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Onyegbutulem HC, Henry-Onyegbutulem PI, Dogo D, Schwarz PEH, Bornstein SR. Metabolic Syndrome and its Correlates among Hypertensive Patients in Abuja, North Central Nigeria. West Afr J Med 2023; 40:1164-1172. [PMID: 38091343] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Metabolic syndrome is a constellation of abnormalities which includes central obesity, dyslipidaemia, elevated blood pressure and hyperglycemia. Hypertension, (which is a very common component of metabolic syndrome), and diabetes mellitus, are independently associated. Also, studies examining metabolic syndrome inAbuja, a city with affluence-driven lifestyle, are not available. This study aimed to investigate the prevalence of metabolic syndrome among hypertensive patients in Abuja, Nigeria, as well as to examine the associations between metabolic syndrome and certain factors in that cohort of hypertensive patients. METHODS This was a retrospective study that used data from hypertensive patients who attended clinic over a period of five years. Eight hundred and fifty-eight, (858-combined), case files of pre-treated, (previously known hypertensive patients) and newly diagnosed hypertensive participants were used for the study. The student t-tests were used to compare continuous variables, while Chi-square (χ2) tests were used for relationship between qualitative variables. The likelihood ratio test was employed to further confirm the statistical significance of certain independent variables relating with metabolic syndrome. A P-value of < 0.05 was considered statistically significant. RESULTS The mean ages were 48.70±12.18, 49.19±11.06 and 48.2±13.3 years for combined group, the pre-treated and the newly-diagnosed groups respectively. The pre-treated, group consists of those previously known hypertensive patients, while the new group consists of those who were newly diagnosed hypertensive patients and were treatment naïve. The prevalence of metabolic syndrome in this study was 45.5% in the combined group, 47.23% in the pre-treated group and 37.3% in the newly diagnosed group. The commonest component of metabolic syndrome was reduced high density lipoprotein cholesterol, HDL-C. CONCLUSION Metabolic syndrome is prevalent among hypertensive patients in Abuja, Nigeria. Some correlates of metabolic syndrome include; elevated BMI, truncal obesity, elevated total cholesterol, the use of thiazide diuretics and beta blockers as antihypertensives.
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Affiliation(s)
- H C Onyegbutulem
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria. , , +23480577757
- Department of Internal Medicine, Nile University of Nigeria Teaching Hospital (Asokoro District Hospital), Abuja, Nigeria
| | | | - D Dogo
- Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
| | - P E H Schwarz
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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Yin X, Takov K, Straube R, Voit-Bak K, Graessler J, Julius U, Tselmin S, Rodionov RN, Barbir M, Walls M, Theofilatos K, Mayr M, Bornstein SR. Precision Medicine Approach for Cardiometabolic Risk Factors in Therapeutic Apheresis. Horm Metab Res 2022; 54:238-249. [PMID: 35413745 DOI: 10.1055/a-1776-7943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Lipoprotein apheresis (LA) is currently the most powerful intervention possible to reach a maximal reduction of lipids in patients with familial hypercholesterolemia and lipoprotein(a) hyperlipidemia. Although LA is an invasive method, it has few side effects and the best results in preventing further major cardiovascular events. It has been suggested that the highly significant reduction of cardiovascular complications in patients with severe lipid disorders achieved by LA is mediated not only by the potent reduction of lipid levels but also by the removal of other proinflammatory and proatherogenic factors. Here we performed a comprehensive proteomic analysis of patients on LA treatment using intra-individually a set of differently sized apheresis filters with the INUSpheresis system. This study revealed that proteomic analysis correlates well with routine clinical chemistry in these patients. The method is eminently suited to discover new biomarkers and risk factors for cardiovascular disease in these patients. Different filters achieve reduction and removal of proatherogenic proteins in different quantities. This includes not only apolipoproteins, C-reactive protein, fibrinogen, and plasminogen but also proteins like complement factor B (CFAB), protein AMBP, afamin, and the low affinity immunoglobulin gamma Fc region receptor III-A (FcγRIIIa) among others that have been described as atherosclerosis and metabolic vascular diseases promoting factors. We therefore conclude that future trials should be designed to develop an individualized therapy approach for patients on LA based on their metabolic and vascular risk profile. Furthermore, the power of such cascade filter treatment protocols may improve the prevention of cardiometabolic disease and its complications.
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Affiliation(s)
- X Yin
- Kings College London, London, UK
| | - K Takov
- Kings College London, London, UK
| | - R Straube
- Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum, Cham, Germany
| | - K Voit-Bak
- Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum, Cham, Germany
| | - J Graessler
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - U Julius
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - S Tselmin
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Roman N Rodionov
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - M Barbir
- Royal Brompton Hospital, London, UK
| | | | | | - M Mayr
- Kings College London, London, UK
- Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Kings College London, London, UK
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
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Yin X, Takov K, Straube R, Voit-Bak K, Graessler J, Julius U, Tselmin S, Rodionov RN, Barbir M, Walls M, Theofilatos K, Mayr M, Bornstein SR. Correction: Precision Medicine Approach for Cardiometabolic Risk Factors in Therapeutic Apheresis. Horm Metab Res 2022; 54:e3. [PMID: 35545115 DOI: 10.1055/a-1840-6523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- X Yin
- Kings College London, London, UK
| | - K Takov
- Kings College London, London, UK
| | - R Straube
- Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum, Cham, Germany
| | - K Voit-Bak
- Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum, Cham, Germany
| | - J Graessler
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - U Julius
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - S Tselmin
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Roman N Rodionov
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - M Barbir
- Royal Brompton Hospital, London, UK
| | | | | | - M Mayr
- Kings College London, London, UK
- Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Kings College London, London, UK
- Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
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Bornstein SR, Guan K, Brunßen C, Mueller G, Kamvissi-Lorenz V, Lechler R, Trembath R, Mayr M, Poston L, Sancho R, Ahmed S, Alfar E, Aljani B, Alves TC, Amiel S, Andoniadou CL, Bandral M, Belavgeni A, Berger I, Birkenfeld A, Bonifacio E, Chavakis T, Chawla P, Choudhary P, Cujba AM, Delgadillo Silva LF, Demcollari T, Drotar DM, Duin S, El-Agroudy NN, El-Armouche A, Eugster A, Gado M, Gavalas A, Gelinsky M, Guirgus M, Hansen S, Hanton E, Hasse M, Henneicke H, Heller C, Hempel H, Hogstrand C, Hopkins D, Jarc L, Jones PM, Kamel M, Kämmerer S, King AJF, Kurzbach A, Lambert C, Latunde-Dada Y, Lieberam I, Liers J, Li JW, Linkermann A, Locke S, Ludwig B, Manea T, Maremonti F, Marinicova Z, McGowan BM, Mickunas M, Mingrone G, Mohanraj K, Morawietz H, Ninov N, Peakman M, Persaud SJ, Pietzsch J, Cachorro E, Pullen TJ, Pyrina I, Rubino F, Santambrogio A, Schepp F, Schlinkert P, Scriba LD, Siow R, Solimena M, Spagnoli FM, Speier S, Stavridou A, Steenblock C, Strano A, Taylor P, Tiepner A, Tonnus W, Tree T, Watt F, Werdermann M, Wilson M, Yusuf N, Ziegler CG. The transCampus Metabolic Training Programme Explores the Link of SARS-CoV-2 Virus to Metabolic Disease. Horm Metab Res 2021; 53:204-206. [PMID: 33652492 DOI: 10.1055/a-1377-6583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Currently, we are experiencing a true pandemic of a communicable disease by the virus SARS-CoV-2 holding the whole world firmly in its grasp. Amazingly and unfortunately, this virus uses a metabolic and endocrine pathway via ACE2 to enter our cells causing damage and disease. Our international research training programme funded by the German Research Foundation has a clear mission to train the best students wherever they may come from to learn to tackle the enormous challenges of diabetes and its complications for our society. A modern training programme in diabetes and metabolism does not only involve a thorough understanding of classical physiology, biology and clinical diabetology but has to bring together an interdisciplinary team. With the arrival of the coronavirus pandemic, this prestigious and unique metabolic training programme is facing new challenges but also new opportunities. The consortium of the training programme has recognized early on the need for a guidance and for practical recommendations to cope with the COVID-19 pandemic for the community of patients with metabolic disease, obesity and diabetes. This involves the optimal management from surgical obesity programmes to medications and insulin replacement. We also established a global registry analyzing the dimension and role of metabolic disease including new onset diabetes potentially triggered by the virus. We have involved experts of infectious disease and virology to our faculty with this metabolic training programme to offer the full breadth and scope of expertise needed to meet these scientific challenges. We have all learned that this pandemic does not respect or heed any national borders and that we have to work together as a global community. We believe that this transCampus metabolic training programme provides a prime example how an international team of established experts in the field of metabolism can work together with students from all over the world to address a new pandemic.
