1
|
Rottmayer K, Schwarze M, Jassoy C, Hoffmann R, Loeffler-Wirth H, Lehmann C. Potential of a Bead-Based Multiplex Assay for SARS-CoV-2 Antibody Detection. Biology (Basel) 2024; 13:273. [PMID: 38666885 PMCID: PMC11047883 DOI: 10.3390/biology13040273] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
Serological assays for SARS-CoV-2 play a pivotal role in the definition of whether patients are infected, the understanding of viral epidemiology, the screening of convalescent sera for therapeutic and prophylactic purposes, and in obtaining a better understanding of the immune response towards the virus. The aim of this study was to investigate the performance of a bead-based multiplex assay. This assay allowed for the simultaneous testing of IgG antibodies against SARS-CoV-2 spike, S1, S2, RBD, and nucleocapsid moieties and S1 of seasonal coronaviruses hCoV-22E, hCoV-HKU1, hCoV-NL63, and hCoV-OC43, as well as MERS and SARS-CoV. We compared the bead-based multiplex assay with commercial ELISA tests. We tested the sera of 27 SARS-CoV-2 PCR-positive individuals who were previously tested with different ELISA assays. Additionally, we investigated the reproducibility of the results by means of multiple testing of the same sera. Finally, the results were correlated with neutralising assays. In summary, the concordance of the qualitative results ranged between 78% and 96% depending on the ELISA assay and the specific antigen. Repeated freezing-thawing cycles resulted in reduced mean fluorescence intensity, while the storage period had no influence in this respect. In our test cohort, we detected up to 36% of sera positive for the development of neutralising antibodies, which is in concordance with the bead-based multiplex and IgG ELISA.
Collapse
Affiliation(s)
- Karla Rottmayer
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Universität Leipzig, Johannisallee 32, 04103 Leipzig, Germany
| | - Mandy Schwarze
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany; (M.S.)
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
| | - Christian Jassoy
- Institute for Medical Microbiology and Virology, Leipzig University Hospital and Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany;
| | - Ralf Hoffmann
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany; (M.S.)
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
| | - Henry Loeffler-Wirth
- Interdisciplinary Centre for Bioinformatics, IZBI, Leipzig University, Haertelstr. 16-18, 04107 Leipzig, Germany;
| | - Claudia Lehmann
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Universität Leipzig, Johannisallee 32, 04103 Leipzig, Germany
| |
Collapse
|
2
|
Doxiadis I, Lehmann C. External proficiency testing exercises: challenges and opportunities. Front Genet 2024; 15:1304312. [PMID: 38404667 PMCID: PMC10884168 DOI: 10.3389/fgene.2024.1304312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/31/2024] [Indexed: 02/27/2024] Open
Affiliation(s)
- Ilias Doxiadis
- Institute for Transfusion Medicine, University Hospital of Leipzig, Leipzig, Germany
| | | |
Collapse
|
3
|
Wichmann G, Vetter N, Lehmann C, Landgraf R, Doxiadis I, Großmann R, Vorobeva E, Dietz A, Zebralla V, Wiegand S, Wald T. Outcome differences in HPV-driven head and neck squamous cell carcinoma attributable to altered human leukocyte antigen frequencies. Front Oncol 2023; 13:1212454. [PMID: 38192630 PMCID: PMC10772155 DOI: 10.3389/fonc.2023.1212454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Background Effective immune surveillance requires a functioning immune system and natural killer (NK) and T cells for adequate innate and antigen-specific immune responses critically depending on human leukocyte antigens (HLAs) and haplotypes representing advantageous combinations of HLA antigens. Recently, we reported a link between altered frequencies of HLA alleles and haplotypes and developing head and neck squamous cell carcinoma (HNSCC). Whereas the majority of HNSCCs seem to be related to classical risk factors alcohol and tobacco, a subset of HNSCC and especially oropharyngeal squamous cell carcinoma (OPSCC) were etiologically linked to human papillomavirus (HPV) recently. Here, we demonstrate in HPV-driven (p16-positive high risk-HPV DNA-positive) HNSCC a deviating distribution of HLA antigens and haplotypes and their relevance to outcome. Methods Leukocyte DNA of n = 94 HPV-driven HNSCC patients (n = 57 OPSCC, n = 37 outside oropharynx) underwent HLA SSO typing, allowing allele, antigen (allele group), and haplo-typing. Besides comparing these frequencies with those of German blood donors, we analyzed their impact on outcome using Kaplan-Meier plots and Cox proportional hazard regression. Results Antigen and haplotype frequencies demonstrate enrichment of rare antigens and haplotypes. The HLA score for unselected HNSCC patients was not predictive for outcome here. However, together with alcohol consumption, tobacco smoking, T category, and extranodal extension of locoregional metastases and treatment applied, eight HLA traits allow for predicting progression-free and tumor-specific survival. Conclusion Patients can be categorized into low, intermediate-low, intermediate-high, and high risk groups. Using a new PFS risk score for HPV-driven HNSCC may allow to improve prognostication.
Collapse
Affiliation(s)
- Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital Leipzig, Leipzig, Germany
| | - Nathalie Vetter
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital Leipzig, Leipzig, Germany
| | - Claudia Lehmann
- Institute for Transfusion Medicine, Transplantation Immunology, University Hospital Leipzig, Leipzig, Germany
| | - Ramona Landgraf
- Institute for Transfusion Medicine, Transplantation Immunology, University Hospital Leipzig, Leipzig, Germany
| | - Ilias Doxiadis
- Institute for Transfusion Medicine, Transplantation Immunology, University Hospital Leipzig, Leipzig, Germany
| | - Rebecca Großmann
- Institute for Transfusion Medicine, Transplantation Immunology, University Hospital Leipzig, Leipzig, Germany
| | - Ekaterina Vorobeva
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital Leipzig, Leipzig, Germany
| | - Veit Zebralla
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital Leipzig, Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital Leipzig, Leipzig, Germany
| | - Theresa Wald
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital Leipzig, Leipzig, Germany
| |
Collapse
|
4
|
Saal M, Loeffler-Wirth H, Gruenewald T, Doxiadis I, Lehmann C. Genetic Predisposition to SARS-CoV-2 Infection: Cytokine Polymorphism and Disease Transmission within Households. Biology (Basel) 2023; 12:1385. [PMID: 37997984 PMCID: PMC10669642 DOI: 10.3390/biology12111385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/25/2023]
Abstract
We addressed the question of the influence of the molecular polymorphism of cytokines from different T helper subsets on the susceptibility to SARS-CoV-2 infection. From a cohort of 527 samples (collected from 26 May 2020 to 31 March 2022), we focused on individuals living in the same household (n = 58) with the SARS-CoV-2-infected person. We divided them into households with all individuals SARS-CoV-2 PCR positive (n = 29, households, 61 individuals), households with mixed PCR pattern (n = 24, 62) and negative households (n = 5, 15), respectively. TGF-β1 and IL-6 were the only cytokines tested with a significant difference between the cohorts. We observed a shift toward Th2 and the regulatory Th17 and Treg subset regulation for households with all members infected compared to those without infection. These data indicate that the genetically determined balance between the cytokines acting on different T helper cell subsets may play a pivotal role in transmission of and susceptibility to SARS-CoV-2 infection. Contacts infected by their index persons were more likely to highly express TGF-β1, indicating a reduced inflammatory response. Those not infected after contact had a polymorphism leading to a higher IL-6 expression. IL-6 acts in innate immunity, allergy and on the T helper cell differentiation, explaining the reduced susceptibility to SARS-CoV-2.
Collapse
Affiliation(s)
- Marius Saal
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany; (M.S.); (I.D.)
| | - Henry Loeffler-Wirth
- Interdisciplinary Centre for Bioinformatics, IZBI, Leipzig University, Haertelstr. 16–18, 04107 Leipzig, Germany;
| | - Thomas Gruenewald
- Clinic for Infectious Diseases and Tropical Medicine, Klinikum Chemnitz, Flemmingstraße 2, 09116 Chemnitz, Germany;
| | - Ilias Doxiadis
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany; (M.S.); (I.D.)
| | - Claudia Lehmann
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany; (M.S.); (I.D.)
| |
Collapse
|
5
|
Rottmayer K, Loeffler-Wirth H, Gruenewald T, Doxiadis I, Lehmann C. Individual Immune Response to SARS-CoV-2 Infection-The Role of Seasonal Coronaviruses and Human Leukocyte Antigen. Biology (Basel) 2023; 12:1293. [PMID: 37887003 PMCID: PMC10603889 DOI: 10.3390/biology12101293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
During the coronavirus pandemic, evidence is growing that the severity, susceptibility and host immune response to SARS-CoV-2 infection can be highly variable. Several influencing factors have been discussed. Here, we investigated the humoral immune response against SARS-CoV-2 spike, S1, S2, the RBD, nucleocapsid moieties and S1 of seasonal coronaviruses: hCoV-229E, hCoV-HKU1, hCoV-NL63 and hCoV-OC43, as well as MERS-CoV and SARS-CoV, in a cohort of 512 individuals. A bead-based multiplex assay allowed simultaneous testing for all the above antigens and the identification of different antibody patterns. Then, we correlated these patterns with 11 HLA loci. Regarding the seasonal coronaviruses, we found a moderate negative correlation between antibody levels against hCoV-229E, hCoV-HKU1 and hCoV-NL63 and the SARS-CoV-2 antigens. This could be an indication of the original immunological imprinting. High and low antibody response patterns were distinguishable, demonstrating the individuality of the humoral response towards the virus. An immunogenetical factor associated with a high antibody response (formation of ≥4 different antibodies) was the presence of HLA A*26:01, C*02:02 and DPB1*04:01 alleles, whereas the HLA alleles DRB3*01:01, DPB1*03:01 and DB1*10:01 were enriched in low responders. A better understanding of this variable immune response could enable more individualized protective measures.
