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Boeselt T, Terhorst P, Kroenig J, Nell C, Spielmanns M, Boas U, Veith M, Vogelmeier C, Greulich T, Koczulla AR, Beutel B, Huber J, Heers H. Specific molecular peak analysis by ion mobility spectrometry of volatile organic compounds in urine of COVID-19 patients: A novel diagnostic approach. J Virol Methods 2024; 326:114910. [PMID: 38452823 DOI: 10.1016/j.jviromet.2024.114910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/08/2024] [Accepted: 03/02/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION SARS-CoV-2 is usually diagnosed from naso-/oropharyngeal swabs which are uncomfortable and prone to false results. This study investigated a novel diagnostic approach to Covid-19 measuring volatile organic compounds (VOC) from patients' urine. METHODS Between June 2020 and February 2021, 84 patients with positive RT-PCR for SARS-CoV-2 were recruited as well as 54 symptomatic individuals with negative RT-PCR. Midstream urine samples were obtained for VOC analysis using ion mobility spectrometry (IMS) which detects individual molecular components of a gas sample based on their size, configuration, and charge after ionization. RESULTS Peak analysis of the 84 Covid and 54 control samples showed good group separation. In total, 37 individual specific peaks were identified, 5 of which (P134, 198, 135, 75, 136) accounted for significant differences between groups, resulting in sensitivities of 89-94% and specificities of 82-94%. A decision tree was generated from the relevant peaks, leading to a combined sensitivity and specificity of 98% each. DISCUSSION VOC-based diagnosis can establish a reliable separation between urine samples of Covid-19 patients and negative controls. Molecular peaks which apparently are disease-specific were identified. IMS is an additional non-invasive and cheap device for the diagnosis of this ongoing endemic infection. Further studies are needed to validate sensitivity and specificity.
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Affiliation(s)
- T Boeselt
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - P Terhorst
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Kroenig
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Nell
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Spielmanns
- Pulmonary Rehabilitation, Zuercher Reha Zentren Klinik Wald, Switzerland; Faculty of Health, Department of Pneumology, University of Witten, Herdecke, Germany
| | - U Boas
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Veith
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - A R Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany; Department of Pulmonology, Schoen-Kliniken Berchtesgaden, Philipps-University Marburg, Germany
| | - B Beutel
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Huber
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany
| | - H Heers
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany.
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Papiris SA, Veith M, Papaioannou AI, Apollonatou V, Ferrarotti I, Ottaviani S, Tzouvelekis A, Tzilas V, Rovina N, Stratakos G, Gerogianni I, Daniil Z, Kolilekas L, Dimakou K, Pitsidianakis G, Tzanakis N, Tryfon S, Fragopoulos F, Antonogiannaki EM, Lazaratou A, Fouka E, Papakosta D, Emmanouil P, Anagnostopoulos N, Karampitsakos T, Vlami K, Kallieri M, Lyberopoulos P, Loukides S, Bouros D, Bush A, Balduyck M, Lombard C, Cottin V, Mornex JF, Vogelmeier CF, Greulich T, Manali ED. Alpha1-antitrypsin deficiency in Greece: Focus on rare variants. Pulmonology 2024; 30:43-52. [PMID: 36797151 DOI: 10.1016/j.pulmoe.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 02/16/2023] Open
Abstract
PURPOSE A1Antitrypsin deficiency (AATD) pathogenic mutations are expanding beyond the PI*Z and PI*S to a multitude of rare variants. AIM to investigate genotype and clinical profile of Greeks with AATD. METHODS Symptomatic adult-patients with early-emphysema defined by fixed airway obstruction and computerized-tomography scan and lower than normal serum AAT levels were enrolled from reference centers all over Greece. Samples were analyzed in the AAT Laboratory, University of Marburg-Germany. RESULTS Included are 45 adults, 38 homozygous or compound heterozygous for pathogenic variants and 7 heterozygous. Homozygous were 57.9% male, 65.8% ever-smokers, median (IQR) age 49.0(42.5-58.5) years, AAT-levels 0.20(0.08-0.26) g/L, FEV1(%predicted) 41.5(28.8-64.5). PI*Z, PI*Q0, and rare deficient allele's frequency was 51.3%, 32.9%,15.8%, respectively. PI*ZZ genotype was 36.8%, PI*Q0Q0 21.1%, PI*MdeficientMdeficient 7.9%, PI*ZQ0 18.4%, PI*Q0Mdeficient 5.3% and PI*Zrare-deficient 10.5%. Genotyping by Luminex detected: p.(Pro393Leu) associated with MHeerlen (M1Ala/M1Val); p.(Leu65Pro) with MProcida; p.(Lys241Ter) with Q0Bellingham; p.(Leu377Phefs*24) with Q0Mattawa (M1Val) and Q0Ourem (M3); p.(Phe76del) with MMalton (M2), MPalermo (M1Val), MNichinan (V) and Q0LaPalma (S); p.(Asp280Val) with PLowell (M1Val); PDuarte (M4), YBarcelona (p.Pro39His). Gene-sequencing (46.7%) detected Q0GraniteFalls, Q0Saint-Etienne, Q0Amersfoort(M1Ala), MWürzburg, NHartfordcity and one novel-variant (c.1A>G) named Q0Attikon.Heterozygous included PI*MQ0Amersfoort(M1Ala), PI*MMProcida, PI*Mp.(Asp280Val), PI*MOFeyzin. AAT-levels were significantly different between genotypes (p = 0.002). CONCLUSION Genotyping AATD in Greece, a multiplicity of rare variants and a diversity of rare combinations, including unique ones were observed in two thirds of patients, expanding knowledge regarding European geographical trend in rare variants. Gene sequencing was necessary for genetic diagnosis. In the future the detection of rare genotypes may add to personalize preventive and therapeutic measures.
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Affiliation(s)
- S A Papiris
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece.