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Affiliation(s)
- S R Bornstein
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- University Hospital Zurich, Department of Endocrinology and Diabetology, Zurich, Switzerland
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - K Guan
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Brunßen
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - G Mueller
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - V Kamvissi-Lorenz
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | - R Trembath
- Department of Medical & Molecular Genetics, King's College London, London, UK
| | - M Mayr
- School of Cardiovascular Medicine and Science, Faculty of Life Science & Medicine, KCL, London, UK
| | - L Poston
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - R Sancho
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - S Ahmed
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - E Alfar
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B Aljani
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T C Alves
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - S Amiel
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - C L Andoniadou
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Craniofacial Development and Stem Cell Biology, KCL, London, UK
| | - M Bandral
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - A Belavgeni
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - I Berger
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Birkenfeld
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - E Bonifacio
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - T Chavakis
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P Chawla
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - P Choudhary
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A M Cujba
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - L F Delgadillo Silva
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - T Demcollari
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - D M Drotar
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Duin
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - N N El-Agroudy
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A El-Armouche
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A Eugster
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Gado
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Gavalas
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - M Gelinsky
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - M Guirgus
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Hansen
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - E Hanton
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - M Hasse
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - H Henneicke
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Heller
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - H Hempel
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Hogstrand
- Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - D Hopkins
- Department of Diabetic Medicine, King's College Hospital NHS Foundation Trust and KCL, London, UK
| | - L Jarc
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - P M Jones
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - M Kamel
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Kämmerer
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A J F King
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A Kurzbach
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Lambert
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | | | - I Lieberam
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - J Liers
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - J W Li
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A Linkermann
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - S Locke
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - B Ludwig
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- University Hospital Zurich, Department of Endocrinology and Diabetology, Zurich, Switzerland
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Manea
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - F Maremonti
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - Z Marinicova
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - B M McGowan
- Department of Diabetes and Endocrinology, London, UK
| | - M Mickunas
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - G Mingrone
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - K Mohanraj
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - H Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - N Ninov
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - M Peakman
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - S J Persaud
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - J Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - E Cachorro
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T J Pullen
- School of Life Course Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - I Pyrina
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - F Rubino
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A Santambrogio
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - F Schepp
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - P Schlinkert
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - L D Scriba
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - R Siow
- Vascular Biology & Inflammation Section, School of Cardiovascular Medicine & Sciences, British Heart Foundation of Research Excellence, King's College London, London, UK
| | - M Solimena
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
- Molecular Diabetology, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - F M Spagnoli
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - S Speier
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - A Stavridou
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Steenblock
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Strano
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P Taylor
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - A Tiepner
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - W Tonnus
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - T Tree
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - F Watt
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - M Werdermann
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - M Wilson
- School of Life Course Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - N Yusuf
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - C G Ziegler
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
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Willmes DM, Daniels M, Kurzbach A, Lieske S, Bechmann N, Schumann T, Henke C, El-Agroudy NN, Da Costa Goncalves AC, Peitzsch M, Hofmann A, Kanczkowski W, Kräker K, Müller DN, Morawietz H, Deussen A, Wagner M, El-Armouche A, Helfand SL, Bornstein SR, de Cabo R, Bernier M, Eisenhofer G, Tank J, Jordan J, Birkenfeld AL. The longevity gene mIndy (I'm Not Dead, Yet) affects blood pressure through sympathoadrenal mechanisms. JCI Insight 2021; 6:136083. [PMID: 33491666 PMCID: PMC7934862 DOI: 10.1172/jci.insight.136083] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022] Open
Abstract
Reduced expression of the plasma membrane citrate transporter INDY (acronym I’m Not Dead, Yet) extends life span in lower organisms. Deletion of the mammalian Indy (mIndy) gene in rodents improves metabolism via mechanisms akin to caloric restriction, known to lower blood pressure (BP) by sympathoadrenal inhibition. We hypothesized that mIndy deletion attenuates sympathoadrenal support of BP. Continuous arterial BP and heart rate (HR) were reduced in mINDY-KO mice. Concomitantly, urinary catecholamine content was lower, and the decreases in BP and HR by mIndy deletion were attenuated after autonomic ganglionic blockade. Catecholamine biosynthesis pathways were reduced in mINDY-KO adrenals using unbiased microarray analysis. Citrate, the main mINDY substrate, increased catecholamine content in pheochromocytoma cells, while pharmacological inhibition of citrate uptake blunted the effect. Our data suggest that deletion of mIndy reduces sympathoadrenal support of BP and HR by attenuating catecholamine biosynthesis. Deletion of mIndy recapitulates beneficial cardiovascular and metabolic responses to caloric restriction, making it an attractive therapeutic target. Deletion of mIndy reduces blood pressure and heart rate by attenuating catecholamine biosynthesis and recapitulates beneficial cardiovascular and metabolic responses to caloric restriction.
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Affiliation(s)
- Diana M Willmes
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Martin Daniels
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen, Tübingen, Germany.,Department of Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tübingen, Germany
| | - Anica Kurzbach
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen, Tübingen, Germany.,Department of Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tübingen, Germany.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Stefanie Lieske
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and
| | - Nicole Bechmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Tina Schumann
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Christine Henke
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Nermeen N El-Agroudy
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | | | - Mirko Peitzsch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Anja Hofmann
- Division of Vascular Endothelium and Microcirculation, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Waldemar Kanczkowski
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Kristin Kräker
- Experimental and Clinical Research Center, Max Delbruck Center for Molecular Medicine and Charité - University Hospital Berlin, Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, Max Delbruck Center for Molecular Medicine and Charité - University Hospital Berlin, Berlin, Germany
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Andreas Deussen
- Department of Physiology, Medical Faculty Carl Gustav Carus, and
| | - Michael Wagner
- Department of Pharmacology and Toxicology, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Ali El-Armouche
- Department of Pharmacology and Toxicology, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Stephen L Helfand
- Department of Molecular Biology, Cell Biology & Biochemistry, Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA
| | - Stephan R Bornstein
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Rafael de Cabo
- Translational Gerontology Branch, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland, USA
| | - Michel Bernier
- Translational Gerontology Branch, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland, USA
| | - Graeme Eisenhofer
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Institute of Clinical Chemistry and Laboratory Medicine, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Jens Tank
- Aerospace Medicine, University of Cologne, Cologne, Germany
| | - Jens Jordan
- Aerospace Medicine, University of Cologne, Cologne, Germany.,Institute for Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Andreas L Birkenfeld
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen, Tübingen, Germany.,Department of Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tübingen, Germany.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
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6
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Abstract
Lipoprotein(a) (Lp(a)) is an internationally accepted independent atherogenic risk factor. Details about its synthesis, many aspects of composition and clearance from the bloodstream are still unknown. LDL receptor (LDLR) (and probably other receptors) play a role in the elimination of Lp(a) particles. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors increase the number of available LDLRs and in this way very effectively reduce the LDL cholesterol (LDL-C) concentrations. As shown in controlled studies using PCSK9 inhibitors, Lp(a) levels are decreased by 20 to 30%, though in some patients no effect was observed. So far, it has not been clarified whether this decrease is associated with an effect on the incidence of cardiovascular events (CVEs). In two recently published well-performed secondary prevention studies (FOURIER with evolocumab, ODYSSEY OUTCOMES with alirocumab) baseline Lp(a) levels were shown to have an impact on CVEs independently of baseline LDL-C concentrations. The rather modest PCSK9 inhibitor-induced decrease of Lp(a) was associated with a reduction of CVEs in both studies, even after adjusting (ODYSSEY OUTCOMES) for demographic variables (age, sex, race, region), baseline Lp(a), baseline LDL-C, change in LDL-C, and clinical variables (time from acute coronary syndrome, body mass index, diabetes, smoking history). The largest decrease of CVEs was seen in patients with relatively low concentrations of both LDL-C and Lp(a) (FOURIER). These findings will probably have an influence on the use of PCSK9 inhibitors in patients with high Lp(a) concentrations.
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Affiliation(s)
- U Julius
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - S Tselmin
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - U Schatz
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - S Fischer
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - S R Bornstein
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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7
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Morawietz H, Langbein H, Shahid A, Hofmann A, Mittag J, Bornstein SR, Brunssen C. P6285Protective effects of exercise on vascular function are mediated by NADPH oxidase 4. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Physical activity is one of the most potent strategies to prevent endothelial dysfunction. Recent evidence indicates vaso-protective properties of H2O2 produced by main endothelial NADPH oxidase isoform 4 (Nox4) in the vasculature.
Purpose
Therefore, we hypothesized that Nox4 connects physical activity with vaso-protective effects.
Methods and results
Analysis of endothelial function by Mulvany myograph showed endothelial dysfunction in wild-type as well as in Nox4−/− mice after 20 weeks on high-fat diet. Access to voluntary running wheels during high-fat diet prevented endothelial dysfunction in wild-type but not in Nox4−/− mice. Mechanistically, exercise led to increased H2O2 release in the aorta of wild-type mice with increased phosphorylation of eNOS pathway member AKT serine/threonine kinase 1 (Akt1), subsequently. Both effects were diminished in aortas of Nox4−/− mice. Deletion of Nox4 also led to decreased capacity for intracellular calcium release and reduced phenylephrine-mediated contraction, whereas potassium-induced contraction was unaffected. H2O2 scavenger catalase reduced phenylephrine-contraction in wild-type mice. Supplementation of H2O2 increased phenylephrine-induced contraction in Nox4−/− mice. Exercise induced key regulator of mitochondria biogenesis peroxisome proliferative activated receptor gamma, coactivator 1 alpha (Ppargc1a) in wild-type but not Nox4−/− mice. Furthermore, exercise induced citrate synthase activity and reduced mitochondria mass in the absence of Nox4. Thus, Nox4−/− mice became less active and ran less compared with wild-type mice.
Conclusions
Nox4 derived H2O2 plays a key role in exercise-induced adaptations of eNOS and Ppargc1a pathway and intracellular calcium release. Hence, loss of Nox4 diminished physical activity performance and vascular protective effects of exercise.
Acknowledgement/Funding
This work was supported by a research grant of the German Cardiac Society (DGK) (to H.L.) and DFG (Grant MO 1695/4-1 to H.M.).
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Affiliation(s)
- H Morawietz
- Dresden University of Technology, Medical Clinic III, Dpt of Vascular Endothelium & Microcirculation, Dresden, Germany
| | - H Langbein
- Dresden University of Technology, Medical Clinic III, Dpt of Vascular Endothelium & Microcirculation, Dresden, Germany
| | - A Shahid
- Dresden University of Technology, Medical Clinic III, Dpt of Vascular Endothelium & Microcirculation, Dresden, Germany
| | - A Hofmann
- Dresden University of Technology, Medical Clinic III, Dpt of Vascular Endothelium & Microcirculation, Dresden, Germany
| | - J Mittag
- Dresden University of Technology, Medical Clinic III, Dpt of Vascular Endothelium & Microcirculation, Dresden, Germany
| | - S R Bornstein
- Dresden University of Technology, Medical Clinic III, Dresden, Germany
| | - C Brunssen
- Dresden University of Technology, Medical Clinic III, Dpt of Vascular Endothelium & Microcirculation, Dresden, Germany
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8
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Khan TZ, Bornstein SR, Barbir M. Lipoprotein(a): the underutilized risk factor for cardiovascular disease. Glob Cardiol Sci Pract 2019; 2019:e201911. [PMID: 31799286 PMCID: PMC6865184 DOI: 10.21542/gcsp.2019.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Raised lipoprotein(a) [Lp(a)] is an important independent cardiovascular risk factor and predictor of adverse outcomes. Challenges remain with regards to the screening, diagnosis and management of this condition. Although further prospective randomised controlled data is required, there is growing evidence suggesting that lowering Lp(a) may reduce the risk of cardiovascular events and ameliorate symptoms.
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9
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Abstract
Lipoprotein(a) (Lp(a)) is an internationally recognized atherogenic risk factor which is inherited and not changed by nutrition or physical activity. At present, only proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may modestly decrease its concentration (but not in all patients)-leading to a certain decrease in cardiovascular events (CVE) in controlled studies. However, at present an elevation of Lp(a) is not a generally accepted indication for their use. More effective is lipoprotein apheresis (LA) therapy with respect to both lowering Lp(a) levels and reduction of CVE. In the future, an antisense oligonucleotide against apolipoprotein(a) will probably be available. Atherosclerosis in patients with an elevation of Lp(a) may affect several vessel regions (carotids, aorta, coronaries, leg arteries). Thus, Lp(a) should be measured in high-risk patients. These patients are usually cared for by their family doctors and by other specialists who should closely cooperate. Lipidologists should decide whether costly therapies like PCSK9 inhibitors or LA should be started. The main aim of current therapy is to optimize all other risk factors (LDL cholesterol, hypertension, diabetes mellitus, body weight, renal insufficiency). Patients should be regularly monitored (lab data, heart, arteries). This paper describes the duties of physicians of different specialties when caring for patients with high Lp(a) concentrations.
