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Hummel S, Rosenberger S, von dem Berge T, Besser REJ, Casteels K, Hommel A, Kordonouri O, Elding Larsson H, Lundgren M, Marcus BA, Oltarzewski M, Rochtus A, Szypowska A, Todd JA, Weiss A, Winkler C, Bonifacio E, Ziegler AG. Early-childhood body mass index and its association with the COVID-19 pandemic, containment measures and islet autoimmunity in children with increased risk for type 1 diabetes. Diabetologia 2024; 67:670-678. [PMID: 38214711 PMCID: PMC10904508 DOI: 10.1007/s00125-023-06079-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/14/2023] [Indexed: 01/13/2024]
Abstract
AIMS/HYPOTHESIS The aim of this study was to determine whether BMI in early childhood was affected by the COVID-19 pandemic and containment measures, and whether it was associated with the risk for islet autoimmunity. METHODS Between February 2018 and May 2023, data on BMI and islet autoimmunity were collected from 1050 children enrolled in the Primary Oral Insulin Trial, aged from 4.0 months to 5.5 years of age. The start of the COVID-19 pandemic was defined as 18 March 2020, and a stringency index was used to assess the stringency of containment measures. Islet autoimmunity was defined as either the development of persistent confirmed multiple islet autoantibodies, or the development of one or more islet autoantibodies and type 1 diabetes. Multivariate linear mixed-effect, linear and logistic regression methods were applied to assess the effect of the COVID-19 pandemic and the stringency index on early-childhood BMI measurements (BMI as a time-varying variable, BMI at 9 months of age and overweight risk at 9 months of age), and Cox proportional hazard models were used to assess the effect of BMI measurements on islet autoimmunity risk. RESULTS The COVID-19 pandemic was associated with increased time-varying BMI (β = 0.39; 95% CI 0.30, 0.47) and overweight risk at 9 months (β = 0.44; 95% CI 0.03, 0.84). During the COVID-19 pandemic, a higher stringency index was positively associated with time-varying BMI (β = 0.02; 95% CI 0.00, 0.04 per 10 units increase), BMI at 9 months (β = 0.13; 95% CI 0.01, 0.25) and overweight risk at 9 months (β = 0.23; 95% CI 0.03, 0.43). A higher age-corrected BMI and overweight risk at 9 months were associated with increased risk for developing islet autoimmunity up to 5.5 years of age (HR 1.16; 95% CI 1.01, 1.32 and HR 1.68, 95% CI 1.00, 2.82, respectively). CONCLUSIONS/INTERPRETATION Early-childhood BMI increased during the COVID-19 pandemic, and was influenced by the level of restrictions during the pandemic. Controlling for the COVID-19 pandemic, elevated BMI during early childhood was associated with increased risk for childhood islet autoimmunity in children with genetic susceptibility to type 1 diabetes.
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Affiliation(s)
- Sandra Hummel
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany.
- School of Medicine, Forschergruppe Diabetes at Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
| | - Sarah Rosenberger
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität München, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | | | - Rachel E J Besser
- Centre for Human Genetics, JDRF/Wellcome Diabetes and Inflammation Laboratory, Nuffield Department of Medicine, NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Kristina Casteels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Angela Hommel
- Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Olga Kordonouri
- Kinder- und Jugendkrankenhaus auf der Bult, Hannover, Germany
| | - Helena Elding Larsson
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Paediatrics, Skane University Hospital, Malmö/Lund, Sweden
| | - Markus Lundgren
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden
| | - Benjamin A Marcus
- School of Medicine, Forschergruppe Diabetes at Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Mariusz Oltarzewski
- Department of Paediatric Diabetology and Paediatrics, The Children's Clinical Hospital Józef Polikarp Brudziński, Warsaw, Poland
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Anne Rochtus
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Agnieszka Szypowska
- Department of Paediatric Diabetology and Paediatrics, The Children's Clinical Hospital Józef Polikarp Brudziński, Warsaw, Poland
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - John A Todd
- Centre for Human Genetics, JDRF/Wellcome Diabetes and Inflammation Laboratory, Nuffield Department of Medicine, NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Andreas Weiss
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany
| | - Ezio Bonifacio
- Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Anette-G Ziegler
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany
- School of Medicine, Forschergruppe Diabetes at Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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Jacobs A, Warnants M, Vollmuth V, Winkler C, Weiss A, Ziegler AG, Lundgren M, Elding Larsson H, Kordonouri O, von dem Berge T, Zielmann ML, Bonifacio E, Hommel A, Ołtarzewski M, Szypowska A, Besser R, Todd JA, Casteels K. Vitamin D insufficiency in infants with increased risk of developing type 1 diabetes: a secondary analysis of the POInT Study. BMJ Paediatr Open 2024; 8:e002212. [PMID: 38216311 PMCID: PMC10806504 DOI: 10.1136/bmjpo-2023-002212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/07/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Vitamin D insufficiency (VDI) may be a factor in the development of type 1 diabetes (T1D). The aim of this study is to investigate the presence and persistence of VDI in a large cohort of infants with increased risk of developing T1D, in light of the differences in local supplementation guidelines. METHODS In the POInT Study, a multicentre primary prevention study between February 2018 and March 2021 in Germany, Poland, Belgium, England and Sweden, including infants aged 4-7 months at high genetic risk of developing β-cell autoantibodies, vitamin D levels were analysed at each study visit from inclusion (4-7 months) until 3 years, with an interval of 2 months (first three visits) or 4-6 months (visits 4-8). The protocol actively promotes vitamin D sufficiency to optimise immune tolerance. VDI was defined as a concentration below 30 ng/mL and was treated according to local guidelines of participating centres. Recovery from VDI was defined as a concentration above or equal to 30 ng/mL on the subsequent visit after VDI. RESULTS 1050 infants were included, of which 5937 vitamin D levels were available for analyses. VDI was observed in 1464 (24.7%) visits and 507 (46.1%) of these were not resolved at the next visit. The risk of having VDI was independently associated with season (higher in winter), weight (higher with increased weight), age (higher with increased age) and country (higher in England). The risk of not recovering from VDI was independently associated with the season of the previously determined VDI, which was higher if VDI was identified in winter. CONCLUSIONS VDI is frequent in infants with increased risk of developing T1D. Treatment guidelines for VDI do not seem effective. Increasing supplementation dosages in this patient population seems warranted, especially during winter, and increasing dosages more aggressively after VDI should be considered.
