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Vella L, Sternjakob A, Lohse S, Fingerle A, Sperling T, Wickenhauser C, Stöckle M, Vogt T, Roemer K, Ołdak M, Smola S. The cutaneous beta human papillomavirus type 8 E6 protein induces CCL2 through the CEBPα/miR-203/p63 pathway to support an inflammatory microenvironment in epidermodysplasia verruciformis skin lesions. Front Cell Infect Microbiol 2024; 14:1336492. [PMID: 38510961 PMCID: PMC10953690 DOI: 10.3389/fcimb.2024.1336492] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Human papillomavirus type 8 (HPV8), a cutaneous genus beta HPV type, has co-carcinogenic potential at sun-exposed sites in patients suffering from the inherited skin disease epidermodysplasia verruciformis (EV). We had previously shown that Langerhans cells responsible for epithelial immunosurveillance were strongly reduced at infected sites and that the HPV8 E7 protein interferes with the CCAAT/enhancer-binding protein (C/EBP)β to suppress the Langerhans cell chemokine CCL20. At the same time, however, we observed that EV lesions are heavily infiltrated with inflammatory immune cells, which is similar to the situation in HPV8 E6 transgenic mice. To identify critical inflammatory factors, we used a broad multiplex approach and found that the monocyte attracting chemokine CCL2 was significantly and strongly induced by HPV8 E6 but not E7-expressing HaCaT cells, which were used as a model for UV-damaged skin keratinocytes. Conditioned media from HPV8 E6-expressing keratinocytes enhanced CCL2-receptor (CCR2)-dependent monocyte recruitment in vitro, and macrophages predominated in the stroma but were also detected in the epidermal compartment of EV lesions in vivo. CCL2 induction by HPV8 E6 was even stronger than stimulation with the proinflammatory cytokine TNF-α, and both HPV8 E6 and TNF-α resulted in substantial suppression of the transcription factor C/EBPα. Using RNAi-mediated knockdown and overexpression approaches, we demonstrated a mechanistic role of the recently identified C/EBPα/miR-203/p63 pathway for HPV8 E6-mediated CCL2 induction at protein and transcriptional levels. Epithelial co-expression of p63 and CCL2 was confirmed in HPV8 E6-expressing organotypic air-liquid interface cultures and in lesional EV epidermis in vivo. In summary, our data demonstrate that HPV8 oncoproteins actively deregulate epidermal immune homeostasis through modulation of C/EBP factor-dependent pathways. While HPV8 E7 suppresses immunosurveillance required for viral persistence, the present study provides evidence that E6 involves the stemness-promoting factor p63 to support an inflammatory microenvironment that may fuel carcinogenesis in EV lesions.
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Affiliation(s)
- Luca Vella
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Anna Sternjakob
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Alina Fingerle
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Tanya Sperling
- Institute of Virology, University of Cologne, Cologne, Germany
| | | | - Michael Stöckle
- Department of Urology and Pediatric Urology, Saarland University Medical Center, Homburg, Germany
| | - Thomas Vogt
- Department of Dermatology, Saarland University Medical Center, Homburg, Germany
| | - Klaus Roemer
- Jose Carreras Center for Immune and Gene Therapy, Saarland University Medical Center, Homburg, Germany
| | - Monika Ołdak
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
- Department of Histology and Embryology, Medical University of Warsaw, Warsaw, Poland
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research, Saarbrücken, Germany
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Abu Dail Y, Daas L, Flockerzi E, Munteanu C, Kahlert J, Smola S, Seitz B. PCR testing for herpesviruses in aqueous humor samples from patients with and without clinical corneal endothelial graft rejection. J Med Virol 2024; 96:e29538. [PMID: 38506230 DOI: 10.1002/jmv.29538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/11/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
To compare prevalence of positive PCR tests for herpesviruses between patients with and without a history of clinical corneal endothelial allograft rejection (AGR). Retrospective cross-sectional study with two-group comparison. A total of 307 aqueous humor (AH) samples from 235 Patients and 244 eyes who underwent penetrating keratoplasty or Descemet membrane endothelial keratoplasty or had a diagnostic AH aspiration due to clinical AGR between 2019 and 2023 were tested for DNA of herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). PCR test results were compared between the two groups (with/without AGR). Another sub-analysis examined the results of patients without a history of herpetic keratitis. A total of 8% of eyes with clinical AGR (9/108) had a positive PCR result for one of the herpesviruses (HSV:3, CMV:3, EBV:2, VZV:1). All patients in the group without AGR had negative PCR results for all previous viruses (0/136). The difference was statistically significant (p < 0.001). The sub-analysis of eyes without a history of herpetic keratitis also revealed significantly more positive herpes PCR results (7/87) in eyes with AGR than in eyes without AGR (0/42, p = 0.005). Clinical AGR after keratoplasty shows a significant correlation to viral replication. Herpetic infection and AGR could occur simultaneously and act synergistically. Timely differentiation between active herpetic infection and/or AGR is pivotal for proper treatment and graft preservation.
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Affiliation(s)
- Yaser Abu Dail
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Loay Daas
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Elias Flockerzi
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Cristian Munteanu
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Julian Kahlert
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Sigrun Smola
- Department of Virology, Institute of Virology, Saarland University Medical Center, Homburg, Saarland, Germany
- Department of Virology, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research, Saarbrücken, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saarland, Germany
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Fu Y, Wedde M, Smola S, Oh DY, Pfuhl T, Rissland J, Zemlin M, Flockerzi FA, Bohle RM, Thürmer A, Duwe S, Biere B, Reiche J, Schweiger B, Mache C, Wolff T, Herrler G, Dürrwald R. Different populations of A(H1N1)pdm09 viruses in a patient with hemolytic-uremic syndrome. Int J Med Microbiol 2024; 314:151598. [PMID: 38237287 DOI: 10.1016/j.ijmm.2024.151598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 03/22/2024] Open
Abstract
Respiratory viral infections may have different impacts ranging from infection without symptoms to severe disease or even death though the reasons are not well characterized. A patient (age group 5-15 years) displaying symptoms of hemolytic uremic syndrome died one day after hospitalization. qPCR, next generation sequencing, virus isolation, antigenic characterization, resistance analysis was performed and virus replication kinetics in well-differentiated airway cells were determined. Autopsy revealed hemorrhagic pneumonia as major pathological manifestation. Lung samples harbored a large population of A(H1N1)pdm09 viruses with the polymorphism H456H/Y in PB1 polymerase. The H456H/Y viruses replicated much faster to high viral titers than upper respiratory tract viruses in vitro. H456H/Y-infected air-liquid interface cultures of differentiated airway epithelial cells did reflect a more pronounced loss of ciliated cells. A different pattern of virus quasispecies was found in the upper airway samples where substitution S263S/F (HA1) was observed. The data support the notion that viral quasispecies had evolved locally in the lung to support high replicative fitness. This change may have initiated further pathogenic processes leading to rapid dissemination of inflammatory mediators followed by development of hemorrhagic lung lesions and fatal outcome.
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Affiliation(s)
- Yuguang Fu
- State Key Laboratory of Veterinary Etiological Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou 730046, China; Institute of Virology, University of Veterinary Medicine Hannover, Foundation, Hannover 30559, Germany
| | - Marianne Wedde
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Saar 66421, Germany
| | - Djin-Ye Oh
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, Homburg, Saar 66421, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, Homburg, Saar 66421, Germany
| | - Michael Zemlin
- Department for General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Saar 66421, Germany
| | - Fidelis A Flockerzi
- Institute of Pathology, Saarland University Medical Center, Homburg, Saar 66421, Germany
| | - Rainer M Bohle
- Institute of Pathology, Saarland University Medical Center, Homburg, Saar 66421, Germany
| | - Andrea Thürmer
- Department Methods Development and Research Infrastructure, Robert Koch Institute, Berlin 13353, Germany
| | - Susanne Duwe
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Barbara Biere
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Janine Reiche
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Brunhilde Schweiger
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Christin Mache
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Thorsten Wolff
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany
| | - Georg Herrler
- Institute of Virology, University of Veterinary Medicine Hannover, Foundation, Hannover 30559, Germany
| | - Ralf Dürrwald
- Influenza and other Respiratory Viruses, Department of Infectious Diseases, Unit 17, Influenza and other Respratory Viruses, Robert Koch Institute, Berlin 13353, Germany.
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Rimbach H, Linxweiler M, Körner S, Smola S, Linxweiler B, Speicher S, Helfrich J, Solomayer EF, Wagner M, Schick B, Kühn JP. Prediction of lymph node status in patients with surgically treated head and neck squamous cell carcinoma via neck lavage cytology: A pilot study. Cancer Cytopathol 2024. [PMID: 38329321 DOI: 10.1002/cncy.22800] [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: 10/12/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Neck dissection is a standardized surgical procedure for patients with head and neck squamous cell carcinoma (HNSCC) and plays a critical role in the choice of adjuvant treatment based on histopathological findings. Saline irrigation is routinely performed at the end of surgery. However, this irrigant is not used for diagnostic purposes. METHODS Intraoperative irrigation of the neck dissection wound was performed in 56 patients with HNSCC (N = 93 neck dissections), and the cytological suspension obtained was processed via the liquid-based cytology (LBC) technique, Papanicolaou staining, and immunocytochemical staining. Microscopic preparations were screened for the presence of tumor cells and classified as positive, borderline, or negative. These results were correlated with the histopathological and clinical data. RESULTS Neck lavage LBC demonstrated high diagnostic value in detecting lymph node metastases (N+) with extracapsular spread (ECS), with a specificity, sensitivity, negative predictive value, and positive predictive value of 93.1%, 100%, 100%, and 80%, respectively. Tumor cells were detected in 4.8% of N- cases, 20% of N+ cases without ECS, and 100% of N+ cases with ECS. Receiver operating characteristic curve analysis showed an area under the curve of 0.8429 for the prediction of N+ (p < .0001) and 0.9658 for the prediction of N+ with ECS (p < .0001). CONCLUSIONS Differential lavage cytology can provide valid and rapid information on the lymph node status in patients with HNSCC and showed an excellent correlation with histopathology. Thus, neck lavage LBC may facilitate faster and more reasonable planning of adjuvant treatment and help improve the therapeutic management of patients with HNSCC.
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Affiliation(s)
- Hugo Rimbach
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | | | - Sandrina Körner
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University, Homburg/Saar, Germany
| | | | - Stefanie Speicher
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | - Johanna Helfrich
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | | | - Mathias Wagner
- Department of Pathology, Saarland University, Homburg/Saar, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
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Och K, Turki AT, Götz KM, Selzer D, Brossette C, Theobald S, Braun Y, Graf N, Rauch J, Rohm K, Weiler G, Kiefer S, Schwarz U, Eisenberg L, Pfeifer N, Ihle M, Grandjean A, Fix S, Riede C, Rissland J, Smola S, Beelen DW, Kaddu‐Mulindwa D, Bittenbring J, Lehr T. A dynamic time-to-event model for prediction of acute graft-versus-host disease in patients after allogeneic hematopoietic stem cell transplantation. Cancer Med 2023; 13:e6833. [PMID: 38132807 PMCID: PMC10807572 DOI: 10.1002/cam4.6833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/26/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Acute graft-versus-host disease (aGvHD) is a major cause of death for patients following allogeneic hematopoietic stem cell transplantation (HSCT). Effective management of moderate to severe aGvHD remains challenging despite recent advances in HSCT, emphasizing the importance of prophylaxis and risk factor identification. METHODS In this study, we analyzed data from 1479 adults who underwent HSCT between 2005 and 2017 to investigate the effects of aGvHD prophylaxis and time-dependent risk factors on the development of grades II-IV aGvHD within 100 days post-HSCT. RESULTS Using a dynamic longitudinal time-to-event model, we observed a non-monotonic baseline hazard overtime with a low hazard during the first few days and a maximum hazard at day 17, described by Bateman function with a mean transit time of approximately 11 days. Multivariable analysis revealed significant time-dependent effects of white blood cell counts and cyclosporine A exposure as well as static effects of female donors for male recipients, patients with matched related donors, conditioning regimen consisting of fludarabine plus total body irradiation, and patient age in recipients of grafts from related donors on the risk to develop grades II-IV aGvHD. Additionally, we found that higher cumulative hazard on day 7 after allo-HSCT are associated with an increased incidence of grades II-IV aGvHD within 100 days indicating that an individual assessment of the cumulative hazard on day 7 could potentially serve as valuable predictor for later grades II-IV aGvHD development. Using the final model, stochastic simulations were performed to explore covariate effects on the cumulative incidence over time and to estimate risk ratios. CONCLUSION Overall, the presented model showed good descriptive and predictive performance and provides valuable insights into the interplay of multiple static and time-dependent risk factors for the prediction of aGvHD.
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Affiliation(s)
- Katharina Och
- Department of Clinical PharmacySaarland UniversitySaarbrückenGermany
| | - Amin T. Turki
- Department of Hematology and Stem Cell Transplantation, West‐German Cancer CenterUniversity Hospital EssenEssenGermany
| | - Katharina M. Götz
- Department of Clinical PharmacySaarland UniversitySaarbrückenGermany
| | - Dominik Selzer
- Department of Clinical PharmacySaarland UniversitySaarbrückenGermany
| | - Christian Brossette
- Department of Pediatric Oncology and HematologySaarland UniversityHomburgGermany
| | - Stefan Theobald
- Department of Pediatric Oncology and HematologySaarland UniversityHomburgGermany
| | - Yvonne Braun
- Department of Pediatric Oncology and HematologySaarland UniversityHomburgGermany
| | - Norbert Graf
- Department of Pediatric Oncology and HematologySaarland UniversityHomburgGermany
| | - Jochen Rauch
- Department of Biomedical Data & BioethicsFraunhofer Institute for Biomedical Engineering (IBMT)SulzbachGermany
| | - Kerstin Rohm
- Department of Biomedical Data & BioethicsFraunhofer Institute for Biomedical Engineering (IBMT)SulzbachGermany
| | - Gabriele Weiler
- Department of Biomedical Data & BioethicsFraunhofer Institute for Biomedical Engineering (IBMT)SulzbachGermany
| | - Stephan Kiefer
- Department of Biomedical Data & BioethicsFraunhofer Institute for Biomedical Engineering (IBMT)SulzbachGermany
| | - Ulf Schwarz
- Institute for Formal Ontology and Medical Information ScienceSaarland UniversitySaarbrückenGermany
| | - Lisa Eisenberg
- Department of Computer ScienceUniversity of TübingenTübingenGermany
| | - Nico Pfeifer
- Department of Computer ScienceUniversity of TübingenTübingenGermany
| | | | | | | | | | - Jürgen Rissland
- Institute of VirologySaarland University Medical CentreHomburgGermany
| | - Sigrun Smola
- Institute of VirologySaarland University Medical CentreHomburgGermany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI)Saarland University CampusSaarbrückenGermany
| | - Dietrich W. Beelen
- Department of Hematology and Stem Cell Transplantation, West‐German Cancer CenterUniversity Hospital EssenEssenGermany
| | | | - Jörg Bittenbring
- Department of Internal Medicine 1University Hospital of the SaarlandHomburgGermany
| | - Thorsten Lehr
- Department of Clinical PharmacySaarland UniversitySaarbrückenGermany
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Fröhlich F, Gronwald B, Bay J, Simon A, Poryo M, Geisel J, Tegethoff SA, Last K, Rissland J, Smola S, Becker SL, Zemlin M, Meyer S, Papan C. Expression of TRAIL, IP-10, and CRP in children with suspected COVID-19 and real-life impact of a computational signature on clinical decision-making: a prospective cohort study. Infection 2023; 51:1349-1356. [PMID: 36757525 PMCID: PMC9910257 DOI: 10.1007/s15010-023-01993-1] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE We evaluated the host-response marker score "BV" and its components TRAIL, IP-10, and CRP in SARS-CoV-2 positive children, and estimated the potential impact on clinical decision-making. METHODS We prospectively analyzed levels of TRAIL, IP-10, CRP, and the BV score, in children with suspected COVID-19. Classification of infectious etiology was performed by an expert panel. We used a 5-point-questionnaire to evaluate the intention to treat with antibiotics before and after receiving test results. RESULTS We screened 111 children, of whom 6 (5.4%) were positive for SARS-CoV-2. A total of 53 children were included for the exploratory analysis. Median age was 3.1 years (interquartile range [IQR] 1.3-4.3), and 54.7% (n = 29) were girls. A viral and a bacterial biomarker pattern was found in 27/53 (50.9%) and 15/53 (28.3%), respectively. BV scores differed between COVID-19, children with other viral infections, and children with bacterial infections (medians 29.5 vs. 9 vs. 66; p = 0.0006). Similarly, median TRAIL levels were different (65.5 vs. 110 vs. 78; p = 0.037). We found no differences in IP-10 levels (555 vs. 504 vs. 285; p = 0.22). We found a concordance between physicians' "unlikely intention to treat" children with a viral test result in most cases (n = 19/24, 79.2%). When physicians expressed a "likely intention to treat" (n = 15), BV test revealed 5 bacterial, viral, and equivocal scores each. Antibiotics were withheld in three cases (20%). Overall, 27/42 (64%) of pediatricians appraised the BV test positively, and considered it helpful in clinical practice. CONCLUSION Host-response based categorization of infectious diseases might help to overcome diagnostic uncertainty, support clinical decision-making and reduce unnecessary antibiotic treatment.
