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Scotto Rosato A, Krogsaeter EK, Jaślan D, Abrahamian C, Montefusco S, Soldati C, Spix B, Pizzo MT, Grieco G, Böck J, Wyatt A, Wünkhaus D, Passon M, Stieglitz M, Keller M, Hermey G, Markmann S, Gruber-Schoffnegger D, Cotman S, Johannes L, Crusius D, Boehm U, Wahl-Schott C, Biel M, Bracher F, De Leonibus E, Polishchuk E, Medina DL, Paquet D, Grimm C. TPC2 rescues lysosomal storage in mucolipidosis type IV, Niemann-Pick type C1, and Batten disease. EMBO Mol Med 2022; 14:e15377. [PMID: 35929194 PMCID: PMC9449600 DOI: 10.15252/emmm.202115377] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 01/05/2023] Open
Abstract
Lysosomes are cell organelles that degrade macromolecules to recycle their components. If lysosomal degradative function is impaired, e.g., due to mutations in lysosomal enzymes or membrane proteins, lysosomal storage diseases (LSDs) can develop. LSDs manifest often with neurodegenerative symptoms, typically starting in early childhood, and going along with a strongly reduced life expectancy and quality of life. We show here that small molecule activation of the Ca2+‐permeable endolysosomal two‐pore channel 2 (TPC2) results in an amelioration of cellular phenotypes associated with LSDs such as cholesterol or lipofuscin accumulation, or the formation of abnormal vacuoles seen by electron microscopy. Rescue effects by TPC2 activation, which promotes lysosomal exocytosis and autophagy, were assessed in mucolipidosis type IV (MLIV), Niemann–Pick type C1, and Batten disease patient fibroblasts, and in neurons derived from newly generated isogenic human iPSC models for MLIV and Batten disease. For in vivo proof of concept, we tested TPC2 activation in the MLIV mouse model. In sum, our data suggest that TPC2 is a promising target for the treatment of different types of LSDs, both in vitro and in‐vivo.
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Affiliation(s)
- Anna Scotto Rosato
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Einar K Krogsaeter
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Dawid Jaślan
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Carla Abrahamian
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
| | | | - Chiara Soldati
- Telethon Institute of Genetics and Medicine, Naples, Italy
| | - Barbara Spix
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
| | | | | | - Julia Böck
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Amanda Wyatt
- Experimental Pharmacology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg, Germany
| | | | - Marcel Passon
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Marc Stieglitz
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität, Munich, Germany
| | - Marco Keller
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität, Munich, Germany
| | - Guido Hermey
- Center for Molecular Neurobiology Hamburg (ZMNH), Institute of Molecular and Cellular Cognition, UKE, Hamburg, Germany
| | | | | | - Susan Cotman
- Department of Neurology, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ludger Johannes
- Cellular and Chemical Biology Department, Institut Curie, U1143 INSERM, UMR3666 CNRS, PSL Research University, Paris, France
| | - Dennis Crusius
- Institute for Stroke and Dementia Research (ISD), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
| | - Ulrich Boehm
- Experimental Pharmacology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg, Germany
| | | | - Martin Biel
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität, Munich, Germany
| | - Franz Bracher
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität, Munich, Germany
| | - Elvira De Leonibus
- Telethon Institute of Genetics and Medicine, Naples, Italy.,Institute of Biochemistry and Cell Biology (IBBC), CNR, Rome, Italy
| | | | - Diego L Medina
- Telethon Institute of Genetics and Medicine, Naples, Italy.,Medical Genetics Unit, Department of Medical and Translational Science, Federico II University, Naples, Italy
| | - Dominik Paquet
- Institute for Stroke and Dementia Research (ISD), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Christian Grimm
- Faculty of Medicine, Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
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2
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Markmann S, De BP, Reid J, Jose CL, Rosenberg JB, Leopold PL, Kaminsky SM, Sondhi D, Pagovich O, Crystal RG. Biology of the Adrenal Gland Cortex Obviates Effective Use of Adeno-Associated Virus Vectors to Treat Hereditary Adrenal Disorders. Hum Gene Ther 2018; 29:403-412. [DOI: 10.1089/hum.2017.203] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Sandra Markmann
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | - Bishnu P. De
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | - Jasmine Reid
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | - Clarisse L. Jose
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | | | - Philip L. Leopold
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | - Stephen M. Kaminsky
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | - Dolan Sondhi
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | - Odelya Pagovich
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| | - Ronald G. Crystal
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
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Markmann S, Krambeck S, Hughes CJ, Mirzaian M, Aerts JMFG, Saftig P, Schweizer M, Vissers JPC, Braulke T, Damme M. Quantitative Proteome Analysis of Mouse Liver Lysosomes Provides Evidence for Mannose 6-phosphate-independent Targeting Mechanisms of Acid Hydrolases in Mucolipidosis II. Mol Cell Proteomics 2017; 16:438-450. [PMID: 28062798 DOI: 10.1074/mcp.m116.063636] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/24/2016] [Indexed: 01/01/2023] Open
Abstract
The efficient receptor-mediated targeting of soluble lysosomal proteins to lysosomes requires the modification with mannose 6-phosphate (M6P) residues. Although the absence of M6P results in misrouting and hypersecretion of lysosomal enzymes in many cells, normal levels of lysosomal enzymes have been reported in liver of patients lacking the M6P-generating phosphotransferase (PT). The identity of lysosomal proteins depending on M6P has not yet been comprehensively analyzed. In this study we purified lysosomes from liver of PT-defective mice and 67 known soluble lysosomal proteins were identified that illustrated quantitative changes using an ion mobility-assisted data-independent label-free LC-MS approach. After validation of various differentially expressed lysosomal components by Western blotting and enzyme activity assays, the data revealed a small number of lysosomal proteins depending on M6P, including neuraminidase 1, cathepsin F, Npc2, and cathepsin L, whereas the majority reach lysosomes by alternative pathways. These data were compared with findings on cultured hepatocytes and liver sinusoid endothelial cells isolated from the liver of wild-type and PT-defective mice. Our findings show that the relative expression, targeting efficiency and lysosomal localization of lysosomal proteins tested in cultured hepatic cells resemble their proportion in isolated liver lysosomes. Hypersecretion of newly synthesized nonphosphorylated lysosomal proteins suggest that secretion-recapture mechanisms contribute to maintain major lysosomal functions in liver.