| | - M Veith
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL), UKGM, Marburg, Germany
| | - A I Papaioannou
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - V Apollonatou
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - I Ferrarotti
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumonology Unit, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy
| | - S Ottaviani
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumonology Unit, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy
| | - A Tzouvelekis
- Department of Respiratory Medicine, General Hospital of Patras, University of Patras, Greece
| | - V Tzilas
- 5th Pulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - N Rovina
- 1st Department of Pulmonary Medicine and Intensive Care Unit, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
| | - G Stratakos
- 1st Respiratory Medicine Department of the National, Kapodistrian University of Athens, Athens, Greece
| | - I Gerogianni
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa Greece
| | - Z Daniil
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa Greece
| | - L Kolilekas
- 7thPulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - K Dimakou
- 5th Pulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - G Pitsidianakis
- Department of Thoracic Medicine, University Hospital, University of Crete, Heraklion, Crete 71110, Greece
| | - N Tzanakis
- Department of Thoracic Medicine, University Hospital, University of Crete, Heraklion, Crete 71110, Greece
| | - S Tryfon
- General Hospital "G. Papanikolaou", Thessaloniki, Greece
| | - F Fragopoulos
- Pulmonary Department, General Hospital of Nicosia, Cyprus
| | - E M Antonogiannaki
- 4th Pulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - A Lazaratou
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - E Fouka
- A Department of Pulmonary Medicine, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | - D Papakosta
- A Department of Pulmonary Medicine, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | | | - N Anagnostopoulos
- 1st Respiratory Medicine Department of the National, Kapodistrian University of Athens, Athens, Greece
| | - T Karampitsakos
- Department of Respiratory Medicine, General Hospital of Patras, University of Patras, Greece
| | - K Vlami
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - M Kallieri
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - P Lyberopoulos
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - S Loukides
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - D Bouros
- Iatriko Medical Center, Athens, Greece; School of Medicine, National and Kapodistrian University of Athens, Athens Greece
| | - A Bush
- Paediatrics and Paediatric Respirology, Imperial College, Imperial Centre for Paediatrics and Child Health, Royal Brompton Harefield NHS Foundation Trust, London, United Kingdom
| | - M Balduyck
- laboratoire de Biochimie et Biologie Moléculaire (HMNO), Centre de Biologie Pathologie, Faculté de pharmacie et EA 7364 RADEME, Laboratoire de Biochimie et Biologie Moléculaire, CHU de Lille, Université de Lille, Lille, France
| | - C Lombard
- Laboratoire d'Immunologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon and Université Claude Bernard-Lyon 1, Lyon, France
| | - V Cottin
- Service de pneumologie, Centre National Coordinateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - J F Mornex
- Service de pneumologie, Centre National Coordinateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - C F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL), UKGM, Marburg, Germany
| | - T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL), UKGM, Marburg, Germany
| | - E D Manali
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
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3
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Papiris SA, Veith M, Lazaratou A, Balduyck M, Lombard C, Dechomet M, Odou MF, Entrena E, Osaba L, Kallieri M, Apollonatou V, Prountzos S, Kontopoulou C, Kolilekas L, Ferrarotti I, Mornex JF, Vogelmeier CF, Greulich T, Manali ED. PI*ZQ0 Attikon genotype discovery in severe alpha-1 antitrypsin deficiency. Pulmonology 2023; 29:564-567. [PMID: 37263862 DOI: 10.1016/j.pulmoe.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023] Open
Affiliation(s)
- S A Papiris
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece
| | - M Veith
- Department of Medicine, Pulmonary and Critical Care Medicine, UKGM, Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - A Lazaratou
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece
| | - M Balduyck
- CHU de Lille, laboratoire de biochimie et biologie moléculaire (HMNO), centre de biologie pathologie, Faculté de pharmacie et EA 7364 RADEME, laboratoire de biochimie et biologie moléculaire, Université de Lille, Lille, France
| | - C Lombard
- Laboratoire d'Immunologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon & Université Claude Bernard-Lyon 1, Lyon, France
| | - M Dechomet
- Laboratoire d'Immunologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon & Université Claude Bernard-Lyon 1, Lyon, France
| | - M-F Odou
- CHU Lille, Service de Biochimie et Biologie moléculaire 'Hormonologie, Métabolisme-Nutrition, Oncologie', Univ. Lille, Inserm, U1286 - Infinite, F-59000 Lille, France
| | - E Entrena
- Progenika Biopharma, a Grifols Company, Derio, Vizcaya, Spain
| | - L Osaba
- Progenika Biopharma, a Grifols Company, Derio, Vizcaya, Spain
| | - M Kallieri
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece
| | - V Apollonatou
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece
| | - S Prountzos
- 2nd Department of Radiology, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece
| | - C Kontopoulou
- 2nd Department of Radiology, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece
| | - L Kolilekas
- 7thPulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - I Ferrarotti
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumonology Unit, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy
| | - J-F Mornex
- Service de pneumologie, Centre national coordinateur de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - C-F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, UKGM, Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, UKGM, Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - E D Manali
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece.
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4
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Buhl R, Bals R, Baur X, Berdel D, Criée CP, Gappa M, Gillissen A, Greulich T, Haidl P, Hamelmann E, Horak F, Kardos P, Kenn K, Klimek L, Korn S, Magnussen H, Nowak D, Pfaar O, Rabe KF, Riedler J, Ritz T, Schultz K, Schuster A, Spindler T, Taube C, Vogelmeier C, von Leupoldt A, Wantke F, Wildhaber J, Worth H, Zacharasiewicz A, Lommatzsch M. [Guideline for the Diagnosis and Treatment of Asthma - Addendum 2020 - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology]. Pneumologie 2021; 75:191-200. [PMID: 33728628 DOI: 10.1055/a-1352-0296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The present addendum of the guideline for the diagnosis and treatment of asthma (2017) complements new insights into the diagnosis and management of asthma as well as for the newly approved drugs for the treatment of asthma. Current, evidence-based recommendations on diagnostic and therapeutic approaches are presented for children and adolescents as well as for adults with asthma.
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Affiliation(s)
- R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - R Bals
- Universitätsklinikum des Saarlandes, Klinik für Innere Medizin V, Homburg/Saar
| | - X Baur
- Haut- und Lasercentrum, Standort Berlin, Berlin
| | | | - C-P Criée
- Evangelisches Krankenhaus Göttingen Weende, Abteilung für Pneumologie, Bovenden-Lenglern
| | - M Gappa
- Evangelisches Krankenhaus Düsseldorf, Klinik für Kinder und Jugendmedizin, Düsseldorf
| | - A Gillissen
- Klinikum Am Steinenberg, Ermstalklinik, Medizinische Klinik III/Innere Medizin und Pneumologie, Reutlingen-Bad Urach
| | - T Greulich
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - P Haidl
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie II, Schmallenberg
| | - E Hamelmann
- Universitäts-Klinikum OWL, Universität Bielefeld, Kinderzentrum Bethel, Bielefeld
| | - F Horak
- Allergiezentrum Wien West, Wien
| | - P Kardos
- Lungenpraxis an der Klinik Maingau vom Roten Kreuz, Frankfurt am Main
| | - K Kenn
- Philips Universität Marburg, Lehrstuhl für pneumologische Rehabilitation, Marburg
| | - L Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden
| | - S Korn
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - H Magnussen
- Pneumologisches Forschungsinstitut an der LungenClinic Grosshansdorf GmbH, Großhansdorf
| | - D Nowak
- Klinikum der Universität München, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München
| | - O Pfaar
- Klinik für Hals-, Nasen-und Ohrenheilkunde, Sektion Rhinologie und Allergologie, Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg, Marburg
| | - K F Rabe
- LungenClinic Grosshansdorf GmbH, Abteilung für Pneumologie, Großhansdorf
| | - J Riedler
- Kardinal Schwarzenberg Klinikum, Kinder- und Jugendmedizin, Schwarzach im Pongau, Österreich
| | - T Ritz
- Southern Methodist University, Department of Psychology, Dallas, USA
| | - K Schultz
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - A Schuster
- Universitätsklinikum Düsseldorf, Zentrum für Kinder- und Jugendmedizin, Düsseldorf
| | - T Spindler
- Hochgebirgsklinik Davos, Abteilung für Kinder und Jugendliche, Davos, Schweiz
| | - C Taube
- Universitätsmedizin Essen, Ruhrlandklinik, Klinik für Pneumologie, Essen
| | - C Vogelmeier
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - A von Leupoldt
- University of Leuven, Health Psychology, Leuven, Belgien
| | - F Wantke
- Floridsdorfer Allergiezentrum, Wien, Österreich
| | - J Wildhaber
- HFR Freiburg, Kantonsspital, Klinik für Pädiatrie, Freiburg, Schweiz
| | - H Worth
- Facharztzentrum Fürth, Fürth
| | - A Zacharasiewicz
- Klinikum Ottakring, Wilhelminenspital, Lehrkrankenhaus der Medizinischen Universität Wien, Abteilung für Kinder- und Jugendheilkunde, Wien, Österreich
| | - M Lommatzsch
- Universitätsmedizin Rostock, Abteilung für Pneumologie, Rostock
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Greulich T, Töpfer V, Hennig M, Orehounig CC, Ams K, Mohrlang CD, Killian PH, Kardos P. COPD in Germany: Use of Diagnostic Measures Including Blood Eosinophil Counts in Daily Practice. Pneumologie 2020; 75:344-352. [PMID: 33307557 PMCID: PMC8093015 DOI: 10.1055/a-1266-6602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Accumulating evidence on the role of blood eosinophils as a biomarker prompted the Global Initiative for Chronic Obstructive Lung Disease (GOLD) committee to refine the existing treatment algorithm by incorporating eosinophil counts into treatment recommendations. However, there is a lack of data on when, why and how frequently such blood tests and other measures are being performed by German private respiratory specialists. METHODS A questionnaire evaluating doctors' opinions on the use of diagnostic measures at initial diagnosis and during follow-up, including blood eosinophil count in patients with COPD, was completed by 27 respiratory specialists. Medical records from the past 12 months of 251 patients treated by the same physicians were reviewed retrospectively to investigate the use of these measures. RESULTS Body plethysmography (100 % of doctors) and chest X-ray (96.3 %) were the most commonly used measures according to the doctor's questionnaire; other measures were COPD assessment test (CAT; 85.2 %) and blood eosinophil count (81.5 %). The evaluation of patients' medical records revealed that body plethysmography was performed in 72.7 %, the CAT in 61.8 % and chest X-ray in 40.6 % of patients. Blood eosinophil count was measured in 7.2 %. CONCLUSIONS In line with the GOLD recommendations, these results confirm that lung function, imaging and patient-reported outcome questionnaires play a crucial role in managing COPD. Our analyses reveal that measurement of the blood eosinophil count gained importance due to physicians' increased awareness of these cells as a useful biomarker. However, this test seems to be performed mainly for initial diagnosis and not on a regular basis.
