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Quack L, Glatter S, Wegener-Panzer A, Cleaveland R, Bertolini A, Endmayr V, Seidl R, Breu M, Wendel E, Schimmel M, Baumann M, Rauchenzauner M, Pritsch M, Boy N, Muralter T, Kluger G, Makoswski C, Kraus V, Leiz S, Loehr-Nilles C, Kreth JH, Braig S, Schilling S, Kern J, Blank C, Tro Baumann B, Vieth S, Wallot M, Reindl M, Ringl H, Wandinger KP, Leypoldt F, Höftberger R, Rostásy K. Corrigendum to "Autoantibody status, neuroradiological and clinical findings in children with acute cerebellitis" [Eur. J. Paediatr. Neurol. 47 (2023) 118-130]. Eur J Paediatr Neurol 2024:S1090-3798(24)00056-4. [PMID: 38692980 DOI: 10.1016/j.ejpn.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Affiliation(s)
- L Quack
- Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - S Glatter
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria; Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - A Wegener-Panzer
- Department of Pediatric Radiology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - R Cleaveland
- Department of Pediatric Radiology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - A Bertolini
- Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - V Endmayr
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria
| | - R Seidl
- Department of Pediatrics, Bethanien Hospital, Moers, Germany
| | - M Breu
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - E Wendel
- Division of Pediatric Neurology, Department of Pediatrics, Olgahospital, Stuttgart, Germany
| | - M Schimmel
- Division of Pediatric Neurology, Clinic of Pediatrics, Augsburg University Hospital, University of Augsburg, Augsburg, Germany
| | - M Baumann
- Department of Pediatric I, Pediatric Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Rauchenzauner
- Department of Pediatric I, Pediatric Neurology, Medical University of Innsbruck, Innsbruck, Austria; Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Hospital for Neuropediatrics and Neurological Rehabilitation, Vogtareuth, Germany
| | - M Pritsch
- Department of Neuropediatrics, Children's Hospital DRK Siegen, Siegen, Germany
| | - N Boy
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - T Muralter
- Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Hospital for Neuropediatrics and Neurological Rehabilitation, Vogtareuth, Germany
| | - G Kluger
- Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Hospital for Neuropediatrics and Neurological Rehabilitation, Vogtareuth, Germany; Research Institute for Rehabilitation, Transition, and Palliation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - C Makoswski
- Pediatric Neurology, Department of Pediatrics, Kinderklinik München Schwabing, School of Medicine, Technical University of Munich, Germany
| | - V Kraus
- Pediatric Neurology, Department of Pediatrics, Kinderklinik München Schwabing, School of Medicine, Technical University of Munich, Germany; Social Pediatrics, Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - S Leiz
- Department of Pediatrics and Adolescent Medicine, Hospital Dritter Orden, Munich, Germany
| | - C Loehr-Nilles
- Department of Neuropediatrics, Klinikum Mutterhaus der Borromäerinnen, Trier, Germany
| | - J H Kreth
- Department of Neuropediatrics, Social Pediatric Center, Klinikum Leverkusen, Leverkusen, Germany
| | - S Braig
- Department of Pediatrics, Klinikum Bayreuth, Bayreuth, Germany
| | - S Schilling
- Department of Neuropediatrics, Clinic of Pediatrics, Barmherzige Brüder St. Hedwig Hospital, Regensburg, Germany
| | - J Kern
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Germany
| | - C Blank
- Department of Pediatric Neurology, Children's Hospital St. Marien, Landshut, Germany
| | - B Tro Baumann
- Department of Neuropediatrics, Children's Hospital DRK Siegen, Siegen, Germany
| | - S Vieth
- Department of Pediatrics, University Medical Center Schleswig Holstein, Kiel, Germany
| | - M Wallot
- Department of Pediatrics, Bethanien Hospital, Moers, Germany
| | - M Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Austria
| | - H Ringl
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Department of Radiology, Klinik Donaustadt, Vienna, Austria
| | - K P Wandinger
- Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - F Leypoldt
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - R Höftberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
| | - K Rostásy
- Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany.
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Quack L, Glatter S, Wegener-Panzer A, Cleaveland R, Bertolini A, Endmayr V, Seidl R, Breu M, Wendel E, Schimmel M, Baumann M, Rauchenzauner M, Pritsch M, Boy N, Muralter T, Kluger G, Makoswski C, Kraus V, Leiz S, Loehr-Nilles C, Kreth JH, Braig S, Schilling S, Kern J, Blank C, Tro Baumann B, Vieth S, Wallot M, Reindl M, Ringl H, Wandinger KP, Leypoldt F, Höftberger R, Rostásy K. Autoantibody status, neuroradiological and clinical findings in children with acute cerebellitis. Eur J Paediatr Neurol 2023; 47:118-130. [PMID: 38284996 DOI: 10.1016/j.ejpn.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Acute cerebellitis (AC) in children and adolescents is an inflammatory disease of the cerebellum due to viral or bacterial infections but also autoimmune-mediated processes. OBJECTIVE To investigate the frequency of autoantibodies in serum and CSF as well as the neuroradiological features in children with AC. MATERIAL AND METHODS Children presenting with symptoms suggestive of AC defined as acute/subacute onset of cerebellar symptoms and MRI evidence of cerebellar inflammation or additional CSF pleocytosis, positive oligoclonal bands (OCBs), and/or presence of autoantibodies in case of negative cerebellar MRI. Children fulfilling the above-mentioned criteria and a complete data set including clinical presentation, CSF studies, testing for neuronal/cerebellar and MOG antibodies as well as MRI scans performed at disease onset were eligible for this retrospective multicenter study. RESULTS 36 patients fulfilled the inclusion criteria for AC (f:m = 14:22, median age 5.5 years). Ataxia was the most common cerebellar symptom present in 30/36 (83 %) in addition to dysmetria (15/36) or dysarthria (13/36). A substantial number of children (21/36) also had signs of encephalitis such as somnolence or seizures. In 10/36 (28 %) children the following autoantibodies (abs) were found: MOG-abs (n = 5) in serum, GFAPα-abs (n = 1) in CSF, GlyR-abs (n = 1) in CSF, mGluR1-abs (n = 1) in CSF and serum. In two further children, antibodies were detected only in serum (GlyR-abs, n = 1; GFAPα-abs, n = 1). MRI signal alterations in cerebellum were found in 30/36 children (83 %). Additional supra- and/or infratentorial lesions were present in 12/36 children, including all five children with MOG-abs. Outcome after a median follow-up of 3 months (range: 1 a 75) was favorable with an mRS ≤2 in 24/36 (67 %) after therapy. Antibody (ab)-positive children were significantly more likely to have a better outcome than ab-negative children (p = .022). CONCLUSION In nearly 30 % of children in our study with AC, a range of abs was found, underscoring that autoantibody testing in serum and CSF should be included in the work-up of a child with suspected AC. The detection of MOG-abs in AC does expand the MOGAD spectrum.
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Affiliation(s)
- L Quack
- Department of Pediatric Neurology, Childreńs Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - S Glatter
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria; Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - A Wegener-Panzer
- Department of Pediatric Radiology, Childreńs Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - R Cleaveland
- Department of Pediatric Radiology, Childreńs Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - A Bertolini
- Department of Pediatric Neurology, Childreńs Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - V Endmayr
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria
| | - R Seidl
- Department of Pediatrics, Bethanien Hospital, Moers, Germany
| | - M Breu
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - E Wendel
- Division of Pediatric Neurology, Department of Pediatrics, Olgahospital, Stuttgart, Germany
| | - M Schimmel
- Division of Pediatric Neurology, Clinic of Pediatrics, Augsburg University Hospital, University of Augsburg, Augsburg, Germany
| | - M Baumann
- Department of Pediatric I, Pediatric Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Rauchenzauner
- Department of Pediatric I, Pediatric Neurology, Medical University of Innsbruck, Innsbruck, Austria; Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Hospital for Neuropediatrics and Neurological Rehabilitation, Vogtareuth, Germany
| | - M Pritsch
- Department of Neuropediatrics, Children's Hospital DRK Siegen, Siegen, Germany
| | - N Boy
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - T Muralter
- Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Hospital for Neuropediatrics and Neurological Rehabilitation, Vogtareuth, Germany
| | - G Kluger
- Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Hospital for Neuropediatrics and Neurological Rehabilitation, Vogtareuth, Germany; Research Institute for Rehabilitation, Transition, and Palliation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - C Makoswski
- Pediatric Neurology, Department of Pediatrics, Kinderklinik München Schwabing, School of Medicine, Technical University of Munich, Germany
| | - V Kraus
- Pediatric Neurology, Department of Pediatrics, Kinderklinik München Schwabing, School of Medicine, Technical University of Munich, Germany; Social Pediatrics, Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - S Leiz
- Department of Pediatrics and Adolescent Medicine, Hospital Dritter Orden, Munich, Germany
| | - C Loehr-Nilles
- Department of Neuropediatrics, Klinikum Mutterhaus der Borromäerinnen, Trier, Germany
| | - J H Kreth
- Department of Neuropediatrics, Social Pediatric Center, Klinikum Leverkusen, Leverkusen, Germany
| | - S Braig
- Department of Pediatrics, Klinikum Bayreuth, Bayreuth, Germany
| | - S Schilling
- Department of Neuropediatrics, Clinic of Pediatrics, Barmherzige Brüder St. Hedwig Hospital, Regensburg, Germany
| | - J Kern
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Germany
| | - C Blank
- Department of Pediatric Neurology, Children's Hospital St. Marien, Landshut, Germany
| | - B Tro Baumann
- Department of Neuropediatrics, Children's Hospital DRK Siegen, Siegen, Germany
| | - S Vieth
- Department of Pediatrics, University Medical Center Schleswig Holstein, Kiel, Germany
| | - M Wallot
- Department of Pediatrics, Bethanien Hospital, Moers, Germany
| | - M Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Austria
| | - H Ringl
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Department of Radiology, Klinik Donaustadt, Vienna, Austria
| | - K P Wandinger
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany
| | - F Leypoldt
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - R Höftberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
| | - K Rostásy
- Department of Pediatric Neurology, Childreńs Hospital Datteln, University Witten/Herdecke, Datteln, Germany.
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Schilling S, August A, Meleux M, Conradt C, Tremmel LM, Teigler S, Adam V, Müller UC, Koo EH, Kins S, Eggert S. APP family member dimeric complexes are formed predominantly in synaptic compartments. Cell Biosci 2023; 13:141. [PMID: 37533067 PMCID: PMC10398996 DOI: 10.1186/s13578-023-01092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The amyloid precursor protein (APP), a key player in Alzheimer's disease (AD), is part of a larger gene family, including the APP like proteins APLP1 and APLP2. They share similar structures, form homo- and heterotypic dimers and exhibit overlapping functions. RESULTS We investigated complex formation of the APP family members via two inducible dimerization systems, the FKBP-rapamycin based dimerization as well as cysteine induced dimerization, combined with co-immunoprecipitations and Blue Native (BN) gel analyses. Within the APP family, APLP1 shows the highest degree of dimerization and high molecular weight (HMW) complex formation. Interestingly, only about 20% of APP is dimerized in cultured cells whereas up to 50% of APP is dimerized in mouse brains, independent of age and splice forms. Furthermore, we could show that dimerized APP originates mostly from neurons and is enriched in synaptosomes. Finally, BN gel analysis of human cortex samples shows a significant decrease of APP dimers in AD patients compared to controls. CONCLUSIONS Together, we suggest that loss of full-length APP dimers might correlate with loss of synapses in the process of AD.