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Affiliation(s)
- An Jacobs
- Department of Pediatric Endocrinology and Diabetes, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | | | - Veronika Vollmuth
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Andreas Weiss
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
| | - Anette-Gabriele Ziegler
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
- Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Markus Lundgren
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden
| | - Helena Elding Larsson
- Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | | | | | - Marie-Luise Zielmann
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ezio Bonifacio
- Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
| | - Angela Hommel
- Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
| | - Mariusz Ołtarzewski
- Department of Screening and Metabolic Diagnostics, Institute of Mother and Child, Warsaw, Poland
| | | | - Rachel Besser
- Department of Paediatrics, University of Oxford, Oxford, UK
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - John A Todd
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Kristina Casteels
- Department of Pediatric Endocrinology and Diabetes, KU Leuven University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Affiliation(s)
- Josephine Schneider
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Gita Gemulla
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Center for Regenerative Therapies Dresden, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
- Center for Pediatric Research, University of Leipzig, Leipzig, Germany
| | - Reinhard Berner
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Angela Hommel
- Center for Regenerative Therapies Dresden, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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Houben J, Janssens M, Winkler C, Besser REJ, Dzygalo K, Fehn A, Hommel A, Lange K, Elding Larsson H, Lundgren M, Roloff F, Snape M, Szypowska A, Weiss A, Zapardiel-Gonzalo J, Zubizarreta N, Ziegler AG, Casteels K, Arnolds S, Bißbort M, Blasius K, Friedl N, Gezginci C, Göppel G, Heigermoser M, Höfelschweiger B, Jolink M, Kisfügedi K, Klein N, Lickert R, Matzke C, Alvarez KM, Niewöhner R, Scholz M, Schütte‐Borkovec K, Voß F, Weiß A, Gonzalo JMZ, Schmidt S, Sifft P, Kapfelsberger H, Vurucu M, Sarcletti K, Sporreiter M, Jacobson S, Zeller I, Warncke K, Bonifacio E, Lernmark Å, Todd JA, Achenbach P, Bonficio E, Larsson HE, Ziegler AG, Achenbach P, Schütte‐Borkovec K, Ziegler AG, Casteels K, Jannsen C, Rochtus A, Jacobs A, Morobé H, Paulus J, Vrancken B, Van den Driessche N, Van Heyste R, Houben J, Smets L, Vanhuyse V, Bonifacio E, Berner R, Arabi S, Blechschmidt R, Dietz S, Gemulla G, Gholizadeh Z, Heinke S, Hoffmann R, Hommel A, Lange F, Loff A, Morgenstern R, Ehrlich F, Loff A, Weigelt M, Zubizarreta N, Kordonouri O, Danne T, Galuschka L, Holtkamp U, Janzen N, Kruse C, Landsberg S, Lange K, Marquardt E, Reschke F, Roloff F, Semler K, von dem Berge T, Weiskorn J, Ziegler AG, Achenbach P, Bunk M, Färber‐Meisterjahn S, Grätz W, Greif I, Herbst M, Hofelich A, Kaiser M, Kaltenecker H, Karapinar E, Kölln A, Marcus B, Munzinger A, Ohli J, Ramminger C, Reinmüller F, Vollmuth V, Welzhofer T, Winkler C, Szypowska A, Ołtarzewski M, Dybkowska S, Dżygało K, Groele L, Kajak K, Owczarek D, Piechowiak K, Popko K, Skrobot A, Szpakowski R, Taczanowska A, Zduńczyk B, Zych A, Larsson HE, Lundgren M, Lernmark Å, Agardh D, Mortin SA, Aronsson CA, Bennet R, Brundin C, Dahlberg S, Fransson L, Jonsdottir B, Jönsson I, Maroufkhani S, Mestan Z, Nilsson C, Ramelius A, Amboh ET, Törn C, Ulvendag U, Way S, Snape M, Todd JA, Haddock G, Bendor‐Samuel O, Bland J, Choi E, Craik R, Davis K, Hawkins S, de la Horra A, Farooq Y, Scudder C, Smith I, Roseman F, Robinson H, Taj N, Vatish M, Willis L, Whelan C, Wishlade T. The emotional well-being of parents with children at genetic risk for type 1 diabetes before and during participation in the POInT-study. Pediatr Diabetes 2022; 23:1707-1716. [PMID: 36323590 DOI: 10.1111/pedi.13448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION This study examined the emotional impact that parents experience when confronted with an increased genetic risk of type 1 diabetes (T1D) in their child. Population-based screening of neonates for genetic risk of chronic disease carries the risk of increased emotional burden for parents. METHODS Information was collected using a well-being questionnaire for parents of infants identified as having an increased risk for T1D in a multinational research study. Parents were asked to complete this questionnaire after they were told their child had an increased risk for T1D (Freder1k-study) and at several time points during an intervention study (POInT-study), where oral insulin was administered daily. RESULTS Data were collected from 2595 parents of 1371 children across five countries. Panic-related anxiety symptoms were reported by only 4.9% after hearing about their child having an increased risk. Symptoms of depression were limited to 19.4% of the parents at the result-communication visit and declined over time during the intervention study. When thinking about their child's risk for developing T1D (disease-specific anxiety), 47.2% worried, felt nervous and tense. Mothers and parents with a first-degree relative (FDR) with T1D reported more symptoms of depression and disease-specific anxiety (p < 0.001) than fathers and parents without a FDR. CONCLUSION Overall, symptoms of depression and panic-related anxiety are comparable with the German population. When asked about their child's risk for T1D during the intervention study, some parents reported disease-specific anxiety, which should be kept in mind when considering population-based screening. As certain subgroups are more prone, it will be important to continue psychological screening and, when necessary, to provide support by an experienced, multidisciplinary team.
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Affiliation(s)
- Janne Houben
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Martha Janssens
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Rachel Elizabeth Jane Besser
- Department of pediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Katarzyna Dzygalo
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Annika Fehn
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Angela Hommel
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Helena Elding Larsson
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Markus Lundgren
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of pediatrics, Kristianstad Hospital, Kristianstad, Sweden
| | - Frank Roloff
- Diabetes Center for Children and Adolescents, Children's Hospital AUF DER BULT, Hannover, Germany
| | - Matthew Snape
- Department of pediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Andreas Weiss
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Jose Zapardiel-Gonzalo
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Nicole Zubizarreta
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anette-Gabriele Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.,Forschergruppe Diabetes, Technische University Munich, Munich, Germany
| | - Kristina Casteels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Warncke K, Weiss A, Achenbach P, von dem Berge T, Berner R, Casteels K, Groele L, Hatzikotoulas K, Hommel A, Kordonouri O, Elding Larsson H, Lundgren M, Marcus BA, Snape MD, Szypowska A, Todd JA, Bonifacio E, Ziegler AG. Elevations in blood glucose before and after the appearance of islet autoantibodies in children. J Clin Invest 2022; 132:e162123. [PMID: 36250461 PMCID: PMC9566912 DOI: 10.1172/jci162123] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/16/2022] [Indexed: 01/07/2023] Open
Abstract
The etiology of type 1 diabetes has polygenic and environmental determinants that lead to autoimmune responses against pancreatic β cells and promote β cell death. The autoimmunity is considered silent without metabolic consequences until late preclinical stages,and it remains unknown how early in the disease process the pancreatic β cell is compromised. To address this, we investigated preprandial nonfasting and postprandial blood glucose concentrations and islet autoantibody development in 1,050 children with high genetic risk of type 1 diabetes. Pre- and postprandial blood glucose decreased between 4 and 18 months of age and gradually increased until the final measurements at 3.6 years of age. Determinants of blood glucose trajectories in the first year of life included sex, body mass index, glucose-related genetic risk scores, and the type 1 diabetes-susceptible INS gene. Children who developed islet autoantibodies had early elevations in blood glucose concentrations. A sharp and sustained rise in postprandial blood glucose was observed at around 2 months prior to autoantibody seroconversion, with further increases in postprandial and, subsequently, preprandial values after seroconversion. These findings show heterogeneity in blood glucose control in infancy and early childhood and suggest that islet autoimmunity is concurrent or subsequent to insults on the pancreatic islets.