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Affiliation(s)
- Sandra Markmann
- From the ‡Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,§Waters Corporation, Wilmslow, SK9 4AX, United Kingdom
| | - Svenja Krambeck
- From the ‡Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,§Waters Corporation, Wilmslow, SK9 4AX, United Kingdom
| | | | - Mina Mirzaian
- ¶Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, Leiden, 2333 CC, The Netherlands
| | - Johannes M F G Aerts
- ¶Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, Leiden, 2333 CC, The Netherlands
| | - Paul Saftig
- ‖Institut für Biochemie, Christian-Albrechts-Universität zu Kiel, 24098 Kiel, Germany
| | - Michaela Schweizer
- **Morphology Unit, Center for Molecular Neurobiology ZMNH, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Thomas Braulke
- From the ‡Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
| | - Markus Damme
- ‖Institut für Biochemie, Christian-Albrechts-Universität zu Kiel, 24098 Kiel, Germany;
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Koehne T, Markmann S, Schweizer M, Muschol N, Friedrich RE, Hagel C, Glatzel M, Kahl-Nieke B, Amling M, Schinke T, Braulke T. Mannose 6-phosphate-dependent targeting of lysosomal enzymes is required for normal craniofacial and dental development. Biochim Biophys Acta Mol Basis Dis 2016; 1862:1570-80. [PMID: 27239697 DOI: 10.1016/j.bbadis.2016.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/04/2016] [Accepted: 05/26/2016] [Indexed: 02/06/2023]
Abstract
Mucolipidosis II (MLII) is a severe systemic genetic disorder caused by defects in mannose 6-phosphate-dependent targeting of multiple lysosomal hydrolases and subsequent lysosomal accumulation of non-degraded material. MLII patients exhibit marked facial coarseness and gingival overgrowth soon after birth, accompanied with delayed tooth eruption and dental infections. To examine the pathomechanisms of early craniofacial and dental abnormalities, we analyzed mice with an MLII patient mutation that mimic the clinical and biochemical symptoms of MLII patients. The mouse data were compared with clinical and histological data of gingiva and teeth from MLII patients. Here, we report that progressive thickening and porosity of calvarial and mandibular bones, accompanied by elevated bone loss due to 2-fold higher number of osteoclasts cause the characteristic craniofacial phenotype in MLII. The analysis of postnatal tooth development by microcomputed tomography imaging and histology revealed normal dentin and enamel formation, and increased cementum thickness accompanied with accumulation of storage material in cementoblasts of MLII mice. Massive accumulation of storage material in subepithelial cells as well as disorganization of collagen fibrils led to gingival hypertrophy. Electron and immunofluorescence microscopy, together with (35)S-sulfate incorporation experiments revealed the accumulation of non-degraded material, non-esterified cholesterol and glycosaminoglycans in gingival fibroblasts, which was accompanied by missorting of various lysosomal proteins (α-fucosidase 1, cathepsin L and Z, Npc2, α-l-iduronidase). Our study shows that MLII mice closely mimic the craniofacial and dental phenotype of MLII patients and reveals the critical role of mannose 6-phosphate-dependent targeting of lysosomal proteins for alveolar bone, cementum and gingiva homeostasis.