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Affiliation(s)
- Sandra Schilling
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Alexander August
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Mathieu Meleux
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Carolin Conradt
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Luisa M Tremmel
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
- Medical, Biochemistry & Molecular Biology, Center for Molecular Signaling (PZMS), Saarland University, 66421, Homburg, Germany
| | - Sandra Teigler
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Virginie Adam
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Ulrike C Müller
- Institute for Pharmacy and Molecular Biotechnology, University of Heidelberg, 69120, Heidelberg, Germany
| | - Edward H Koo
- Department of Neuroscience, University of California, San Diego (UCSD), La Jolla, CA, 92093-0662, USA
| | - Stefan Kins
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Simone Eggert
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany.
- Department of Neurogenetics, Max-Planck-Institute for Multidisciplinary Sciences, City-Campus, Hermann-Rein-Str. 3, 37075, Göttingen, Germany.
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Schilling S, Pradhan A, Heesch A, Helbig A, Blennow K, Koch C, Bertgen L, Koo EH, Brinkmalm G, Zetterberg H, Kins S, Eggert S. Differential effects of familial Alzheimer's disease-causing mutations on amyloid precursor protein (APP) trafficking, proteolytic conversion, and synaptogenic activity. Acta Neuropathol Commun 2023; 11:87. [PMID: 37259128 DOI: 10.1186/s40478-023-01577-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/04/2023] [Indexed: 06/02/2023] Open
Abstract
The amyloid precursor protein (APP) is a key player in Alzheimer`s disease (AD) and the precursor of the Aβ peptide, which is generated by consecutive cleavages of β- and γ-secretases. Familial Alzheimer's disease (FAD) describes a hereditary subgroup of AD that represents a low percentage of AD cases with an early onset of the disease. Different APP FAD mutations are thought to have qualitatively different effects on its proteolytic conversion. However, few studies have explored the pathogenic and putative physiological differences in more detail. Here, we compared different FAD mutations, located at the β- (Swedish), α- (Flemish, Arctic, Iowa) or γ-secretase (Iberian) cleavage sites. We examined heterologous expression of APP WT and FAD mutants in non-neuronal cells and their impact on presynaptic differentiation in contacting axons of co-cultured neurons. To decipher the underlying molecular mechanism, we tested the subcellular localization, the endocytosis rate and the proteolytic processing in detail by immunoprecipitation-mass spectrometry. Interestingly, we found that only the Iberian mutation showed altered synaptogenic function. Furthermore, the APP Iowa mutant shows significantly decreased α-secretase processing which is in line with our results that APP carrying the Iowa mutation was significantly increased in early endosomes. However, most interestingly, immunoprecipitation-mass spectrometry analysis revealed that the amino acid substitutions of APP FAD mutants have a decisive impact on their processing reflected in altered Aβ profiles. Importantly, N-terminally truncated Aβ peptides starting at position 5 were detected preferentially for APP Flemish, Arctic, and Iowa mutants containing amino acid substitutions around the α-secretase cleavage site. The strongest change in the ratio of Aβ40/Aβ42 was observed for the Iberian mutation while APP Swedish showed a substantial increase in Aβ1-17 peptides. Together, our data indicate that familial AD mutations located at the α-, β-, and γ-secretase cleavage sites show considerable differences in the underlying pathogenic mechanisms.
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Affiliation(s)
- Sandra Schilling
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Ajay Pradhan
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Amelie Heesch
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Andrea Helbig
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Christian Koch
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Lea Bertgen
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Edward H Koo
- San Diego (UCSD), Department of Neuroscience, University of California, La Jolla, CA, 92093-0662, USA
| | - Gunnar Brinkmalm
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Stefan Kins
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany
| | - Simone Eggert
- Department of Human Biology and Human Genetics, University of Kaiserslautern, 67663, Kaiserslautern, Germany.
- Department of Neurogenetics, Max Planck Institute for Multidisciplinary Sciences, City-Campus, Hermann-Rein-Str. 3, 37075, Göttingen, Germany.
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Schilling S, Koeck JA, Kontny U, Orlikowsky T, Erdmann H, Eisert A. High-alert medications for hospitalised paediatric patients - a two-step survey among paediatric clinical expert pharmacists in Germany. Pharmazie 2022; 77:207-215. [PMID: 35751160 DOI: 10.1691/ph.2022.12025] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Paediatric patients are more vulnerable to be harmed by medication errors compared to adults due to pharmacokinetic and pharmacodynamic changes in their development, individual dosing calculations, and manipulation of ready to-use products intended for adult patients. According to the Institute of Safe Medication Practices, there are some "drugs that bear a heightened risk of causing significant patient harm when they are used in error"; these drugs are called high-alert medications (HAM). The two-step survey among paediatric clinical expert pharmacists presented here aimed to compile a nation-wide HAM list. To provide detailed guidance, this survey followed a drugbased approach, resulting in specific potential drug related problems (DRPs) and associated recommendations for prevention. In contrast to this approach, in the first round of the survey two drug classes were included that both were rated as HAM (i.e.chemotherapy and parenteral nutrition). Twenty single drugs were identified as HAM, 65% of which were cardiovascular or neurological drugs. The paediatric expert pharmacists mentioned in total 216 potential DRPs; in particular, they identified potential administration-related problems (28% of all DRPs), dosing-related problems (26%), and drug-choice-related problems (18%, e.g.drug confusion and drug monitoring). Moreover, they suggested 275 potential interventions to address these DRPs. Two thirds of all interventions dealt with the preparation by the hospital pharmacy, standardisation of processes (e.g.labelling), and education or training. In conclusion, this survey provided a German paediatric high-alert medication list from a paediatric pharmacist point of view. Moreover, the experts mentioned for the first time specific potential DRPs and associated interventions to guide a local multidisciplinary approach for preventing medication-related harm in children.
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Affiliation(s)
| | - J A Koeck
- Hospital Pharmacy, Flensburg, Germany; Institute of Clinical Pharmacology, Flensburg, Germany;,
| | - U Kontny
- Division of Paediatric Haematology, Oncology and Stem Cell Transplantation, Department of Paediatric and Adolescent Medicine, Flensburg, Germany
| | - T Orlikowsky
- Section of Neonatology, Department of Paediatric and Adolescent Medicine, RWTH Aachen University Hospital, Aachen, Flensburg, Germany
| | - H Erdmann
- Hospital Pharmacy, Malteser Krankenhaus St. Franziskus-Hospital, Flensburg, Germany
| | - A Eisert
- Hospital Pharmacy, Flensburg, Germany; Institute of Clinical Pharmacology, Flensburg, Germany
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Klein M, Kaleem A, Oetjen S, Wünkhaus D, Binkle L, Schilling S, Gjorgjieva M, Scholz R, Gruber-Schoffnegger D, Storch S, Kins S, Drewes G, Hoffmeister-Ullerich S, Kuhl D, Hermey G. Converging roles of PSENEN/PEN2 and CLN3 in the autophagy-lysosome system. Autophagy 2021; 18:2068-2085. [PMID: 34964690 PMCID: PMC9397472 DOI: 10.1080/15548627.2021.2016232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
PSENEN/PEN2 is the smallest subunit of the γ-secretase complex, an intramembrane protease that cleaves proteins within their transmembrane domains. Mutations in components of the γ-secretase underlie familial Alzheimer disease. In addition to its proteolytic activity, supplementary, γ-secretase independent, functions in the macroautophagy/autophagy-lysosome system have been proposed. Here, we screened for PSENEN-interacting proteins and identified CLN3. Mutations in CLN3 are causative for juvenile neuronal ceroid lipofuscinosis, a rare lysosomal storage disorder considered the most common neurodegenerative disease in children. As mutations in the PSENEN and CLN3 genes cause different neurodegenerative diseases, understanding shared cellular functions of both proteins might be pertinent for understanding general cellular mechanisms underlying neurodegeneration. We hypothesized that CLN3 modulates γ-secretase activity and that PSENEN and CLN3 play associated roles in the autophagy-lysosome system. We applied CRISPR gene-editing and obtained independent isogenic HeLa knockout cell lines for PSENEN and CLN3. Following previous studies, we demonstrate that PSENEN is essential for forming a functional γ-secretase complex and is indispensable for γ-secretase activity. In contrast, CLN3 does not modulate γ-secretase activity to a significant degree. We observed in PSENEN- and CLN3-knockout cells corresponding alterations in the autophagy-lysosome system. These include reduced activity of lysosomal enzymes and lysosome number, an increased number of autophagosomes, increased lysosome-autophagosome fusion, and elevated levels of TFEB (transcription factor EB). Our study strongly suggests converging roles of PSENEN and CLN3 in the autophagy-lysosome system in a γ-secretase activity-independent manner, supporting the idea of common cytopathological processes underlying different neurodegenerative diseases. Abbreviations: Aβ, amyloid-beta; AD, Alzheimer disease; APP, amyloid precursor protein; ATP5MC, ATP synthase membrane subunit c; DQ-BSA, dye-quenched bovine serum albumin; ER, endoplasmic reticulum; GFP, green fluorescent protein; ICC, immunocytochemistry; ICD, intracellular domain; JNCL, juvenile neuronal ceroid lipofuscinosis; KO, knockout; LC3, microtubule associated protein 1 light chain 3; NCL, neuronal ceroid lipofuscinoses; PSEN, presenilin; PSENEN/PEN2: presenilin enhancer, gamma-secretase subunit; TAP, tandem affinity purification; TEV, tobacco etch virus; TF, transferrin; WB, Western blot; WT, wild type.