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Affiliation(s)
- Katharina Warncke
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
- Department of Pediatrics, Kinderklinik München Schwabing, School of Medicine, Technical University Munich, Munich, Germany
| | - Andreas Weiss
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
| | - Peter Achenbach
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
- Forschergruppe Diabetes, School of Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
| | | | - Reinhard Berner
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kristina Casteels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Lidia Groele
- Department of Paediatrics, The Children’s Clinical Hospital Józef Polikarp Brudziński, Warsaw, Poland
| | - Konstantinos Hatzikotoulas
- Institute of Translational Genomics, Helmholtz Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Angela Hommel
- Technische Universität Dresden, Center for Regenerative Therapies Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Germany
| | - Olga Kordonouri
- Kinder- und Jugendkrankenhaus auf der Bult, Hannover, Germany
| | - Helena Elding Larsson
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Paediatrics, Skåne University Hospital, Malmö, Sweden
| | - Markus Lundgren
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden
| | - Benjamin A. Marcus
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
- Forschergruppe Diabetes, School of Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Matthew D. Snape
- Oxford Vaccine Group, University of Oxford Department of Paediatrics, and NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | | | - John A. Todd
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Ezio Bonifacio
- Technische Universität Dresden, Center for Regenerative Therapies Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Germany
| | - Anette-G. Ziegler
- Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany
- Forschergruppe Diabetes, School of Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
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Heinke S, Hommel A, Loff A, Berner R, Bonifacio E. The Willingness to Participate in Pediatric Type 1 Diabetes Studies. Dtsch Arztebl Int 2022; 119:488-489. [PMID: 36342093 PMCID: PMC9664987 DOI: 10.3238/arztebl.m2022.0171] [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] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/04/2021] [Accepted: 03/22/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Sophie Heinke
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden,
| | - Angela Hommel
- Center for Regenerative Therapies (CRTD), Technische Universität Dresden
| | - Anja Loff
- Center for Regenerative Therapies (CRTD), Technische Universität Dresden
| | - Reinhard Berner
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden,
| | - Ezio Bonifacio
- Center for Regenerative Therapies (CRTD), Technische Universität Dresden
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Watts D, Janßen M, Jaykar M, Palmucci F, Weigelt M, Petzold C, Hommel A, Sparwasser T, Bonifacio E, Kretschmer K. Transient Depletion of Foxp3 + Regulatory T Cells Selectively Promotes Aggressive β Cell Autoimmunity in Genetically Susceptible DEREG Mice. Front Immunol 2021; 12:720133. [PMID: 34447385 PMCID: PMC8382961 DOI: 10.3389/fimmu.2021.720133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/12/2021] [Indexed: 01/10/2023] Open
Abstract
Type 1 diabetes (T1D) represents a hallmark of the fatal multiorgan autoimmune syndrome affecting humans with abrogated Foxp3+ regulatory T (Treg) cell function due to Foxp3 gene mutations, but whether the loss of Foxp3+ Treg cell activity is indeed sufficient to promote β cell autoimmunity requires further scrutiny. As opposed to human Treg cell deficiency, β cell autoimmunity has not been observed in non-autoimmune-prone mice with constitutive Foxp3 deficiency or after diphtheria toxin receptor (DTR)-mediated ablation of Foxp3+ Treg cells. In the spontaneous nonobese diabetic (NOD) mouse model of T1D, constitutive Foxp3 deficiency did not result in invasive insulitis and hyperglycemia, and previous studies on Foxp3+ Treg cell ablation focused on Foxp3DTR NOD mice, in which expression of a transgenic BDC2.5 T cell receptor (TCR) restricted the CD4+ TCR repertoire to a single diabetogenic specificity. Here we revisited the effect of acute Foxp3+ Treg cell ablation on β cell autoimmunity in NOD mice in the context of a polyclonal TCR repertoire. For this, we took advantage of the well-established DTR/GFP transgene of DEREG mice, which allows for specific ablation of Foxp3+ Treg cells without promoting catastrophic autoimmune diseases. We show that the transient loss of Foxp3+ Treg cells in prediabetic NOD.DEREG mice is sufficient to precipitate severe insulitis and persistent hyperglycemia within 5 days after DT administration. Importantly, DT-treated NOD.DEREG mice preserved many clinical features of spontaneous diabetes progression in the NOD model, including a prominent role of diabetogenic CD8+ T cells in terminal β cell destruction. Despite the severity of destructive β cell autoimmunity, anti-CD3 mAb therapy of DT-treated mice interfered with the progression to overt diabetes, indicating that the novel NOD.DEREG model can be exploited for preclinical studies on T1D under experimental conditions of synchronized, advanced β cell autoimmunity. Overall, our studies highlight the continuous requirement of Foxp3+ Treg cell activity for the control of genetically pre-installed autoimmune diabetes.
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Affiliation(s)
- Deepika Watts
- Molecular and Cellular Immunology/Immune Regulation, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany.,Paul Langerhans Institute Dresden (PLID) of the Helmholtz Zentrum München at the University Hospital and Medical Faculty Carl Gustav Carus of TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Marthe Janßen
- Molecular and Cellular Immunology/Immune Regulation, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany.,Paul Langerhans Institute Dresden (PLID) of the Helmholtz Zentrum München at the University Hospital and Medical Faculty Carl Gustav Carus of TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Mangesh Jaykar
- Molecular and Cellular Immunology/Immune Regulation, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany
| | - Francesco Palmucci
- Molecular and Cellular Immunology/Immune Regulation, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany.,Paul Langerhans Institute Dresden (PLID) of the Helmholtz Zentrum München at the University Hospital and Medical Faculty Carl Gustav Carus of TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Marc Weigelt
- Regenerative Therapies for Diabetes, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany
| | - Cathleen Petzold
- Molecular and Cellular Immunology/Immune Regulation, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany
| | - Angela Hommel
- Regenerative Therapies for Diabetes, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany
| | - Tim Sparwasser
- Institute of Infection Immunology, TWINCORE/Centre for Experimental and Clinical Infection Research, Hanover, Germany
| | - Ezio Bonifacio
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Zentrum München at the University Hospital and Medical Faculty Carl Gustav Carus of TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Regenerative Therapies for Diabetes, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany
| | - Karsten Kretschmer
- Molecular and Cellular Immunology/Immune Regulation, Center for Regenerative Therapies Dresden (CRTD), Center for Molecular and Cellular Bioengineering (CMCB), Technische Universität Dresden, Dresden, Germany.,Paul Langerhans Institute Dresden (PLID) of the Helmholtz Zentrum München at the University Hospital and Medical Faculty Carl Gustav Carus of TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
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8
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Bergman J, Nordström A, Hommel A, Kivipelto M, Nordström P. Correction to: Bisphosphonates and mortality: confounding in observational studies. Osteoporos Int 2021; 32:797-800. [PMID: 33606046 PMCID: PMC8026462 DOI: 10.1007/s00198-021-05884-9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J Bergman
- Unit of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 90187, Umeå, Sweden
| | - A Nordström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187, Umeå, Sweden
- School of Sport Sciences, UiTArctic University of Norway, Postboks 1621, 9509, Alta, Norway
| | - A Hommel
- Department of Care Sciences, Malmö University, 20506, Malmö, Sweden
| | - M Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Plan 7, 14183, Huddinge, Sweden
- Theme Aging, Karolinska Univeristy Hospital, 14186, Stockholm, Sweden
- Research and Development Unit, Stockholm Sjukhem, Mariebergsgatan 22, 11219, Stockholm, Sweden
| | - P Nordström
- Unit of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 90187, Umeå, Sweden.