Collapse
Affiliation(s)
- Karla Rottmayer
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany
| | - Henry Loeffler-Wirth
- Interdisciplinary Centre for Bioinformatics, IZBI, Leipzig University, Haertelstr. 16–18, 04107 Leipzig, Germany
| | - Thomas Gruenewald
- Clinic for Infectious Diseases and Tropical Medicine, Klinikum Chemnitz, Flemmingstraße 2, 09116 Chemnitz, Germany
| | - Ilias Doxiadis
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany
| | - Claudia Lehmann
- Laboratory for Transplantation Immunology, University Hospital Leipzig, Johannisallee 32, 04103 Leipzig, Germany
| |
Collapse
|
6
|
Brunner TJJ, Schuster T, Lehmann C. Leadership's long arm: The positive influence of digital leadership on managing technology-driven change over a strengthened service innovation capacity. Front Psychol 2023; 14:988808. [PMID: 36818099 PMCID: PMC9929460 DOI: 10.3389/fpsyg.2023.988808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/13/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction In this qualitative study, we examine digital leadership (DL) capabilities and their positive influence on the management of technology-driven change by leveraging service innovations. The context of digital transformation (DT) has triggered a new leadership paradigm, among others referred to as digital leadership (DL). However, despite its practical relevance, leadership research has yet paid little attention to conceptualise DL as an approach to digitally transform organisations. Methods Drawing on mid- and top-level mangers' experiences with service innovation projects, and based on Grounded Theory, we develop a taxonomy of DL-related capabilities and a conceptual framework which exemplifies their influences on dynamic service innovation capabilities (DSICs). DSICs build on the dynamic capabilities view (DCV) and represent the "organisational muscle" to repeatedly deliver service innovations indicating an effective management of technology-driven change. Results and Discussion Taxonomy results show that aggregated dimensions in terms of a digital leader's personal, social, and organisational capital serve as underpinnings (DL-related capabilities) to drive strategic change in DT contexts. The conceptual framework further reveals that especially the personal and organisational capital of a digital leader owns several strong and moderate influences on DSICs which demonstrates DL's "long arm" on the management of technology-driven change. Our findings contribute to leadership research by advancing the conceptualisation of DL and by adding a novel micro-foundational perspective towards the DCV discourse. As organisations struggle to realise the full benefits of DT initiatives, our results also provide a valuable contribution for practitioners by supporting them to strategically prepare for the human-related challenges of DT.
Collapse
|
7
|
Lehmann C, Pehnke S, Weimann A, Bachmann A, Dittrich K, Petzold F, Fürst D, de Fallois J, Landgraf R, Henschler R, Lindner TH, Halbritter J, Doxiadis I, Popp B, Münch J. Extended genomic HLA typing identifies previously unrecognized mismatches in living kidney transplantation. Front Immunol 2023; 14:1094862. [PMID: 36776892 PMCID: PMC9911689 DOI: 10.3389/fimmu.2023.1094862] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Antibody mediated rejection (ABMR) is the most common cause of long-term allograft loss in kidney transplantation (KT). Therefore, a low human leukocyte antigen (HLA) mismatch (MM) load is favorable for KT outcomes. Hitherto, serological or low-resolution molecular HLA typing have been adapted in parallel. Here, we aimed to identify previously missed HLA mismatches and corresponding antibodies by high resolution HLA genotyping in a living-donor KT cohort. Methods 103 donor/recipient pairs transplanted at the University of Leipzig Medical Center between 1998 and 2018 were re-typed using next generation sequencing (NGS) of the HLA loci -A, -B, -C, -DRB1, -DRB345, -DQA1, -DQB1, -DPA1, and -DPB1. Based on these data, we compiled HLA MM counts for each pair and comparatively evaluated genomic HLA-typing with pre-transplant obtained serological/low-resolution HLA (=one-field) typing results. NGS HLA typing (=two-field) data was further used for reclassification of de novo HLA antibodies as "donor-specific". Results By two-field HLA re-typing, we were able to identify additional MM in 64.1% (n=66) of cases for HLA loci -A, -B, -C, -DRB1 and -DQB1 that were not observed by one-field HLA typing. In patients with biopsy proven ABMR, two-field calculated MM count was significantly higher than by one-field HLA typing. For additional typed HLA loci -DRB345, -DQA1, -DPA1, and -DPB1 we observed 2, 26, 3, and 23 MM, respectively. In total, 37.3% (69/185) of de novo donor specific antibodies (DSA) formation was directed against these loci (DRB345 ➔ n=33, DQA1 ➔ n=33, DPA1 ➔ n=1, DPB1 ➔ n=10). Conclusion Our results indicate that two-field HLA typing is feasible and provides significantly more sensitive HLA MM recognition in living-donor KT. Furthermore, accurate HLA typing plays an important role in graft management as it can improve discrimination between donor and non-donor HLA directed cellular and humoral alloreactivity in the long range. The inclusion of additional HLA loci against which antibodies can be readily detected, HLA-DRB345, -DQA1, -DQB1, -DPA1, and -DPB1, will allow a more precise virtual crossmatch and better prediction of potential DSA. Furthermore, in living KT, two-field HLA typing could contribute to the selection of the immunologically most suitable donors.
Collapse
Affiliation(s)
- Claudia Lehmann
- Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Sarah Pehnke
- Division of Nephrology, Department of Internal Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Antje Weimann
- Division of Visceral Surgery and Transplantation Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Anette Bachmann
- Division of Nephrology, Department of Internal Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Katalin Dittrich
- Department of Pediatric Nephrology, University of Leipzig Medical Center, Leipzig, Germany
| | - Friederike Petzold
- Division of Nephrology, Department of Internal Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Daniel Fürst
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Jonathan de Fallois
- Division of Nephrology, Department of Internal Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Ramona Landgraf
- Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Reinhard Henschler
- Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Tom H Lindner
- Division of Nephrology, Department of Internal Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Jan Halbritter
- Division of Nephrology, Department of Internal Medicine, University of Leipzig Medical Center, Leipzig, Germany.,Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ilias Doxiadis
- Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Bernt Popp
- Institute of Human Genetics, University of Leipzig, Leipzig, Germany
| | - Johannes Münch
- Division of Nephrology, Department of Internal Medicine, University of Leipzig Medical Center, Leipzig, Germany.,Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
8
|
Schwarze M, Luo J, Brakel A, Krizsan A, Lakowa N, Grünewald T, Lehmann C, Wolf J, Borte S, Milkovska-Stamenova S, Gabert J, Scholz M, Hoffmann R. Evaluation of S- and M-Proteins Expressed in Escherichia coli and HEK Cells for Serological Detection of Antibodies in Response to SARS-CoV-2 Infections and mRNA-Based Vaccinations. Pathogens 2022; 11:pathogens11121515. [PMID: 36558849 PMCID: PMC9782079 DOI: 10.3390/pathogens11121515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
This study investigated the IgG and IgA antibody response against recombinant S1 and receptor binding domains (RBD) of the spike (S-) protein and the membrane (M-) protein using a set of 115 serum samples collected from patients infected with SARS-CoV-2 in Germany before April 2021 using protein and peptide ELISA. As S1- and RBD-proteins expressed in Escherichia coli provided poor sensitivities in ELISA, they were replaced by proteins expressed in HEK cells. The RBD-ELISA provided a sensitivity of 90.6% (N = 85) for samples collected from patients with confirmed SARS-CoV-2 infections more than 14 days after symptom onset or a positive PCR test. In population-based controls, the specificity was 97.9% (N = 94). In contrast, the sensitivities were only 41.2% and 72.6% for M- and N-proteins, respectively, while the specificities were 88.5% and 100%, respectively. Considering also 20 samples collected during the first two weeks of symptom onset or PCR confirmation, the sensitivity of RBD- and N-protein ELISA decreased to 82.6% and 72.6%, respectively. The combination of two data sets, i.e., N- and RBD-, N- and M-, or RBD- and M-proteins increased the sensitivity to 85.8%, 77.9%, and 87.8%, respectively. Peptide mapping mostly confirmed epitopes previously reported for S1- and M-proteins, but they were only recognized by a few samples already tested positive in the corresponding protein ELISA indicating that peptide-based assays will not improve the diagnostic sensitivity.
