1
|
Blesl A, Wurm P, Waschina S, Gröchenig HP, Novacek G, Primas C, Reinisch W, Kutschera M, Illiasch C, Hennlich B, Steiner P, Koch R, Tillinger W, Haas T, Reicht G, Mayer A, Ludwiczek O, Miehsler W, Steidl K, Binder L, Reider S, Watschinger C, Fürst S, Kump P, Moschen A, Aden K, Gorkiewicz G, Högenauer C. Prediction of Response to Systemic Corticosteroids in Active UC by Microbial Composition-A Prospective Multicenter Study. Inflamm Bowel Dis 2024; 30:9-19. [PMID: 37463118 PMCID: PMC10769779 DOI: 10.1093/ibd/izad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Corticosteroids are used for induction of remission in patients with moderately to severely active ulcerative colitis. However, up to one-third of patients fail to this therapy. We investigated if fecal microbial composition or its metabolic capacity are associated with response to systemic corticosteroids. METHODS In this prospective, multicenter study, patients with active ulcerative colitis (Lichtiger score ≥4) receiving systemic corticosteroids were eligible. Data were assessed and fecal samples collected before and after 4 weeks of treatment. Patients were divided into responders (decrease of Lichtiger Score ≥50%) and nonresponders. The fecal microbiome was assessed by the 16S rRNA gene marker and analyzed with QIIME 2. Microbial metabolic pathways were predicted using parsimonious flux balance analysis. RESULTS Among 93 included patients, 69 (74%) patients responded to corticosteroids after 4 weeks. At baseline, responders could not be distinguished from nonresponders by microbial diversity and composition, except for a subgroup of biologic-naïve patients. Within 4 weeks of treatment, responders experienced changes in beta diversity with enrichment of ascribed beneficial taxa, including Blautia, Anaerostipes, and Bifidobacterium, as well as an increase in predicted butyrate synthesis. Nonresponders had only minor longitudinal taxonomic changes with a significant increase of Streptococcus salivarius and a microbial composition shifting away from responders. CONCLUSION Baseline microbial diversity and composition seem to be of limited use to predict response to systemic corticosteroids in active ulcerative colitis. Response is longitudinally associated with restoration of microbial composition and its metabolic capacity.
Collapse
Affiliation(s)
- Andreas Blesl
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Philipp Wurm
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Silvio Waschina
- Christian-Albrechts-University Kiel, Institute for Human Nutrition and Food Science, Nutriinformatics, Kiel, Germany
| | | | - Gottfried Novacek
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Christian Primas
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Walter Reinisch
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Maximilian Kutschera
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Robert Koch
- Medical University of Innsbruck, Innsbruck, Austria
| | | | | | | | | | | | | | - Karin Steidl
- Brothers of Saint John of God Hospital, St. Veit an der Glan, Austria
| | - Lukas Binder
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Simon Reider
- Department of Internal Medicine 2 (Gastroenterology and Hepatology), Faculty of Medicine, Kepler University Hospital, Johannes Kepler University, Linz, Austria
- Christian Doppler Laboratory for Mucosal Immunology, Johannes Kepler University Linz, Linz, Austria
| | - Christina Watschinger
- Department of Internal Medicine 2 (Gastroenterology and Hepatology), Faculty of Medicine, Kepler University Hospital, Johannes Kepler University, Linz, Austria
- Christian Doppler Laboratory for Mucosal Immunology, Johannes Kepler University Linz, Linz, Austria
| | - Stefan Fürst
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Patrizia Kump
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Alexander Moschen
- Department of Internal Medicine 2 (Gastroenterology and Hepatology), Faculty of Medicine, Kepler University Hospital, Johannes Kepler University, Linz, Austria
- Christian Doppler Laboratory for Mucosal Immunology, Johannes Kepler University Linz, Linz, Austria
| | - Konrad Aden
- Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
- Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | | | - Christoph Högenauer
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| |
Collapse
|
2
|
Wurm P, Stampfer L, Greimel T, Leitner E, Zechner EL, Bauchinger S, Hauer AC, Gorkiewicz G, Högenauer C, Hoffmann KM. Gut Microbiota Dysbiosis in Suspected Food Protein Induced Proctocolitis-A Prospective Comparative Cohort Trial. J Pediatr Gastroenterol Nutr 2023; 77:31-38. [PMID: 37040073 DOI: 10.1097/mpg.0000000000003789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVES In infants with suspected food protein induced proctocolitis (sFPIP) only a minority of patients are finally diagnosed with the disease following diagnostic dietary intervention (DDI). There is a need for a pathophysiological explanation for the cause of hematochezia in the majority of sFPIP infants. METHODS We prospectively recruited infants with sFPIP and healthy controls. Fecal samples were collected at inclusion, week 4 (end of DDI in sFPIP), and week 8. For 16S rRNA sequencing (515F/806R) we used Illumina MiSeq sequencing system. Amplicon sequence variants were generated using Qiime2 and DADA2. Qiime diversity alpha and beta group comparisons and linear discriminant analysis effect size analysis was performed. For shotgun metagenomic analysis on species level we used KneadData and MetaPhlAn2. RESULTS Fourteen sFPIP infants were compared to 55 healthy infants. At inclusion overall microbial composition of sFPIP infants differed significantly from controls (weighted UniFrac; Pairwise PERMANOVA, P = 0.002, pseudo- F = 5.008). On genus level healthy infant microbiota was significantly enriched with Bifidobacterium ( B ) compared to sFPIP patients (linear discriminant analysis [LDA] = 5.5, P < 0.001, 31.3% vs 12.1%). sFPIP stool was significantly enriched by Clostridium sensu stricto 1 over controls (LDA = 5.3, P = 0.003, 3.5% vs 18.3%). DDI caused a significant and sustained increase of Bifidobacterium (LDA = 5.4, P = 0.048, 27.9%) in sFPIP infants. Species level analysis revealed significant reduction of abundance of B longum in sFPIP patients, which after DDI was reversed by B. species other than B longum . CONCLUSIONS We revealed a gut microbiota dysbiosis phenomenon in sFPIP infants. DDI induces a microbiota composition comparable to that of healthy infants. In most sFPIP infants hematochezia might be triggered by a gut microbiota dysbiosis phenomenon.