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9
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Abstract
UNLABELLED Numerous observational studies suggest that bisphosphonates reduce mortality. This study showed that bisphosphonate use is associated with lower mortality within days of treatment, although the association was not significant until the second week. Such an early association is consistent with confounding, although an early treatment effect cannot be ruled out. INTRODUCTION The purpose of this study was to examine whether confounding explains why numerous observational studies show that bisphosphonate use is associated with lower mortality. To this end, we examined how soon after treatment initiation a lower mortality rate can be observed. We hypothesized that, due to confounding, the association would be observed immediately. METHODS This was a retrospective cohort study of hip fracture patients discharged from Swedish hospitals between 1 July 2006 and 31 December 2015. The data covered 260,574 hip fracture patients and were obtained from the Swedish Hip Fracture Register and national registers. Of the 260,574 patients, 49,765 met all eligibility criteria and 10,178 were pair matched (bisphosphonate users to controls) using time-dependent propensity scores. The matching variables were age, sex, diagnoses, prescription medications, type of hip fracture, type of surgical procedure, known or suspected dementia, and physical functioning status. RESULTS Over a median follow-up of 2.8 years, 2922 of the 10,178 matched patients died. The mortality rate was 7.9 deaths per 100 person-years in bisphosphonate users and 9.4 deaths in controls, which corresponded to a 15% lower mortality rate in bisphosphonate users (hazard ratio 0.85, 95% confidence interval 0.79-0.91). The risk of death was lower in bisphosphonate users from day 6 of treatment, although the association was not significant until the second week. CONCLUSION Bisphosphonate use was associated with lower mortality within days of treatment initiation. This finding is consistent with confounding, although an early treatment effect cannot be ruled out.
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Affiliation(s)
- J Bergman
- Unit of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 90187, Umeå, Sweden
| | - A Nordström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187, Umeå, Sweden
- School of Sport Sciences, UiT Arctic University of Norway, Postboks 1621, 9509, Alta, Norway
| | - A Hommel
- Department of Care Sciences, Malmö University, 20506, Malmö, Sweden
| | - M Kivipelto
- Division of Clinical geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Plan 7, 14183, Huddinge, Sweden
- Theme Aging, Karolinska Univeristy Hospital, 14186, Stockholm, Sweden
- Research and Development Unit, Stockholm Sjukhem, Mariebergsgatan 22, 11219, Stockholm, Sweden
| | - P Nordström
- Unit of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 90187, Umeå, Sweden.
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10
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Winkler C, Haupt F, Heigermoser M, Zapardiel‐Gonzalo J, Ohli J, Faure T, Kalideri E, Hommel A, Delivani P, Berner R, Kordonouri O, Roloff F, von dem Berge T, Lange K, Oltarzewski M, Glab R, Szypowska A, Snape MD, Vatish M, Todd JA, Larsson HE, Ramelius A, Kördel JÅ, Casteels K, Paulus J, Ziegler AG, Bonifacio E. Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results. Pediatr Diabetes 2019; 20:720-727. [PMID: 31192505 PMCID: PMC6851563 DOI: 10.1111/pedi.12870] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/17/2019] [Accepted: 05/21/2019] [Indexed: 01/15/2023] Open
Abstract
Primary prevention of type 1 diabetes (T1D) requires intervention in genetically at-risk infants. The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) has established a screening program, GPPAD-02, that identifies infants with a genetic high risk of T1D, enrolls these into primary prevention trials, and follows the children for beta-cell autoantibodies and diabetes. Genetic testing is offered either at delivery, together with the regular newborn testing, or at a newborn health care visits before the age of 5 months in regions of Germany (Bavaria, Saxony, Lower Saxony), UK (Oxford), Poland (Warsaw), Belgium (Leuven), and Sweden (Region Skåne). Seven clinical centers will screen around 330 000 infants. Using a genetic score based on 46 T1D susceptibility single-nucleotide polymorphisms (SNPs) or three SNPS and a first-degree family history for T1D, infants with a high (>10%) genetic risk for developing multiple beta-cell autoantibodies by the age of 6 years are identified. Screening from October 2017 to December 2018 was performed in 50 669 infants. The prevalence of high genetic risk for T1D in these infants was 1.1%. Infants with high genetic risk for T1D are followed up and offered to participate in a randomized controlled trial aiming to prevent beta-cell autoimmunity and T1D by tolerance induction with oral insulin. The GPPAD-02 study provides a unique path to primary prevention of beta-cell autoimmunity in the general population. The eventual benefit to the community, if successful, will be a reduction in the number of children developing beta-cell autoimmunity and T1D.
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Affiliation(s)
- Christiane Winkler
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany,Forschergruppe Diabetes e.V. at Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
| | - Florian Haupt
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany,Forschergruppe Diabetes e.V. at Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
| | - Martin Heigermoser
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
| | - Jose Zapardiel‐Gonzalo
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
| | - Jasmin Ohli
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
| | - Theresa Faure
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
| | - Evdokia Kalideri
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany
| | - Angela Hommel
- Faculty of Medicine, Center for Regenerative Therapies Dresden (CRTD)Technische Universität DresdenDresdenGermany
| | - Petrina Delivani
- Faculty of Medicine, Center for Regenerative Therapies Dresden (CRTD)Technische Universität DresdenDresdenGermany
| | - Reinhard Berner
- Department of Pediatrics, University Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Olga Kordonouri
- Hannoversche Kinderheilanstalt, Kinder‐ und Jugendkrankenhaus AUF DER BULTHannoverGermany
| | - Frank Roloff
- Hannoversche Kinderheilanstalt, Kinder‐ und Jugendkrankenhaus AUF DER BULTHannoverGermany
| | - Thekla von dem Berge
- Hannoversche Kinderheilanstalt, Kinder‐ und Jugendkrankenhaus AUF DER BULTHannoverGermany
| | - Karin Lange
- Department of Medical PsychologyHannover Medical SchoolHannoverGermany
| | | | | | | | - Matthew D. Snape
- Department of Paediatrics, NIHR Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Manu Vatish
- Nuffield Department of Women's & Reproductive HealthUniversity of OxfordOxfordUK
| | - John A. Todd
- Nuffield Department of Medicine, Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Helena E. Larsson
- Unit for Pediatric Endocrinology, Department of Clinical Sciences MalmöLund UniversityLundSweden,Department of PaediatricsSkåne University HospitalMalmöSweden
| | | | | | - Kristina Casteels