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Affiliation(s)
- Franziska Fröhlich
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, Homburg, Germany
- Department of General Pediatrics and Neonatology, Saarland University Hospital, Homburg, Germany
| | - Benjamin Gronwald
- Department of General Pediatrics and Neonatology, Saarland University Hospital, Homburg, Germany
| | - Johannes Bay
- Department of General Pediatrics and Neonatology, Saarland University Hospital, Homburg, Germany
| | - Arne Simon
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Martin Poryo
- Department of Pediatric Cardiology, Saarland University Hospital, Homburg, Germany
| | - Jürgen Geisel
- Department of Clinical Chemistry and Laboratory Medicine, Saarland University Medical Centre, Saarland University Hospital, Homburg, Germany
| | - Sina A Tegethoff
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, Homburg, Germany
| | - Katharina Last
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, Homburg, Germany
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
- Helmholtz Center for Infection Research (HZI), Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarland University Campus, Saarbrücken, Germany
| | - Sören L Becker
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, Homburg, Germany
| | - Michael Zemlin
- Department of General Pediatrics and Neonatology, Saarland University Hospital, Homburg, Germany
| | - Sascha Meyer
- Department of General Pediatrics and Neonatology, Saarland University Hospital, Homburg, Germany
| | - Cihan Papan
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, Homburg, Germany.
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany.
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Stein JA, Kaes M, Smola S, Schulz-Schaeffer WJ. Neuropathology in COVID-19 autopsies is defined by microglial activation and lesions of the white matter with emphasis in cerebellar and brain stem areas. Front Neurol 2023; 14:1229641. [PMID: 37521293 PMCID: PMC10374362 DOI: 10.3389/fneur.2023.1229641] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction This study aimed to investigate microglial and macrophage activation in 17 patients who died in the context of a COVID-19 infection in 2020 and 2021. Methods Through immunohistochemical analysis, the lysosomal marker CD68 was used to detect diffuse parenchymal microglial activity, pronounced perivascular macrophage activation and macrophage clusters. COVID-19 patients were compared to control patients and grouped regarding clinical aspects. Detection of viral proteins was attempted in different regions through multiple commercially available antibodies. Results Microglial and macrophage activation was most pronounced in the white matter with emphasis in brain stem and cerebellar areas. Analysis of lesion patterns yielded no correlation between disease severity and neuropathological changes. Occurrence of macrophage clusters could not be associated with a severe course of disease or preconditions but represent a more advanced stage of microglial and macrophage activation. Severe neuropathological changes in COVID-19 were comparable to severe Influenza. Hypoxic damage was not a confounder to the described neuropathology. The macrophage/microglia reaction was less pronounced in post COVID-19 patients, but detectable i.e. in the brain stem. Commercially available antibodies for detection of SARS-CoV-2 virus material in immunohistochemistry yielded no specific signal over controls. Conclusion The presented microglial and macrophage activation might be an explanation for the long COVID syndrome.
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Affiliation(s)
- Julian A. Stein
- Institute of Neuropathology, Medical Faculty of the Saarland University, Homburg, Germany
| | - Manuel Kaes
- Institute of Neuropathology, Medical Faculty of the Saarland University, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research, Saarbrücken, Germany
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Knebel M, Körner S, Kühn JP, Wemmert S, Brust L, Smola S, Wagner M, Bohle RM, Morris LGT, Pandey A, Schick B, Linxweiler M. Prognostic impact of intra- and peritumoral immune cell subpopulations in head and neck squamous cell carcinomas - comprehensive analysis of the TCGA-HNSC cohort and immunohistochemical validation on 101 patients. Front Immunol 2023; 14:1172768. [PMID: 37383237 PMCID: PMC10294051 DOI: 10.3389/fimmu.2023.1172768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/31/2023] [Indexed: 06/30/2023] Open
Abstract
Background Due to the expanding role of immune checkpoint inhibition in the treatment of head and neck squamous cell carcinoma, understanding immunological processes in the tumor microevironment (TME) has strong translational importance. Though analytical methods for a comprehensive analysis of the immunological TME have constantly improved and expanded over the past years the prognostic relevance of immune cell composition in head and neck cancer TME largely remains ambiguous with most studies focusing on one or a small subset of immune cells. Methods The overall survival (OS) of the TCGA-HNSC patient cohort comprising 513 head and neck cancer patients was correlated with a total of 29 different immune metrics including a wide spectrum of immune cell subpopulations as well as immune checkpoint receptors and cytokines using RNAseq based immune deconvolution analyses. The most significant predictors of survival among these 29 immune metrics were validated on a separate HNSCC patient cohort (n=101) using immunohistochemistry: CD3, CD20+CXCR5, CD4+CXCR5, Foxp3 and CD68. Results Overall immune infiltration irrespective of immune cell composition showed no significant correlation with the patients' overall survival in the TCGA-HNSC cohort. However, when focusing on different immune cell subpopulations, naïve B cells (p=0.0006), follicular T-helper cells (p<0.0001), macrophages (p=0.0042), regulatory T cells (p=0.0306), lymphocytes (p=0.0001), and cytotoxic T cells (p=0.0242) were identified as highly significant predictors of improved patient survival. Using immunohistochemical detection of these immune cells in a second independent validation cohort of 101 HNSCC patients, we confirmed the prognostic relevance of follicular T helper cells, cytotoxic T cells and lymphocytes. In multivariable analysis, HPV negativity and advanced UICC stages were identified as additional prognostic biomarkers associated with poor outcome. Conclusion Our study highlights the prognostic relevance of the immunological tumor environment in head and neck cancer and demonstrates that a more detailed analysis of immune cell composition and immune cell subtypes is necessary to accurately prognosticate. We observed the highest prognostic relevance for lymphocytes, cytotoxic T cells, and follicular T helper cells, suggesting further investigations focusing on these specific immune cell subpopulations not only as predictors of patient prognosis but also as promising targets of new immunotherapeutic strategies.
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Affiliation(s)
- Moritz Knebel
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Sandrina Körner
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Silke Wemmert
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Lukas Brust
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Rainer M. Bohle
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Luc G. T. Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY, United States
| | - Abhinav Pandey
- Weill Cornell School of Medical Sciences, New York City, NY, United States
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
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9
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Tegethoff SA, Eisenbeis J, Danziger G, Last K, Geisel J, Rissland J, Krawczyk M, Lepper PM, Becker SL, Smola S, Papan C. Evaluation of the host-response biomarker IP-10 in predicting SARS-CoV-2 infectiousness. J Hosp Infect 2023; 135:201-203. [PMID: 36898433 PMCID: PMC9995295 DOI: 10.1016/j.jhin.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023]
Affiliation(s)
- Sina A Tegethoff
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Janina Eisenbeis
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Guy Danziger
- Department of Medicine V: Pneumology, Allergology and Intensiv Care Medicine, ECLS Center Saar, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Katharina Last
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany; Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Jürgen Geisel
- Department of Clinical Chemistry and Laboratory Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Philipp M Lepper
- Department of Medicine V: Pneumology, Allergology and Intensiv Care Medicine, ECLS Center Saar, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Sören L Becker
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany; Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany
| | - Cihan Papan
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany; Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany.
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10
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Kos IA, Kiefer M, Brill K, Cetin O, Bittenbring JT, Ahlgrimm M, Smola S, Lohse S, Christofyllakis K, Kaddu-Mulindwa D, Neumann F, Bewarder M, Thurner L. Adaptive humoral immune response and cellular immune status in cancer patients and patients under immunosuppression vaccinated against SARS-CoV-2. Expert Rev Vaccines 2022; 21:1683-1689. [PMID: 35994606 DOI: 10.1080/14760584.2022.2116009] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Patients with cancer and autoimmune diseases are at higher risk of severe COVID-19. They may not develop protective immune responses following vaccination. We investigated patients' cellular and humoral immune response after two COVID-19 vaccine doses. RESEARCH DESIGN AND METHODS Subjects were stratified into subgroups according to therapy and grade of immunosuppression at time of vaccination. RESULTS Antibody titers were compared to healthy controls. 32/122 (26%) did not develop detectable antibody titers. Of these, 22 (66.6%) had active therapy. Patients showed significant lower antibody titers compared to controls (median 790 vs. 3923 AU/mL, p = 0.026). Patients with active therapy had significant lower antibody titers compared to those without (median 302 vs. 3952 U/L P < 0.001). B-cell count was lower in the group without antibody titers (median 29.97 vs. 152.8; p = 0.002). 100% of patients under anti-CD20 therapy had no detectable antibody titer, followed by anti-TNF (66%), BTK inhibitors (50%), ruxolitinib (35.5%), TKI (14.2%), and lenalidomide (12.5%). Anti-CD20 therapy, ruxolitinib, BTK inhibitors, and anti-CD38 therapy presented significant lower antibody titers compared to controls. CONCLUSIONS Patients undergoing therapy for cancer or autoimmune diseases are at higher risk of insufficient humoral immune response following COVID-19 vaccination. Furthermore, alterations in the B-cell compartment correlate with lower antibody titers.
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Affiliation(s)
- Igor Age Kos
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Maximilian Kiefer
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Katharina Brill
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Onur Cetin
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Joerg Thomas Bittenbring
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Manfred Ahlgrimm
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Konstantinos Christofyllakis
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Dominic Kaddu-Mulindwa
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Frank Neumann
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Moritz Bewarder
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
| | - Lorenz Thurner
- Department of Internal Medicine I, Hematology and Oncology, Rheumatology and Clinical Immunology, Saarland University Medical Center, Homburg, Germany
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11
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Thurner L, Kessel C, Fadle N, Regitz E, Seidel F, Kindermann I, Lohse S, Kos I, Tschöpe C, Kheiroddin P, Kiblboeck D, Hoffmann MC, Bette B, Carbon G, Cetin O, Preuss KD, Christofyllakis K, Bittenbring JT, Pickardt T, Fischer Y, Thiele H, Baldus S, Stangl K, Steiner S, Gietzen F, Kerber S, Deneke T, Jellinghaus S, Linke A, Ibrahim K, Grabmaier U, Massberg S, Thilo C, Greulich S, Gawaz M, Mayatepek E, Meyer-Dobkowitz L, Kindermann M, Birk E, Birk M, Lainscak M, Foell D, Lepper PM, Bals R, Krawczyk M, Mevorach D, Hasin T, Keren A, Kabesch M, Abdul-Khaliq H, Smola S, Bewarder M, Thurner B, Böhm M, Pfeifer J, Klingel K. IL-1RA Antibodies in Myocarditis after SARS-CoV-2 Vaccination. N Engl J Med 2022; 387:1524-1527. [PMID: 36130012 PMCID: PMC9513854 DOI: 10.1056/nejmc2205667] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | | | | | | | | | | | | | - Igor Kos
- Saarland University, Homburg, Germany
| | | | | | | | | | | | | | | | | | | | | | - Thomas Pickardt
- Competence Network for Congenital Heart Defects, Berlin, Germany
| | - Yvan Fischer
- Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | | | | | - Karl Stangl
- Charité University Medicine Berlin, Berlin, Germany
| | | | - Frank Gietzen
- Cardiovascular Center Bad Neustadt-Saale, Bad Neustadt-Saale, Germany
| | - Sebastian Kerber
- Cardiovascular Center Bad Neustadt-Saale, Bad Neustadt-Saale, Germany
| | - Thomas Deneke
- Cardiovascular Center Bad Neustadt-Saale, Bad Neustadt-Saale, Germany
| | | | - Axel Linke
- Technische Universität Dresden, Dresden, Germany
| | | | | | | | | | | | | | - Ertan Mayatepek
- University Children's Hospital Duesseldorf, Duesseldorf, Germany
| | | | | | - Einat Birk
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Merav Birk
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | | | - Dirk Foell
- University Children's Hospital Muenster, Muenster, Germany
| | | | | | | | | | - Tal Hasin
- Shaare Zedek Medical Center, Jerusalem, Israel
| | - Andre Keren
- Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Michael Kabesch
- University Children's Hospital Regensburg, Regensburg, Germany
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12
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Mohr T, Zwick A, Hans MC, Bley IA, Braun FL, Khalmurzaev O, Matveev VB, Loertzer P, Pryalukhin A, Hartmann A, Geppert CI, Loertzer H, Wunderlich H, Naumann CM, Kalthoff H, Junker K, Smola S, Lohse S. The prominent role of the S100A8/S100A9-CD147 axis in the progression of penile cancer. Front Oncol 2022; 12:891511. [PMID: 36303837 PMCID: PMC9592847 DOI: 10.3389/fonc.2022.891511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Currently, no established biomarkers are recommended for the routine diagnosis of penile carcinoma (PeCa). The rising incidence of this human papillomavirus (HPV)–related cancer entity highlights the need for promising candidates. The Calprotectin subunits S100A8 and S100A9 mark myeloid-derived suppressor cells in other HPV-related entities while their receptor CD147 was discussed to identify patients with PeCa at a higher risk for poor prognoses and treatment failure. We thus examined their expression using immunohistochemistry staining of PeCa specimens from 74 patients on tissue microarrays of the tumor center, the invasion front, and lymph node metastases. Notably, whereas the tumor center was significantly more intensively stained than the invasion front, lymph node metastases were thoroughly positive for both S100 subunits. An HPV-positive status combined with an S100A8+S100A9+ profile was related with an elevated risk for metastases. We observed several PeCa specimens with S100A8+S100A9+-infiltrating immune cells overlapping with CD15 marking neutrophils. The S100A8+S100A9+CD15+ profile was associated with dedifferentiated and metastasizing PeCa, predominantly of HPV-associated subtype. These data suggest a contribution of neutrophil-derived suppressor cells to the progression of HPV-driven penile carcinogenesis. CD147 was elevated, expressed in PeCa specimens, prominently at the tumor center and in HPV-positive PeCa cell lines. CD147+HPV+ PeCa specimens were with the higher-frequency metastasizing cancers. Moreover, an elevated expression of CD147 of HPV-positive PeCa cell lines correlated negatively with the susceptibility to IgA-based neutrophil-mediated tumor cell killing. Finally, stratifying patients regarding their HPV/S100A8/S100A9/CD15/CD147 profile may help identify patients with progressing cancer and tailor immunotherapeutic treatment strategies.
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Affiliation(s)
- Tobias Mohr
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Anabel Zwick
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | | | | | - Felix Leon Braun
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Oybek Khalmurzaev
- Department of Urology and Paediatric Urology, Saarland University Medical Center, Homburg, Germany
- Department of Urology, Federal State Budgetary Institution “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vsevolod Borisovich Matveev
- Department of Urology, Federal State Budgetary Institution “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Philine Loertzer
- Department of Urology and Paediatric Urology, Westpfalz Klinikum, Kaiserslautern, Germany
| | - Alexey Pryalukhin
- Institute of Pathology, Saarland University Medical Center, Homburg, Germany
- Institute of Pathology, University Medical Center Bonn, Bonn, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Hagen Loertzer
- Department of Urology and Paediatric Urology, Westpfalz Klinikum, Kaiserslautern, Germany
| | - Heiko Wunderlich
- Department of Urology and Paediatric Urology, St. Georg Klinikum, Eisenach, Germany
| | - Carsten Maik Naumann
- Department of Urology and Paediatric Urology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Holger Kalthoff
- Division of Molecular Oncology, Institute of Experimental Cancer Research, University Hospital Schleswig Holstein, Kiel, Germany
| | - Kerstin Junker
- Department of Urology and Paediatric Urology, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
- *Correspondence: Stefan Lohse,
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13
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Mohr T, Zwick A, Hans M, Bley I, Braun F, Khalmurzaev O, Matveev V, Loertzer P, Pryalukhin A, Hartmann A, Loertzer H, Geppert C, Wunderlich H, Naumann C, Kalthoff H, Junker K, Smola S, Lohse S. The prominent role of the Calprotectin-CD147-neutrophil axis in the progression of penile cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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14
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Dings C, Götz KM, Och K, Sihinevich I, Werthner Q, Smola S, Bliem M, Mahfoud F, Volk T, Kreuer S, Rissland J, Selzer D, Lehr T. Model-Based Analysis of SARS-CoV-2 Infections, Hospitalization and Outcome in Germany, the Federal States and Districts. Viruses 2022; 14:2114. [PMID: 36298669 PMCID: PMC9607468 DOI: 10.3390/v14102114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/01/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic challenged many national health care systems, with hospitals reaching capacity limits of intensive care units (ICU). Thus, the estimation of acute local burden of ICUs is critical for appropriate management of health care resources. In this work, we applied non-linear mixed effects modeling to develop an epidemiological SARS-CoV-2 infection model for Germany, with its 16 federal states and 400 districts, that describes infections as well as COVID-19 inpatients, ICU patients with and without mechanical ventilation, recoveries, and fatalities during the first two waves of the pandemic until April 2021. Based on model analyses, covariates influencing the relation between infections and outcomes were explored. Non-pharmaceutical interventions imposed by governments were found to have a major impact on the spreading of SARS-CoV-2. Patient age and sex, the spread of variant B.1.1.7, and the testing strategy (number of tests performed weekly, rate of positive tests) affected the severity and outcome of recorded cases and could reduce the observed unexplained variability between the states. Modeling could reasonably link the discrepancies between fine-grained model simulations of the 400 German districts and the reported number of available ICU beds to coarse-grained COVID-19 patient distribution patterns within German regions.