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Affiliation(s)
- U Julius
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - S Tselmin
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - U Schatz
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - S Fischer
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - S R Bornstein
- Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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10
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Ullmann E, Licinio J, Perry SW, White LO, Klein AM, Barthel A, Petrowski K, Stalder T, Oratovski B, von Klitzing K, Bornstein SR, Kirschbaum C. Inherited anxiety-related parent-infant dyads alter LHPA activity. Stress 2019; 22:27-35. [PMID: 30424700 DOI: 10.1080/10253890.2018.1494151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The pathogenesis of post-traumatic stress disorder (PTSD) is incompletely understood. We hypothesize that disruptions in mother-child relations may be a key contributor to development of PTSD. A normal and healthy separation-individuation process requires adaptations of self- and interactive contingency in both the mother and her child, especially in early childhood development. Anxious mothers are prone to overprotection, which may hinder the individuation process in their children. We examined long-term stress hormones and other stress markers in subjects three generations removed from the Holocaust, to assess the long-term consequences of inherited behavioral and physiological responses to prior stress and trauma. Jewish subjects who recalled overprotective parental behavior had higher hairsteroid-concentrations and dampened limbic-hypothalamic-pituitary-adrenal (LHPA) axis reactivity compared to German and Russian-German subjects with overprotective parents. We suggest that altered LHPA axis activity in maternally overprotected Jewish subjects may indicate a transmitted pathomechanism of "frustrated individuation" resulting from cross-generational anti-Semitic experiences. Thus measurements of hairsteroid-concentrations and parenting practices may have clinical value for diagnosis of PTSD. We propose that this apparent inherited adaptivity of LHPA axis activity could promote higher individual stress resistance, albeit with risk of an allostatic overload.
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Affiliation(s)
- E Ullmann
- a Department of Medicine , Carl Gustav Carus, Technical University of Dresden , Dresden , Germany
- b Department of Child and Adolescent Psychiatry , Psychotherapy, and Psychosomatics, University of Leipzig , Leipzig , Germany
| | - J Licinio
- c College of Medicine , SUNY Upstate Medical University , New York , NY, USA
| | - S W Perry
- c College of Medicine , SUNY Upstate Medical University , New York , NY, USA
| | - L O White
- b Department of Child and Adolescent Psychiatry , Psychotherapy, and Psychosomatics, University of Leipzig , Leipzig , Germany
| | - A M Klein
- b Department of Child and Adolescent Psychiatry , Psychotherapy, and Psychosomatics, University of Leipzig , Leipzig , Germany
- d International Psychoanalytic University Berlin , Berlin, Germany
| | - A Barthel
- a Department of Medicine , Carl Gustav Carus, Technical University of Dresden , Dresden , Germany
- e Medicover , Bochum , Germany
| | - K Petrowski
- f Department of Psychology , University of Witten/Herdecke , Witten/Herdecke , Germany
| | - T Stalder
- g Department of Psychology , Biopsychology, Technical University of Dresden , Dresden , Germany
- h Department of Developmental Psychology , University of Siegen , Siegen , Germany
| | - B Oratovski
- a Department of Medicine , Carl Gustav Carus, Technical University of Dresden , Dresden , Germany
| | - K von Klitzing
- b Department of Child and Adolescent Psychiatry , Psychotherapy, and Psychosomatics, University of Leipzig , Leipzig , Germany
| | - S R Bornstein
- a Department of Medicine , Carl Gustav Carus, Technical University of Dresden , Dresden , Germany
- i Faculty of Life Sciences & Medicine, Endocrinology and Diabetes , Kings College London , London , UK
| | - C Kirschbaum
- g Department of Psychology , Biopsychology, Technical University of Dresden , Dresden , Germany
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11
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Ullmann E, Bornstein SR, Lanzman RS, Kirschbaum C, Sierau S, Doehnert M, Zimmermann P, Kindler H, Schauer M, Ruf-Leuschner M, Fegert JM, von Klitzing K, Ziegenhain U. Countering posttraumatic LHPA activation in refugee mothers and their infants. Mol Psychiatry 2018; 23:2-5. [PMID: 29133953 PMCID: PMC5754471 DOI: 10.1038/mp.2017.235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- E Ullmann
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany,Department of Medicine, Technische Universität Dresden, Carl Gustav Carus, Dresden, Germany,Department of Medicine, University of Dresden, Fetscherstraße 74, Dresden D-01307, Germany. E-mail:
| | - S R Bornstein
- Department of Medicine, Technische Universität Dresden, Carl Gustav Carus, Dresden, Germany,Faculty of Life Sciences & Medicine, Endocrinology and Diabetes, Kings College London, London, UK
| | - R S Lanzman
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - C Kirschbaum
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - S Sierau
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - M Doehnert
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - P Zimmermann
- Department of Psychology/Developmental Psychology, University of Wuppertal, Wuppertal, Germany
| | - H Kindler
- German Youth Institute, Munich, Germany
| | - M Schauer
- Center of Excellence for Psychotraumatology, University of Konstanz, Konstanz, Germany
| | - M Ruf-Leuschner
- Center of Excellence for Psychotraumatology, University of Konstanz, Konstanz, Germany
| | - J M Fegert
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Ulm, Ulm, Germany
| | - K von Klitzing
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - U Ziegenhain
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Ulm, Ulm, Germany
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12
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Capristo E, Panunzi S, De Gaetano A, Raffaelli M, Guidone C, Iaconelli A, L'Abbate L, Birkenfeld AL, Bellantone R, Bornstein SR, Mingrone G. Intensive lifestyle modifications with or without liraglutide 3mg vs. sleeve gastrectomy: A three-arm non-randomised, controlled, pilot study. Diabetes Metab 2017; 44:235-242. [PMID: 29398254 DOI: 10.1016/j.diabet.2017.12.007] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 12/04/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND/OBJECTIVES As only 1% of clinically eligible subjects choose to undergo surgical treatment for obesity, other options should be investigated. This study aimed to assess the effects of intensive lifestyle modification (ILM) with or without 3-mg liraglutide daily vs. sleeve gastrectomy (SG) on BMI after 1 year. SUBJECTS/METHODS In this study performed at an Italian university hospital, non-diabetic patients eligible for bariatric surgery were recruited from a weight-loss clinic and had the option to choose from three possible weight-loss programmes up to an allocation of 25 subjects in each arm matched by BMI and age. ILM consisted in 813kcal of a very low-calorie diet (VLCD) for 1 month, followed by a diet of 12kcal/kg body weight of high protein and high fat for 11 months plus 30min of brisk walking daily and at least 3h of aerobic exercise weekly. SG patients followed a VLCD for 1 month and a free diet thereafter. Patients were evaluated at baseline and at 1, 3, 6, 9 and 12 months. RESULTS A total of 75 patients were enrolled; retention was 100% in the SG and 85% in the two medical arms. SG reduced BMI by 32% (P<0.001 vs. medical arm), while ILM+liraglutide and ILM led to BMI reductions of 24% and 14%, respectively (P<0.001). More women allocated themselves to the ILM+liraglutide group. Weight loss was 43kg with SG, 26kg with ILM+liraglutide and 15kg with ILM alone. Lean body mass reductions were -11.6kg with SG, -6.3kg with ILM and -8.3kg with ILM+liraglutide. Prevalence of prediabetes was significantly lower with ILM+liraglutide, and insulin resistance was reduced by about 70% by both ILM+liraglutide and SG vs. 39% by ILM alone. Cardiometabolic risk factors were greatly reduced in all three groups. DISCUSSION At least in the short-term, liraglutide 3.0mg once daily associated with drastic calorie-intake restriction and intensive physical activity promoted a 24% weight loss, which was almost two times greater than ILM alone and only about 25% less than with SG, while preserving lean body mass. Although this study was non-randomised, it was designed to explore the efficacy of medical treatments for obesity in everyday clinical practice.
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Affiliation(s)
- E Capristo
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - S Panunzi
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - A De Gaetano
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - M Raffaelli
- Department of Surgery, Catholic University, Rome, Italy
| | - C Guidone
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - A Iaconelli
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - L L'Abbate
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - A L Birkenfeld
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom; Paul Langerhans Institute Dresden of the Helmholtz Centre Munich at University Hospital Dresden, a member of the German Centre for Diabetes Research (DZD e.V.), Dresden, Germany
| | - R Bellantone
- Department of Surgery, Catholic University, Rome, Italy
| | - S R Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom
| | - G Mingrone
- Department of Internal Medicine, Catholic University, Rome, Italy; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom.
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13
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Jellinghaus S, Reich C, Schatz U, Tselmin S, Ibrahim K, Pfluecke C, Schauer A, Bornstein SR, Hohenstein B, Strasser RH, Julius U, Poitz DM. Lipoprotein apheresis influences monocyte subpopulations. ATHEROSCLEROSIS SUPP 2017; 30:108-114. [PMID: 29096825 DOI: 10.1016/j.atherosclerosissup.2017.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Monocytes can be differentiated into subpopulations depending on their expression profile of CD14 and CD16. CD16-positive monocytes are associated with coronary artery disease. Up to now, no data exist about the effect of lipoprotein apheresis (LA) on the distribution of monocyte subpopulations. METHODS 80 patients who underwent LA at the University Hospital Dresden were included in the study. 8 out of the 80 LA patients received LA for the first time at the time point of blood analysis. Six different methods of LA were used (H.E.L.P. n = 8; Liposorber D n = 10; LF n = 14; DALI n = 17; MONET n = 11; Therasorb® LDL n = 12). Blood samples were taken immediately before and after LA and analyzed for CD14 and CD16 expression on monocytes. A total of 42 patients with cardiovascular risk factors but no indication for LA served as control group. RESULTS The composition of monocyte-population was analyzed in regard to the 3 subpopulations. After LA, an increase in classical monocytes (CD14++CD16-) (93.3% vs. 93.9%, p < 0.01) and a decrease in non-classical monocytes (CD14+CD16+) (1.5% vs 1.0%; p < 0.001) were observed. LA did not change the amount of intermediate monocytes (CD14++CD16+) (5.3% vs. 5.1%). Two methods (MONET and Therasorb® LDL) did not influence the distribution of monocyte subpopulations. Interestingly, patients with LDL-C above 2.5 mmol/l prior LA showed increased amounts of intermediate monocytes. CONCLUSION The distribution of monocyte populations is influenced by LA but depends on the distinct method of LA. Influences of LA were mainly observed in the content of classical and non-classical monocytes, whereas the intermediate monocyte population remained unaltered by LA.
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Affiliation(s)
- S Jellinghaus
- Internal Medicine and Cardiology, Heart Center Dresden, University Hospital at the Technische Universität, Dresden, Germany
| | - C Reich
- Internal Medicine and Cardiology, Heart Center Dresden, University Hospital at the Technische Universität, Dresden, Germany
| | - U Schatz
- Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - S Tselmin
- Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - K Ibrahim
- Internal Medicine and Cardiology, Heart Center Dresden, University Hospital at the Technische Universität, Dresden, Germany
| | - C Pfluecke
- Internal Medicine and Cardiology, Heart Center Dresden, University Hospital at the Technische Universität, Dresden, Germany
| | - A Schauer
- Internal Medicine and Cardiology, Heart Center Dresden, University Hospital at the Technische Universität, Dresden, Germany
| | - S R Bornstein
- Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - B Hohenstein
- Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - R H Strasser
- Internal Medicine and Cardiology, Heart Center Dresden, University Hospital at the Technische Universität, Dresden, Germany
| | - U Julius
- Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - D M Poitz
- Internal Medicine and Cardiology, Heart Center Dresden, University Hospital at the Technische Universität, Dresden, Germany.