- Department of PediatricsUniversity Hospitals LeuvenLeuvenBelgium,Department of Development and RegenerationKU LeuvenLeuvenBelgium
| | - Jasmin Paulus
- Department of PediatricsUniversity Hospitals LeuvenLeuvenBelgium
| | - Anette G. Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany,Forschergruppe Diabetes e.V. at Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthMunichGermany,Forschergruppe DiabetesKlinikum rechts der Isar, Technical University MunichMunichGermany
| | - Ezio Bonifacio
- Faculty of Medicine, Center for Regenerative Therapies Dresden (CRTD)Technische Universität DresdenDresdenGermany
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11
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Schreiber M, Weigelt M, Karasinsky A, Anastassiadis K, Schallenberg S, Petzold C, Bonifacio E, Kretschmer K, Hommel A. Inducible IL-7 Hyperexpression Influences Lymphocyte Homeostasis and Function and Increases Allograft Rejection. Front Immunol 2019; 10:742. [PMID: 31024566 PMCID: PMC6467976 DOI: 10.3389/fimmu.2019.00742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/19/2019] [Indexed: 12/11/2022] Open
Abstract
The IL-7/IL-7R pathway is essential for lymphocyte development and disturbances in the pathway can lead to immune deficiency or T cell mediated destruction. Here, the effect of transient hyperexpression of IL-7 was investigated on immune regulation and allograft rejection under immunosuppression. An experimental in vivo immunosuppressive mouse model of IL-7 hyperexpression was developed using transgenic mice (C57BL/6 background) carrying a tetracycline inducible IL-7 expression cassette, which allowed the temporally controlled induction of IL-7 hyperexpression by Dexamethasone and Doxycycline treatment. Upon induction of IL-7, the B220+ c-kit+ Pro/Pre-B I compartment in the bone marrow increased as compared to control mice in a serum IL-7 concentration-correlated manner. IL-7 hyperexpression also preferentially increased the population size of memory CD8+ T cells in secondary lymphoid organs, and reduced the proportion of CD4+Foxp3+ T regulatory cells. Of relevance to disease, conventional CD4+ T cells from an IL-7-rich milieu escaped T regulatory cell-mediated suppression in vitro and in a model of autoimmune diabetes in vivo. These findings were validated using an IL-7/anti-IL7 complex treatment mouse model to create an IL-7 rich environment. To study the effect of IL-7 on islet graft survival in a mismatched allograft model, BALB/c mice were rendered diabetic by streptozotocin und transplanted with IL-7-inducible or control islets from C57BL/6 mice. As expected, Dexamethasone and Doxycycline treatment prolonged graft median survival as compared to the untreated control group in this transplantation mouse model. However, upon induction of local IL-7 hyperexpression in the transplanted islets, graft survival time was decreased and this was accompanied by an increased CD4+ and CD8+ T cell infiltration in the islets. Altogether, the findings show that transient elevations of IL-7 can impair immune regulation and lead to graft loss also under immune suppression.
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Affiliation(s)
- Maria Schreiber
- Preclinical Approaches to Stem Cell Therapy/Diabetes, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany.,Molecular and Cellular Immunology/Immune Regulation, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany
| | - Marc Weigelt
- Preclinical Approaches to Stem Cell Therapy/Diabetes, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany.,TU Dresden Faculty of Medicine, Paul Langerhans Institute Dresden, University Clinic Carl Gustav Carus, Helmholtz Centre Munich, Dresden, Germany
| | - Anne Karasinsky
- Preclinical Approaches to Stem Cell Therapy/Diabetes, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany
| | | | - Sonja Schallenberg
- Molecular and Cellular Immunology/Immune Regulation, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany
| | - Cathleen Petzold
- Molecular and Cellular Immunology/Immune Regulation, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany
| | - Ezio Bonifacio
- Preclinical Approaches to Stem Cell Therapy/Diabetes, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany.,TU Dresden Faculty of Medicine, Paul Langerhans Institute Dresden, University Clinic Carl Gustav Carus, Helmholtz Centre Munich, Dresden, Germany
| | - Karsten Kretschmer
- Molecular and Cellular Immunology/Immune Regulation, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany.,TU Dresden Faculty of Medicine, Paul Langerhans Institute Dresden, University Clinic Carl Gustav Carus, Helmholtz Centre Munich, Dresden, Germany
| | - Angela Hommel
- Preclinical Approaches to Stem Cell Therapy/Diabetes, DFG-Center for Regenerative Therapies Dresden Cluster of Excellence, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, Dresden, Germany.,TU Dresden Faculty of Medicine, Paul Langerhans Institute Dresden, University Clinic Carl Gustav Carus, Helmholtz Centre Munich, Dresden, Germany
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12
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Kindt AS, Fuerst RW, Knoop J, Laimighofer M, Telieps T, Hippich M, Woerheide MA, Wahl S, Wilson R, Sedlmeier EM, Hommel A, Todd JA, Krumsiek J, Ziegler AG, Bonifacio E. Allele-specific methylation of type 1 diabetes susceptibility genes. J Autoimmun 2018; 89:63-74. [DOI: 10.1016/j.jaut.2017.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/23/2017] [Accepted: 11/25/2017] [Indexed: 01/09/2023]
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13
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Jonsson MH, Bentzer P, Turkiewicz A, Hommel A. Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden - A prospective observational study. Acta Anaesthesiol Scand 2018; 62:1057-1063. [PMID: 29687439 PMCID: PMC6099275 DOI: 10.1111/aas.13131] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/18/2018] [Accepted: 03/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Little is known about accuracy of common risk prediction scores in elderly patients suffering from hip fractures. The objective of this study was to investigate accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) score, Portsmouth-POSSUM (P-POSSUM) score and the Nottingham Hip Fracture Score (NHFS) for prediction of mortality and morbidity in this patient group. METHODS This was a prospective single centre observational study on 997 patients suffering out-of-hospital cervical, trochanteric or subtrochanteric fracture of the neck of the femur. Calibration and discrimination was assessed by calculating the ratio of observed to expected events (O:E) and areas under receiver operating characteristics curves (ROC). RESULTS The 30-day mortality was 6.2% and complications, as defined by POSSUM, occurred in 41% of the patients. Overall O:E ratios for POSSUM, P-POSSUM and NHFS scores for 30-day mortality were 0.90, 0.98, and 0.79 respectively. The models underestimated mortality in the lower risk bands and overestimated mortality in the higher risk bands. In contrast, POSSUM predicted morbidity well with O:E ratios close to unity in most risk bands. The areas under the ROC curves for the scoring systems was 0.60-0.67. CONCLUSION The POSSUM score and NHFS show moderate calibration and poor discrimination in this cohort. The results suggest that mortality and morbidity in hip fracture patients are largely dependent on factors that are not included in these scores.
