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Mai EK, Goldschmid H, Miah K, Bertsch U, Besemer B, Hänel M, Krzykalla J, Fenk R, Schlenzka J, Munder M, Dürig J, Blau IW, Huhn S, Hose D, Jauch A, Kunz C, Mann C, Weinhold N, Scheid C, Schroers R, von Metzler I, Schieferdecker A, Thomalla J, Reimer P, Mahlberg R, Graeven U, Kremers S, Martens UM, Kunz C, Hensel M, Benner A, Seidel-Glätzer A, Weisel KC, Raab MS, Salwender HJ. Elotuzumab, lenalidomide, bortezomib, dexamethasone, and autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GMMG-HD6): results from a randomised, phase 3 trial. Lancet Haematol 2024; 11:e101-e113. [PMID: 38302221 DOI: 10.1016/s2352-3026(23)00366-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND The aim of this trial was to investigate the addition of the anti-SLAMF7 monoclonal antibody elotuzumab to lenalidomide, bortezomib, and dexamethasone (RVd) in induction and consolidation therapy as well as to lenalidomide maintenance treatment in transplant-eligible patients with newly diagnosed multiple myeloma. METHODS GMMG-HD6 was a phase 3, randomised trial conducted at 43 main trial sites and 26 associated trial sites throughout Germany. Adult patients (aged 18-70 years) with previously untreated, symptomatic multiple myeloma, and a WHO performance status of 0-3, with 3 being allowed only if caused by myeloma disease and not by comorbid conditions, were randomly assigned 1:1:1:1 to four treatment groups. Induction therapy consisted of four 21-day cycles of RVd (lenalidomide 25 mg orally on days 1-14; bortezomib 1·3 mg/m2 subcutaneously on days 1, 4, 8, and 11]; and dexamethasone 20 mg orally on days 1, 2, 4, 5, 8, 9, 11, 12, and 15 for cycles 1-2) or, RVd induction plus elotuzumab (10 mg/kg intravenously on days 1, 8, and 15 for cycles 1-2, and on days 1 and 11 for cycles 3-4; E-RVd). Autologous haematopoietic stem-cell transplantation was followed by two 21-day cycles of either RVd consolidation (lenalidomide 25 mg orally on days 1-14; bortezomib 1·3 mg/m2 subcutaneously on days 1, 8, and 15; and dexamethasone 20 mg orally on days 1, 2, 8, 9, 15, and 16) or elotuzumab plus RVd consolidation (with elotuzumab 10 mg/kg intravenously on days 1, 8, and 15) followed by maintenance with either lenalidomide (10 mg orally on days 1-28 for cycles 1-3; thereafter, up to 15 mg orally on days 1-28; RVd/R or E-RVd/R group) or lenalidomide plus elotuzumab (10 mg/kg intravenously on days 1 and 15 for cycles 1-6, and on day 1 for cycles 7-26; RVd/E-R or E-RVd/E-R group) for 2 years. The primary endpoint was progression-free survival analysed in a modified intention-to-treat (ITT) population. Safety was analysed in all patients who received at least one dose of trial medication. This trial is registered with ClinicalTrials.gov, NCT02495922, and is completed. FINDINGS Between June 29, 2015, and on Sept 11, 2017, 564 patients were included in the trial. The modified ITT population comprised 559 (243 [43%] females and 316 [57%] males) patients and the safety population 555 patients. After a median follow-up of 49·8 months (IQR 43·7-55·5), there was no difference in progression-free survival between the four treatment groups (adjusted log-rank p value, p=0·86), and 3-year progression-free survival rates were 69% (95% CI 61-77), 69% (61-76), 66% (58-74), and 67% (59-75) for patients treated with RVd/R, RVd/E-R, E-RVd/R, and E-RVd/E-R, respectively. Infections (grade 3 or worse) were the most frequently observed adverse event in all treatment groups (28 [20%] of 137 for RVd/R; 32 [23%] of 138 for RVd/E-R; 35 [25%] of 138 for E-RVd/R; and 48 [34%] of 142 for E-RVd/E-R). Serious adverse events (grade 3 or worse) were observed in 68 (48%) of 142 participants in the E-RVd/E-R group, 53 (39%) of 137 in the RVd/R, 53 (38%) of 138 in the RVd/E-R, and 50 (36%) of 138 in the E-RVd/R (36%) group. There were nine treatment-related deaths during the study. Two deaths (one sepsis and one toxic colitis) in the RVd/R group were considered lenalidomide-related. One death in the RVd/E-R group due to meningoencephalitis was considered lenalidomide and elotuzumab-related. Four deaths (one pulmonary embolism, one septic shock, one atypical pneumonia, and one cardiovascular failure) in the E-RVd/R group and two deaths (one sepsis and one pneumonia and pulmonary fibrosis) in the E-RVd/E-R group were considered related to lenalidomide or elotuzumab, or both. INTERPRETATION Addition of elotuzumab to RVd induction or consolidation and lenalidomide maintenance in patients with transplant-eligible newly diagnosed multiple myeloma did not provide clinical benefit. Elotuzumab-containing therapies might be reserved for patients with relapsed or refractory multiple myeloma. FUNDING Bristol Myers Squibb/Celgene and Chugai.
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Affiliation(s)
- Elias K Mai
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany
| | - Hartmut Goldschmid
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany; National Centre for Tumour Diseases Heidelberg, Heidelberg, Germany.
| | - Kaya Miah
- Division of Biostatistics, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Uta Bertsch
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany; National Centre for Tumour Diseases Heidelberg, Heidelberg, Germany
| | - Britta Besemer
- Department of Internal Medicine II, University Hospital Tübingen, Tübingen, Germany
| | - Mathias Hänel
- Department of Internal Medicine III, Clinic Chemnitz, Chemnitz, Germany
| | - Julia Krzykalla
- Division of Biostatistics, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Roland Fenk
- Department of Haematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Jana Schlenzka
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Munder
- Department of Internal Medicine III, University Hospital Mainz, Mainz, Germany
| | - Jan Dürig
- Department for Haematology and Stem Cell Transplantation, University Hospital Essen, Essen, Germany
| | - Igor W Blau
- Medical Clinic, Charité University Medicine Berlin, Berlin, Germany
| | - Stefanie Huhn
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany
| | - Dirk Hose
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Christina Kunz
- Division of Biostatistics, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Christoph Mann
- Department of Haematology, Oncology and Immunology, Philipps-University Marburg, Marburg, Germany
| | - Niels Weinhold
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany
| | - Christof Scheid
- Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | | | - Ivana von Metzler
- Department of Internal Medicine II, University Hospital Frankfurt, Frankfurt, Germany
| | - Aneta Schieferdecker
- Department of Oncology, Haematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Peter Reimer
- Clinic for Haematology, Oncology and Stem Cell Transplantation, Evangelische Kliniken Essen-Mitte, Essen, Germany
| | - Rolf Mahlberg
- Internal Medicine I, Hospital Mutterhaus der Borromäerinnen, Trier, Germany
| | - Ullrich Graeven
- Medical Clinic I, Hospital Maria Hilf, Mönchengladbach, Germany
| | | | - Uwe M Martens
- Haematology, Oncology, Palliative Care, SLK Clinic Heilbronn, Heilbronn, Germany
| | - Christian Kunz
- Haematology and Oncology, Westpfalz-Klinikum, Kaiserslautern, Germany
| | | | - Axel Benner
- Division of Biostatistics, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | | | - Katja C Weisel
- Department of Oncology, Haematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marc S Raab
- Department of Medicine V, Heidelberg Myeloma Centre, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans J Salwender
- Asklepios Tumorzentrum Hamburg, Asklepios Hospital Hamburg Altona and St Georg, Hamburg, Germany
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Schreiner S, Berghaus N, Poos AM, Raab MS, Besemer B, Fenk R, Goldschmidt H, Mai EK, Müller-Tidow C, Weinhold N, Hegenbart U, Huhn S, Schönland SO. Sequence diversity of kappa light chains from patients with AL amyloidosis and multiple myeloma. Amyloid 2024:1-9. [PMID: 38206120 DOI: 10.1080/13506129.2023.2295221] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND AL amyloidosis (AL) results from the misfolding of immunoglobulin light chains (IG LCs). Aim of this study was to comprehensively analyse kappa LC sequences from AL patients in comparison with multiple myeloma (MM). OBJECTIVE We analysed IGKV/IGKJ usage and associated organ tropism and IGKV1/D-33 in terms of mutational analysis and theoretical biochemical properties. MATERIAL AND METHODS cDNA and bulk RNA sequencing of the LCs of AL and MM patients. RESULTS We studied 41 AL and 83 MM patients showing that IGKV1 was most expressed among kappa AL and MM, with higher frequency in AL (80% vs. 53%, p = .002). IGKV3 was underrepresented in AL (10% vs. 30%, p = .014). IGKJ2 was more commonly used in AL than in MM (39% vs. 29%). Patients with IGKV1/D-33 were associated with heart involvement (75%, p = .024). IGKV1/D-33-segments of AL had a higher mutation count (AL = 12.0 vs. MM = 10.0). FR3 and CDR3 were most frequently mutated in both, with a median mutation count in FR3 being the highest (AL = 4.0; MM = 3.5) and one mutation hotspot (FR3 (83I)) for IGKV1/D-33/IGKJ2 was associated with cardiac involvement. CONCLUSION This study confirmed that germline usage has an influence on AL amyloidosis risk and organ involvement.
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Affiliation(s)
- Sarah Schreiner
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Natalie Berghaus
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Alexandra M Poos
- Medical Department V, Heidelberg Myeloma Center, Heidelberg University Hospital, Germany
| | - Marc S Raab
- Medical Department V, Heidelberg Myeloma Center, Heidelberg University Hospital, National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Britta Besemer
- Department of Internal Medicine II, Tübingen University Hospital, Tübingen, Germany
| | - Roland Fenk
- Department of Hematology, Oncology, and Clinical Immunology, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Hartmut Goldschmidt
- Medical Department V, Heidelberg Myeloma Center, Heidelberg University Hospital, National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Elias K Mai
- Medical Department V, Heidelberg Myeloma Center, Heidelberg University Hospital, National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | | | - Niels Weinhold
- Medical Department V, Heidelberg Myeloma Center, Heidelberg University Hospital, Germany
| | - Ute Hegenbart
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefanie Huhn
- Medical Department V, Heidelberg Myeloma Center, Heidelberg University Hospital, Germany
| | - Stefan O Schönland
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
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3
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Zhao D, Rohde C, Göllner S, Zhou F, Pauli C, Blank MF, Zinz R, Grab AL, Poos AM, John L, Huhn S, Raab MS, Müller-Tidow C, Weinhold N. The landscape of small nucleolar RNA expression in multiple myeloma is determined by cytogenetic alterations. Leukemia 2023; 37:2526-2531. [PMID: 37845284 PMCID: PMC10681893 DOI: 10.1038/s41375-023-02060-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/23/2023] [Accepted: 10/04/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Duoduo Zhao
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Christian Rohde
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Stefanie Göllner
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Fengbiao Zhou
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Cornelius Pauli
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
- Division of Mechanisms Regulation Gene Expression, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maximilian Felix Blank
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
- Division Proteomics of Stem Cells and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rafael Zinz
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Anna Luise Grab
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit (CCU) Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexandra M Poos
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit (CCU) Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lukas John
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit (CCU) Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefanie Huhn
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Marc-Steffen Raab
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit (CCU) Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Niels Weinhold
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
- Clinical Cooperation Unit (CCU) Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Poos AM, Prokoph N, Przybilla MJ, Mallm JP, Steiger S, Seufert I, John L, Tirier SM, Bauer K, Baumann A, Rohleder J, Munawar U, Rasche L, Kortüm KM, Giesen N, Reichert P, Huhn S, Müller-Tidow C, Goldschmidt H, Stegle O, Raab MS, Rippe K, Weinhold N. Resolving therapy resistance mechanisms in multiple myeloma by multiomics subclone analysis. Blood 2023; 142:1633-1646. [PMID: 37390336 PMCID: PMC10733835 DOI: 10.1182/blood.2023019758] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/17/2023] [Accepted: 06/12/2023] [Indexed: 07/02/2023] Open
Abstract
Intratumor heterogeneity as a clinical challenge becomes most evident after several treatment lines, when multidrug-resistant subclones accumulate. To address this challenge, the characterization of resistance mechanisms at the subclonal level is key to identify common vulnerabilities. In this study, we integrate whole-genome sequencing, single-cell (sc) transcriptomics (scRNA sequencing), and chromatin accessibility (scATAC sequencing) together with mitochondrial DNA mutations to define subclonal architecture and evolution for longitudinal samples from 15 patients with relapsed or refractory multiple myeloma. We assess transcriptomic and epigenomic changes to resolve the multifactorial nature of therapy resistance and relate it to the parallel occurrence of different mechanisms: (1) preexisting epigenetic profiles of subclones associated with survival advantages, (2) converging phenotypic adaptation of genetically distinct subclones, and (3) subclone-specific interactions of myeloma and bone marrow microenvironment cells. Our study showcases how an integrative multiomics analysis can be applied to track and characterize distinct multidrug-resistant subclones over time for the identification of molecular targets against them.