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14
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Papin J, Brennand A, Arbore G, Hohenstein B, Kamvissi V, Kemper C, Bornstein SR. Dysregulation of the CD4 + T cells lineage differentiation in dyslipidemic patients and impact of lipoprotein-apheresis treatment: A case study. ATHEROSCLEROSIS SUPP 2017; 30:238-245. [PMID: 29096844 DOI: 10.1016/j.atherosclerosissup.2017.05.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Lipoprotein-apheresis (LA) is a therapeutic approach used against severe forms of dyslipidemia in patients who are non-responders or intolerant to pharmacological treatments. However, little is known about the potential pleiotropic effects of LA, particularly regarding the immune system and its regulation. Thus, in an attempt to analyse the potential effects of dyslipidemia and LA on the regulation of CD4+ T cells activation and lineage differentiation, we compared the CD4+ T cells cytokines secretion profiles of dyslipidemic patients before and after LA with the profiles observed in healthy donors. METHODS CD4+ T cells were isolated from 5 LA patients and 5 healthy donors and activated with anti-CD3 or anti-CD3 + anti-CD46 antibodies. The supernatants were collected after 36 h incubation and levels of secreted cytokines analysed by flow cytometry. RESULTS Our results revealed a deep remodelling of CD4+ T cells cytokines secretion patterns in dyslipidemic patients compared to healthy donors, as reflected by a 15 times higher IFN-γ secretion rate after CD3 + CD46 co-activation in dyslipidemic patients after LA compared to healthy subjects and 8 times higher after CD3 activation alone (p = 0.0187 and p = 0.0118 respectively). Moreover, we demonstrated that LA itself also modifies the phenotype and activation pattern of CD4+ T-cells in dyslipidemic patients. CONCLUSION These observations could be of fundamental importance in the improvement of LA columns/systems engineering and in developing new therapeutic approaches regarding dyslipidemia and associated pathologies such as atherosclerosis and type 2 diabetes.
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Affiliation(s)
- J Papin
- Department of Endocrinology and Diabetes, Division of Diabetes and Nutritional Sciences, King's College London, London SE5 9NU, UK; Faculty of Medicine Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany.
| | - A Brennand
- Department of Endocrinology and Diabetes, Division of Diabetes and Nutritional Sciences, King's College London, London SE5 9NU, UK; Faculty of Medicine Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| | - G Arbore
- MRC Centre for Transplantation, Division of Transplant Immunology and Mucosal Biology, King's College London, London SE1 9RT, UK
| | - B Hohenstein
- Nephrological Center Villingen-Schwenningen, Albert-Schweitzer-Str. 6, 78052, Villingen-Schwenningen, Germany; Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - V Kamvissi
- Department of Endocrinology and Diabetes, Division of Diabetes and Nutritional Sciences, King's College London, London SE5 9NU, UK; Faculty of Medicine Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany; Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - C Kemper
- MRC Centre for Transplantation, Division of Transplant Immunology and Mucosal Biology, King's College London, London SE1 9RT, UK; Laboratory of Molecular Immunology and Immunology Center, National Heart, Lung, and Blood Institute, Bethesda, MD 20892, USA
| | - S R Bornstein
- Department of Endocrinology and Diabetes, Division of Diabetes and Nutritional Sciences, King's College London, London SE5 9NU, UK; Faculty of Medicine Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany; Department of Medicine III, Technische Universität Dresden, Dresden, Germany
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15
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Wong ML, Arcos-Burgos M, Liu S, Vélez JI, Yu C, Baune BT, Jawahar MC, Arolt V, Dannlowski U, Chuah A, Huttley GA, Fogarty R, Lewis MD, Bornstein SR, Licinio J. The PHF21B gene is associated with major depression and modulates the stress response. Mol Psychiatry 2017; 22:1015-1025. [PMID: 27777418 PMCID: PMC5461220 DOI: 10.1038/mp.2016.174] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/14/2016] [Accepted: 08/16/2016] [Indexed: 12/04/2022]
Abstract
Major depressive disorder (MDD) affects around 350 million people worldwide; however, the underlying genetic basis remains largely unknown. In this study, we took into account that MDD is a gene-environment disorder, in which stress is a critical component, and used whole-genome screening of functional variants to investigate the 'missing heritability' in MDD. Genome-wide association studies (GWAS) using single- and multi-locus linear mixed-effect models were performed in a Los Angeles Mexican-American cohort (196 controls, 203 MDD) and in a replication European-ancestry cohort (499 controls, 473 MDD). Our analyses took into consideration the stress levels in the control populations. The Mexican-American controls, comprised primarily of recent immigrants, had high levels of stress due to acculturation issues and the European-ancestry controls with high stress levels were given higher weights in our analysis. We identified 44 common and rare functional variants associated with mild to moderate MDD in the Mexican-American cohort (genome-wide false discovery rate, FDR, <0.05), and their pathway analysis revealed that the three top overrepresented Gene Ontology (GO) processes were innate immune response, glutamate receptor signaling and detection of chemical stimulus in smell sensory perception. Rare variant analysis replicated the association of the PHF21B gene in the ethnically unrelated European-ancestry cohort. The TRPM2 gene, previously implicated in mood disorders, may also be considered replicated by our analyses. Whole-genome sequencing analyses of a subset of the cohorts revealed that European-ancestry individuals have a significantly reduced (50%) number of single nucleotide variants compared with Mexican-American individuals, and for this reason the role of rare variants may vary across populations. PHF21b variants contribute significantly to differences in the levels of expression of this gene in several brain areas, including the hippocampus. Furthermore, using an animal model of stress, we found that Phf21b hippocampal gene expression is significantly decreased in animals resilient to chronic restraint stress when compared with non-chronically stressed animals. Together, our results reveal that including stress level data enables the identification of novel rare functional variants associated with MDD.
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Affiliation(s)
- M-L Wong
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia,Mind & Brain Theme, South Australian Health and Medical
Research Institute (SAHMRI), North Terrace, PO Box 11060,
Adelaide, SA
5001, Australia. E-mail: or
| | - M Arcos-Burgos
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia,University of Rosario International
Institute of Translational Medicine, Bogotá,
Colombia
| | - S Liu
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia
| | - J I Vélez
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia,Universidad del Norte,
Barranquilla, Colombia
| | - C Yu
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia
| | - B T Baune
- Discipline of Psychiatry, University of
Adelaide, Adelaide, SA, Australia
| | - M C Jawahar
- Discipline of Psychiatry, University of
Adelaide, Adelaide, SA, Australia
| | - V Arolt
- Department of Psychiatry and
Psychotherapy, University of Münster, Münster,
Germany
| | - U Dannlowski
- Department of Psychiatry and
Psychotherapy, University of Münster, Münster,
Germany,Department of Psychiatry and
Psychotherapy, University of Marburg, Marburg,
Germany
| | - A Chuah
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia
| | - G A Huttley
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia
| | - R Fogarty
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia
| | - M D Lewis
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia
| | - S R Bornstein
- Department of Psychiatry and
Psychotherapy, University of Münster, Münster,
Germany,Medical Clinic III, Carl Gustav Carus
University Hospital, Dresden University of Technology, Dresden,
Germany
| | - J Licinio
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia,Mind & Brain Theme, South Australian Health and Medical
Research Institute (SAHMRI), North Terrace, PO Box 11060,
Adelaide, SA
5001, Australia. E-mail: or
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16
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Ullmann E, Licinio J, Barthel A, Petrowski K, Stalder T, Bornstein SR, Kirschbaum C. Persistent LHPA Activation in German Individuals Raised in an Overprotective Parental Behavior. Sci Rep 2017; 7:2778. [PMID: 28584276 PMCID: PMC5459846 DOI: 10.1038/s41598-017-01718-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 04/04/2017] [Indexed: 11/24/2022] Open
Abstract
Parental upbringing may affect their offspring’s mental state across the entire lifespan. Overprotective parental child-rearing style may increase the disease burden in the offspring. Furthermore, this child-rearing style may also play a pathogenetic role by transmitting trauma- and stressor-related disorders (TSRD) across generations. Studies with animals have demonstrated that the mother’s immediate and expansive protection of the newborn decreases the limbic-hypothalamic-pituitary-adrenal (LHPA) axis activity in the offspring. However, few studies have investigated how stress impact humans raised in an overprotective manner. In a cross-sectional study with 40 healthy students recalling their overprotective upbringing, we show an increase in the dehydroepiandrostendione (DHEA) concentration and a reduction in the cortisol/DHEA-ratio in hair. Additionally, this child rearing style was associated with heightened indications of mental burden, depressiveness, and sense of coherence. Our results provide insight into the roots and consequences of psychological trauma across several generations. Further investigations focusing particularly on multigenerational transmission in extremely burdened families will augment our results.
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Affiliation(s)
- E Ullmann
- Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany. .,Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany.
| | - J Licinio
- Mind and Brain Theme, South Australian Health and Medical Research Institute, Adelaide, Australia.,Department of Psychiatry, Flinders University, School of Medicine, Adelaide, Australia.,South Ural State University, Biomedical School, Chelyabinsk, Russian Federation
| | - A Barthel
- Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany.,Medicover, Bochum, Germany
| | | | - T Stalder
- Department of Psychology, TU Dresden, Dresden, Germany.,Clinical Psychology, University of Siegen, Siegen, Germany
| | - S R Bornstein
- Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany.,Faculty of Life Sciences & Medicine, Rayne Institute, Endocrinology and Diabetes, Kings College London, London, UK
| | - C Kirschbaum
- Department of Psychology, TU Dresden, Dresden, Germany
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17
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Hanefeld M, Appelt D, Engelmann K, Sandner D, Bornstein SR, Ganz X, Henkel E, Haase R, Birkenfeld AL. Serum and Plasma Levels of Vascular Endothelial Growth Factors in Relation to Quality of Glucose Control, Biomarkers of Inflammation, and Diabetic Nephropathy. Horm Metab Res 2016; 48:620. [PMID: 27756080 DOI: 10.1055/s-0036-1585504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- M Hanefeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - D Appelt
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - K Engelmann
- Klinik für Augenheilkunde, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - D Sandner
- Augenklinik und Poliklinik, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Medical Clinic III, Universitätsklinikum "Carl Gustav Carus", Paul Langerhans Institute Dresden (PLID), Technische Universität Dresden, Dresden, Germany
| | - X Ganz
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - E Henkel
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - R Haase
- Zentrum f. klin. Neurowissenschaften, eHealth Group, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - A L Birkenfeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
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18
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Hanefeld M, Appelt D, Engelmann K, Sandner D, Bornstein SR, Ganz X, Henkel E, Haase R, Birkenfeld AL. Serum and Plasma Levels of Vascular Endothelial Growth Factors in Relation to Quality of Glucose Control, Biomarkers of Inflammation, and Diabetic Nephropathy. Horm Metab Res 2016; 48:529-34. [PMID: 27388431 DOI: 10.1055/s-0042-106295] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Levels of vascular endothelial growth factors (VEGF) are regulated in a complex network of adipokines, glucose control, and low grade inflammation together with activated platelets, leucocytes, and endothelial dysfunction. Increased levels of VEGF are associated with enhanced angiogenesis and impaired repair mechanisms of vascular lesions in endorgans. Little is known about the interaction of systemic VEGF levels with quality of diabetes control, biomarkers of inflammation, and diabetic nephropathy. Moreover, it is unclear, whether serum and plasma VEGF levels are similarly suited to reflect risk associated with VEGF.In this case control study, we analyzed these parameters in serum and plasma of age and sex matched controls without diabetes (n=99) and type 2 diabetes (n=302). Serum VEGF-A was significantly increased in patients with T2DM while plasma levels were in the same range as for controls. Individual levels varied in a wide range. Serum levels were 4.9 times higher in controls and 7.3 times higher in T2DM as compared to plasma levels. T2DM was associated with significantly higher levels of hsCRP, ALAT, and albumin/creatinine ratio. When calculated for tertiles of HbA1c, we observed a highly significant increase from tertile one to the upper tertile for serum VEGF-A but not for plasma VEGF-A. Correlation analysis revealed a significant relationship between VEGF-A, HbA1c, inflammation, and diabetic nephropathy. Our results indicate that increased VEGF-A levels in T2DM significantly depend on quality of HbA1c control. Serum levels of VEGF-A, with a strong contribution of platelet derived VEGF, better reflect the glycemic burden than plasma levels of VEGF-A. Mechanistic studies are needed to explore links to inflammation and diabetic nephropathy.