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Affiliation(s)
- Till Koehne
- Department of Orthodontics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; Department of Osteology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sandra Markmann
- Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Michaela Schweizer
- ZMNH, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Nicole Muschol
- Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Hagel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Markus Glatzel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Bärbel Kahl-Nieke
- Department of Orthodontics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Michael Amling
- Department of Osteology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thorsten Schinke
- Department of Osteology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thomas Braulke
- Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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5
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Blanz J, Zunke F, Markmann S, Damme M, Braulke T, Saftig P, Schwake M. Mannose 6-phosphate-independent Lysosomal Sorting of LIMP-2. Traffic 2015; 16:1127-36. [PMID: 26219725 DOI: 10.1111/tra.12313] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/22/2015] [Accepted: 07/23/2015] [Indexed: 12/12/2022]
Abstract
The lysosomal integral membrane protein type 2 (LIMP-2/SCARB2) has been described as a mannose 6-phosphate (M6P)-independent trafficking receptor for β-glucocerebrosidase (GC). Recently, a putative M6P residue in a crystal structure of a recombinantly expressed LIMP-2 ectodomain has been reported. Based on surface plasmon resonance and fluorescence lifetime imaging analyses, it was suggested that the interaction of soluble LIMP-2 with the cation-independent M6P receptor (MPR) results in M6P-dependent targeting of LIMP-2 to lysosomes. As the physiological relevance of this observation was not addressed, we investigated M6P-dependent delivery of LIMP-2 to lysosomes in murine liver and mouse embryonic fibroblasts. We demonstrate that LIMP-2 and GC reach lysosomes independent of the M6P pathway. In fibroblasts lacking either MPRs or the M6P-forming N-acetylglucosamine (GlcNAc)-1-phosphotransferase, LIMP-2 still localizes to lysosomes. Immunoblot analyses also revealed comparable LIMP-2 levels within lysosomes purified from liver of wild-type (wt) and GlcNAc-1-phosphotransferase-defective mice. Heterologous expression of the luminal domain of LIMP-2 in wild-type, LIMP-2-deficient and GlcNAc-1-phosphotransferase-defective cells further established that the M6P modification is dispensable for lysosomal sorting of LIMP-2. Finally, cathepsin Z, a known GlcNAc-1-phosphotransferase substrate, but not LIMP-2, could be precipitated with M6P-specific antibodies. These data prove M6P-independent lysosomal sorting of LIMP-2 and subsequently GC in vivo.
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Affiliation(s)
- Judith Blanz
- Biochemisches Institut der Christian Albrechts Universität zu Kiel, Otto-Hahn-Platz 9, 24118, Kiel, Germany
| | - Friederike Zunke
- Biochemisches Institut der Christian Albrechts Universität zu Kiel, Otto-Hahn-Platz 9, 24118, Kiel, Germany
| | - Sandra Markmann
- Arbeitsbereich Molekularbiologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Damme
- Biochemisches Institut der Christian Albrechts Universität zu Kiel, Otto-Hahn-Platz 9, 24118, Kiel, Germany
| | - Thomas Braulke
- Arbeitsbereich Molekularbiologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Saftig
- Biochemisches Institut der Christian Albrechts Universität zu Kiel, Otto-Hahn-Platz 9, 24118, Kiel, Germany
| | - Michael Schwake
- Biochemie III/ Fakultät für Chemie, Universität Bielefeld, Universitätsstr. 25, 33615, Bielefeld, Germany
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Kuehn SC, Koehne T, Cornils K, Markmann S, Riedel C, Pestka JM, Schweizer M, Baldauf C, Yorgan TA, Krause M, Keller J, Neven M, Breyer S, Stuecker R, Muschol N, Busse B, Braulke T, Fehse B, Amling M, Schinke T. Impaired bone remodeling and its correction by combination therapy in a mouse model of mucopolysaccharidosis-I. Hum Mol Genet 2015; 24:7075-86. [PMID: 26427607 DOI: 10.1093/hmg/ddv407] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/22/2015] [Indexed: 01/21/2023] Open
Abstract
Mucopolysaccharidosis-I (MPS-I) is a lysosomal storage disease (LSD) caused by inactivating mutations of IDUA, encoding the glycosaminoglycan-degrading enzyme α-l-iduronidase. Although MPS-I is associated with skeletal abnormalities, the impact of IDUA deficiency on bone remodeling is poorly defined. Here we report that Idua-deficient mice progressively develop a high bone mass phenotype with pathological lysosomal storage in cells of the osteoblast lineage. Histomorphometric quantification identified shortening of bone-forming units and reduced osteoclast numbers per bone surface. This phenotype was not transferable into wild-type mice by bone marrow transplantation (BMT). In contrast, the high bone mass phenotype of Idua-deficient mice was prevented by BMT from wild-type donors. At the cellular level, BMT did not only normalize defects of Idua-deficient osteoblasts and osteocytes but additionally caused increased osteoclastogenesis. Based on clinical observations in an individual with MPS-I, previously subjected to BMT and enzyme replacement therapy (ERT), we treated Idua-deficient mice accordingly and found that combining both treatments normalized all histomorphometric parameters of bone remodeling. Our results demonstrate that BMT and ERT profoundly affect skeletal remodeling of Idua-deficient mice, thereby suggesting that individuals with MPS-I should be monitored for their bone remodeling status, before and after treatment, to avoid long-term skeletal complications.