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Affiliation(s)
- Alexandra M. Poos
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Nina Prokoph
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Moritz J. Przybilla
- Division Computational Genomics and Systems Genetics, German Cancer Research Center, Heidelberg, Germany
- Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Cambridge, United Kingdom
| | - Jan-Philipp Mallm
- Single Cell Open Lab, German Cancer Research Center and BioQuant, Heidelberg, Germany
| | - Simon Steiger
- Division of Chromatin Networks, German Cancer Research Center and BioQuant, Heidelberg, Germany
| | - Isabelle Seufert
- Division of Chromatin Networks, German Cancer Research Center and BioQuant, Heidelberg, Germany
| | - Lukas John
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Stephan M. Tirier
- Division of Chromatin Networks, German Cancer Research Center and BioQuant, Heidelberg, Germany
| | - Katharina Bauer
- Single Cell Open Lab, German Cancer Research Center and BioQuant, Heidelberg, Germany
| | - Anja Baumann
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Jennifer Rohleder
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Umair Munawar
- Department of Internal Medicine 2, University Hospital of Würzburg, Würzburg, Germany
| | - Leo Rasche
- Department of Internal Medicine 2, University Hospital of Würzburg, Würzburg, Germany
- Mildred Scheel Early Career Center, University Hospital of Würzburg, Würzburg, Germany
| | - K. Martin Kortüm
- Department of Internal Medicine 2, University Hospital of Würzburg, Würzburg, Germany
| | - Nicola Giesen
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Philipp Reichert
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefanie Huhn
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, GMMG-Study Group at University Hospital Heidelberg, Heidelberg, Germany
| | - Oliver Stegle
- Division Computational Genomics and Systems Genetics, German Cancer Research Center, Heidelberg, Germany
- Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Marc S. Raab
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Karsten Rippe
- Division of Chromatin Networks, German Cancer Research Center and BioQuant, Heidelberg, Germany
| | - Niels Weinhold
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
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5
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Berghaus N, Schreiner S, Poos AM, Raab MS, Goldschmidt H, Mai EK, Salwender HJ, Bernhard H, Thurner L, Müller-Tidow C, Weinhold N, Hegenbart U, Schönland SO, Huhn S. Comparison of IGLV2-14 light chain sequences of patients with AL amyloidosis or multiple myeloma. FEBS J 2023; 290:4256-4267. [PMID: 37097223 DOI: 10.1111/febs.16805] [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: 11/02/2022] [Revised: 02/24/2023] [Accepted: 04/25/2023] [Indexed: 04/26/2023]
Abstract
Light chain amyloidosis (AL) is one of the most common forms of systemic amyloidosis and is caused by the deposition of insoluble fibrils derived from misfolded and aggregated immunoglobulin light chains (LC). To uncover the causes leading to this aggregation, we compared AL LC sequences with those of patients with the related disease multiple myeloma (MM), which do not aggregate in insoluble fibrils in vivo. IGLV2-14 is one of the most common AL-associated IGLV subfamilies. Here, we analysed IGLV2-14 LC sequences of 13 AL and eight MM patients in detail. We found that AL-associated LCs presented a lower median mutation count (7.0 vs. 11.5 in MM; P = 0.045), as well as an overall composition of less charged amino acids than MM LCs. However, we did not find a mutation that was present in ≥ 50% of the AL and not in the MM sequences. Furthermore, we did not find a significant difference in the isoelectric point (pI) in general, suggesting similar stability of the LCs in AL and MM. However, the subgroup of patients without a detectable heavy chain stood out. Surprisingly, they are characterized by an increase in mutation count (median 7.0 vs. 5.5) and pI (median 7.82 vs. 6.44, P = 0.043). In conclusion, our data suggest that the amount of mutations and the introduction of charges play a crucial role in AL fibril formation, as well as the absence or presence of a potential heavy chain binding partner.
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Affiliation(s)
- Natalie Berghaus
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Germany
| | - Sarah Schreiner
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Germany
| | - Alexandra M Poos
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Germany
| | - Marc S Raab
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Germany
- National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hartmut Goldschmidt
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Germany
| | - Elias K Mai
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Germany
- National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | | | - Helga Bernhard
- Medical Department V, Hematology/Oncology, Hospital Darmstadt GmbH, Germany
| | - Lorenz Thurner
- Internal Medicine I, University Hospital Saarland, Homburg/ Saar, Germany
| | | | - Niels Weinhold
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Germany
| | - Ute Hegenbart
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Germany
| | - Stefan O Schönland
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Germany
| | - Stefanie Huhn
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Germany
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6
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John L, Poos AM, Brobeil A, Schinke C, Huhn S, Prokoph N, Lutz R, Wagner B, Zangari M, Tirier SM, Mallm JP, Schumacher S, Vonficht D, Solé-Boldo L, Quick S, Steiger S, Przybilla MJ, Bauer K, Baumann A, Hemmer S, Rehnitz C, Lückerath C, Sachpekidis C, Mechtersheimer G, Haberkorn U, Dimitrakopoulou-Strauss A, Reichert P, Barlogie B, Müller-Tidow C, Goldschmidt H, Hillengass J, Rasche L, Haas SF, van Rhee F, Rippe K, Raab MS, Sauer S, Weinhold N. Resolving the spatial architecture of myeloma and its microenvironment at the single-cell level. Nat Commun 2023; 14:5011. [PMID: 37591845 PMCID: PMC10435504 DOI: 10.1038/s41467-023-40584-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/02/2023] [Indexed: 08/19/2023] Open
Abstract
In multiple myeloma spatial differences in the subclonal architecture, molecular signatures and composition of the microenvironment remain poorly characterized. To address this shortcoming, we perform multi-region sequencing on paired random bone marrow and focal lesion samples from 17 newly diagnosed patients. Using single-cell RNA- and ATAC-seq we find a median of 6 tumor subclones per patient and unique subclones in focal lesions. Genetically identical subclones display different levels of spatial transcriptional plasticity, including nearly identical profiles and pronounced heterogeneity at different sites, which can include differential expression of immunotherapy targets, such as CD20 and CD38. Macrophages are significantly depleted in the microenvironment of focal lesions. We observe proportional changes in the T-cell repertoire but no site-specific expansion of T-cell clones in intramedullary lesions. In conclusion, our results demonstrate the relevance of considering spatial heterogeneity in multiple myeloma with potential implications for models of cell-cell interactions and disease progression.
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Affiliation(s)
- Lukas John
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexandra M Poos
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexander Brobeil
- Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Carolina Schinke
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Stefanie Huhn
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Nina Prokoph
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Raphael Lutz
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
- Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, Heidelberg, Germany
| | - Barbara Wagner
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Maurizio Zangari
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Stephan M Tirier
- Division of Chromatin Networks, German Cancer Research Center (DKFZ) and BioQuant, Heidelberg, Germany
| | - Jan-Philipp Mallm
- Single Cell Open Lab, German Cancer Research Center (DKFZ) and BioQuant, Heidelberg, Germany
| | - Sabrina Schumacher
- Division of Chromatin Networks, German Cancer Research Center (DKFZ) and BioQuant, Heidelberg, Germany
| | - Dominik Vonficht
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
- Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, Heidelberg, Germany
| | - Llorenç Solé-Boldo
- Institute of Health (BIH) at Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Department of Hematology, Oncology and Tumor Immunology, Charité University Medicine, Berlin, Germany
| | - Sabine Quick
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Simon Steiger
- Division of Chromatin Networks, German Cancer Research Center (DKFZ) and BioQuant, Heidelberg, Germany
| | - Moritz J Przybilla
- Division Computational Genomics and Systems Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
| | - Katharina Bauer
- Single Cell Open Lab, German Cancer Research Center (DKFZ) and BioQuant, Heidelberg, Germany
| | - Anja Baumann
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefan Hemmer
- Department of Orthopedic Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Rehnitz
- Department of Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Lückerath
- Department of Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christos Sachpekidis
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Uwe Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Antonia Dimitrakopoulou-Strauss
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Philipp Reichert
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Bart Barlogie
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Jens Hillengass
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Leo Rasche
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Internal Medicine 2, University Hospital of Würzburg, Würzburg, Germany
- Mildred Scheel Early Career Center (MSNZ), University Hospital of Würzburg, Würzburg, Germany
| | - Simon F Haas
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
- Institute of Health (BIH) at Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Department of Hematology, Oncology and Tumor Immunology, Charité University Medicine, Berlin, Germany
| | - Frits van Rhee
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Karsten Rippe
- Division of Chromatin Networks, German Cancer Research Center (DKFZ) and BioQuant, Heidelberg, Germany
| | - Marc S Raab
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sandra Sauer
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Niels Weinhold
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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7
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Baur J, Berghaus N, Schreiner S, Hegenbart U, Schönland SO, Wiese S, Huhn S, Haupt C. Identification of AL proteins from 10 λ-AL amyloidosis patients by mass spectrometry extracted from abdominal fat and heart tissue. Amyloid 2023; 30:27-37. [PMID: 35792725 DOI: 10.1080/13506129.2022.2095618] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Systemic AL amyloidosis arises from the misfolding of patient-specific immunoglobulin light chains (LCs). Potential drivers of LC amyloid formation are mutational changes and post-translational modifications (PTMs). However, little information is available on the exact primary structure of the AL proteins and their precursor LCs. OBJECTIVE We analyse the exact primary structure of AL proteins extracted from 10 λ AL amyloidosis patients and their corresponding precursor LCs. MATERIALS AND METHODS By cDNA sequencing of the precursor LC genes in combination with mass spectrometry of the AL proteins, the exact primary structure and PTMs were determined. This information was used to analyse their biochemical properties. RESULTS All AL proteins comprise the VL and a small part of the CL with a common C-terminal truncation region. While all AL proteins retain the conserved native disulphide bond of the VL, we found no evidence for presence of other common PTMs. The analysis of the biochemical properties revealed that the isoelectric point of the VL is significantly increased due to introduced mutations. CONCLUSION Our data imply that mutational changes influence the surface charge properties of the VL and that common proteolytic processes are involved in the generation of the cleavage sites of AL proteins.
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Affiliation(s)
- Julian Baur
- Institute of Protein Biochemistry, Ulm University, Ulm, Germany
| | - Natalie Berghaus
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Sarah Schreiner
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Ute Hegenbart
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan O Schönland
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Sebastian Wiese
- Core Unit Mass Spectrometry and Proteomics, Medical Faculty, Ulm University, Ulm, Germany
| | - Stefanie Huhn
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Haupt
- Institute of Protein Biochemistry, Ulm University, Ulm, Germany
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8
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Niazi Y, Paramasivam N, Blocka J, Kumar A, Huhn S, Schlesner M, Weinhold N, Sijmons R, De Jong M, Durie B, Goldschmidt H, Hemminki K, Försti A. Investigation of Rare Non-Coding Variants in Familial Multiple Myeloma. Cells 2022; 12:cells12010096. [PMID: 36611892 PMCID: PMC9818386 DOI: 10.3390/cells12010096] [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: 11/02/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Multiple myeloma (MM) is a plasma cell malignancy whereby a single clone of plasma cells over-propagates in the bone marrow, resulting in the increased production of monoclonal immunoglobulin. While the complex genetic architecture of MM is well characterized, much less is known about germline variants predisposing to MM. Genome-wide sequencing approaches in MM families have started to identify rare high-penetrance coding risk alleles. In addition, genome-wide association studies have discovered several common low-penetrance risk alleles, which are mainly located in the non-coding genome. Here, we further explored the genetic basis in familial MM within the non-coding genome in whole-genome sequencing data. We prioritized and characterized 150 upstream, 5' untranslated region (UTR) and 3' UTR variants from 14 MM families, including 20 top-scoring variants. These variants confirmed previously implicated biological pathways in MM development. Most importantly, protein network and pathway enrichment analyses also identified 10 genes involved in mitogen-activated protein kinase (MAPK) signaling pathways, which have previously been established as important MM pathways.
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Affiliation(s)
- Yasmeen Niazi
- Hopp Children’s Cancer Center (KiTZ), 69120 Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), 69120 Heidelberg, Germany
- Correspondence: (Y.N.); (K.H.)
| | - Nagarajan Paramasivam
- Computational Oncology, Molecular Precision Oncology Program, National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Joanna Blocka
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
- Department of Medical Oncology, Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Abhishek Kumar
- Institute of Bioinformatics, International Technology Park, Bangalore 560066, India
- Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Stefanie Huhn
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
- National Center for Tumor Diseases Heidelberg (NCT), 69120 Heidelberg, Germany
| | - Matthias Schlesner
- Bioinformatics and Omics Data Analytics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Niels Weinhold
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
| | - Rolf Sijmons
- University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands
| | - Mirjam De Jong
- University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands
| | - Brian Durie
- Cedars Sinai Cancer Center, Los Angeles, CA 90048, USA
| | - Hartmut Goldschmidt
- Computational Oncology, Molecular Precision Oncology Program, National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
| | - Kari Hemminki
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 323 00 Pilsen, Czech Republic
- Correspondence: (Y.N.); (K.H.)
| | - Asta Försti
- Hopp Children’s Cancer Center (KiTZ), 69120 Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), 69120 Heidelberg, Germany
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9
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Goldschmidt H, Mai EK, Bertsch U, Fenk R, Nievergall E, Tichy D, Besemer B, Dürig J, Schroers R, von Metzler I, Hänel M, Mann C, Asemissen AM, Heilmeier B, Weinhold N, Huhn S, Kriegsmann K, Luntz SP, Holderried TAW, Trautmann-Grill K, Gezer D, Klaiber-Hakimi M, Müller M, Khandanpour C, Knauf W, Scheid C, Munder M, Geer T, Riesenberg H, Thomalla J, Hoffmann M, Raab MS, Salwender HJ, Weisel KC, Asemissen AM, Behringer J, Bernhard H, Bernhardt C, Bertsch U, Besemer B, Blau IW, Bolling C, Debatin D, Dingeldein G, Dürig J, Fenk R, Ferstl B, Fest C, Fronhoffs S, Fuhrmann S, Gaska T, Geer T, Gezer D, Goldschmidt H, Görner M, Graeven U, Grassinger J, Hänel M, Heilmeier B, Heinsch M, Held G, Hoffmann M, Holderried TAW, Hopfer O, Huhn S, Immenschuh P, Kaddu-Mulindwa D, Khandanpour C, Klaiber-Hakimi M, Klausmann M, Klein S, Knauf W, Ko YD, Köchling G, Koenigsmann M, Kostrewa P, Kraemer DM, Kremers S, Kriegsmann K, Kropff M, La Rosée P, Luntz SP, Mahlberg R, Mai EK, Mann C, Martens U, von Metzler I, Müller M, Munder M, Neise M, Nievergall E, Nückel H, Pönisch W, Procaccianti M, Raab MS, Rafiyan MR, Reimer P, Riecke A, Riesenberg H, Rummel M, Runde V, Salwender HJ, Schaich M, Scheid C, Schmidt-Hieber M, Schmitt S, Schöndube D, Schroers R, Schwarzer A, Staib P, Steiniger H, Sturmberg D, Thomalla J, Tichy D, Tischler HJ, Trautmann-Grill K, Trummer A, Tschechne B, Verbeek W, Weinhold N, Weisel KC, Whitlock B, de Wit M, Zaiß M, Ziske C. Addition of isatuximab to lenalidomide, bortezomib, and dexamethasone as induction therapy for newly diagnosed, transplantation-eligible patients with multiple myeloma (GMMG-HD7): part 1 of an open-label, multicentre, randomised, active-controlled, phase 3 trial. The Lancet Haematology 2022; 9:e810-e821. [DOI: 10.1016/s2352-3026(22)00263-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/08/2022]
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10
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Berghaus N, Schreiner S, Granzow M, Müller-Tidow C, Hegenbart U, Schönland SO, Huhn S. Analysis of the complete lambda light chain germline usage in patients with AL amyloidosis and dominant heart or kidney involvement. PLoS One 2022; 17:e0264407. [PMID: 35213605 PMCID: PMC8880859 DOI: 10.1371/journal.pone.0264407] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 11/18/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022] Open
Abstract
Light chain amyloidosis is one of the most common forms of systemic amyloidosis. The disease is caused by the misfolding and aggregation of immunoglobulin light chains to insoluble fibrils. These fibrils can deposit in different tissues and organs such as heart and kidney and cause organ impairments that define the clinical presentation. In this study, we present an overview of IGLV-IGLJ and IGLC germline utilization in 85 patients classified in three clinically important subgroups with dominant cardiac, renal as well as cardiac and renal involvement. We found that IGLV3 was the most frequently detected IGLV-family in patients with dominant cardiac involvement, whereas in renal patients IGLV1 were most frequently identified. For patients with dominant heart and kidney involvement IGLV6 was the most frequently detected IGLV-family. In more detailed analysis IGLV3-21 was observed as the most dominant IGLV-subfamily for patients with dominant heart involvement and IGLV1-44 as the most frequent IGLV-subfamily in the group of patients with dominant kidney involvement. For patients with dominant heart and kidney involvement IGLV6-57 was the most frequently detected IGLV-subfamily. Additionally, we were able to show an exclusive linkage between IGLJ1 and IGLC1 as well as between IGLJ2 and IGLC2 in the fully assembled IGL mRNA.