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Affiliation(s)
- Marcel Klein
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Abuzar Kaleem
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra Oetjen
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Lars Binkle
- Institute of Neuroimmunology and Multiple Sclerosis, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra Schilling
- Division of Human Biology and Human Genetics, University of Kaiserslautern, Kaiserslautern, Germany
| | - Milena Gjorgjieva
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Scholz
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Stephan Storch
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Kins
- Division of Human Biology and Human Genetics, University of Kaiserslautern, Kaiserslautern, Germany
| | - Gerard Drewes
- Cellzome, Functional Genomics Research and Development, Heidelberg, Germany
| | - Sabine Hoffmeister-Ullerich
- Bioanalytics, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dietmar Kuhl
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Hermey
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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7
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Fuladi A, Suresh S, Thomas R, Wong M, Schilling S, Ee L, Choo K, Bourke C, McBride C, Masters BI, Kapur N. Multidisciplinary approach to paediatric aerodigestive disorders: A single-centre longitudinal observational study. J Paediatr Child Health 2020; 56:1929-1932. [PMID: 32886957 DOI: 10.1111/jpc.15090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 12/25/2022]
Abstract
AIM Aerodigestive clinics (ADCs) are multidisciplinary programmes for the care of children with complex congenital or acquired conditions affecting breathing, swallowing and growth. Our objective was to describe the demographic, clinical, etiological and investigational profile of children attending the inaugural ADC at a tertiary paediatric centre in Queensland. METHODS Children referred to the ADC at Queensland Children's Hospital from August 2018 to December 2019 were included. Data on clinical, growth and lung function parameters, bronchoscopy and upper gastrointestinal endoscopy findings, thoracic imaging and comorbidities were retrospectively analysed. RESULTS Fifty-six children (median (range) age 4 years (3 months-15 years); 18 female) attended the ADC during this 17-month period. Forty-six (82%) children had previous oesophageal atresia with tracheo-oesophageal fistula; 43 of these were type C. Previous isolated oesophageal atresia, congenital diaphragmatic hernia and congenital pulmonary malformation were the underlying disorder in three (5%) children each, with one child having a repaired laryngeal cleft. Vertebral Anal Tracheo Esophageal Renal Limb anomalies (VACTERL)/Vertebral Anal Tracheo Esophageal renal anomalies (VATER) association was seen in 21 (38%) children. Growth was adequate (median weight and body mass index z-score -0.63 and -0.48, respectively). Thirty-four (61%) children reported ongoing wet cough, with 12 (21%) requiring previous hospital admission for lower respiratory tract infection. Fourteen (25%) had bronchiectasis on computed tomography chest and 33 (59%) had clinical tracheomalacia, apparent on bronchoscopic examination in 21 patients. Dysphagia was reported in 15 (27%) children, 11 (20%) were gastrostomy feed-dependent and 5 (9%) had biopsy-proven eosinophilic oesophagitis. CONCLUSION High proportion of children attending the ADC have ongoing respiratory symptoms resulting in chronic pulmonary suppuration and bronchiectasis. Potential benefits of this model of care need to be studied prospectively to better understand the outcomes.
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Affiliation(s)
- Amol Fuladi
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Sadasivam Suresh
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Rahul Thomas
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Matthew Wong
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Sandra Schilling
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Looi Ee
- Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Kelvin Choo
- Department of Paediatric Surgery, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Christopher Bourke
- Department of Paediatric Surgery, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Craig McBride
- Department of Paediatric Surgery, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Brent I Masters
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Nitin Kapur
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
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8
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Kapur N, Nixon G, Robinson P, Massie J, Prentice B, Wilson A, Schilling S, Twiss J, Fitzgerald DA. Respiratory management of infants with chronic neonatal lung disease beyond the NICU: A position statement from the Thoracic Society of Australia and New Zealand. Respirology 2020; 25:880-888. [PMID: 32510776 PMCID: PMC7496866 DOI: 10.1111/resp.13876] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/16/2020] [Accepted: 05/21/2020] [Indexed: 12/17/2022]
Abstract
Chronic neonatal lung disease (CNLD) is defined as continued need for any form of respiratory support (supplemental oxygen and/or assisted ventilation) beyond 36 weeks PMA. Low-flow supplemental oxygen facilitates discharge from hospital of infants with CNLD who are hypoxic in air and is widely used despite lack of evidence on the most appropriate minimum mean target oxygen saturations. Furthermore, there are minimal data to guide the home monitoring, titration or weaning of supplemental oxygen in these infants. The purpose of this position statement is to provide a guide for the respiratory management of infants with CNLD, with special emphasis on role and logistics of supplemental oxygen therapy beyond the NICU stay. Reflecting a variety of clinical practices and infant comorbidities (presence of pulmonary hypertension, retinopathy of prematurity and adequacy of growth), it is recommended that the minimum mean target range for SpO2 during overnight oximetry to be 93-95% with less than 5% of total recording time to be below 90% SpO2 . Safety of short-term disconnection from supplemental oxygen should be assessed before discharge, with majority of infants with CNLD not ready for discharge until supplemental oxygen requirement is ≤0.5 L/min. Sleep-time assessment of oxygenation with continuous overnight oximetry is recommended when weaning supplemental oxygen. Palivizumab is considered safe and effective for the reduction of hospital admissions with RSV infection in this group. This statement would be useful for paediatricians, neonatologists, respiratory and sleep physicians and general practitioners managing children with CNLD.
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Affiliation(s)
- Nitin Kapur
- Department of Respiratory and Sleep MedicineQueensland Children's HospitalBrisbaneQLDAustralia
- School of MedicineUniversity of QueenslandBrisbaneQLDAustralia
| | - Gillian Nixon
- Melbourne Children's Sleep CentreMonash Children's HospitalMelbourneVICAustralia
- Department of PaediatricsMonash UniversityMelbourneVICAustralia
| | - Philip Robinson
- Respiratory and Sleep MedicineRoyal Children's Hospital, Murdoch Children's Research InstituteMelbourneVICAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia
| | - John Massie
- Department of Respiratory MedicineRoyal Children's HospitalMelbourneVICAustralia
| | - Bernadette Prentice
- Department of Respiratory MedicineSydney Children's HospitalSydneyNSWAustralia
| | - Andrew Wilson
- Department of Respiratory and Sleep MedicinePrincess Margaret Hospital for ChildrenPerthWAAustralia
| | - Sandra Schilling
- Department of Respiratory and Sleep MedicineQueensland Children's HospitalBrisbaneQLDAustralia
- School of MedicineUniversity of QueenslandBrisbaneQLDAustralia
| | - Jacob Twiss
- Respiratory DepartmentStarship Children's HospitalAucklandNew Zealand
| | - Dominic A. Fitzgerald
- Discipline of Child and Adolescent Health, Faculty of Medicine and HealthUniversity of Sydney and the Children's Hospital at WestmeadSydneyNew South WalesAustralia
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9
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O'Rourke C, Schilling S, Martin R, Joyce P, Bernadette Chang A, Kapur N. Is out-patient based treatment of bronchiectasis exacerbations in children comparable to inpatient based treatment? Pediatr Pulmonol 2020; 55:994-999. [PMID: 32068973 DOI: 10.1002/ppul.24670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/18/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Children with bronchiectasis have recurrent exacerbations and may require hospitalization. "Hospital in the home (HITH)" is used as an alternative to hospitalization for children with cystic fibrosis (CF) but to date, there is no published data on children without CF. We describe our experience of HITH (intravenous [IV] antibiotics and at least once-daily physiotherapy-treated airway clearance therapy) in a cohort of children with bronchiectasis, comparing outcomes between hospital and HITH-based pathways. METHODS Medical records were retrospectively reviewed in children with bronchiectasis who were hospitalized in our center from July 2016 to July 2018. We compared treatment duration, symptom resolution, adverse events, oral antibiotic prescription on discharge and "time-to-next hospitalization" between children managed with the two treatment pathways. RESULTS Exacerbations in 63 children (median age = 6 years [range: 1-17]; females = 33, indigenous = 8) with bronchiectasis treated with IV antibiotic therapy were analyzed (HITH n = 45, 71.5%). Duration of treatment and symptom resolution was similar between groups (hospital: median = 14 days [interquartile range {IQR}: 14-14] and 12/18 [66.6%], respectively vs HITH: 14 [14-15.5] and 31/45 [69%]; P = .53 and .85, respectively). There was no significant difference in adverse events (16.6% vs 9%), prescription of oral antibiotics on discharge (44% vs 24%), or "time-to-next hospitalization" (median 42 [IQR: 24-100] vs 67 [IQR: 32-95] weeks) between hospital and HITH groups, respectively. CONCLUSIONS In children with bronchiectasis treated for a severe exacerbation, receiving treatment in the home setting with HITH does not compromise short-term clinical outcomes compared to hospital only treatment. Prospective studies are required to provide more robust evidence in this under-researched area.
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Affiliation(s)
- Claudia O'Rourke
- Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Queensland, Australia
| | - Sandra Schilling
- Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Queensland, Australia
| | - Rebecca Martin
- Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Queensland, Australia
| | - Patrick Joyce
- Department of Paediatric Medicine, School of Medicine, University of Queensland, Queensland, Australia
| | - Anne Bernadette Chang
- Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Queensland, Australia.,Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Paediatrics, Children's Centre of Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nitin Kapur
- Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Queensland, Australia.,Department of Paediatric Medicine, School of Medicine, University of Queensland, Queensland, Australia.,Department of Paediatrics, Children's Centre of Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
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10
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Drews P, Killer C, Cosfeld J, Knieps A, Brezinsek S, Jakubowski M, Brandt C, Bozhenkov S, Dinklage A, Cai J, Endler M, Hammond K, Henkel M, Gao Y, Geiger J, Grulke O, Höschen D, König R, Krämer-Flecken A, Liang Y, Li Y, Liu S, Niemann H, Nicolai D, Neubauer O, Neuner U, Rack M, Rahbarnia K, Rudischhauser L, Sandri N, Satheeswaran G, Schilling S, Thomsen H, Windisch T, Sereda S. Edge plasma measurements on the OP 1.2a divertor plasmas at W7-X using the combined probe. Nuclear Materials and Energy 2019. [DOI: 10.1016/j.nme.2019.02.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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11
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Carlozzi NE, Schilling S, Kratz AL, Paulsen JS, Frank S, Stout JC. Understanding patient-reported outcome measures in Huntington disease: at what point is cognitive impairment related to poor measurement reliability? Qual Life Res 2018; 27:2541-2555. [PMID: 29909483 PMCID: PMC6295362 DOI: 10.1007/s11136-018-1912-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE Symptom progression in Huntington disease (HD) is associated with cognitive decline which may interfere with the self-report of symptoms. Unfortunately, data to support or refute the psychometric reliability of patient-reported outcomes (PROs) as HD progresses are limited. This is problematic given that PROs are increasingly recognized as important measures of efficacy for new treatments. METHODS We examined PRO data from the HDQLIFE Measurement System (Speech Difficulties; Swallowing Difficulties; Chorea) in 509 individuals with premanifest, early-stage, or late-stage HD. Clinician-administered assessments of motor functioning (items from the UHDRS) and standardized objective assessments of cognition (Stroop, Symbol Digit Modalities) were also collected. We examined item bias using differential item functioning (DIF) across HD stage (premanifest, early-, late-) and relative to cognitive performance. We also examined the correlations between self-report and clinician ratings. Regression models that considered total cognitive ability were utilized to determine psychometric reliability of the PROs. RESULTS Most PRO items were free from DIF for both staging and cognition. There were modest correlations between PROs and clinician report (ranged from - 0.40 to - 0.60). Modeling analyses indicated that psychometric reliability breaks down with poorer cognition and more progressed disease stage; split-half reliability was compromised (i.e., split-half reliability < 0.80) when scores were < 136 for Chorea, < 109 for Speech Difficulties, and < 179 for Swallowing Difficulties. CONCLUSIONS Results indicate that the psychometric reliability of PROs can be compromised as HD symptoms progress and cognition declines. Clinicians should consider PROs in conjunction with other types of assessments when total cognition scores exceed critical thresholds.