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Affiliation(s)
| | - Till Koehne
- Department of Osteology and Biomechanics, Department of Orthodontics
| | - Kerstin Cornils
- Department of Stem Cell Transplantation, Research Department Cell and Gene Therapy
| | | | | | | | - Michaela Schweizer
- Center of Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany and
| | | | | | | | | | - Mona Neven
- Department of Osteology and Biomechanics
| | - Sandra Breyer
- Children's Hospital Hamburg-Altona, Department of Orthopedics, University Clinic Hamburg, Hamburg 22763, Germany
| | - Ralf Stuecker
- Children's Hospital Hamburg-Altona, Department of Orthopedics, University Clinic Hamburg, Hamburg 22763, Germany
| | | | | | | | - Boris Fehse
- Department of Stem Cell Transplantation, Research Department Cell and Gene Therapy
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Klünder S, Heeren J, Markmann S, Santer R, Braulke T, Pohl S. Site-1 protease-activated formation of lysosomal targeting motifs is independent of the lipogenic transcription control. J Lipid Res 2015; 56:1625-32. [PMID: 26108224 DOI: 10.1194/jlr.m060756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Indexed: 12/25/2022] Open
Abstract
Site-1 protease (S1P) cleaves membrane-bound lipogenic sterol regulatory element-binding proteins (SREBPs) and the α/β-subunit precursor protein of the N-acetylglucosamine-1-phosphotransferase forming mannose 6-phosphate (M6P) targeting markers on lysosomal enzymes. The translocation of SREBPs from the endoplasmic reticulum (ER) to the Golgi-resident S1P depends on the intracellular sterol content, but it is unknown whether the ER exit of the α/β-subunit precursor is regulated. Here, we investigated the effect of cholesterol depletion (atorvastatin treatment) and elevation (LDL overload) on ER-Golgi transport, S1P-mediated cleavage of the α/β-subunit precursor, and the subsequent targeting of lysosomal enzymes along the biosynthetic and endocytic pathway to lysosomes. The data showed that the proteolytic cleavage of the α/β-subunit precursor into mature and enzymatically active subunits does not depend on the cholesterol content. In either treatment, lysosomal enzymes are normally decorated with M6P residues, allowing the proper sorting to lysosomes. In addition, we found that, in fibroblasts of mucolipidosis type II mice and Niemann-Pick type C patients characterized by aberrant cholesterol accumulation, the proteolytic cleavage of the α/β-subunit precursor was not impaired. We conclude that S1P substrate-dependent regulatory mechanisms for lipid synthesis and biogenesis of lysosomes are different.
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Affiliation(s)
- Sarah Klünder
- Biochemistry Section, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jörg Heeren
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sandra Markmann
- Biochemistry Section, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - René Santer
- Biochemistry Section, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thomas Braulke
- Biochemistry Section, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sandra Pohl
- Biochemistry Section, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Markmann S, Thelen M, Cornils K, Schweizer M, Brocke-Ahmadinejad N, Willnow T, Heeren J, Gieselmann V, Braulke T, Kollmann K. Lrp1/LDL Receptor Play Critical Roles in Mannose 6-Phosphate-Independent Lysosomal Enzyme Targeting. Traffic 2015; 16:743-59. [DOI: 10.1111/tra.12284] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 01/01/2023]
Affiliation(s)
- Sandra Markmann
- Department for Biochemistry, Children's Hospital; University Medical Center Hamburg-Eppendorf; D-20246 Hamburg Germany
| | - Melanie Thelen
- Institute of Biochemistry and Molecular Biology; University of Bonn; Nussallee 11 D-53115 Bonn Germany
| | - Kerstin Cornils
- Research Department Cell and Gene Therapy, Clinic for Stem Cell Transplantation; University Medical Center Hamburg-Eppendorf; D-20246 Hamburg Germany
| | - Michaela Schweizer
- Center for Molecular Neurobiology Hamburg, ZMNH; University Medical Center Hamburg-Eppendorf; 20246 Hamburg Germany
| | - Nahal Brocke-Ahmadinejad
- Institute of Biochemistry and Molecular Biology; University of Bonn; Nussallee 11 D-53115 Bonn Germany
| | - Thomas Willnow
- Max Delbrück Center for Molecular Medicine; 13125 Berlin-Buch Germany
| | - Joerg Heeren
- Department of Biochemistry and Molecular Cell Biology; University Medical Center Hamburg-Eppendorf; D-20246 Hamburg Germany
| | - Volkmar Gieselmann
- Institute of Biochemistry and Molecular Biology; University of Bonn; Nussallee 11 D-53115 Bonn Germany
| | - Thomas Braulke
- Department for Biochemistry, Children's Hospital; University Medical Center Hamburg-Eppendorf; D-20246 Hamburg Germany
| | - Katrin Kollmann
- Department for Biochemistry, Children's Hospital; University Medical Center Hamburg-Eppendorf; D-20246 Hamburg Germany
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9
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Schweizer M, Markmann S, Braulke T, Kollmann K. Ultrastructural analysis of neuronal and non-neuronal lysosomal storage in mucolipidosis type II knock-in mice. Ultrastruct Pathol 2014; 37:366-72. [PMID: 24047352 DOI: 10.3109/01913123.2013.810687] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The GlcNAc-1-phosphotransferase catalyzes the first step in the formation of mannose 6-phosphate (M6P) residues on lysosomal acid hydrolases that is essential for the efficient transport of newly synthesized lysosomal enzymes to lysosomes and the maintenance of lysosomal functions. Mutations in the GlcNAc-1-phosphotransferase cause the lysosomal storage disease mucolipidosis type II (MLII), resulting in mistargeting and hypersecretion of multiple lysosomal hydrolases and subsequent lysosomal accumulation of nondegraded material in several tissues. To describe cell-type specificity, compositional differences, and subcellular distribution of the stored material we performed an in-depth ultrastructural analysis of lysosomal storage in brain and retina of MLII knock-in mice using electron microscopy. Massive vacuoles filled with heterogeneous storage material have been found in the soma, swollen axons, and dendrites of Purkinje, and granular cells in 9-month-old MLII mice. In addition, non-neuronal cells, such as microglial, astroglial, and endothelial cells, exhibit storage material. Fucose-specific lectin histochemistry demonstrated the accumulation of fucose-containing oligosaccharides, indicating that targeting of the lysosomal α-fucosidase is strongly impaired in all cerebellar cell types. The data suggest that the accumulation of storage material might affect neuronal function and survival in a direct cell-autonomous manner, as well as indirectly by disturbed metabolic homeostasis between glial and neuronal cells or by cerebrovascular complications.