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Affiliation(s)
- Natalie Berghaus
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Sarah Schreiner
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Granzow
- Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Medical Department V, Heidelberg University Hospital, Heidelberg, Germany
- National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Ute Hegenbart
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan O. Schönland
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefanie Huhn
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Heidelberg, Germany
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11
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Nozdrzykowski M, Fahr F, Schulz U, Jawad K, Huhn S, Al-Naamani A, Eifert S, Garbade J, Borger M, Saeed D. Stroke and Pump Thrombosis following LVAD Implantation: Impact of the Implantation Approach. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742845] [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: 10/19/2022]
Affiliation(s)
| | - F. Fahr
- Herzzentrum Leipzig, Leipzig, Deutschland
| | - U. Schulz
- Heart Center Leipzig, Leipzig, Deutschland
| | - K. Jawad
- Heart Center Leipzig, Leipzig, Deutschland
| | - S. Huhn
- Herzzentrum Leipzig, Leipzig, Deutschland
| | | | - S. Eifert
- Heart Center Leipzig, Leipzig, Deutschland
| | - J. Garbade
- Herzchirurgie, Klinikum Links der Weser, Bremen, Deutschland
| | - M. Borger
- Herzzentrum Leipzig, Leipzig, Deutschland
| | - D. Saeed
- Heart Center Leipzig, Leipzig, Deutschland
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12
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Khandanpour C, Eisfeld C, Nimmagadda SC, Raab MS, Weinhold N, Seckinger A, Hose D, Jauch A, Försti A, Hemminki K, Hielscher T, Hummel M, Lenz G, Goldschmidt H, Huhn S. Prevalence of the GFI1-36N SNP in Multiple Myeloma Patients and Its Impact on the Prognosis. Front Oncol 2021; 11:757664. [PMID: 34760702 PMCID: PMC8574071 DOI: 10.3389/fonc.2021.757664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
Transcription factor Growth Factor Independence 1 (GFI1) regulates the expression of genes important for survival, proliferation and differentiation of hematopoietic cells. A single nucleotide polymorphism (SNP) variant of GFI1 (GFI1-36N: serine replaced by asparagine at position 36), has a prevalence of 5-7% among healthy Caucasians and 10-15% in patients with myelodysplastic syndrome (MDS) and acute myeloid leukaemia (AML) predisposing GFI-36N carriers to these diseases. Since GFI1 is implicated in B cell maturation and plasma cell (PC) development, we examined its prevalence in patients with multiple myeloma (MM), a haematological malignancy characterized by expansion of clonal PCs. Strikingly, as in MDS and AML, we found that the GFI1-36N had a higher prevalence among MM patients compared to the controls. In subgroup analyses, GFI1-36N correlates to a shorter overall survival of MM patients characterized by the presence of t(4;14) translocation and gain of 1q21 (≤3 copies). MM patients carrying gain of 1q21 (≥3 copies) demonstrated poor progression free survival. Furthermore, gene expression analysis implicated a role for GFI1-36N in epigenetic regulation and metabolism, potentially promoting the initiation and progression of MM.
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Affiliation(s)
- Cyrus Khandanpour
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Christine Eisfeld
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Subbaiah Chary Nimmagadda
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Marc S Raab
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Niels Weinhold
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Anja Seckinger
- Department of Hematology and Immunology, Myeloma Center Brussels & Laboratory for Myeloma research, Vrije Universiteit Brussel (VUB), Jette, Belgium
| | - Dirk Hose
- Department of Hematology and Immunology, Myeloma Center Brussels & Laboratory for Myeloma research, Vrije Universiteit Brussel (VUB), Jette, Belgium
| | - Anna Jauch
- Institute of Human Genetics, University Heidelberg, Heidelberg, Germany
| | - Asta Försti
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany.,Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kari Hemminki
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, Pilsen, Czechia
| | - Thomas Hielscher
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manuela Hummel
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Roche Diagnostics GmbH, Penzberg, Germany
| | - Georg Lenz
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Hartmut Goldschmidt
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany.,National Centre of Tumor Diseases, Heidelberg, Germany
| | - Stefanie Huhn
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
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13
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Radamaker L, Karimi-Farsijani S, Andreotti G, Baur J, Neumann M, Schreiner S, Berghaus N, Motika R, Haupt C, Walther P, Schmidt V, Huhn S, Hegenbart U, Schönland SO, Wiese S, Read C, Schmidt M, Fändrich M. Role of mutations and post-translational modifications in systemic AL amyloidosis studied by cryo-EM. Nat Commun 2021; 12:6434. [PMID: 34741031 PMCID: PMC8571268 DOI: 10.1038/s41467-021-26553-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 06/18/2021] [Accepted: 10/01/2021] [Indexed: 12/29/2022] Open
Abstract
Systemic AL amyloidosis is a rare disease that is caused by the misfolding of immunoglobulin light chains (LCs). Potential drivers of amyloid formation in this disease are post-translational modifications (PTMs) and the mutational changes that are inserted into the LCs by somatic hypermutation. Here we present the cryo electron microscopy (cryo-EM) structure of an ex vivo λ1-AL amyloid fibril whose deposits disrupt the ordered cardiomyocyte structure in the heart. The fibril protein contains six mutational changes compared to the germ line and three PTMs (disulfide bond, N-glycosylation and pyroglutamylation). Our data imply that the disulfide bond, glycosylation and mutational changes contribute to determining the fibril protein fold and help to generate a fibril morphology that is able to withstand proteolytic degradation inside the body.
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Affiliation(s)
- Lynn Radamaker
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | | | - Giada Andreotti
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | - Julian Baur
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | | | - Sarah Schreiner
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Natalie Berghaus
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Raoul Motika
- Department of Asia-Africa-Studies, Middle Eastern History and Culture, University of Hamburg, 20148, Hamburg, Germany
| | - Christian Haupt
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | - Paul Walther
- Central Facility for Electron Microscopy, Ulm University, 89081, Ulm, Germany
| | - Volker Schmidt
- Institute of Stochastics, Ulm University, 89081, Ulm, Germany
| | - Stefanie Huhn
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Ute Hegenbart
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Stefan O Schönland
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Sebastian Wiese
- Core Unit Mass Spectrometry and Proteomics, Medical Faculty, Ulm University, 89081, Ulm, Germany
| | - Clarissa Read
- Central Facility for Electron Microscopy, Ulm University, 89081, Ulm, Germany
- Institute of Virology, Ulm University Medical Center, 89081, Ulm, Germany
| | - Matthias Schmidt
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | - Marcus Fändrich
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany.
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14
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Kimmich CR, Terzer T, Benner A, Hansen T, Carpinteiro A, Dittrich T, Veelken K, Jauch A, Huhn S, Basset M, Goldschmidt H, Müller‐Tidow C, Schönland SO, Hegenbart U. Daratumumab, lenalidomide, and dexamethasone in systemic light-chain amyloidosis: High efficacy, relevant toxicity and main adverse effect of gain 1q21. Am J Hematol 2021; 96:E253-E257. [PMID: 33844864 DOI: 10.1002/ajh.26191] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/05/2021] [Accepted: 04/05/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Christoph R. Kimmich
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
- Amyloidosis Center, Heidelberg University Hospital Heidelberg Germany
- Department of Oncology and Hematology, Klinikum Oldenburg University Clinic Oldenburg Germany
| | - Tobias Terzer
- Division of Biostatistics German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Axel Benner
- Division of Biostatistics German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Timon Hansen
- Hematology/Oncology practice Hämatologisch‐Onkologische Praxis Altona Hamburg Germany
| | | | - Tobias Dittrich
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
- Amyloidosis Center, Heidelberg University Hospital Heidelberg Germany
| | - Kaya Veelken
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
- Amyloidosis Center, Heidelberg University Hospital Heidelberg Germany
| | - Anna Jauch
- Institute of Human Genetics University Heidelberg Heidelberg Germany
| | - Stefanie Huhn
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
| | - Marco Basset
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
- Amyloidosis Center, Heidelberg University Hospital Heidelberg Germany
- Amyloidosis Research and Treatment Center, IRCCS Policlinico San Matteo University of Pavia Pavia Italy
- Department of Molecular Medicine University of Pavia Pavia Italy
| | - Hartmut Goldschmidt
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
- National Center for Tumor Diseases (NCT), Heidelberg University Hospital Heidelberg Germany
| | - Carsten Müller‐Tidow
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
| | - Stefan O. Schönland
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
- Amyloidosis Center, Heidelberg University Hospital Heidelberg Germany
| | - Ute Hegenbart
- Division of Hematology/Oncology, Department of Internal Medicine V Heidelberg University Hospital Heidelberg Germany
- Amyloidosis Center, Heidelberg University Hospital Heidelberg Germany
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15
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Radamaker L, Baur J, Huhn S, Haupt C, Hegenbart U, Schönland S, Bansal A, Schmidt M, Fändrich M. Cryo-EM reveals structural breaks in a patient-derived amyloid fibril from systemic AL amyloidosis. Nat Commun 2021; 12:875. [PMID: 33558536 PMCID: PMC7870857 DOI: 10.1038/s41467-021-21126-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [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: 08/05/2020] [Accepted: 12/21/2020] [Indexed: 01/30/2023] Open
Abstract
Systemic AL amyloidosis is a debilitating and potentially fatal disease that arises from the misfolding and fibrillation of immunoglobulin light chains (LCs). The disease is patient-specific with essentially each patient possessing a unique LC sequence. In this study, we present two ex vivo fibril structures of a λ3 LC. The fibrils were extracted from the explanted heart of a patient (FOR005) and consist of 115-residue fibril proteins, mainly from the LC variable domain. The fibril structures imply that a 180° rotation around the disulfide bond and a major unfolding step are necessary for fibrils to form. The two fibril structures show highly similar fibril protein folds, differing in only a 12-residue segment. Remarkably, the two structures do not represent separate fibril morphologies, as they can co-exist at different z-axial positions within the same fibril. Our data imply the presence of structural breaks at the interface of the two structural forms.
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Affiliation(s)
- Lynn Radamaker
- grid.6582.90000 0004 1936 9748Institute of Protein Biochemistry, Ulm University, Ulm, Germany
| | - Julian Baur
- grid.6582.90000 0004 1936 9748Institute of Protein Biochemistry, Ulm University, Ulm, Germany
| | - Stefanie Huhn
- grid.5253.10000 0001 0328 4908Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Haupt
- grid.6582.90000 0004 1936 9748Institute of Protein Biochemistry, Ulm University, Ulm, Germany
| | - Ute Hegenbart
- grid.5253.10000 0001 0328 4908Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Schönland
- grid.5253.10000 0001 0328 4908Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Akanksha Bansal
- grid.6582.90000 0004 1936 9748Institute of Protein Biochemistry, Ulm University, Ulm, Germany
| | - Matthias Schmidt
- grid.6582.90000 0004 1936 9748Institute of Protein Biochemistry, Ulm University, Ulm, Germany
| | - Marcus Fändrich
- grid.6582.90000 0004 1936 9748Institute of Protein Biochemistry, Ulm University, Ulm, Germany
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Pradhan T, Annamalai K, Sarkar R, Huhn S, Hegenbart U, Schönland S, Fändrich M, Reif B. Seeded fibrils of the germline variant of human λ-III immunoglobulin light chain FOR005 have a similar core as patient fibrils with reduced stability. J Biol Chem 2020; 295:18474-18484. [PMID: 33093170 PMCID: PMC7939468 DOI: 10.1074/jbc.ra120.016006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/21/2020] [Indexed: 11/26/2022] Open
Abstract
Systemic antibody light chains (AL) amyloidosis is characterized by deposition of amyloid fibrils derived from a particular antibody light chain. Cardiac involvement is a major risk factor for mortality. Using MAS solid-state NMR, we studied the fibril structure of a recombinant light chain fragment corresponding to the fibril protein from patient FOR005, together with fibrils formed by protein sequence variants that are derived from the closest germline (GL) sequence. Both analyzed fibril structures were seeded with ex-vivo amyloid fibrils purified from the explanted heart of this patient. We find that residues 11-42 and 69-102 adopt β-sheet conformation in patient protein fibrils. We identify arginine-49 as a key residue that forms a salt bridge to aspartate-25 in the patient protein fibril structure. In the germline sequence, this residue is replaced by a glycine. Fibrils from the GL protein and from the patient protein harboring the single point mutation R49G can be both heterologously seeded using patient ex-vivo fibrils. Seeded R49G fibrils show an increased heterogeneity in the C-terminal residues 80-102, which is reflected by the disappearance of all resonances of these residues. By contrast, residues 11-42 and 69-77, which are visible in the MAS solid-state NMR spectra, show 13Cα chemical shifts that are highly like patient fibrils. The mutation R49G thus induces a conformational heterogeneity at the C terminus in the fibril state, whereas the overall fibril topology is retained. These findings imply that patient mutations in FOR005 can stabilize the fibril structure.