Collapse
Affiliation(s)
- Mandy Schwarze
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
| | - Ji Luo
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
- Adversis Pharma GmbH, 04103 Leipzig, Germany
| | - Alexandra Brakel
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
| | - Andor Krizsan
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
| | - Nicole Lakowa
- Klinik für Infektions- und Tropenmedizin, Klinikum Chemnitz gGmbH, 09113 Chemnitz, Germany
| | - Thomas Grünewald
- Klinik für Infektions- und Tropenmedizin, Klinikum Chemnitz gGmbH, 09113 Chemnitz, Germany
| | - Claudia Lehmann
- Laboratory for Transplantation Immunology, Institute for Transfusion Medicine, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Johannes Wolf
- Department of Laboratory Medicine, Hospital St. Georg gGmbH, 04129 Leipzig, Germany
- Immuno Deficiency Center Leipzig, Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiency Diseases, Hospital St. Georg gGmbH, 04129 Leipzig, Germany
| | - Stephan Borte
- Department of Laboratory Medicine, Hospital St. Georg gGmbH, 04129 Leipzig, Germany
- Immuno Deficiency Center Leipzig, Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiency Diseases, Hospital St. Georg gGmbH, 04129 Leipzig, Germany
| | - Sanja Milkovska-Stamenova
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
- Adversis Pharma GmbH, 04103 Leipzig, Germany
| | - Jörg Gabert
- Adversis Pharma GmbH, 04103 Leipzig, Germany
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, 04107 Leipzig, Germany
- LIFE Research Center of Civilization Diseases, Universität Leipzig, 04103 Leipzig, Germany
| | - Ralf Hoffmann
- Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, Universität Leipzig, 04103 Leipzig, Germany
- Center for Biotechnology and Biomedicine, Universität Leipzig, 04103 Leipzig, Germany
- Correspondence:
| |
Collapse
|
9
|
Luo J, Brakel A, Krizsan A, Ludwig T, Mötzing M, Volke D, Lakowa N, Grünewald T, Lehmann C, Wolf J, Borte S, Milkovska-Stamenova S, Gabert J, Fingas F, Scholz M, Hoffmann R. Sensitive and specific serological ELISA for the detection of SARS-CoV-2 infections. Virol J 2022; 19:50. [PMID: 35305688 PMCID: PMC8934124 DOI: 10.1186/s12985-022-01768-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/24/2022] [Indexed: 12/28/2022] Open
Abstract
Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered the worldwide coronavirus disease 2019 (COVID-19) pandemic. Serological assays for the detection of SARS-CoV-2 infections are important to understand the immune response in patients and to obtain epidemiological data about the number of infected people, especially to identify asymptomatic persons not aware of a past infection. Methods We recombinantly produced SARS-CoV-2 nucleocapsid (N)-protein in Escherichia coli. We used the purified protein to develop an indirect enzyme-linked immunosorbent assay (ELISA) for the detection of SARS-CoV-2 specific antibodies. This ELISA method was optimized and validated with serum samples collected from 113 patients with RT-PCR-confirmed SARS-CoV-2 infections including hospitalized COVID-19 patients and 1500 control sera mostly collected before 2015 with different clinical background. Results The optimized N-protein-ELISA provided a sensitivity of 89.7% (n = 68) for samples collected from patients with confirmed SARS-CoV-2 infections and mild to severe symptoms more than 14 days after symptom onset or a positive PCR test. The antibody levels remained low for serum samples collected in the first six days (n = 23) and increased in the second week (n = 22) post symptom onset or PCR confirmation. At this early phase, the ELISA provided a sensitivity of 39.1% and 86.4%, respectively, reflecting the time of an IgG immune response against pathogens. The assay specificity was 99.3% (n = 1500; 95% CI 0.995–0.999). Serum samples from persons with confirmed antibody titers against human immunodeficiency viruses 1/2, parvovirus B19, hepatitis A/B virus, cytomegalovirus, Epstein Barr virus, and herpes simplex virus were tested negative. Conclusions We conclude that the N-protein-based ELISA developed here is well suited for the sensitive and specific serological detection of SARS-CoV-2 specific IgG antibodies in human serum for symptomatic infections. It may also prove useful to identify previous SARS-CoV-2 infections in vaccinated people, as all currently approved vaccines rely on the SARS-CoV-2 spike (S-) protein. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01768-4.
Collapse
|
10
|
Vittoraki AG, Fylaktou A, Tarassi K, Tsinaris Z, Siorenta A, Petasis GC, Gerogiannis D, Lehmann C, Carmagnat M, Doxiadis I, Iniotaki AG, Theodorou I. Hidden Patterns of Anti-HLA Class I Alloreactivity Revealed Through Machine Learning. Front Immunol 2021; 12:670956. [PMID: 34386000 PMCID: PMC8353326 DOI: 10.3389/fimmu.2021.670956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
Detection of alloreactive anti-HLA antibodies is a frequent and mandatory test before and after organ transplantation to determine the antigenic targets of the antibodies. Nowadays, this test involves the measurement of fluorescent signals generated through antibody-antigen reactions on multi-beads flow cytometers. In this study, in a cohort of 1,066 patients from one country, anti-HLA class I responses were analyzed on a panel of 98 different antigens. Knowing that the immune system responds typically to "shared" antigenic targets, we studied the clustering patterns of antibody responses against HLA class I antigens without any a priori hypothesis, applying two unsupervised machine learning approaches. At first, the principal component analysis (PCA) projections of intra-locus specific responses showed that anti-HLA-A and anti-HLA-C were the most distantly projected responses in the population with the anti-HLA-B responses to be projected between them. When PCA was applied on the responses against antigens belonging to a single locus, some already known groupings were confirmed while several new cross-reactive patterns of alloreactivity were detected. Anti-HLA-A responses projected through PCA suggested that three cross-reactive groups accounted for about 70% of the variance observed in the population, while anti-HLA-B responses were mainly characterized by a distinction between previously described Bw4 and Bw6 cross-reactive groups followed by several yet undocumented or poorly described ones. Furthermore, anti-HLA-C responses could be explained by two major cross-reactive groups completely overlapping with previously described C1 and C2 allelic groups. A second feature-based analysis of all antigenic specificities, projected as a dendrogram, generated a robust measure of allelic antigenic distances depicting bead-array defined cross reactive groups. Finally, amino acid combinations explaining major population specific cross-reactive groups were described. The interpretation of the results was based on the current knowledge of the antigenic targets of the antibodies as they have been characterized either experimentally or computationally and appear at the HLA epitope registry.
Collapse
Affiliation(s)
- Angeliki G Vittoraki
- Immunology Department & National Tissue Typing Center, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Asimina Fylaktou
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - Katerina Tarassi
- Immunology-Histocompatibility Department, "Evangelismos" General Hospital, Athens, Greece
| | - Zafeiris Tsinaris
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - Alexandra Siorenta
- Immunology Department & National Tissue Typing Center, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - George Ch Petasis
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - Demetris Gerogiannis
- Department of Computer Science & Engineering , University of Ioannina, Ioannina, Greece
| | - Claudia Lehmann
- Laboratory for Transplantation Immunology, Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | | | - Ilias Doxiadis
- Laboratory for Transplantation Immunology, Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Aliki G Iniotaki
- Nephrology and Transplantation Unit, Medical School of Athens, Laikon Hospital, Athens, Greece
| | - Ioannis Theodorou
- Laboratoire d'Immunologie, Hôpital St. Louis, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses UPMC UMRS CR7-Inserm U1135-CNRS ERL, Paris, France
| |
Collapse
|
11
|
Paul G, Meißner A, Neuneier J, Neuschmelting V, Grau S, Yagdiran A, Scheyerer MJ, Malin JJ, Suárez I, Lehmann C, Exner M, Wiesmüller GA, Higgins PG, Seifert H, Fätkenheuer G, Zweigner J, Jung N. Outbreak of Pseudomonas aeruginosa infections after CT-guided spinal injections. J Hosp Infect 2021; 116:1-9. [PMID: 34298033 DOI: 10.1016/j.jhin.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Meningitis and spinal infections with Gram-negative bacteria after local injections for treatment of chronic back pain are rare. This study investigated an outbreak of Pseudomonas aeruginosa infections following computed tomography (CT)-guided spinal injections (SI). METHODS A case was defined as a spinal infection or meningitis with P. aeruginosa after SI between 10th January and 1st March 2019 in the same outpatient clinic. Patients without microbiological evidence of P. aeruginosa but with a favourable response to antimicrobial therapy active against P. aeruginosa were defined as probable cases. FINDINGS Twenty-eight of 297 patients receiving CT-guided SI during the study period developed meningitis or spinal infections. Medical records were available for 19 patients. In 15 patients, there was microbiological evidence of P. aeruginosa, and four patients were defined as probable cases. Two of 19 patients developed meningitis, while the remaining 17 patients developed spinal infections. The median time from SI to hospital admission was 8 days (interquartile range 2-23 days). Patients mainly presented with back pain (N=18; 95%), and rarely developed fever (N=3; 16%). Most patients required surgery (N=16; 84%). Seven patients (37%) relapsed and one patient died. Although the source of infection was not identified microbiologically, documented failures in asepsis when performing SI probably contributed to these infections. CONCLUSIONS SI is generally considered safe, but non-adherence to asepsis can lead to deleterious effects. Spinal infections caused by P. aeruginosa are difficult to treat and have a high relapse rate.