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Affiliation(s)
- Michaela Schweizer
- Department of Electron Microscopy, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany and
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Patejdl R, Markmann S, Benecke R, Wittstock M. Severe acute motor neuropathy after treatment with triple tyrosine kinase inhibitor BIBF 1120 (Nintedanib). Clin Neurol Neurosurg 2013; 115:1851-2. [PMID: 23414813 DOI: 10.1016/j.clineuro.2013.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 01/22/2013] [Accepted: 01/23/2013] [Indexed: 11/27/2022]
Affiliation(s)
- R Patejdl
- Department of Neurology, University of Rostock, Rostock, Germany.
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Kollmann K, Damme M, Markmann S, Morelle W, Schweizer M, Hermans-Borgmeyer I, Röchert AK, Pohl S, Lübke T, Michalski JC, Käkelä R, Walkley SU, Braulke T. Lysosomal dysfunction causes neurodegeneration in mucolipidosis II 'knock-in' mice. ACTA ACUST UNITED AC 2012; 135:2661-75. [PMID: 22961545 DOI: 10.1093/brain/aws209] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Mucolipidosis II is a neurometabolic lysosomal trafficking disorder of infancy caused by loss of mannose 6-phosphate targeting signals on lysosomal proteins, leading to lysosomal dysfunction and accumulation of non-degraded material. However, the identity of storage material and mechanisms of neurodegeneration in mucolipidosis II are unknown. We have generated 'knock-in' mice with a common mucolipidosis II patient mutation that show growth retardation, progressive brain atrophy, skeletal abnormalities, elevated lysosomal enzyme activities in serum, lysosomal storage in fibroblasts and brain and premature death, closely mimicking the mucolipidosis II disease in humans. The examination of affected mouse brains at different ages by immunohistochemistry, ultrastructural analysis, immunoblotting and mass spectrometric analyses of glycans and anionic lipids revealed that the expression and proteolytic processing of distinct lysosomal proteins such as α-l-fucosidase, β-hexosaminidase, α-mannosidase or Niemann-Pick C2 protein are more significantly impacted by the loss of mannose 6-phosphate residues than enzymes reaching lysosomes independently of this targeting mechanism. As a consequence, fucosylated N-glycans, GM2 and GM3 gangliosides, cholesterol and bis(monoacylglycero)phosphate accumulate progressively in the brain of mucolipidosis II mice. Prominent astrogliosis and the accumulation of organelles and storage material in focally swollen axons were observed in the cerebellum and were accompanied by a loss of Purkinje cells. Moreover, an increased neuronal level of the microtubule-associated protein 1 light chain 3 and the formation of p62-positive neuronal aggregates indicate an impairment of constitutive autophagy in the mucolipidosis II brain. Our findings demonstrate the essential role of mannose 6-phosphate for selected lysosomal proteins to maintain the capability for degradation of sequestered components in lysosomes and autophagolysosomes and prevent neurodegeneration. These lysosomal proteins might be a potential target for a valid therapeutic approach for mucolipidosis II disease.
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Affiliation(s)
- K Kollmann
- Department of Biochemistry, Children’s Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Eiermann W, Rezai M, Kümmel S, Kühn T, Warm M, Friedrichs K, Schneeweiss A, Markmann S, Eggemann H, Hilfrich J, Jackisch C, Witzel I, Eidtmann H, Bachinger A, Hell S, Blohmer J. The 21-gene recurrence score assay impacts adjuvant therapy recommendations for ER-positive, node-negative and node-positive early breast cancer resulting in a risk-adapted change in chemotherapy use. Ann Oncol 2012; 24:618-24. [PMID: 23136233 PMCID: PMC3574549 DOI: 10.1093/annonc/mds512] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [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: 12/29/2022] Open
Abstract
Background We carried out a prospective clinical study to evaluate the impact of the Recurrence Score (RS) on treatment decisions in early breast cancer (EBC). Patients and methods A total of 379 eligible women with estrogen receptor positive (ER+), HER2-negative EBC and 0–3 positive lymph nodes were enrolled. Treatment recommendations, patients' decisional conflict, physicians' confidence before and after knowledge of the RS and actual treatment data were recorded. Results Of the 366 assessable patients 244 were node negative (N0) and 122 node positive (N+). Treatment recommendations changed in 33% of all patients (N0 30%, N+ 39%). In 38% of all patients (N0 39%, N+ 37%) with an initial recommendation for chemoendocrine therapy, the post-RS recommendation changed to endocrine therapy, in 25% (N0 22%, N+ 39%) with an initial recommendation for endocrine therapy only to combined chemoendocrine therapy, respectively. A patients' decisional conflict score improved by 6% (P = 0.028) and physicians' confidence increased in 45% (P < 0.001) of all cases. Overall, 33% (N0 29%, N+ 38%) of fewer patients actually received chemotherapy as compared with patients recommended chemotherapy pre-test. Using the test was cost-saving versus current clinical practice. Conclusion RS-guided chemotherapy decision-making resulted in a substantial modification of adjuvant chemotherapy usage in node-negative and node-positive ER+ EBC.