Collapse
Affiliation(s)
- Philipp Wurm
- From Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Laura Stampfer
- the Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Theresa Greimel
- the Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Eva Leitner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ellen L Zechner
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
| | - Sebastian Bauchinger
- the Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Almuthe C Hauer
- the Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Gregor Gorkiewicz
- From Institute of Pathology, Medical University of Graz, Graz, Austria
| | | | - K Martin Hoffmann
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- Kinderärzte Zentrum Graz-Raaba, Raaba-Grambach, Austria
| |
Collapse
|
3
|
Zacharias M, Kashofer K, Wurm P, Regitnig P, Schütte M, Neger M, Ehmann S, Marsh LM, Kwapiszewska G, Loibner M, Birnhuber A, Leitner E, Thüringer A, Winter E, Sauer S, Pollheimer MJ, Vagena FR, Lackner C, Jelusic B, Ogilvie L, Durdevic M, Timmermann B, Lehrach H, Zatloukal K, Gorkiewicz G. Host and microbiome features of secondary infections in lethal covid-19. iScience 2022; 25:104926. [PMID: 35992303 PMCID: PMC9374491 DOI: 10.1016/j.isci.2022.104926] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/12/2022] [Accepted: 08/09/2022] [Indexed: 12/15/2022] Open
Abstract
Secondary infections contribute significantly to covid-19 mortality but driving factors remain poorly understood. Autopsies of 20 covid-19 cases and 14 controls from the first pandemic wave complemented with microbial cultivation and RNA-seq from lung tissues enabled description of major organ pathologies and specification of secondary infections. Lethal covid-19 segregated into two main death causes with either dominant diffuse alveolar damage (DAD) or secondary pneumonias. The lung microbiome in covid-19 showed a reduced biodiversity and increased prototypical bacterial and fungal pathogens in cases of secondary pneumonias. RNA-seq distinctly mirrored death causes and stratified DAD cases into subgroups with differing cellular compositions identifying myeloid cells, macrophages and complement C1q as strong separating factors suggesting a pathophysiological link. Together with a prominent induction of inhibitory immune-checkpoints our study highlights profound alterations of the lung immunity in covid-19 wherein a reduced antimicrobial defense likely drives development of secondary infections on top of SARS-CoV-2 infection. Covid-19 autopsy cohort complemented with microbial cultivation and deep sequencing Major death causes stratify into DAD and secondary pneumonias Prototypical bacterial and fungal agents are found in secondary pneumonias Macrophages and C1q stratify DAD subgroups and indicate immune impairment in lungs
Collapse
Affiliation(s)
- Martin Zacharias
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Karl Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Philipp Wurm
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Peter Regitnig
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Moritz Schütte
- Alacris Theranostics GmbH, Max-Planck-Strasse 3, 12489 Berlin, Germany
| | - Margit Neger
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Sandra Ehmann
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Leigh M Marsh
- Ludwig Boltzmann Institute for Lung Vascular Research, Neue Stiftingtalstrasse 6/VI, 8010 Graz, Austria
| | - Grazyna Kwapiszewska
- Ludwig Boltzmann Institute for Lung Vascular Research, Neue Stiftingtalstrasse 6/VI, 8010 Graz, Austria
| | - Martina Loibner
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Anna Birnhuber
- Ludwig Boltzmann Institute for Lung Vascular Research, Neue Stiftingtalstrasse 6/VI, 8010 Graz, Austria
| | - Eva Leitner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Andrea Thüringer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Elke Winter
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Stefan Sauer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Marion J Pollheimer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Fotini R Vagena
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Carolin Lackner
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Barbara Jelusic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Lesley Ogilvie
- Alacris Theranostics GmbH, Max-Planck-Strasse 3, 12489 Berlin, Germany
| | - Marija Durdevic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Bernd Timmermann
- Max Planck Institute for Molecular Genetics, Ihnestrasse 63, 14195 Berlin, Germany
| | - Hans Lehrach
- Alacris Theranostics GmbH, Max-Planck-Strasse 3, 12489 Berlin, Germany.,Max Planck Institute for Molecular Genetics, Ihnestrasse 63, 14195 Berlin, Germany
| | - Kurt Zatloukal
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Gregor Gorkiewicz
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| |
Collapse
|
4
|
Loibner M, Barach P, Wolfgruber S, Langner C, Stangl V, Rieger J, Föderl-Höbenreich E, Hardt M, Kicker E, Groiss S, Zacharias M, Wurm P, Gorkiewicz G, Regitnig P, Zatloukal K. Resilience and Protection of Health Care and Research Laboratory Workers During the SARS-CoV-2 Pandemic: Analysis and Case Study From an Austrian High Security Laboratory. Front Psychol 2022; 13:901244. [PMID: 35936273 PMCID: PMC9353000 DOI: 10.3389/fpsyg.2022.901244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2022] Open
Abstract