Collapse
Affiliation(s)
- G Paul
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Gastroenterology, Hepatology, Pneumology and Infectious Diseases, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany.
| | - A Meißner
- Department of Hospital Hygiene and Infection Control, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - J Neuneier
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - V Neuschmelting
- Centre for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - S Grau
- Centre for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - A Yagdiran
- Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - M J Scheyerer
- Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - J J Malin
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - I Suárez
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - C Lehmann
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - M Exner
- Institute of Hygiene and Public Health, Bonn University, Bonn, Germany
| | - G A Wiesmüller
- Abteilung Infektions- and Umwelthygiene, Gesundheitsamt der Stadt Köln, Germany
| | - P G Higgins
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - H Seifert
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - G Fätkenheuer
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - J Zweigner
- Department of Hospital Hygiene and Infection Control, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - N Jung
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| |
Collapse
|
12
|
Dela Cruz M, Littmann E, Nayak R, Lehmann C, Keskey R, Baker T, Lin H, Bennett A, Kim G, Pinney S, Pamer E, Nguyen A. The Gut Microbiome in Heart Transplantation: A Prospective Pilot Study. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
13
|
Mosig T, Lehmann C, Neyer AK. Data-Driven Business Model Innovation: About Barriers and New Perspectives. Int J Innovation Technol Management 2021. [DOI: 10.1142/s0219877020400179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Today, data are increasing in importance for firms trying to create and maintain a competitive advantage. As value creation is highly dependent on this key resource, data, the necessity of re-designing firms’ business models arises. By conducting and analyzing 58 in-depth interviews, we contribute a distinct set of barriers to data-driven business model innovation showing how data-related, technology-related, aversions and regulatory hurdles are the most challenging. Based on six focus groups that discussed these findings, participants identified the necessity for a change in companies’ firm-centered perspectives on business. Hence, we propose a model of data-driven business ecosystems that aims to provide guidance for conducting successful business in a data-driven world.
Collapse
Affiliation(s)
- Tim Mosig
- HHL Leipzig Graduate School of Management, Center for Leading Innovation and Cooperation, Jahnallee 59 Leipzig, Saxony 04109, Germany
| | - Claudia Lehmann
- HHL Leipzig Graduate School of Management, Center for Leading Innovation and Cooperation, Jahnallee 59 Leipzig, Saxony 04109, Germany
| | - Anne-Katrin Neyer
- Chair for Human Resources Management and Business Governance, Martin-Luther-University Halle-Wittenberg Große Steinstraße 73, Halle (Saale), Saxony-Anhalt 06108, Germany
| |
Collapse
|
14
|
Horn C, Augustin M, Ercanoglu MS, Heger E, Knops E, Bondet V, Duffy D, Chon SH, Nierhoff D, Oette M, Schäfer H, Vivaldi C, Held K, Anderson J, Geldmacher C, Suárez I, Rybniker J, Klein F, Fätkenheuer G, Müller-Trutwin M, Lehmann C. HIV DNA reservoir and elevated PD-1 expression of CD4 T-cell subsets particularly persist in the terminal ileum of HIV-positive patients despite cART. HIV Med 2021; 22:397-408. [PMID: 33421299 DOI: 10.1111/hiv.13031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/23/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Despite its importance as an HIV anatomic sanctuary, little is known about the characteristics of the HIV reservoir in the terminal ileum (TI). In blood, the immune checkpoint inhibitor programmed-death-1 (PD-1) has been linked to the HIV reservoir and T-cell immune dysfunction. We thus evaluated PD-1 expression and cell-associated HIV DNA in memory CD4 T-cell subsets from TI, peripheral blood (PB) and rectum (RE) of untreated and treated HIV-positive patients to identify associations between PD-1 and HIV reservoir in other sites. METHODS Using mononuclear cells from PB, TI and RE of untreated HIV-positive (N = 6), treated (n = 18) HIV-positive and uninfected individuals (n = 16), we identified and sorted distinct memory CD4 T-cell subsets by flow cytometry, quantified their cell-associated HIV DNA using quantitative PCR and assessed PD-1 expression levels using geometric mean fluorescence intensity. Combined HIV-1 RNA in situ hybridization and immunohistochemistry was performed on ileal biopsy sections. RESULTS Combined antiretroviral therapy (cART)-treated patients with undetectable HIV RNA and significantly lower levels of HIV DNA in PB showed particularly high PD-1 expression in PB and TI, and high HIV DNA levels in TI, irrespective of clinical characteristics. By contrast, in treatment-naïve patients HIV DNA levels in memory CD4 T-cell subsets were high in PB and TI. CONCLUSION Elevated PD-1 expression on memory CD4 T-cells in PB and TI despite treatment points to continuous immune dysfunction and underlines the importance of evaluating immunotherapy in reversing HIV latency and T-cell reconstitution. As HIV DNA particularly persists in TI despite cART, investigating samples from TI is crucial in understanding HIV immunopathogenesis.
Collapse
Affiliation(s)
- C Horn
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Cologne, Germany
| | - M Augustin
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Cologne, Germany
| | - M S Ercanoglu
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany.,Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - E Heger
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - E Knops
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - V Bondet
- Immunobiology of Dendritic Cells Unit, Inserm U1223, Institut Pasteur, Paris Cedex 15, France
| | - D Duffy
- Immunobiology of Dendritic Cells Unit, Inserm U1223, Institut Pasteur, Paris Cedex 15, France
| | - S-H Chon
- Department of General, Visceral Surgery and Cancer Surgery, University Hospital Cologne, Cologne, Germany
| | - D Nierhoff
- Clinic for Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, Germany
| | - M Oette
- Clinic for Coloproctology, PanKlinik, Cologne, Germany
| | - H Schäfer
- Clinic for Coloproctology, PanKlinik, Cologne, Germany
| | - C Vivaldi
- Clinic for Coloproctology, PanKlinik, Cologne, Germany
| | - K Held
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.,German Center for Infection Research (DZIF), Munich, Germany
| | - J Anderson
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - C Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.,German Center for Infection Research (DZIF), Munich, Germany
| | - I Suárez
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - J Rybniker
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Cologne, Germany
| | - F Klein
- German Center for Infection Research (DZIF), Cologne, Germany.,Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - G Fätkenheuer
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Cologne, Germany
| | - M Müller-Trutwin
- Unité HIV, Inflammation & Persistence, Institut Pasteur, Paris Cedex 15, France
| | - C Lehmann
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Cologne, Germany
| |
Collapse
|
15
|
Suhr M, Lehmann C, Bauer CR, Bender T, Knopp C, Freckmann L, Öst Hansen B, Henke C, Aschenbrandt G, Kühlborn LK, Rheinländer S, Weber L, Marzec B, Hellkamp M, Wieder P, Sax U, Kusch H, Nussbeck SY. Menoci: lightweight extensible web portal enhancing data management for biomedical research projects. BMC Bioinformatics 2020; 21:582. [PMID: 33334310 PMCID: PMC7745495 DOI: 10.1186/s12859-020-03928-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Biomedical research projects deal with data management requirements from multiple sources like funding agencies' guidelines, publisher policies, discipline best practices, and their own users' needs. We describe functional and quality requirements based on many years of experience implementing data management for the CRC 1002 and CRC 1190. A fully equipped data management software should improve documentation of experiments and materials, enable data storage and sharing according to the FAIR Guiding Principles while maximizing usability, information security, as well as software sustainability and reusability. RESULTS We introduce the modular web portal software menoci for data collection, experiment documentation, data publication, sharing, and preservation in biomedical research projects. Menoci modules are based on the Drupal content management system which enables lightweight deployment and setup, and creates the possibility to combine research data management with a customisable project home page or collaboration platform. CONCLUSIONS Management of research data and digital research artefacts is transforming from individual researcher or groups best practices towards project- or organisation-wide service infrastructures. To enable and support this structural transformation process, a vital ecosystem of open source software tools is needed. Menoci is a contribution to this ecosystem of research data management tools that is specifically designed to support biomedical research projects.