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Affiliation(s)
- W Eiermann
- Interdisciplinary Oncology Center, Munich.
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Wuerstlein R, Gluz O, Degenhardt T, Kreipe HH, Kates R, Liedtke C, Shak S, Schumann RV, Clemens M, Markmann S, Christgen M, Svedman C, Aktas B, Salem M, Uleer C, Augustin D, Thomssen C, Nitz U, Harbeck N. Welche Prognosefaktoren sind geeignet für den klinischen Einsatz beim Mammakarzinom? Prospektiver Vergleich von Recurrence Score, uPA/PAI-1, Grading und molekularen Subtypen und Korrelationen aus der WSG-Plan B Studie. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1318581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Wuerstlein R, Gluz O, Liedtke C, Degenhardt T, Kreipe H, Kates R, Shak S, Clemens M, Markmann S, Aktas B, Salem M, Bensmann E, Augustin D, Mallmann P, Thomssen C, Nitz U, Harbeck N. Korrelation von Recurrence Score, uPA/PAI-1 und Tumorbiologie bei der adjuvanten Therapieentscheidung des primären Mammacarcinoms: Interimsanalyse der Plan-B Studie der WSG. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1286444] [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: 10/17/2022] Open
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Koensgen D, Belau A, Sehouli J, Sommer HL, Bartz K, Markmann S, Schneidewind L, Scharf JP, Ehmke M, Stengel D, Ledwon P, Guba H, Zygmunt M, Koehler G, Mustea A. Adjuvant sequential chemo-radiation therapy in high-risk endometrial cancer: Results of a prospective, multicenter phase II study of the NOGGO. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gamarra F, Hauck C, Markmann S, Braunschweig F, Huber RM. Mukoziliäre Funktion des nasalen Epithels von Patienten mit Samter-Trias vor und nach adaptiven Desaktivierung mit Aspirin: in-vitro Messungen. Pneumologie 2011. [DOI: 10.1055/s-0031-1272323] [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: 10/18/2022]
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Gluz O, Liedtke C, Markmann S, Henschen S, Clemens MR, Salem M, Thomssen C, Kreipe H, Harbeck N, Nitz U. WSG PLAN B trial: Evaluating efficacy of anthracycline-free chemotherapy in primary HER2-negative breast cancer after molecular-based risk assessment according to Oncotype DX and uPA/PAI-1. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps106] [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: 11/20/2022] Open
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Sehouli J, Oskay-Özcelik G, Stengel D, Harter P, Kurzeder C, Belau A, Markmann S, Lorenz R, Mueller L, Lichtenegger W. 8002 What is the best schedule of Topotecan? – weekly versus routine 5-day schedule in patients with platinum-resistant ovarian cancer – a randomized, multicenter trial of the North-Eastern German Society of Gynaecological Oncology (TOWER). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71524-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sehouli J, Oskay-Oezcelik G, Stengel D, Harter P, Kurzeder C, Belau A, Belau A, Markmann S, Lorenz R, Mueller L, Lichtenegger W. Topotecan weekly versus routine 5-day schedule in patients with platinum-resistant ovarian cancer (TOWER): A randomized, multicenter trial of the North-Eastern German Society of Gynecological Oncology (NOGGO). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5553 Background: In women with platinum-resistant recurrent ovarian cancer, weekly administration of topotecan (Tw) may be equally effective, but better tolerated than conventional 5-day dosing (Tc). We conducted a randomized multicenter trial to validate this assumption. Methods: The trial was pre-registered at clinicaltrials.gov ( NCT00170677 ). Women with platinum-resistant ovarian and fallopian tube cancers or primary peritoneal carcinoma, and measurable or assessable disease (GCIG criteria) were randomized to receive either Tw (d1,8,15/q28d, 4 mg/m2) or Tc (d1–5/q21d, 1.25 mg/m2). The predefined stopping rule, based on the primary endpoint of best CA-125 or tumor response, was not reached (presented at ASCO 2007, Abstract 5526). This permitted the accrual of 194 patients, 154 of whom could be assessed for CA-125 or tumor response (SD + CR + PR). We also compared progression-free (PFS) and overall survival (OS), as well as toxicity between trial groups. Results: Mean age was 61.8 (SD 9.8) years, and 59 women were on third-line treatment. Patients received a total of 809 cycles of chemotherapy. Demographic baseline characteristics, tumor stages and grades, and previous lines of chemotherapy were well balanced between treatment groups. There were 35 / 75 (47%) and 45 / 79 (57%) responses in the Tw and Tc groups, respectively (risk ratio [RR] 1.22, 95% CI 0.89–1.66). Median PFS and OS did not differ markedly between both regimens (3.2 versus 4.4 months, hazard ratio [HR] 1.30, 95% CI 0.96–1.77 and 9.8 versus 10.0 months, HR 1.08, 95% CI 0.77–1.52). The risk of grade III/IV hematological toxicity was significantly lower in the Tw group (anemia: RR 0.35, p = 0.007, neutropenia: RR 0.38, p = 0.0001, thrombopenia: RR 0.23, p = 0.0004). Conclusions: Weekly administration of topotecan shows no substantial difference in endpoints of effectiveness compared to conventional dosing, but is associated with a significantly lower likelihood of severe hematological toxicity. Weekly topotecan should be considered as a possible treatment alternative in women with platinum-resistant ovarian cancer because of its favourable benefit-risk-profile. No significant financial relationships to disclose.