The SARS-CoV-2 pandemic has highlighted the interdependency of healthcare systems and research organizations on manufacturers and suppliers of personnel protective equipment (PPE) and the need for well-trained personnel who can react quickly to changing working conditions. Reports on challenges faced by research laboratory workers (RLWs) are rare in contrast to the lived experience of hospital health care workers. We report on experiences gained by RLWs (e.g., molecular scientists, pathologists, autopsy assistants) who significantly contributed to combating the pandemic under particularly challenging conditions due to increased workload, sickness and interrupted PPE supply chains. RLWs perform a broad spectrum of work with SARS-CoV-2 such as autopsies, establishment of virus cultures and infection models, development and verification of diagnostics, performance of virus inactivation assays to investigate various antiviral agents including vaccines and evaluation of decontamination technologies in high containment biological laboratories (HCBL). Performance of autopsies and laboratory work increased substantially during the pandemic and thus led to highly demanding working conditions with working shifts of more than eight hours working in PPE that stressed individual limits and also the ergonomic and safety limits of PPE. We provide detailed insights into the challenges of the stressful daily laboratory routine since the pandemic began, lessons learned, and suggest solutions for better safety based on a case study of a newly established HCBL (i.e., BSL-3 laboratory) designed for autopsies and research laboratory work. Reduced personal risk, increased resilience, and stress resistance can be achieved by improved PPE components, better training, redundant safety measures, inculcating a culture of safety, and excellent teamwork.
Collapse
Affiliation(s)
- Martina Loibner
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Paul Barach
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Stella Wolfgruber
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Christine Langner
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Verena Stangl
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Julia Rieger
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | | | - Melina Hardt
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Eva Kicker
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Silvia Groiss
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Martin Zacharias
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Philipp Wurm
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Gregor Gorkiewicz
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Peter Regitnig
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Kurt Zatloukal
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| |
Collapse
|
5
|
Greimel TM, Stampfer L, Leitner E, Kienesberger S, Zechner EL, Bozic M, Wagner GE, Unterhauser K, Kitsera M, Hauer AC, Gorkiewicz G, Wurm P, Valitutti F, Högenauer C, Hoffmann KM. Toxin-Producing Klebsiella oxytoca in Healthy Infants: Commensal or Pathobiont? J Pediatr Gastroenterol Nutr 2022; 74:e1-e7. [PMID: 34520403 DOI: 10.1097/mpg.0000000000003299] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Klebsiella oxytoca is a gastrointestinal pathobiont with the potential to produce the toxins tilivalline and tilimycin, which cause antibiotic-associated hemorrhagic colitis. Overgrowth of toxigenic K oxytoca has recently been implicated in necrotizing enterocolitis. K oxytoca colonizes 2-9% of healthy adults, however, there is no systematic data on colonization in healthy children. We investigated K oxytoca colonization and its toxigenic properties in healthy infants. METHODS We sampled stool of healthy infants and determined K oxytoca colonization using stool culture and PCR (pehX). Toxin in stool was measured with HPLC/high-resolution mass spectrometry. K oxytoca isolates were typed using multi-locus sequence typing (MLST) and K oxytoca toxin PCR (npsA/B). Cytotoxin production of isolates was analyzed by MTT assay. RESULTS K oxytoca was detected in 30 of 61 infants (49%) using stool culture and in 45 of 61 (73%) using PCR (pehX). Toxin marker PCR (npsA/B) was positive in 66% of stool samples positive for K oxytoca PCR. Stool toxin levels were too low for quantitation but traces of tilivalline were detected. Contrarily, 49% of K oxytoca isolates demonstrated toxicity in the MTT assay. MLST revealed 36 distinct sequence types affiliated with all known K oxytoca sequence type clusters (A, B1 and B2). CONCLUSIONS More than 70% of healthy infants were colonized with K oxytoca. Toxin quantities in stool of colonized healthy infants were below detection level, yet half of the isolates produced toxin in vitro demonstrating their pathobiont potential. The high occurrence of toxigenic K oxytoca in healthy infants has to be considered for future disease association studies.
Collapse
Affiliation(s)
- Theresa M Greimel
- Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine
| | - Laura Stampfer
- Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine
| | - Eva Leitner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz
| | - Sabine Kienesberger
- Institute of Molecular Biosciences, University of Graz
- BioTechMed-Graz
- Field of Excellence BioHealth - University of Graz, Graz
| | - Ellen L Zechner
- Institute of Molecular Biosciences, University of Graz
- BioTechMed-Graz
- Field of Excellence BioHealth - University of Graz, Graz
| | - Michael Bozic
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz
| | - Gabriel E Wagner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz
| | | | | | - Almuthe C Hauer
- Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine
| | - Gregor Gorkiewicz
- Institute of Pathology, Medical University of Graz, Austria
- BioTechMed-Graz
| | - Philipp Wurm
- Institute of Pathology, Medical University of Graz, Austria
| | | | - Christoph Högenauer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz
- BioTechMed-Graz
| | - Karl Martin Hoffmann
- Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine
- Kinderärzte Zentrum Graz-Raaba, Raaba-Grambach, Austria
| |
Collapse
|
6
|
Zacharias M, Stangl V, Thüringer A, Loibner M, Wurm P, Wolfgruber S, Zatloukal K, Kashofer K, Gorkiewicz G. Rapid Antigen Test for Postmortem Evaluation of SARS-CoV-2 Carriage. Emerg Infect Dis 2021; 27:1734-1737. [PMID: 33848454 PMCID: PMC8153888 DOI: 10.3201/eid2706.210226] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Detecting severe acute respiratory syndrome coronavirus 2 in deceased patients is key when considering appropriate safety measures to prevent infection during postmortem examinations. A prospective cohort study comparing a rapid antigen test with quantitative reverse transcription PCR showed the rapid test’s usability as a tool to guide autopsy practice.