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Affiliation(s)
- T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University Marburg, Member of the German Centre for Lung Research (DZL) Marburg, Germany
| | - V Töpfer
- Pneumological Group Practice, Pulmonary Centre Ulm, Ulm, Germany
| | - M Hennig
- GlaxoSmithKline GmbH & Co. KG, Munich, Germany
| | | | - K Ams
- GlaxoSmithKline GmbH & Co. KG, Munich, Germany
| | | | - P H Killian
- GlaxoSmithKline GmbH & Co. KG, Munich, Germany
| | - P Kardos
- Group Practice and Centre for Allergy, Respiratory and Sleep Medicine, Red Cross Maingau Hospital, Frankfurt am Main, Germany
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6
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Greulich T, Fähndrich S, Clarenbach C, Gleiber W, Hautmann H, Heine R, Idzko M, Schmidt-Scherzer K, Skowasch D, Wiewrodt R, Bals R, Koczulla AR. [Alpha-1 Antitrypsin Deficiency (AATD) - D-A-CH-Expert Statement]. Pneumologie 2020; 74:436-442. [PMID: 32492720 DOI: 10.1055/a-1143-8186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Philips-Universität, Marburg.,PneumoPraxis-Marburg, Marburg
| | - S Fähndrich
- Medizinische Klinik und Poliklinik Innere Medizin V Abteilung Pneumologie, Universitätsklinikum Freiburg, Freiburg
| | - C Clarenbach
- Universitätsspital Zürich, Klinik für Pneumologie, Zürich, Schweiz
| | - W Gleiber
- Medizinische Klinik I: Pneumologie und Allergologie, Universitätsklinikum Frankfurt am Main, Goethe-Universität, Frankfurt am Main
| | - H Hautmann
- Klinik für Innere Medizin und Pneumologie, Klinikverbund Allgäu, Ottobeuren
| | - R Heine
- Krankenhaus St. Elisabeth und St. Barbara, Halle
| | - M Idzko
- Medizinische Universität Wien, Klinik für Innere Medizin II, Wien, Österreich
| | - K Schmidt-Scherzer
- Zweite Medizinische Abteilung mit Pneumologie mit Ambulanz, Wilhelminenspital, Wien, Österreich
| | - D Skowasch
- Medizinische Klinik + Poliklinik II Schwerpunkt Pneumologie, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelm-Universität, Bonn
| | - R Wiewrodt
- Medizinische Klinik A Schwerpunkt Pneumologie, Universitätsklinikum Münster, Münster
| | - R Bals
- Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg
| | - A R Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Philips-Universität, Marburg.,Fachzentrum für Pneumologie, Schön Klinik Berchtesgadener Land, Schönau am Königssee
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7
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Buhl R, Bals R, Baur X, Berdel D, Criée CP, Gappa M, Gillissen A, Greulich T, Haidl P, Hamelmann E, Kardos P, Kenn K, Klimek L, Korn S, Lommatzsch M, Magnussen H, Nicolai T, Nowak D, Pfaar O, Rabe KF, Riedler J, Ritz T, Schultz K, Schuster A, Spindler T, Taube C, Taube K, Vogelmeier C, von Leupoldt A, Wantke F, Weise S, Wildhaber J, Worth H, Zacharasiewicz A. [Guideline for the Diagnosis and Treatment of Asthma - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology]. Pneumologie 2018; 71:e3. [PMID: 30406626 DOI: 10.1055/a-0790-0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - R Bals
- Universitätsklinikum des Saarlandes, Klinik für Innere Medizin V, Homburg/Saar
| | - X Baur
- European Society for Environmental and Occupational Medicine, EOM, Berlin
| | | | - C-P Criée
- Evangelisches Krankenhaus Göttingen Weende, Abteilung für Pneumologie, Bovenden-Lenglern
| | - M Gappa
- Marien-Hospital gGmbH, Klinik für Kinder- und Jugendmedizin, Wesel
| | - A Gillissen
- Klinikum Am Steinenberg, Ermstalklinik, Medizinische Klinik III/Innere Medizin und Pneumologie, Reutlingen-Bad Urach
| | - T Greulich
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - P Haidl
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie II, Schmallenberg
| | - E Hamelmann
- Evangelisches Klinikum Bethel, Klinik für Kinder- und Jugendmedizin, Bielefeld
| | - P Kardos
- Lungenpraxis an der Klinik Maingau vom Roten Kreuz, Frankfurt am Main
| | - K Kenn
- Schön Klinik Berchtesgadener Land, Fachzentrum für Pneumologie, Schönau am Königssee, Philipps Universität Marburg, Standort Schönau
| | - L Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden
| | - S Korn
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - M Lommatzsch
- Universitätsmedizin Rostock, Abteilung Pneumologie, Rostock
| | - H Magnussen
- Pneumologisches Forschungsinstitut an der LungenClinic Grosshansdorf GmbH, Großhansdorf
| | - T Nicolai
- Klinikum der Universität München, Kinderklinik und Kinderpoliklinik, LMU München
| | - D Nowak
- Klinikum der Universität München, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München
| | - O Pfaar
- Zentrum für Rhinologie und Allergologie, Wiesbaden.,HNO-Universitätsklinik Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
| | - K F Rabe
- LungenClinic Grosshansdorf GmbH, Abteilung für Pneumologie, Großhansdorf
| | - J Riedler
- Kardinal Schwarzenberg Klinikum, Kinder- und Jugendmedizin, Schwarzach im Pongau, Österreich
| | - T Ritz
- Southern Methodist University, Department of Psychology, Dallas, USA
| | - K Schultz
- Klinik Bad Reichenhall, Fachbereich Pneumologie, Bad Reichenhall
| | - A Schuster
- Universitätsklinikum Düsseldorf, Zentrum für Kinder- und Jugendmedizin, Düsseldorf
| | - T Spindler
- Waldburg-Zeil Kliniken, Fachkliniken Wangen, Klinik für Pädiatrische Pneumologie und Allergologie, Rehabilitationsklinik für Kinder und Jugendliche, Wangen
| | - C Taube
- Universitätsmedizin Essen, Ruhrlandklinik, Klinik für Pneumologie, Essen
| | | | - C Vogelmeier
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - A von Leupoldt
- University of Leuven, Health Psychology, Leuven, Belgien
| | - F Wantke
- Floridsdorfer Allergiezentrum, Wien, Österreich
| | - S Weise
- Atem- und Physiotherapie Solln, München
| | - J Wildhaber
- HFR Freiburg, Kantonsspital, Klinik für Pädiatrie, Freiburg, Schweiz
| | - H Worth
- Facharztzentrum Fürth, Fürth
| | - A Zacharasiewicz
- Wilhelminenspital, Lehrkrankenhaus der Medizinischen Universität Wien, Abteilung für Kinder- und Jugendheilkunde, Wien, Österreich
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8
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Greulich T, Kostikas K, Gaga M, Aalamian-Mattheis M, Patalano F, Nunez X, Pagano VA, Clemens A, Fogel R, Vogelmeier C. Indacaterol/glycopyrronium (IND/GLY) reduces the risk of clinically important deterioration (CID) in patients with moderate COPD: Results from the CRYSTAL study. Pneumologie 2018. [DOI: 10.1055/s-0037-1619342] [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: 10/28/2022]