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Affiliation(s)
- M Hanefeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - D Appelt
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - K Engelmann
- Klinik für Augenheilkunde, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - D Sandner
- Augenklinik und Poliklinik, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Medical Clinic III, Universitätsklinikum "Carl Gustav Carus", Paul Langerhans Institute Dresden (PLID), Technische Universität Dresden, Dresden, Germany
| | - X Ganz
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - E Henkel
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - R Haase
- Zentrum f. klin. Neurowissenschaften, eHealth Group, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - A L Birkenfeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
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19
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Hanefeld M, Appelt D, Engelmann K, Sandner D, Bornstein SR, Ganz X, Henkel E, Haase R, Birkenfeld AL. Einfluss der Qualität der Diabeteskontrolle auf systematische Vascular Endothelial Growth Factors (VEGF) und Biomarker der subklinischen Inflammation bei Typ 2 Diabetes. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Nikolakopoulou P, Poser SW, Masjkur J, Fernandez Rubin de Celis M, Toutouna L, Andoniadou CL, McKay RD, Chrousos G, Ehrhart-Bornstein M, Bornstein SR, Androutsellis-Theotokis A. STAT3-Ser/Hes3 Signaling: A New Molecular Component of the Neuroendocrine System? Horm Metab Res 2016; 48:77-82. [PMID: 26783739 DOI: 10.1055/s-0041-111699] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The endocrine system involves communication among different tissues in distinct organs, including the pancreas and components of the Hypothalamic-Pituitary-Adrenal Axis. The molecular mechanisms underlying these complex interactions are a subject of intense study as they may hold clues for the progression and treatment of a variety of metabolic and degenerative diseases. A plethora of signaling pathways, activated by hormones and other endocrine factors have been implicated in this communication. Recent advances in the stem cell field introduce a new level of complexity: adult progenitor cells appear to utilize distinct signaling pathways than the more mature cells in the tissue they co-reside. It is therefore important to elucidate the signal transduction requirements of adult progenitor cells in addition to those of mature cells. Recent evidence suggests that a common non-canonical signaling pathway regulates adult progenitors in several different tissues, rendering it as a potentially valuable starting point to explore their biology. The STAT3-Ser/Hes3 Signaling Axis was first identified as a major regulator of neural stem cells and, subsequently, cancer stem cells. In the endocrine/neuroendocrine system, this pathway operates on several levels, regulating other types of plastic cells: (a) it regulates pancreatic islet cell function and insulin release; (b) insulin in turn activates the pathway in broadly distributed neural progenitors and possibly also hypothalamic tanycytes, cells with important roles in the control of the adrenal gland; (c) adrenal progenitors themselves operate this pathway. The STAT3-Ser/Hes3 Signaling Axis therefore deserves additional research in the context of endocrinology.
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Affiliation(s)
- P Nikolakopoulou
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - S W Poser
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - J Masjkur
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | | | - L Toutouna
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - C L Andoniadou
- Department of Craniofacial Development and Stem Cell Biology, King's College London, UK
| | - R D McKay
- Lieber Institute for Brain Development, Baltimore, USA
| | - G Chrousos
- 1st Department of Pediatrics, University of Athens Medical School, Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - M Ehrhart-Bornstein
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
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21
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Ullmann E, Barthel A, Taché S, Bornstein A, Licinio J, Bornstein SR. Emotional and psychological trauma in refugees arriving in Germany in 2015. Mol Psychiatry 2015; 20:1483-4. [PMID: 26527128 DOI: 10.1038/mp.2015.164] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- E Ullmann
- Department of Medicine, University of Dresden, Dresden, Germany.,Center of Developmental Pediatrics, City Hospital Dresden, Dresden, Germany
| | - A Barthel
- Department of Medicine, University of Dresden, Dresden, Germany.,Endokrinologikum Ruhr, Bochum, Germany
| | - S Taché
- German Red Cross, Dresden, Germany
| | - A Bornstein
- Department of Medicine, University of Dresden, Dresden, Germany
| | - J Licinio
- Mind and Brain Theme, South Australian Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - S R Bornstein
- Department of Medicine, University of Dresden, Dresden, Germany.,Endocrinology and Diabetes, Division of Diabetes & Nutritional Sciences, Rayne Institute, Denmark Hill Campus, Faculty of Life Sciences & Medicine, Kings College London, London, UK
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22
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Saha S, Bornstein SR, Graessler J, Kopprasch S. Crosstalk Between Glycoxidative Modification of Low-Density Lipoprotein, Angiotensin II-Sensitization, and Adrenocortical Aldosterone Release. Horm Metab Res 2015; 47:855-60. [PMID: 25602349 DOI: 10.1055/s-0034-1395568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Low-density lipoprotein (LDL) is considered to be a risk factor for atherosclerosis. In the presence of hyperglycemia, LDL undergoes glycoxidative modification and this glycoxidized (glycox) LDL promotes atherosclerosis in type 2 diabetic (T2D) individuals. Moreover, because of its cholesterol content, LDL contributes to aldosterone biosynthesis, which is modulated by angiotensin II (AngII) and has been implicated in cardiovascular complications of T2D. However, the molecular mechanism of the crosstalk between glycoxLDL, AngII, and aldosterone has not been explained clearly. Therefore, this study has been aimed to investigate the impact of in vitro modified glycoxLDL on aldosterone release in an AngII-sensitized adrenocortical carcinoma cell line (NCI H295R). Native LDL (natLDL), isolated from healthy volunteers by sequential density gradient ultracentrifugation, was subjected to d-glucose (200 mmol/l), for glycoxidative modification, at 37 °C for 6 days. The AngII-sensitized H295R cells were treated with natLDL and glycoxLDL for 24 h and the supernatant was used for aldosterone measurement. The treated cells were utilized for protein isolation and mRNA quantification. Compared to natLDL, glycoxLDL produced a significantly greater effect on aldosterone release from AngII-sensitized cells. The treatment with specific pharmacological inhibitors suggests that modified LDL recruits ERK1/2 and janus kinase-2 for transcriptional regulation of aldosterone synthase. Moreover, glycoxLDL modulates aldosterone release via cAMP-dependent protein kinase A (PKA) pathway. However, glycoxLDL induces ERK phosphorylation independent of PKA activation and this novel mechanism could be targeted for therapeutic trials. In conclusion, this in vitro study emphasizes a possible causal relationship between LDL glycoxidative modification, AngII-sensitization, and adrenocortical steroid hormone release.
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Affiliation(s)
- S Saha
- Department of Internal Medicine 3, Carl Gustav Carus Medical School,Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Department of Internal Medicine 3, Carl Gustav Carus Medical School,Technische Universität Dresden, Dresden, Germany
| | - J Graessler
- Department of Internal Medicine 3, Carl Gustav Carus Medical School,Technische Universität Dresden, Dresden, Germany
| | - S Kopprasch
- Department of Internal Medicine 3, Carl Gustav Carus Medical School,Technische Universität Dresden, Dresden, Germany
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23
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Baraban E, Chavakis T, Hamilton BS, Sales S, Wabitsch M, Bornstein SR, Ehrhart-Bornstein M. Anti-inflammatory properties of bone morphogenetic protein 4 in human adipocytes. Int J Obes (Lond) 2015; 40:319-27. [PMID: 26228459 DOI: 10.1038/ijo.2015.141] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 07/05/2015] [Accepted: 07/05/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Obesity is characterized by increased adipocyte number and size as well as white adipose tissue (WAT) inflammation, which is fundamental for the development of insulin resistance and type-2 diabetes. These processes, regulated by various endocrine, paracrine and autocrine factors, are extensively studied with the hope to interfere and to inhibit weight gain and related complications in obese patients. Recent data suggest an important role of bone morphogenic protein 4 (BMP4) in the regulation of adipogenesis and development of obesity. BMP4 is a growth factor of the transforming growth factor-β superfamily. Initially, BMPs were identified as inducers of ectopic bone formation. It is now apparent, however, that these proteins have different pleiotropic developmental actions and including playing a role in white adipogenesis. METHODS AND RESULTS Here, we demonstrate that the expression of BMP4 in human WAT is negatively correlated to body mass index and to the expression of pro-inflammatory cytokines. In vitro, BMP4 expression in cultured human adipocytes is upregulated after induction of differentiation. Cells treated with exogenous BMP4 increased peroxisome proliferator-activated receptor γ (PPARγ) expression and significantly reduced the expression of pro-inflammatory cytokines including tumor necrosis factor α (TNF-α) and monocyte chemoattractant protein 1. TNF-α treatment of fully differentiated adipocytes resulted in downregulation of the expression of adipogenic genes and elevated expression of pro-inflammatory cytokines. Exogenous BMP4 addition significantly reduced the negative effect of TNF-α on the expression profile of adipocytes. Finally, treatment of human adipocytes with exogenous BMP4 reduced the adipocytes' chemoattractant potential and the migration of monocytes toward adipocyte-conditioned medium. CONCLUSIONS These results indicate that BMP4 is an important anti-inflammatory molecule, which may act through PPARγ and reduces TNF-α-mediated pro-inflammatory cytokine production in human adipocytes. Through its anti-inflammatory potential, BMP4 may serve as a protective factor for inflammation-related diseases such as insulin-tolerance or type-2 diabetes.