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Affiliation(s)
- Christiane Dings
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | | | - Katharina Och
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Iryna Sihinevich
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Quirin Werthner
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), 66123 Saarbrücken, Germany
| | - Marc Bliem
- CompuGroup Medical (CGM), 56070 Koblenz, Germany
| | - Felix Mahfoud
- Department of Internal Medicine III (Cardiology, Angiology, Intensive Care Medicine), Saarland University Medical Center and Saarland University Faculty of Medicine, 66421 Homburg, Germany
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Thomas Volk
- Department of Anesthesiology, University Hospital of the Saarland, 66421 Homburg, Germany
| | - Sascha Kreuer
- Department of Anesthesiology, University Hospital of the Saarland, 66421 Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Dominik Selzer
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Thorsten Lehr
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
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15
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Sternjakob-Marthaler A, Berkó-Göttel B, Rissland J, Schöpe J, Taurian E, Müller H, Weber G, Lohse S, Lamberty T, Holleczek B, Stoffel H, Hauptmann G, Giesen M, Firk C, Schanzenbach A, Brandt F, Hohmann H, Werthner Q, Selzer D, Lehr T, Wagenpfeil S, Smola S. Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates. PLoS One 2022; 17:e0273332. [PMID: 36054196 PMCID: PMC9439211 DOI: 10.1371/journal.pone.0273332] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/07/2022] [Indexed: 11/18/2022] Open
Abstract
In Germany, the incidence of cervical cancer, a disease caused by human papillomaviruses (HPV), is higher than in neighboring European countries. HPV vaccination has been recommended for girls since 2007. However, it continues to be significantly less well received than other childhood vaccines, so its potential for cancer prevention is not fully realized. To find new starting points for improving vaccination rates, we analyzed pseudonymized routine billing data from statutory health insurers in the PRÄZIS study (prevention of cervical carcinoma and its precursors in women in Saarland) in the federal state Saarland serving as a model region. We show that lowering the HPV vaccination age to 9 years led to more completed HPV vaccinations already in 2015. Since then, HPV vaccination rates and the proportion of 9- to 11-year-old girls among HPV-vaccinated females have steadily increased. However, HPV vaccination rates among 15-year-old girls in Saarland remained well below 50% in 2019. Pediatricians vaccinated the most girls overall, with a particularly high proportion at the recommended vaccination age of 9–14 years, while gynecologists provided more HPV catch-up vaccinations among 15-17-year-old girls, and general practitioners compensated for HPV vaccination in Saarland communities with fewer pediatricians or gynecologists. We also provide evidence for a significant association between attendance at the children´s medical check-ups “U11” or “J1” and HPV vaccination. In particular, participation in HPV vaccination is high on the day of U11. However, obstacles are that U11 is currently not financed by all statutory health insurers and there is a lack of invitation procedures for both U11 and J1, resulting in significantly lower participation rates than for the earlier U8 or U9 screenings, which are conducted exclusively with invitations and reminders. Based on our data, we propose to restructure U11 and J1 screening in Germany, with mandatory funding for U11 and organized invitations for HPV vaccination at U11 or J1 for both boys and girls.
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Affiliation(s)
| | | | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Jakob Schöpe
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg, Germany
| | - Emeline Taurian
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Hanna Müller
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Gero Weber
- Physical Geography and Environmental Research, Saarland University, Saarbrücken, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Thomas Lamberty
- Ministry of Health, Social Affairs, Women and the Family, Saarbrücken, Germany
| | - Bernd Holleczek
- Ministry of Health, Social Affairs, Women and the Family, Saarbrücken, Germany
- Saarland Cancer Registry, Saarbrücken, Germany
| | - Harry Stoffel
- Kassenärztliche Vereinigung Saarland, Saarbrücken, Germany
| | | | | | | | | | | | | | - Quirin Werthner
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Dominik Selzer
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Thorsten Lehr
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research, Saarbrücken, Germany
- * E-mail:
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16
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Tegethoff SA, Danziger G, Kühn D, Kimmer C, Adams T, Heintz L, Metz C, Reifenrath K, Angresius R, Mang S, Rixecker T, Becker A, Geisel J, Jentgen C, Seiler F, Reichert MC, Fröhlich F, Meyer S, Rissland J, Ewen S, Wagenpfeil G, Last K, Smola S, Bals R, Lammert F, Becker SL, Krawczyk M, Lepper PM, Papan C. TNF-related apoptosis-inducing ligand, interferon gamma-induced protein 10, and C-reactive protein in predicting the progression of SARS-CoV-2 infection: a prospective cohort study. Int J Infect Dis 2022; 122:178-187. [PMID: 35643306 PMCID: PMC9132472 DOI: 10.1016/j.ijid.2022.05.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 02/03/2022] [Revised: 04/08/2022] [Accepted: 05/22/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Early prognostication of COVID-19 severity will potentially improve patient care. Biomarkers, such as TNF-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein 10 (IP-10), and C-reactive protein (CRP), might represent possible tools for point-of-care testing and severity prediction. METHODS In this prospective cohort study, we analyzed serum levels of TRAIL, IP-10, and CRP in patients with COVID-19, compared them with control subjects, and investigated the association with disease severity. RESULTS A total of 899 measurements were performed in 132 patients (mean age 64 years, 40.2% females). Among patients with COVID-19, TRAIL levels were lower (49.5 vs 87 pg/ml, P = 0.0142), whereas IP-10 and CRP showed higher levels (667.5 vs 127 pg/ml, P <0.001; 75.3 vs 1.6 mg/l, P <0.001) than healthy controls. TRAIL yielded an inverse correlation with length of hospital and intensive care unit (ICU) stay, Simplified Acute Physiology Score II, and National Early Warning Score, and IP-10 showed a positive correlation with disease severity. Multivariable regression revealed that obesity (adjusted odds ratio [aOR] 5.434, 95% confidence interval [CI] 1.005-29.38), CRP (aOR 1.014, 95% CI 1.002-1.027), and peak IP-10 (aOR 1.001, 95% CI 1.00-1.002) were independent predictors of in-ICU mortality. CONCLUSIONS We demonstrated a correlation between COVID-19 severity and TRAIL, IP-10, and CRP. Multivariable regression showed a role for IP-10 in predicting unfavourable outcomes, such as in-ICU mortality. TRIAL REGISTRATION Clinicaltrials.gov, NCT04655521.
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Affiliation(s)
- Sina A Tegethoff
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Guy Danziger
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Dennis Kühn
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany; Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Charlotte Kimmer
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Thomas Adams
- Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Lena Heintz
- Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Carlos Metz
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Katharina Reifenrath
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany; Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Rebecca Angresius
- Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Sebastian Mang
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Torben Rixecker
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - André Becker
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Jürgen Geisel
- Department of Clinical Chemistry and Laboratory Medicine, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Christophe Jentgen
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Frederik Seiler
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Matthias C Reichert
- Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Franziska Fröhlich
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany; Department of General Paediatrics and Neonatology, Saarland University, Homburg, Germany
| | - Sascha Meyer
- Department of General Paediatrics and Neonatology, Saarland University, Homburg, Germany
| | - Jürgen Rissland
- Centre for Infectious Diseases, Institute of Virology, Saarland University Medical Centre, Homburg, Germany
| | - Sebastian Ewen
- Department of Emergency Medicine, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Gudrun Wagenpfeil
- Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany
| | - Katharina Last
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Sigrun Smola
- Centre for Infectious Diseases, Institute of Virology, Saarland University Medical Centre, Homburg, Germany; Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarland University Campus, Saarbrücken, Germany
| | - Robert Bals
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Frank Lammert
- Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany; Hannover Medical School (MHH), Hannover, Germany
| | - Sören L Becker
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Philipp M Lepper
- Department of Medicine V: Pneumology, Allergology and Intensive Care Medicine, ECLS Centre Saar, Saarland University Medical Centre, Saarland University, Homburg, Germany
| | - Cihan Papan
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
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17
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Bock T, Bewarder M, Cetin O, Fadle N, Regitz E, Schwarz EC, Held J, Roth S, Lohse S, Pfuhl T, Wagener R, Smola S, Becker SL, Bohle RM, Trümper L, Siebert R, Hansmann M, Pfreundschuh M, Drexler HG, Hoth M, Kubuschok B, Roemer K, Preuss K, Hartmann S, Thurner L. B‐cell receptors of EBV‐negative Burkitt lymphoma bind modified isoforms of autoantigens. eJHaem 2022; 3:739-747. [PMID: 36051037 PMCID: PMC9421956 DOI: 10.1002/jha2.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 11/08/2022]
Abstract
Burkitt lymphoma (BL) represents the most aggressive B‐cell‐lymphoma. Beside the hallmark of IG‐MYC‐translocation, surface B‐cell receptor (BCR) is expressed, and mutations in the BCR pathway are frequent. Coincidental infections in endemic BL, and specific extra‐nodal sites suggest antigenic triggers. To explore this hypothesis, BCRs of BL cell lines and cases were screened for reactivities against a panel of bacterial lysates, lysates of Plasmodium falciparum, a custom‐made virome array and against self‐antigens, including post‐translationally modified antigens. An atypically modified, SUMOylated isoform of Bystin, that is, SUMO1‐BYSL was identified as the antigen of the BCR of cell line CA46. SUMO1‐BYSL was exclusively expressed in CA46 cells with K139 as site of the SUMOylation. Secondly, an atypically acetylated isoform of HSP40 was identified as the antigen of the BCR of cell line BL41. K104 and K179 were the sites of immunogenic acetylation, and the acetylated HSP40 isoform was solely present in BL41 cells. Functionally, addition of SUMO1‐BYSL and acetylated HSP40 induced BCR pathway activation in CA46 and BL41 cells, respectively. Accordingly, SUMO1‐BYSL‐ETA’ immunotoxin, produced by a two‐step intein‐based conjugation, led to the specific killing of CA46 cells. Autoantibodies directed against SUMO1‐BYSL were found in 3 of 14 (21.4%), and autoantibodies against acetylated HSP40 in 1/14(7.1%) patients with sporadic Burkitt‐lymphoma. No reactivities against antigens of the infectious agent spectrum could be observed. These results indicate a pathogenic role of autoreactivity evoked by immunogenic post‐translational modifications in a subgroup of sporadic BL including two EBV‐negative BL cell lines.
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Affiliation(s)
- Theresa Bock
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Moritz Bewarder
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Onur Cetin
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Natalie Fadle
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Evi Regitz
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Eva C. Schwarz
- Center for Integrative Physiology and Molecular Medicine (CIPMM) School of Medicine Homburg Germany
| | - Jana Held
- Institute of Tropical Medicine Eberhard Karls Universität Tübingen Tübingen Germany
| | - Sophie Roth
- Institute of Medical Microbiology and Hygiene Saarland University Homburg/Saar Germany
| | - Stefan Lohse
- Institute of Virology University of Saarland Homburg Germany
| | - Thorsten Pfuhl
- Institute of Virology University of Saarland Homburg Germany
| | - Rabea Wagener
- Institute of Human Genetics Ulm University and Ulm University Medical Center Ulm Germany
| | - Sigrun Smola
- Institute of Virology University of Saarland Homburg Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS) Saarbrücken Germany
| | - Sören L. Becker
- Institute of Medical Microbiology and Hygiene Saarland University Homburg/Saar Germany
| | - Rainer Maria Bohle
- Institute of Pathology Saarland University Medical School Homburg/Saar Germany
| | - Lorenz Trümper
- Department of Hematology and Oncology Georg August University Göttingen Göttingen Germany
| | - Reiner Siebert
- Institute of Human Genetics Ulm University and Ulm University Medical Center Ulm Germany
| | - Martin‐Leo Hansmann
- Dr. Senckenberg Institute of Pathology Goethe University Hospital of Frankfurt a. Main Frankfurt a. Main Germany
| | - Michael Pfreundschuh
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Hans G. Drexler
- Faculty of Life sciences Technical University of Braunschweig Braunschweig Germany
| | - Markus Hoth
- Center for Integrative Physiology and Molecular Medicine (CIPMM) School of Medicine Homburg Germany
| | - Boris Kubuschok
- Department of Internal Medicine II Augsburg University Medical Center Augsburg Germany
| | - Klaus Roemer
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Klaus‐Dieter Preuss
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
| | - Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology Goethe University Hospital of Frankfurt a. Main Frankfurt a. Main Germany
| | - Lorenz Thurner
- Department of Internal Medicine I and José Carreras Center for Immuno‐ and Gene Therapy Saarland University Medical School Homburg/Saar Germany
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18
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Kühn JP, Bochen F, Körner S, Schick B, Wagner M, Smola S, Berkó-Göttel B, Morris LGT, Wang J, Bozzato A, Linxweiler M. Podoplanin expression in lymph node metastases of head and neck cancer and cancer of unknown primary patients. Int J Biol Markers 2022; 37:280-288. [PMID: 35880270 DOI: 10.1177/03936155221105524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Head and neck squamous cell carcinomas (HNSCCs) are cancers with generally poor prognosis. Outcomes have not improved in decades, with more than half of the patients presenting with lymph node metastases at the time of diagnosis. A unique subtype of HNSCC, cancer of unknown primary of the head and neck (HNCUP) is associated with a poor outcome. Increased expression of the D2-40 gene (podoplanin) has been described for several human malignancies and has been associated with increased metastatic potential of cancer cells. METHODS In order to examine the role of podoplanin in lymph node metastasis of HNSCC generally and HNCUP specifically, we evaluated the prognostic impact of podoplanin expression in HNSCC- (n = 68) and HNCUP-associated lymph node metastases (n = 30). The expression of podoplanin was analyzed by immunohistochemical staining of lymph node tissue samples and correlated with clinical and histopathological data. RESULTS We found a non-significant tendency towards a higher podoplanin expression in HNCUP compared to HNSCC lymph node metastases and a significant correlation between a high podoplanin expression and advanced node-stage classification. Podoplanin expression had no significant impact on overall survival for both groups and did not correlate with human papillomavirus tumor status. CONCLUSION Taken together, our results suggest that upregulation of podoplanin may be associated with a stimulation of lymphatic metastasis in head and neck cancer.