Affiliation(s)
- T Greulich
- Schwerpunkt Pneumologie, Klinik für Innere Medizin, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | | | - M Gaga
- 7th Respiratory Medicine Department, Athens Chest Hospital Sotiria
| | | | | | | | | | | | - R Fogel
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - C Vogelmeier
- Pulmonary and Critical Care Medicine, Philipps-Universität Marburg
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9
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Greulich T, Wencker M, Chlumsky J, Vit O, Fries M, Chung T, Chapman KR, McElvaney NG, Vogelmeier C. Verträglichkeit von zwei-wöchentlichen Infusionen mit Alpha-1 Antitrypsin. Pneumologie 2018. [DOI: 10.1055/s-0037-1619360] [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: 10/28/2022]
Affiliation(s)
- T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | | | - J Chlumsky
- Thomayer Hospital, First Medical Faculty, Charles University, Department of Pulmonary Diseases, Prag
| | - O Vit
- Clinical Research and Development, CSL Behring, Bern
| | - M Fries
- Clinical Strategy and Development, CSL Behring, King of Prussia, USA
| | - T Chung
- Statistics Department, CSL Behring, King of Prussia, USA
| | - KR Chapman
- Department of Medicine, University of Toronto
| | - NG McElvaney
- Department of Respiratory Medicine, Beaumont Hospital, Royal College of Surgeons in Ireland
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
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10
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Buhl R, Bals R, Baur X, Berdel D, Criée CP, Gappa M, Gillissen A, Greulich T, Haidl P, Hamelmann E, Kardos P, Kenn K, Klimek L, Korn S, Lommatzsch M, Magnussen H, Nicolai T, Nowak D, Pfaar O, Rabe KF, Riedler J, Ritz T, Schultz K, Schuster A, Spindler T, Taube C, Taube K, Vogelmeier C, von Leupold A, Wantke F, Weise S, Wildhaber J, Worth H, Zacharasiewicz A. [Guideline for the Diagnosis and Treatment of Asthma - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology]. Pneumologie 2018; 71:e2. [PMID: 29334688 DOI: 10.1055/s-0044-100881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - R Bals
- Universitätsklinikum des Saarlandes, Klinik für Innere Medizin V, Homburg/Saar
| | - X Baur
- European Society for Environmental and Occupational Medicine, EOM, Berlin
| | | | - C-P Criée
- Evangelisches Krankenhaus Göttingen Weende, Abteilung für Pneumologie, Bovenden-Lenglern
| | - M Gappa
- Marien-Hospital gGmbH, Klinik für Kinder- und Jugendmedizin, Wesel
| | - A Gillissen
- Klinikum Am Steinenberg, Ermstalklinik, Medizinische Klinik III/Innere Medizin und Pneumologie, Reutlingen-Bad Urach
| | - T Greulich
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - P Haidl
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie II, Schmallenberg
| | - E Hamelmann
- Evangelisches Klinikum Bethel, Klinik für Kinder- und Jugendmedizin, Bielefeld
| | - P Kardos
- Lungenpraxis an der Klinik Maingau vom Roten Kreuz, Frankfurt am Main
| | - K Kenn
- Schön Klinik Berchtesgadener Land, Fachzentrum für Pneumologie, Schönau am Königssee, Philipps Universität Marburg, Standort Schönau
| | - L Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden
| | - S Korn
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - M Lommatzsch
- Universitätsmedizin Rostock, Abteilung Pneumologie, Rostock
| | - H Magnussen
- Pneumologisches Forschungsinstitut an der LungenClinic Grosshansdorf GmbH, Großhansdorf
| | - T Nicolai
- Klinikum der Universität München, Kinderklinik und Kinderpoliklinik, LMU München
| | - D Nowak
- Klinikum der Universität München, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München
| | - O Pfaar
- Zentrum für Rhinologie und Allergologie, Wiesbaden.,HNO-Universitätsklinik Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
| | - K F Rabe
- LungenClinic Grosshansdorf GmbH, Abteilung für Pneumologie, Großhansdorf
| | - J Riedler
- Kardinal Schwarzenberg Klinikum, Kinder- und Jugendmedizin, Schwarzach im Pongau, Österreich
| | - T Ritz
- Southern Methodist University, Department of Psychology, Dallas, USA
| | - K Schultz
- Klinik Bad Reichenhall, Fachbereich Pneumologie, Bad Reichenhall
| | - A Schuster
- Universitätsklinikum Düsseldorf, Zentrum für Kinder- und Jugendmedizin, Düsseldorf
| | - T Spindler
- Waldburg-Zeil Kliniken, Fachkliniken Wangen, Klinik für Pädiatrische Pneumologie und Allergologie, Rehabilitationsklinik für Kinder und Jugendliche, Wangen
| | - C Taube
- Universitätsmedizin Essen, Ruhrlandklinik, Klinik für Pneumologie, Essen
| | | | - C Vogelmeier
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - A von Leupold
- University of Leuven, Health Psychology, Leuven, Belgien
| | - F Wantke
- Floridsdorfer Allergiezentrum, Wien, Österreich
| | - S Weise
- Atem- und Physiotherapie Solln, München
| | - J Wildhaber
- HFR Freiburg, Kantonsspital, Klinik für Pädiatrie, Freiburg, Schweiz
| | - H Worth
- Facharztzentrum Fürth, Fürth
| | - A Zacharasiewicz
- Wilhelminenspital, Lehrkrankenhaus der Medizinischen Universität Wien, Abteilung für Kinder- und Jugendheilkunde, Wien, Österreich
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11
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Buhl R, Bals R, Baur X, Berdel D, Criée CP, Gappa M, Gillissen A, Greulich T, Haidl P, Hamelmann E, Kardos P, Kenn K, Klimek L, Korn S, Lommatzsch M, Magnussen H, Nicolai T, Nowak D, Pfaar O, Rabe KF, Riedler J, Ritz T, Schultz K, Schuster A, Spindler T, Taube C, Taube K, Vogelmeier C, von Leupoldt A, Wantke F, Weise S, Wildhaber J, Worth H, Zacharasiewicz A. [Guideline for the Diagnosis and Treatment of Asthma - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology]. Pneumologie 2017; 71:849-919. [PMID: 29216678 DOI: 10.1055/s-0043-119504] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present guideline is a new version and an update of the guideline for the diagnosis and treatment of asthma, which replaces the previous version for german speaking countries from the year 2006. The wealth of new data on the pathophysiology and the phenotypes of asthma, and the expanded spectrum of diagnostic and therapeutic options necessitated a new version and an update. This guideline presents the current, evidence-based recommendations for the diagnosis and treatment of asthma, for children and adolescents as well as for adults with asthma.