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Affiliation(s)
- E Baraban
- Division of Molecular Endocrinology, Medical Clinic III, Technische Universität Dresden, Dresden, Germany
| | - T Chavakis
- Division of Molecular Endocrinology, Medical Clinic III, Technische Universität Dresden, Dresden, Germany.,Department of Clinical Pathobiochemistry, Institute of Clinical Chemistry and Laboratory Medicine, University Clinic, Technische Universität Dresden, Dresden, Germany
| | - B S Hamilton
- CardioMetabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach an der Riß, Germany
| | - S Sales
- Division of Molecular Endocrinology, Medical Clinic III, Technische Universität Dresden, Dresden, Germany.,Max Planck Institute of Molecular Cell Biology and Genetics, Shevchenko Lab, Dresden, Germany
| | - M Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany
| | - S R Bornstein
- Division of Molecular Endocrinology, Medical Clinic III, Technische Universität Dresden, Dresden, Germany
| | - M Ehrhart-Bornstein
- Division of Molecular Endocrinology, Medical Clinic III, Technische Universität Dresden, Dresden, Germany
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24
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Affiliation(s)
- S R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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25
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Catar RA, Muller G, Brandt A, Langbein H, Brunssen C, Goettsch C, Frenzel A, Hofmann A, Goettsch W, Steinbronn N, Strasser RH, Schubert U, Ludwig B, Bornstein SR, Morawietz H. Increased gene expression of the cardiac endothelin system in obese mice. Horm Metab Res 2015; 47:509-15. [PMID: 25181417 DOI: 10.1055/s-0034-1387761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Obesity is a well-known risk factor of atherosclerosis and heart failure. In the human heart, a local endothelin system containing prepro-endothelin-1, endothelin-converting enzyme-1, and endothelin receptors A and B has been described. The endothelin system is activated in heart failure; however, the impact of obesity on the cardiac endothelin system is unknown. In this study, 18-week-old male C57BL/6 mice fed either a control diet or a high-fat diet for 10 weeks were analyzed. High-fat diet significantly increased the body weight of the animals and augmented low-density lipoprotein, high-density lipoprotein, and cholesterol plasma levels, compared to control. The animal groups showed no significant differences in left ventricular size or function (heart rate, ejection fraction, fractional shortening, left ventricular posterior wall thickness, cardiac output) after control or high-fat diet. We did not observe signs of cardiac hypertrophy or changes in markers of cardiac fibrosis in these heart samples. The cardiac expression of prepro-endothelin-1 mRNA, endothelin-converting enzyme-1 mRNA, and protein and endothelin receptors A and B mRNA was increased in 18-week-old obese C57BL/6 mice compared to animals with normal weight (p<0.05 vs. control). Furthermore, endothelin-1 plasma levels showed an increasing trend. In conclusion, an increased expression of genes of the endothelin system was observed in the hearts of 18-week-old mice after high-fat diet, possibly contributing to later cardiovascular complications of obesity.
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Affiliation(s)
- R A Catar
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - G Muller
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - A Brandt
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - H Langbein
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Brunssen
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Goettsch
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - A Frenzel
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - A Hofmann
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - W Goettsch
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - N Steinbronn
- Department of Internal Medicine and Cardiology, TU Dresden, Dresden, Germany
| | - R H Strasser
- Department of Internal Medicine and Cardiology, TU Dresden, Dresden, Germany
| | - U Schubert
- Department of Medicine III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - B Ludwig
- Department of Medicine III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - S R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - H Morawietz
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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26
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Affiliation(s)
- A Barthel
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany and Endokrinologikum RUHR, Bochum, Germany
| | - S R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany and Diabetes and Nutritional Sciences Division, King's College London, United Kingdom
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Kanczkowski W, Neuwirth A, Grossklaus S, Zacharowski K, Chavakis T, Bornstein SR. The role of hematopoietic TLR-signaling in sepsis-associated adrenal inflammation and the HPA axis activation. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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28
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Gräßler J, Sales S, Bickle M, Al-Atrip R, Bornstein SR, Shevchenko A. Sex-specific differences of plasma lipidomic profile in young healthy individuals. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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Rubin de Celis MF, Garcia-Martin R, Wittig D, Enikolopov G, Chavakis T, Bornstein SR, Androutsellis-Theotokis A, Ehrhart-Bornstein M. A multipotent stem cell population in the adult adrenal medulla mediates stress response. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1549081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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Jennewein C, Tran N, Kanczkowski W, Bornstein SR, Zacharowski K. Mortality in septic mice strongly correlates with adrenal inflammation and dysfunction. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Zhao M, Choudhary P, Srinivasan P, Tang H, Heaton N, Fung M, Barthel A, Bornstein SR, Amiel SA, Huang GC. Modification of human islet preparation: an effective approach to improve graft outcome after islet transplantation? Horm Metab Res 2015; 47:72-7. [PMID: 25372780 DOI: 10.1055/s-0034-1390489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Revascularisation of transplanted islets is an essential prerequisite for graft survival and function. However, current islet isolation procedures deprive the islets of endothelial tubulets. This may have a detrimental effect on the revascularisation process of islets following transplantation. We hypothesise that modification of the isolation procedure that preserves islet endothelial vessels may improve the islet revascularisation process following transplantation. Here, we present a modified islet isolation method by which a substantial amount of endothelial cells still attached to the islets could be preserved. The islets with preserved endothelial cells isolated by this method were revascularised within 3 days, not observed in islets isolated by standard methods. Further, we observed that grafts of islets isolated by standard methods had more patches of dead tissue than islet grafts obtained by the modified method, indicating that attached endothelial cells may play an important role in the islet revascularisation process and potentially help to improve the transplantation outcome.
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Affiliation(s)
- M Zhao
- Department of Diabetes and Endocrinology, Division of Diabetes and Nutrients King's College London, London, UK
| | - P Choudhary
- Department of Diabetes and Endocrinology, Division of Diabetes and Nutrients King's College London, London, UK
| | - P Srinivasan
- Institute of Liver Studies, King's College Hospital, London, UK
| | - H Tang
- Department of Diabetes and Endocrinology, Division of Diabetes and Nutrients King's College London, London, UK
| | - N Heaton
- Institute of Liver Studies, King's College Hospital, London, UK
| | - M Fung
- Department of Diabetes and Endocrinology, Division of Diabetes and Nutrients King's College London, London, UK
| | - A Barthel
- Department of Medicine III, Dresden, Germany
| | - S R Bornstein
- Department of Diabetes and Endocrinology, Division of Diabetes and Nutrients King's College London, London, UK
| | - S A Amiel
- Department of Diabetes and Endocrinology, Division of Diabetes and Nutrients King's College London, London, UK
| | - G C Huang
- Department of Diabetes and Endocrinology, Division of Diabetes and Nutrients King's College London, London, UK
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Abstract
We comment here on the suitability of available mouse models for type 1 diabetes research including research on therapeutic pancreatic islet transplantation. The major emphasis will be laid on models that require minimal invasive procedures. Most biological processes are too complex for a complete recapitulation in a test tube. The study of innate or even adaptive immune responses involves a number of different cell types and organs making in vitro studies unreliable but also providing extreme challenges for the use of surrogate model organisms. Studying these processes directly in humans is impossible due to ethical and technical constraints. To resolve this problem small animal models such as mice or rats are frequently used to study mechanisms of complex diseases. This has brought much insight into hematopoiesis and immune cell function including type 1 diabetes (T1D); however, 65 million years of evolution introduced striking differences between mice and humans 1. In fact, none of the many suggested therapies arising from studies using mice 2 3 that have promised prevention or even reversion of T1D made it into the clinic yet 4 5 6. The reason for this are major species-specific differences between rodents and humans regarding the immune system and beta cells.
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Affiliation(s)
- S Rahmig
- Regeneration in Hematopoiesis and Animal Models in Hematopoiesis, Institute for Immunology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Department of Internal Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - T Chavakis
- Department of Internal Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - E Jaeckel
- Hannover Medical School, Department of Gastroenterology, Hepatology & Endocrinology, Hannover, Germany
| | - C Waskow
- Regeneration in Hematopoiesis and Animal Models in Hematopoiesis, Institute for Immunology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Abstract
The role of incretins in glucose homeostasis is well known. Yet, in recent years, the sustained weight loss and rapid glycemic control following bariatric surgery has challenged our understanding of the intestinal-pancreatic interaction. This in turn led to the introduction of metabolic surgery, an innovative medical discipline in which a surgical manipulation of the gastrointestinal tract (e. g., through a Roux-en-Y gastric bypass, RYGB, or Bilio-Pancreatic-Diversion, BPD) yields a sustained remission of diabetes mellitus. The pathophysiological background of this metabolic effect is, amongst other things, based on the anti-incretin theory. This theory postulates that in addition to the well-known incretin effect, nutrient passage through the GI-tract could also activate negative feedback mechanisms (anti-incretins) to balance the effects of incretins and other postprandial glucose-lowering mechanisms (i. e., suppression of ghrelin, glucagon, and hepatic glucose production via activation of nutrient sensing). This in turn prevents postprandial hyperinsulinemic hypoglycemia. The bypass of the duodenum, the entire jejunum and the first portion of the ileum by BPD induce normalization of peripheral insulin sensitivity, while the bypass of a shorter intestinal tract by RYGB mainly improves the hepatic insulin sensitivity. In addition, RYGB greatly increases insulin secretion. Therefore, metabolic surgery highlights the important role of the small intestine in glucose homeostasis, while until few years ago, it was only the pancreas and the liver that were thought to represent the regulatory organs for glucose disposal.
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Affiliation(s)
- V Kamvissi
- King's College London, Department of Endocrinology, Diabetes and Nutritional Sciences London, UK
| | - A Salerno
- King's College Hospital, Bariatric and Metabolic Surgery, London, UK
| | - S R Bornstein
- King's College London, Department of Endocrinology, Diabetes and Nutritional Sciences London, UK
| | - G Mingrone
- Catholic University of Rome, Department of Internal Medicine, Rome, Italy
| | - F Rubino
- King's College London, Department of Endocrinology, Diabetes and Nutritional Sciences London, UK
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Abstract
For the majority of patients with type 1 diabetes intensive insulin therapy is effective and safe for maintaining glycemia and minimizing diabetes-associated complications. However, a rare number of patients show highly labile metabolic control and experience repeated and unpredictable hypoglycemic episodes. Such condition is often caused by defective counterregulatory mechanisms and autonomous neuropathy. Patients are at high risk for severe acute and chronic complications, and quality of life is considerably impaired. For this small subset of patients, restoration of endogenous insulin secretion can substantially improve metabolic control and quality of life. In our experience, this is irrespective of insulin independency. Here, we report on our 5 years' experience with implementing islet transplantation as a potential treatment option for type 1 diabetes. All patients were treated by long-term insulin pump therapy prior to enrolment. The main indication was severely unstable diabetes and repeated hypoglycemia. From 2008 to 2013, 10 patients have been transplanted with single islet infusion; mean follow-up time was 35 months. All patients show persistent graft function, stable glycemic control with a reduction in HbA1c in the absence of hypoglycemia. All patients are kept on minimal exogenous insulin. In conclusion, islet transplantation can be an excellent therapy for selected patients. Key prerequisite for success is a strict indication. The primary goal for islet transplantation should be stabile glycemia and prevention of hypoglycemia rather than insulin independence. In fact, maintaining minimal exogenous insulin may protect the islet graft from metabolic stress and even prolong islet graft function.
