei Institute of Cancer Research, National Cancer Centre Singapore, Singapore, Singapore
| | - M Z Habbal
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - E Schaeffeler
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - M Eichelbaum
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - W Schroth
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - M Schwab
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- Department of Clinical Pharmacology, University Hospital Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Brauch
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Emami-Riedmaier A, Schaeffeler E, Nies AT, Mörike K, Schwab M. Stratified medicine for the use of antidiabetic medication in treatment of type II diabetes and cancer: where do we go from here? J Intern Med 2015; 277:235-247. [PMID: 25418285 DOI: 10.1111/joim.12330] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
At present, the global diabetes epidemic is affecting 347 million individuals, 90% of whom are diagnosed with type II diabetes mellitus (T2DM). T2DM is commonly treated with more than one type of therapy, including oral antidiabetic drugs (OADs) and agents used in the treatment of diabetic complications. Several pharmacological classes of OADs are currently available for the treatment of T2DM, of which insulin secretagogues (i.e. sulphonylureas and meglitinides), insulin sensitizers [thiazolidinediones (TZDs)] and biguanides are the most commonly prescribed. Although many of these OADs have been used for more than half a century in the treatment of T2DM, the pharmacogenomic characteristics of these compounds have only recently been investigated, primarily in retrospective studies. Recent advances in pharmacogenomics have led to the identification of polymorphisms that affect the expression and function of drug-metabolizing enzymes and drug transporters, as well as drug targets and receptors. These polymorphisms have been shown to affect the therapeutic response to and side effects associated with OADs. The aim of this review was to provide an up-to-date summary of some of the pharmacogenomic data obtained from studies of T2DM treatment, with a focus on polymorphisms in genes affecting pharmacokinetics, pharmacodynamics and treatment outcome of the most commonly prescribed OADs. In addition, the implications of pharmacogenomics in the use of the OAD metformin in cancer will be briefly discussed. Finally, we will focus on recent advances in novel 'omics' technologies and discuss how these might aid in the personalized management of T2DM.
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Affiliation(s)
- A Emami-Riedmaier
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - E Schaeffeler
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - A T Nies
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - K Mörike
- Department of Clinical Pharmacology, University Hospital Tübingen, Tübingen, Germany
| | - M Schwab
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,Department of Clinical Pharmacology, University Hospital Tübingen, Tübingen, Germany
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43
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Muth I, Rupprecht S, Hoyer H, Ligges C, Ligges M, Schwab M, Hoyer D, Schleußner E. Langzeiteffekte einer pränatalen Betamethason-Behandlung auf die anthropometrischen Maße zur Geburt und im Grundschulalter. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388065] [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: 10/24/2022] Open
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44
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Muth I, Rupprecht S, Hoyer H, Ligges C, Ligges M, Schwab M, Hoyer D, Schleußner E. Langzeiteffekte von ein- und mehrfachen pränatalen Betamethason-Behandlungen auf die autonome und humorale Stressantwort im Grundschulalter. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388081] [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: 10/24/2022] Open
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46
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Taeuscher C, Schultze T, Nowack S, Hoyer D, Schwab M, Witte O, Ehrhardt J, Rupprecht S. P290: Blood pressure and heart rate regulation is already disturbed in prodromal α-synucleinopathy due to peripheral autonomic denervation. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50412-9] [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: 11/15/2022]
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47
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Ehrhardt J, Finn S, Nowack S, Schwab M, Schultze T, Witte O, Hoyer D, Rupprecht S. Autonome Dysregulation ist Ursache einer erhöhten systemischen Entzündungsreaktion bei Patienten mit asymptomatischer extrakranieller Karotisstenose. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371238] [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: 10/25/2022]
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48
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Caudle KE, Thorn CF, Klein TE, Swen JJ, McLeod HL, Diasio RB, Schwab M. Clinical Pharmacogenetics Implementation Consortium guidelines for dihydropyrimidine dehydrogenase genotype and fluoropyrimidine dosing. Clin Pharmacol Ther 2013; 94:640-5. [PMID: 23988873 PMCID: PMC3831181 DOI: 10.1038/clpt.2013.172] [Citation(s) in RCA: 245] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 08/22/2013] [Indexed: 01/07/2023]
Abstract
The fluoropyrimidines are the mainstay chemotherapeutic agents for the treatment of many types of cancers. Detoxifying metabolism of fluoropyrimidines requires dihydropyrimidine dehydrogenase (DPD, encoded by the DPYD gene), and reduced or absent activity of this enzyme can result in severe, and sometimes fatal, toxicity. We summarize evidence from the published literature supporting this association and provide dosing recommendations for fluoropyrimidines based on DPYD genotype (updates at http://www.pharmgkb.org).