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Affiliation(s)
| | | | | | - R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - R Bals
- Universitätsklinikum des Saarlandes, Klinik für Innere Medizin V, Homburg/Saar
| | - X Baur
- European Society for Environmental and Occupational Medicine, EOM, Berlin
| | | | - C-P Criée
- Evangelisches Krankenhaus Göttingen Weende, Abteilung für Pneumologie, Bovenden-Lenglern
| | - M Gappa
- Marien-Hospital gGmbH, Klinik für Kinder- und Jugendmedizin, Wesel
| | - A Gillissen
- Klinikum Am Steinenberg, Ermstalklinik, Medizinische Klinik III/Innere Medizin und Pneumologie, Reutlingen-Bad Urach
| | - T Greulich
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - P Haidl
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie II, Schmallenberg
| | - E Hamelmann
- Evangelisches Klinikum Bethel, Klinik für Kinder- und Jugendmedizin, Bielefeld
| | - P Kardos
- Lungenpraxis an der Klinik Maingau vom Roten Kreuz, Frankfurt am Main
| | - K Kenn
- Schön Klinik Berchtesgadener Land, Fachzentrum für Pneumologie, Schönau am Königssee, Philipps Universität Marburg, Standort Schönau
| | - L Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden
| | - S Korn
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Schwerpunkt Pneumologie, III. Medizinische Klinik, Mainz
| | - M Lommatzsch
- Universitätsmedizin Rostock, Abteilung Pneumologie, Rostock
| | - H Magnussen
- Pneumologisches Forschungsinstitut an der LungenClinic Grosshansdorf GmbH, Großhansdorf
| | - T Nicolai
- Klinikum der Universität München, Kinderklinik und Kinderpoliklinik, LMU München
| | - D Nowak
- Klinikum der Universität München, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München
| | - O Pfaar
- Zentrum für Rhinologie und Allergologie, Wiesbaden.,HNO-Universitätsklinik Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
| | - K F Rabe
- LungenClinic Grosshansdorf GmbH, Abteilung für Pneumologie, Großhansdorf
| | - J Riedler
- Kardinal Schwarzenberg Klinikum, Kinder- und Jugendmedizin, Schwarzach im Pongau, Österreich
| | - T Ritz
- Southern Methodist University, Department of Psychology, Dallas, USA
| | - K Schultz
- Klinik Bad Reichenhall, Fachbereich Pneumologie, Bad Reichenhall
| | - A Schuster
- Universitätsklinikum Düsseldorf, Zentrum für Kinder- und Jugendmedizin, Düsseldorf
| | - T Spindler
- Waldburg-Zeil Kliniken, Fachkliniken Wangen, Klinik für Pädiatrische Pneumologie und Allergologie, Rehabilitationsklinik für Kinder und Jugendliche, Wangen
| | - C Taube
- Universitätsmedizin Essen, Ruhrlandklinik, Klinik für Pneumologie, Essen
| | | | - C Vogelmeier
- Universitätsklinikum Gießen und Marburg, Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Marburg
| | - A von Leupoldt
- University of Leuven, Health Psychology, Leuven, Belgien
| | - F Wantke
- Floridsdorfer Allergiezentrum, Wien, Österreich
| | - S Weise
- Atem- und Physiotherapie Solln, München
| | - J Wildhaber
- HFR Freiburg, Kantonsspital, Klinik für Pädiatrie, Freiburg, Schweiz
| | - H Worth
- Facharztzentrum Fürth, Fürth
| | - A Zacharasiewicz
- Wilhelminenspital, Lehrkrankenhaus der Medizinischen Universität Wien, Abteilung für Kinder- und Jugendheilkunde, Wien, Österreich
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12
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Greulich T, Regner W, Branscheidt M, Herr C, Koczulla AR, Vogelmeier CF, Bals R. Altered blood levels of vitamin D, cathelicidin and parathyroid hormone in patients with sepsis-a pilot study. Anaesth Intensive Care 2017; 45:36-45. [PMID: 28072933 DOI: 10.1177/0310057x1704500106] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
It has been recognised that vitamin D (VitD) has a potential role in the regulation of inflammation and protection from infection. In a prospective clinical observational pilot study, we investigated the serum levels of 25-hydroxyvitamin-D3 (25(OH)D3), 1,25-hydroxyvitamin-D3 (1,25(OH)2D3), parathyroid hormone (PTH), and cathelicidin in intensive care unit (ICU) patients with or without systemic inflammatory response syndrome (SIRS). We included 32 patients with SIRS (septic patients), 16 ICU patients without SIRS, and 16 healthy controls. To substantiate the findings of the clinical study, we stimulated monocyte-derived macrophages with microbial patterns and analysed the impact of VitD on release of cytokines and antimicrobial activity. We found that patients with or without SIRS had relatively low levels of 25(OH)D3 and 1,25(OH)2D3. Patients with sepsis had significantly lower levels of 25(OH)D3 as compared to ICU control patients and healthy controls (10.53 ± 11.3 µg/l versus 16.46 ± 12.58 µg/l versus 24.04 ± 12.07 µg/l); the same was true for 1,25(OH)2D3. Serum levels of PTH and cathelicidin were significantly increased in sepsis patients, as compared to the other groups. In vitro, VitD significantly decreased the release of pro-inflammatory cytokines from macrophages and increased the antimicrobial activity of the cells. We concluded that patients with sepsis have significantly lower VitD levels. In vitro, VitD modulates inflammation and increases the antibacterial activity of innate immune cells. These findings suggest that VitD insufficiency is mechanistically related to increased susceptibility to SIRS and sepsis.
