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Girndt M, Fiedler R, Martus P, Pawlak M, Storr M, Bohler T, Glomb MA, Liehr K, Henning C, Templin M, Trojanowicz B, Ulrich C, Werner K, Zickler D, Schindler R. High cut-off dialysis in chronic haemodialysis patients. Eur J Clin Invest 2015; 45:1333-40. [PMID: 26519693 DOI: 10.1111/eci.12559] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/26/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Haemodialysis patients suffer from chronic systemic inflammation and high incidence of cardiovascular disease. One cause for this may be the failure of diseased kidneys to eliminate immune mediators. Current haemodialysis treatment achieves insufficient elimination of proteins in the molecular weight range 15-45 kD. Thus, high cut-off dialysis might improve the inflammatory state. DESIGN In this randomized crossover trial, 43 haemodialysis patients were treated for 3 weeks with high cut-off or high-flux dialysis. Inflammatory plasma mediators, monocyte subpopulation distribution and leucocyte gene expression were quantified. RESULTS High cut-off dialysis supplemented by a low-flux filter did not influence the primary end-point, expression density of CD162 on monocytes. Nevertheless, treatment reduced multiple immune mediators in plasma. Such reduction proved - at least for some markers - to be a sustained effect over the interdialytic interval. Thus, for example, soluble TNF-receptor 1 concentration predialysis was reduced from median 13·3 (IQR 8·9-17·2) to 9·7 (IQR 7·5-13·2) ng/mL with high cut-off while remaining constant with high-flux treatment. The expression profile of multiple proinflammatory genes in leucocytes was significantly dampened. Treatment was well tolerated although albumin losses in high cut-off dialysis would be prohibitive against long-term use. CONCLUSIONS The study shows for the first time that a dampening effect of high cut-off dialysis on systemic inflammation is achievable. Earlier studies had failed due to short study duration or insufficient dialysis efficacy. Removal of soluble mediators from the circulation influences cellular activation levels in leucocytes. Continued development of less albumin leaky membranes with similar cytokine elimination is justified.
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Affiliation(s)
- Matthias Girndt
- Department of Internal Medicine II, Martin-Luther-University Halle, Halle, Germany
| | - Roman Fiedler
- Department of Internal Medicine II, Martin-Luther-University Halle, Halle, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
| | | | - Markus Storr
- Department of Research and Development, Gambro Dialysatoren GmbH, Hechingen, Germany
| | - Torsten Bohler
- Department of Research and Development, Gambro Dialysatoren GmbH, Hechingen, Germany
| | - Marcus A Glomb
- Institute for Chemistry, Food Chemistry, Martin-Luther-University Halle, Halle, Germany
| | - Kristin Liehr
- Institute for Chemistry, Food Chemistry, Martin-Luther-University Halle, Halle, Germany
| | - Christian Henning
- Institute for Chemistry, Food Chemistry, Martin-Luther-University Halle, Halle, Germany
| | | | - Bogusz Trojanowicz
- Department of Internal Medicine II, Martin-Luther-University Halle, Halle, Germany
| | - Christof Ulrich
- Department of Internal Medicine II, Martin-Luther-University Halle, Halle, Germany
| | - Kristin Werner
- Department of Research and Development, Gambro Dialysatoren GmbH, Hechingen, Germany
| | - Daniel Zickler
- Department of Nephrology and Internal Intensive Care Medicine, Charité-Universitaetsmedizin Berlin, Campus Virchow Clinic, Berlin, Germany
| | - Ralf Schindler
- Department of Nephrology and Internal Intensive Care Medicine, Charité-Universitaetsmedizin Berlin, Campus Virchow Clinic, Berlin, Germany
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Pchejetski D, Bohler T, Brizuela L, Sauer L, Doumerc N, Golzio M, Salunkhe V, Teissié J, Malavaud B, Waxman J, Cuvillier O. FTY720 (fingolimod) sensitizes prostate cancer cells to radiotherapy by inhibition of sphingosine kinase-1. Cancer Res 2010; 70:8651-61. [PMID: 20959468 DOI: 10.1158/0008-5472.can-10-1388] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Radiotherapy is widely used as a radical treatment for prostate cancer, but curative treatments are elusive for poorly differentiated tumors where survival is just 15% at 15 years. Dose escalation improves local response rates but is limited by tolerance in normal tissues. A sphingosine analogue, FTY720 (fingolimod), a drug currently in phase III studies for treatment of multiple sclerosis, has been found to be a potent apoptosis inducer in prostate cancer cells. Using in vitro and in vivo approaches, we analyzed the impact of FTY720 on sphingolipid metabolism in hormone-refractory metastatic prostate cancer cells and evaluated its potential as a radiosensitizer on cell lines and prostate tumor xenografts. In prostate cancer cell lines, FTY720 acted as a sphingosine kinase 1 (SphK1) inhibitor that induced prostate cancer cell apoptosis in a manner independent of sphingosine-1-phosphate receptors. In contrast, γ irradiation did not affect SphK1 activity in prostate cancer cells yet synergized with FTY720 to inhibit SphK1. In mice bearing orthotopic or s.c. prostate cancer tumors, we show that FTY720 dramatically increased radiotherapeutic sensitivity, reducing tumor growth and metastasis without toxic side effects. Our findings suggest that low, well-tolerated doses of FTY720 could offer significant improvement to the clinical treatment of prostate cancer.
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Affiliation(s)
- Dmitri Pchejetski
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
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Pshezhetskiy D, Bohler T, Doumerc N, Golzio M, Brinkmann V, Waxman J, Malavaud B, Cuvillier O. Immunosuppressive drug FTY720 sensitizes prostate cancer cells to radiotherapy by inhibition of sphingosine kinase‐1. FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.805.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Galvani S, Auge N, Calise D, Thiers JC, Canivet C, Kamar N, Rostaing L, Abbal M, Le Bouteiller P, Salvayre R, Bohler T, Stastny P, Negre-Salvayre A, Thomsen M. 43-OR: Antibodies towards HLA class I antigens provoke graft arteriosclerosis. Hum Immunol 2007. [DOI: 10.1016/j.humimm.2007.08.238] [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: 12/01/2022]
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Bohler T, Wagner S, Seiberth V, Linderkamp O. Blood rheology and retinopathy in premature infants with very low birth weight. Clin Hemorheol Microcirc 1995. [DOI: 10.3233/ch-1995-15303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- T. Bohler
- Department of Neonatology, Children's Hospital at Mannheim, University of Heidelberg im Neuenheimer Feld 150, 69120 Heidelberg, Germany
| | - S. Wagner
- Department of Neonatology, Children's Hospital at Mannheim, University of Heidelberg im Neuenheimer Feld 150, 69120 Heidelberg, Germany
| | - V. Seiberth
- Department of Ophthalmology at Mannheim, University of Heidelberg im Neuenheimer Feld 150, 69120 Heidelberg, Germany
| | - O. Linderkamp
- Department of Neonatology, Children's Hospital at Mannheim, University of Heidelberg im Neuenheimer Feld 150, 69120 Heidelberg, Germany
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