Collapse
|
7
|
Wurm P, Halwachs-Wenzl B, Kashofer K, von Lewinski D, Eisner F, Krause R, Gorkiewicz G, Hoegenauer C. 2575. Dramatic Time-Dependent Changes of Bacterial and Fungal Taxonomic Signatures in 4 Body Regions of ICU Patients. Open Forum Infect Dis 2019. [PMCID: PMC6810305 DOI: 10.1093/ofid/ofz360.2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background It has been hypothesized that intensive care unit (ICU)-related complications like nosocomial pneumonia or gastrointestinal dysfunction are associated with disturbances of normal host microorganisms. However, these alterations are largely unknown in ICU patients. The bacterio- and mycobiota in 4 body regions in 14 ICU patients was investigated after admission until death or discharge to other wards. Methods Medical ICU patients were sampled with pharyngeal swabs, endotracheal aspirates, gastric secretions and stools or rectal swabs (in constipated patients). V1-V2 (16S rRNA gene) and eukaryoitic ITS sequencing was performed as previously described as well as denoizing, transformation into amplicon sequence variants and analysis using qiime2 and LEfSe (LDA Score > 3.0, P-value < 0.05). For sequence classification databases SILVA 132 (16S) and UNITE version 7.2 (ITS) were used. Results Samples were obtained at multiple time points from day 1 up to day 47 with a median of 11 samples per patient (range 2 to 17). In 11 patients all intended body regions were sampled (stool was missing in two patients and gastric secretion in two patients). The length of ICU stay and number of antibiotics administered during ICU stay was associated with loss of diversity in all investigated body sites. Taxonomic profiling showed a significant reduction of physiological members from the oral and fecal microbial community (e.g., Clostridiales, Bacteroidales, Faecalibacterium spp. etc.) after 2 weeks at the ICU. In contrast, Enterococcus spp. and Staphylococcus spp. were enriched in the gastric and fecal microbiota. Candida spp. dominated fungal communities of all body sites investigated. Staphylococcus aureus was associated with ITS positive, Candida spp. dominated samples throughout all body sites, while Pseudomonas aeruginosa was associated with ITS-negative samples. Conclusion The length of the ICU stay and the number of different antibiotics administered during the stay at the ICU are associated with severe intestinal dysbiosis, determined by loss of physiological microbes, decreased bacterial richness and domination of low-diversity fecal microbiota. Early colonization of Candida spp. might favor a co-existance of a Staphylococcus spp.-dominated microbiota in the ICU. Disclosures All authors: No reported disclosures.
Collapse
Affiliation(s)
- Philipp Wurm
- Medical University of Graz, Institute of Pathology and Division of Gastroenterology and Hepatology, Graz, Steiermark, Austria
| | | | - Karl Kashofer
- Medical University of Graz, Institute of Pathology, Graz, Steiermark, Austria
| | - Dirk von Lewinski
- Medical University of Graz, Division of Cardiology, Graz, Steiermark, Austria
| | - Florian Eisner
- Medical University of Graz, Intensive Care Unit, Graz, Steiermark, Austria
| | - Robert Krause
- Medical University of Graz, Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Graz, Steiermark, Austria
| | - Gregor Gorkiewicz
- Medical University of Graz, Institute of Pathology, Graz, Steiermark, Austria
| | - Christoph Hoegenauer
- Medical University of Graz, Division of Gastroenterology and Hepatology, Graz, Steiermark, Austria
| |
Collapse
|
8
|
Kump P, Wurm P, Gröchenig HP, Wenzl H, Petritsch W, Halwachs B, Wagner M, Stadlbauer V, Eherer A, Hoffmann KM, Deutschmann A, Reicht G, Reiter L, Slawitsch P, Gorkiewicz G, Högenauer C. The taxonomic composition of the donor intestinal microbiota is a major factor influencing the efficacy of faecal microbiota transplantation in therapy refractory ulcerative colitis. Aliment Pharmacol Ther 2018; 47:67-77. [PMID: 29052237 PMCID: PMC5765501 DOI: 10.1111/apt.14387] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [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: 07/12/2017] [Revised: 08/04/2017] [Accepted: 09/27/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Faecal microbiota transplantation is an experimental approach for the treatment of patients with ulcerative colitis. Although there is growing evidence that faecal microbiota transplantation is effective in this disease, factors affecting its response are unknown. AIMS To establish a faecal microbiota transplantation treatment protocol in ulcerative colitis patients, and to investigate which patient or donor factors are responsible for the treatment success. METHODS This is an open controlled trial of repeated faecal microbiota transplantation after antibiotic pre-treatment (FMT-group, n = 17) vs antibiotic pre-treatment only (AB-group, n = 10) in 27 therapy refractory ulcerative colitis patients over 90 days. Faecal samples of donors and patients were analysed by 16SrRNA gene-based microbiota analysis. RESULTS In the FMT-group, 10/17 (59%) of patients showed a response and 4/17 (24%) a remission to faecal microbiota transplantation. Response to faecal microbiota transplantation was mainly influenced by the taxonomic composition of the donor's microbiota. Stool of donors with a high bacterial richness (observed species remission 946 ± 93 vs no response 797 ± 181 at 15367 rps) and a high relative abundance of Akkermansia muciniphila (3.3 ± 3.1% vs 0.1 ± 0.2%), unclassified Ruminococcaceae (13.8 ± 5.0% vs 7.5 ± 3.7%), and Ruminococcus spp. (4.9 ± 3.5% vs 1.0 ± 0.7%) were more likely to induce remission. In contrast antibiotic treatment alone (AB-group) was poorly tolerated, probably because of a sustained decrease of intestinal microbial richness. CONCLUSIONS The taxonomic composition of the donor's intestinal microbiota is a major factor influencing the efficacy of faecal microbiota transplantation in ulcerative colitis patients. The design of specific microbial preparation might lead to new treatments for ulcerative colitis.