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Affiliation(s)
- T Greulich
- Senior Physician, Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - W Regner
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - M Branscheidt
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - C Herr
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | - A R Koczulla
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - C F Vogelmeier
- Professor, Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - R Bals
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
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13
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Greulich T, Aalamian-Mattheis M, Marin J, Castellani W, Similowski T, Ninane V, Gaga M, Lane S, Nunez X, Patalano F, Kostikas K, Vogelmeier C. Wirksamkeit und Sicherheit bei der direkten Umstellung von verschiedenen COPD-Therapien auf Glycopyrronium oder Indacaterol/Glycopyrronium bei Patienten mit moderater COPD: die CRYSTAL Studie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598305] [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: 10/20/2022]
Affiliation(s)
- T Greulich
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | | | - J Marin
- Respiratory Medicine, Hospital Universitario Miguel Servet
| | - W Castellani
- Department of Respiratory Physiopathology, Palagi Hospital
| | - T Similowski
- Respiratory Medicine and Intensive Care, Pitié – Salpêtrière Hospital
| | - V Ninane
- Chu Saint-Pierre – Service de Pneumologie
| | - M Gaga
- Athens Chest Hospital „Sotiria“
| | - S Lane
- Adelaide & Meath Hospital
| | | | | | | | - C Vogelmeier
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
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14
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Karl FM, Holle R, Bals R, Greulich T, Jörres RA, Karch A, Karrasch S, Koch A, Leidl R, Schulz H, Vogelmeier C, Wacker M. Kosten und gesundheitsbezogene Lebensqualität bei COPD-Patienten mit Alpha-1-Antitrypsin-Mangel: Ergebnisse der COSYCONET COPD-Kohorte. Pneumologie 2017. [DOI: 10.1055/s-0037-1598549] [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: 10/20/2022]
Affiliation(s)
- FM Karl
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - R Holle
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - R Bals
- Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes
| | - T Greulich
- Klinik für Innere Medizin Schwerpunkt Pneumologie, Universitätsklinikum Marburg, Universities Gießen and Marburg Lung Center (Ugmlc), Mitglied des Deutschen Zentrums für Lungenforschung
| | - RA Jörres
- Arbeits-, Sozial- und Umweltmedizin, Ludwig-Maximilians-Universität München
| | - A Karch
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - S Karrasch
- Institut für Epidemiologie I, Helmholtz Zentrum München, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - A Koch
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - R Leidl
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - H Schulz
- Institut für Epidemiologie I, Helmholtz Zentrum München, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - C Vogelmeier
- Klinik für Innere Medizin Schwerpunkt Pneumologie, Universitätsklinikum Marburg, Universities Gießen and Marburg Lung Center (Ugmlc), Mitglied des Deutschen Zentrums für Lungenforschung
| | - M Wacker
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
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15
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Bernhard N, Fähndrich S, Greulich T, Vogelmeier C, Wagenpfeil S, Seibert M, Lepper PM, Bals R. Longitudinale Analyse des Verlustes der FEV1/Jahr und DLCO/Jahr bei Alpha-1-Antitrypsin-Mangel – Auswertung des deutschen Registers. Pneumologie 2017. [DOI: 10.1055/s-0037-1598548] [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: 10/20/2022]
Affiliation(s)
- N Bernhard
- Klinik für Innere Medizin V – Pneumologie, Allergologie, Internistische Intensivmedizin und Beatmungsmedizin, Universitätsklinikum des Saarlandes
| | - S Fähndrich
- Klinik für Innere Medizin V – Pneumologie, Allergologie, Internistische Intensivmedizin und Beatmungsmedizin, Universitätsklinikum des Saarlandes
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - S Wagenpfeil
- Institut für Medizinische Biometrie, Epidemiologie und Medizinischer Informatik, Universitätsklinikum des Saarlandes
| | - M Seibert
- Klinik für Innere Medizin V – Pneumologie, Allergologie, Internistische Intensivmedizin und Beatmungsmedizin, Universitätsklinikum des Saarlandes
| | - PM Lepper
- Klinik für Innere Medizin V – Pneumologie, Allergologie, Internistische Intensivmedizin und Beatmungsmedizin, Universitätsklinikum des Saarlandes
| | - R Bals
- Klinik für Innere Medizin V – Pneumologie, Allergologie, Internistische Intensivmedizin und Beatmungsmedizin, Universitätsklinikum des Saarlandes
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16
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Hinds D, Chapman KR, Piazza P, Gibbs M, Raherison C, Gaalswyk K, Greulich T, Lin J, Adachi M, Davis K. Physician Perspectives on the Burden and Management of Asthma in Six Countries: The Global Asthma Physician Survey (GAPS). Pneumologie 2017. [DOI: 10.1055/s-0037-1598376] [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: 10/20/2022]
Affiliation(s)
- D Hinds
- Worldwide Epidemiology, GlaxoSmithKline, Collegeville, Pennsylvania
| | | | - P Piazza
- Dock Family Medical Practice, Five Dock
| | - M Gibbs
- Global Respiratory Franchise, GlaxoSmithKline, Brentford
| | | | | | | | - J Lin
- China-Japan Friendship Hospital, Beijing
| | - M Adachi
- International University of Health and Welfare, Tokyo
| | - K Davis
- Worldwide Epidemiology, GlaxoSmithKline, Collegeville, Pennsylvania
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17
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Kölpin J, Kaufhold F, Böselt T, Nell C, Herth FJF, Vogelmeier C, Alter P, Kähler CM, Veith M, Greulich T, Spielmanns M, Kenn K, Kreuter M, Koczulla AR. Drei-Center Studie (DZL) zur Untersuchung von Trainingstherapieauswirkungen eines dreimonatigen Ganzkörpervibrationstrainings bei Patienten mit Lungenfibrose auf Muskelkraft, Lungenfunktion, gesundheitsbezogene Lebensqualität und Inflammationsmarker. Pneumologie 2017. [DOI: 10.1055/s-0037-1598477] [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: 10/20/2022]
Affiliation(s)
- J Kölpin
- Pneumologie, Philipps Universität Marburg
| | - F Kaufhold
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C Nell
- Pneumologie, Philipps Universität Marburg
| | - FJF Herth
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - P Alter
- Pneumologie, Philipps Universität Marburg
| | | | - M Veith
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
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18
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Jimenez Siebert M, Böselt T, Greulich T, Alter P, Herth FJF, Kahn N, Bornitz F, Vogelmeier C, Nell C, Kähler CJ, Hummler S, Koczulla AR. Effects of a 6 week whole-body vibration training (WBVT) in stable COPD patients: a randomized clinical trial. Pneumologie 2017. [DOI: 10.1055/s-0037-1598478] [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: 10/20/2022]
Affiliation(s)
- M Jimenez Siebert
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - T Böselt
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - T Greulich
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - P Alter
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - FJF Herth
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - N Kahn
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - F Bornitz
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - C Vogelmeier
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - C Nell
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - CJ Kähler
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Fachkliniken Wangen
| | - S Hummler
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - AR Koczulla
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
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19
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Böselt T, Spielmanns M, Nell C, Storre JH, Windisch W, Magerhans L, Beutel B, Kenn K, Greulich T, Alter P, Vogelmeier C, Koczulla AR. Validity and usability of physical activity monitoring in patients with chronic obstructive pulmonary disease (COPD). Pneumologie 2017. [DOI: 10.1055/s-0037-1598310] [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: 10/20/2022]
Affiliation(s)
- T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - C Nell
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - JH Storre
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - W Windisch
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - L Magerhans