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Affiliation(s)
- N E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
- Department of Physical Medicine & Rehabilitation, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Building NCRC B14, Room G216, Ann Arbor, MI, 48109-2800, USA.
| | - S Schilling
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - A L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - J S Paulsen
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
- Department of Neurology, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
- Department of Psychology, The University of Iowa, Iowa City, IA, USA
| | - S Frank
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - J C Stout
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
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12
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Abstract
We report a case of a 65-year-old man examined for hematuria and neurologic symptoms. Radiologically a tumour of the kidney was suspected, with metastatic involvement of the brain and both lungs. The urologists then performed a cytoreductive nephrectomy.In histopathological examination of the nephrectomy specimen a clear cell renal cell carcinoma (clear cell RCC) was found. However, an additional focus of a high-grade adenocarcinoma was discovered that turned out to be a metastasis of a poor differentiated lung adenocarcinoma. This diagnosis was supported by positive TTF1 and napsin-A as well as good clinical correlations.The article summarizes the differential diagnostic considerations of poor differentiated adenocarcinoma of the kidney, aimed at gross and microscopic morphology, immunohistochemistry and clinical-pathological correlation. A review of literature about a tumour-in-tumour metastasis is included.
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Affiliation(s)
- J Hrudka
- Institut für Pathologie, 3. Medizinische Fakultät, Karls-Universität, Universitätskrankenhaus Kralovske Vinohrady, Šrobárova 1150/50, 10034, Prag, Tschechien.
| | - V Eis
- Institut für Pathologie, 3. Medizinische Fakultät, Karls-Universität, Universitätskrankenhaus Kralovske Vinohrady, Šrobárova 1150/50, 10034, Prag, Tschechien
| | - J Šach
- Institut für Pathologie, 3. Medizinische Fakultät, Karls-Universität, Universitätskrankenhaus Kralovske Vinohrady, Šrobárova 1150/50, 10034, Prag, Tschechien
| | - P Klézl
- Urologische Klinik, 3. Medizinische Fakultät, Karls-Universität, Universitätskrankenhaus Kralovske Vinohrady, Prag, Tschechien
| | - S Schilling
- Institut für Pathologie, Klinikum Fürth, Fürth, Deutschland
| | - D Bandke
- Institut für Pathologie und Mikrobiologie, Neuromed Campus, Kepler Universitätsklinikum, Linz, Österreich
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13
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Eggert S, Gonzalez AC, Thomas C, Schilling S, Schwarz SM, Tischer C, Adam V, Strecker P, Schmidt V, Willnow TE, Hermey G, Pietrzik CU, Koo EH, Kins S. Dimerization leads to changes in APP (amyloid precursor protein) trafficking mediated by LRP1 and SorLA. Cell Mol Life Sci 2017; 75:301-322. [PMID: 28799085 DOI: 10.1007/s00018-017-2625-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/17/2017] [Accepted: 08/08/2017] [Indexed: 12/22/2022]
Abstract
Proteolytic cleavage of the amyloid precursor protein (APP) by α-, β- and γ-secretases is a determining factor in Alzheimer's disease (AD). Imbalances in the activity of all three enzymes can result in alterations towards pathogenic Aβ production. Proteolysis of APP is strongly linked to its subcellular localization as the secretases involved are distributed in different cellular compartments. APP has been shown to dimerize in cis-orientation, affecting Aβ production. This might be explained by different substrate properties defined by the APP oligomerization state or alternatively by altered APP monomer/dimer localization. We investigated the latter hypothesis using two different APP dimerization systems in HeLa cells. Dimerization caused a decreased localization of APP to the Golgi and at the plasma membrane, whereas the levels in the ER and in endosomes were increased. Furthermore, we observed via live cell imaging and biochemical analyses that APP dimerization affects its interaction with LRP1 and SorLA, suggesting that APP dimerization modulates its interplay with sorting molecules and in turn its localization and processing. Thus, pharmacological approaches targeting APP oligomerization properties might open novel strategies for treatment of AD.
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Affiliation(s)
- Simone Eggert
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany.
| | - A C Gonzalez
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany.,Institute for Biochemistry, Christian Albrechts University Kiel, 24118, Kiel, Germany
| | - C Thomas
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany
| | - S Schilling
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany
| | - S M Schwarz
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany.,Institute for Medical Virology, University of Frankfurt, 60596, Frankfurt, Germany
| | | | - V Adam
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany
| | - P Strecker
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany
| | - V Schmidt
- Max Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - T E Willnow
- Max Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - G Hermey
- Institute for Molecular and Cellular Cognition, Center for Molecular University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - C U Pietrzik
- Institute for Pathobiochemistry, Molecular Neurodegeneration, University Medical Center of the Johannes Gutenberg-University Mainz, 55099, Mainz, Germany
| | - E H Koo
- Department of Neuroscience, University of California San Diego (UCSD), La Jolla, CA, 92093-0662, USA
| | - Stefan Kins
- Department of Human Biology and Human Genetics, University of Kaiserslautern, Erwin-Schrödinger-Str. 13, 67663, Kaiserslautern, Germany.
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14
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Herr UM, Strecker P, Storck SE, Thomas C, Rabiej V, Junker A, Schilling S, Schmidt N, Dowds CM, Eggert S, Pietrzik CU, Kins S. LRP1 Modulates APP Intraneuronal Transport and Processing in Its Monomeric and Dimeric State. Front Mol Neurosci 2017; 10:118. [PMID: 28496400 PMCID: PMC5406469 DOI: 10.3389/fnmol.2017.00118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 04/10/2017] [Indexed: 12/31/2022] Open
Abstract
The low-density lipoprotein receptor-related protein 1, LRP1, interacts with APP and affects its processing. This is assumed to be mostly caused by the impact of LRP1 on APP endocytosis. More recently, also an interaction of APP and LRP1 early in the secretory pathway was reported whereat retention of LRP1 in the ER leads to decreased APP cell surface levels and in turn, to reduced Aβ secretion. Here, we extended the biochemical and immunocytochemical analyses by showing via live cell imaging analyses in primary neurons that LRP1 and APP are transported only partly in common (one third) but to a higher degree in distinct fast axonal transport vesicles. Interestingly, co-expression of LRP1 and APP caused a change of APP transport velocities, indicating that LRP1 recruits APP to a specific type of fast axonal transport vesicles. In contrast lowered levels of LRP1 facilitated APP transport. We further show that monomeric and dimeric APP exhibit similar transport characteristics and that both are affected by LRP1 in a similar way, by slowing down APP anterograde transport and increasing its endocytosis rate. In line with this, a knockout of LRP1 in CHO cells and in primary neurons caused an increase of monomeric and dimeric APP surface localization and in turn accelerated shedding by meprin β and ADAM10. Notably, a choroid plexus specific LRP1 knockout caused a much higher secretion of sAPP dimers into the cerebrospinal fluid compared to sAPP monomers. Together, our data show that LRP1 functions as a sorting receptor for APP, regulating its cell surface localization and thereby its processing by ADAM10 and meprin β, with the latter exhibiting a preference for APP in its dimeric state.
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Affiliation(s)
- Uta-Mareike Herr
- Institute of Pathobiochemistry, Molecular Neurodegeneration, University Medical Center of the Johannes Gutenberg-University MainzMainz, Germany
| | - Paul Strecker
- Division of Human Biology and Human Genetics, Technical University of KaiserslauternKaiserslautern, Germany
| | - Steffen E Storck
- Institute of Pathobiochemistry, Molecular Neurodegeneration, University Medical Center of the Johannes Gutenberg-University MainzMainz, Germany
| | - Carolin Thomas
- Division of Human Biology and Human Genetics, Technical University of KaiserslauternKaiserslautern, Germany
| | - Verena Rabiej
- Institute of Pathobiochemistry, Molecular Neurodegeneration, University Medical Center of the Johannes Gutenberg-University MainzMainz, Germany
| | - Anne Junker
- Institute of Pathobiochemistry, Molecular Neurodegeneration, University Medical Center of the Johannes Gutenberg-University MainzMainz, Germany
| | - Sandra Schilling
- Division of Human Biology and Human Genetics, Technical University of KaiserslauternKaiserslautern, Germany
| | - Nadine Schmidt
- Division of Human Biology and Human Genetics, Technical University of KaiserslauternKaiserslautern, Germany
| | - C Marie Dowds
- Division of Human Biology and Human Genetics, Technical University of KaiserslauternKaiserslautern, Germany
| | - Simone Eggert
- Division of Human Biology and Human Genetics, Technical University of KaiserslauternKaiserslautern, Germany
| | - Claus U Pietrzik
- Institute of Pathobiochemistry, Molecular Neurodegeneration, University Medical Center of the Johannes Gutenberg-University MainzMainz, Germany
| | - Stefan Kins
- Division of Human Biology and Human Genetics, Technical University of KaiserslauternKaiserslautern, Germany
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15
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Freidel K, Linck-Eleftheriadis S, Röhrig B, Schilling S, Heckmann J. [A 10-year evaluation of geriatric rehabilitation in Rhineland-Palatinate]. Z Gerontol Geriatr 2016; 50:365-373. [PMID: 27412584 DOI: 10.1007/s00391-016-1101-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 10/21/2015] [Revised: 05/23/2016] [Accepted: 06/10/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND An evaluation of geriatric rehabilitation has been carried out in Rhineland-Palatinate for over 10 years by collecting data of patients absolving an inpatient geriatric rehabilitation program. The aim of the project was to improve the transparency of outcome quality. The procedure is equally supported by geriatric rehabilitation clinics, health insurance companies and the Medical Service of Health Insurance (MDK). MATERIAL AND METHODS Consented information about the rehabilitation process has been collected from every geriatric rehabilitation clinic in Rhineland-Palatinate. The data were pseudonymized and sent to the MDK in Rhineland-Palatinate for statistical analysis. The dataset included age, diagnosis, life circumstances before rehabilitation, duration of the rehabilitation, therapy implemented and need for support (with or without personal assistance) in eight activities of daily living at the beginning and at the end of rehabilitation. RESULTS The results of 45,751 participants who underwent rehabilitation between 2005 and 2014 are presented. There was a slight tendency towards an increase in the number of very old geriatric patients undergoing rehabilitation. The average duration of rehabilitation decreased slightly during the observation period, while the frequency of therapy increased. The reduction in the need for assistance during rehabilitation remained constant over the observation period. CONCLUSION Systematic evaluation improves the transparency of the rehabilitation process.