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Affiliation(s)
- Tejaswini Pradhan
- Helmholtz-Zentrum München (HMGU), Deutsches Forschungszentrum für Gesundheit und UmweltInstitute of Structural Biology (STB), Neuherberg, Germany; Munich Center for Integrated Protein Science (CIPS-M) at the Dept. of Chemistry, Technische Universität München (TUM), Garching, Germany
| | | | - Riddhiman Sarkar
- Helmholtz-Zentrum München (HMGU), Deutsches Forschungszentrum für Gesundheit und UmweltInstitute of Structural Biology (STB), Neuherberg, Germany; Munich Center for Integrated Protein Science (CIPS-M) at the Dept. of Chemistry, Technische Universität München (TUM), Garching, Germany
| | - Stefanie Huhn
- Medical Department V, Multiple Myeloma Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Ute Hegenbart
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Schönland
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Marcus Fändrich
- Institute of Protein Biochemistry, Ulm University, Ulm, Germany
| | - Bernd Reif
- Helmholtz-Zentrum München (HMGU), Deutsches Forschungszentrum für Gesundheit und UmweltInstitute of Structural Biology (STB), Neuherberg, Germany; Munich Center for Integrated Protein Science (CIPS-M) at the Dept. of Chemistry, Technische Universität München (TUM), Garching, Germany.
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17
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Kriegsmann K, Hundemer M, Hofmeister-Mielke N, Reichert P, Manta CP, Awwad MH, Sauer S, Bertsch U, Besemer B, Fenk R, Hänel M, Munder M, Weisel KC, Blau IW, Neubauer A, Müller-Tidow C, Raab MS, Goldschmidt H, Huhn S. Comparison of NGS and MFC Methods: Key Metrics in Multiple Myeloma MRD Assessment. Cancers (Basel) 2020; 12:cancers12082322. [PMID: 32824635 PMCID: PMC7464347 DOI: 10.3390/cancers12082322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022] Open
Abstract
In order to meet the challenges in data evaluation and comparability between studies in multiple myeloma (MM) minimal residual disease (MRD) assessment, the goal of the current study was to provide a step-by-step evaluation of next-generation sequencing (NGS) and multicolor flow cytometry (MFC) data. Bone marrow (BM) sample pairs from 125 MM patients were analyzed by NGS and MFC MM MRD methods. Tumor load (TL) and limit of detection (LOD) and quantification (LOQ) were calculated. The best-fit MRD cut-off was chosen as 1 × 10−5, resulting in an overall 9.6% (n overall = 12 (NGS n = 2, MFC n = 10)) nonassessable cases. The overall concordance rate between NGS and MFC was 68.0% (n = 85); discordant results were found in 22.4% (11.2% (n = 14) of cases in each direction. Overall, 55.1% (n = 60/109) and 49.5% (n = 54/109) of patients with a serological response ≥ very good partial response (VGPR) showed BM MRD negativity by NGS and MFC, respectively. A good correlation in the TL assessed by both techniques was found (correlation coefficient = 0.8, n = 40, p < 0.001). Overall, our study shows good concordance between MM BM MRD status and TL when comparing NGS and MFC at a threshold of 10–5. However, a sufficient number of analyzed events and calculation of MRD key metrics are essential for the comparison of methods and evaluability of data at a specific MRD cut-off.
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Affiliation(s)
- Katharina Kriegsmann
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
- Correspondence: (K.K.); (M.H.); Tel.: +49-6221-5637238 (K.K.); +49-6221-5639481 (M.H.)
| | - Michael Hundemer
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
- Correspondence: (K.K.); (M.H.); Tel.: +49-6221-5637238 (K.K.); +49-6221-5639481 (M.H.)
| | - Nicole Hofmeister-Mielke
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
| | - Philipp Reichert
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
| | - Calin-Petru Manta
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
| | - Mohamed H.S. Awwad
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
| | - Sandra Sauer
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
| | - Uta Bertsch
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
- National Center for Tumor Diseases Heidelberg, 69120 Heidelberg, Germany
| | - Britta Besemer
- Department of Hematology, Oncology and Immunology, University Hospital Tübingen, 72076 Tübingen, Germany;
| | - Roland Fenk
- Department of Hematology, Oncology and Clinical Immunology, University Hospital Düsseldorf, 40225 Düsseldorf, Germany;
| | - Mathias Hänel
- Department of Internal Medicine III, Klinikum Chemnitz, 09113 Chemnitz, Germany;
| | - Markus Munder
- Department of Internal Medicine III, University Medical Center Mainz, 55131 Mainz, Germany;
| | - Katja C. Weisel
- Department of Oncology, Hematology and Bone Marrow Transplantation with Department of Pneumology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Igor W. Blau
- Medical Clinic, Charité University Medicine Berlin, 10117 Berlin, Germany;
| | - Andreas Neubauer
- Department of Hematology, Oncology and Immunology, Philipps-University Marburg, 35043 Marburg, Germany;
| | - Carsten Müller-Tidow
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
| | - Marc S. Raab
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
| | - Hartmut Goldschmidt
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
- National Center for Tumor Diseases Heidelberg, 69120 Heidelberg, Germany
| | - Stefanie Huhn
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (N.H.-M.); (P.R.); (C.-P.M.); (M.H.S.A.); (S.S.); (U.B.); (C.M.-T.); (M.S.R.); (H.G.); (S.H.)
- National Center for Tumor Diseases Heidelberg, 69120 Heidelberg, Germany
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Saeed D, Jawad K, Sipahi F, Huhn S, Kalampokas N, Albert A, Borger M, Lichtenberg A. Reduced Rethoracotomy Rate for Bleeding and Postoperative Hospital Stay with Less Invasive Ventricular Assist Device Implantation, Multicenter Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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19
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Chattopadhyay S, Thomsen H, Weinhold N, Meziane I, Huhn S, da Silva Filho MI, Vodicka P, Vodickova L, Hoffmann P, Nöthen MM, Jöckel KH, Schmidt B, Landi S, Hajek R, Hallmans G, Pettersson-Kymmer U, Ohlsson C, Milani P, Merlini G, Rowcieno D, Hawkins P, Hegenbart U, Palladini G, Wechalekar A, Schönland SO, Houlston R, Goldschmidt H, Hemminki K, Försti A. Eight novel loci implicate shared genetic etiology in multiple myeloma, AL amyloidosis, and monoclonal gammopathy of unknown significance. Leukemia 2020; 34:1187-1191. [PMID: 31695157 DOI: 10.1038/s41375-019-0619-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/24/2019] [Indexed: 02/08/2023]
Affiliation(s)
- Subhayan Chattopadhyay
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
| | - Hauke Thomsen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
| | - Niels Weinhold
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Iman Meziane
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
| | - Stefanie Huhn
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Miguel Inacio da Silva Filho
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
| | - Pavel Vodicka
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 142 00, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Albertov 4, 128 00, Prague, Czech Republic
- Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 30605, Pilsen, Czech Republic
| | - Ludmila Vodickova
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 142 00, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Albertov 4, 128 00, Prague, Czech Republic
- Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 30605, Pilsen, Czech Republic
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Research Center, University of Bonn, Bonn, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Stefano Landi
- Department of Biology, University of Pisa, Pisa, Italy
| | - Roman Hajek
- Department of Hematooncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Göran Hallmans
- Department of Medical Biosciences/Pathology, University of Umea, Umea, Sweden
| | - Ulrika Pettersson-Kymmer
- Clinical Pharmacology, Department of Pharmacology and Clinical Neuroscience, Umea University, Umea, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Paolo Milani
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo" and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo" and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Dorota Rowcieno
- National Amyloidosis Centre, University College London Medical School, Royal Free Hospital Campus, London, Rowland Hill Street, London, NW32PF, UK
| | - Philip Hawkins
- National Amyloidosis Centre, University College London Medical School, Royal Free Hospital Campus, London, Rowland Hill Street, London, NW32PF, UK
| | - Ute Hegenbart
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Giovanni Palladini
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo" and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Ashutosh Wechalekar
- National Amyloidosis Centre, University College London Medical School, Royal Free Hospital Campus, London, Rowland Hill Street, London, NW32PF, UK
| | - Stefan O Schönland
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Richard Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, SM2 5NG, UK
- Division of Molecular Patholog, The Institute of Cancer Research, 15 Cotswold Road, Sutton, London, SM2 5NG, UK
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
- National Centre of Tumor Diseases, Heidelberg, Germany
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
- Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 30605, Pilsen, Czech Republic
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany.
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany.
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Saeed D, Muslem R, Rasheed M, Caliskan K, Kalampokas N, Sipahi F, Lichtenberg A, Jawad K, Borger M, Huhn S, Cogswell R, John R, Schultz J, Shah H, Hsu S, Gilotra N, Tomashitis B, Hajj ME, Lozonschi L, Houston B, Tedford R. Less Invasive Surgical Implant Strategy is Associated with Significant Reduction in INTERMACS Defined Right Heart Failure Following LVAD Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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21
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Saeed D, Jawad K, Huhn S, Schulz U, Eifert S, Sipahi N, Kalampokas N, Garbade J, Lichtenberg A, Borger M. Less Invasive Ventricular Assist Device Implantation Lowers Rethoracotomy Rate for Bleeding and Reduces Postoperative Hospital Stay: Multicenter Experience. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705352] [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: 10/24/2022]
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22
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Blocka J, Durie BGM, Huhn S, Mueller-Tidow C, Försti A, Hemminki K, Goldschmidt H. Familial Cancer: How to Successfully Recruit Families for Germline Mutations Studies? Multiple Myeloma as an Example. Clin Lymphoma Myeloma Leuk 2019; 19:635-644.e2. [PMID: 31377209 DOI: 10.1016/j.clml.2019.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/15/2019] [Accepted: 06/27/2019] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Identification of germline mutations related to an increased cancer risk enables diagnostic, preventive, and therapeutic measures for individuals carrying the disease variant. However, recruitment of families for studies on these mutations can be challenging. Herein we present some of the obstacles that can arise during such studies. We suggest solutions for overcoming or avoiding these difficulties, enabling an efficient and ethically correct family recruitment. PATIENTS AND METHODS We describe a study on germline mutations associated with familial risk of multiple myeloma using next-generation sequencing of the whole genome. To date, the study has recruited 54 participants/16 families from different centers in Germany. It was performed at the University Hospital of Heidelberg and German Cancer Research Center. RESULTS We were confronted with ethical/psychological concerns of patients and family members, a large number of ineligible families, a profound time investment by the participants and the study team, incidental findings, and participants' death. We present solutions to these difficulties such as: knowledge of and adherence to the laws protecting participants' rights, an exact clarification of the inclusion and exclusion criteria, a clear division of tasks within members of the study team, a collaboration with general practitioners/oncologists and patients' support groups, a detailed and understandable informed consent including information about incidental findings, and a choice of a representative in case of participant's death. CONCLUSION A successful recruitment for studies on familial cancer is challenging, yet possible. It can be facilitated by applying the previously mentioned strategies.
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Affiliation(s)
- Joanna Blocka
- Department of Hematology, Oncology, and Rheumatology, University Hospital of Heidelberg, Heidelberg, Germany.
| | - Brian G M Durie
- Department of Hematology and Oncology, Cedars-Sinai Outpatient Cancer Center, Los Angeles, CA
| | - Stefanie Huhn
- Department of Hematology, Oncology, and Rheumatology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Carsten Mueller-Tidow
- Department of Hematology, Oncology, and Rheumatology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Asta Försti
- Department of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Kari Hemminki
- Department of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Hematology, Oncology, and Rheumatology, University Hospital of Heidelberg, Heidelberg, Germany; Department of Hematology and Oncology, National Center of Tumor Diseases, Heidelberg, Germany
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23
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Salwender H, Bertsch U, Weisel K, Duerig J, Kunz C, Benner A, Blau IW, Raab MS, Hillengass J, Hose D, Huhn S, Hundemer M, Andrulis M, Jauch A, Seidel-Glaetzer A, Lindemann HW, Hensel M, Fronhoffs S, Martens U, Hansen T, Wattad M, Graeven U, Munder M, Fenk R, Haenel M, Scheid C, Goldschmidt H. Rationale and design of the German-speaking myeloma multicenter group (GMMG) trial HD6: a randomized phase III trial on the effect of elotuzumab in VRD induction/consolidation and lenalidomide maintenance in patients with newly diagnosed myeloma. BMC Cancer 2019; 19:504. [PMID: 31138244 PMCID: PMC6537200 DOI: 10.1186/s12885-019-5600-x] [Citation(s) in RCA: 25] [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: 02/07/2018] [Accepted: 04/12/2019] [Indexed: 12/03/2022] Open
Abstract
Background Despite major advances in therapy, multiple myeloma is still an incurable malignancy in the majority of patients. To increase survival, deeper remissions (i.e. CR) translating into longer PFS need to be achieved. Incorporation of new drugs (i.e. bortezomib and lenalidomide) as induction and maintenance treatment in an intensified treatment concept, including high dose melphalan (200 mg/m2), has resulted in increased CR rates, and is considered the standard of care for younger patients. Elotuzumab in combination with lenalidomide and dexamethasone has given better results as lenalidomide and dexamethasone alone in a phase III trial. The GMMG-HD6 trial will be the first phase III trial investigating the role of elotuzumab in combination with bortezomib, lenalidomide and dexamethasone (VRD) induction/consolidation and lenalidomide maintenance within a high dose concept. Methods GMMG-HD6 is a randomized, open, multicenter phase III trial. The planned recruitment number is 564 NDMM patients. All patients will receive 4 VRD cycles as induction and undergo peripheral blood stem cell mobilization and harvesting. Thereafter they will be treated with high dose melphalan therapy plus autologous stem cell transplantation followed by 2 cycles of VRD consolidation and lenalidomide maintenance. Patients in arm B1 + B2 will additionally receive elotuzumab in the induction phase, whereas patients in A2 + B2 will be treated with elotuzumab added to consolidation and maintenance. The primary endpoint of the trial is PFS. Secondary objectives and endpoints are OS, CR rates after induction therapy comparing the two arms VRD (A1 + A2) vs VRD + elotuzumab (B1 + B2), CR rates after consolidation treatment, best response to treatment during the study, time to progression (TTP), duration of response (DOR), toxicity and quality of life. Results Since this is the publication of a study protocol of an ongoing study, no results can be presented. Discussion This phase III trial is designed to evaluate whether the addition of elotuzumab to an intensified treatment concept with high dose melphalan chemotherapy plus autologous stem cell transplantation and induction, consolidation and maintenance treatment with bortezomib and lenalidomide is able to improve PFS compared to the same concept without elotuzumab. Trial registration NCT02495922 on June 24th, 2015.