Collapse
Affiliation(s)
- P. Kump
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria,Theodor Escherich Laboratory for Medical Microbiome ResearchMedical University of GrazGrazAustria
| | - P. Wurm
- Theodor Escherich Laboratory for Medical Microbiome ResearchMedical University of GrazGrazAustria,Institute of PathologyMedical University of GrazGrazAustria
| | | | - H. Wenzl
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria
| | - W. Petritsch
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria
| | - B. Halwachs
- Theodor Escherich Laboratory for Medical Microbiome ResearchMedical University of GrazGrazAustria,Institute of PathologyMedical University of GrazGrazAustria,BioTechMed‐GrazInteruniversity CooperationGrazAustria
| | - M. Wagner
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria
| | - V. Stadlbauer
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria
| | - A. Eherer
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria
| | - K. M. Hoffmann
- Department of Pediatrics and Adolescent MedicineMedical University of GrazGrazAustria
| | - A. Deutschmann
- Department of Pediatrics and Adolescent MedicineMedical University of GrazGrazAustria
| | - G. Reicht
- Barmherzige Brüder HospitalGrazAustria
| | - L. Reiter
- Barmherzige Brüder HospitalGrazAustria
| | | | - G. Gorkiewicz
- Theodor Escherich Laboratory for Medical Microbiome ResearchMedical University of GrazGrazAustria,Institute of PathologyMedical University of GrazGrazAustria,BioTechMed‐GrazInteruniversity CooperationGrazAustria
| | - C. Högenauer
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria,Theodor Escherich Laboratory for Medical Microbiome ResearchMedical University of GrazGrazAustria,BioTechMed‐GrazInteruniversity CooperationGrazAustria
| |
Collapse
|
9
|
Wurm P, Spindelboeck W, Krause R, Plank J, Fuchs G, Bashir M, Petritsch W, Halwachs B, Langner C, Högenauer C, Gorkiewicz G. Antibiotic-Associated Apoptotic Enterocolitis in the Absence of a Defined Pathogen: The Role of Intestinal Microbiota Depletion. Crit Care Med 2017; 45:e600-e606. [PMID: 28333760 PMCID: PMC5432091 DOI: 10.1097/ccm.0000000000002310] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Supplemental Digital Content is available in the text. Objective: Antibiotic therapy is a major risk factor for the development of diarrhea and colitis with varying severity. Often the origin of antibiotic-associated gastrointestinal deterioration remains elusive and no specific infectious agents could be discerned. Patients: We represent three cases of intractable high-volume diarrhea associated with combined antibiotic and steroid therapy in critically ill patients not fitting into established disease entities. Cases presented with severe apoptotic enterocolitis resembling acute intestinal graft-versus-host-disease. Microbiologic workup precluded known enteropathogens, but microbiota analysis revealed a severely depleted gut microbiota with concomitant opportunistic pathogen overgrowth. Interventions: Fecal microbiota transplantation, performed in one patient, was associated with correction of dysbiosis, rapid clinical improvement, and healing of enterocolitis. Conclusions: Our series represents a severe form of antibiotic-associated colitis in critically ill patients signified by microbiota depletion, and reestablishment of a physiologic gastrointestinal microbiota might be beneficial for this condition.