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Affiliation(s)
- Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Sandrina Körner
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | | | - Luc G T Morris
- Department of Surgery, 5803Memorial Sloan Kettering Cancer Center, New York City, NY, USA.,Human Oncology and Pathogenesis Program, 39072Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Jingming Wang
- Human Oncology and Pathogenesis Program, 39072Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
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19
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Lohse S, Sternjakob-Marthaler A, Lagemann P, Schöpe J, Rissland J, Seiwert N, Pfuhl T, Müllendorff A, Kiefer LS, Vogelgesang M, Vella L, Denk K, Vicari J, Zwick A, Lang I, Weber G, Geisel J, Rech J, Schnabel B, Hauptmann G, Holleczek B, Scheiblauer H, Wagenpfeil S, Smola S. German federal-state-wide seroprevalence study of 1 st SARS-CoV-2 pandemic wave shows importance of long-term antibody test performance. Commun Med (Lond) 2022; 2:52. [PMID: 35603305 PMCID: PMC9117207 DOI: 10.1038/s43856-022-00100-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 03/09/2022] [Indexed: 12/12/2022] Open
Abstract
Background Reliable data on the adult SARS-CoV-2 infection fatality rate in Germany are still scarce. We performed a federal state-wide cross-sectional seroprevalence study named SaarCoPS, that is representative for the adult population including elderly individuals and nursing home residents in the Saarland. Methods Serum was collected from 2940 adults via stationary or mobile teams during the 1st pandemic wave steady state period. We selected an antibody test system with maximal specificity, also excluding seroreversion effects due to a high longitudinal test performance. For the calculations of infection and fatality rates, we accounted for the delays of seroconversion and death after infection. Results Using a highly specific total antibody test detecting anti-SARS-CoV-2 responses over more than 180 days, we estimate an adult infection rate of 1.02% (95% CI: [0.64; 1.44]), an underreporting rate of 2.68-fold (95% CI: [1.68; 3.79]) and infection fatality rates of 2.09% (95% CI: (1.48; 3.32]) or 0.36% (95% CI: [0.25; 0.59]) in all adults including elderly individuals, or adults younger than 70 years, respectively. Conclusion The study highlights the importance of study design and test performance for seroprevalence studies, particularly when seroprevalences are low. Our results provide a valuable baseline for evaluation of future pandemic dynamics and impact of public health measures on virus spread and human health in comparison to neighbouring countries such as Luxembourg or France.
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Affiliation(s)
- Stefan Lohse
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | | | - Paul Lagemann
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jakob Schöpe
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Nastasja Seiwert
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Alana Müllendorff
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Laurent S Kiefer
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Markus Vogelgesang
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Luca Vella
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Katharina Denk
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Julia Vicari
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Anabel Zwick
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Isabelle Lang
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Gero Weber
- Physical Geography and Environmental Research, Saarland University, 66125 Saarbrücken, Germany
| | - Jürgen Geisel
- Central Laboratory, Saarland University Hospital, 66421 Homburg, Germany
| | - Jörg Rech
- Ministry of Health, Social Affairs, Women and the Family, 66119 Saarbrücken, Germany
| | - Bernd Schnabel
- Ministry of Health, Social Affairs, Women and the Family, 66119 Saarbrücken, Germany
| | - Gunter Hauptmann
- Kassenärztliche Vereinigung Saarland, 66113 Saarbrücken, Germany
| | - Bernd Holleczek
- Ministry of Health, Social Affairs, Women and the Family, 66119 Saarbrücken, Germany.,Saarland Cancer Registry, 66117 Saarbrücken, Germany
| | | | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany.,Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, 66123 Saarbrücken, Germany
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20
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Casper M, Reichert MC, Rissland J, Smola S, Lammert F, Krawczyk M. Pre-endoscopy SARS-CoV-2 testing strategy during COVID-19 pandemic: the care must go on. Eur J Med Res 2022; 27:41. [PMID: 35303954 PMCID: PMC8931568 DOI: 10.1186/s40001-022-00672-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background In response to the COVID-19 pandemic, endoscopic societies initially recommended reduction of endoscopic procedures. In particular non-urgent endoscopies should be postponed. However, this might lead to unnecessary delay in diagnosing gastrointestinal conditions. Methods Retrospectively we analysed the gastrointestinal endoscopies performed at the Central Endoscopy Unit of Saarland University Medical Center during seven weeks from 23 March to 10 May 2020 and present our real-world single-centre experience with an individualized rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy. We also present our experience with this strategy in 2021. Results Altogether 359 gastrointestinal endoscopies were performed in the initial period. The testing strategy enabled us to conservatively handle endoscopy programme reduction (44% reduction as compared 2019) during the first wave of the COVID-19 pandemic. The results of COVID-19 rtPCR from nasopharyngeal swabs were available in 89% of patients prior to endoscopies. Apart from six patients with known COVID-19, all other tested patients were negative. The frequencies of endoscopic therapies and clinically significant findings did not differ between patients with or without SARS-CoV-2 tests. In 2021 we were able to unrestrictedly perform all requested endoscopic procedures (> 5000 procedures) by applying the rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy, regardless of next waves of COVID-19. Only two out-patients (1893 out-patient procedures) were tested positive in the year 2021. Conclusion A structured pre-endoscopy SARS-CoV-2 testing strategy is feasible in the clinical routine of an endoscopy unit. rtPCR-based pre-endoscopy SARS-CoV-2 testing safely allowed unrestricted continuation of endoscopic procedures even in the presence of high incidence rates of COVID-19. Given the low frequency of positive tests, the absolute effect of pre-endoscopy testing on viral transmission may be low when FFP-2 masks are regularly used.
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Affiliation(s)
- M Casper
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany.
| | - M C Reichert
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany
| | - J Rissland
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - S Smola
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - F Lammert
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany.,Hannover Medical School, Hannover Health Sciences Campus, Hannover, Germany
| | - M Krawczyk
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany.,Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Center for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
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21
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Tóth G, Berkó‐Göttel B, Seitz B, Langenbucher A, Stachon T, Pluzsik MT, Nagy ZZ, Smola S, Szentmáry N. Herpes simplex virus PCR in 2230 explanted corneal buttons. Acta Ophthalmol 2022; 100:e77-e82. [PMID: 34126653 DOI: 10.1111/aos.14872] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/19/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine herpes simplex virus (HSV) DNA prevalence and mean cycle threshold of polymerase chain reaction (PCR) in corneal tissue of patients with penetrating keratoplasty (PKP), with (HSK+) and without (HSK-) previous clinical herpetic keratitis history. METHODS Retrospective review of recipient corneal buttons which were explanted through PKP between March 2010 and September 2018 at the Department of Ophthalmology, Saarland University Medical Center in Homburg/Saar, Germany. Corneal tissue samples were analysed by real-time PCR for the presence of HSV DNA. For each subject, clinical data, including patients' demographics and clinical diagnoses, were collected. RESULTS In total, 2230 corneal samples (age at the time of the surgery 57.3 ± 19.2 years) of 1860 patients were analysed. HSV PCR was positive in 137 (6.1%) corneal samples, with a 30.57 ± 6.01 (range 14-39) mean cycle threshold (Ct) value. Two hundred ninety-eight (13.4%) corneas of 266 patients were clinically HSK+, and 1932 (86.6%) corneas of 1600 patients were clinically HSK-. HSV DNA was detected significantly more frequently (p < 0.0001) in HSK+ corneal samples (108 corneal samples; 36.2%), than in HSK- corneal samples (29 corneal samples; 1.5%). Ct value was significantly lower in HSK+ than in HSK- corneal samples (29.8 ± 5.8 versus 32.6 ± 5.9; p = 0.008). CONCLUSION Our data demonstrate that a positive clinical history of HSK is related to HSV PCR positivity in about every 2.8th patient. In addition, about every 66th explanted corneal tissue is HSV PCR-positive despite the lack of clinical suspicion. These patients may need additional local/systemic antiviral treatment to avoid newly acquired HSK following penetrating keratoplasty.
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Affiliation(s)
- Gábor Tóth
- Department of Ophthalmology Saarland University Medical Center Homburg/Saar Germany
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research Saarland University Homburg/Saar Germany
- Department of Ophthalmology Semmelweis University Budapest Hungary
| | | | - Berthold Seitz
- Department of Ophthalmology Saarland University Medical Center Homburg/Saar Germany
| | | | - Tanja Stachon
- Department of Ophthalmology Saarland University Medical Center Homburg/Saar Germany
| | - Milán Tamás Pluzsik
- Department of Ophthalmology Saarland University Medical Center Homburg/Saar Germany
- Department of Ophthalmology Semmelweis University Budapest Hungary
| | | | - Sigrun Smola
- Institute of Virology Saarland University Medical Center Homburg/Saar Germany
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research Saarland University Homburg/Saar Germany
- Department of Ophthalmology Semmelweis University Budapest Hungary
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22
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Kaddu-Mulindwa D, Keuser L, Lesan V, Rissland J, Smola S, Werdecker V, Stilgenbauer S, Christofyllakis K, Thurner L, Bewarder M, Lohr B, Lutz J, Lohse S, Rieke A. IgG seroprevalence of COVID-19 among people living with HIV or at high risk of HIV in south-west Germany: A seroprevalence study. HIV Med 2021; 23:564-569. [PMID: 34811869 PMCID: PMC9011579 DOI: 10.1111/hiv.13207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/26/2021] [Accepted: 11/09/2021] [Indexed: 12/11/2022]
Abstract
Objectives Seroprevalence studies of SARS‐CoV‐2 have shown that there is a high number of undiagnosed missing cases. Seroprevalence of SARS‐CoV‐2 in people living with HIV (PLWH) is lacking. Therefore, we conducted a prospective cross‐sectional study to estimate the seroprevalence of SARS‐CoV‐2 among PLWH without known diagnosis of COVID‐19 in the south‐west of Germany. Methods Serological testing for SARS‐CoV‐2 immunoglobulin G (IgG) antibodies based on two assays was performed in PLWH who visited the outpatient HIV centre of two hospitals from April to June 2020. Additionally, patients had to answer questionnaires about possible COVID‐19‐related symptoms and predefined risk factors. Moreover, we tested 50 non‐HIV‐infected patients receiving post‐ or pre‐exposure (PEP/PrEP) HIV prophylaxis. Results In all, 594 (488 male, 106 female) PLWH (median age 51 years) and 50 PEP/PrEP‐users were included in the study. The estimated seroprevalence of the PLWH cohort was 1.85% (11/594), with 11 positive tested cases in the cohort. Among all patients, only five had COVID‐19‐related symptoms. One PCR‐positive patient did not show any antibody response in repeatedly carried out tests. None of the patients was hospitalized due to COVID‐19. Three PrEP users were tested positive. Three patients had been previously diagnosed with SARS‐COV‐2 infection before inclusion. The used questionnaire did not help to detect SARS‐CoV‐2 positive patients. Conclusions Despite the limitation of being only a snapshot in time because of the ongoing pandemic, to our knowledge this is the largest study so far on seroprevalence of SARS‐CoV‐2 in PLWH in Germany. Our study suggests that the seroprevalence of SARS‐CoV‐2 in PLWH is comparable to those previously reported for parts of the general German population and that the questionnaire used here might not be the best tool to predict COVID‐19 diagnosis.
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Affiliation(s)
- Dominic Kaddu-Mulindwa
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Lukas Keuser
- Gemeinschaftsklinikum Mittelrhein, Kemperhof Koblenz, Koblenz, Germany
| | - Vadim Lesan
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany.,Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany
| | - Victoria Werdecker
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Stephan Stilgenbauer
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | | | - Lorenz Thurner
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Moritz Bewarder
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Benedikt Lohr
- MVZ für Laboratoriumsmedizin und Mikrobiologie Koblenz-Mittelrhein, Koblenz, Germany
| | - Jens Lutz
- Gemeinschaftsklinikum Mittelrhein, Kemperhof Koblenz, Koblenz, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Ansgar Rieke
- Gemeinschaftsklinikum Mittelrhein, Kemperhof Koblenz, Koblenz, Germany
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23
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Bley IA, Zwick A, Hans MC, Thieser K, Wagner V, Ludwig N, Khalmurzaev O, Matveev VB, Loertzer P, Pryalukhin A, Hartmann A, Geppert CI, Loertzer H, Wunderlich H, Naumann CM, Kalthoff H, Junker K, Smola S, Lohse S. DKK1 inhibits canonical Wnt signaling in human papillomavirus-positive penile cancer cells. Transl Oncol 2021; 15:101267. [PMID: 34773828 PMCID: PMC8592926 DOI: 10.1016/j.tranon.2021.101267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/21/2021] [Accepted: 11/07/2021] [Indexed: 02/07/2023] Open
Abstract
Elevated expression of Wnt pathway associated factors in HPV-positive penile cancer cells. lacking nuclear beta-catenin translocation indicated an actively abrogated Wnt signaling. elevated expression of the Wnt antagonist DKK1 in HPV-positive penile cancer cells. DKK1-driven autocrine Wnt pathway inhibition in penile cancer cells. DKK1+ penile cancers are with a higher frequency HPV+, less differentiated and grow more aggressively.
Penile squamous cell cancer (PSCC) is the most frequent penile malignant disease. Infections with human papillomaviruses (HPV) are a major etiologic driver of PSCC. However, the molecular details of the underlying carcinogenesis are understudied because of rare clinical specimens and missing cell lines. Here, we investigated if the expression of high-risk HPV16 oncogenes causes an augmentation of the Wnt pathway using unique HPV-positive penile cancer (PeCa) cell lines in monolayer and organotypic 3D raft cultures as well as tissue micro arrays containing clinical tissue specimens. The HPV oncoproteins enhanced the expression of Leucine-rich repeat-containing G-protein coupled receptor 6 (LGR6) and the HPV-positive PeCa cells expressed a signature of Wnt target and stemness-associated genes. However, the notable lack of nuclear β-catenin in vitro and in situ raised the question if the enhanced expression of Wnt pathway factors is tantamount to an active Wnt signaling. Subsequent TOP-flash reporter assays revealed Wnt signaling as absent and not inducible by respective Wnt ligands in PeCa cell lines. The HPV-positive PeCa cells and especially HPV-positive PeCa specimens of the tumor core expressed the Wnt antagonist and negative feedback-regulator Dickkopf1 (DKK1). Subsequent neutralization experiments using PeCa cell line-conditioned media demonstrated that DKK1 is capable to impair ligand-induced Wnt signaling. While gene expression analyses suggested an augmented and active canonical Wnt pathway, the respective signaling was inhibited due to the endogenous expression of the antagonist DKK1. Subsequent TMA stainings indicated Dkk1 as linked with HPV-positivity and metastatic disease progression in PeCa suggesting potential as a prognostic marker.
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Affiliation(s)
- Isabelle Ariane Bley
- Institute of Virology, Saarland University Medical Center, Kirrberger Str. Building 47, Homburg 66421, Germany
| | - Anabel Zwick
- Institute of Virology, Saarland University Medical Center, Kirrberger Str. Building 47, Homburg 66421, Germany
| | - Muriel Charlotte Hans
- Institute of Virology, Saarland University Medical Center, Kirrberger Str. Building 47, Homburg 66421, Germany
| | - Katrin Thieser
- Institute of Virology, Saarland University Medical Center, Kirrberger Str. Building 47, Homburg 66421, Germany
| | - Viktoria Wagner
- Clinical Bioinformatics, Saarland University, Saarbrücken, Germany
| | - Nicole Ludwig
- Department of Human Genetics, Saarland University, Homburg, Germany
| | - Oybek Khalmurzaev
- Department of Urology and Pediatric Urology, Saarland University Medical Center, Homburg, Germany; Department of Urology, Federal State Budgetary Institution, "N.N. Blokhin National Medical Research Center of Oncology" оf the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Vsevolod Borisovich Matveev
- Department of Urology, Federal State Budgetary Institution, "N.N. Blokhin National Medical Research Center of Oncology" оf the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Philine Loertzer
- Department of Urology and Pediatric Urology, Saarland University Medical Center, Homburg, Germany
| | - Alexey Pryalukhin
- Institute of Pathology, Saarland University Medical Centre, Homburg, Germany; Institute of Pathology, University Medical Centre Bonn, Bonn, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Hagen Loertzer
- Department of Urology and Pediatric Urology, Westpfalz Klinikum, Kaiserslautern, Germany
| | - Heiko Wunderlich
- Department of Urology and Paediatric Urology, St. Georg Klinikum, Eisenach, Germany
| | - Carsten Maik Naumann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Holger Kalthoff
- Division of Molecular Oncology, Institute of Experimental Cancer Research, University Hospital Schleswig Holstein, Kiel, Germany
| | - Kerstin Junker
- Department of Urology and Pediatric Urology, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Kirrberger Str. Building 47, Homburg 66421, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Kirrberger Str. Building 47, Homburg 66421, Germany.