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Affiliation(s)
- Hans Salwender
- Asklepios Hospital Hamburg, Altona, Hematology, Oncology and Palliative Care, 22763, Hamburg, Germany.
| | - Uta Bertsch
- University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | - Katja Weisel
- University Hospital Tuebingen, Tuebingen, Germany.,University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Jan Duerig
- University Hospital Essen, Essen, Germany
| | - Christina Kunz
- German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Axel Benner
- German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Igor W Blau
- Charité Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - Dirk Hose
- University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | | | | | - Mindaugas Andrulis
- Institute of Pathology, Klinikum Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - Anna Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Andrea Seidel-Glaetzer
- Cordination Center for Clinical Trials, University of Heidelberg (KKS), Heidelberg, Germany
| | | | | | - Stefan Fronhoffs
- Zentrum fuer ambulante Haematologie und Onkologie Siegburg, Siegburg, Germany
| | | | - Timon Hansen
- University Hospital Hamburg Eppendorf, Hamburg, Germany
| | | | - Ullrich Graeven
- Krankenhaus Maria Hilf Moenchengladbach, Moenchengladbach, Germany
| | | | - Roland Fenk
- University Hospital Duesseldorf, Dusseldorf, Germany
| | | | | | - Hartmut Goldschmidt
- University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
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24
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Radamaker L, Lin YH, Annamalai K, Huhn S, Hegenbart U, Schönland SO, Fritz G, Schmidt M, Fändrich M. Cryo-EM structure of a light chain-derived amyloid fibril from a patient with systemic AL amyloidosis. Nat Commun 2019; 10:1103. [PMID: 30894526 PMCID: PMC6427026 DOI: 10.1038/s41467-019-09032-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/15/2019] [Indexed: 12/27/2022] Open
Abstract
Amyloid fibrils derived from antibody light chains are key pathogenic agents in systemic AL amyloidosis. They can be deposited in multiple organs but cardiac amyloid is the major risk factor of mortality. Here we report the structure of a λ1 AL amyloid fibril from an explanted human heart at a resolution of 3.3 Å which we determined using cryo-electron microscopy. The fibril core consists of a 91-residue segment presenting an all-beta fold with ten mutagenic changes compared to the germ line. The conformation differs substantially from natively folded light chains: a rotational switch around the intramolecular disulphide bond being the crucial structural rearrangement underlying fibril formation. Our structure provides insight into the mechanism of protein misfolding and the role of patient-specific mutations in pathogenicity.
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Affiliation(s)
- Lynn Radamaker
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | - Yin-Hsi Lin
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | | | - Stefanie Huhn
- Medical Department V, Section of Multiple Myeloma, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Ute Hegenbart
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Stefan O Schönland
- Medical Department V, Amyloidosis Center, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Günter Fritz
- Institute of Microbiology, University of Hohenheim, 70599, Stuttgart, Germany
- Institute for Neuropathology, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany
| | - Matthias Schmidt
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany
| | - Marcus Fändrich
- Institute of Protein Biochemistry, Ulm University, 89081, Ulm, Germany.
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25
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Campa D, Martino A, Macauda A, Dudziński M, Suska A, Druzd-Sitek A, Raab MS, Moreno V, Huhn S, Butrym A, Sainz J, Szombath G, Rymko M, Marques H, Lesueur F, Vangsted AJ, Vogel U, Kruszewski M, Subocz E, Buda G, Iskierka-Jażdżewska E, Ríos R, Merz M, Schöttker B, Mazur G, Perrial E, Martinez-Lopez J, Butterbach K, García Sanz R, Goldschmidt H, Brenner H, Jamroziak K, Reis RM, Kadar K, Dumontet C, Wątek M, Haastrup EK, Helbig G, Jurczyszyn A, Jerez A, Varkonyi J, Barington T, Grzasko N, Zaucha JM, Andersen V, Zawirska D, Canzian F. Genetic polymorphisms in genes of class switch recombination and multiple myeloma risk and survival: an IMMEnSE study. Leuk Lymphoma 2019; 60:1803-1811. [PMID: 30633655 DOI: 10.1080/10428194.2018.1551536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/30/2022]
Abstract
Genetic variants in genes acting during the maturation process of immature B-cell to differentiated plasma cell could influence the risk of developing multiple myeloma (MM). During B-cell maturation, several programmed genetic rearrangements occur to increase the variation of the immunoglobulin chains. Class switch recombination (CSR) is one of the most important among these mechanisms. Germline polymorphisms altering even subtly this process could play a role in the etiology and outcome of MM. We performed an association study of 30 genetic variants in the key CSR genes, using 2632 MM patients and 2848 controls from the International Multiple Myeloma rESEarch (IMMEnSE) consortium, the Heidelberg MM Group and the ESTHER cohort. We found an association between LIG4-rs1555902 and decreased MM risk, which approached statistical significance, as well as significant associations between AICDA-rs3794318 and better outcome. Our results add to our knowledge on the genetic component of MM risk and survival.
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Affiliation(s)
- Daniele Campa
- a Department of Biology , University of Pisa , Pisa , Italy
| | - Alessandro Martino
- b Genomic Epidemiology Group, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Angelica Macauda
- a Department of Biology , University of Pisa , Pisa , Italy.,b Genomic Epidemiology Group, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Marek Dudziński
- c Hematology Department , Teaching Hospital No 1 , Rzeszów , Poland
| | - Anna Suska
- d Department of Hematology , Jagiellonian University Medical College , Cracow , Poland
| | - Agnieszka Druzd-Sitek
- e Lymphoma Department , Centre of Oncology-Institute of Maria Skłodowska-Curie , Warsaw , Poland
| | - Marc-Steffen Raab
- f Department of Internal Medicine V , Heidelberg University Hospital , Heidelberg , Germany.,g Max-Eder Research Group Experimental Therapies for Hematologic Malignancies, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Victor Moreno
- h Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, CIBERESP and Department of Clinical Sciences, Faculty of Medicine , University of Barcelona , Barcelona , Spain
| | - Stefanie Huhn
- i Molecular Biology Laboratory, Section of Multiple Myeloma, Department of Internal Medicine V , Heidelberg University Hospital , Heidelberg , Germany
| | - Aleksandra Butrym
- j Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology , Wroclaw Medical University , Wroclaw , Poland
| | - Juan Sainz
- k PTS Granada , Genomic Oncology Area, GENYO. Centre for Genomics and Oncological Research: Pfizer / University of Granada / Andalusian Regional Government , Granada , Spain.,l Monoclonal Gammopathies Unit, University Hospital Virgen de las Nieves , Granada , Spain.,m Pharmacogenetics Unit. Instituto de Investigación Biosanitaria de Granada (Ibs. Granada) , Hospitales Universitarios de Granada / Universidad de Granada , Granada , Spain
| | - Gergely Szombath
- n Department of Intrenal Medicine , Semmelweis University , Budapest , Hungary
| | - Marcin Rymko
- o Department of Haematology , Copernicus Town Hospital of Torun , Torun , Poland
| | - Herlander Marques
- p Life and Health Sciences Research Institute (ICVS), School of Health Sciences , University of Minho , Braga , Portugal
| | - Fabienne Lesueur
- q INSERM U900 , Paris , France.,r Institut Curie , Paris , France.,s Mines ParisTech , Fontainebleau , France.,t PSL University , Paris , France
| | - Annette Juul Vangsted
- u Department of Hematology , Copenhagen University Hospital , Rigshospitalet , Denmark
| | - Ulla Vogel
- v National Research Centre for the Working Environment , Denmark
| | - Marcin Kruszewski
- w Department of Hematology , University Hospital , Bydgoszcz , Poland
| | - Edyta Subocz
- x Department of Haematology , Military Institute of Medicine , Warsaw , Poland
| | - Gabriele Buda
- y Hematology Unit, Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy
| | | | - Rafael Ríos
- k PTS Granada , Genomic Oncology Area, GENYO. Centre for Genomics and Oncological Research: Pfizer / University of Granada / Andalusian Regional Government , Granada , Spain.,l Monoclonal Gammopathies Unit, University Hospital Virgen de las Nieves , Granada , Spain.,m Pharmacogenetics Unit. Instituto de Investigación Biosanitaria de Granada (Ibs. Granada) , Hospitales Universitarios de Granada / Universidad de Granada , Granada , Spain
| | - Maximilian Merz
- f Department of Internal Medicine V , Heidelberg University Hospital , Heidelberg , Germany
| | - Ben Schöttker
- aa Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.,ab Network Aging Research (NAR) , University of Heidelberg , Heidelberg , Germany
| | - Grzegorz Mazur
- j Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology , Wroclaw Medical University , Wroclaw , Poland
| | - Emeline Perrial
- ac Cancer Research Center of Lyon, INSERM 1052/CNRS 5286 , University of Lyon , Lyon , France
| | | | - Katja Butterbach
- ab Network Aging Research (NAR) , University of Heidelberg , Heidelberg , Germany
| | - Ramón García Sanz
- ae Department of Hematology , University Hospital of Salamanca , Salamanca , Spain
| | - Hartmut Goldschmidt
- f Department of Internal Medicine V , Heidelberg University Hospital , Heidelberg , Germany.,af National Center for Tumor Diseases (NCT) , Heidelberg , Germany
| | - Hermann Brenner
- aa Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.,ab Network Aging Research (NAR) , University of Heidelberg , Heidelberg , Germany.,ag Division of Preventive Oncology , National Center for Tumor Diseases (NCT) German Cancer Research Center (DKFZ) , Heidelberg , Germany.,ah German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Krzysztof Jamroziak
- ai Department of Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland
| | - Rui Manuel Reis
- p Life and Health Sciences Research Institute (ICVS), School of Health Sciences , University of Minho , Braga , Portugal.,aj ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães , Portugal.,ak Barretos Cancer Hospital , Molecular Oncology Research Center , S. Paulo , Brazil
| | - Katalin Kadar
- n Department of Intrenal Medicine , Semmelweis University , Budapest , Hungary
| | - Charles Dumontet
- ac Cancer Research Center of Lyon, INSERM 1052/CNRS 5286 , University of Lyon , Lyon , France
| | - Marzena Wątek
- al Department of Hematology , Holy Cross Oncology Center , Kielce , Poland
| | - Eva Kannik Haastrup
- am Department of Clinical Immunology , Copenhagen University Hospital , Rigshospitalet, Copenhagen , Denmark
| | - Grzegorz Helbig
- an Department of Hematology and Bone Marrow Transplantation , Medical University of Silesia , Katowice , Poland
| | - Artur Jurczyszyn
- d Department of Hematology , Jagiellonian University Medical College , Cracow , Poland
| | - Andrés Jerez
- ao Department of Hematology , University Hospital Morales Meseguer, IMIB , Murcia , Spain
| | - Judit Varkonyi
- n Department of Intrenal Medicine , Semmelweis University , Budapest , Hungary
| | - Torben Barington
- ap Department of Clinical Immunology , Odense University Hospital , Odense , Denmark
| | - Norbert Grzasko
- aq Department of Hematology , St. John's Cancer Center , Lublin , Poland.,ar Department of Experimental Hematooncology , Medical University of Lublin , Lublin , Poland
| | | | - Vibeke Andersen
- at IRS-Center Sønderjylland , Aabenraa , Denmark.,au Institute of Molecular Biology, University of Southern Denmark , Odense , Denmark
| | - Daria Zawirska
- av Department of Haematology , University Hospital of Cracow , Cracow , Poland
| | - Federico Canzian
- b Genomic Epidemiology Group, German Cancer Research Center (DKFZ) , Heidelberg , Germany
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26
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Chattopadhyay S, Thomsen H, Yadav P, da Silva Filho MI, Weinhold N, Nöthen MM, Hoffman P, Bertsch U, Huhn S, Morgan GJ, Goldschmidt H, Houlston R, Hemminki K, Försti A. Genome-wide interaction and pathway-based identification of key regulators in multiple myeloma. Commun Biol 2019; 2:89. [PMID: 30854481 PMCID: PMC6399257 DOI: 10.1038/s42003-019-0329-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 10/23/2018] [Accepted: 01/29/2019] [Indexed: 02/08/2023] Open
Abstract
Inherited genetic susceptibility to multiple myeloma has been investigated in a number of studies. Although 23 individual risk loci have been identified, much of the genetic heritability remains unknown. Here we carried out genome-wide interaction analyses on two European cohorts accounting for 3,999 cases and 7,266 controls and characterized genetic susceptibility to multiple myeloma with subsequent meta-analysis that discovered 16 unique interacting loci. These risk loci along with previously known variants explain 17% of the heritability in liability scale. The genes associated with the interacting loci were found to be enriched in transforming growth factor beta signaling and circadian rhythm regulation pathways suggesting immunoglobulin trait modulation, TH17 cell differentiation and bone morphogenesis as mechanistic links between the predisposition markers and intrinsic multiple myeloma biology. Further tissue/cell-type enrichment analysis associated the discovered genes with hemic-immune system tissue types and immune-related cell types indicating overall involvement in immune response.
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Affiliation(s)
- Subhayan Chattopadhyay
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
- Faculty of Medicine, University of Heidelberg, Heidelberg, 69117, Germany
| | - Hauke Thomsen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Pankaj Yadav
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | | | - Niels Weinhold
- University Clinic Heidelberg, Internal Medicine V, Heidelberg, 69117, Germany
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, 72205, AR, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, 53127, Germany
- Department of Genomics, Life & Brain Research Center, University of Bonn, Bonn, 53127, Germany
| | - Per Hoffman
- Institute of Human Genetics, University of Bonn, Bonn, 53127, Germany
- Department of Genomics, Life & Brain Research Center, University of Bonn, Bonn, 53127, Germany
- Department of Biomedicine, University of Basel, Basel, 4003, Switzerland
| | - Uta Bertsch
- University Clinic Heidelberg, Internal Medicine V, Heidelberg, 69117, Germany
| | - Stefanie Huhn
- University Clinic Heidelberg, Internal Medicine V, Heidelberg, 69117, Germany
| | - Gareth J Morgan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, 72205, AR, USA
| | - Hartmut Goldschmidt
- University Clinic Heidelberg, Internal Medicine V, Heidelberg, 69117, Germany
- National Centre of Tumor Diseases, Heidelberg, 69120, Germany
| | - Richard Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, SW7 3RP, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, SW7 3RP, UK
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
- Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany.
- Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden.
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27
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Huhn S, da Silva Filho MI, Sanmuganantham T, Pichulik T, Catalano C, Pardini B, Naccarati A, Polakova-Vymetálkova V, Jiraskova K, Vodickova L, Vodicka P, Löffler MW, Courth L, Wehkamp J, Din FVN, Timofeeva M, Farrington SM, Jansen L, Hemminki K, Chang-Claude J, Brenner H, Hoffmeister M, Dunlop MG, Weber ANR, Försti A. Coding variants in NOD-like receptors: An association study on risk and survival of colorectal cancer. PLoS One 2018; 13:e0199350. [PMID: 29928061 PMCID: PMC6013205 DOI: 10.1371/journal.pone.0199350] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/06/2018] [Indexed: 11/19/2022] Open
Abstract
Nod-like receptors (NLRs) are important innate pattern recognition receptors and regulators of inflammation or play a role during development. We systematically analysed 41 non-synonymous single nucleotide polymorphisms (SNPs) in 21 NLR genes in a Czech discovery cohort of sporadic colorectal cancer (CRC) (1237 cases, 787 controls) for their association with CRC risk and survival. Five SNPs were found to be associated with CRC risk and eight with survival at 5% significance level. In a replication analysis using data of two large genome-wide association studies (GWASs) from Germany (DACHS: 1798 cases and 1810 controls) and Scotland (2210 cases and 9350 controls) the associations found in the Czech discovery set were not confirmed. However, expression analysis in human gut-related tissues and immune cells revealed that the NLRs associated with CRC risk or survival in the discovery set were expressed in primary human colon or rectum cells, CRC tissue and/or cell lines, providing preliminary evidence for a potential involvement of NLRs in general in CRC development and/or progression. Most interesting was the finding that the enigmatic development-related NLRP5 (also known as MATER) was not expressed in normal colon tissue but in colon cancer tissue and cell lines. Future studies may show whether regulatory variants instead of coding variants might affect the expression of NLRs and contribute to CRC risk and survival.
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Affiliation(s)
- Stefanie Huhn
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Multiple Myeloma, Internal Medicine V: Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
| | - Miguel I. da Silva Filho
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tharmila Sanmuganantham
- Interfaculty Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Tica Pichulik
- Interfaculty Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Calogerina Catalano
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Barbara Pardini
- Italian Institute for Genomic Medicine (IIGM), Turin, Italy
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Alessio Naccarati
- Italian Institute for Genomic Medicine (IIGM), Turin, Italy
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Veronika Polakova-Vymetálkova
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katerina Jiraskova
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Vodickova
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
- Biomedical Centre, Faculty of Medicine Pilsen, Charles University Prague, Pilsen, Czech Republic
| | - Pavel Vodicka
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
- Biomedical Centre, Faculty of Medicine Pilsen, Charles University Prague, Pilsen, Czech Republic
| | - Markus W. Löffler
- Interfaculty Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Lioba Courth
- Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany
| | - Jan Wehkamp
- Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany
| | - Farhat V. N. Din
- Colon Cancer Genetics Group, MRC Human Genetics Unit, The University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Maria Timofeeva
- Colon Cancer Genetics Group, MRC Human Genetics Unit, The University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Susan M. Farrington
- Colon Cancer Genetics Group, MRC Human Genetics Unit, The University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kari Hemminki
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, SE, Sweden
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Malcolm G. Dunlop
- Colon Cancer Genetics Group, MRC Human Genetics Unit, The University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Alexander N. R. Weber
- Interfaculty Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Asta Försti
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, SE, Sweden
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28
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Lu S, Catalano C, Huhn S, Pardini B, Vymetalkova V, Vodickova L, Hemminki K, Foersti A. Single nucleotide polymorphisms within Mucin-type O-glycan genes are associated with colorectal cancer survival. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15607] [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: 11/20/2022] Open
Affiliation(s)
- Shun Lu
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Calogerina Catalano
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Stefanie Huhn
- 1Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | - Veronika Vymetalkova
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Ludmila Vodickova
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Asta Foersti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
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29
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Meziane I, Huhn S, Filho MIDS, Weinhold N, Campo C, Nickel J, Hoffmann P, Nöthen MM, Jöckel KH, Landi S, Mitchell JS, Johnson D, Jauch A, Morgan GJ, Houlston R, Goldschmidt H, Milani P, Merlini G, Rowcieno D, Hawkins P, Hegenbart U, Palladini G, Wechalekar A, Försti A, Schönland SO, Hemminki K. Genome-wide association study of clinical parameters in immunoglobulin light chain amyloidosis in three patient cohorts. Haematologica 2017; 102:e411-e414. [PMID: 28679651 DOI: 10.3324/haematol.2017.171108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Iman Meziane
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefanie Huhn
- Department of Internal Medicine V, University of Heidelberg, Germany
| | | | - Niels Weinhold
- Department of Internal Medicine V, University of Heidelberg, Germany.,Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Chiara Campo
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jolanta Nickel
- Department of Internal Medicine V, University of Heidelberg, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Germany.,Department of Biomedicine, University of Basel, Switzerland
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Research Center, University of Bonn, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Germany
| | | | - Jonathan S Mitchell
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Surrey, UK
| | - David Johnson
- Division of Molecular Pathology, The Institute of Cancer Research, Surrey, UK
| | - Anna Jauch
- Institute of Human Genetics, University of Heidelberg, Germany
| | - Gareth J Morgan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Richard Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Surrey, UK.,Division of Molecular Pathology, The Institute of Cancer Research, Surrey, UK
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, University of Heidelberg, Germany.,National Centre of Tumor Diseases, Heidelberg, Germany
| | - Paolo Milani
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Italy
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Italy
| | - Dorota Rowcieno
- National Amyloidosis Centre, University College London Medical School, Royal Free Hospital Campus, London, UK
| | - Philip Hawkins
- National Amyloidosis Centre, University College London Medical School, Royal Free Hospital Campus, London, UK
| | - Ute Hegenbart
- Department of Internal Medicine V, University of Heidelberg, Germany
| | - Giovanni Palladini
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo", Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Italy
| | - Ashutosh Wechalekar
- National Amyloidosis Centre, University College London Medical School, Royal Free Hospital Campus, London, UK
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmo, Sweden
| | | | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmo, Sweden
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30
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Huhn S, Weinhold N, Nickel J, Pritsch M, Hielscher T, Hummel M, Bertsch U, Huegle-Doerr B, Vogel M, Angermund R, Hänel M, Salwender HJ, Weisel K, Dürig J, Görner M, Kirchner H, Peter N, Graeven U, Lordick F, Hoffmann M, Reimer P, Blau IW, Jauch A, Dembowsky K, Möhler T, Wuchter P, Goldschmidt H. Circulating tumor cells as a biomarker for response to therapy in multiple myeloma patients treated within the GMMG-MM5 trial. Bone Marrow Transplant 2017; 52:1194-1198. [PMID: 28504661 PMCID: PMC5543255 DOI: 10.1038/bmt.2017.91] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 11/19/2022]
Affiliation(s)
- S Huhn
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - N Weinhold
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J Nickel
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - M Pritsch
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - T Hielscher
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - M Hummel
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - U Bertsch
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | - B Huegle-Doerr
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - M Vogel
- Janssen-Cilag, Neuss, Germany
| | | | - M Hänel
- Department of Internal Medicine III, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - H J Salwender
- Department of Hematology/Oncology, Asklepios Klinik Altona, Hamburg, Germany
| | - K Weisel
- Department of Internal Medicine II-Hematology and Oncology, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - J Dürig
- Department of Hematology, University Hospital Essen, Essen, Germany
| | - M Görner
- Department of Hematology, Oncology and Palliative Care, Community Hospital Bielefeld, Bielefeld, Germany
| | - H Kirchner
- Medical Clinic III Hematology and Oncology, Städt. Krankenhaus Siloah, Hannover, Germany
| | - N Peter
- 2nd Medical Department, Academic Teaching Hospital of the Charité, Carl-Thiem-Klinikum Cottbus, Cottbus, Germany
| | - U Graeven
- Hematology, Oncology and Gastroenterology, Maria-Hilf-Krankenhaus, Mönchengladbach, Germany
| | - F Lordick
- 3rd Medical Department, Haematology and Oncology, Klinikum Braunschweig, Braunschweig, Germany.,University Cancer Center Leipzig (UCCL), University Medical Center Leipzig, Leipzig, Germany
| | - M Hoffmann
- Medical Clinic A, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen am Rhein, Germany
| | - P Reimer
- Hematology, Oncology and Stem Cell Transplantation, Evangelisches Krankenhaus Essen-Werden gGmbH, Essen, Germany
| | - I W Blau
- Medical Clinic III Hematology and Oncology, Charité University Medicine Berlin, Berlin, Germany
| | - A Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | | | - T Möhler
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,inVentiv Health, Boston, MA, USA
| | - P Wuchter
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Institute of Transfusion Medicine and Immunology, German Red Cross Blood Service Baden-Württemberg-Hessen, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - H Goldschmidt
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
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31
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da Silva Filho MI, Försti A, Weinhold N, Meziane I, Campo C, Huhn S, Nickel J, Hoffmann P, Nöthen MM, Jöckel KH, Landi S, Mitchell JS, Johnson D, Morgan GJ, Houlston R, Goldschmidt H, Jauch A, Milani P, Merlini G, Rowcieno D, Hawkins P, Hegenbart U, Palladini G, Wechalekar A, Schönland SO, Hemminki K. Genome-wide association study of immunoglobulin light chain amyloidosis in three patient cohorts: comparison with myeloma. Leukemia 2016; 31:1735-1742. [PMID: 28025584 DOI: 10.1038/leu.2016.387] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/28/2016] [Accepted: 11/30/2016] [Indexed: 01/27/2023]
Abstract
Immunoglobulin light chain (AL) amyloidosis is characterized by tissue deposition of amyloid fibers derived from immunoglobulin light chain. AL amyloidosis and multiple myeloma (MM) originate from monoclonal gammopathy of undetermined significance. We wanted to characterize germline susceptibility to AL amyloidosis using a genome-wide association study (GWAS) on 1229 AL amyloidosis patients from Germany, UK and Italy, and 7526 healthy local controls. For comparison with MM, recent GWAS data on 3790 cases were used. For AL amyloidosis, single nucleotide polymorphisms (SNPs) at 10 loci showed evidence of an association at P<10-5 with homogeneity of results from the 3 sample sets; some of these were previously documented to influence MM risk, including the SNP at the IRF4 binding site. In AL amyloidosis, rs9344 at the splice site of cyclin D1, promoting translocation (11;14), reached the highest significance, P=7.80 × 10-11; the SNP was only marginally significant in MM. SNP rs79419269 close to gene SMARCD3 involved in chromatin remodeling was also significant (P=5.2 × 10-8). These data provide evidence for common genetic susceptibility to AL amyloidosis and MM. Cyclin D1 is a more prominent driver in AL amyloidosis than in MM, but the links to aggregation of light chains need to be demonstrated.
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Affiliation(s)
- M I da Silva Filho
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmo, Sweden
| | - N Weinhold
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - I Meziane
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Campo
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Huhn
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - J Nickel
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - P Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Research Center, University of Bonn, Bonn, Germany
| | - K-H Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Germany
| | - S Landi
- Department of Biology, University of Pisa, Pisa, Italy
| | - J S Mitchell
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Surrey, UK
| | - D Johnson
- Division of Molecular Pathology, The Institute of Cancer Research, Surrey, UK
| | - G J Morgan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Surrey, UK.,Division of Molecular Pathology, The Institute of Cancer Research, Surrey, UK
| | - H Goldschmidt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,National Centre of Tumor Diseases, Heidelberg, Germany
| | - A Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - P Milani
- Department of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation 'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo', University of Pavia, Pavia, Italy
| | - G Merlini
- Department of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation 'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo', University of Pavia, Pavia, Italy
| | - D Rowcieno
- National Amyloidosis Centre, University College London Medical School, London UK
| | - P Hawkins
- National Amyloidosis Centre, University College London Medical School, London UK
| | - U Hegenbart
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - G Palladini
- Department of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation 'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo', University of Pavia, Pavia, Italy
| | - A Wechalekar
- National Amyloidosis Centre, University College London Medical School, London UK
| | - S O Schönland
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - K Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmo, Sweden
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32
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Thomsen H, Filho MIDS, Woltmann A, Johansson R, Eyfjörd JE, Hamann U, Manjer J, Enquist-Olsson K, Henriksson R, Herms S, Hoffmann P, Chen B, Huhn S, Hemminki K, Lenner P, Försti A. Inbreeding and homozygosity in breast cancer survival. Sci Rep 2015; 5:16467. [PMID: 26558712 PMCID: PMC4642301 DOI: 10.1038/srep16467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 10/14/2015] [Indexed: 02/07/2023] Open
Abstract
Genome-wide association studies (GWASs) help to understand the effects of single nucleotide polymorphisms (SNPs) on breast cancer (BC) progression and survival. We performed multiple analyses on data from a previously conducted GWAS for the influence of individual SNPs, runs of homozygosity (ROHs) and inbreeding on BC survival. (I.) The association of individual SNPs indicated no differences in the proportions of homozygous individuals among short-time survivors (STSs) and long-time survivors (LTSs). (II.) The analysis revealed differences among the populations for the number of ROHs per person and the total and average length of ROHs per person and among LTSs and STSs for the number of ROHs per person. (III.) Common ROHs at particular genomic positions were nominally more frequent among LTSs than in STSs. Common ROHs showed significant evidence for natural selection (iHS, Tajima's D, Fay-Wu's H). Most regions could be linked to genes related to BC progression or treatment. (IV.) Results were supported by a higher level of inbreeding among LTSs. Our results showed that an increased level of homozygosity may result in a preference of individuals during BC treatment. Although common ROHs were short, variants within ROHs might favor survival of BC and may function in a recessive manner.