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Affiliation(s)
- J. Sehouli
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - G. Oskay-Oezcelik
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - D. Stengel
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - P. Harter
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - C. Kurzeder
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - A. Belau
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - A. Belau
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - S. Markmann
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - R. Lorenz
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - L. Mueller
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - W. Lichtenegger
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
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Leunig A, Braunschweig F, Havel M, Markmann S, Kramer M, Menz G. [Chronic rhinosinusitis and aspirin intolerance]. MMW Fortschr Med 2009; 151:44-45. [PMID: 19391414] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
MESH Headings
- Adult
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/adverse effects
- Aspirin/administration & dosage
- Aspirin/adverse effects
- Asthma/chemically induced
- Asthma/diagnosis
- Bronchial Spasm/chemically induced
- Bronchial Spasm/diagnosis
- Desensitization, Immunologic
- Diagnosis, Differential
- Drug Hypersensitivity/diagnosis
- Female
- Humans
- Male
- Middle Aged
- Nasal Polyps/chemically induced
- Nasal Polyps/diagnostic imaging
- Radiography
- Rhinitis, Allergic, Perennial/chemically induced
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/therapy
- Sinusitis/chemically induced
- Sinusitis/diagnosis
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Affiliation(s)
- A Leunig
- HNO-Klinik, Klinikum Grosshadern der LMU München, München.
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Sehouli J, Oskay-Oezcelik G, Stengel D, du Bois A, Markmann S, Loibl S, Wilke J, Nugent A, Belau A, Lichtenegger W. Topotecan weekly versus routine 5-day schedule in patients with platinum-resistant ovarian cancer (TOWER): A randomized, two-stage phase-II study of the North-Eastern German Society of Gynaecological Oncology (NOGGO). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5526] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5526 Background: Optimizing the therapeutic index (that is, maintaining drug effectiveness while reducing toxicity) is a major goal in chemotherapy for platinum-resistant ovarian cancer. Early phase-I/II studies suggest that weekly topotecan (T) might be effective and apparently better tolerated than the established 5-day regimen. As yet, no randomized comparison of both regimes was attempted. To prove the hypothesis of an improved therapeutic index with weekly T, we conducted a randomized, multicenter, two-stage phase-II trial, and herein present the data of the planned interim analysis. Methods: Pts with platinresistent ovarian and fallopian tube cancers or primary peritoneal carcinoma, measurable or assessable disease (GCIG-CA-125 response criteria), were eligible. Pts were randomized to receive either weekly T (d1,8,15/q28d, 4 mg/m2) or T from d1–5/q21d at a dose of 1.25 mg/m2. According to Gehan’s two-stage-design, both arms were handled as independent studies. Overall response rate (CR + PR) was defined as primary study endpoint, secondary endpoints of the interim analysis were toxicity and safety. Results: 28 pts in the weekly and 21 pts in the conventional group, enrolled at 38 centers form the basis of this report. 230 cycles of chemotherapy were evaluated for toxicity analyses. Median age was 61 years (range, 36 - 82 years). Demographic baseline characteristics, including tumor stage and grade were well balanced between treatment arms. There were 2/28 and 5/21 responses in weekly and the conventional arm, respectively (Risk Ratio [RR] 0.30, 95% confidence interval [CI] 0.06 - 1.40, p=0.122). The risk of early treatment termination due to tumor progression (RR 1.39, 95%CI 0.75 - 2.56), haematological (RR 0.20, 95% CI 0.01 - 3.97) or non- hematological toxicities (RR 1.96, 95% CI 0.18 - 20.83) did not differ significantly between groups. The only three events of neutropenic fever occurred in the conventional arm (RR 1.70, 95% CI 0.99 - 1.16). Conclusions: Weekly T is well tolerated and potentially active. The second stage of this study will require additional 46 patients each arm. Complete enrolment is expected to be accomplished in May 2007. No significant financial relationships to disclose.