Collapse
Affiliation(s)
- M Suhr
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany.
| | - C Lehmann
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - C R Bauer
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - T Bender
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - C Knopp
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - L Freckmann
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - B Öst Hansen
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - C Henke
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - G Aschenbrandt
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - L K Kühlborn
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - S Rheinländer
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - L Weber
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - B Marzec
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - M Hellkamp
- GWDG, Gesellschaft für Wissenschaftliche Datenverarbeitung mbH Göttingen, Am Faßberg 11, 37077, Göttingen, Germany
| | - P Wieder
- GWDG, Gesellschaft für Wissenschaftliche Datenverarbeitung mbH Göttingen, Am Faßberg 11, 37077, Göttingen, Germany
| | - U Sax
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - H Kusch
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
- Department of Molecular Biology, University Medical Center Göttingen, Humboldtallee 23, 37075, Göttingen, Germany
| | - S Y Nussbeck
- Department of Medical Informatics, University Medical Center Göttingen, von-Siebold-Str. 3, 37075, Göttingen, Germany
- University Medical Center Göttingen, UMG Biobank, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| |
Collapse
|
16
|
Meyer M, Rübsteck E, Lehmann C, Klein F, Gruell H, Hünseler C, Weber LT. [Prevalence of SARS-CoV-2 in children from a cohort of 2192 patients]. Monatsschr Kinderheilkd 2020; 169:46-51. [PMID: 33235395 PMCID: PMC7676857 DOI: 10.1007/s00112-020-01067-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/08/2020] [Indexed: 01/10/2023]
Abstract
Hintergrund In Deutschland sind aktuell (Stand 18.06.2020) 187.764 SARS-CoV-2-Infektionen gemeldet. 6,9 % der Infizierten sind dabei unter 19 Jahre. Es gibt erste Hinweise darauf, dass Kinder häufig asymptomatisch sind und einen milderen Verlauf zeigen. Ziel der Arbeit Ziel dieser Arbeit war es, eine Aussage bezüglich der Infektionsprävalenz in dieser speziellen Patientengruppe zu ermöglichen. Material und Methoden Im Rahmen der SARS-CoV-2-Pandemie wurden zwischen dem 13.03.2020 und dem 18.06.2020 alle Kinder und Jugendlichen, welche entweder zum Ausschluss einer SARS-CoV-2-Infektion oder als Verdachtsfall einen Abstrich auf SARS-CoV‑2 erhielten, erfasst. Die Daten wurden auf standardisierten Anamnesebogen gesammelt und retrospektiv anonymisiert ausgewertet. Ergebnisse In dem Zeitraum wurden 2192 Kinder und Jugendliche auf SARS-CoV‑2 abgestrichen. 37 Patienten wurden positiv getestet (1,7 %). 36/37 waren Verdachtsfälle, und 28/37 waren symptomatisch. Führende Symptome waren trockener Husten, Schnupfen und Fieber. Drei Kinder mussten stationär betreut werden. Keines zeigte einen schweren Verlauf. Unter den Getesteten waren 505 Patienten, die aufgrund ihrer chronischen Grunderkrankung als Risikopatienten eingestuft wurden, von denen 3 (0,6 %) einen positiven Nachweis mit asymptomatischem bzw. mildem Verlauf hatten. Schlussfolgerung Hiermit können die ersten Daten bestätigt werden, wonach Kinder und Jugendliche häufig asymptomatische oder klinisch milde Infektions- bzw. Erkrankungsverläufe zeigen. Zudem fanden wir keinen Hinweis für eine hohe Dunkelziffer für SARS-CoV-2-Infektionen in dieser regionalen pädiatrischen Kohorte.
Collapse
Affiliation(s)
- M. Meyer
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Kerpener Str. 62, 50924 Köln, Deutschland
| | - E. Rübsteck
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Kerpener Str. 62, 50924 Köln, Deutschland
| | - C. Lehmann
- Medizinische Fakultät und Uniklinik Köln, Innere Medizin I (Onkologie, Hämatologie, Klinische Infektiologie, Klinische Immunologie, Hämostaseologie, Internistische Intensivmedizin), Universität zu Köln, Köln, Deutschland
| | - F. Klein
- Medizinische Fakultät und Uniklinik Köln, Institut für Virologie, Universität zu Köln, Köln, Deutschland
| | - H. Gruell
- Medizinische Fakultät und Uniklinik Köln, Institut für Virologie, Universität zu Köln, Köln, Deutschland
| | - C. Hünseler
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Kerpener Str. 62, 50924 Köln, Deutschland
| | - L. T. Weber
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Kerpener Str. 62, 50924 Köln, Deutschland
| |
Collapse
|
17
|
Paul G, Wesselmann J, Adzic D, Malin JJ, Suarez I, Priesner V, Kümmerle T, Wyen C, Jung N, van Bremen K, Schlabe S, Wasmuth JC, Boesecke C, Fätkenheuer G, Rockstroh J, Schwarze-Zander C, Lehmann C. Predictors of serofast state after treatment for early syphilis in HIV-infected patients. HIV Med 2020; 22:165-171. [PMID: 33128333 DOI: 10.1111/hiv.12985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/25/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Non-treponemal serological tests are used to monitor treatment response during syphilis infection. Syphilis- and HIV-coinfected patients may experience incomplete resolution in non-treponemal titres, which is referred to as the serofast state. The goal of this study was to evaluate risk factors for serofast state in HIV-infected patients. METHODS From November 2015 to June 2018, 1530 HIV-positive patients were tested for syphilis using a Treponema pallidum particle agglutination (TPPA) assay. Among TPPA-positive patients, medical records were reviewed for early syphilis infection. Serofast state was defined as a less than four-fold decrease in non-treponemal antibody titres during a 6-month follow-up period in the absence of symptoms of syphilis. Baseline characteristics were tested as predictive factors of serological response. RESULTS In all, 515 patients (33.7%) tested positive in TPPA assays, and in 163 patients at least one previous syphilis infection was documented. A total of 61 out of 163 patients (37.4%) were in a serofast state. A history of previous syphilis infection (61 vs. 43%; P = 0.04) was more common in serofast patients than in patients with serological cure after 6 months. Non-treponemal titres ≥ 1:32 before therapy (47 vs. 25%; P = 0.005) and adjunctive corticosteroids to prevent the Jarisch-Herxheimer reaction (35% vs 15%; P = 0.006) were associated with serological cure after 6 months, but corticosteroid therapy had no influence at 12 months. The intensity of syphilis treatment did not affect serological cure. CONCLUSION Corticosteroids for prevention of the Jarisch-Herxheimer reaction were associated with earlier serological cure. Although serological response is the accredited surrogate method to monitor syphilis treatment, the biological significance of the serofast state remains unclear.
Collapse
Affiliation(s)
- G Paul
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Department of Gastroenterology, Hepatology, Pneumology and Infectious Diseases, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany
| | - J Wesselmann
- Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | - D Adzic
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - J J Malin
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - I Suarez
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - V Priesner
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - T Kümmerle
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - C Wyen
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - N Jung
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - K van Bremen
- Department of Medicine I, Bonn University Hospital, Bonn, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - S Schlabe
- Department of Medicine I, Bonn University Hospital, Bonn, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - J-C Wasmuth
- Department of Medicine I, Bonn University Hospital, Bonn, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - C Boesecke
- Department of Medicine I, Bonn University Hospital, Bonn, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - G Fätkenheuer
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - J Rockstroh
- Department of Medicine I, Bonn University Hospital, Bonn, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - C Schwarze-Zander
- Department of Medicine I, Bonn University Hospital, Bonn, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - C Lehmann
- Division of Infectious Diseases, Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| |
Collapse
|
18
|
Vittoraki AG, Fylaktou A, Tarassi K, Tsinaris Z, Petasis GC, Gerogiannis D, Kheav VD, Carmagnat M, Lehmann C, Doxiadis I, Iniotaki AG, Theodorou I. Patterns of 1,748 Unique Human Alloimmune Responses Seen by Simple Machine Learning Algorithms. Front Immunol 2020; 11:1667. [PMID: 32849576 PMCID: PMC7399170 DOI: 10.3389/fimmu.2020.01667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/22/2020] [Indexed: 01/15/2023] Open
Abstract
Allele specific antibody response against the polymorphic system of HLA is the allogeneic response marker determining the immunological risk for graft acceptance before and after organ transplantation and therefore routinely studied during the patient's workup. Experimentally, bead bound antigen- antibody reactions are detected using a special multicolor flow cytometer (Luminex). Routinely for each sample, antibody responses against 96 different HLA antigen groups are measured simultaneously and a 96-dimensional immune response vector is created. Under a common experimental protocol, using unsupervised clustering algorithms, we analyzed these immune intensity vectors of anti HLA class II responses from a dataset of 1,748 patients before or after renal transplantation residing in a single country. Each patient contributes only one serum sample in the analysis. A population view of linear correlations of hierarchically ordered fluorescence intensities reveals patterns in human immune responses with striking similarities with the previously described CREGs but also brings new information on the antigenic properties of class II HLA molecules. The same analysis affirms that "public" anti-DP antigenic responses are not correlated to anti DR and anti DQ responses which tend to cluster together. Principal Component Analysis (PCA) projections also demonstrate ordering patterns clearly differentiating anti DP responses from anti DR and DQ on several orthogonal planes. We conclude that a computer vision of human alloresponse by use of several dimensionality reduction algorithms rediscovers proven patterns of immune reactivity without any a priori assumption and might prove helpful for a more accurate definition of public immunogenic antigenic structures of HLA molecules. Furthermore, the use of Eigen decomposition on the Immune Response generates new hypotheses that may guide the design of more effective patient monitoring tests.