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Affiliation(s)
- Hauke Thomsen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Andrea Woltmann
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Robert Johansson
- Department of Radiation Sciences & Oncology, Umeå University, Umeå, Sweden
| | - Jorunn E. Eyfjörd
- Cancer Research Laboratory, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jonas Manjer
- The Malmö Diet and Cancer Study, Lund University, Malmö, Sweden
- Department of Plastic Surgery, Skåne University Hospital, Malmö, Lund University, Malmö, Sweden
| | - Kerstin Enquist-Olsson
- Department of Public Health and Clinical Medicine/Nutritional Research, Umeå University, Umeå, Sweden
| | - Roger Henriksson
- Department of Radiation Sciences & Oncology, Umeå University, Umeå, Sweden
- Cancer Center Stockholm Gotland, Stockholm, Sweden
| | - Stefan Herms
- Institute of Human Genetics, Department of Genomics, University of Bonn, Bonn, Germany
- Division of Medical Genetics and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Per Hoffmann
- Institute of Human Genetics, Department of Genomics, University of Bonn, Bonn, Germany
- Division of Medical Genetics and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Bowang Chen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefanie Huhn
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | - Per Lenner
- Department of Radiation Sciences & Oncology, Umeå University, Umeå, Sweden
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
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33
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Weber A, Huhn S, Klimosch S, da Silva Filho MI, Sanmuganantham T, Pichulik T, Padini B, Naccarati A, Schafmayer C, Vodickova L, Vodicka P, Hemminki K, Försti A. Influence of human TLR and NLR genetic variants on colorectal cancer - involvement of commensal bacterial detection, gut immunity or microbiome diversity? (HUM1P.311). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.52.36] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Studies on TLR and NLR knock out mice have suggested these pattern recognition receptors (PRRs) drastically affect gut mucosal immunity and composition of the gut microbiome, which may give rise to diseases such as colorectal cancer. We have identified several coding SNPs in TLR5 and different NLR (including the so far enigmatic group of development-associated NLRs) to be associated with different parameters of colorectal cancer, and for TLR5 have observed a functional effect in human blood immune cells. With a view to further elucidating the underlying mechanisms of these SNPs in colorectal cancer, we have begun to investigate the role of these PRR variants on gut immune activation levels and microbiome diversity in humans. Our hypothesis is that functional TLR and NLR variants are associated with different immune potential in the gut, shaping or being shaped by the host microbiome. We have built-up, genotyped and started to assay a cohort of 125 healthy volunteers and established stool assays for sIgA and cytokine levels by ELISA, cellular contents by flow cytometry analysis and PRR stimulating potential. Additionally, a functional characterization of coding NLR SNPs in cellular model systems is being carried out. Our studies dissect the functional impact and relationship of host genetic factors and the microbiome in humans, which may reveal novel targets in the diagnosis or treatment of colorectal cancer or other gut-related diseases.
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Affiliation(s)
| | - Stefanie Huhn
- 2Molecular Genetic Epidemiology, German Cancer Res. Ctr. (DKFZ), Heidelberg, Germany
| | | | | | | | | | | | | | | | | | | | - Kari Hemminki
- 2Molecular Genetic Epidemiology, German Cancer Res. Ctr. (DKFZ), Heidelberg, Germany
| | - Asta Försti
- 2Molecular Genetic Epidemiology, German Cancer Res. Ctr. (DKFZ), Heidelberg, Germany
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34
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Lu S, Pardini B, Cheng B, Naccarati A, Huhn S, Vymetalkova V, Vodickova L, Buchler T, Hemminki K, Vodicka P, Försti A. Single nucleotide polymorphisms within interferon signaling pathway genes are associated with colorectal cancer susceptibility and survival. PLoS One 2014; 9:e111061. [PMID: 25350395 PMCID: PMC4211713 DOI: 10.1371/journal.pone.0111061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 09/18/2014] [Indexed: 12/27/2022] Open
Abstract
Interferon (IFN) signaling has been suggested to play an important role in colorectal carcinogenesis. Our study aimed to examine potentially functional genetic variants in interferon regulatory factor 3 (IRF3), IRF5, IRF7, type I and type II IFN and their receptor genes with respect to colorectal cancer (CRC) risk and clinical outcome. Altogether 74 single nucleotide polymorphisms (SNPs) were covered by the 34 SNPs genotyped in a hospital-based case-control study of 1327 CRC cases and 758 healthy controls from the Czech Republic. We also analyzed these SNPs in relation to overall survival and event-free survival in a subgroup of 483 patients. Seven SNPs in IFNA1, IFNA13, IFNA21, IFNK, IFNAR1 and IFNGR1 were associated with CRC risk. After multiple testing correction, the associations with the SNPs rs2856968 (IFNAR1) and rs2234711 (IFNGR1) remained formally significant (P = 0.0015 and P<0.0001, respectively). Multivariable survival analyses showed that the SNP rs6475526 (IFNA7/IFNA14) was associated with overall survival of the patients (P = 0.041 and event-free survival among patients without distant metastasis at the time of diagnosis, P = 0.034). The hazard ratios (HRs) for rs6475526 remained statistically significant even after adjustment for age, gender, grade and stage (P = 0.029 and P = 0.036, respectively), suggesting that rs6475526 is an independent prognostic marker for CRC. Our data suggest that genetic variation in the IFN signaling pathway genes may play a role in the etiology and survival of CRC and further studies are warranted.
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Affiliation(s)
- Shun Lu
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Bowang Cheng
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alessio Naccarati
- Human Genetics Foundation (HuGeF), Turin, Italy
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Stefanie Huhn
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Veronika Vymetalkova
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Prague, Czech Republic
| | - Ludmila Vodickova
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Prague, Czech Republic
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Thomas Buchler
- Department of Oncology, Thomayer Hospital, Prague, Czech Republic
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center of Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | - Pavel Vodicka
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Prague, Czech Republic
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center of Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
- * E-mail:
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35
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Wang H, Flannery SM, Dickhöfer S, Huhn S, George J, Kubarenko AV, Lascorz J, Bevier M, Willemsen J, Pichulik T, Schafmayer C, Binder M, Manoury B, Paludan SR, Alarcon-Riquelme M, Bowie AG, Försti A, Weber ANR. A coding IRAK2 protein variant compromises Toll-like receptor (TLR) signaling and is associated with colorectal cancer survival. J Biol Chem 2014; 289:23123-23131. [PMID: 24973222 DOI: 10.1074/jbc.m113.492934] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Within innate immune signaling pathways, interleukin-1 receptor-associated kinases (IRAKs) fulfill key roles downstream of multiple Toll-like receptors and the interleukin-1 receptor. Although human IRAK4 deficiency was shown to lead to severe immunodeficiency in response to pyogenic bacterial infection during childhood, little is known about the role of human IRAK2. We here identified a non-synonymous IRAK2 variant, rs35060588 (coding R214G), as hypofunctional in terms of NF-κB signaling and Toll-like receptor-mediated cytokine induction. This was due to reduced ubiquitination of TRAF6, a key step in signal transduction. IRAK2 rs35060588 occurs in 3-9% of individuals in different ethnic groups, and our studies suggested a genetic association of rs35060588 with colorectal cancer survival. This for the first time implicates human IRAK2 in a human disease and highlights the R214G IRAK2 variant as a potential novel and broadly applicable biomarker for disease or as a therapeutic intervention point.
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Affiliation(s)
- Hui Wang
- Junior Research Group Toll-like Receptors and Cancer and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany; Interfaculty Institute for Cell Biology, Department of Immunology, University of Tübingen, Auf der Morgenstelle 15, 72076 Tübingen, Germany
| | - Sinead M Flannery
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Sabine Dickhöfer
- Interfaculty Institute for Cell Biology, Department of Immunology, University of Tübingen, Auf der Morgenstelle 15, 72076 Tübingen, Germany
| | - Stefanie Huhn
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Julie George
- Junior Research Group Toll-like Receptors and Cancer and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Andriy V Kubarenko
- Junior Research Group Toll-like Receptors and Cancer and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Jesus Lascorz
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Melanie Bevier
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Joschka Willemsen
- Department of Infectious Diseases/Molecular Virology, Heidelberg University, Im Neuenheimer Feld 345, 69120 Heidelberg, Germany
| | - Tica Pichulik
- Junior Research Group Toll-like Receptors and Cancer and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Clemens Schafmayer
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, 24105 Kiel, Germany,; POPGEN Biobank Project, Christian-Albrechts University, 24105 Kiel, Germany
| | - Marco Binder
- Department of Infectious Diseases/Molecular Virology, Heidelberg University, Im Neuenheimer Feld 345, 69120 Heidelberg, Germany
| | - Bénédicte Manoury
- INSERM, Unité 1013 and Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 75015 Paris, France
| | - Søren R Paludan
- Department of Biomedicine, Aarhus University, Bartholin Building, 8000 Aarhus, Denmark
| | - Marta Alarcon-Riquelme
- Pfizer-Universidad de Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Avenida de la Ilustración 114, 18016 Granada, Spain,; Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma 73104,; BIOLUPUS Network, European Science Foundation, F-67080 Strasbourg Cedex, France, and
| | - Andrew G Bowie
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany,; Center for Primary Health Care Research, Clinical Research Center, Lund University, 20502 Malmö, Sweden
| | - Alexander N R Weber
- Junior Research Group Toll-like Receptors and Cancer and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany; Interfaculty Institute for Cell Biology, Department of Immunology, University of Tübingen, Auf der Morgenstelle 15, 72076 Tübingen, Germany,.
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Lu S, Bevier M, Huhn S, Sainz J, Lascorz J, Pardini B, Naccarati A, Vodickova L, Novotny J, Hemminki K, Vodicka P, Försti A. Genetic variants in C-type lectin genes are associated with colorectal cancer susceptibility and clinical outcome. Int J Cancer 2013; 133:2325-33. [PMID: 23650115 DOI: 10.1002/ijc.28251] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 04/15/2013] [Indexed: 11/09/2022]
Abstract
Inflammatory responses play a vital role at different stages of colorectal carcinogenesis. C-type lectins mediate inflammatory/immune responses and participate in immune escape of pathogens and tumors. Our study aimed to evaluate the correlation between polymorphisms in three C-type lectin genes, CD209, MBL2 and REG4, and colorectal cancer (CRC) risk and clinical outcome. We genotyped 15 potentially functional single nucleotide polymorphisms (SNPs) and assessed their associations with CRC risk in a case-control study of 1353 CRC cases and 767 healthy controls from the Czech Republic. We also analyzed these SNPs in relation to overall and event-free survival in 414 patients. Two CD209 SNPs were associated with CRC risk after adjustment for multiple comparison. Minor allele carriers of the promoter SNP rs2287886 had an increased risk of CRC (OR 1.30, 95% CI 1.08-1.56), while minor allele carriers of the 3'UTR SNP, rs7248637, had a decreased risk (OR 0.74, 95% CI 0.60-0.91). Multivariate survival analyses, including age, gender, TNM stage and grade, showed that patients without distant metastasis at the time of diagnosis and carrying the rs2994809 T allele had a decreased overall and event-free survival (HR 2.11, 95% CI 1.20-3.72 and HR 2.00, 95% CI 1.18-3.39, respectively). We show that SNPs in CD209 may affect CRC risk, while a SNP in REG4 may be a useful marker for CRC progression.
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Affiliation(s)
- Shun Lu
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Huhn S, Bevier M, Rudolph A, Pardini B, Naccarati A, Hein R, Hoffmeister M, Vodickova L, Novotny J, Brenner H, Chang-Claude J, Hemminki K, Vodicka P, Försti A. Shared ancestral susceptibility to colorectal cancer and other nutrition related diseases. BMC Med Genet 2012; 13:94. [PMID: 23036011 PMCID: PMC3522999 DOI: 10.1186/1471-2350-13-94] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 09/28/2012] [Indexed: 12/31/2022]
Abstract
Background The majority of non-syndromic colorectal cancers (CRCs) can be described as a complex disease. A two-stage case–control study on CRC susceptibility was conducted to assess the influence of the ancestral alleles in the polymorphisms previously associated with nutrition-related complex diseases. Methods In stage I, 28 single nucleotide polymorphisms (SNPs) were genotyped in a hospital-based Czech population (1025 CRC cases, 787 controls) using an allele-specific PCR-based genotyping system (KASPar®). In stage II, replication was carried out for the five SNPs with the lowest p values. The replication set consisted of 1798 CRC cases and 1810 controls from a population-based German study (DACHS). Odds ratios (ORs) and 95% confidence intervals (CIs) for associations between genotypes and CRC risk were estimated using logistic regression. To identify signatures of selection, Fay-Wu’s H and Integrated Haplotype Score (iHS) were estimated. Results In the Czech population, carriers of the ancestral alleles of AGT rs699 and CYP3A7 rs10211 showed an increased risk of CRC (OR 1.26 and 1.38, respectively; two-sided p≤0.05), whereas carriers of the ancestral allele of ENPP1 rs1044498 had a decreased risk (OR 0.79; p≤0.05). For rs1044498, the strongest association was detected in the Czech male subpopulation (OR 0.61; p=0.0015). The associations were not replicated in the German population. Signatures of selection were found for all three analyzed genes. Conclusions Our study showed evidence of association for the ancestral alleles of polymorphisms in AGT and CYP3A7 and for the derived allele of a polymorphism in ENPP1 with an increased risk of CRC in Czechs, but not in Germans. The ancestral alleles of these SNPs have previously been associated with nutrition-related diseases hypertension (AGT and CYP3A7) and insulin resistance (ENPP1). Future studies may shed light on the complex genetic and environmental interactions between different types of nutrition-related diseases.
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Affiliation(s)
- Stefanie Huhn
- Department of Molecular Genetic Epidemiology, German Cancer Research Center DKFZ, Heidelberg, Germany.
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Abstract
Every year, approximately 1 million new colorectal cancer (CRC) cases are diagnosed and about half a million people worldwide die due to this cancer. Known differences in CRC incidence rates are mainly attributed to differences in diet and other environmental factors represented, among others, by nutrition-related complex diseases (e.g. obesity and diabetes mellitus type II). Within the last years, it has become evident that environmental risk factors can be complemented by a genetic component when considering the risk of CRC. For example, a number of polymorphisms are known to be associated with an increased risk of obesity and obesity is a risk factor for CRC. Several studies have shown that the 'ancestral-susceptibility model' can be reasonably applied to nutrition-related complex diseases such as obesity. The work in hand shortly discusses whether the ancestral-susceptibility model can also be applied to CRC as a nutrition-related complex disease.