Collapse
Affiliation(s)
- Philipp Wurm
- 1Institute of Pathology, Medical University of Graz, Graz, Austria. 2Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria. 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 4Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 5Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria. 6Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 7BioTechMed, Interuniversity Cooperation, Graz, Austria
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Moser AM, Spindelboeck W, Strohmaier H, Enzinger C, Gattringer T, Fuchs S, Fazekas F, Gorkiewicz G, Wurm P, Högenauer C, Khalil M. Mucosal biopsy shows immunologic changes of the colon in patients with early MS. Neurol Neuroimmunol Neuroinflamm 2017. [PMID: 28638851 PMCID: PMC5471347 DOI: 10.1212/nxi.0000000000000362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: To investigate immune cells of the colonic mucosa and fecal short-chain fatty acids (SCFAs) in treatment-naive patients with a clinically isolated syndrome (CIS) or early relapsing MS. Methods: In this cross-sectional proof-of-concept study, we obtained mucosal specimens during ileocolonoscopy from 15 untreated patients with CIS/MS and 10 controls. Mucosal immune cells were analyzed by FACS, and gas chromatography-mass spectrometry measurements of stool samples served to determine SCFA. Results: The number of total dendritic cells (DCs), CD103+ tolerogenic DCs, and CD4+25+127–regulatory T cells (Tregs) was significantly reduced in the distal colon of patients with CIS/MS compared with controls, whereas we found no differences in the proximal colon. The patients' fecal samples also showed a substantially lower content of SCFA and especially lower levels of butyrate and acetate. Conclusions: Our findings indicate a disturbed homeostasis of colonic DCs and Tregs in patients with MS which could be associated with colonic SCFA depletion. Although not implying causality, these findings confirm parallel abnormalities of the gut in MS and warrant further research if modulation of the colonic SCFA profile or the colonic Treg pool can serve to modify the course of MS.
Collapse
Affiliation(s)
- Adrian Mathias Moser
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Walter Spindelboeck
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Heimo Strohmaier
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Christian Enzinger
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Thomas Gattringer
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Siegrid Fuchs
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Franz Fazekas
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Gregor Gorkiewicz
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Philipp Wurm
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Christoph Högenauer
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| | - Michael Khalil
- Department of Internal Medicine (A.M.M., W.S., C.H.), Division of Gastroenterology and Hepatology, Theodor Escherich Laboratory for Microbiome Research (A.M.M., W.S., G.G., P.W., C.H.), Center for Medical Research (H.S.), Department of Neurology (C.E., T.G., S.F., F.F., M.K.), and Institute of Pathology (G.G., P.W.), Medical University of Graz, Austria
| |
Collapse
|
11
|
Montalban-Arques A, Wurm P, Trajanoski S, Schauer S, Kienesberger S, Halwachs B, Högenauer C, Langner C, Gorkiewicz G. Propionibacterium acnes overabundance and natural killer group 2 member D system activation in corpus-dominant lymphocytic gastritis. J Pathol 2016; 240:425-436. [PMID: 27538697 PMCID: PMC5111592 DOI: 10.1002/path.4782] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/15/2016] [Accepted: 08/09/2016] [Indexed: 12/30/2022]
Abstract
Corpus‐dominant lymphocytic gastritis (LyG) is characterized by CD8+ T‐cell infiltration of the stomach epithelium by a so far uncharacterized mechanism. Although Helicobacter pylori is typically undetectable in LyG, patients respond to H. pylori antibiotic eradication therapy, suggesting a non‐H. pylori microbial trigger for the disease. Comparative microbiota analysis of specimens from LyG, H. pylori gastritis and healthy controls precluded involvement of H. pylori in LyG but identified Propionibacterium acnes as a possible disease trigger. In addition, the natural killer group 2 member D (NKG2D) system and the proinflammatory cytokine interleukin (IL)‐15 are significantly upregulated in the gastric mucosa of LyG patients, and gastric epithelial cells respond to microbe‐derived stimuli, including live P. acnes and the microbial products short‐chain fatty acids, with induction of NKG2D ligands. In contrast, H. pylori infection does not activate or even repress NKG2D ligands. Together, our findings identify P. acnes as a possible causative agent for LyG, which is dependent on the NKG2D system and IL‐15 activation. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
Collapse
Affiliation(s)
- Ana Montalban-Arques
- Institute of Pathology, Medical University of Graz, Graz, Austria.,Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria
| | - Philipp Wurm
- Institute of Pathology, Medical University of Graz, Graz, Austria.,Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria
| | - Slave Trajanoski
- Centre for Medical Research, Medical University of Graz, Graz, Austria
| | - Silvia Schauer
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Sabine Kienesberger
- Institute of Molecular Biosciences, University of Graz, Graz, Austria.,BioTechMed, Interuniversity Cooperation, Graz, Austria
| | - Bettina Halwachs
- Institute of Pathology, Medical University of Graz, Graz, Austria.,Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria.,BioTechMed, Interuniversity Cooperation, Graz, Austria
| | - Christoph Högenauer
- Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria.,Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Cord Langner
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Gregor Gorkiewicz
- Institute of Pathology, Medical University of Graz, Graz, Austria.,Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria.,BioTechMed, Interuniversity Cooperation, Graz, Austria
| |
Collapse
|
12
|
Bashir M, Prietl B, Tauschmann M, Mautner SI, Kump PK, Treiber G, Wurm P, Gorkiewicz G, Högenauer C, Pieber TR. Effects of high doses of vitamin D3 on mucosa-associated gut microbiome vary between regions of the human gastrointestinal tract. Eur J Nutr 2015; 55:1479-89. [PMID: 26130323 PMCID: PMC4875045 DOI: 10.1007/s00394-015-0966-2] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/16/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE Vitamin D is well known for its effects on bone mineralisation but has also been attributed immunomodulatory properties. It positively influences human health, but in vivo data describing vitamin D effects on the human gut microbiome are missing. We aimed to investigate the effects of oral vitamin D3 supplementation on the human mucosa-associated and stool microbiome as well as CD8(+) T cells in healthy volunteers. METHODS This was an interventional, open-label, pilot study. Sixteen healthy volunteers (7 females, 9 males) were endoscopically examined to access a total of 7 sites. We sampled stomach, small bowel, colon, and stools before and after 8 weeks of vitamin D3 supplementation. Bacterial composition was assessed by pyrosequencing the 16S rRNA gene (V1-2), and CD8(+) T cell counts were determined by flow cytometry. RESULTS Vitamin D3 supplementation changed the gut microbiome in the upper GI tract (gastric corpus, antrum, and duodenum). We found a decreased relative abundance of Gammaproteobacteria including Pseudomonas spp. and Escherichia/Shigella spp. and increased bacterial richness. No major changes occurred in the terminal ileum, appendiceal orifice, ascending colon, and sigmoid colon or in stools, but the CD8(+) T cell fraction was significantly increased in the terminal ileum. CONCLUSION Vitamin D3 modulates the gut microbiome of the upper GI tract which might explain its positive influence on gastrointestinal diseases, such as inflammatory bowel disease or bacterial infections. The local effects of vitamin D demonstrate pronounced regional differences in the response of the GI microbiome to external factors, which should be considered in future studies investigating the human microbiome.