- Klinik für Innere Medizin, Schwerpunkt Nephrologie, Philipps Universität Marburg
| | - B Beutel
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - P Alter
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
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20
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Vogelmeier C, Aalamian-Mattheis M, Greulich T, Marin JM, Castellani W, Similowski T, Ninane V, Gaga M, Lane S, Nunez X, Patalano F, Clemens A, Kostikas K. S35 Efficacy and safety of the direct switch from various previous treatments to glycopyrronium or indacaterol/glycopyrronium in patients with moderate copd: the crystal study. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Böselt T, Nell C, Kehr K, Holland A, Greulich T, Kenn K, Böder J, Klapdor B, Vogelmeier C, Alter P, Koczulla R. Ganzkörpervibrationstherapie bei Intensivpatienten: eine Machbarkeits- und Sicherheitsstudie. Pneumologie 2016. [DOI: 10.1055/s-0036-1583512] [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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22
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Greulich T, Vogelmeier C, Zhong N, Mezzi K, Fogel R, Banerji D. Einmal-täglich Indacaterol/Glycopyrronium verbessert Lungenfunktion und Gesundheitsstatus versus zweimal-täglich Salmeterol/Fluticason bei symptomatischen GOLD B und GOLD D COPD Patienten: LANTERN/ILLUMINATE gepoolte Analyse. Pneumologie 2016. [DOI: 10.1055/s-0036-1572089] [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: 10/22/2022]
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23
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Greulich T, Wedzicha W, Price D, Mezzi K, Fogel R, Banerji D. Vergleich der Fixdosiskombinationen Indacaterol/Glycopyrronium (IND/GLY) und Salmeterol/Fluticason (SFC) in Bezug auf Exazerbationen unter Berücksichtigung der Baseline-Blut-Eosinophilen: eine gepoolte Analyse der LANTERN und ILLUMINATE Studien. Pneumologie 2016. [DOI: 10.1055/s-0036-1572136] [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: 10/22/2022]
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24
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Greulich T, Buhl R, Abrahams R, Grönke L, Korducki L, Flezar M, Ferguson GT. Tiotropium Plus Olodaterol Fixed-Dose Combination Therapy Provides Lung Function Benefits When Compared With Tiotropium Alone, Irrespective Of Prior Treatment With A Long-Acting Bronchodilator: Post Hoc Analyses Of Two 1-Year-Studies. Pneumologie 2016. [DOI: 10.1055/s-0036-1572054] [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: 10/22/2022]
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Böselt T, Nell C, Kehr K, Holland A, Dresel M, Greulich T, Tackenberg B, Kenn K, Boeder J, Klapdor B, Kirschbaum A, Vogelmeier C, Alter P, Koczulla R. Ganzkörper-Vibrationstherapie bei Intensivpatienten. Pneumologie 2016. [DOI: 10.1055/s-0036-1572255] [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: 10/22/2022]
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26
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Greulich T, Boeselt T, Nell C, Koepke J, Fechtel J, Franke M, Schmeck B, Haid D, Apelt S, Filipovic S, Kenn K, Janciauskiene S, Vogelmeier C, Koczulla AR. Aktive Muskelstimulation hat einen positiven Effekt auf hospitalisierte Patienten mit exazerbierter COPD. Pneumologie 2015. [DOI: 10.1055/s-0035-1548661] [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: 10/23/2022]
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27
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Schaumann A, Weber N, Greulich T, Behr J. Eine seltene Variante von Alpha-1-Antitrypsinmangel. Pneumologie 2015. [DOI: 10.1055/s-0035-1544754] [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: 10/24/2022]
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Alter P, van des Sand K, Nell C, Figiel JH, Greulich T, Vogelmeier C, Koczulla AR. Lung function in COPD is correlated with increased left ventricular wall stress in coincident heart failure. Pneumologie 2015. [DOI: 10.1055/s-0035-1544768] [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: 10/24/2022]
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Köhnlein T, Schmidt-Scherzer K, Greulich T, Bals R. [Expert statement for augmentation therapy in patients with alpha-1 antitrypsin deficiency]. Pneumologie 2014; 68:492-5. [PMID: 25006842 DOI: 10.1055/s-0034-1365802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Augmentation therapy in Alpha-1 Antitrypsin Deficiency aims to reduce the progression of lung emphysema, to reduce exacerbation frequency, and to improve quality of life. This expert statement briefly summarizes the most important treatment studies performed in patients with Alpha-1 Antitrypsin Deficiency and severe lung emphysema. Indications and contraindications for long-term intravenous augmentation therapy with human Alpha-1 Antitrypsin are derived from the available study results. Safety issues and the controversies of this topic are discussed in detail.
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Affiliation(s)
- T Köhnlein
- Klinikum St. Georg gGmbH Leipzig, Robert-Koch-Klinik
| | | | - T Greulich
- Universitätsklinikum Marburg, Klinik für Innere Medizin, Schwerpunkt Pneumologie
| | - R Bals
- Universitätsklinikum des Saarlandes, Innere Medizin V - Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Homburg/Saar
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Rembert Koczulla A, Greulich T, Nell C, Koepke J, Fechtel J, Franke M, Schmeck B, Haid D, Apelt S, Kenn K, Janciauskiene S, Vogelmeier C. Benefits of whole body vibration training in patients hospitalised for COPD exacerbations – a randomized clinical trial. Pneumologie 2014. [DOI: 10.1055/s-0034-1375920] [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: 10/25/2022]
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Alter P, Luetteken L, Nell C, Haid D, Kehr K, Greulich T, Apelt S, Langenhan K, Hohmann C, Vogelmeier CF, Koczulla AR. Exercise training leads to physiological left ventricular hypertrophy in COPD. Int J Cardiol 2014; 174:156-7. [PMID: 24726167 DOI: 10.1016/j.ijcard.2014.03.160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- P Alter
- University of Marburg, Internal Medicine, Cardiology, Germany.
| | - L Luetteken
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C Nell
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - D Haid
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - K Kehr
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - T Greulich
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - S Apelt
- University of Marburg, Physiotherapy, Germany
| | - K Langenhan
- University of Marburg, Physiotherapy, Germany
| | - C Hohmann
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C F Vogelmeier
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - A R Koczulla
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany.
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Greulich T, Hashimoto S, Nagase T, Chen H, Gallagher N, D'Andrea P, Alagappan V, Banerji D. QVA149 erzielt eine überlegene Peak-Lungenfunktion bei Patienten mit COPD. Pneumologie 2014. [DOI: 10.1055/s-0034-1368039] [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: 10/25/2022]
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Greulich T, Nell C, Kehr K, Kotke V, Wiedmann S, Herr C, Bals R, Vogelmeier C, Koczulla AR. Detektion von Patienten mit Alpha-1-Antitrypsin-Mangel in Deutschland – 10 Jahre Erfahrung. Pneumologie 2014. [DOI: 10.1055/s-0034-1367833] [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: 10/25/2022]
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Abstract
Data about the clinical presentation of chronic obstructive pulmonary disease (COPD) have resulted in a new classification of the disease. The degree of airflow limitation has been amended by symptoms and exacerbation rate. The standard pharmacotherapy of stable COPD is in transition, as fixed combinations of long acting beta agonists and long acting anticholinergics are in the late stages of clinical development. On this background inhaled corticosteroids will need to be re-evaluated. Roflumilast is a recently approved therapeutic option that primarily diminishes exacerbation frequency in patients with chronic bronchitis and severe airflow obstruction (FEV(1) < 50%). In COPD patients with acute exacerbations procalcitonin levels can be used to guide antibiotic therapy. Comparable clinical outcomes can be achieved while using significantly less amounts of antibiotics.
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Affiliation(s)
- T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Giessen und Marburg, Philipps-Universität Marburg, Deutschland.