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Affiliation(s)
- B Ludwig
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - A Reichel
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - A Kruppa
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - S Ludwig
- Centre for Diabetes Research, Paul Langerhans Institute Dresden, Dresden, Germany
| | - A Steffen
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - J Weitz
- Department of Visceral, Thorax, and Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany
| | - S R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
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35
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Evron Y, Zimermann B, Ludwig B, Barkai U, Colton CK, Weir GC, Arieli B, Maimon S, Shalev N, Yavriyants K, Goldman T, Gendler Z, Eizen L, Vardi P, Bloch K, Barthel A, Bornstein SR, Rotem A. Oxygen supply by photosynthesis to an implantable islet cell device. Horm Metab Res 2015; 47:24-30. [PMID: 25365509 DOI: 10.1055/s-0034-1394375] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Transplantation of islet cells is an effective treatment for type 1 diabetes with critically labile metabolic control. However, during islet isolation, blood supply is disrupted, and the transport of nutrients/metabolites to and from the islet cells occurs entirely by diffusion. Adequate oxygen supply is essential for function/survival of islet cells and is the limiting factor for graft integrity. Recently, we developed an immunoisolated chamber system for transplantation of human islets without immunosuppression. This system depended on daily oxygen supply. To provide independence from this external source, we incorporated a novel approach based on photosynthetically-generated oxygen. The chamber system was packed sandwich-like with a slab of immobilized photosynthetically active microorganisms (Synechococcus lividus) on top of a flat light source (LEDs, red light at 660 nm, intensity of 8 μE/m(2)/s). Islet cells immobilized in an alginate slab (500-1,000 islet equivalents/cm(2)) were mounted on the photosynthetic slab separated by a gas permeable silicone rubber-Teflon membrane, and the complete module was sealed with a microporous polytetrafluorethylene (Teflon) membrane (pore size: 0.4 μm) to protect the contents from the host immune cells. Upon illumination, oxygen produced by photosynthesis diffused via the silicone Teflon membrane into the islet compartment. Oxygen production from implanted encapsulated microorganisms was stable for 1 month. After implantation of the device into diabetic rats, normoglycemia was achieved for 1 week. Upon retrieval of the device, blood glucose levels returned to the diabetic state. Our results demonstrate that an implanted photosynthetic bioreactor can supply oxygen to transplanted islets and thus maintain islet viability/functionality.
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Affiliation(s)
- Y Evron
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - B Zimermann
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - B Ludwig
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - U Barkai
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - C K Colton
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, USA
| | - G C Weir
- Section of islet Transplantation and Cell Biology, Joslin Diabetes Center, Research Division, One Joslin Place, Boston, USA
| | - B Arieli
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - S Maimon
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - N Shalev
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - K Yavriyants
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - T Goldman
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - Z Gendler
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - L Eizen
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
| | - P Vardi
- Diabetes and Obesity Research Laboratory, Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel-Aviv University, Beilinson Campus, Petah Tikva, Israel
| | - K Bloch
- Diabetes and Obesity Research Laboratory, Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel-Aviv University, Beilinson Campus, Petah Tikva, Israel
| | - A Barthel
- University Hospital Carl Gustav Carus, Department of Medicine III, Dresden, Germany
| | - S R Bornstein
- University Hospital Carl Gustav Carus, Department of Medicine III, Dresden, Germany
| | - A Rotem
- Beta-O2 Technologies, Rosh Ha'ain, Afek Park, Israel
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Reichart B, Niemann H, Chavakis T, Denner J, Jaeckel E, Ludwig B, Marckmann G, Schnieke A, Schwinzer R, Seissler J, Tönjes RR, Klymiuk N, Wolf E, Bornstein SR. Xenotransplantation of porcine islet cells as a potential option for the treatment of type 1 diabetes in the future. Horm Metab Res 2015; 47:31-5. [PMID: 25506683 DOI: 10.1055/s-0034-1395518] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Solid organ and cell transplantation, including pancreatic islets constitute the treatment of choice for chronic terminal diseases. However, the clinical use of allogeneic transplantation is limited by the growing shortage of human organs. This has prompted us to initiate a unique multi-center and multi-team effort to promote translational research in xenotransplantation to bring xenotransplantation to the clinical setting. Supported by the German Research Foundation, an interdisciplinary group of surgeons, internal medicine doctors, diabetologists, material sciences experts, immunologists, cell biologists, virologists, veterinarians, and geneticists have established a collaborative research center (CRC) focusing on the biology of xenogeneic cell, tissue, and organ transplantation. A major strength of this consortium is the inclusion of members of the regulatory bodies, including the Paul-Ehrlich Institute (PEI), infection specialists from the Robert Koch Institute and PEI, veterinarians from the German Primate Center, and representatives of influential ethical and religious institutions. A major goal of this consortium is to promote islet xenotransplantation, based on the extensive expertise and experience of the existing clinical islet transplantation program. Besides comprehensive approaches to understand and prevent inflammation-mediated islet xenotransplant dysfunction [immediate blood-mediated inflammatory reaction (IBMIR)], we also take advantage of the availability of and experience with islet macroencapsulation, with the goal to improve graft survival and function. This consortium harbors a unique group of scientists with complementary expertise under a cohesive program aiming at developing new therapeutic approaches for islet replacement and solid organ xenotransplantation.
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Affiliation(s)
- B Reichart
- Institute for Surgical Research at the Walter-Brendel-Centre for Experimental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - H Niemann
- Friedrich-Loeffler-Institute Mariensee, Federal Research Institute for Animal Health, Neustadt, Germany
| | - T Chavakis
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - J Denner
- Robert-Koch-Institute, Berlin, Germany
| | - E Jaeckel
- Medical School of Hannover, Department Gastroenterology, Hepatology, Endocrinology, Diabetology, Hannover, Germany
| | - B Ludwig
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - G Marckmann
- Institute for Ethics, History and Theory of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - A Schnieke
- Chair of Livestock Biotechnology, Technical University of Munich, Freising, Germany
| | - R Schwinzer
- Transplant Laboratory, Clinic for General,- Visceral-, and Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | - J Seissler
- Medizinische Klinik und Poliklinik IV, Diabetes Zentrum, Ludwig-Maximilians-University, Munich, Germany
| | - R R Tönjes
- Paul-Ehrlich-Institute, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - N Klymiuk
- Gene Center, Molecular Animal Breeding and Biotechnology, Ludwig-Maximilians-University, Munich, Germany
| | - E Wolf
- Gene Center, Molecular Animal Breeding and Biotechnology, Ludwig-Maximilians-University, Munich, Germany
| | - S R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
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Bornstein SR, Amiel SA, Rubino F, Mingrone G, Kamvissi V, Solimena M, Bonifacio E, Jones P, Schwarz P, Birkenfeld AL, Behrens A, Barthel A, Lechler R, Peakman M. Creating a "Transcampus" in diabetes research between King's College London and the Technische Universität Dresden: update on islet biology and transplantation. Horm Metab Res 2015; 47:1-3. [PMID: 25478704 DOI: 10.1055/s-0034-1394453] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S R Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - S A Amiel
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - F Rubino
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - G Mingrone
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - V Kamvissi
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - M Solimena
- Molecular Diabetology, Paul Langerhans Institute Dresden, TU Dresden
| | - E Bonifacio
- German Center for Diabetes Research (DZD e.V.), Dresden, Germany
| | - P Jones
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - P Schwarz
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A L Birkenfeld
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A Behrens
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A Barthel
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - R Lechler
- MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK
| | - M Peakman
- Department of Immunobiology, King's College London School of Medicine, London, UK
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38
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Abstract
This study analyses new information on gene mutations in paragangliomas and puts them into a clinical context. A suspicion of malignancy is critical to determine the workup and surgical approach in adrenal (A-PGL) and extra-adrenal (E-PGL) paragangliomas (PGLs). Malignancy rates vary with location, family history, and gene tests results. Currently there is no algorithm incorporating the above information for clinical use. A sum of 1,821 articles were retrieved from PubMed using the search terms "paraganglioma genetics". Thirty-seven articles were selected of which 9 were analyzed. It was found that 599/2,487 (24%) patients affected with paragangliomas had a germline mutation. Of these 30.2% were mutations in SDHB, 25% VHL, 19.4% RET, 18.4% SDHD, 5.0% NF1, and 2.0% SDHC genes. A family history was positive in 18.1-64.3% of patients. Adrenal PGLs accounted for 55.1% in mutation (+) and 81.0% in mutation (-) patients (RR 1.2, p < 0.0001). Bilateral A-PGLs accounted for 56.4% in mutation (+) and 3.2% in mutation (-) patients (RR 8.7, p < 0.0001). E-PGL were found in 33.6% of mut+ and 17.3% of mut- (RR 1.7, p < 0.0001). In mutation (+) patients PGLs malignancy varied with location, adrenal (6.4%) thoraco-abdominal E-PGL (38%), H & N E-PGL (10%). Malignancy rates were 8.2% in mutation (-) and lower in mutation (+) PGLs except for SDHB 36.5% and SDHC 8.3%. Exclusion of a mutation lowered the probability of malignancy significantly in E-PGL (RR 0.03 (95% CI 0.1-0.6); p < 0.001). Mutation analysis provides valuable preoperative information to assess the risk of malignancy in A-PG and E-PGLs and should be considered in the work up of all E-PGL lesions.