Collapse
Affiliation(s)
- Mina Bashir
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Barbara Prietl
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Martin Tauschmann
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Selma I Mautner
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Patrizia K Kump
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Gerlies Treiber
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Philipp Wurm
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | | | - Christoph Högenauer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Thomas R Pieber
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
| |
Collapse
|
13
|
Schwarz H, Posselt G, Wurm P, Ulbing M, Duschl A, Horejs-Hoeck J. TLR8 and NOD signaling synergistically induce the production of IL-1β and IL-23 in monocyte-derived DCs and enhance the expression of the feedback inhibitor SOCS2. Immunobiology 2012; 218:533-42. [PMID: 22795647 DOI: 10.1016/j.imbio.2012.06.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 05/02/2012] [Accepted: 06/20/2012] [Indexed: 11/18/2022]
Abstract
Pattern recognition receptors (PRRs) like Toll-like receptors (TLRs) and NOD-like receptors (NLRs) are important sensors of microbial products. Although they are referred to as innate immune receptors, they make essential contributions to adaptive immune responses by activating dendritic cells (DCs). Simultaneous activation of DCs via different classes of PRRs provides a powerful tool for inducing strong immune responses. In the present study we investigate the interplay of the NLRs NOD1 and NOD2 and their crosstalk with TLR signaling in terms of DC-activation. We found strong synergistic effects upon treatment with NOD1 and NOD2 ligands combined with the TLR7/8 agonist R848. Simultaneous stimulation of monocyte-derived DCs resulted in highly increased production of IL-1β, IL-23 and SOCS2, a member of the suppressor of cytokine signaling (SOCS) family. Silencing of SOCS2 resulted in enhanced IL-23 expression, indicating that SOCS2 is involved in the regulation of TLR/NOD-dependent cytokine secretion. Finally, we demonstrate that TLR7/8-, NOD1- and NOD2-activated DCs promote CD4+ T cells to release increased amounts of IL-17. These results demonstrate that cooperative activation of DCs with NOD1 and NOD2 agonists and TLR7/8 ligands results in a synergistic release of pro-inflammatory mediators which promote the activation of IL-17-producing T cells.
Collapse
Affiliation(s)
- Harald Schwarz
- Department of Molecular Biology, Division of Allergy and Immunology, Paris Lodron University of Salzburg, Austria
| | | | | | | | | | | |
Collapse
|
14
|
Adlarson P, Adolph C, Augustyniak W, Baru V, Bashkanov M, Bednarski T, Bergmann FS, Berłowski M, Bhatt H, Brinkmann KT, Büscher M, Calén H, Clement H, Coderre D, Czerwiński E, Doroshkevich E, Ekström C, Engels R, Erven W, Eyrich W, Fedorets P, Föhl K, Fransson K, Goldenbaum F, Goslawski P, Grigoryev K, Grishina V, Gullström CO, Hampe J, Hanhart C, Heijkenskjöld L, Hejny V, Hinterberger F, Hodana M, Höistad B, Jacewicz M, Janusz M, Jany A, Jany BR, Jarczyk L, Johansson T, Kamys B, Kemmerling G, Khakimova O, Khoukaz A, Kistryn S, Klaja J, Kleines H, Kłos B, Kren F, Krzemień W, Kulessa P, Kullander S, Kupść A, Lalwani K, Lorentz B, Magiera A, Maier R, Marciniewski P, Mariański B, Mikirtychiants M, Moskal P, Morsch HP, Nandi BK, Niedźwiecki S, Ohm H, Passfeld A, Pauly C, del Rio EP, Petukhov Y, Piskunov N, Pluciński P, Podkopał P, Povtoreyko A, Prasuhn D, Pricking A, Pysz K, Rausmann T, Redmer CF, Ritman J, Roy A, Ruber RJMY, Rudy Z, Sawant S, Schadmand S, Schmidt A, Schroeder W, Sefzick T, Serdyuk V, Shah N, Siemaszko M, Siudak R, Skorodko T, Skurzok M, Smyrski J, Sopov V, Stassen R, Stepaniak J, Sterzenbach G, Stockhorst H, Ströher H, Szczurek A, Täschner A, Tolba T, Trzciński A, Varma R, Vlasov P, Wagner GJ, Węglorz W, Winnemöller A, Wirzba A, Wolke M, Wrońska A, Wüstner P, Wurm P, Yuan X, Yurev L, Zabierowski J, Zheng C, Zieliński MJ, Zipper W, Złomańczuk J, Zuprański P. Abashian-Booth-Crowe effect in basic double-pionic fusion: a new resonance? Phys Rev Lett 2011; 106:242302. [PMID: 21770567 DOI: 10.1103/physrevlett.106.242302] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Indexed: 05/31/2023]
Abstract
We report on an exclusive and kinematically complete high-statistics measurement of the basic double-pionic fusion reaction pn→dπ(0)π(0) over the full energy region of the ABC effect, a pronounced low-mass enhancement in the ππ-invariant mass spectrum. The measurements, which cover also the transition region to the conventional t-channel ΔΔ process, were performed with the upgraded WASA detector setup at COSY. The data reveal the Abashian-Booth-Crowe effect to be uniquely correlated with a Lorentzian energy dependence in the integral cross section. The observables are consistent with a narrow resonance with m=2.37 GeV, Γ≈70 MeV and I(J(P))=0(3(+)) in both pn and ΔΔ systems. Necessary further tests of the resonance interpretation are discussed.