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Affiliation(s)
- K Freidel
- Medizinischer Dienst der Krankenversicherung (MDK) Rheinland-Pfalz, Albiger Str. 19d, 55232, Alzey, Deutschland.
| | - S Linck-Eleftheriadis
- Medizinischer Dienst der Krankenversicherung (MDK) Rheinland-Pfalz, Albiger Str. 19d, 55232, Alzey, Deutschland
| | - B Röhrig
- Medizinischer Dienst der Krankenversicherung (MDK) Rheinland-Pfalz, Albiger Str. 19d, 55232, Alzey, Deutschland
| | - S Schilling
- Geriatrische Rehabilitationsklinik St. Irminen, Trier, Deutschland
| | - J Heckmann
- Geriatrische Fachklinik Rheinhessen-Nahe, Bad Kreuznach, Deutschland
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16
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Schlenzig D, Wermann M, Ramsbeck D, Moenke-Wedler T, Schilling S. Expression, purification and initial characterization of human meprin β from Pichia pastoris. Protein Expr Purif 2015; 116:75-81. [PMID: 26256061 DOI: 10.1016/j.pep.2015.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 07/30/2015] [Accepted: 08/03/2015] [Indexed: 12/26/2022]
Abstract
Human meprin β (h-meprin β), a single-zinc metalloendoprotease of the astacin family, is potentially involved in disorders such as fibrosis and Alzheimer's disease. Here, we describe the expression of the enzyme in the yeast Pichia pastoris. The N-terminal signal sequence was replaced by the α-leader of Saccharomyces, enabling efficient secretion of the mature enzyme, harboring either an N-terminal or C-terminal His-tag. The purification by affinity and hydrophobic interaction chromatography resulted in isolation of 58.4 mg/l of homogenous human pro-meprin β from fermentation broth. The activated enzyme isolated from yeast (yh-meprin β) displayed virtually identical enzymatic activity as h-meprin from a mammalian cell line. Furthermore, the yh-meprin β was N-glycosylated and secreted as a dimer with a molecular mass of 148 kDa. Endoglycosidase H treatment generated a protein with a molecular mass of 133 kDa, but essentially unchanged kinetic parameters. Thus, our data suggest that human meprin β expressed in P. pastoris displays virtually identical parameters as meprin from other sources. The high yield of protein expression, the ease of purification and the deglycosylation in its native state appear to favor further studies aiming at inhibitor screening and structure-based inhibitor refinement.
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Affiliation(s)
- D Schlenzig
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Drug Design and Target Validation (IZI-MWT), Weinbergweg 22, 06120 Halle/Saale, Germany
| | - M Wermann
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Drug Design and Target Validation (IZI-MWT), Weinbergweg 22, 06120 Halle/Saale, Germany
| | - D Ramsbeck
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Drug Design and Target Validation (IZI-MWT), Weinbergweg 22, 06120 Halle/Saale, Germany
| | - T Moenke-Wedler
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Drug Design and Target Validation (IZI-MWT), Weinbergweg 22, 06120 Halle/Saale, Germany
| | - S Schilling
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Drug Design and Target Validation (IZI-MWT), Weinbergweg 22, 06120 Halle/Saale, Germany.
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Schilling S, Maltezou HC, Fusco FM, De Iaco G, Brodt HR, Bannister B, Brouqui P, Carson G, Puro V, Gottschalk R, Ippolito G. Transportation capacity for patients with highly infectious diseases in Europe: a survey in 16 nations. Clin Microbiol Infect 2015; 21S:e1-e5. [PMID: 25636943 PMCID: PMC7128608 DOI: 10.1111/1469-0691.12290] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 07/23/2012] [Indexed: 11/28/2022]
Abstract
Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. In most European Union member states specialized isolation facilities are responsible for the management of such cases. Ground ambulances are often affiliated with those facilities because rapid relocation of patients is most desirable. To date, no pooled data on the accessibility, technical specifications and operational procedures for such transport capacities are available. During 2009, the ‘European Network for HIDs’ conducted a cross-sectional analysis of hospitals responsible for HID patients in Europe including an assessment of (a) legal aspects; (b) technical and infrastructure aspects; and (c) operational procedures for ground ambulances used for HID transport. Overall, 48 isolation facilities in 16 European countries were evaluated and feedback rates ranged from 78% to 100% (n = 37 to n = 48 centres). Only 46.8% (22/47) of all centres have both national and local guidelines regulating HID patient transport. If recommended, specific equipment is found in 90% of centres (9/10), but standard ambulances in only 6/13 centres (46%). Exclusive entrances (32/45; 71%) and pathways (30/44; 68.2%) for patient admission, as well as protocols for disinfection of ambulances (34/47; 72.3%) and equipment (30/43; 69.8%) exist in most centres. In conclusion, the availability and technical specifications of ambulances broadly differ, reflecting different preparedness levels within the European Union. Hence, regulations for technical specifications and operational procedures should be harmonized to promote patient and healthcare worker safety.
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Affiliation(s)
- S Schilling
- Department for Infectious Diseases, Goethe University, Frankfurt, Germany.
| | - H C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - F M Fusco
- Department for Infectious Diseases, National Institute for Infectious Diseases "L. Spallanzani" (INMI), Rome, Italy
| | - G De Iaco
- Department for Infectious Diseases, National Institute for Infectious Diseases "L. Spallanzani" (INMI), Rome, Italy
| | - H-R Brodt
- Department for Infectious Diseases, Goethe University, Frankfurt, Germany
| | - B Bannister
- Department for Infectious Diseases, Royal Free Hospital, London, UK
| | - P Brouqui
- Research Unit on Emerging Infectious and Tropical Diseases (URMITE), Marseilles, France
| | - G Carson
- Department for Infectious Diseases, Health Protection Agency, UK
| | - V Puro
- Department for Infectious Diseases, National Institute for Infectious Diseases "L. Spallanzani" (INMI), Rome, Italy
| | | | - G Ippolito
- Department for Infectious Diseases, National Institute for Infectious Diseases "L. Spallanzani" (INMI), Rome, Italy
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Kahaly G, Grübl M, Moncayo R, Schilling S, Weber P, Beyer J, Krause U. Thyroid-stimulating and eye muscle antibodies in Graves' disease and Graves' orbitopathy. Dev Ophthalmol 2015; 20:68-78. [PMID: 2574117 DOI: 10.1159/000417921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- G Kahaly
- Department of Internal Medicine, Endocrinology, and Metabolism, Johannes Gutenberg University, Mainz, FRG
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19
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Stahl R, Schilling S, Soba P, Rupp C, Hartmann T, Wagner K, Merdes G, Eggert S, Kins S. Shedding of APP limits its synaptogenic activity and cell adhesion properties. Front Cell Neurosci 2014; 8:410. [PMID: 25520622 PMCID: PMC4253958 DOI: 10.3389/fncel.2014.00410] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 10/30/2014] [Accepted: 11/11/2014] [Indexed: 01/05/2023] Open
Abstract
The amyloid precursor protein (APP) plays a central role in Alzheimer's disease (AD) and has essential synapse promoting functions. Synaptogenic activity as well as cell adhesion properties of APP presumably depend on trans-cellular dimerization via its extracellular domain. Since neuronal APP is extensively processed by secretases, it raises the question if APP shedding affects its cell adhesion and synaptogenic properties. We show that inhibition of APP shedding using cleavage deficient forms of APP or a dominant negative α-secretase strongly enhanced its cell adhesion and synaptogenic activity suggesting that synapse promoting function of APP is tightly regulated by α-secretase mediated processing, similar to other trans-cellular synaptic adhesion molecules.
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Affiliation(s)
- Ronny Stahl
- Center of Molecular Biology ZMBH, University of Heidelberg Heidelberg, Germany ; Department of Physiological Genomics, Institute of Physiology, Ludwig-Maximilians University Munich Munich, Germany
| | - Sandra Schilling
- Department of Human Biology and Human Genetics, Technical University of Kaiserslautern Kaiserslautern, Germany
| | - Peter Soba
- Center of Molecular Biology ZMBH, University of Heidelberg Heidelberg, Germany ; Center for Molecular Neurobiology (ZMNH), University of Hamburg Hamburg, Germany
| | - Carsten Rupp
- Department of Human Biology and Human Genetics, Technical University of Kaiserslautern Kaiserslautern, Germany
| | - Tobias Hartmann
- Deutsches Institut für DemenzPrävention, Experimental Neurology, Saarland University Homburg/Saar, Germany
| | - Katja Wagner
- Center of Molecular Biology ZMBH, University of Heidelberg Heidelberg, Germany ; Department of Human Biology and Human Genetics, Technical University of Kaiserslautern Kaiserslautern, Germany
| | - Gunter Merdes
- Center of Molecular Biology ZMBH, University of Heidelberg Heidelberg, Germany ; Department of Biosystems Science and Engineering, ETH Zürich Basel, Switzerland
| | - Simone Eggert
- Department of Human Biology and Human Genetics, Technical University of Kaiserslautern Kaiserslautern, Germany
| | - Stefan Kins
- Center of Molecular Biology ZMBH, University of Heidelberg Heidelberg, Germany ; Department of Human Biology and Human Genetics, Technical University of Kaiserslautern Kaiserslautern, Germany ; Deutsches Institut für DemenzPrävention, Experimental Neurology, Saarland University Homburg/Saar, Germany
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20
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Lison H, Happel MFK, Schneider F, Baldauf K, Kerbstat S, Seelbinder B, Schneeberg J, Zappe M, Goldschmidt J, Budinger E, Schröder UH, Ohl FW, Schilling S, Demuth HU, Scheich H, Reymann KG, Rönicke R. Disrupted cross-laminar cortical processing in β amyloid pathology precedes cell death. Neurobiol Dis 2013; 63:62-73. [PMID: 24291517 DOI: 10.1016/j.nbd.2013.11.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 10/04/2013] [Accepted: 11/19/2013] [Indexed: 02/06/2023] Open
Abstract
Disruption of neuronal networks in the Alzheimer-afflicted brain is increasingly recognized as a key correlate of cognitive and memory decline in Alzheimer patients. We hypothesized that functional synaptic disconnections within cortical columnar microcircuits by pathological β-amyloid accumulation, rather than cell death, initially causes the cognitive impairments. During development of cortical β-amyloidosis with still few plaques in the transgenic 5xFAD mouse model single cell resolution mapping of neuronal thallium uptake revealed that electrical activity of pyramidal cells breaks down throughout infragranular cortical layer V long before cell death occurs. Treatment of 5xFAD mice with the glutaminyl cyclase inhibitor, PQ 529, partially prevented the decline of pyramidal cell activity, indicating pyroglutamate-modified forms, potentially mixed oligomers of Aβ are contributing to neuronal impairment. Laminar investigation of cortical circuit dysfunction with current source density analysis identified an early loss of excitatory synaptic input in infragranular layers, linked to pathological recurrent activations in supragranular layers. This specific disruption of normal cross-laminar cortical processing coincided with a decline of contextual fear learning.