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Affiliation(s)
- M. H. Jonsson
- Department of Anaesthesia and Intensive Care MedicineYstad HospitalYstadSweden
- Department of Clinical SciencesLund UniversityLundSweden
| | - P. Bentzer
- Department of Clinical SciencesLund UniversityLundSweden
- Department of Anaesthesia and Intensive CareHelsingborg HospitalHelsingborgSweden
| | - A. Turkiewicz
- Department of Clinical SciencesLund UniversityLundSweden
- Clinical Epidemiology UnitOrthopaedicsLund UniversityLundSweden
| | - A. Hommel
- Department of Clinical SciencesLund UniversityLundSweden
- Clinical Epidemiology UnitOrthopaedicsLund UniversityLundSweden
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14
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Müller I, Gottschalk M, Deliviani P, Heinke S, Hommel A, Reichert J, Rodrigues R, Zubizaretta N, Ziegler AG, Berner R, Bonifacio E, Lange K. Welche Folgen hat das Wissen um ein erhöhtes Diabetesrisiko eines Säuglings für dessen Eltern? Erste Ergebnisse des Freder1k-Screenings auf Diabetesrisikogene in Sachsen. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641781] [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)
- I Müller
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
| | - M Gottschalk
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - P Deliviani
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - S Heinke
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - A Hommel
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - J Reichert
- Universitätsklinikum Carl Gustav Carus; Klinik und Poliklinik für Kinder- und Jugendmedizin, Dresden, Germany
| | - R Rodrigues
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
| | - N Zubizaretta
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - AG Ziegler
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - R Berner
- Universitätsklinikum Carl Gustav Carus; Klinik und Poliklinik für Kinder- und Jugendmedizin, Dresden, Germany
| | - E Bonifacio
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - K Lange
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
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15
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Hommel A, Haupt F, Delivani P, Winkler C, Stopsack M, Wimberger P, Nitzsche K, Heinke S, Naeke A, Ceglarek U, Thiery J, Bergert R, Stadthaus D, Groeger K, Heubner G, Schramm U, Dziambor U, Zirkel A, Kiess W, Mueller I, Lange K, Berner R, Bonifacio E, Ziegler AG. Screening for Type 1 Diabetes Risk in Newborns: The Freder1k Pilot Study in Saxony. Horm Metab Res 2018; 50:44-49. [PMID: 29121687 DOI: 10.1055/s-0043-120921] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
An increased risk for type 1 diabetes can be identified using genetic and immune markers. The Freder1k study introduces genetic testing for type 1 diabetes risk within the context of the newborn screening in order to identify newborns with a high risk to develop type 1 diabetes for follow-up testing of early stage type 1 diabetes and for primary prevention trials. Consent for research-based genetic testing of type 1 diabetes risk is obtained with newborn screening. Increased risk is assessed using three single nucleotide polymorphisms for HLA DRB1*03 (DR3), HLA DRB1*04 (DR4), HLA DQB1*0302 (DQ8) alleles, and defined as 1. an HLA DR3/DR4-DQ8 or DR4-DQ8/DR4-DQ8 genotype or 2. an HLA DR4-DQ8 haplotype and a first-degree family history of type 1 diabetes. Families of infants with increased risk are asked to participate in follow-up visits at infant age 6 months, 2 years, and 4 years for autoantibody testing and early diagnosis of type 1 diabetes. After 8 months, the screening rate has reached 181 per week, with 63% coverage of newborns within Freder1k-clinics and 24% of all registered births in Saxony. Of 4178 screened, 2.6% were identified to have an increased risk, and around 80% of eligible infants were recruited to follow-up. Psychological assessment of eligible families is ongoing with none of 31 families demonstrating signs of excessive burden associated with knowledge of type 1 diabetes risk. This pilot study has shown that it is feasible to perform genetic risk testing for childhood disease within the context of newborn screening programs.
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Affiliation(s)
- Angela Hommel
- DFG-Center for Regenerative Therapies Dresden, Faculty of Medicine, TU Dresden - AG Bonifacio, Dresden, Germany
| | - Florian Haupt
- Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany
| | - Petrina Delivani
- DFG-Center for Regenerative Therapies Dresden, Faculty of Medicine, TU Dresden - AG Bonifacio, Dresden, Germany
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany
| | - Marina Stopsack
- Institut of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Katharina Nitzsche
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Sophie Heinke
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andrea Naeke
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Joachim Thiery
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Renate Bergert
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Krankenhaus St. Joseph-Stift Dresden - Department of Pediatrics, Dresden, Germany
| | - Daniel Stadthaus
- HELIOS Klinikum Pirna, Department of Gynecology and Obstetrics, Pirna, Sachsen, Germany
| | - Katrin Groeger
- Muldentalklinikum GmbH, Krankenhaus Wurzen, Department of Pediatrics, Wurzen, Germany
| | - Georg Heubner
- Städtisches Klinikum Dresden - Department of Pediatrics, Dresden, Germany
| | - Ursula Schramm
- Oberlausitz-Klinikum GmbH, Krankenhaus Bautzen - Department of Pediatrics, Bautzen, Germany
| | - Ullrich Dziambor
- Oberlausitz-Klinikum gGmbH, Krankenhaus Bischofswerda, Department of Gynecology and Obstetrics, Bischofswerda, Germany
| | - Agnes Zirkel
- Diakonissen Krankenhaus Dresden, Department of Gynecology and Obstetrics, Dresden, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Iris Mueller
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Karin Lange
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Reinhard Berner
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ezio Bonifacio
- DFG-Center for Regenerative Therapies Dresden, Faculty of Medicine, TU Dresden - AG Bonifacio, Dresden, Germany
| | - Anette-Gabriele Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany
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Affiliation(s)
- A.J. Meehan
- International Collaboration of Orthopaedic Nursing; Akron OH USA
- Nursing Administration; Akron General Medical Center; Akron OH USA
| | - A.B. Maher
- International Collaboration of Orthopaedic Nursing; Akron OH USA
- Long Branch NJ USA
| | - A. Hommel
- International Collaboration of Orthopaedic Nursing; Akron OH USA
- Department of Health Sciences; Lund University; Lund Sweden
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Cerdá-Esteban N, Hommel A, Bonifacio E, Spagnoli FM. Stepwise reprogramming of liver to pancreas under the control of a single transcriptional regulator. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374888] [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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18
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Hommel A, Weigelt M, Karasinsky A, Wilhelm C, Lindner A, Anastassiadis K, Bonifacio E. Establishment of an in vivo mouse model that can be induced to produce IL-7. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375046] [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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19
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Borg DJ, Weigelt M, Wilhelm C, Gerlach M, Bickle M, Speier S, Bonifacio E, Hommel A. Mesenchymal stromal cells improve transplanted islet survival and islet function in a syngeneic mouse model. Diabetologia 2014; 57:522-31. [PMID: 24253203 DOI: 10.1007/s00125-013-3109-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/23/2013] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Islet transplantation is used therapeutically in a minority of patients with type 1 diabetes. Successful outcomes are hampered by early islet beta cell loss. The adjuvant co-transplantation of mesenchymal stromal cells (MSCs) has the promise to improve islet transplant outcome. METHODS We used a syngeneic marginal islet mass transplantation model in a mouse model of diabetes. Mice received islets or islets plus 250,000 MSCs. Kidney subcapsule, intra-hepatic and intra-ocular islet transplantation sites were used. Apoptosis, vascularisation, beta cell proliferation, MSC differentiation and laminin levels were determined by immunohistochemical analysis and image quantification post-transplant. RESULTS Glucose homeostasis after the transplantation of syngeneic islets was improved by the co-transplantation of MSCs together with islets under the kidney capsule (p = 0.01) and by intravenous infusion of MSCs after intra-hepatic islet transplantation (p = 0.05). MSC co-transplantation resulted in reduced islet apoptosis, with reduced numbers of islet cells positive for cleaved caspase 3 being observed 14 days post-transplant. In kidney subcapsule, but not in intra-ocular islet transplant models, we observed increased re-vascularisation rates, but not increased blood vessel density in and around islets co-transplanted with MSCs compared with islets that were transplanted alone. Co-transplantation of MSCs did not increase beta cell proliferation, extracellular matrix protein laminin production or alpha cell numbers, and there was negligible MSC transdifferentiation into beta cells. CONCLUSIONS/INTERPRETATION Co-transplantation of MSCs may lead to improved islet function and survival in the early post-transplantation period in humans receiving islet transplantation.