Collapse
Affiliation(s)
- P Adlarson
- Department of Physics and Astronomy, Uppsala University, Uppsala, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Talwar V, Wurm P, Bankart MJG, Gershlick AH, de Caestecker JS. Clinical trial: chest pain caused by presumed gastro-oesophageal reflux in coronary artery disease - controlled study of lansoprazole vs. placebo. Aliment Pharmacol Ther 2010; 32:191-9. [PMID: 20456303 DOI: 10.1111/j.1365-2036.2010.04336.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND Gastro-oesophageal reflux (GER) and coronary artery disease commonly co-exist. Coronary artery disease patients may mistake GER-induced pain for cardiac pain or GER might provoke angina. AIM To investigate if GER might contribute to nocturnal/rest chest pain among coronary artery disease patients. METHODS Double-blind placebo-controlled crossover study investigating effect of lansoprazole on chest pain; 125 patients with angiographically proven coronary artery disease enrolled with at least one weekly episode of nocturnal/rest pain, randomized to lansoprazole 30 mg daily or placebo with crossover after 4 weeks. Symptoms recorded and QOL assessed by Nottingham Health Profile Questionnaire; ST segment depression episodes counted from 24 h electrocardiographic monitoring in final week of both periods. STATISTICAL ANALYSIS ANCOVA with period and carryover analysis. RESULTS In all, 108 patients completed the study. There was a modest increase in pain-free days on lansoprazole vs. placebo (P < 0.02), with fewer days with pain at rest (P < 0.05) and at night (P < 0.009) on lansoprazole vs. placebo, but no significant differences in ST segment depression episodes (P = 0.64). There was a trend for reduction in the 'physical pain' QOL domain. CONCLUSIONS Among coronary artery disease patients, lansoprazole modestly increases pain-free days and reduces rest/nocturnal pain. As lansoprazole did not affect ST segments, this may be by suppression of GER-provoked pain misinterpreted as angina, rather than acid-provoked ischaemia.
Collapse
Affiliation(s)
- V Talwar
- Digestive Diseases Centre, University Hospitals of Leicester, Leicester, UK
| | | | | | | | | |
Collapse
|
16
|
Abstract
OBJECTIVE There is an increased risk of colorectal cancer in patients with inflammatory bowel disease (IBD). The aim of this study was to compare the prevalence of left sided adenomas in patients with IBD aged 55-64 years with a local age matched control population. METHOD A review of clinical notes. The prevalence of adenomas in patients with IBD attending for either sigmoidoscopy or colonoscopy was compared with local age matched controls that participated in the national screening trial for colorectal cancer with flexible sigmoidoscopy. RESULTS Of 106 patients (61 male, 45 female, mean age of 59 years), 80 suffered from ulcerative colitis, 20 from Crohn's disease, and six from indeterminate colitis. All patients had undergone at least one flexible sigmoidoscopy and 75 had a colonoscopy. Distal adenomas were found in three patients with ulcerative colitis compared with 67 of 749 controls (2.8% v 8.9%, chi(2) = 4.6, p = 0.03). CONCLUSIONS The results suggest that distal adenomatous polyps are rare in patients aged 55-64 years with IBD compared with a control population. This supports the hypothesis that lesions other than polyps are important for the development of colorectal cancer in patients with IBD.
Collapse
Affiliation(s)
- A Dixon
- The Digestive Diseases Centre, University Hospitals of Leicester, UK.
| | | | | | | |
Collapse
|
17
|
Abstract
Kikuchi's disease is usually a self limiting illness characterised by pyrexia, neutropenia, and cervical lymphadenopathy particularly in young women of Asian descent. This often leads to an initial misdiagnosis of lymphoma. A case of a young Asian woman who presented with pyrexia of unknown origin is described.
Collapse
Affiliation(s)
- P Wurm
- Department of Gastroenterology, Leicester General Hospital, Leicester, UK.
| | | | | | | |
Collapse
|
18
|
|
19
|
Novotný F, Wurm P. [Changes on the kidneys in psoriatics (author's transl)]. Cesk Dermatol 1979; 54:336-42. [PMID: 535048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|