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Affiliation(s)
- J. Sehouli
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - G. Oskay-Oezcelik
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - D. Stengel
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - A. du Bois
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - S. Markmann
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - S. Loibl
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - J. Wilke
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - A. Nugent
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - A. Belau
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - W. Lichtenegger
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
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Reimer T, Fietkau R, Markmann S, Stachs A, Gerber B. How important is the axillary nodal status for adjuvant treatment decisions at a breast cancer multidisciplinary tumor board? A survival analysis. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11041] [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: 11/20/2022] Open
Abstract
11041 Background: Postoperative tumor board recommendations for breast cancer are mainly based on patient characteristics and tumor parameters such as size, histologic grade, lymphovascular invasion (LVI), hormone receptor and HER2/neu status. In the era of potential avoidance of axillary surgery in clinically node-negative patients we evaluate the impact of pathologic nodal status for adjuvant treatment decisions. Methods: The postoperative tumor board records of 207 consecutive breast cancer patients over a 1-year period were rediscussed without knowledge of pathologic nodal status. Differences between the two board recommendations for each patient were classified as major (chemo- and/or radiotherapy: present/absent) or minor (different chemotherapeutic protocols) discrepancies. The disease-free and overall survival rates among subgroups with different recommendations were calculated using Adjuvant! Online tool. The binary logistic regression was performed to analyze the impact of factors for prediction the major discrepancy subgroup. Results: The tumor board without information of pathologic nodal status resulted in treatment changes in 72 of the 207 patients studied (34.8%). Major discrepancies were observed in 37 patients (17.9%) leading to a complete shift of postoperative management. Disease-free and overall survival rates were not significantly different due to a balanced over- and undertreatment in this subgroup (21 cases with under-, 16 cases with overtreatment). The major discrepancies were related to LVI (P=0.001), postmenopausal status (P=0.047), and positive hormone receptor status (P=0.17) in the univariate setting. LVI was an independent parameter to predict the subgroup with major discrepancies performing a multivariate analysis (P=0.006; RR=4.5 [95%CI: 1.5–13.4]). Conclusions: The knowledge of pathologic nodal status is important for postoperative chemotherapy and postmastectomy radiotherapy indications. There is a risk for one third of all patients when avoiding axillary surgery to get an adjuvant therapy which differ from the current treatment guidelines. It is mandatory to know the nodal status for breast tumors with LVI. No significant financial relationships to disclose.
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Affiliation(s)
- T. Reimer
- Klinikum Suedstadt, Rostock, Germany; University of Rostock, Rostock, Germany
| | - R. Fietkau
- Klinikum Suedstadt, Rostock, Germany; University of Rostock, Rostock, Germany
| | - S. Markmann
- Klinikum Suedstadt, Rostock, Germany; University of Rostock, Rostock, Germany
| | - A. Stachs
- Klinikum Suedstadt, Rostock, Germany; University of Rostock, Rostock, Germany
| | - B. Gerber
- Klinikum Suedstadt, Rostock, Germany; University of Rostock, Rostock, Germany
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Rohr UD, Oberhoff C, Markmann S, Gerber B, Scheulen M, Schindler AE. WITHDRAWN: The safety of synthetic paclitaxel by intralesional delivery with OncoGeltrade mark into skin breast cancer metastases: method and results of a clinical pilot trial. Arch Gynecol Obstet 2005. [PMID: 16315026 DOI: 10.1007/s00404-005-0095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Accepted: 09/22/2005] [Indexed: 10/25/2022]
Abstract
Ahead of Print article withdrawn by publisher
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Affiliation(s)
- U D Rohr
- Department of Gynecology and Obstetrics, University of Essen, Hufelandstr. 55, 45147, Essen, Germany,
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Mylonas I, Hansch S, Markmann S, Bolz M, Friese K. Unilateral ovarian agenesis: report of three cases and review of the literature. Arch Gynecol Obstet 2003; 268:57-60. [PMID: 12673478 DOI: 10.1007/s00404-002-0451-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2002] [Accepted: 10/22/2002] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Unilateral ovarian agenesis is a rare event and only a few case have been reported. CASE REPORT We present three additional cases, where patients presented with diffuse lower abdominal pain. During laparoscopy, an unilateral ovarian agenesis was observed in the three cases. DISCUSSION There are two possible explanations of a unilateral ovarian absence, involving an asymptomatic adnexal torsion or congenital absence. Unknown environmental factors or genetic predisposition could contribute to this kind of anomaly.
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Affiliation(s)
- I Mylonas
- Frauenklinik, Klinikum Innenstadt, Ludwig-Maximilians Universität, Munich, Germany
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Gerber B, Krause A, Markmann S, Reimer T, Fietkau R, Müller H. Effectiveness of Trastuzumab (Herceptin) in a patient with locally recurrent breast cancer after cardiac failure caused by severe cytotoxic pretreatment. Oncology 2002; 61:271-4. [PMID: 11721173 DOI: 10.1159/000055333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In HER2-positive breast cancer patients, the humanized anti-HER-2 monoclonal antibody trastuzumab (Herceptin) may improve overall survival. No reports exist regarding the application of trastuzumab in patients with cytotoxically induced cardiac failure and decreased left ventricular ejection fraction or about locally recurrent and advanced disease. In this case report, trastuzumab resulted in a complete and long-lasting response of recurrent and locally advanced breast cancer and was well tolerated in a severely cytotoxically pretreated patient with cardiac failure. We encourage other oncologists to offer trastuzumab also to severely cytotoxically pretreated patients with conditions after cardiac insufficiency or with locally advanced breast cancer.
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Affiliation(s)
- B Gerber
- Department of Obstetrics and Gynecology, University of Rostock, Germany.
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