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Affiliation(s)
- K E Caudle
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - C F Thorn
- Department of Genetics, Stanford University Medical Center, Stanford, California, USA
| | - T E Klein
- Department of Genetics, Stanford University Medical Center, Stanford, California, USA
| | - J J Swen
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - H L McLeod
- Moffitt Cancer Center, Tampa, Florida, USA
| | - R B Diasio
- Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - M Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- Department of Clinical Pharmacology, University Hospital, Tuebingen, Germany
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49
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Müller KAL, Karathanos A, Tavlaki E, Stimpfle F, Meissner M, Bigalke B, Stellos K, Schwab M, Schaeffeler E, Müller II, Gawaz M, Geisler T. Combination of high on-treatment platelet aggregation and low deaggregation better predicts long-term cardiovascular events in PCI patients under dual antiplatelet therapy. Platelets 2013; 25:439-46. [PMID: 24102318 DOI: 10.3109/09537104.2013.829914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/13/2022]
Abstract
High on-treatment platelet reactivity is associated with short-term major cardiovascular (CV) events in patients undergoing percutaneous coronary intervention (PCI). Maximum and final aggregation assessed by light transmission aggregometry (LTA) have both been used to predict short-term outcome after PCI, however their long-term prognostic impact remains controversial. There is currently no information regarding the prognostic role of deaggregation and its added value in combination with established aggregation parameters. About 1279 patients with symptomatic coronary artery disease (CAD) undergoing PCI were enrolled in this monocentric study. On-treatment platelet aggregation under clopidogrel maintenance therapy, as well as deaggregation was determined by maximum and final aggregation (5 min after adding of the agonist). Deaggregation was defined as slope of the tangent between Aggmax +0.5 min. Primary endpoints were the composite of myocardial infarction, stroke, and CV death or stent thrombosis according to the ARC criteria. Low deaggregation, defined as values in the lowest tertile (<1.5), was more frequent in patients with acute coronary syndromes (ACS) compared to patients with stable angina pectoris (SAP), ACS: 29.6% vs. SAP: 22.0%, p = 0.001. The combination of high on-treatment platelet reactivity, defined by the upper tertile of Aggmax and low deaggregation, was associated with significantly increased risk for combined long-term CV events. The combination of low deaggregation and high on-treatment platelet reactivity is associated with higher risk for recurrent events in patients with CAD undergoing PCI. Thus, deaggregation might be a more sensitive parameter providing added value in terms of risk prediction for long-term recurrent CV events in relation with established aggregation parameters.
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Affiliation(s)
- K A L Müller
- Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen , Tübingen , Germany and
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50
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Xie L, Antonow-Schlorke I, Schwab M, McDonald TJ, Nathanielsz PW, Li C. The frontal cortex IGF system is down regulated in the term, intrauterine growth restricted fetal baboon. Growth Horm IGF Res 2013; 23:187-192. [PMID: 23911858 PMCID: PMC3919499 DOI: 10.1016/j.ghir.2013.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/03/2013] [Accepted: 07/04/2013] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The IGF system exerts systemic and local actions during development. We previously demonstrated that fetal cerebral cortical IGF1 is reduced at 0.5 gestation in our IUGR baboon nonhuman primate model. We hypothesized that by term protein expression of several key IGF system stimulatory peptide pathway components and downstream nutrient signaling effectors of IGF, mammalian target of rapamycin (mTOR) and S6, would decrease, indicating reduced cellular nutrient uptake and protein synthesis. DESIGN We fed 7 control baboons ad libitum while 6 baboons ate a globally reduced diet (70% of feed eaten by controls) from 0.16 gestation through pregnancy that produces IUGR. Fetuses were removed at Cesarean section at 0.9 gestation. Frontal cortex sections were stained for IGFI, IGFII, IGFRI, IGFR2, IGFBP2, 3, 5 and 6, and mTOR and ribosomal protein S6 and double stained with NeuN a neuron-specific nuclear antigen. RESULTS All proteins stained neuronal cytoplasm except IGFRI which showed only glial cell cytoplasmic and blood vessel staining. IUGR fetuses showed decreased frontal cortical immunoreactive IGFI, IGFII, IGFRI, IGFBP2, 5 and 6, and mTOR and S6 (p < 0.05). IGFBP3 increased (p < 0.05) and IGFR2 was unchanged (p > 0.05). There were no differences between male and female fetal brains. CONCLUSIONS When fetal nutrient availability is decreased, IUGR down regulates the IGF system and its mTOR signaling pathway in the fetal frontal cortex coincident with slowed growth. These findings emphasize the importance of the local tissue IGF system in fetal primate brain development.
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Affiliation(s)
- L Xie
- The University of Texas Health Science Center San Antonio, Center for Pregnancy and Newborn Research, Dept. OB/GYN, San Antonio, TX 78229, USA
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