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Affiliation(s)
- Stefanie Huhn
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69121 Heidelberg, Germany
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39
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Huhn S, Ingelfinger D, Bermejo JL, Bevier M, Pardini B, Naccarati A, Steinke V, Rahner N, Holinski-Feder E, Morak M, Schackert HK, Görgens H, Pox CP, Goecke T, Kloor M, Loeffler M, Büttner R, Vodickova L, Novotny J, Demir K, Cruciat CM, Renneberg R, Huber W, Niehrs C, Boutros M, Propping P, Vodička P, Hemminki K, Försti A. Polymorphisms in CTNNBL1 in relation to colorectal cancer with evolutionary implications. Int J Mol Epidemiol Genet 2011; 2:36-50. [PMID: 21537400 PMCID: PMC3077237] [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] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 11/23/2010] [Indexed: 05/30/2023]
Abstract
Colorectal cancer (CRC) is a complex disease related to environmental and genetic risk factors. Several studies have shown that susceptibility to complex diseases can be mediated by ancestral alleles. Using RNAi screening, CTNNBL1 was identified as a putative regulator of the Wnt signaling pathway, which plays a key role in colorectal carcinogenesis. Recently, single nucleotide polymorphisms (SNPs) in CTNNBL1 have been associated with obesity, a known risk factor for CRC. We investigated whether genetic variation in CTNNBL1 affects susceptibility to CRC and tested for signals of recent selection. We applied a tagging SNP approach that cover all known common variation in CTNNBL1 (allele frequency >5%; r(2)>0.8). A case-control study was carried out using two well-characterized study populations: a hospital-based Czech population composed of 751 sporadic cases and 755 controls and a family/early onset-based German population (697 cases and 644 controls). Genotyping was performed using allele specific PCR based TaqMan® assays (Applied Biosystems, Weiterstadt, Germany). In the Czech cohort, containing sporadic cases, the ancestral alleles of three SNPs showed evidence of association with CRC: rs2344481 (OR 1.44, 95%CI 1.06-1.95, dominant model), rs2281148 (OR 0.59, 95%CI 0.36-0.96, dominant model) and rs2235460 (OR 1.38, 95%CI 1.01-1.89, AA vs. GG). The associations were less prominent in the family/early onset-based German cohort. Data derived from several databases and statistical tests consistently pointed to a likely shaping of CTNNBL1 by positive selection. Further studies are needed to identify the actual function of CTNNBL1 and to validate the association results in other populations.
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Affiliation(s)
- Stefanie Huhn
- Department of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ)Heidelberg; Germany
| | - Dierk Ingelfinger
- Division of Signaling and Functional Genomics; German Cancer Research Center (DKFZ) and University of HeidelbergGermany
| | - Justo Lorenzo Bermejo
- Department of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ)Heidelberg; Germany
- Institute of Medical Biometry and Informatics; University Hospital HeidelbergGermany
| | - Melanie Bevier
- Department of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ)Heidelberg; Germany
| | - Barbara Pardini
- Department of Molecular Biology of Cancer at the Institute of Experimental Medicine; Academy of Sciences of the Czech RepublicPrague; Czech Republic
| | - Alessio Naccarati
- Department of Molecular Biology of Cancer at the Institute of Experimental Medicine; Academy of Sciences of the Czech RepublicPrague; Czech Republic
| | - Verena Steinke
- Institute of Human Genetics; Rheinische Friedrich-Wilhelms-UniversitätBonn; Germany
| | - Nils Rahner
- Institute of Human Genetics; Rheinische Friedrich-Wilhelms-UniversitätBonn; Germany
| | - Elke Holinski-Feder
- Department of Internal Medicine, Campus Innenstadt; University Hospital of the Ludwig-Maximilians-University MunichGermany
| | - Monika Morak
- Department of Internal Medicine, Campus Innenstadt; University Hospital of the Ludwig-Maximilians-University MunichGermany
| | - Hans K Schackert
- Department of Surgical Research at the Universitätsklinikum Carl Gustav Carus; Technische Universität DresdenGermany
| | - Heike Görgens
- Department of Surgical Research at the Universitätsklinikum Carl Gustav Carus; Technische Universität DresdenGermany
| | - Christian P Pox
- Medical Department at the Knappschaftskrankenhaus Bochum; Ruhr University BochumGermany
| | - Timm Goecke
- Institute of Human Genetics and Anthropology; Heinrich-Heine-Universität DüsseldorfGermany
| | - Matthias Kloor
- Department of Applied Tumour Biology at the Institute of Pathology; Ruprecht-Karls-Universität HeidelbergGermany
| | - Markus Loeffler
- Faculty of Medicine, Institute of Medical Informatics, Statistics and Epidemiology; University of LeipzigGermany
| | - Reinhard Büttner
- Institute of Pathology; Rheinische Friedrich-Wilhelms-Universität BonnGermany
| | - Ludmila Vodickova
- Department of Molecular Biology of Cancer at the Institute of Experimental Medicine; Academy of Sciences of the Czech RepublicPrague; Czech Republic
- Department of Toxicogenomics; National Institute of Public HealthPrague; Czech Republic
| | - Jan Novotny
- Department of Oncology; General Teaching HospitalPrague; Czech Republic
| | - Kubilay Demir
- Division of Signaling and Functional Genomics; German Cancer Research Center (DKFZ) and University of HeidelbergGermany
| | - Cristina-Maria Cruciat
- Division of Molecular Embryology; German Cancer Research Center (DKFZ)Heidelberg; Germany
| | | | | | - Christof Niehrs
- Division of Molecular Embryology; German Cancer Research Center (DKFZ)Heidelberg; Germany
| | - Michael Boutros
- Division of Signaling and Functional Genomics; German Cancer Research Center (DKFZ) and University of HeidelbergGermany
| | - Peter Propping
- Institute of Human Genetics; Rheinische Friedrich-Wilhelms-UniversitätBonn; Germany
| | - Pavel Vodička
- Department of Molecular Biology of Cancer at the Institute of Experimental Medicine; Academy of Sciences of the Czech RepublicPrague; Czech Republic
| | - Kari Hemminki
- Department of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ)Heidelberg; Germany
- Center of Primary Health Care Research at the Clinical Research Center; Lund UniversityMalmö; Sweden
| | - Asta Försti
- Department of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ)Heidelberg; Germany
- Center of Primary Health Care Research at the Clinical Research Center; Lund UniversityMalmö; Sweden
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Silverberg GD, Levinthal E, Sullivan EV, Bloch DA, Chang SD, Leverenz J, Flitman S, Winn R, Marciano F, Saul T, Huhn S, Mayo M, McGuire D. Assessment of low-flow CSF drainage as a treatment for AD: results of a randomized pilot study. Neurology 2002; 59:1139-45. [PMID: 12391340 DOI: 10.1212/01.wnl.0000031794.42077.a1] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This prospective, randomized, controlled study was designed to investigate the safety, feasibility, and preliminary efficacy of long-term CSF drainage via a low-flow ventriculoperitoneal shunt in subjects suffering from AD. METHODS Twenty-nine subjects selected for probable AD (National Institute of Neurological and Communicative Diseases and Stroke-Alzheimer's Disease and Related Dementias Association criteria) were screened to exclude normal pressure hydrocephalus or other etiologies of dementia and randomized to treatment (shunt) or no treatment groups. The study endpoint was the comparison of group performance on psychometric testing at quarterly intervals for 1 year. Shunted subjects had CSF withdrawn for MAP-tau and Abeta((1-42)) assays at the same time intervals. RESULTS There was no mortality from the surgical procedure, and no patient sustained a subdural hematoma. Five notable postoperative adverse events, which resolved without permanent neurologic deficit, were reported in the shunt group. Group mean Mattis Dementia Rating Scale total scores showed little change over the year in the shunt-treatment group, in contrast to a decline in the control group (p = 0.06). Mini-Mental State Examination mean scores supported a trend in favor of shunt treatment (p = 0.1). There was a concomitant decrease in ventricular CSF concentrations of AD biomarkers MAP-tau and Abeta((1-42)). CONCLUSIONS The surgical procedure and the device are reasonably safe. Adverse events were consistent with shunt procedures for hydrocephalus in this older population. The endpoint data show a trend in favor of the treated group. A larger, randomized, double-blinded, controlled, clinical trial is underway.
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Affiliation(s)
- G D Silverberg
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Silverberg GD, Heit G, Huhn S, Jaffe RA, Chang SD, Bronte-Stewart H, Rubenstein E, Possin K, Saul TA. The cerebrospinal fluid production rate is reduced in dementia of the Alzheimer's type. Neurology 2001; 57:1763-6. [PMID: 11723260 DOI: 10.1212/wnl.57.10.1763] [Citation(s) in RCA: 160] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the production rate of CSF in patients with differing disease states. METHODS The authors measured the production rate of CSF in three groups of patients: five patients with PD below age 60 (aged 51 +/- 4 years, mean +/- SD), nine with PD over age 60 (aged 69 +/- 6 years, mean +/- SD), and seven with dementia of the Alzheimer's type (AD) (aged 72 +/- 9 years, mean +/- SD). This method, based on the Masserman technique, employs ventricular rather than a lumbar access to the CSF space. Furthermore, the volume of CSF removed during the procedure is only 3 mL rather than 10 mL. RESULTS These measurements indicate that the mean rate of CSF production in patients with PD under age 60 was 0.47 +/- 0.13 mL/minute, in patients with PD aged 60 or older the mean rate was 0.40 +/- 0.12 mL/minute, and in patients with AD the mean rate was 0.20 +/- 0.06 mL/minute. CONCLUSION These results indicate that the rate of CSF production in patients with PD is normal, and that the rate of CSF production in patients with AD is markedly reduced.
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Affiliation(s)
- G D Silverberg
- Department of Neurosurgery, Stanford University School of Medicine, CA 94305-5327, USA.
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Huhn S. [HIV and AIDS in the aged]. Pflege Aktuell 2000; 54:673-4. [PMID: 11288317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Huhn S. [The bed as an aid in nursing: as you make your bed so will you lie]. Pflege Z 1999; 52:410-2. [PMID: 10562127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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44
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Huhn S. [With a clear aim towards the future. 10 years of geriatric nursing in 1999. Geriatric fair and congress]. Pflege Aktuell 1999; 53:289-90. [PMID: 10578873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Huhn S. [Assistance in eating and drinking for patients and residents: feeding patients may be delegated only after training]. Pflege Z 1998; 51:118-9. [PMID: 9574051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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46
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Huhn S. [Eating and drinking in the care of the elderly]. Pflege Z 1998; 51:67-9. [PMID: 9479273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Nelson SJ, Huhn S, Vigneron DB, Day MR, Wald LL, Prados M, Chang S, Gutin PH, Sneed PK, Verhey L, Hawkins RA, Dillon WP. Volume MRI and MRSI techniques for the quantitation of treatment response in brain tumors: presentation of a detailed case study. J Magn Reson Imaging 1997; 7:1146-52. [PMID: 9400861 DOI: 10.1002/jmri.1880070630] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Patients with primary brain tumors may be considered for several different treatments during the course of their disease. Assessments of disease progression and response to therapy are typically performed by visual interpretation of serial MRI examinations. Although such examinations provide useful morphologic information, they are unable to reliably distinguish active tumor from radiation necrosis. This poses a particular problem in the assessment of response to localized radiation therapies such as gamma knife radiosurgery. In this paper, we present methodology for evaluating changes in tissue morphology and metabolism based on serial volumetric MRI and magnetic resonance spectroscopic imaging (MRSI) examinations. Registration and quantitative analysis of these data provide measurements of the temporal and spatial distributions of gadolinium enhancement and of N-acetylasparate, choline, creatine, and lactate/lipid. The key features of this approach and the potential clinical benefits are illustrated by a detailed analysis of six serial MRI/MRSI examinations and three serial 1-[F-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) studies on a patient with a recurrent anaplastic astrocytoma.
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Affiliation(s)
- S J Nelson
- Department of Radiology, University of California, San Francisco 94143, USA.
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Huhn S. [Importance of the Bobath concept in the care of patients with hemiplegia]. Pflege Aktuell 1997; 51:328-31. [PMID: 9239090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Huhn S, McLone DG, Radkowski MA, De Leon G, Laurent JP. 15-year-old young woman with brachial plexus tumor. Pediatr Neurosurg 1997; 26:277-80. [PMID: 9440499 DOI: 10.1159/000121205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- S Huhn
- Department of Surgery, Children's Memorial Hospital, Chicago, Ill. 60614, USA
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Nelson SJ, Day MR, Buffone PJ, Wald LL, Budinger TF, Hawkins R, Dillon WP, Huhn S, Prados MD, Chang S, Vigneron DB. Alignment of volume MR images and high resolution [18F]fluorodeoxyglucose PET images for the evaluation of patients with brain tumors. J Comput Assist Tomogr 1997; 21:183-91. [PMID: 9071283 DOI: 10.1097/00004728-199703000-00004] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE The goal of the study was to investigate the use of automated registration techniques for interpretation of volume MR and high resolution FDG-PET images that were obtained from patients with brain tumors. METHOD Twenty-one patients with brain tumors were studied on one or more occasions using MRI and high resolution FDG-PET. The data were aligned using automated volume- and surface-matching algorithms. Composite images comprising the resliced pre- and postgadolinium spoiled GRE, T2-weighted SE, and PET data were constructed to correlate intensities of regions on the PET images with regions that corresponded to normal gray matter, white matter, and gadolinium enhancement. RESULTS The accuracy of registration between the MR and PET images was estimated to be within 1-2 mm based upon the distance between surfaces of the outside of the head. In 12 of the 24 examinations, there were diagnoses of recurrent tumor, with only 5 of these exhibiting regions of higher FDG uptake than normal gray matter. For 19 of the 24 studies, the anatomic context provided by the registered MR images was found to be important in distinguishing recurrent tumor from necrosis based upon FDG uptake. CONCLUSION The automated alignment was found to be an important factor in interpreting the high resolution PET images. This was particularly true for small lesions close to the cortex and for situations where FDG uptake had been reduced by prior treatment with radiation therapy.
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Affiliation(s)
- S J Nelson
- Department of Radiology, University of California, San Francisco 94143, USA
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