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24
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Herr C, Mang S, Mozafari B, Guenther K, Speer T, Seibert M, Srikakulam SK, Beisswenger C, Ritzmann F, Keller A, Mueller R, Smola S, Eisinger D, Zemlin M, Danziger G, Volk T, Hoersch S, Krawczyk M, Lammert F, Adams T, Wagenpfeil G, Kindermann M, Marcu C, Ataya ZWD, Mittag M, Schwarzkopf K, Custodis F, Grandt D, Schaefer H, Eltges K, Lepper PM, Bals R. Distinct Patterns of Blood Cytokines Beyond a Cytokine Storm Predict Mortality in COVID-19. J Inflamm Res 2021; 14:4651-4667. [PMID: 34552347 PMCID: PMC8451220 DOI: 10.2147/jir.s320685] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 05/18/2021] [Accepted: 08/24/2021] [Indexed: 12/21/2022] Open
Abstract
Background COVID-19 comprises several severity stages ranging from oligosymptomatic disease to multi-organ failure and fatal outcomes. The mechanisms why COVID-19 is a mild disease in some patients and progresses to a severe multi-organ and often fatal disease with respiratory failure are not known. Biomarkers that predict the course of disease are urgently needed. The aim of this study was to evaluate a large spectrum of established laboratory measurements. Patients and Methods Patients from the prospective PULMPOHOM and CORSAAR studies were recruited and comprised 35 patients with COVID-19, 23 with conventional pneumonia, and 28 control patients undergoing elective non-pulmonary surgery. Venous blood was used to measure the serum concentrations of 79 proteins by Luminex multiplex immunoassay technology. Distribution of biomarkers between groups and association with disease severity and outcomes were analyzed. Results The biomarker profiles between the three groups differed significantly with elevation of specific proteins specific for the respective conditions. Several biomarkers correlated significantly with disease severity and death. Uniform manifold approximation and projection (UMAP) analysis revealed a significant separation of the three disease groups and separated between survivors and deceased patients. Different models were developed to predict mortality based on the baseline measurements of several protein markers. A score combining IL-1ra, IL-8, IL-10, MCP-1, SCF and CA-9 was associated with significantly higher mortality (AUC 0.929). Discussion Several newly identified blood markers were significantly increased in patients with severe COVID-19 (AAT, EN-RAGE, myoglobin, SAP, TIMP-1, vWF, decorin) or in patients that died (IL-1ra, IL-8, IL-10, MCP-1, SCF, CA-9). The use of established assay technologies allows for rapid translation into clinical practice.
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Affiliation(s)
- Christian Herr
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Sebastian Mang
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Bahareh Mozafari
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Katharina Guenther
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Thimoteus Speer
- Department of Internal Medicine IV - Nephrology and Hypertension & Translational Cardio-Renal Medicine, Saarland University, Homburg, 66421, Germany
| | - Martina Seibert
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Sanjay Kumar Srikakulam
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Christoph Beisswenger
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Felix Ritzmann
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Andreas Keller
- Clinical Bioinformatics, Saarland University, Homburg, 66421, Germany
| | - Rolf Mueller
- Helmholtz-Institute for Pharmaceutical Science Saarland, Saarbrücken, 66123, Germany
| | - Sigrun Smola
- Institute for Virology, Saarland University, Homburg, 66421, Germany
| | | | - Michael Zemlin
- Department of General Pediatrics and Neonatology, Saarland University, Homburg, 66421, Germany
| | - Guy Danziger
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Thomas Volk
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Saarland University, Homburg, 66421, Germany
| | - Sabrina Hoersch
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Saarland University, Homburg, 66421, Germany
| | - Marcin Krawczyk
- Department of Internal Medicine II - Gastroenterology, Saarland University, Homburg, 66421, Germany
| | - Frank Lammert
- Department of Internal Medicine II - Gastroenterology, Saarland University, Homburg, 66421, Germany
| | - Thomas Adams
- Department of Internal Medicine II - Gastroenterology, Saarland University, Homburg, 66421, Germany
| | - Gudrun Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg, 66421, Germany
| | - Michael Kindermann
- Department of Internal Medicine, Cardiology and Intensive Care Medicine, Caritas Hospital St. Theresia Saarbrücken, Saarbrücken, 66113, Germany
| | - Constantin Marcu
- Department of Internal Medicine, Cardiology and Intensive Care Medicine, Caritas Hospital St. Theresia Saarbrücken, Saarbrücken, 66113, Germany
| | - Zuhair Wolf Dietrich Ataya
- Department of Gastroenterology, Internal and Intensive Care Medicine, Caritas Hospital St. Josef Saarbrücken, Saarbrücken, 66125, Germany
| | - Marc Mittag
- Department of Anesthesiology, Gastroenterology and Intensive Care Medicine, Saarbrücken Hospital, Saarbrücken, 66119, Germany
| | - Konrad Schwarzkopf
- Department of Anesthesiology, Gastroenterology and Intensive Care Medicine, Saarbrücken Hospital, Saarbrücken, 66119, Germany
| | - Florian Custodis
- Department of Anesthesiology, Gastroenterology and Intensive Care Medicine, Saarbrücken Hospital, Saarbrücken, 66119, Germany
| | - Daniel Grandt
- Department of Anesthesiology, Gastroenterology and Intensive Care Medicine, Saarbrücken Hospital, Saarbrücken, 66119, Germany
| | - Harald Schaefer
- Department of Internal Medicine and Pulmonology, SHG-Hospital Völklingen, Saarbrücken, 66333, Germany
| | - Kai Eltges
- Department of Internal Medicine and Pulmonology, SHG-Hospital Völklingen, Saarbrücken, 66333, Germany
| | - Philipp M Lepper
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
| | - Robert Bals
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, 66421, Germany
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25
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Kühn JP, Schmid W, Körner S, Bochen F, Wemmert S, Rimbach H, Smola S, Radosa JC, Wagner M, Morris LG, Bozzato V, Bozzato A, Schick B, Linxweiler M. HPV Status as Prognostic Biomarker in Head and Neck Cancer-Which Method Fits the Best for Outcome Prediction? Cancers (Basel) 2021; 13:cancers13184730. [PMID: 34572957 PMCID: PMC8469433 DOI: 10.3390/cancers13184730] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/11/2021] [Accepted: 09/20/2021] [Indexed: 01/22/2023] Open
Abstract
The incidence of human papillomavirus (HPV)-related head and neck cancer (HNSCC) is rising globally, presenting challenges for optimized clinical management. To date, it remains unclear which biomarker best reflects HPV-driven carcinogenesis, a process that is associated with better therapeutic response and outcome compared to tobacco/alcohol-induced cancers. Six potential HPV surrogate biomarkers were analyzed using FFPE tissue samples from 153 HNSCC patients (n = 78 oropharyngeal cancer (OPSCC), n = 35 laryngeal cancer, n = 23 hypopharyngeal cancer, n = 17 oral cavity cancer): p16, CyclinD1, pRb, dual immunohistochemical staining of p16 and Ki67, HPV-DNA-PCR, and HPV-DNA-in situ hybridization (ISH). Biomarkers were analyzed for correlation with one another, tumor subsite, and patient survival. P16-IHC alone showed the best performance for discriminating between good (high expression) vs poor outcome (low expression; p = 0.0030) in OPSCC patients. Additionally, HPV-DNA-ISH (p = 0.0039), HPV-DNA-PCR (p = 0.0113), and p16-Ki67 dual stain (p = 0.0047) were significantly associated with prognosis in uni- and multivariable analysis for oropharyngeal cancer. In the non-OPSCC group, however, none of the aforementioned surrogate markers was prognostic. Taken together, P16-IHC as a single biomarker displays the best diagnostic accuracy for prognosis stratification in OPSCC patients with a direct detection of HPV-DNA by PCR or ISH as well as p16-Ki67 dual stain as potential alternatives.
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Affiliation(s)
- Jan Philipp Kühn
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Wendelin Schmid
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Sandrina Körner
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Florian Bochen
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Silke Wemmert
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Hugo Rimbach
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Julia Caroline Radosa
- Department of Gynecology and Obstetrics, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Luc G.T. Morris
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Victoria Bozzato
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
- Correspondence: ; Tel.: +49-6841-1622928
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26
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Theobald L, Stroeder R, Melchior P, Iordache II, Tänzer T, Port M, Glombitza B, Marx S, Schub D, Herr C, Hart M, Ludwig N, Meese E, Kim YJ, Bohle RM, Smola S, Rübe C, Solomayer EF, Walch-Rückheim B. Chemoradiotherapy-induced increase in Th17 cell frequency in cervical cancer patients is associated with therapy resistance and early relapse. Mol Oncol 2021; 15:3559-3577. [PMID: 34469022 PMCID: PMC8637579 DOI: 10.1002/1878-0261.13095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/22/2021] [Accepted: 08/31/2021] [Indexed: 12/19/2022] Open
Abstract
Cervical cancer therapy is still a major clinical challenge, as patients substantially differ in their response to standard treatments, including chemoradiotherapy (CRT). During cervical carcinogenesis, T-helper (Th)-17 cells accumulate in the peripheral blood and tumor tissues of cancer patients and are associated with poor prognosis. In this prospective study, we find increased Th17 frequencies in the blood of patients after chemoradiotherapy and a post-therapeutic ratio of Th17/CD4+ T cells > 8% was associated with early recurrence. Furthermore, Th17 cells promote resistance of cervical cancer cells toward CRT, which was dependent on the AKT signaling pathway. Consistently, patients with high Th17 frequencies in pretherapeutic biopsies exhibit lower response to primary CRT. This work reveals a key role of Th17 cells in CRT resistance and elevated Th17 frequencies in the blood after CRT correspond with early recurrence. Our results may help to explain individual treatment responses of cervical cancer patients and suggest evaluation of Th17 cells as a novel predictive biomarker for chemoradiotherapy responses and as a potential target for immunotherapy in cervical cancer.
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Affiliation(s)
- Laura Theobald
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
| | - Russalina Stroeder
- Department of Obstetrics and Gynecology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Patrick Melchior
- Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Ioan Iulian Iordache
- Department of Obstetrics and Gynecology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Tanja Tänzer
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
| | - Meike Port
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
| | - Birgit Glombitza
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
| | - Stefanie Marx
- Department of Transplant and Infection Immunology, Saarland University, Homburg/Saar, Germany
| | - David Schub
- Department of Transplant and Infection Immunology, Saarland University, Homburg/Saar, Germany
| | - Christian Herr
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University Medical Center, Homburg/Saar, Germany
| | - Martin Hart
- Institute of Human Genetics, Saarland University, Homburg/Saar, Germany
| | - Nicole Ludwig
- Institute of Human Genetics and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
| | - Eckart Meese
- Institute of Human Genetics, Saarland University, Homburg/Saar, Germany
| | - Yoo-Jin Kim
- Institute of Pathology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Rainer Maria Bohle
- Institute of Pathology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Sigrun Smola
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
| | - Christian Rübe
- Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Erich Franz Solomayer
- Department of Obstetrics and Gynecology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Barbara Walch-Rückheim
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
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27
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Tierling S, Kattler K, Vogelgesang M, Pfuhl T, Lohse S, Lo Porto C, Schmitt B, Nastasja S, Salhab A, Smola S, Walter J. Rapid Base-Specific Calling of SARS-CoV-2 Variants of Concern Using Combined RT-PCR Melting Curve Screening and SIRPH Technology. Open Forum Infect Dis 2021; 8:ofab364. [PMID: 34409122 PMCID: PMC8364759 DOI: 10.1093/ofid/ofab364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/14/2021] [Accepted: 07/12/2021] [Indexed: 12/01/2022] Open
Abstract
Background The emergence of novel variants of concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) demands fast and reliable detection of such variants in local populations. Methods Here we present a cost-efficient and fast workflow combining a prescreening of SARS-CoV-2-positive samples using reverse transcription polymerase chain reaction melting curve analysis with multiplexed IP-RP-HPLC-based single nucleotide primer extensions. Results The entire workflow from positive SARS-CoV-2 testing to base-specific identification of variants requires about 24 hours. Conclusions We applied the sensitive method to monitor local variant of concern outbreaks in SARS-CoV-2-positive samples collected in a confined region of Germany.
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Affiliation(s)
- Sascha Tierling
- Department of Genetics, Saarland University, Saarbrücken, Saarland, Germany
| | - Kathrin Kattler
- Department of Genetics, Saarland University, Saarbrücken, Saarland, Germany
| | - Markus Vogelgesang
- Institute of Virology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Christina Lo Porto
- Department of Genetics, Saarland University, Saarbrücken, Saarland, Germany
| | - Beate Schmitt
- Department of Genetics, Saarland University, Saarbrücken, Saarland, Germany
| | - Seiwert Nastasja
- Institute of Virology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Abdulrahman Salhab
- Department of Genetics, Saarland University, Saarbrücken, Saarland, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Jörn Walter
- Department of Genetics, Saarland University, Saarbrücken, Saarland, Germany
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28
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Ritzmann F, Chitirala P, Krüger N, Hoffmann M, Zuo W, Lammert F, Smola S, Tov N, Alagem N, Lepper PM, Pöhlmann S, Beisswenger C, Herr C, Bals R. Therapeutic Application of Alpha-1 Antitrypsin in COVID-19. Am J Respir Crit Care Med 2021; 204:224-227. [PMID: 33961754 PMCID: PMC8650782 DOI: 10.1164/rccm.202104-0833le] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | - Nadine Krüger
- German Primate Center-Leibniz Institute for Primate Research Göttingen, Germany
| | - Markus Hoffmann
- German Primate Center-Leibniz Institute for Primate Research Göttingen, Germany.,University of Göttingen Göttingen, Germany
| | - Wei Zuo
- Tongji University Shanghai, China
| | - Frank Lammert
- Saarland University Homburg, Germany.,Hannover Medical School Hannover, Germany
| | - Sigrun Smola
- Saarland University Medical Center Homburg, Germany
| | | | | | | | - Stefan Pöhlmann
- German Primate Center-Leibniz Institute for Primate Research Göttingen, Germany.,University of Göttingen Göttingen, Germany
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29
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Kos I, Balensiefer B, Lesan V, Kaddu-Mulindwa D, Thurner L, Christofyllakis K, Bittenbring JT, Ahlgrimm M, Seiffert M, Wagenpfeil S, Bewarder Y, Neumann F, Rixecker T, Smola S, Link A, Krawczyk M, Lammert F, Lepper PM, Bals R, Stilgenbauer S, Bewarder M. Increased B-cell activity with consumption of activated monocytes in severe COVID-19 patients. Eur J Immunol 2021; 51:1449-1460. [PMID: 33788264 PMCID: PMC8250224 DOI: 10.1002/eji.202049163] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/30/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022]
Abstract
The pathogenesis of autoimmune complications triggered by SARS-CoV2 has not been completely elucidated. Here, we performed an analysis of the cellular immune status, cell ratios, and monocyte populations of patients with COVID-19 treated in the intensive care unit (ICU) (cohort 1, N = 23) and normal care unit (NCU) (cohort 2, n = 10) compared with control groups: patients treated in ICU for noninfectious reasons (cohort 3, n = 30) and patients treated in NCU for infections other than COVID-19 (cohort 4, n = 21). Patients in cohort 1 presented significant differences in comparison with the other cohorts, including reduced frequencies of lymphocytes, reduced CD8+T-cell count, reduced percentage of activated and intermediate monocytes and an increased B/T8 cell ratio. Over time, patients in cohort 1 who died presented with lower counts of B, T, CD4+ T, CD8+ T-lymphocytes, NK cells, and activated monocytes. The B/T8 ratio was significantly lower in the group of survivors. In cohort 1, significantly higher levels of IgG1 and IgG3 were found, whereas cohort 3 presented higher levels of IgG3 compared to controls. Among many immune changes, an elevated B/T8-cell ratio and a reduced rate of activated monocytes were mainly observed in patients with severe COVID-19. Both parameters were associated with death in cohort 1.