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Affiliation(s)
- H Lison
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - M F K Happel
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - F Schneider
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), c/o Universitätsklinikum Magdeburg, Leipziger Strasse 44/Haus 64, 39120 Magdeburg, Germany
| | - K Baldauf
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), c/o Universitätsklinikum Magdeburg, Leipziger Strasse 44/Haus 64, 39120 Magdeburg, Germany
| | - S Kerbstat
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), c/o Universitätsklinikum Magdeburg, Leipziger Strasse 44/Haus 64, 39120 Magdeburg, Germany
| | - B Seelbinder
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - J Schneeberg
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), c/o Universitätsklinikum Magdeburg, Leipziger Strasse 44/Haus 64, 39120 Magdeburg, Germany
| | - M Zappe
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), c/o Universitätsklinikum Magdeburg, Leipziger Strasse 44/Haus 64, 39120 Magdeburg, Germany
| | - J Goldschmidt
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - E Budinger
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - U H Schröder
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - F W Ohl
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - S Schilling
- Probiodrug AG, Weinbergweg 22, 06120 Halle (Saale), Germany
| | - H-U Demuth
- Probiodrug AG, Weinbergweg 22, 06120 Halle (Saale), Germany
| | - H Scheich
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - K G Reymann
- Leibniz-Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), c/o Universitätsklinikum Magdeburg, Leipziger Strasse 44/Haus 64, 39120 Magdeburg, Germany
| | - R Rönicke
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), c/o Universitätsklinikum Magdeburg, Leipziger Strasse 44/Haus 64, 39120 Magdeburg, Germany; Department of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.
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Davis M, Manoucheri E, Schilling S, Wang K. Technique to Minimize Spillage during Ovarian Cystectomy of Dermoid Cyst. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Maltezou HC, Fusco FM, Schilling S, De Iaco G, Gottschalk R, Brodt HR, Bannister B, Brouqui P, Thomson G, Puro V, Ippolito G. Infection control practices in facilities for highly infectious diseases across Europe. J Hosp Infect 2012; 81:184-91. [PMID: 22648013 PMCID: PMC7114579 DOI: 10.1016/j.jhin.2012.04.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 04/17/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND The management of patients with highly infectious diseases (HIDs) is a challenge for healthcare provision requiring a high level of care without compromising the safety of other patients and healthcare workers. AIM To study the infection control practice in isolation facilities participating in the European Network for Highly Infectious Diseases (EuroNHID) project. METHODS A survey was conducted during 2009 of 48 isolation facilities caring for patients with HIDs in 16 European countries. Checklists and standard evaluation forms were used to collect and interpret data on hand hygiene, routine hygiene and disinfection, and waste management. FINDINGS Forty percent of HIDs had no non-hand-operated sinks or alcohol-based antiseptic distributors, while 27% did not have procedures for routine hygiene, final disinfection, or safe discarding of non-disposable objects or equipment. There was considerable variation in the management of waste and in the training of housekeeping personnel. EuroNHID has developed recommendations for hand hygiene, disinfection, routine hygiene, and waste management. CONCLUSIONS Most aspects of hand hygiene, routine hygiene and disinfection, and waste management were considered at least partially adequate in the majority of European isolation facilities dedicated for the care of patients with HIDs. But considerable variability was observed, with management of waste and training of housekeeping personnel being generally less satisfactory.
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Affiliation(s)
- H C Maltezou
- Hellenic Center for Disease Control and Prevention, Athens, Greece.
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23
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Sondergaard BC, Catala-Lehnen P, Huebner AK, Bay-Jensen AC, Schinke T, Henriksen K, Schilling S, Haberland M, Nielsen RH, Amling M, Karsdal MA. Mice over-expressing salmon calcitonin have strongly attenuated osteoarthritic histopathological changes after destabilization of the medial meniscus. Osteoarthritis Cartilage 2012; 20:136-43. [PMID: 22122987 DOI: 10.1016/j.joca.2011.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 10/18/2011] [Accepted: 11/04/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Calcitonin is well-known for its inhibitory actions on bone-resorbing osteoclasts and recently potential beneficial effects on cartilage were shown. We investigated effects of salmon calcitonin (sCT) on the articular cartilage and bone, after destabilization of the medial meniscus (DMM) in normal and sCT over-expressing mice. DESIGN Bone phenotype of transgenic (TG) C57Bl/6 mice over-expressing sCT at 6 months and 12 months was investigated by (1) serum osteocalcin and urinary deoxypyridinoline and (2) dynamic and normal histomorphometry of vertebrae bodies. In subsequent evaluation of cartilage and subchondral bone changes, 44 10-week old TG or wild-type (WT) mice were randomized into four groups and subjected to DMM or sham-operations. After 7 weeks animals were sacrificed, and knee joints were isolated for histological analysis. RESULTS Trabecular bone volume (BV/TV) increased 150% after 6 months and 300% after 12 months in sCT-expressing mice when compared to WT controls (P<0.05). Osteoblast number, bone formation rate and osteocalcin measurements were not affected in TG mice over-expressing sCT. In WT animals, a 5-fold increase in the quantitative erosion index was observed after DMM, and the semi-quantitative OARSI score showed over 400% (P<0.001) increase, compared to sham-operated WT mice. DMM-operated TG mice were protected against cartilage erosion and showed a 65% and 64% (P<0.001) reduction, respectively, for the two histopathological evaluation methods. CONCLUSIONS sCT over-expressing mice had higher bone volume, and were protected against cartilage erosion. These data suggest that increased levels of sCT may hamper the pathogenesis of osteoarthritis (OA). However more studies are necessary to confirm these preliminary results.
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Affiliation(s)
- B C Sondergaard
- Cartilage Biology and Biomarker R&D, Nordic Bioscience, Herlev, Denmark.
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Schilling S, Klotz P, Weis J, Gold R. Steroidresponsives demenzielles Syndrom und vaskulitische Polyneuropathie. Akt Neurol 2010. [DOI: 10.1055/s-0029-1223512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schilling S, Follin P, Jarhall B, Tegnell A, Lastilla M, Bannister B, Fusco FM, Biselli R, Brodt HR, Puro V. European concepts for the domestic transport of highly infectious patients. Clin Microbiol Infect 2009; 15:727-33. [DOI: 10.1111/j.1469-0691.2009.02871.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Fusco F, Schilling S, Puro V, Brodt HR, Follin P, Jarhall B, Bannister B, Maltezou H, Thomson G, Brouqui P, Ippolito G. EuroNHID checklists for the assessment of high-level isolation units and referral centres for highly infectious diseases: results from the pilot phase of a European survey. Clin Microbiol Infect 2009; 15:711-9. [DOI: 10.1111/j.1469-0691.2009.02874.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schilling S, Cynis H, Demuth HU. Abstract: P689 ISOLATION OF AN ISOENZYME OF HUMAN GLUTAMINYL CYCLASE. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70857-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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28
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Schilling S, Käsbauer J, Melter M, Hehr U. Fallbericht Holoprosenzephalie-Sequenz: klinische und zytogenetische Befunde eines Patienten mit chromosomaler Deletion 7Q34→QTER. Klin Padiatr 2009. [DOI: 10.1055/s-0029-1214334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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29
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Ruiz Carrillo D, Parthier C, Stelter M, Grandke J, Jaenckel N, Schilling S, Neumann P, Demuth H, Stubbs M, Rahfeld J. Structural characterization of the bacterial glutaminyl cyclase from Zymomonas mobilis. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308087886] [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: 11/10/2022] Open
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Schilling S, Goelz S, Linker R, Luehder F, Gold R. Fumaric acid esters are effective in chronic experimental autoimmune encephalomyelitis and suppress macrophage infiltration. Clin Exp Immunol 2006; 145:101-7. [PMID: 16792679 PMCID: PMC1942010 DOI: 10.1111/j.1365-2249.2006.03094.x] [Citation(s) in RCA: 205] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Fumaric acid esters (FAE) have proven their therapeutic efficacy in psoriasis, a Th1 mediated skin disease. More recently, preliminary data have suggested an activity in multiple sclerosis (MS) as well. To investigate further possible mechanisms of action of these compounds in inflammatory diseases, we studied the FAE methyl hydrogen fumarate (MHF) and dimethyl fumarate (DMF) in chronic experimental autoimmune encephalomyelitis (EAE) induced by immunization of C57BL/6 mice with MOG peptide aa 35-55. Preventive treatment with these FAE was delivered twice a day by oral gavage. Both esters had a significant therapeutic effect on the disease course and histology showed a strongly reduced macrophage inflammation in the spinal cord. Multiparameter cytokine analysis from blood detected an increase of IL-10 in the treated animals. We conclude that the underlying biological activity of FAE in EAE is complex and, to elucidate the molecular mechanisms, further investigation is needed.
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Affiliation(s)
- S Schilling
- Institute for Multiple Sclerosis Research, University of Goettingen, Goettingen, Germany
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31
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Geis T, Schilling S, Segerer H. [A young infant with afebrile pneumonia caused by Chlamydia trachomatis]. Klin Padiatr 2006; 220:91-2. [PMID: 16888699 DOI: 10.1055/s-2006-942128] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Pregnant women who have an urogenital Chlamydia trachomatis infection may transmit the infection to their infants. Conjunctivitis and nasopharyngeal infection are the most frequent manifestations. Less frequently the infants may develop pneumonia. We report a case of a 5-week-old girl with poor feeding, staccato cough and clinical signs of pneumonia. Chest radiography revealed severe bronchopneumonia. Despite of intravenous therapy with ampicillin and gentamicin respiration deteriorated and oxygen supplementation became necessary. After additional treatment with oral erythromycin (50 mg/kg per day) had been started the clinical condition improved. Polymerase chain reaction with a nasopharyngeal specimen was found to be positive for Chlamydia trachomatis.
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Affiliation(s)
- T Geis
- Klinik für Kinder- und Jugendmedizin St. Hedwig, Krankenhaus Barmherzige Brüder Regensburg.
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Schilling S, Linker RA, König FB, Koziolek M, Bähr M, Müller GA, Paulus W, Gärtner J, Brück W, Chan A, Gold R. Plasmaaustausch bei steroidresistenten Multiple-Sklerose-Schüben. Nervenarzt 2006; 77:430-8. [PMID: 16341736 DOI: 10.1007/s00115-005-2019-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Patients with severe multiple sclerosis (MS) relapses which do not respond sufficiently to corticosteroids can undergo escalating immunotherapy with plasma exchange. We review the course of 14 apheresis cycles in 13 adult patients and three pediatric cases from our center between 2004 and 2005. Nine cases were due to optic neuritis, five had experienced clinically isolated syndromes, and two suffered from Devic's disease. Of the adult patients, 71% had good or very good outcome. The mean time point of improvement was after the third plasmapheresis session, and early initiation of plasma exchange therapy (within 1 month after begin of relapse) was associated with better outcome. In pediatric MS, two of three patients showed clear improvement. These data argue for a very good therapeutic effect of plasma exchange if performed early and with adequate indication.