Collapse
Affiliation(s)
- Angeliki G Vittoraki
- National Tissue Typing Center & Immunology Department, General Hospital of Athens "G.Gennimatas", Athens, Greece
| | - Asimina Fylaktou
- National Peripheral Histocompatibility Center - Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - Katerina Tarassi
- Immunology-Histocompatibility Department, "Evangelismos" General Hospital, Athens, Greece
| | - Zafeiris Tsinaris
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - George Ch Petasis
- National Peripheral Histocompatibility Center - Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - Demetris Gerogiannis
- Department of Computer Science & Engineering, University of Ioannina, Ioannina, Greece
| | | | | | - Claudia Lehmann
- Laboratory for Transplantation Immunology, Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Ilias Doxiadis
- Laboratory for Transplantation Immunology, Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Aliki G Iniotaki
- Nephrology and Transplantation Unit, Medical School of Athens, Laikon Hospital, Athens, Greece
| | - Ioannis Theodorou
- Laboratoire d'Immunologie, Hôpital St. Louis, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses UPMC UMRS CR7 - Inserm U1135 - CNRS ERL 8255, Paris, France
| |
Collapse
|
19
|
Pehnke S, Lindner TH, Popp B, Doxiadis I, Landgraf R, Lehmann C, Halbritter J, Münch J. P1776HLA TYPING BY NGS ENHANCES MISMATCH DETECTION IN LIVING KIDNEY TRANSPLANTATION. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Antibody mediated rejection (ABMR) due to the development of donor specific HLA antibodies is the most common cause for graft loss in kidney transplant recipients. Therefore, a low count of HLA mismatches is favorable in the course of transplantation. Hitherto, several techniques for HLA typing have been adapted in parallel, e.g. serological or low-resolution PCR. In this single-center study, we aimed to perform “HLA re-typing” by next generation sequencing (NGS) in a living kidney transplant cohort (n=143), in order to identify HLA mismatches in donor/recipient pairs, that were missed by previous HLA typing methods.
Method
We isolated DNA of 102 donor/recipient pairs, that received a living kidney transplantation at the University Hospital Leipzig (Germany) between 1998 and 2018, and performed long range PCR of all known HLA loci. Using these NGS results, we compiled a genomic HLA mismatch formula. We evaluated, if genomic HLA typing identifies more HLA mismatches compared to the results of previous HLA typing methods, that were recorded in the Eurotransplant database for our donor/recipient pairs.
Results
By genomic HLA typing, we were able to identify HLA mismatches in 10.2 % of donor/recipient pairs, that have been missed by previous methods. In our cohort, we recognized most mismatches in the DRB1 locus, that were missed with other HLA typing techniques.
Conclusion
Our results suggest, that genomic HLA typing can be more precise in detecting HLA mismatches in donor recipient/pairs. Especially in the course of living kidney transplantation, a higher accuracy in HLA typing might enhance donor selection. Furthermore, accurate HLA typing can influence graft management in the course of ABMR, as it may improve the detection of donor specific HLA directed antibodies.
Collapse
Affiliation(s)
- Sarah Pehnke
- University Hospital Leipzig, Division of Nephrology, Department of Internal Medicine, Leipzig, Germany
| | - Tom H Lindner
- University Hospital Leipzig, Division of Nephrology, Department of Internal Medicine, Leipzig, Germany
| | - Bernt Popp
- University Hospital Leipzig, Institute of Human Genetics, Leipzig, Germany
| | - Ilias Doxiadis
- University Hospital Leipzig, Institute for Transfusion Medicine, Leipzig, Germany
| | - Ramona Landgraf
- University Hospital Leipzig, Institute for Transfusion Medicine, Leipzig, Germany
| | - Claudia Lehmann
- University Hospital Leipzig, Institute for Transfusion Medicine, Leipzig, Germany
| | - Jan Halbritter
- University Hospital Leipzig, Division of Nephrology, Department of Internal Medicine, Leipzig, Germany
| | - Johannes Münch
- University Hospital Leipzig, Division of Nephrology, Department of Internal Medicine, Leipzig, Germany
| |
Collapse
|
20
|
Raspe M, Rolling T, Leisse C, Fischer J, Lehmann C. [Career Prospects for Young Physicians in Infectious Diseases]. Pneumologie 2019; 73:586-591. [PMID: 31622997 DOI: 10.1055/a-0976-8928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Infectious Diseases are a cross-sectional area connected to various medical disciplines and offer interested physicians multiple working opportunities. The spectrum of infectious diseases covers both out- and inpatient care as well as basic, clinical and epidemiological research. The need for infectious diseases specialists is increasing, thus career prospects are promising. Working conditions in infectious diseases are comparatively family-friendly. With this article we intend to arouse interest for working in the fascinating fields of infectious diseases and provide information on career opportunities. Data from a recently conducted survey among members of the German Society of Infectious Diseases deliver insight, how infectious disease specialists work today.
Collapse
Affiliation(s)
- M Raspe
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik m. S. Infektiologie und Pneumologie, Berlin
| | - T Rolling
- I. Medizinische Klinik und Poliklinik, Sektion Infektiologie, Universitätsklinikum Hamburg-Eppendorf.,Deutsches Zentrum für Infektionsforschung, Hamburg-Lübeck-Borstel-Riems, Standort Hamburg
| | - C Leisse
- Klinik I für Innere Medizin, Klinische Infektiologie, Universitätsklinikum Köln
| | - J Fischer
- Klinik I für Innere Medizin, Klinische Infektiologie, Universitätsklinikum Köln.,Deutsches Zentrum für Infektionsforschung, Köln-Bonn, Standort Köln
| | - C Lehmann
- Klinik I für Innere Medizin, Klinische Infektiologie, Universitätsklinikum Köln.,Deutsches Zentrum für Infektionsforschung, Köln-Bonn, Standort Köln
| |
Collapse
|
21
|
Abstract
Human immunodeficiency virus (HIV) infection has become a chronic disease with a favourable prognosis if adequate antiretroviral therapy (ART) is applied. Therefore, each patient with HIV infection should be treated irrespectively of clinical symptoms or of immunological status. A combination of three active drugs that have to be taken life-long has been standard for many years. The regimen contains two nucleoside reverse transcriptase inhibitors plus either an integrase inhibitor, a boosted protease inhibitor, or a non-nucleoside reverse transcriptase inhibitor. Integrase inhibitors are recommended as the third partner of choice by recent guidelines due to their high efficacy and their favourable safety profile. Many combination drugs are now available which allow a simple treatment with few tablets and in many instances a one-pill combination per day is an option. Potential interactions with drugs given for other diseases have to be taken into account, especially if a pharmacological booster is part of the regimen. Combination therapy should be changed if either virological failure (HIV RNA >200 copies/ml) or drug-related adverse events occur. In special situations (e. g. pregnancy) highly experienced experts in the field should be consulted. Novel approaches for HIV therapy include dual therapy as well as treatment with long-acting substances. Beside therapy, antiretroviral drugs are used for prevention either as post-exposure prophylaxis or as pre-exposure prophylaxis.
Collapse
Affiliation(s)
- C Lehmann
- Deutsches Zentrum für Infektionsforschung, Köln-Bonn, Standort Köln, Köln, Deutschland. .,Klinische Infektiologie, Innere Medizin I, Universitätsklinikum Köln, Köln, Deutschland.
| | - J Malin
- Klinische Infektiologie, Innere Medizin I, Universitätsklinikum Köln, Köln, Deutschland
| | - I Suárez
- Deutsches Zentrum für Infektionsforschung, Köln-Bonn, Standort Köln, Köln, Deutschland.,Klinische Infektiologie, Innere Medizin I, Universitätsklinikum Köln, Köln, Deutschland
| | - G Fätkenheuer
- Deutsches Zentrum für Infektionsforschung, Köln-Bonn, Standort Köln, Köln, Deutschland.,Klinische Infektiologie, Innere Medizin I, Universitätsklinikum Köln, Köln, Deutschland
| |
Collapse
|
22
|
Ziemann M, Altermann W, Angert K, Arns W, Bachmann A, Bakchoul T, Banas B, von Borstel A, Budde K, Ditt V, Einecke G, Eisenberger U, Feldkamp T, Görg S, Guthoff M, Habicht A, Hallensleben M, Heinemann FM, Hessler N, Hugo C, Kaufmann M, Kauke T, Koch M, König IR, Kurschat C, Lehmann C, Marget M, Mühlfeld A, Nitschke M, Pego da Silva L, Quick C, Rahmel A, Rath T, Reinke P, Renders L, Sommer F, Spriewald B, Staeck O, Stippel D, Süsal C, Thiele B, Zecher D, Lachmann N. Preformed Donor-Specific HLA Antibodies in Living and Deceased Donor Transplantation: A Multicenter Study. Clin J Am Soc Nephrol 2019; 14:1056-1066. [PMID: 31213508 PMCID: PMC6625630 DOI: 10.2215/cjn.13401118] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/23/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES The prognostic value of preformed donor-specific HLA antibodies (DSA), which are only detectable by sensitive methods, remains controversial for kidney transplantation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The outcome of 4233 consecutive kidney transplants performed between 2012 and 2015 in 18 German transplant centers was evaluated. Most centers used a stepwise pretransplant antibody screening with bead array tests and differentiation of positive samples by single antigen assays. Using these screening results, DSA against HLA-A, -B, -C, -DRB1 and -DQB1 were determined. Data on clinical outcome and possible covariates were collected retrospectively. RESULTS Pretransplant DSA were associated with lower overall graft survival, with a hazard ratio of 2.53 for living donation (95% confidence interval [95% CI], 1.49 to 4.29; P<0.001) and 1.59 for deceased donation (95% CI, 1.21 to 2.11; P=0.001). ABO-incompatible transplantation was associated with worse graft survival (hazard ratio, 2.09; 95% CI, 1.33 to 3.27; P=0.001) independent from DSA. There was no difference between DSA against class 1, class 2, or both. Stratification into DSA <3000 medium fluorescence intensity (MFI) and DSA ≥3000 MFI resulted in overlapping survival curves. Therefore, separate analyses were performed for 3-month and long-term graft survival. Although DSA <3000 MFI tended to be associated with both lower 3-month and long-term transplant survival in deceased donation, DSA ≥3000 MFI were only associated with worse long-term transplant survival in deceased donation. In living donation, only strong DSA were associated with reduced graft survival in the first 3 months, but both weak and strong DSA were associated with reduced long-term graft survival. A higher incidence of antibody-mediated rejection within 6 months was only associated with DSA ≥3000 MFI. CONCLUSIONS Preformed DSA were associated with an increased risk for graft loss in kidney transplantation, which was greater in living than in deceased donation. Even weak DSA <3000 MFI were associated with worse graft survival. This association was stronger in living than deceased donation.