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Affiliation(s)
- Danielle J Borg
- DFG-Center for Regenerative Therapies Dresden, Technische Universität Dresden, Fetscherstrasse 105, 01307, Dresden, Germany
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20
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Fridlund B, Jönsson AC, Andersson EK, Bala SV, Dahlman GB, Forsberg A, Glasdam S, Hommel A, Kristensson A, Lindberg C, Sivberg B, Sjöström-Strand A, Wihlborg J, Samuelson K. Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojn.2014.43023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Hesse D, Jaschke A, Augustin R, Hommel A, Püschel GP, Petzke KJ, Joost HG, Schürmann A. Die Rolle des trans-Golgis für die Sekretion von IGF1 und die Glycogenspeicherung in der Leber. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314644] [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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22
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Gunningberg L, Hommel A, Bååth C, Idvall E. Pressure ulcer prevention in Sweden -evidence-based guidelines and prevalence studies on the national agenda. INT J EVID-BASED HEA 2011. [DOI: 10.1097/01258363-201109000-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Björkelund KB, Hommel A, Thorngren KG, Gustafson L, Larsson S, Lundberg D. Reducing delirium in elderly patients with hip fracture: a multi-factorial intervention study. Acta Anaesthesiol Scand 2010; 54:678-88. [PMID: 20236093 DOI: 10.1111/j.1399-6576.2010.02232.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is an evident need for improved management of elderly patients with trauma in order to avoid common and troublesome complications such as delirium. The aim of this study was to investigate whether an implementation of a multi-factorial program including intensified pre-hospital and perioperative treatment and care could reduce the incidence of delirium in elderly patients with hip fracture, cognitively intact at admission to the hospital. In addition, we explored the factors that characterize patients who developed delirium. METHODS A prospective, quasi-experimental design was used. A total of 263 patients with hip fracture (> or = 65 years), cognitively intact at admission, were consecutively included between April 2003 and April 2004. On 1 October 2003, a new program was introduced. All patients were screened for cognitive impairment within 30 min after admission to the emergency department using The Short Portable Mental Status Questionnaire (SPMSQ). To screen for delirium, patients were tested within 4 h of admission and thereafter daily, using the Organic Brain Syndrome scale. RESULTS The number of patients who developed delirium during hospitalization was 74 (28.1%), with a decrease from 34% (45 of 132) in the control group to 22% (29 of 131) in the intervention group (P=0.031). Patients who developed delirium were statistically older, more often had > 4 prescribed drugs at admission and scored less well in the SPMSQ test. CONCLUSION The use of a multi-factorial intervention program in elderly hip fracture patients, lucid at admission, reduced the incidence of delirium during hospitalization by 35%.
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Affiliation(s)
- K B Björkelund
- Department of Anesthesiology and Intensive Care, Clinical Sciences, Lund University, Lund, Sweden.
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24
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Hesse D, Hommel A, Jaschke A, Völker W, Engel T, Chadt A, Blüher M, Ruschke K, Kluge R, Joost HG, Schürmann A. Durch eine Beeinträchtigung der Lipidtropfenbildung und eine erhöhte Lipolyse resultiert die Deletion der GTPase Arfrp1 im Fettgewebe in einem lipodystrophen Phänotyp. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253979] [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: 10/19/2022]
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25
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Borg D, Weigelt M, Wilhelm C, Hommel A, Bonifacio E. Verbesserung der Transplantationsrate von Langerhansschen Inselzellen durch unterstützende mesenchymale Stammzellen. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253800] [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: 10/19/2022]
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26
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Thorngren KG, Norrman PO, Hommel A, Cedervall M, Thorngren J, Wingstrand H. Influence of age, sex, fracture type and pre-fracture living on rehabilitation pattern after hip fracture in the elderly. Disabil Rehabil 2009; 27:1091-7. [PMID: 16278177 DOI: 10.1080/09638280500056402] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the influence of background factors on the rehabilitation pattern after a hip fracture in the elderly. METHOD Prospective registration based on the Swedish national register for hip fracture patients called RIKSHOFT/SAHFE (Standardised Audit of Hip Fractures in Europe). The place of living was registered both before fracture and during the following four months period (120 days). Graphs were calculated and drawn based on day-to-day changes. Also influences of age, sex, fracture type and type of operation were analyzed. RESULTS The patient's pre-fracture functional capacity as evidence by the place they were able to manage to live before the fracture was the most discriminating factor for the rehabilitation; more than sex, fracture type or type of operation. Age was also a highly discriminating factor with a pronounced influence on the rehabilitation pattern. CONCLUSIONS These background parameters are very important factors when planning the rehabilitation of hip fracture patients. A strategy with individualized planning of the rehabilitation procedure will be highly necessary in the future, in view of the increasing amount of elderly with hip fractures prognosticated during the coming decades. The knowledge about influencing factors here presented will be useful when planning and performing the rehabilitation for this resource-consuming group of patients.
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Affiliation(s)
- K-G Thorngren
- Department of Orthopedics, University Hospital, Lund, Sweden.
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27
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Hommel A, Hesse D, Blüher M, Engel T, Zahn C, Moser M, Kluge R, Joost HG, Schürmann A. The Ras-homologous GTPase Arfrp1 is involved in the regulation of triglyceride storage in mouse and human adipose tissue. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221808] [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: 10/20/2022]
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28
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Hesse D, Hommel A, Zahn C, Augustin R, Henkel J, Püschel GP, Joost HG, Schürmann A. Die GTPase ARFRP1 ist essentiell für die Differenzierung der Hepatozyten und die Etablierung eines störungsfreien Glucosestoffwechsels. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221804] [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: 10/20/2022]
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29
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Schmidt S, Hommel A, Gawlik V, Augustin R, Junicke N, Florian S, Richter M, Walther DJ, Montag D, Joost HG, Schürmann A. Essential role of glucose transporter GLUT3 for post-implantation embryonic development. J Endocrinol 2009; 200:23-33. [PMID: 18948350 PMCID: PMC2632781 DOI: 10.1677/joe-08-0262] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Deletion of glucose transporter gene Slc2a3 (GLUT3) has previously been reported to result in embryonic lethality. Here, we define the exact time point of growth arrest and subsequent death of the embryo. Slc2a3(-/-) morulae and blastocysts developed normally, implanted in vivo, and formed egg-cylinder-stage embryos that appeared normal until day 6.0. At day 6.5, apoptosis was detected in the ectodermal cells of Slc2a3(-/-) embryos resulting in severe disorganization and growth retardation at day 7.5 and complete loss of embryos at day 12.5. GLUT3 was detected in placental cone, in the visceral ectoderm and in the mesoderm of 7.5-day-old wild-type embryos. Our data indicate that GLUT3 is essential for the development of early post-implanted embryos.