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Affiliation(s)
- S Schilling
- Institut für Multiple-Sklerose-Forschung, Bereich Humanmedizin der Universität Göttingen und Gemeinnützige Hertie-Stiftung
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Kuhn J, Bewermeyer H, Hartmann-Klosterkoetter U, Emmerich P, Schilling S, Valassina M. Toscana virus causing severe meningoencephalitis in an elderly traveller. J Neurol Neurosurg Psychiatry 2005; 76:1605-6. [PMID: 16227565 PMCID: PMC1739407 DOI: 10.1136/jnnp.2004.060863] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Härtel C, Schilling S, Sperner J, Thyen U. The clinical outcomes of neonatal and childhood stroke: review of the literature and implications for future research. Eur J Neurol 2004; 11:431-8. [PMID: 15257679 DOI: 10.1111/j.1468-1331.2004.00861.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [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: 12/31/2022]
Abstract
A detailed assessment of clinical outcomes after ischemic stroke in childhood is necessary to evaluate prognostic factors. Previous studies are difficult to compare because of differences in test instruments, study design, heterogeneity of cohorts and number of included cases. Depending on neurodevelopmental assessment methods, major and subtle/minor disabilities, especially in infants, may not have been detected. Most outcome studies reveal only limited information about behavioral changes and quality of life in children with ischemic stroke. Thus the assumption that children make a better recovery from stroke than adults due to the immature brain's capacity to reorganize function is not evidence-based. We systematically review the current literature with regard to the neurological and psychosocial development of affected children as well as their quality of life. Implications for future research strategies follow the review to encourage further clinical study of the neurobehavioral trajectory of childhood stroke.
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Affiliation(s)
- C Härtel
- Department of Pediatrics, University of Lübeck Medical School, Lübeck, Germany.
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Boehm BO, Schilling S, Rosinger S, Lang GE, Lang GK, Kientsch-Engel R, Stahl P. Elevated serum levels of N(epsilon)-carboxymethyl-lysine, an advanced glycation end product, are associated with proliferative diabetic retinopathy and macular oedema. Diabetologia 2004; 47:1376-9. [PMID: 15258735 DOI: 10.1007/s00125-004-1455-y] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.3] [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] [Received: 03/01/2004] [Accepted: 05/04/2004] [Indexed: 11/26/2022]
Abstract
AIMS/HYPOTHESIS Diabetic retinopathy is a frequent microvascular complication. In search of novel risk markers, we analysed the association between serum levels of the major advanced glycation end product N(epsilon)-carboxymethyl-lysine (CML) and prevalence of advanced stages of retinopathy in Type 2 diabetic patients without nephropathy. METHODS We carried out a case-control study of Type 2 diabetic patients with and without advanced stages of diabetic retinopathy. Retinopathy and macular oedema were defined according to standard criteria. Serum levels of CML were estimated by means of a novel competition-based ELISA assay. RESULTS Serum levels of CML were significantly different between age-matched controls (n=792; mean value +/- SD: 521+/-134 ng/ml), Type 2 diabetic patients without severe retinopathy (821+/-141 ng/ml; p<0.0001) and Type 2 diabetic patients with proliferative retinopathy (1182+/-346 ng/ml; p<0.0001). Levels of CML greater than 1000 ng/ml represented a 25-fold increase in risk of proliferative retinopathy. Receiver operating characteristics analysis revealed a CML threshold of 1087 ng/ml (100% sensitivity, 93% specificity) for clinically significant macular oedema. CONCLUSIONS/INTERPRETATION High serum levels of CML were associated with advanced stages of retinopathy. Serum levels were shown to be a progressive risk marker, whereby a level of more than 1000 ng/ml induced a 25-fold increase in risk of proliferative retinopathy and clinically significant macular oedema. Our data suggest that serum levels of CML provide a novel risk marker for advanced stages of diabetic retinopathy in Type 2 diabetic patients.
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Affiliation(s)
- B O Boehm
- Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Ulm, Ulm, Germany.
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Dietmaier W, Woenckhaus M, Ruemmele P, Bettstetter M, Schilling S, Schalke M, Hofstaedter F. Microsatellite instability as a predictor of lower relapse frequency in adjuvant chemotherapy treated stage III colon cancer patients. Pathol Res Pract 2004. [DOI: 10.1016/s0344-0338(04)80416-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Suresh S, Schilling S, Dakin C, Harris MA. Palivizumab prophylaxis of respiratory syncytial virus infection in high-risk infants: a note of caution. J Paediatr Child Health 2003; 39:637. [PMID: 14629536 DOI: 10.1046/j.1440-1754.2003.00253.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schilling S, Glaichenhaus N. T cells that react to the immunodominant Leishmania major LACK antigen prevent early dissemination of the parasite in susceptible BALB/c mice. Infect Immun 2001; 69:1212-4. [PMID: 11160025 PMCID: PMC98009 DOI: 10.1128/iai.69.2.1212-1214.2001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Susceptibility of BALB/c mice to Leishmania major depends on the early production of IL-4 by CD4(+) T cells which react to the parasite LACK antigen. Here, we show that LACK-specific cells are rapidly recruited to the site of infection and favor the early dissemination of L. major to the internal organs.
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Affiliation(s)
- S Schilling
- Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, 06560 Valbonne, France
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40
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Küchenhoff J, Könnecke R, Schilling S, Pfisterer M, Ermel S. [Evaluation of infertile men after 1 year of andrological therapy. Results of treatment and its effect on desire for children and self-esteem]. Hautarzt 2000; 51:581-9. [PMID: 10997313 DOI: 10.1007/s001050051175] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Many couples have to cope with periods of involuntary childlessness and they often ask for medical help. In the Heidelberg Project of involuntary childlessness in men, andrological patients were surveyed from the time before diagnosis till the end of 1 year's andrological treatment. PATIENTS/METHODS 145 andrological patients were interviewed and filled out questionnaires to assess their wishes for parenting and their self-esteem. RESULTS As expected men with a normal spermiographic finding had an increased chance to father a child--even more so, when no andrological treatment was performed. For those who remained childless, the wish for parenting had a higher importance than for the eventual fathers. There was little change in self-esteem, either at the beginning of treatment or one year later--with one exception: men who became fathers and had been treated suffered from more social isolation than those who became fathers and had not been treated. CONCLUSIONS Beyond the desired effects of medical treatment, psychological and social effects have to be considered in men with involuntary childlessness, especially with those patients whose spermiogram is not severely reduced.
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Gottschalk R, Seidl C, Schilling S, Braner A, Seifried E, Hoelzer D, Kaltwasser JP. Iron-overload and genotypic expression of HFE mutations H63D/C282Y and transferrin receptor Hin6I and BanI polymorphism in german patients with hereditary haemochromatosis. Eur J Immunogenet 2000; 27:129-34. [PMID: 10940080 DOI: 10.1046/j.1365-2370.2000.00215.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Gene variations of HFE, a HLA-class I like molecule, are highly associated with hereditary haemochromatosis (HH). Functional as well as molecular studies of the HFE protein have indicated that the molecule is involved in iron metabolism and that the HFE gene variations observed among HH patients affect its interaction with the transferrin receptor (TfR). In the present study, we have therefore analysed the relationship between the HFE gene variants, C282Y and H63D, and body iron status among 85 German HH patients. In addition, two TfR gene polymorphism, TfR-Hin6I and TfR-BanI, were typed that have been reported to define ethnically distinct haplotypes. As controls we used 251/159 healthy German blood donors. Seventy-eight (92%) patients were C292Y homozygous, the H63D mutation was present in five (6%) patients with none of the patients being H63D homozygous. Serum transferrin, transferrin saturation and liver iron content were determined prior to therapeutic intervention. Among C282Y homozygous patients serum ferritin levels (2294 +/- 3174 vs. 463 +/- 224 microg L-1, P < 0.0001) and transferrin saturation (86 +/- 18% vs. 62 +/- 25%, P = 0.048) were elevated significantly compared with C282Y and/or H63D heterozygous patients. In addition, the liver iron content (291 +/- 165 vs. 138 +/- 95 micromol g-1, P = 0.028) and liver iron index (6.4 +/- 2.8 vs. 3.2 +/- 2.3, P = 0.019) were increased among C282Y homozygotes compared with C282Y heterozygotes. In contrast, no difference was observed between patients and controls regarding the distribution of TfR-Hin6I and TfR-BanI alleles. These data indicate that the iron intake is higher among C282Y homozygous patients compared with C282Y heterozygous or C282Y/H63D compound heterozygous individuals and supports the functional role of the HFE protein in iron metabolism whereas the TfR gene variants seem to have no influence on iron uptake.
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Affiliation(s)
- R Gottschalk
- Department of Internal Medicine III, J-W Goethe University, Frankfurt/ Main, Germany
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Hertl M, Hertl MC, Kunkel P, Schilling S, Prevot B, Kluth D, Malagó M, Broelsch CE. Tauroursodeoxycholate ameliorates reperfusion injury after pig liver transplantation. Transpl Int 2000; 12:454-62. [PMID: 10654358 DOI: 10.1007/s001470050257] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Reperfusion injury is a serious problem after clinical liver transplantation, often leading to dys- or even non-function of grafts. The present study was designed to determine whether the hydrophilic bile salt tauroursodeoxycholate (TUDC), known to be hepatoprotective in cholestatic liver disease, mitigates reperfusion injury in an in vivo pig liver transplantation model. Liver transplantation was performed in 12 pigs after a preservation time of 8 h. TUDC was administered to donor and recipient animals, and saline to controls. Blood was drawn at different time points for determination of liver enzymes. Bile samples were collected, and bile flow (BF), and bile salt secretion rate (BSSR) determined. Samples of liver tissue and bile ducts were taken for assessment by light and electron microscopy. Liver enzymes were significantly lower in the TUDC group. BF and BSSR were significantly higher. Microscopy revealed better preservation of bile duct architecture of the TUDC-infused animals. We can conclude that infusions of TUDC in pig livers ameliorate reperfusion injury in vivo. The molecular basis for this finding may be the membrane stabilizing effect of TUDC. Further studies are warranted to clarify its effect.