Collapse
Affiliation(s)
| | - Wolfgang Altermann
- Institute for Transfusion Medicine, University Hospital Halle, Halle, Germany
| | | | - Wolfgang Arns
- Clinic for Internal Medicine I, Kliniken der Stadt Köln, Cologne, Germany
| | - Anette Bachmann
- Medical Department III - Endocrinology, Nephrology, Rheumatology and
| | | | - Bernhard Banas
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Annette von Borstel
- Institute for Transfusion Medicine, Kliniken der Stadt Köln, Cologne, Germany
| | - Klemens Budde
- Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Vanessa Ditt
- Institute for Transfusion Medicine, Kliniken der Stadt Köln, Cologne, Germany
| | | | | | - Thorsten Feldkamp
- Transplant Center, University Hospital of Schleswig-Holstein, Kiel, Germany
| | | | - Martina Guthoff
- Section for Renal and Hypertensive Disorders, Clinic for Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
| | | | - Michael Hallensleben
- Institute for Transfusion Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Nicole Hessler
- Institute of Medical Biometry and Statistics, University Medical Center Schleswig-Holstein Lübeck, Germany
| | - Christian Hugo
- Clinic for Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Matthias Kaufmann
- Regional Office North, German Organ Transplantation Foundation, Hannover, Germany
| | - Teresa Kauke
- Department of General, Visceral, Vascular, and Transplant Surgery and.,Department for Transfusion Medicine, Hospital of the Ludwig-Maximilians-University München München, Germany.,Department for Transfusion Medicine, Hospital of the Ludwigs-Maximilians-University München, München, Germany
| | | | - Inke R König
- Institute of Medical Biometry and Statistics, University Medical Center Schleswig-Holstein Lübeck, Germany
| | | | - Claudia Lehmann
- Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Marget
- Institute for Transfusion Medicine, University Hospital Hamburg, Hamburg, Germany
| | - Anja Mühlfeld
- Clinic for Renal and Hypertensive Disorders, Rheumatological and Immunological Diseases, University Hospital Aachen, Aachen, Germany
| | - Martin Nitschke
- Transplant center, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | | | - Carmen Quick
- Clinic for Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Axel Rahmel
- German Organ Transplantation Foundation, Frankfurt, Germany
| | - Thomas Rath
- Department for Nephrology and Transplantation, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Petra Reinke
- Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lutz Renders
- Department for Nephrology, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany
| | - Florian Sommer
- Department of General, Visceral, and Transplant Surgery, Klinikum Augsburg, Augsburg, Germany
| | - Bernd Spriewald
- Department of Medicine 5 - Hematology and Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Oliver Staeck
- Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Dirk Stippel
- Department of General, Visceral Surgery and Surgical Oncology, University Hospital Cologne, Cologne, Germany
| | - Caner Süsal
- Institute of Immunology and Transplant Immunology, University Hospital, Heidelberg, Heidelberg, Germany
| | - Bernhard Thiele
- Institut für Immunologie und Genetik Kaiserslautern, Kaiserslautern, Germany; and
| | - Daniel Zecher
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Nils Lachmann
- HLA Laboratory, Institute of Transfusion Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
23
|
Stecher M, Chaillon A, Eis-Hübinger AM, Lehmann C, Fätkenheuer G, Wasmuth JC, Knops E, Vehreschild JJ, Mehta S, Hoenigl M. Pretreatment human immunodeficiency virus type 1 (HIV-1) drug resistance in transmission clusters of the Cologne-Bonn region, Germany. Clin Microbiol Infect 2019; 25:253.e1-253.e4. [PMID: 30315957 PMCID: PMC6349503 DOI: 10.1016/j.cmi.2018.09.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/25/2018] [Accepted: 09/28/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES In Germany, previous reports have demonstrated transmitted human immunodeficiency virus type 1 (HIV-1) drug-resistance mutations (DRM) in 11% of newly diagnosed individuals, highlighting the importance of drug-resistance screening before the initiation of antiretroviral therapy (ART). Here, we sought to understand the molecular epidemiology of HIV DRM transmission in the Cologne-Bonn region of Germany, given one of the highest rates of new HIV diagnoses in western Europe (13.7 per 100 000 habitants). METHODS We analysed 714 HIV-1 ART-naive infected individuals diagnosed at the University Hospitals Cologne and Bonn between 2001 and 2016. Screening for DRM was performed according to the Stanford University Genotypic Resistance Interpretation. Shared DRM were defined as any DRM present in genetically linked individuals (<1.5% genetic distance). Phylogenetic and network analyses were performed to infer putative relationships and shared DRM. RESULTS The prevalence of any DRM at time of diagnosis was 17.2% (123/714 participants). Genetic transmission network analyses showed comparable frequencies of DRM in clustering versus non-clustering individuals (17.1% (85/497) versus 17.5% (38/217)). The observed rate of DRM in the region was higher than previous reports 10.8% (87/809) (p < 0.001), revealing the need to reduce onward transmission in this area. Genetically linked individuals harbouring shared DRM were more likely to live in suburban areas (24/38) than in central Cologne (1/38) (p < 0.001). CONCLUSION The rate of DRM was exceptionally high. Network analysis elucidated frequent cases of shared DRM among genetically linked individuals, revealing the potential spread of DRM and the need to prevent onward transmission of DRM in the Cologne-Bonn area.
Collapse
Affiliation(s)
- M Stecher
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - A Chaillon
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA.
| | - A M Eis-Hübinger
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
| | - C Lehmann
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - G Fätkenheuer
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J-C Wasmuth
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany; Department for Internal Medicine I, University Hospital of Bonn, Bonn, Germany
| | - E Knops
- Institute of Virology, University Hospital of Cologne, Cologne, Germany
| | - J J Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - S Mehta
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Department of Medicine, San Diego VA Medical Centre, San Diego, CA, USA
| | - M Hoenigl
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Division of Pulmonology and Section of Infectious Diseases, Medical University of Graz, Graz, Austria
| |
Collapse
|
24
|
Scholten M, Suárez I, Platten M, Kümmerle T, Jung N, Wyen C, Ernst A, Horn C, Burst V, Suárez V, Rybniker J, Fätkenheuer G, Lehmann C. To prescribe, or not to prescribe: decision making in HIV-1 post-exposure prophylaxis. HIV Med 2018; 19:645-653. [PMID: 29993176 DOI: 10.1111/hiv.12645] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We investigated the trend in usage of post-exposure prophylaxis (PEP) after HIV-1 risk exposure and evaluated PEP prescription decision making of physicians according to guidelines. METHODS All PEP consultations from January 2014 to December 2016 in patients presenting at the University Hospital of Cologne (Germany) were retrospectively analysed. HIV risk contacts included sexual and occupational exposure. The European AIDS Clinical Society (EACS) Guidelines for HIV PEP (version 9.0, 2017) were used for assessment. RESULTS A total of 649 patients presented at the emergency department (ED) or the clinic for infectious diseases (IDC) for PEP consultations. A continuous increase in the number of PEP requests was recorded: 189 in 2014, 208 in 2015 and 252 in 2016. PEP consultations in men who have sex with men (MSM) showed a remarkable increase in 2016 (2014, n = 96; 2015, n = 101; 2016, n = 152). Decisions taken by physicians with a specialization in infectious diseases (n = 547) included 61 (11%) guideline-discordant prescriptions [2014: 14% (n = 22); 2015: 9% (n = 16); 2016: 11% (n = 23)]. Among these, sexual exposure accounted for 45 (74%) cases, including 15 cases of nonconsensual sex, while occupational exposure accounted for 14 (23%) cases and other exposure two cases (3%). The main reason for guideline-discordant PEP prescriptions was emotional stress of the patient (n = 37/61). CONCLUSIONS PEP prescriptions are increasing and decision making is influenced by patients' emotional stress, but PEP prescriptions should be strictly administered according to risk assessment.