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Affiliation(s)
- S Schmidt
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - A Hommel
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - V Gawlik
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - R Augustin
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - N Junicke
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - S Florian
- Department of ToxicologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - M Richter
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - D J Walther
- Department of Human Molecular GeneticsMax Planck Institute for Molecular GeneticsD-14195, BerlinGermany
| | - D Montag
- Research Group NeurogeneticsLeibniz-Institute for NeurobiologyD-39118, MagdeburgGermany
| | - H-G Joost
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
| | - A Schürmann
- Department of PharmacologyGerman Institute of Human NutritionPotsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558, NuthetalGermany
- Correspondence should be addressed to A Schürmann ()
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Zahn C, Jaschke A, Weiske J, Hommel A, Hesse D, Augustin R, Lu L, Hong W, Florian S, Scheepers A, Joost HG, Huber O, Schürmann A. ADP-ribosylation Factor-like GTPase ARFRP1 Is Required for Trans-Golgi to Plasma Membrane Trafficking of E-cadherin. J Biol Chem 2008; 283:27179-88. [DOI: 10.1074/jbc.m802108200] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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31
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Hesse D, Hommel A, Zahn C, Augustin R, Henkel J, Püschel GP, Joost HG, Schürmann A. Veränderungen im Glucosemetabolismus nach leberspezifischer Deletion der GTPase ARFRP1 in der Maus. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076261] [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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Zahn C, Hommel A, Lu L, Hong W, Walther DJ, Florian S, Joost HG, Schürmann A. Knockout of Arfrp1 leads to disruption of ARF-like1 (ARL1) targeting to the trans-Golgi in mouse embryos and HeLa cells. Mol Membr Biol 2007; 23:475-85. [PMID: 17127620 DOI: 10.1080/09687860600840100] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ADP-ribosylation factor related protein 1 (ARFRP1) is a member of the ARF-family of GTPases which operate as molecular switches in the regulation of intracellular protein traffic. Deletion of the mouse Arfrp1 gene leads to embryonic lethality during early gastrulation, suggesting that ARFRP1 is required for cell adhesion-related processes. Here we show that ARFRP1 specifically controls targeting of ARL1 and its effector Golgin-245 to the trans-Golgi. GTP-bound ARFRP1 (ARFRP1-Q79L mutant) is associated with Golgi membranes and co-localized with the GTPase ARL1. In contrast, the guanine nucleotide exchange defective ARFRP1 mutant (ARFRP1-T31N) clusters within the cytosol. ARFRP1-T31N or depletion of endogenous ARFRP1 by RNA interference disrupts the Golgi association of ARL1 and of the GRIP-domain protein Golgin-245 and alters the distribution of a trans-Golgi network marker, syntaxin 6. In contrast, the targeting of two other Golgi-associated proteins, GM130 and giantin, was unaffected. Furthermore, in Arfrp1-/ - embryos ARL1 dislocated from Golgi membranes whereas it was associated with intracellular membranes in wild-type embryos. These data suggest that lethality of Arfrp1 knockout embryos is due to a specific disruption of protein targeting, e.g., of ARL1 and Golgin-245, to the Golgi.
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Affiliation(s)
- Claudia Zahn
- Department of Pharmacology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
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Hommel A, Zahn C, Schmidt S, Kluge R, Augustin R, Jaschke A, Moser M, Joost HG, Schürmann A. Die fettspezifische Deletion der monomeren GTPase ARFRP1 resultiert in einem Verlust des WAT und einer Hepatosteatose. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982143] [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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34
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Affiliation(s)
- K-G Thorngren
- Department of Orthopedics, Lund University Hospital, Sweden
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35
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Hahn S, Hommel A. [Not Available]. Arch Hist Filoz Med 2001; 54:91-4. [PMID: 11630008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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36
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Hommel A. [Not Available]. Abh Gesch Med Naturwiss 2001:54-65. [PMID: 11625926] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A Hommel
- Karl-Sudhoff-Institut für Geschichte der Medizin und der Naturwissenschaften, Leipzig
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37
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Alexander H, Hommel A. [The Leipzig University Gynecologic Clinic (Trier Institute) from its establishment in 1810 to 1945]. Zentralbl Gynakol 2001; 122:507-13. [PMID: 11072684 DOI: 10.1055/s-2000-10081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
At the beginning of the 19th century the childless couple Trier gave a plot of land to Leipzig University with the impost of founding a maternity hospital (Accoucheur Institute) and demand to take their family name as clinic name. The institute was erected in 1810 and later (1892) extended as a department of obstetrics and gynecology. The Women's Clinic of the University ("Triersches Institut") developed very favorably through the 19. and 20. century, including the difficult time of national socialism and the years after World War II. This is documented by it's expansion with several enlargements and new buildings. The institution acquired a remarkable national and international reputation due to prominent scientific and clinical results of the famous professors working at the place such as Jörg, Credé, Zweifel, Stoeckel, Sellheim and Robert Schroeder.
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Hommel A, Alexander H. [Some aspects of the life work of Ludwig Fraenkel (1870-1951) with special reference to his social gynecology and sexology studies]. Zentralbl Gynakol 1998; 120:475-80. [PMID: 9823647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The gynaecologist Ludwig Fraenkel is known because of his works concerning the endocrine function of the corpus luteum. Moreover he was an important representative of the social gynaecology and sexology during the first decades of this century. His studies in these fields identify Fraenkel as an independent scientist considering for example social living conditions as a cause of gynaecological illnesses. On the other hand he took over problematic positions in eugenics hoping to improve public health. During the Hitler era the Jew Ludwig Fraenkel was dismissed from the directorate of the Women's clinic of the University of Breslau. He left Germany forever.
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Affiliation(s)
- A Hommel
- Universitätsfrauenklinik Leipzig, Triersches Institut
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39
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Hommel A, Alexander H. [Hugo Sellheim (1871-1936): Leipzig acknowledgement of gynecology]. Zentralbl Gynakol 1998; 120:160-4. [PMID: 9610518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In 1928 Hugo Sellheim, Professor and Chairman of gynaecology and obstetrics at the University of Leipzig (1926-1936), inaugurated the new Clinic of Gynaecology and Obstetrics. The opening ceremony found a critical public response. Although the new building had been drawn up by his predecessor Walter Stoeckel, Sellheim developed own ideas concerning the equipment of the institution. In Leipzig Sellheim is continued his scientific efforts with a story focus on female reproduction and its sociocultural impact during the period of the Weimar Republic.
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Affiliation(s)
- A Hommel
- Universitätsfrauenklinik Leipzig
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Hommel A, Nijboer C, Schuyt T. [Informal care; a critical observation]. Tijdschr Gerontol Geriatr 1995; 26:220-4. [PMID: 8750983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In this article the policy aimed at cutting down expenses for professional care and at optimizing the contribution of informal, unpaid care (e.g. family caregivers and volunteers) is questioned. After a brief outline of the non-professional care system for the elderly, some problematic aspects of informal care are discussed, especially the influence of such care in terms of (over)burden, the quality of care and the consequences for the relationship between caregiver and person being cared for. Voluntary services are also questioned, particularly the lack of control, the power of volunteers and their knowledge, attitude and skills. It is concluded that expectations towards nonprofessional caregivers should not be too great. The importance of a finely tuned coordination and clear division of tasks in the care network is underlined. Finally a number of recommendations is made to settle the observed bottlenecks.
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Affiliation(s)
- A Hommel
- Unie van Katholieke Bonden van Ouderen, 's-Hertogenbosch
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Hommel A. [Not Available]. Medizinhist J 1994; 29:121-148. [PMID: 11640627] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- A Hommel
- Karl-Sudhoff-Institut für Geschichte der Medizin und der Naturwissenschaften and der Universität Leipzig
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