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Affiliation(s)
- Igor Kos
- Internal Medicine I, Saarland University Medical Center, Homburg, Germany
| | | | - Vadim Lesan
- Internal Medicine I, Saarland University Medical Center, Homburg, Germany
| | | | - Lorenz Thurner
- Internal Medicine I, Saarland University Medical Center, Homburg, Germany
| | | | | | - Manfred Ahlgrimm
- Internal Medicine I, Saarland University Medical Center, Homburg, Germany
| | - Martina Seiffert
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
| | - Stefan Wagenpfeil
- Institute for Medical Biometrics, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany
| | - Yvonne Bewarder
- Department of Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Frank Neumann
- Internal Medicine I, Saarland University Medical Center, Homburg, Germany
| | - Torben Rixecker
- Department of Pulmonology, Allergology and Critical Care Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Andreas Link
- Department of Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
- Hannover Medical School, Hannover, Germany
| | - Philipp M Lepper
- Department of Pulmonology, Allergology and Critical Care Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Robert Bals
- Department of Pulmonology, Allergology and Critical Care Medicine, Saarland University Medical Center, Saarland University, Homburg, Germany
| | | | - Moritz Bewarder
- Internal Medicine I, Saarland University Medical Center, Homburg, Germany
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30
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Mang S, Kaddu-Mulindwa D, Metz C, Becker A, Seiler F, Smola S, Maßmann A, Becker SL, Papan C, Bals R, Lepper PM, Danziger G. Pneumocystis jirovecii Pneumonia and Severe Acute Respiratory Syndrome Coronavirus 2 Coinfection in a Patient With Newly Diagnosed HIV-1 Infection. Clin Infect Dis 2021; 72:1487-1489. [PMID: 32607564 PMCID: PMC7337649 DOI: 10.1093/cid/ciaa906] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sebastian Mang
- Department of Pneumology, Allergology and Critical Care Medicine, Saarland University, Homburg/Saar, Germany
| | - Dominic Kaddu-Mulindwa
- Department of Hematology, Oncology, Clinical Immunology, Rheumatology, Saarland University, Homburg/Saar, Germany
| | - Carlos Metz
- Department of Pneumology, Allergology and Critical Care Medicine, Saarland University, Homburg/Saar, Germany
| | - André Becker
- Department of Pneumology, Allergology and Critical Care Medicine, Saarland University, Homburg/Saar, Germany
| | - Frederik Seiler
- Department of Pneumology, Allergology and Critical Care Medicine, Saarland University, Homburg/Saar, Germany
| | - Sigrun Smola
- Center for Infectious Diseases, Institute of Virology, Saarland University, Homburg/Saar, Germany
| | - Alexander Maßmann
- Clinic for Diagnostic and Interventional Radiology, Saarland University, Homburg/Saar, Germany
| | - Sören L Becker
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
| | - Cihan Papan
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
| | - Robert Bals
- Department of Pneumology, Allergology and Critical Care Medicine, Saarland University, Homburg/Saar, Germany
| | - Philipp M Lepper
- Department of Pneumology, Allergology and Critical Care Medicine, Saarland University, Homburg/Saar, Germany
| | - Guy Danziger
- Department of Pneumology, Allergology and Critical Care Medicine, Saarland University, Homburg/Saar, Germany
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31
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Tóth G, Xanthopoulou K, Stachon T, Németh J, Hécz R, Berkó-Göttel B, Pfuhl T, Smola S, Seitz B, Szentmáry N. Impact of COVID-19 Pandemic on Emergency Inpatient Volume at a Tertiary Eye Care Center in Germany with Corneal Main Specialization. Klin Monbl Augenheilkd 2021; 238:715-720. [PMID: 33733448 DOI: 10.1055/a-1327-3393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND To estimate the impact of the COVID-19 pandemic on emergency inpatient volume in a tertiary eye care center in Germany with corneal main subspecialization. MATERIAL AND METHODS A retrospective review of ocular emergency patients who attended the inpatient unit of the Department of Ophthalmology of Saarland University, Homburg/Saar, Germany during the COVID-19 pandemic, between 1 March and 30 April 2020, in comparison to the same time period in 2019. For each subject, clinical history and surgical reports were reviewed. After 24 March 2020, PCR examinations for SARS-CoV-2 were performed from throat swab specimens in all patients using real-time RT-PCR. RESULTS Totally, 135 patients were admitted in 2019 and 115 patients in 2020 as emergency cases. The patient age at the time of admission did not differ significantly between the two time periods (63.6 ± 17.9 years vs. 62.5 ± 19.6 years) (p = 0.792), but the average length of hospital stays increased significantly for 2020 (4.0 ± 3.6 vs. 4.4 ± 2.7 days, p = 0.043). The percentage of admissions due to acute corneal hydrops (0% vs. 3.5%) increased significantly from 2019 to 2020 (χ2 = 4.772, p = 0.028), however, there was not a significant difference between the two years for any other diagnosis (χ2 ≤ 3.564, p ≥ 0.059). From 2019 to 2020, the percentage of acute intravitreal anti-VEGF injections decreased significantly (7.9% vs. 1.3%, χ2 = 3.985, p = 0.045), but the proportion of other emergency surgeries did not differ between the two years (χ2 ≤ 3.617, p ≥ 0.057). COVID-19 PCR examination was performed in 66 (57.4%) cases in 2020 and all samples (100%) were negative. CONCLUSIONS The COVID pandemic did not change emergency inpatient volume in our department, but duration of hospital stay was extended on average by 8 hours, mainly due to additional COVID-19-PCR examinations. The proportion of the most frequently performed surgeries did not change remarkably between 2019 and 2020, but with the introduction of Muraine's sutures in 2019, the percentage of admissions with acute corneal hydrops (with or without subsequent surgery) increased for 2020. No urgent surgery had to be postponed due to the COVID-19 pandemic at our department; all operations were performed successfully.
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Affiliation(s)
- Gábor Tóth
- Department of Ophthalmology, Saarland University Medical Center, UKS, Homburg/Saar, Germany.,Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg/Saar, Germany.,Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Kassandra Xanthopoulou
- Department of Ophthalmology, Saarland University Medical Center, UKS, Homburg/Saar, Germany
| | - Tanja Stachon
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Réka Hécz
- Pulmonology Hospital, Törökbálint, Hungary
| | - Barbara Berkó-Göttel
- Institute of Virology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, UKS, Homburg/Saar, Germany
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg/Saar, Germany.,Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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32
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Gross GE, Werner RN, Avila Valle GL, Bickel M, Brockmeyer NH, Doubek K, Gallwas J, Gieseking F, Haase H, Hillemanns P, Ikenberg H, Jongen J, Kaufmann AM, Klußmann JP, von Knebel Doeberitz M, Knuf M, Köllges R, Laws HJ, Mikolajczyk R, Neis KJ, Petry KU, Pfister H, Schlaeger M, Schneede P, Schneider A, Smola S, Tiews S, Nast A, Gaskins M, Wieland U. Evidenz‐ und konsensbasierte (S3) Leitlinie: Impfprävention HPV‐assoziierter Neoplasien. J Dtsch Dermatol Ges 2021; 19:479-494. [PMID: 33709591 DOI: 10.1111/ddg.14438_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Gerd E Gross
- Klinik für Dermatologie und Venerologie, Universitätsklinik Rostock, Rostock.,Paul-Ehrlich-Gesellschaft für Chemotherapie e.V., HPV Management Forum
| | - Ricardo N Werner
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | - Gabriela L Avila Valle
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | | | - Norbert H Brockmeyer
- Klinik für Dermatologie, Venerologie und Allergologie der Ruhr-Universität -Bochum, Zentrum für Sexuelle Gesundheit - WIR "Walk In Ruhr", Bochum
| | | | - Julia Gallwas
- Klinik für Gynäkologie und Geburtshilfe, Georg-August-Universität Göttingen
| | | | | | | | - Hans Ikenberg
- MVZ für Zytologie und Molekularbiologie Frankfurt GbR (CytoMol), Frankfurt am Main
| | | | - Andreas M Kaufmann
- Klinik für Gynäkologie, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Jens Peter Klußmann
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Uniklinik Köln, Medizinische Fakultät, Universität zu Köln
| | - Magnus von Knebel Doeberitz
- Abteilung für Angewandte Tumorbiologie, Institut für Pathologie, Universitätsklinikum Heidelberg und Klinische Kooperationseinheit G105 des Deutschen Krebsforschungszentrums (DKFZ)
| | - Markus Knuf
- Klinik für Kinder und Jugendliche, Helios Dr. Horst Schmidt Kliniken, Wiesbaden.,Pädiatrische Infektiologie, Universitätsmedizin Mainz, Mainz
| | - Ralf Köllges
- Praxis für Kinder und Jugendliche, Mönchengladbach
| | - Hans-Jürgen Laws
- Klinik für Kinderonkologie, -hämatologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf
| | - Rafael Mikolajczyk
- Institut für Medizinische Epidemiologie, Biometrie und Informatik (IMEBI), Martin-Luther Universität Halle-Wittenberg, Halle (Saale)
| | | | | | | | | | | | | | - Sigrun Smola
- Institut für Virologie, Universitätsklinikum des Saarlandes, Medizinische Fakultät, Universität des Saarlandes, Homburg/Saar
| | - Sven Tiews
- MVZ Labor für Cytopathologie Dr. Steinberg GmbH, Soest
| | - Alexander Nast
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | - Matthew Gaskins
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, -corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin -Institute of Health, Berlin
| | - Ulrike Wieland
- Nationales Referenzzentrum für Papillom- und Polyomaviren, Institut für Virologie, Uniklinik Köln, Universität zu Köln, Köln
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33
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Gross GE, Werner RN, Avila Valle GL, Bickel M, Brockmeyer NH, Doubek K, Gallwas J, Gieseking F, Haase H, Hillemanns P, Ikenberg H, Jongen J, Kaufmann AM, Klußmann JP, von Knebel Doeberitz M, Knuf M, Köllges R, Laws HJ, Mikolajczyk R, Neis KJ, Petry KU, Pfister H, Schlaeger M, Schneede P, Schneider A, Smola S, Tiews S, Nast A, Gaskins M, Wieland U. German evidence and consensus-based (S3) guideline: Vaccination recommendations for the prevention of HPV-associated lesions. J Dtsch Dermatol Ges 2021; 19:479-494. [PMID: 33634583 DOI: 10.1111/ddg.14438] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/10/2020] [Indexed: 11/28/2022]
Abstract
Anogenital and oropharyngeal infections with human papilloma viruses (HPV) are common. Clinically manifest disease may significantly impact quality of life; the treatment of HPV-associated lesions is associated with a high rate of recurrence and invasive neoplasms, such as cervical, anal, vulvar, penile, and oropharyngeal cancers, which are characterized by significant morbidity and mortality. Vaccination against HPV is an effective and safe measure for the primary prevention of HPV-associated lesions, but immunization rates are still low in Germany. The present publication is an abridged version of the German evidence and consensus-based guideline "Vaccination recommendations for the prevention of HPV-associated lesions", which is available on the website of the German Association of the Scientific Medical Societies (AWMF). On the basis of a systematic review with meta-analyses, a representative panel developed and agreed upon recommendations for the vaccination of different populations against HPV. In addition, consensus-based recommendations were developed for specific issues relevant to everyday practice. Based on current evidence and a representative expert consensus, these recommendations are intended to provide guidance in a field in which there is often uncertainty and in which both patients and health care providers are sometimes confronted with controversial and emotionally charged points of view.
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Affiliation(s)
- Gerd E Gross
- Department of Dermatology and Venereology, University Hospital Rostock, Rostock, Germany.,Paul Ehrlich Society for Chemotherapy, HPV Management Forum, Germany
| | - Ricardo N Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriela L Avila Valle
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Markus Bickel
- Infektiologikum Frankfurt, Frankfurt am Main, Germany
| | - Norbert H Brockmeyer
- Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Center for Sexual Health - WIR "Walk In Ruhr", Bochum, Germany
| | - Klaus Doubek
- Gynecology Office Dr. Klaus Doubek, Wiesbaden, Germany
| | - Julia Gallwas
- Department of Gynecology and Obstetrics, Georg August University Göttingen, Göttingen, Germany
| | | | | | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Hans Ikenberg
- MVZ for Cytology and Molecular Biology (CytoMol), Frankfurt am Main, Germany
| | | | - Andreas M Kaufmann
- Department of Gynecology, Campus Virchow Hospital, Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin and Berlin Institute of Health, Berlin, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, -University Hospital of Cologne, Medical Faculty, University of Cologne, Cologne, Germany
| | - Magnus von Knebel Doeberitz
- Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, Clinical Cooperation Unit G105 of the German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Markus Knuf
- Hospital for Child and Adolescent Health, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany.,Pediatric Infectiology, University Medical Center Mainz, Mainz, Germany
| | - Ralf Köllges
- Office for Child and Adolescent Health, Mönchengladbach, Germany
| | - Hans-Jürgen Laws
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometry and Informatics (IMEBI), Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Klaus J Neis
- Gynecology Office am Staden, Saarbrücken, Germany
| | | | - Herbert Pfister
- Institute of Virology, University of Cologne, Cologne, Germany
| | | | | | | | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Medical Faculty, Saarland University, Homburg/Saar, Germany
| | - Sven Tiews
- MVZ Laboratory for Cytopathology Dr. Steinberg GmbH, Soest, Germany
| | - Alexander Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Matthew Gaskins
- Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - University Medical Center Berlin, corporate member of Free University Berlin, Humboldt University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ulrike Wieland
- National Reference Center for Papilloma and Polyoma Viruses, Institute of Virology, University Hospital of Cologne, University of Cologne, Cologne, Germany
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34
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Kaddu-Mulindwa D, Thurner L, Bewarder M, Murawski N, Ahlgrimm M, Pfuhl T, Gärtner B, Smola S, Stilgenbauer S. Protection strategy against outbreak of COVID-19 at a tertiary hematology-oncology: strengths and pitfalls. Infect Agent Cancer 2021; 16:17. [PMID: 33627114 PMCID: PMC7903402 DOI: 10.1186/s13027-021-00356-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
Due to the worldwide COVID-19 outbreak it is mandatory for health care workers to develop containment strategies. Recently published data showed, that cancer patients might have a higher risk for severe course of the disease. We therefore developed a strategy of screening and containment for SARS-CoV-2 for hospitalized cancer patients. Our approach includes a temporary isolation in a so-called floating zone and testing strategy for screening of asymptomatic individuals by pooling of samples before RT-PCR amplification. Patients as far as health care professionals got tested twice a week. Nurses and physicians entered the floating zone with full body protection. Within 8 weeks we tested 418 individuals (professionals and patients) in total. Only 2 patients had COVID-19 without documented further transmission of SARS-CoV-2. We therefore think that our strategy might be a useful approach to protect inpatients with cancer at high risk for SARS-CoV-2 infection during this ongoing pandemic.
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Affiliation(s)
- Dominic Kaddu-Mulindwa
- Department of Internal Medicine 1 (Oncology, Hematology, Rheumatology and Clinical Immunology), Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Germany.
| | - Lorenz Thurner
- Department of Internal Medicine 1 (Oncology, Hematology, Rheumatology and Clinical Immunology), Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Moritz Bewarder
- Department of Internal Medicine 1 (Oncology, Hematology, Rheumatology and Clinical Immunology), Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Niels Murawski
- Department of Internal Medicine 1 (Oncology, Hematology, Rheumatology and Clinical Immunology), Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Manfred Ahlgrimm
- Department of Internal Medicine 1 (Oncology, Hematology, Rheumatology and Clinical Immunology), Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, 66421, Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421, Homburg, Germany
| | - Stephan Stilgenbauer
- Department of Internal Medicine 1 (Oncology, Hematology, Rheumatology and Clinical Immunology), Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Germany
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35
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Bernhard MC, Zwick A, Mohr T, Gasparoni G, Khalmurzaev O, Matveev VB, Loertzer P, Pryalukhin A, Hartmann A, Geppert CI, Loertzer H, Wunderlich H, Naumann CM, Kalthoff H, Junker K, Smola S, Lohse S. The HPV and p63 Status in Penile Cancer Are Linked with the Infiltration and Therapeutic Availability of Neutrophils. Mol Cancer Ther 2020; 20:423-437. [PMID: 33273057 DOI: 10.1158/1535-7163.mct-20-0173] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/10/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022]
Abstract
Squamous penile cancer displays a rare human papillomavirus (HPV)-associated tumor entity. Investigations on the molecular pathogenesis of HPV-driven penile cancer are impaired by the rareness of clinical specimens and, in particular, are missing relevant cell culture models. Here, we identified in HPV-positive penile cancer cell lines that HPV16 oncoproteins control TP63 expression by modulating critical regulators, while integration into the TP63 open reading frame facilitates oncogene expression. The resulting feed-forward loop leads to elevated p63 levels that in turn enhance the release of the neutrophil-recruiting chemokine CXCL8. Remarkably, elevated CXCL8 amounts lead to the increased surface exposition of the Fc receptor of human IgA antibodies, FcαRI, on neutrophils and correlated with a higher susceptibility to antibody-dependent neutrophil-mediated cytotoxicity (ADCC) using an EGFR-specific IgA2 antibody. IHC staining of tissue microarrays proved that elevated expression of p63 together with neutrophil infiltration were significantly more frequent in HPV-positive penile cancer displaying a higher tumor grade. In summary, we identified a promising marker profile of patients with penile cancer at higher risk for worse prognosis. However, these patients may benefit from immunotherapeutic approaches efficiently engaging neutrophils for tumor cell killing.