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Affiliation(s)
- M Hertl
- Department of General and Transplantation Surgery, University Hospital Essen, Germany
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Schilling S, Kalodikis L, Hermes B, Kohl PK, Spreng A. Ulcus cruris bei einem 37jährigen Mann als Hinweis auf ein Klinefelter-Syndrom. Phlebologie 1999. [DOI: 10.1055/s-0037-1617155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungIn der Ätiopathogenese des chronischen venösen Ulcus cruris spielen neben den vaskulären weitere hereditäre, hormonelle sowie stoffwechselbedingte Faktoren eine Rolle, welche differentialdiagnostisch berücksichtigt werden müssen. Bei einem 37jährigen Patienten mit Ulcus cruris auf dem Boden einer chronischen venösen Insuffizienz wurde aufgrund verkleinerter Hoden und einer Gynäkomastie, bei insgesamt eher weiblichem Körperbau, ein Klinefelter-Syndrom vermutet, das durch eine Chromosomenanalyse bestätigt wurde. In der Literatur finden sich Hinweise darauf, daß hypostatische Ulcera crurum bei Klinefelter-Patienten 20- bis 50mal häufiger auftreten als in der Normalbevölkerung. Nach Ausschluß einer postthrombotischen Genese des Ulkus ergaben weiterführende Laboruntersuchungen erhöhte Kardiolipin-IgG-Antikörper und einen ebenfalls erhöhten Wert für den Plasminogen-Aktivator-Inhibitor, dessen Aktivität ebenfalls eine Rolle in der Pathogenese der Ulzera bei Klinefelter-Patienten spielen soll.
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Abstract
We have isolated and characterised three barley cDNAs encoding glutathione peroxidase (GPX) homologues, designated HVGPH1, HVGPH2 and HVGPH3. HVGPH1 may represent a cytosolic form of GPX. The structure of the HVGPH2 N-terminal domain is typical for a plastid transit peptide. A potential peroxisomal targeting sequence occurs near the N-terminus of HVGPH3. Transcript levels of HVGPH1 and HVGPH2 were increased in leaves undergoing stress. In contrast, HVGPH3 mRNA accumulation showed a negative response to stress. Our data indicate that the barley genome bears a small gene family encoding GPX homologues differing in their function and cellular localisation.
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Affiliation(s)
- Y Churin
- Institute of Biology, Division of Genetics, Humboldt-University, Chausseestr. 117, D-10115, Berlin, Germany
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Viale A, Ortola C, Richard F, Vernier P, Presse F, Schilling S, Dutrillaux B, Nahon JL. Emergence of a brain-expressed variant melanin-concentrating hormone gene during higher primate evolution: a gene "in search of a function". Mol Biol Evol 1998; 15:196-214. [PMID: 9491616 DOI: 10.1093/oxfordjournals.molbev.a025915] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Two related but distinct melanin-concentrating hormone (MCH) gene systems, i.e., the authentic and variant genes, have been characterized in the human, while only a single MCH gene has been found in the rat. We previously established that the variant gene corresponds to exon-I-deleted copies of the authentic gene mapped on chromosomes 5 and 12, respectively. In this report, we examined the expression of the authentic and variant MCH genes in the human brain. Mature mRNAs of the authentic MCH gene appeared to be predominantly expressed in the hypothalamus, whereas putative unprocessed transcripts of the variant MCH gene were found in other brain areas but not in the hypothalamus. Several products of the variant MCH gene were identified by RACE-PCR in the fetal human brain. One of these transcripts encoded a putative protein of 72 amino acids, while another transcript may potentially generate a protein of 35 amino acids. Thereafter, we explored the question of MCH gene transposition during Primate evolution. Southern blotting, PCR analyses using several genomic DNAs of Primates, and in situ hybridization on metaphase chromosomes led us to define at least three types of genetic events associated with the emergence of the variant MCH gene: (1) translocation of an exon II-exon III copy of the authentic MCH gene onto the equivalent of the human chromosome 5p arm of Anthropoidea ancestors (between 25 and 55 MYA); (2) exon II truncation and mutations before divergence of the Hylobatidae (about 15 MYA); and (3) duplication of the variant gene on the equivalent of the human chromosome 5p and 5q arms in the Hominidae, i.e., 5-10 MYA. Taken together, these results support the hypothesis that transposition/gene rearrangement processes could underlie the evolutionary emergence of new MCH-related genes expressed differentially in the brains of higher Primates, illustrating the concept of genes "in search of function" instead of true "pseudogenes."
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Affiliation(s)
- A Viale
- Institut de Pharmacologie Moléculaire et Cellulaire, CNRS, Valbonne, France
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Faller H, Bülzebruck H, Schilling S, Drings P, Lang H. [Do psychological factors modify survival of cancer patients? II: Results of an empirical study with bronchial carcinoma patients]. Psychother Psychosom Med Psychol 1997; 47:206-18. [PMID: 9333831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The present prospective test study of hypotheses addressed the question whether psychological factors are predictive of survival time in lung cancer patients. The hypotheses were: Emotional distress, depression and depressive coping are associated with shorter survival; hope and active coping with longer survival. The study was based on a sample of n = 103 patients who were investigated post-diagnosis and before the beginning of primary treatment. Emotional distress and hope were assessed by clinical scales (self-reports and interviewer ratings), depression by the Depression Scale of von Zerssen, depressive coping and active coping by the Freiburg Questionnaire on Coping with illness by Muthny. At follow-up, which took place three to five years later, n = 74 patients had died, for n = 29 patients the survival data are censored. The prediction of the survival time was performed applying multivariate analyses (Kaplan-Meier-method, Cox-Regression), adjusting for biological risk factors (histological classification, stage of the disease, type and amount of treatment, Karnofsky performance status, age). Results were as follows: Active coping and hope were associated with longer survival, emotional distress, depression and depressive coping with shorter survival, respectively. These associations were found consistently across assessment methods. The predictive effects of coping and distress were statistically independent of the influence of the somatic risk factors. The best psychological predictor was the interviewer rating of active coping. Its predictive power equalled that of the Karnofsky performance status. However, there was evidence that the effects of the psychological factors varied somewhat in interaction with treatment modalities. The findings are discussed from a methodological perspective. Possible causal models and mechanisms are presented which could account for interactions of psychological measures and the course of the disease: Thus, it can be conceived that psychological effects were mediated by patients' compliance with medical treatment. In addition, it cannot be ruled out that psychological factors themselves were influenced by the physical status of the patients at the time of entry to the study.
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Affiliation(s)
- H Faller
- Institut für Psychotherapie und Medizinische Psychologie, Universität Würzburg. off
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Schilling S, Küchenhoff J, Könnecke R, Tilgen W. [Unfulfilled desire for children in the man: coping and pain. Results of a psychosomatic-andrologic cooperative study]. Hautarzt 1996; 47:686-92. [PMID: 8999024 DOI: 10.1007/s001050050490] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
115 andrological patients were studied with psychological self-assessment tests to assess both their motivation concerning parenthood, and their own explanations for the causes. Additionally self-esteem was evaluated in 51 patients. The main results were: Motivation concerning parenthood is of greater importance in coping with involuntary childlessness than objective andrological data. Patients assess their situation quite realistically; no tendency to misinterpret the medical data in order to defend negative feelings and to protect self-esteem could be found. Most patients with reduced fertility consider this situation a challenge and are willing to mobilize resources and the help of others in order to cope. Self-esteem was only threatened in those patients with longlasting unvoluntary childlessness and little acceptance of medical infertility treatment and parenting substitutes, e.g. adopting a child.
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Affiliation(s)
- S Schilling
- Psychosomatische Klinik, Universität, Heidelberg
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Faller H, Lang H, Schilling S. [Causal "cancer personality" attribution--an expression of maladaptive coping with illness?]. Z Klin Psychol Psychiatr Psychother 1996; 44:104-116. [PMID: 8686364] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
In psycho-oncology, the concept of a "cancer-prone personality" has gained some attention. This notion means that persons who try to stay pseudo-normal in spite of severe life stress, suppress negative emotions, particularly anger, and sacrifice themselves for other people without uttering any personal demands, are at a high risk to develop cancer. However, it has been demonstrated by previous research that features of the cancer-prone personality could only be found if the ill person was convinced to suffer from cancer, irrespective of what the factual diagnosis was. Thus it can be concluded that at least some aspects of the so called cancer personality might be the results of coping with the belief of having cancer. The present study had the objective to describe causal attributions to psychosocial factors in cancer patients, and to find out if these were connected with emotional state and coping. N = 120 newly diagnosed lung cancer patients were included in the study. The instruments consisted of a semi-structured interview, a check-list of subjective causal factors, self-reports and interviewer ratings on emotional state and standardised questionnaires about depression and coping. Patients who made a psychosocial causal attribution proved to suffer from greater emotional distress, to be more depressed and less hopeful than other patients. This difference seemed to be mediated by a depressive way of coping with the illness (brooding, wrangling). Thus, an attribution of the illness to psychological factors seems indicative of a maladaptive way of coping with illness. This result is supported by similar findings of previous research. The question is put up to discussion if the psychosomatic concept of a cancer personality may reflect patients' subjective theories which in turn may be the expression of their depressive coping modes.
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Affiliation(s)
- H Faller
- Institut für Psychotherapie und Medizinische Psychologie Universitt Würzburg
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Abstract
The aim of the present study was to describe lung cancer patients' causal attributions and examine their associations with adaptation. Methods were based on semi-structured interview, content analysis, self-reports, interviewer ratings and standardized questionnaires. 'Smoking cigarettes' and 'toxins in the work place' were the most commonly mentioned possible causes. Patients who made a psychosocial causal attribution suffered greater emotional distress, were more depressed, and less hopeful than other patients. They were also more likely to be rated as showing a maladaptive way of coping with illness. The implications of these findings for psychosocial care are discussed.
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Affiliation(s)
- H Faller
- Institute of Psychotherapy and Medical Psychology, University of Würzburg, Germany
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Faller H, Schilling S, Lang H. [Does coping improve emotional adjustment? Results of a longitudinal study with bronchial carcinoma patients]. Psychother Psychosom Med Psychol 1994; 44:355-64. [PMID: 7972654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Coping research has been able to identify some maladaptive coping behaviours, but only little is known about favorable modes of adaptation. These findings have raised the issue of circularity, i.e. the question as to whether depressive ways of coping are actually the cause or rather the effect of emotional distress, whether those correlations reflect different aspects of psychological distress, or, even worse, confounded measures. Cross-sectional correlations are unable to solve this problem. The present study applies cross-lagged multiple regression analysis within a panel design. N = 120 newly diagnosed lung cancer patients who were admitted to a large tumor centre are included in the sample. Patients are assessed by self-reports and interviewer-ratings on measures of psychological adjustment (distress, hope) and coping (active confrontation, arguing with one's fate, consolation, distancing) at three times: Time 1 pre-treatment, Time 2 post-treatment, Time 3 recurrence. Results pertaining to the course of the measures of adjustment and coping are presented. Systematic deteriorating effects can be reveiled only at time 3. Stability coefficients prove to be lower than expected, especially with respect to the longer time interval. The cross-lagged pane 1 design allows testing alternative causal models. The time 1- time 2 results show, that arguing with one's fate may lead to future emotional distress, whereas hope is connected with reduced future arguing with one's fate. These short term findings are confirmed in the prediction of the time 3-data. In addition, consolation seems to have a negative impact on hope in the long term.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Faller
- Institut für Psychotherapie und Medizinische Psychologie, Universität Würzburg
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