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Koehler U, Greulich T, Gross V, Hildebrandt O, Redhardt F, Sohrabi K, Weissflog A, Koczulla R. Die akute Exazerbation der COPD. Dtsch Med Wochenschr 2013; 138:837-41. [DOI: 10.1055/s-0032-1332982] [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: 10/27/2022]
Affiliation(s)
- U. Koehler
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - T. Greulich
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - V. Gross
- SP Biomedizinische Technik, Fachbereich Krankenhaus- und Medizintechnik, Umwelt- und Biotechnologie (KMUB), Technische Hochschule Mittelhessen, Gießen
| | - O. Hildebrandt
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - F. Redhardt
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - K. Sohrabi
- Fachbereich MNI, Medizinische Informatik, Technische Hochschule Mittelhessen, Gießen
| | - A. Weissflog
- SP Biomedizinische Technik, Fachbereich Krankenhaus- und Medizintechnik, Umwelt- und Biotechnologie (KMUB), Technische Hochschule Mittelhessen, Gießen
| | - R. Koczulla
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
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37
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Knipel V, Köhnlein T, Greulich T, Windisch W. PiSMHeerlen - Seltene Variante eines Alpha1-Antitrypsin-Mangels. Pneumologie 2013. [DOI: 10.1055/s-0033-1334634] [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: 10/27/2022]
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Koepke J, Dresel M, Hattesohl A, Janciauskiene S, Greulich T, Vogelmeier C, Koczulla RA. Der kurzfristige Effekt der Alpha-1-Antitrypsin Substitutionstherapie auf die Degranulierung von neutrophilen Granulozyten. Pneumologie 2013. [DOI: 10.1055/s-0033-1334759] [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: 10/27/2022]
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Greulich T, Schürmann W, Müller S, Fechtel J, Franke M, Lütteken L, Nell C, Holland A, Bach JP, Tackenberg B, Kenn K, Vogelmeier C, Koczulla RA. Spezielle Ganzkörpervibrationstrainingstherapie zur Reduktion der Inflammation bei zwei Patienten mit Myositis. Pneumologie 2013. [DOI: 10.1055/s-0033-1334608] [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: 10/27/2022]
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Guttmann C, Fähndrich S, Herr C, Greulich T, Vogelmeier C, Lepper PM, Bals R. Geschlechtsspezifische Aspekte bei Alpha-1-Antitrypsin-Mangel. Pneumologie 2013. [DOI: 10.1055/s-0033-1334663] [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: 10/27/2022]
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Fähndrich S, Guttmann C, Herr C, Greulich T, Vogelmeier C, Lepper PM, Bals R. Epidemiologische Daten des deutschen Alpha1-Antitrypsin Registers 2012. Pneumologie 2013. [DOI: 10.1055/s-0033-1334661] [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: 10/27/2022]
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Greulich T, Korenblat PE, Hébert J, Gallagher N, Martin C, Banerji D, Lu Y. NVA237 einmal täglich verbessert die Atemnot und die gesundheitsbezogene Lebensqualität bei Patienten mit COPD: die GLOW2 Studie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334774] [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: 10/27/2022]
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Greulich T, Nell C, Wencker M, Kehr K, Kotke V, Herr C, Vogelmeier C, Bals R, Koczulla RA. Detektion von Patienten mit Alpha-1-Antitrypsin-Mangel in Deutschland - Trends im Verlauf zwischen 2003 und 2011. Pneumologie 2013. [DOI: 10.1055/s-0033-1334504] [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: 10/27/2022]
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Schmid ST, Koepke J, Dresel M, Hattesohl A, Frenzel E, Perez J, Lomas DA, Miranda E, Greulich T, Noeske S, Wencker M, Teschler H, Vogelmeier C, Janciauskiene S, Koczulla AR. The effects of weekly augmentation therapy in patients with PiZZ α1-antitrypsin deficiency. Int J Chron Obstruct Pulmon Dis 2012; 7:687-96. [PMID: 23055718 PMCID: PMC3468059 DOI: 10.2147/copd.s34560] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The major concept behind augmentation therapy with human α1-antitrypsin (AAT) is to raise the levels of AAT in patients with protease inhibitor phenotype ZZ (Glu342Lys)-inherited AAT deficiency and to protect lung tissues from proteolysis and progression of emphysema. Objective To evaluate the short-term effects of augmentation therapy (Prolastin®) on plasma levels of AAT, C-reactive protein, and chemokines/cytokines. Materials and methods Serum and exhaled breath condensate were collected from individuals with protease inhibitor phenotype ZZ AAT deficiency-related emphysema (n = 12) on the first, third, and seventh day after the infusion of intravenous Prolastin. Concentrations of total and polymeric AAT, interleukin-8 (IL-8), monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, vascular endothelial growth factor, and C-reactive protein were determined. Blood neutrophils and primary epithelial cells were also exposed to Prolastin (1 mg/mL). Results There were significant fluctuations in serum (but not in exhaled breath condensate) levels of AAT polymers, IL-8, monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, and vascular endothelial growth factor within a week of augmentation therapy. In general, augmented individuals had higher AAT and lower serum levels of IL-8 than nonaugmented subjects. Prolastin added for 3 hours to neutrophils from protease inhibitor phenotype ZZ individuals in vitro reduced IL-8 release but showed no effect on cytokine/chemokine release from human bronchial epithelial cells. Conclusion Within a week, augmentation with Prolastin induced fluctuations in serum levels of AAT polymers and cytokine/chemokines but specifically lowered IL-8 levels. It remains to be determined whether these effects are related to the Prolastin preparation per se or to the therapeutic efficacy of augmentation with AAT.
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Affiliation(s)
- S T Schmid
- Department of Internal Medicine, Division for Pulmonary Diseases, University Hospital Marburg, Marburg, Germany
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Koepke J, Dresel M, Hattesohl A, Muramatsu R, Greulich T, Vogelmeier C, Koczulla AR. Short term effects of alpha1-antitrypsin substitution therapy on the degranulation of neutrophil granulocytes. Pneumologie 2012. [DOI: 10.1055/s-0032-1315494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Koczulla AR, Greulich T, Beutel B, Vogelmeier C. Chronisch obstruktive Lungenerkrankung (COPD). Dtsch Med Wochenschr 2012; 137:1185-7. [DOI: 10.1055/s-0032-1305000] [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: 10/28/2022]
Affiliation(s)
- A.-R. Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps-Universität Marburg
| | - T. Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps-Universität Marburg
| | - B. Beutel
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps-Universität Marburg
| | - C. Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps-Universität Marburg
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Greulich T, Franke M, Fechtel J, Nell C, Kehr K, Müller S, Schubert H, Kenn K, Vogelmeier C, Koczulla RA. Aktive Muskelstimulation hat einen positiven Effekt auf hospitalisierte Patienten mit exazerbierter COPD. Pneumologie 2012. [DOI: 10.1055/s-0032-1302569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dresel M, Koepke J, Muramatsu R, Hattesohl A, Greulich T, Vogelmeier C, Koczulla RA. Auswirkungen von oxidiertem α1-Antitrypsin auf neutrophile Granulozyten und humanes Lungenepithel. Pneumologie 2012. [DOI: 10.1055/s-0032-1302595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Koepke J, Dresel M, Hattesohl A, Greulich T, Vogelmeier C, Koczulla RA. Einfluss von Alpha 1-Antitrypsin auf die Ausbildung von NET-Strukturen bei Alpha-1-Antitrypsinmangelpatienten. Pneumologie 2012. [DOI: 10.1055/s-0032-1302721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Greulich T, Nell C, Kehr K, Kotke V, Wiedmann S, Herr C, Vogelmeier C, Bals R, Koczulla RA. Detektion von Patienten mit Alpha-1 Antitrypsin-Mangel in Deutschland – Update 2011. Pneumologie 2012. [DOI: 10.1055/s-0032-1302848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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