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Affiliation(s)
| | - Anabel Zwick
- Institute of Virology, University of Saarland, Homburg, Germany
| | - Tobias Mohr
- Institute of Virology, University of Saarland, Homburg, Germany
| | - Gilles Gasparoni
- Department of Genetics, University of Saarland, Saarbrücken, Germany
| | - Oybek Khalmurzaev
- Department of Urology and Pediatric Urology, University of Saarland, Homburg, Germany.,Department of Urology, Federal State Budgetary Institution "N.N. Blokhin National Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vsevolod Borisovich Matveev
- Department of Urology, Federal State Budgetary Institution "N.N. Blokhin National Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Philine Loertzer
- Department of Urology and Pediatric Urology, University of Saarland, Homburg, Germany
| | - Alexey Pryalukhin
- Institute of Pathology, Saarland University Medical Centre, Homburg, Germany.,Institute of Pathology, University Medical Centre Bonn, Bonn, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Hagen Loertzer
- Department of Urology and Pediatric Urology, Westpfalz Klinikum, Kaiserslautern, Germany
| | - Heiko Wunderlich
- Department of Urology and Paediatric Urology, St. Georg Klinikum, Eisenach, Germany
| | - Carsten Maik Naumann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Holger Kalthoff
- Division of Molecular Oncology, Institute of Experimental Cancer Research, University Hospital Schleswig Holstein, Kiel, Germany
| | - Kerstin Junker
- Department of Urology and Pediatric Urology, University of Saarland, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, University of Saarland, Homburg, Germany
| | - Stefan Lohse
- Institute of Virology, University of Saarland, Homburg, Germany.
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36
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Lohse S, Pfuhl T, Berkó-Göttel B, Rissland J, Geißler T, Gärtner B, Becker SL, Schneitler S, Smola S. Pooling of samples for testing for SARS-CoV-2 in asymptomatic people. Lancet Infect Dis 2020. [PMID: 32530425 DOI: 10.1016/s1473–3099[20]30362–-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Affiliation(s)
- Stefan Lohse
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Barbara Berkó-Göttel
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Tobias Geißler
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany; Clinic for Anesthesiology, Intensive Care Medicine and Pain Therapy, Saarland University Medical Center, 66421 Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sophie Schneitler
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany.
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37
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Bewarder M, Held G, Thurner L, Stilgenbauer S, Smola S, Preuss KD, Carbon G, Bette B, Christofyllakis K, Bittenbring JT, Felbel A, Hasse A, Murawski N, Kaddu-Mulindwa D, Neumann F. Characterization of an HLA-restricted and human cytomegalovirus-specific antibody repertoire with therapeutic potential. Cancer Immunol Immunother 2020; 69:1535-1548. [PMID: 32300857 PMCID: PMC7347513 DOI: 10.1007/s00262-020-02564-1] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 04/02/2020] [Indexed: 01/04/2023]
Abstract
With an infection rate of 60-90%, the human cytomegalovirus (HCMV) is very common among adults but normally causes no symptoms. When T cell-mediated immunity is compromised, HCMV reactivation can lead to increased morbidity and mortality. HCMV antigens are processed and presented as peptides on the cell surface via HLA I complexes to the T cell receptor (TCR) of T cells. The generation of antibodies against HCMV peptides presented on HLA complexes (TCR-like antibodies) has been described, but is without therapeutic applications to date due to the polygenic and polymorphic nature of HLA genes. We set out to obtain antibodies specific for HLA/HCMV-peptides, covering the majority of HLA alleles present in European populations. Using phage display technology, we selected 10 Fabs, able to bind to HCMV-peptides presented in the 6 different HLA class I alleles A*0101, A*0201, A*2402, B*0702, B*0801 and B*3501. We demonstrate specific binding of all selected Fabs to HLA-typed lymphoblastoid cell lines (EBV-transformed B cells) and lymphocytes loaded with HCMV-peptides. After infection with HCMV, 4/10 tetramerized Fabs restricted to the alleles HLA-A*0101, HLA-A*0201 and HLA-B*0702 showed binding to infected primary fibroblasts. When linked to the pseudomonas exotoxin A, these Fab antibodies induce highly specific cytotoxicity in HLA matched cell lines loaded with HCMV peptides. TCR-like antibody repertoires therefore represent a promising new treatment modality for viral infections and may also have applications in the treatment of cancers.
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Affiliation(s)
- Moritz Bewarder
- Internal Medicine I, Saarland University Medical Center, 66421, Homburg, Germany.
- José Carreras Center, Saarland University Medical Center, Homburg, Germany.
| | - Gerhard Held
- Internal Medicine I, Westpfalz-Klinikum Kaiserslautern, Kaiserslautern, Germany
| | - Lorenz Thurner
- Internal Medicine I, Saarland University Medical Center, 66421, Homburg, Germany
- José Carreras Center, Saarland University Medical Center, Homburg, Germany
| | - Stephan Stilgenbauer
- Internal Medicine I, Saarland University Medical Center, 66421, Homburg, Germany
- José Carreras Center, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | | | - Gabi Carbon
- José Carreras Center, Saarland University Medical Center, Homburg, Germany
| | - Birgit Bette
- José Carreras Center, Saarland University Medical Center, Homburg, Germany
| | | | | | - Arne Felbel
- Internal Medicine I, Saarland University Medical Center, 66421, Homburg, Germany
| | - Alexander Hasse
- Internal Medicine I, Saarland University Medical Center, 66421, Homburg, Germany
| | - Niels Murawski
- Internal Medicine I, Saarland University Medical Center, 66421, Homburg, Germany
| | | | - Frank Neumann
- José Carreras Center, Saarland University Medical Center, Homburg, Germany
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38
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Lohse S, Pfuhl T, Berkó-Göttel B, Rissland J, Geißler T, Gärtner B, Becker SL, Schneitler S, Smola S. Pooling of samples for testing for SARS-CoV-2 in asymptomatic people. Lancet Infect Dis 2020; 20:1231-1232. [PMID: 32530425 PMCID: PMC7194818 DOI: 10.1016/s1473-3099(20)30362-5] [Citation(s) in RCA: 218] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Stefan Lohse
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Barbara Berkó-Göttel
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Tobias Geißler
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany; Clinic for Anesthesiology, Intensive Care Medicine and Pain Therapy, Saarland University Medical Center, 66421 Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sophie Schneitler
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany.
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39
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Venuti A, Lohse S, Tommasino M, Smola S. Cross-talk of cutaneous beta human papillomaviruses and the immune system: determinants of disease penetrance. Philos Trans R Soc Lond B Biol Sci 2019; 374:20180287. [PMID: 30955489 PMCID: PMC6501898 DOI: 10.1098/rstb.2018.0287] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 01/23/2019] [Indexed: 12/19/2022] Open
Abstract
Human papillomaviruses (HPVs) infect the epithelia of skin or mucosa, where they can induce hyperproliferative lesions. More than 220 different HPV types have been characterized and classified into five different genera. Mucosal high-risk HPVs are causative for cancers of the anogenital region and oropharynx. Clinical data from patients with the rare genetic disorder epidermodysplasia verruciformis (EV) indicate that genus beta-HPVs cooperate with ultraviolet (UV) radiation in the development of cutaneous squamous cell carcinoma. In addition, epidemiological and biological findings indicate that beta-HPV types play a role in UV-mediated skin carcinogenesis also in non-EV individuals. However, the mechanisms used by these cutaneous viruses to promote epithelial carcinogenesis differ significantly from those of mucosal HPVs. Recent studies point to a delicate cross-talk of beta-HPVs with the cell-autonomous immunity of the host keratinocytes and the local immune microenvironment that eventually determines the fate of cutaneous HPV infection and the penetrance of disease. This review gives an overview of the critical interactions of genus beta-HPVs with the local immune system that allow the virus to complete its life cycle, to escape from extrinsic immunity, and eventually to cause chronic inflammation contributing to skin carcinogenesis. This article is part of the theme issue 'Silent cancer agents: multi-disciplinary modelling of human DNA oncoviruses'.
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Affiliation(s)
- Assunta Venuti
- 1 Infections and Cancer Biology Group, International Agency for Research on Cancer , 150 Cours Albert Thomas, Lyon 69008 , France
| | - Stefan Lohse
- 2 Institute of Virology, Saarland University Medical Center , Kirrbergerstr. Building 47, 66421 Homburg/Saar , Germany
| | - Massimo Tommasino
- 1 Infections and Cancer Biology Group, International Agency for Research on Cancer , 150 Cours Albert Thomas, Lyon 69008 , France
| | - Sigrun Smola
- 2 Institute of Virology, Saarland University Medical Center , Kirrbergerstr. Building 47, 66421 Homburg/Saar , Germany
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40
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Walch-Rückheim B, Ströder R, Theobald L, Pahne-Zeppenfeld J, Hegde S, Kim YJ, Bohle RM, Juhasz-Böss I, Solomayer EF, Smola S. Cervical Cancer-Instructed Stromal Fibroblasts Enhance IL23 Expression in Dendritic Cells to Support Expansion of Th17 Cells. Cancer Res 2019; 79:1573-1586. [PMID: 30696656 DOI: 10.1158/0008-5472.can-18-1913] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/16/2018] [Accepted: 01/23/2019] [Indexed: 11/16/2022]
Abstract
Persistent infection with high-risk human papillomavirus (HPV) is a prerequisite for the development of cervical cancer. HPV-transformed cells actively instruct their microenvironment, promoting chronic inflammation and cancer progression. We previously demonstrated that cervical cancer cells contribute to Th17 cell recruitment, a cell type with protumorigenic properties. In this study, we analyzed the expression of the Th17-promoting cytokine IL23 in the cervical cancer micromilieu and found CD83+ mature dendritic cells (mDC) coexpressing IL23 in the stroma of cervical squamous cell carcinomas in situ. This expression of IL23 correlated with stromal Th17 cells, advanced tumor stage, lymph node metastasis, and cervical cancer recurrence. Cocultures of cervical cancer-instructed mDCs and cervical fibroblasts led to potent protumorigenic expansion of Th17 cells in vitro but failed to induce antitumor Th1 differentiation. Correspondingly, cervical cancer-instructed fibroblasts increased IL23 production in cocultured cervical cancer-instructed mDCs, which mediated subsequent Th17 cell expansion. In contrast, production of the Th1-polarizing cytokine IL12 in the cancer-instructed mDCs was strongly reduced. This differential IL23 and IL12 regulation was the consequence of an increased expression of the IL23 subunits IL23p19 and IL12p40 but decreased expression of the IL12 subunit IL12p35 in cervical cancer-instructed mDCs. Cervical cancer cell-derived IL6 directly suppressed IL12p35 in mDCs but indirectly induced IL23 expression in fibroblast-primed mDCs via CAAT/enhancer-binding protein β (C/EBPβ)-dependent induction of IL1β. In summary, our study defines a mechanism by which the cervical cancer micromilieu supports IL23-mediated Th17 expansion associated with cancer progression. SIGNIFICANCE: Cervical cancer cells differentially regulate IL23 and IL12 in DC fibroblast cocultures in an IL6/C/EBPβ/IL1β-dependent manner, thereby supporting the expansion of Th17 cells during cancer progression.
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Affiliation(s)
- Barbara Walch-Rückheim
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany.
| | - Russalina Ströder
- Department of Obstetrics and Gynecology, Saarland University, Homburg/Saar, Germany
| | - Laura Theobald
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
| | - Jennifer Pahne-Zeppenfeld
- Center for Molecular Medicine Cologne and Institute of Virology, University of Cologne, Cologne, Germany
| | - Subramanya Hegde
- Center for Molecular Medicine Cologne and Institute of Virology, University of Cologne, Cologne, Germany
| | - Yoo-Jin Kim
- Institute of Pathology, Saarland University, Homburg/Saar, Germany
| | | | - Ingolf Juhasz-Böss
- Department of Obstetrics and Gynecology, Saarland University, Homburg/Saar, Germany
| | | | - Sigrun Smola
- Institute of Virology and Center of Human and Molecular Biology, Saarland University, Homburg/Saar, Germany
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41
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Pfister HJ, Gariglio M, Smola S. Editorial: Human Papillomaviruses and Polyomaviruses in Skin Cancer. Front Microbiol 2018; 9:2778. [PMID: 30498488 PMCID: PMC6250093 DOI: 10.3389/fmicb.2018.02778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/30/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Marisa Gariglio
- Scuola di Medicina, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Sigrun Smola
- Institute of Virology, Saarland University, Saarbrücken, Germany
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42
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Müller CSL, Kreie L, Bochen F, Pfuhl T, Smola S, Gräber S, Vogt T, Schick B, Linxweiler M. Expression of 3q oncogene SEC62 in atypical fibroxanthoma-immunohistochemical analysis of 41 cases and correlation with clinical, viral and histopathologic features. Oncol Lett 2018; 17:1768-1776. [PMID: 30675236 PMCID: PMC6341582 DOI: 10.3892/ol.2018.9767] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/26/2018] [Indexed: 12/30/2022] Open
Abstract
Atypical fibroxanthoma (AFX) is a rare mesenchymal tumor with predominance in older male patients located mainly in chronically UV-exposed skin. Differentiation from clinically more aggressive pleomorphic dermal sarcoma (PDS) is still under debate and immunohistochemical markers are not available yet. An immunohistochemical study, including 41 cases of AFX was conducted to investigate the expression of 3q encoded oncogene SEC62 in AFX and determine the associations with histomorphologic, clinical and viral parameters. Our cohort displayed a mean of 79.9 years at the onset of the disease. In total, 90.2% (37/41) AFXs were located in the head and neck area, whereas, four were located at the extremities (9.7%). Tumor diameter ranged between 0.06 and 40 cm2 with a mean of 5.7 cm2. SEC62 expression was markedly increased in lesional tissue compared with the adjacent healthy squamous epithelium. We found significantly higher expression of SEC62 in cases of AFX with tumor necrosis. Tendency of higher Sec62-IRS-scores were found for tumors with higher Clark levels and a tumor size >5 cm2. Sec62 is involved in endoplasmic reticulum stress tolerance and cell migration, and has been identified as a novel prognostic marker for non-small cell lung cancer as well as head and neck squamous cell carcinoma. For the first time, to the best of our knowledge, we suggest a role of 3q oncogene SEC62 in AFX and discuss a potential prognostic relevance in cases of disputable AFX with unfavorable histomorphologic features and may initiate a discussion on Sec62 serving as discriminating marker between AFX and PDS.
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Affiliation(s)
- Cornelia S L Müller
- Department of Dermatology, Venereology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Léa Kreie
- Department of Dermatology, Venereology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Stefan Gräber
- Institute of Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Thomas Vogt
- Department of Dermatology, Venereology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany
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43
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Müller CSL, Laue M, Kremer K, Becker S, Vogt T, Smola S. Molluscum-contagiosum-Virus in einer Epidermalzyste. J Dtsch Dermatol Ges 2018; 16:1144-1146. [DOI: 10.1111/ddg.13633_g] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Cornelia Sigrid Lissi Müller
- Klinik für Dermatologie; Allergologie und Venerologie; Universitätsklinkum des Saarlandes; Homburg/Saar Deutschland
| | - Michael Laue
- Spezielle Licht- und Elektronenmikroskopie (ZBS 4); Robert Koch-Institut; Berlin Deutschland
| | - Kim Kremer
- Praxis für Dermatologie; Wasserbillig Luxemburg
| | - Stephanie Becker
- Klinik für Dermatologie; Allergologie und Venerologie; Universitätsklinkum des Saarlandes; Homburg/Saar Deutschland
| | - Thomas Vogt
- Klinik für Dermatologie; Allergologie und Venerologie; Universitätsklinkum des Saarlandes; Homburg/Saar Deutschland
| | - Sigrun Smola
- Institut für Virologie; Universitätsklinikum des Saarlandes; Homburg/Saar Deutschland
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44
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Müller CSL, Laue M, Kremer K, Becker S, Vogt T, Smola S. Presence of molluscum contagiosum virus within an epidermal cyst. J Dtsch Dermatol Ges 2018; 16:1143-1145. [PMID: 30130000 DOI: 10.1111/ddg.13633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Michael Laue
- Advanced Light and Electron Microscopy (ZBS 4), Robert Koch Institute, Berlin, Germany
| | - Kim Kremer
- Praxis für Dermatologie, Wasserbillig, Luxembourg
| | - Stephanie Becker
- Department of Dermatology, Saarland University Hospital, Homburg/Saar, Germany
| | - Thomas Vogt
- Department of Dermatology, Saarland University Hospital, Homburg/Saar, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg/Saar, Germany
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45
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Zeuschner P, Ueberdiek S, Pryalukhin A, Veith C, Saar M, Smola S, Bohle RM, Junker K, Stöckle M, Heinzelbecker J. Human Papillomavirus-Associated Invasive Condylomas in a Man with Immunosuppressive Comorbidities. Urol Int 2018; 102:238-242. [PMID: 30130762 DOI: 10.1159/000491098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 06/19/2018] [Indexed: 11/19/2022]
Abstract
Human papilloma virus (HPV) infections are one of the most common sexually transmitted diseases. We present the case of a 77-year-old Caucasian male with enormous genital warts of the penis, scrotum, groins and anus. Lesions were excised by electrosurgery. The histological examination revealed Condylomata gigantea as well as an invasive perianal squamous cell carcinoma. Mucosal "low-risk" HPV type 6 was detected. The patient had a history of an immunosuppressing disease. During the 4-year follow-up, multiple relapses occurred. Thus, particularly in immunosuppressed patients, early prophylactic HPV vaccination seems to be indicated for use in the prevention of HPV-associated mutilating and life-threatening disease. Vaccination should also protect from "low-risk" HPV.