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Affiliation(s)
- K-M Schulte
- Department of Endocrine Surgery, King's College Hospital, King's Health Partners, London, UK
| | - N Talat
- Department of Endocrine Surgery, King's College Hospital, King's Health Partners, London, UK
| | - G Galata
- Department of Endocrine Surgery, King's College Hospital, King's Health Partners, London, UK
| | - S Aylwin
- Department of Endocrinology, King's College Hospital, King's Health -Partners, London, UK
| | - L Izatt
- Clinical Genetics Department, Guy's Hospital, London, UK
| | - G Eisenhofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Dresden, Dresden, Germany
| | - A Barthel
- Department of Medicine III, University Hospital of Dresden, Dresden, Germany
| | - S R Bornstein
- Department of Medicine III, University Hospital of Dresden, Dresden, Germany
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39
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Schulte KM, Talat N, Galata G, Gilbert J, Miell J, Hofbauer LC, Barthel A, Diaz-Cano S, Bornstein SR. Oncologic resection achieving r0 margins improves disease-free survival in parathyroid cancer. Ann Surg Oncol 2014; 21:1891-7. [PMID: 24522991 DOI: 10.1245/s10434-014-3530-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Parathyroid cancer has a poor mid-term prognosis, often because of local recurrence, observed in half of all patients. Modern diagnostic workup increasingly enables a preoperative diagnosis of parathyroid cancer. There is limited evidence that more comprehensive oncologic surgery can reduce the risk of local recurrence. This study aims to identify the best specific surgical approach in parathyroid cancer. METHODS This observational cohort study comprises 19 consecutive patients who had undergone oncologic or nononcologic resection for parathyroid cancer. Baseline parameters were compared by using univariate analysis; outcomes were assessed by χ (2) testing and Kaplan-Meier statistics. RESULTS Fifteen of 19 patients were primarily operated on in our tertiary center between 1996 and 2013, and four were referred for follow-up because of their cancer diagnosis. Patient cohorts defined by histologic R-status were comparable for established risk factors: sex, calcium levels, low-risk/high-risk status, and presence of vascular invasion. Oncologic resections were performed in 13 of 15 patients primarily treated in the center and 0 of 4 treated elsewhere (χ (2) = 5.6; p < 0.01). R0 margins were achieved in 11 of 13 (85 %) undergoing oncologic resection and 1 of 6 (17 %) undergoing local excision (χ (2) = 8.1; p < 0.01). R0 margins and primary oncologic resection were associated with higher disease-free survival rates (χ (2) = 7.9; p = 0.005 and χ (2) = 4.7; p = 0.03, respectively). Revision surgery achieved R0 margins in only 2 of 4 (50 %) of patients. CONCLUSIONS In parathyroid cancer, a more comprehensive surgery (primary oncologic resection) provides significantly better outcomes than local excision as a result of reduction of R1 margins and locoregional recurrence.
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Affiliation(s)
- K M Schulte
- Department of Endocrine Surgery, King's College Hospital, King's Health Partners, King's College London, London, UK,
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40
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Pamporaki C, Bursztyn M, Reimann M, Ziemssen T, Bornstein SR, Sweep FCGJ, Timmers H, Lenders JWM, Eisenhofer G. Seasonal variation of plasma free normetanephrine concentrations: implications for biochemical diagnosis of pheochromocytoma. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1371997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Phieler J, Chung KJ, Chatzigeorgiou A, Klotzsche-von Ameln A, Garcia-Martin R, Bornstein SR, Lambris JD, Chavakis T. Distinct role of complement anaphylatoxin receptors C5aR and C3aR in obese adipose tissue inflammation and insulin resistance. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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42
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Rubin de Celis MF, Garcia-Martin R, Diaz Valencia GA, Chavakis T, Bornstein SR, Androutsellis-Theotokis A, Ehrhart-Bornstein M. Identification and characterization of chromaffin progenitor cells in murine adrenal medulla. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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43
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Vukicevic V, Bornstein SR, Ehrhart-Bornstein M. Exposure to valproic acid increases a subset of chromaffin progenitor cells within chromospheres. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1371998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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44
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Ziegler CG, Ullrich M, Bergmann R, Pietzsch J, Cartellieri M, Chavakis T, Qin N, Peitzsch M, Ehrhart-Bornstein M, Eisenhofer G, Bornstein SR. Evaluation of a novel fluorescence-based animal model of pheochromocytoma for theragnostic investigations. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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45
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Kanczkowski W, Chatzigeorgiou A, Lehnert U, Großklaus S, Bornstein SR, Chavakis T. The role of IL17 in systemic inflammation mediated downregulation of the endothelial anti-inflammatory factor Del-1 in the adrenal gland and related HPA axis dysregulation. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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46
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Giannakidou-Jordan E, Brenken C, Benker G, Bornstein SR, Barthel A. [19-year-old woman with nodular painless skin alterations]. Dtsch Med Wochenschr 2014; 139:481-2. [PMID: 24570193 DOI: 10.1055/s-0033-1360085] [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: 10/25/2022]
Affiliation(s)
| | | | | | - S R Bornstein
- Medizinische Klinik und Poliklinik III, Carl-Gustav Carus Universität, Universitätsklinikum Dresden
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47
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Schlottmann I, Ehrhart-Bornstein M, Wabitsch M, Bornstein SR, Lamounier-Zepter V. Calcium-dependent release of adipocyte fatty acid binding protein from human adipocytes. Int J Obes (Lond) 2013; 38:1221-7. [PMID: 24352293 DOI: 10.1038/ijo.2013.241] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/18/2013] [Accepted: 12/04/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Fatty acid binding protein 4 (FABP4) is a predominantly cytosolic protein of the adipocytes, but also abundantly present in human plasma; its plasma concentrations were linked to obesity and metabolic syndrome. Recent studies have suggested a direct extracellular effect of FABP4 in the regulation of glucose metabolism and heart function independently of its effect as a carrier protein. Interestingly, FABP4 has no secretory signal sequence; hence, the mechanisms how FABP4 is released from adipocytes are unclear. METHODS AND RESULTS In this study we investigated the mechanisms for FABP4 secretion from human adipocytes by using isolated primary pre-adipocytes (PAs) and the human adipocyte cell strain Simpson-Golabi-Behmel syndrome. In undifferentiated PAs, FABP4 expression was barely detectable and increased continuously during differentiation. The increase in FABP4 mRNA expression was accompanied by high levels of FABP4 secretion. In differentiated human adipocytes, FABP4 secretion was not abolished by blocking the Golgi-dependent secretory pathway in vitro, supporting a non-classical secretion mechanism for FABP4. However, raising intracellular Ca(2+) levels enhanced FABP4 secretion in a concentration-dependent manner. CONCLUSION This study shows that FABP4 is actively released from human adipocytes in vitro via a non-classical, calcium-dependent mechanism.
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Affiliation(s)
- I Schlottmann
- Medical Clinic III, Dresden University of Technology, Dresden, Germany
| | | | - M Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, University of Ulm, Germany
| | - S R Bornstein
- Medical Clinic III, Dresden University of Technology, Dresden, Germany
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48
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Müller G, Parfentyeva E, Olschewsky J, Bornstein SR, Schwarz PEH. Assessment of small fiber neuropathy to predict future risk of type 2 diabetes. Prim Care Diabetes 2013; 7:269-273. [PMID: 24076379 DOI: 10.1016/j.pcd.2013.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/20/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Sudomotor dysfunction due to small fiber neuropathy can be observed very early in pre-diabetes. The aim of this study was to assess the predictive power of EZSCAN, a non invasive, quick and simple measurement of sudomotor function to identify glucose impairment. RESEARCH DESIGN AND METHODS The study was performed in 76 German subjects at risk of diabetes. Glucose metabolism was assessed by using, oral glucose tolerance test (OGTT) at baseline and after 2 year follow-up. Sudomotor function was evaluated by measuring hand and foot electrochemical sweat conductances to calculate a risk score. RESULTS At baseline, 38 patients had normal glucose tolerance (NGT), 34 had pre-diabetes (impaired fasting glucose, IFG and/or impaired glucose tolerance, IGT) and 4 had newly diagnosed type 2 diabetes. The AUC values for FPG, 2h-OGTT glucose, 1h-OGTT glucose, HbA1C and EZSCAN score to predict pre-diabetes were 0.50, 0.65, 0.64, 0.72 and 0.76, respectively. Subjects having a moderate or high EZSCAN score (>50) at baseline had a substantially increased risk for having IFG and/or IGT at follow-up visit presented by an odds ratio of 12.0 [1.4-100.5], the OR for having 1h-OGTT ≥ 8.6mmol/L at follow-up was 9.8 [1.0-92.8] and for having HbA1C ≥ 5.7% was 15.7 [1.9-131.5] compared to subjects with low EZSCAN risk. CONCLUSIONS This preliminary study, which must be confirmed in a larger population, shows that EZSCAN risk score is associated with diabetes progression which have implications for prevention and disease management.
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Affiliation(s)
- G Müller
- Institute for Medical Informatics and Biometry, Medical Faculty at the Technical University Dresden, Germany
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Abstract
This paper summarizes the situation pertinent to treatment via lipoprotein apheresis in the federal state of Saxony, Germany in 2010. In total, 119 predominately male patients were treated in 10 centers; the majority of the patients was older than the mean age of the general population. Several risk factors were present, particularly a familial predisposition and hypertension. All patients had experienced cardiovascular events and the majority was taking statins. Patient data from the University Hospital Carl Gustav Carus in Dresden concurred with data derived from patients treated at nephrological practices. In the mean, patients attended the centers for about 6 years, the majority weekly. LDL cholesterol concentrations prior to apheresis were clearly higher than target levels; apheresis sessions decreased LDL cholesterol by 69%. Lipoprotein(a) levels could be measured in 75 patients and were effectively reduced by lipoprotein apheresis. In Saxony, 29 patients per 1 million inhabitants received lipoprotein apheresis, which is higher than the proportion of patients treated in Germany as a whole. The need for this extracorporeal treatment seems to be much greater than its current utilization. Among the patients only one homozygous patient with familial hypercholesterolemia was observed. Physicians should be actively informed about this therapeutic possibility to reduce the cardiovascular risk efficiently. The introduction of new drugs may alter the position of lipoprotein apheresis within the therapeutic spectrum.
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Affiliation(s)
- U Julius
- Department of Internal Medicine III, University Hospital Carl Gustav Carus Dresden, Fetscherstr 74, 01307 Dresden, Germany.
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50
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von Dryander M, Fischer S, Passauer J, Müller G, Bornstein SR, Julius U. Differences in the atherogenic risk of patients treated by lipoprotein apheresis according to their lipid pattern. ATHEROSCLEROSIS SUPP 2013; 14:39-44. [PMID: 23357139 DOI: 10.1016/j.atherosclerosissup.2012.10.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In high-risk patients who are already on a maximal lipid-lowering therapy, a lipoprotein apheresis is an important therapeutic option in preventing further progress of vascular complications as it may decrease both LDL-cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) levels. We looked at the occurrence of cardiovascular events before apheresis and during apheresis in three groups defined by their lipid patterns at the start of an apheresis treatment: Group 1 (LDL-C ≥ 3.4 mmol/l and Lp(a) ≤ 600 mg/l; n = 35), Group 2 (LDL-C ≤ 3.4 mmol/l and Lp(a) ≥ 600 mg/l n = 37) and Group 3 (LDL-C ≥ 3.4 mmol/l and Lp(a) ≥ 600 mg/l; n = 15). Group 2 shows a time period of about 10 years from the first event until the start of apheresis treatment (compared to 2-6 years in the other two groups). Before the start of apheresis treatment 2.1 events per patient had occurred in Group 1, 3.4 events per patient in Group 2 and 1.8 events per patient in Group 3. Under apheresis therapy just 0.9 events per patient occurred in Group 1, 0.5 in Group 2 and 0.5 in Group 3. When comparing the two years before the start of apheresis treatment with the first two years under apheresis we saw the following reduction rates of cardiovascular events: Group 1-54%; Group 2-83%; Group 3-83.5%. Our results show that the reduction of cardiovascular events due to lipoprotein apheresis is especially high in patients with elevated levels of Lp(a) compared to patients with elevated LDL-C only indicating that physicians should be more focused on the risk factor elevated Lp(a).
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Affiliation(s)
- M von Dryander
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307 Dresden, Germany.
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