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Affiliation(s)
- Philip Zeuschner
- Department of Urology and Pediatric Urology, Saarland University, Homburg,
| | - Stefan Ueberdiek
- Department of Urology and Pediatric Urology, Saarland University, Homburg, Germany
| | - Alexey Pryalukhin
- Institute of Pathology and Neuropathology, Saarland University, Homburg, Germany
| | - Christian Veith
- Institute of Pathology and Neuropathology, Saarland University, Homburg, Germany
| | - Matthias Saar
- Department of Urology and Pediatric Urology, Saarland University, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University, Homburg, Germany
| | - Rainer Maria Bohle
- Institute of Pathology and Neuropathology, Saarland University, Homburg, Germany
| | - Kerstin Junker
- Department of Urology and Pediatric Urology, Saarland University, Homburg, Germany
| | - Michael Stöckle
- Department of Urology and Pediatric Urology, Saarland University, Homburg, Germany
| | - Julia Heinzelbecker
- Department of Urology and Pediatric Urology, Saarland University, Homburg, Germany
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46
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Stroeder R, Walch-Rückheim B, Fischbach J, Juhasz-Böss I, Rübe C, Solomayer EF, Smola S. Oncostatin M treatment increases the responsiveness toward cisplatin-based chemoradiotherapy in cervical cancer cells in a STAT3-dependent manner. Oncol Lett 2018; 16:3351-3358. [PMID: 30127934 DOI: 10.3892/ol.2018.8987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 05/22/2018] [Indexed: 01/01/2023] Open
Abstract
Cervical cancer stage-dependent therapies include surgery, chemotherapy, radiotherapy and chemoradiotherapy. Concurrent cisplatin-based chemoradiotherapy (CCRT) is the standard therapy for locally advanced cervical carcinoma (FIGO>IIB), however therapy resistance in a subset of patients is still a major clinical challenge. The present study aimed to analyze the impact of Oncostatin M (OSM) stimulation on CCRT-induced cell death. The present study used cells derived from cervical squamous cell carcinomas (SW756, 808, CaSki and 879) and adenocarcinoma (HeLa). The cervical carcinoma cells were HPV18-positive (HeLa, SW756, 808) or HPV16-positive (CaSki, 879). In addition to the established cell lines HeLa, SW756 and CaSki, the more recently generated cervical cancer cells 808 and 879 were also used. To analyze their radiosensitivity, cells were treated with increasing doses of irradiation (0-8 Gy). To mimic chemotherapy, radiotherapy or CCRT in vitro, the cells were challenged with 0.975 µg/ml cisplatin, irradiated with 6 Gy or a combination. A total of 10 ng/ml OSM was applied for 2 h prior to the respective therapy. The responsiveness toward radiation alone varied among the cervical carcinoma cells. CaSki, 808 and 879 cells were resistant to irradiation up to 8 Gy. OSM pre-treatment sensitized two out of five cell lines (HeLa and 879) to irradiation. Notably, all tested cells were sensitized by OSM for CCRT-treatment, particularly in the less radiosensitive cells. Cell death enhancement was dependent on phosphorylated signal transducer and activator of transcription 3 (STAT3; Tyr705) signaling activation as demonstrated with a dominant-negative version of STAT3 interfering with phosphorylation at Tyr705 (dnSTAT3-Y705F). In conclusion, OSM pre-treatment was able to override resistance to CCRT via the STAT3 signaling pathway.
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Affiliation(s)
- Russalina Stroeder
- Department of Gynecology and Obstetrics, Saarland University, D-66421 Homburg/Saar, Germany
| | | | - Jil Fischbach
- Institute of Virology, Saarland University, D-66421 Homburg/Saar, Germany
| | - Ingolf Juhasz-Böss
- Department of Gynecology and Obstetrics, Saarland University, D-66421 Homburg/Saar, Germany
| | - Christian Rübe
- Department of Radiotherapy and Radiation Oncology, Saarland University, D-66421 Homburg/Saar, Germany
| | - Erich-Franz Solomayer
- Department of Gynecology and Obstetrics, Saarland University, D-66421 Homburg/Saar, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University, D-66421 Homburg/Saar, Germany
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47
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Peretti A, Geoghegan EM, Pastrana DV, Smola S, Feld P, Sauter M, Lohse S, Ramesh M, Lim ES, Wang D, Borgogna C, FitzGerald PC, Bliskovsky V, Starrett GJ, Law EK, Harris RS, Killian JK, Zhu J, Pineda M, Meltzer PS, Boldorini R, Gariglio M, Buck CB. Characterization of BK Polyomaviruses from Kidney Transplant Recipients Suggests a Role for APOBEC3 in Driving In-Host Virus Evolution. Cell Host Microbe 2018; 23:628-635.e7. [PMID: 29746834 PMCID: PMC5953553 DOI: 10.1016/j.chom.2018.04.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [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] [Received: 06/15/2017] [Revised: 12/05/2017] [Accepted: 03/19/2018] [Indexed: 12/31/2022]
Abstract
BK polyomavirus (BKV) frequently causes nephropathy (BKVN) in kidney transplant recipients (KTRs). BKV has also been implicated in the etiology of bladder and kidney cancers. We characterized BKV variants from two KTRs who developed BKVN followed by renal carcinoma. Both patients showed a swarm of BKV sequence variants encoding non-silent mutations in surface loops of the viral major capsid protein. The temporal appearance and disappearance of these mutations highlights the intra-patient evolution of BKV. Some of the observed mutations conferred resistance to antibody-mediated neutralization. The mutations also modified the spectrum of receptor glycans engaged by BKV during host cell entry. Intriguingly, all observed mutations were consistent with DNA damage caused by antiviral APOBEC3 cytosine deaminases. Moreover, APOBEC3 expression was evident upon immunohistochemical analysis of renal biopsies from KTRs. These results provide a snapshot of in-host BKV evolution and suggest that APOBEC3 may drive BKV mutagenesis in vivo.
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Affiliation(s)
- Alberto Peretti
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Eileen M Geoghegan
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Diana V Pastrana
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sigrun Smola
- Institute of Virology, Saarland University, Homburg/Saar 66421, Germany
| | - Pascal Feld
- Institute of Virology, Saarland University, Homburg/Saar 66421, Germany
| | - Marlies Sauter
- Institute of Virology, Saarland University, Homburg/Saar 66421, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University, Homburg/Saar 66421, Germany
| | - Mayur Ramesh
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI 48202 USA
| | - Efrem S Lim
- Departments of Molecular Microbiology and Pathology & Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - David Wang
- Departments of Molecular Microbiology and Pathology & Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Cinzia Borgogna
- Virology Unit, Department of Translational Medicine, Novara Medical School, Novara 28100, Italy
| | - Peter C FitzGerald
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Valery Bliskovsky
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Gabriel J Starrett
- Department of Biochemistry, Molecular Biology and Biophysics, Masonic Cancer Center, Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Emily K Law
- Department of Biochemistry, Molecular Biology and Biophysics, Masonic Cancer Center, Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA; Howard Hughes Medical Institute, University of Minnesota, Minneapolis, MN 55455, USA
| | - Reuben S Harris
- Department of Biochemistry, Molecular Biology and Biophysics, Masonic Cancer Center, Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA; Howard Hughes Medical Institute, University of Minnesota, Minneapolis, MN 55455, USA
| | - J Keith Killian
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jack Zhu
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Marbin Pineda
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Paul S Meltzer
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Renzo Boldorini
- Pathology Unit, Department of Health Sciences, Novara Medical School, Novara 28100, Italy
| | - Marisa Gariglio
- Virology Unit, Department of Translational Medicine, Novara Medical School, Novara 28100, Italy
| | - Christopher B Buck
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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48
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Wemmert S, Linxweiler M, Lerner C, Bochen F, Kulas P, Linxweiler J, Smola S, Urbschat S, Wagenpfeil S, Schick B. Combinational chromosomal aneuploidies and HPV status for prediction of head and neck squamous cell carcinoma prognosis in biopsies and cytological preparations. J Cancer Res Clin Oncol 2018; 144:1129-1141. [PMID: 29560516 DOI: 10.1007/s00432-018-2629-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/15/2018] [Indexed: 01/12/2023]
Abstract
PURPOSE Head and neck squamous cell carcinoma (HNSCC) is one of the most common human cancer types with a very poor prognosis despite improvements in therapeutic modalities. The major known risk factors are tobacco use and alcohol consumption or infection with high-risk human papilloma viruses (HPV), especially in oropharyngeal tumors. The current management based on the assessment of a variety of clinical and pathological parameters does not sufficiently predict outcome. METHODS Chromosomal alterations detected in HNSCCs were characterized by metaphase comparative genomic hybridization (CGH) and correlated with clinical parameters as well as survival time. Candidate regions were validated by quantitative polymerase chain reaction, fluorescence-in situ-hybridization (FISH) on dapped tumor tissue and liquid-based cytological smear preparations. In addition, HPV status was determined by polymerase chain reaction and simultaneous immunocytochemical p16INK4a-Ki67 staining. RESULTS The most frequent DNA copy number gains were observed on chromosome arms 3q, 8q, 5p, 7q, 12p, and 12q. DNA copy number decreases occurred most frequently at 3p, 17p, 4q, and 5q. FISH analysis verified in part the observed alterations by CGH on dapped tissues and was especially able to detect the most frequent DNA copy changes in cytological specimens. CONCLUSION The combination of HPV status and prognostic copy number alteration detected by FISH in biopsies or cytological specimens may be an applicable protocol for screening head and neck cancer patients prior to therapy.
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Affiliation(s)
- Silke Wemmert
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Street 100, 66421, Homburg (Saar), Germany.
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Street 100, 66421, Homburg (Saar), Germany
| | - Cornelia Lerner
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Street 100, 66421, Homburg (Saar), Germany
| | - Florian Bochen
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Street 100, 66421, Homburg (Saar), Germany
| | - Philipp Kulas
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Street 100, 66421, Homburg (Saar), Germany
| | | | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Steffi Urbschat
- Department of Neurosurgery, Saarland University, Homburg (Saar), Germany
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg (Saar), Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Street 100, 66421, Homburg (Saar), Germany
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49
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Podgórska M, Ołdak M, Marthaler A, Fingerle A, Walch-Rückheim B, Lohse S, Müller CSL, Vogt T, Ustav M, Wnorowski A, Malejczyk M, Majewski S, Smola S. Chronic Inflammatory Microenvironment in Epidermodysplasia Verruciformis Skin Lesions: Role of the Synergism Between HPV8 E2 and C/EBPβ to Induce Pro-Inflammatory S100A8/A9 Proteins. Front Microbiol 2018; 9:392. [PMID: 29563902 PMCID: PMC5845987 DOI: 10.3389/fmicb.2018.00392] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/21/2018] [Indexed: 01/01/2023] Open
Abstract
Persistent genus β-HPV (human papillomavirus) infection is a major co-factor for non-melanoma skin cancer in patients suffering from the inherited skin disease epidermodysplasia verruciformis (EV). Malignant EV lesions are particularly associated with HPV type 5 or 8. There is clinical and molecular evidence that HPV8 actively suppresses epithelial immunosurveillance by interfering with the recruitment of Langerhans cells, which may favor viral persistence. Mechanisms how persistent HPV8 infection promotes the carcinogenic process are, however, less well understood. In various tumor types chronic inflammation has a central role in tumor progression. The calprotectin complex consisting of S100A8 and S100A9 proteins has recently been identified as key driver of chronic and tumor promoting inflammation in skin carcinogenesis. It induces chemotaxis of neutrophil granulocytes and modulates inflammatory as well as immune responses. In this study, we demonstrate that skin lesions of EV-patients are massively infiltrated by inflammatory cells, including CD15+ granulocytes. At the same time we observed a very strong expression of S100A8 and S100A9 proteins in lesional keratinocytes, which was mostly confined to the suprabasal layers of the epidermis. Both proteins were hardly detected in non-lesional skin. Further experiments revealed that the HPV8 oncoproteins E6 and E7 were not involved in S100A8/A9 up-regulation. They rather suppressed differentiation-induced S100A8/A9 expression. In contrast, the viral transcription factor E2 strongly enhanced PMA-mediated S100A8/A9 up-regulation in primary human keratinocytes. Similarly, a tremendous up-regulation of both S100 proteins was observed, when minute amounts of the PMA-inducible CCAAT/enhancer binding protein β (C/EBPβ), which is expressed at low levels in the suprabasal layers of the epidermis, were co-expressed together with HPV8 E2. This confirmed our previous observation that C/EBPβ interacts and functionally synergizes with the HPV8 E2 protein in differentiation-dependent gene expression. Potent synergistic up-regulation of S100A8/A9 was seen at transcriptional and protein levels. S100A8/A9 containing supernatants from keratinocytes co-expressing HPV8 E2 and C/EBPβ significantly induced chemotaxis of granulocytes in migration assays supporting the relevance of our finding. In conclusion, our data suggest that the HPV8 E2 protein actively contributes to the recruitment of myeloid cells into EV skin lesions, which may support chronic inflammation and progression to skin cancer.
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Affiliation(s)
- Marta Podgórska
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Monika Ołdak
- Institute of Virology, Saarland University Medical Center, Homburg, Germany.,Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Anna Marthaler
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Alina Fingerle
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | | | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Cornelia S L Müller
- Department of Dermatology, Saarland University Medical Center, Homburg, Germany
| | - Thomas Vogt
- Department of Dermatology, Saarland University Medical Center, Homburg, Germany
| | - Mart Ustav
- Icosagen Cell Factory OÜ, Institute of Technology, University of Tartu, Tartu, Estonia
| | - Artur Wnorowski
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Magdalena Malejczyk
- Diagnostic Laboratory of STDs, Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland
| | - Sławomir Majewski
- Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
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50
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Bochen F, Adisurya H, Wemmert S, Lerner C, Greiner M, Zimmermann R, Hasenfus A, Wagner M, Smola S, Pfuhl T, Bozzato A, Al Kadah B, Schick B, Linxweiler M. Effect of 3q oncogenes SEC62 and SOX2 on lymphatic metastasis and clinical outcome of head and neck squamous cell carcinomas. Oncotarget 2018; 8:4922-4934. [PMID: 28002801 PMCID: PMC5354881 DOI: 10.18632/oncotarget.13986] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 06/21/2016] [Accepted: 12/05/2016] [Indexed: 12/13/2022] Open
Abstract
Chromosome 3q26 amplification represents a frequent alteration in head and neck squamous cell carcinomas (HNSCCs). Overexpression of 3q26 encoded genes SEC62 and SOX2 was detected in various cancers, including HNSCCs, indicating their potential function as oncogenes. In our study, we elucidated the function of SEC62 and SOX2 in HNSCC patients, with a main focus on their effect on lymphatic metastasis and patient survival. We analyzed SEC62 and SOX2 expression in tissue specimens from 65 HNSCC patients and 29 patients with cervical cancer of unknown primary (CUP); a higher SEC62 and lower SOX2 expression was observed in the lymph node metastases from HNSCC patients compared with the respective primary tumor. Lymph node metastases from CUP patients showed higher SEC62 and lower SOX2 expression compared with lymph node metastases from HNSCC patients. When proceeding from the N1 to the N3 stage, SEC62 expression in the lymph node metastases showed an increase and SOX2 expression showed a decrease. Moreover, both genes showed a highly significant relevance as prognostic biomarkers, with the worst prognosis for patients with high SEC62 and low SOX2 expression levels. In functional analyses, knockdown of SEC62 resulted in an inhibition of HNSCC cell migration while, conversely, SEC62 and SOX2 overexpression stimulated cell migration. Taken together, our study showed that the expression of the 3q oncogenes SEC62 and SOX2 affects lymphatic metastasis and cell migration in HNSCC and CUP patients and has a high prognostic relevance in these diseases.
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Affiliation(s)
- Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany.,Institute of Medical Biochemistry and Molecular Biology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Hana Adisurya
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Silke Wemmert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Cornelia Lerner
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Markus Greiner
- Institute of Medical Biochemistry and Molecular Biology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Richard Zimmermann
- Institute of Medical Biochemistry and Molecular Biology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Andrea Hasenfus
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, Homburg (Saar), Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Basel Al Kadah
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
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