Collapse
Affiliation(s)
- M Scholten
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - I Suárez
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - M Platten
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF) Partner Site Bonn-Cologne, Cologne, Germany
| | - T Kümmerle
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Practice Ebertplatz, Cologne, Germany
| | - N Jung
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF) Partner Site Bonn-Cologne, Cologne, Germany
| | - C Wyen
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Practice Ebertplatz, Cologne, Germany
| | - A Ernst
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - C Horn
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - V Burst
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - V Suárez
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - J Rybniker
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF) Partner Site Bonn-Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - G Fätkenheuer
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF) Partner Site Bonn-Cologne, Cologne, Germany
| | - C Lehmann
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF) Partner Site Bonn-Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| |
Collapse
|
25
|
Wichmann G, Lehmann C, Herchenhahn C, Kolb M, Hofer M, Wiegand S, Dietz A. Development of a Human Leukocyte Antigen Score to Predict Progression-Free Survival in Head and Neck Squamous Cell Carcinoma Patients. Front Oncol 2018; 8:168. [PMID: 29868484 PMCID: PMC5966661 DOI: 10.3389/fonc.2018.00168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/01/2018] [Indexed: 01/09/2023] Open
Abstract
Background In personalized medicine and treatment stratification of head and neck squamous cell carcinoma (HNSCC), the heterogeneous genetic background of patients is not considered. Human leukocyte antigen (HLA) alleles and HLA haplotypes (HLA traits) are linked to development of HNSCC and affect progression-free survival (PFS) of HNSCC patients but most head and neck oncologists are not familiar with HLA typing. Hence, we developed an HLA-score abstracting from complexity of HLA-typing results to facilitate potential use of HLA-associated hazard ratios (HR) for prognostic stratification. Methods The HR for PFS of 8 HLA traits shown to be independent predictors (Pi) of PFS in a test cohort (TC) of 90 HNSCC patients were used to build the HLA-score based on the natural logarithm (ln) of the Pi-associated HR. Crude ln-transformed HR of the eight Pi, alleles B*13 (2), B*35 (1), B*51 (2), DQB1*06 (1), homozygous Cw (1), homozygous DRB4 (2), and haplotypes A*01/B*08 (−6) and B*08/C*07 (4), were summed up to yield the individual patient’s HLA-score. Receiver operating characteristic (ROC) and Kaplan–Meier curves were used to proof the suitability of the HLA-score as prognostic marker for PFS. An independent validation cohort (iVC) of 32 patients treated in the larynx-organ preservation trial DeLOS-II was utilized for validation. Results The individual HLA-scores (range −2 to 6) in TC classified HNSCC patients regarding PFS. ROC analysis (area under the curve = 0.750, 95% CI 0.665–0.836; P = 0.0000034) demonstrated an optimum cutoff for the HLA-score at 0.5 (97.9% sensitivity, 34.7% specificity), and 70/90 patients in TC with HLA-score > 0 had significant reduced PFS (P = 0.001). Applying the same classifier (HLA-score > 0) confirmed these findings in the iVC revealing reduced PFS of 25/32 patients (P = 0.040). Conclusion HLA traits constitute critical Pi. Considering the HLA-score may potentially facilitate the use of genetic information from HLA typing for prognostic stratification, e.g., within clinical trials.
Collapse
Affiliation(s)
- Gunnar Wichmann
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Claudia Lehmann
- Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Cindy Herchenhahn
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany.,Clinic for Anesthesiology and Intensive Care, University Hospital Leipzig, Leipzig, Germany
| | - Marlen Kolb
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Mathias Hofer
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Susanne Wiegand
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| |
Collapse
|
26
|
Weiss C, Lehmann C, Maas R, Burghardt R, Niggemann B, Grüber C. Dysfunktionelle respiratorische Symptome bei Kindern und Jugendlichen. ACTA ACUST UNITED AC 2018. [DOI: 10.1055/s-0038-1629267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungDysfunktionelle respiratorische Symptome sind durch rekurrierend oder chronisch auftretende respiratorische Krankheitszeichen charakterisiert, die sich nicht durch strukturelle Besonderheiten der Atemwege erklären lassen und Symptome somatischer Erkrankungen imitieren können (somatoforme Atemstörungen). Die Systematisierung von dysfunktionellen respiratorischen Symptomen sowie die Entwicklung diagnostischer und therapeutischer Algorithmen sind relativ junge Arbeitsfelder der Pädiatrischen Pneumologie. Inzwischen sind diagnostische Mindestkriterien vorgeschlagen worden, die zur besseren Erkennung und Abgrenzung von somatischen Erkrankungen beitragen sollen. Eine frühzeitige Diagnosestellung ist erforderlich, um der Entwicklung von Fehlanpassungen entgegenzuwirken.
Collapse
|
27
|
Singh A, Kulkarni H, Langbein T, Lehmann C, Niepsch K, Müller D, Hommann M, Kaemmerer D, Jochems A, Lambin P, Hörsch D, Baum R. Peptide receptor radionuclide therapy of neuroendocrine neoplasms using lutetium-177 and yttrium-90 labeled somatostatin analogs: A single center experience in over 1000 patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368.011] [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: 11/12/2022] Open
|
28
|
Menrath I, Ernst G, Lehmann C, Mönkemöller K, Szczepanski R, Thyen U. Einfluss psychosozialer Risikofaktoren auf den Effekt von Patientenschulungen bei chronisch kranken Kindern. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605629] [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: 10/18/2022]
Affiliation(s)
- I Menrath
- Universitätsklinikum Schleswig-Holstein, Klinik für Kinder- und Jugendmedizin, Lübeck
| | - G Ernst
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover
| | - C Lehmann
- Charité Berlin, Pädiatrische Pneumonologie und Immunologie, Berlin
| | - K Mönkemöller
- Kliniken der Stadt Köln gGmbH, Kinderkrankenhaus Amsterdammerstraße, Köln
| | | | - U Thyen
- Universitätsklinikum Schleswig-Holstein, Klinik für Kinder- und Jugendmedizin, Lübeck
| |
Collapse
|
29
|
Guenter Greeff N, Heldstab H, Lehmann C. Domain Specific Role of S4 for Stepping into and Recovering from the Inactivated State as Obtained from Omega- and R4H Mutants in Nav1.2. Biophys J 2017. [DOI: 10.1016/j.bpj.2016.11.587] [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] Open
|
30
|
Lehmann C, Heldstab H, Guenter Greeff N. Omega Mutations along S4 in Nav1.2 Channels Give Insight into Domain Specific Contribution to Activation and Steady State Inactivation. Biophys J 2017. [DOI: 10.1016/j.bpj.2016.11.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
31
|
Arora N, Islam S, Wafa K, Zhou J, Toguri JT, Cerny V, Lehmann C. Evaluation of iris functional capillary density in experimental local and systemic inflammation. J Microsc 2017; 266:55-59. [PMID: 28102536 DOI: 10.1111/jmi.12518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/09/2016] [Accepted: 11/29/2016] [Indexed: 11/30/2022]
Abstract
The ocular microcirculation represents an important target to treat inflammatory diseases of eye, where impairment of microvascular blood flow plays key role as, for example, in anterior uveitis. To evaluate novel interventions targeting the microcirculation, appropriate and reliable tools to study this particular microvascular bed are needed. Intravital microscopy (IVM) belongs to several methods allowing evaluation of microcirculation experimentally, even in small animals. The aim of our study was to examine the iridial microcirculation (IMIC) in uveitis induced by local or systemic endotoxin administration in rats and mice by IVM and to propose new parameters to quantify the changes within the IMIC. Systemic inflammation was induced in rats by intravenous endotoxin administration, control group received normal saline intravenously. Local inflammation was induced in mice by intravitreal endotoxin administration, the control group received normal saline intravitreally. IVM of IMIC was performed in animals receiving systemic endotoxin prior injection and 1 and 2 h afterwards, respectively, in animals receiving intravitreal endotoxin/saline prior local injection and 5 h afterwards. Obtained video recordings were analyzed off-line. Functional capillary density (FCD) and dysfunctional capillary density (DCD) were evaluated for description of IMIC, and calculation of FCD/DCD ratio was performed. In systemic inflammation, FCD was significantly decreased compared to control animals. In local inflammation, the number of functional capillaries in the IMIC was significantly reduced following the endotoxin challenge. Analysis of the DCD revealed a significant increase in capillaries with reduced perfusion after intravitreal endotoxin administration and right shift of the FCD/DCD ratio was observed after endotoxin local injection. Detecting and quantifying changes in IMIC during systemic or local inflammation in experimental animals by IVM was feasible. Therefore, IVM of the IMIC represents a valuable tool to evaluate and quantify inflammatory changes in experimental eye disease.
Collapse
Affiliation(s)
- N Arora
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - S Islam
- Department of Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Pharmacy, East West University, Dhaka, Bangladesh
| | - K Wafa
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - J Zhou
- Department of Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - J T Toguri
- Department of Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - V Cerny
- Department of Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Anaesthesiology and Intensive Care Medicine, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic.,Department of Anesthesiology, Perioperative Medicine and Intensive Care, J.E. Purkinje University, Masaryk Hospital, Usti nad Labem, Czech Republic
| | - C Lehmann
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada.,Department of Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.,Department of Physiology and Biophysics, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
32
|
George RB, DesRoches J, Abdo I, Lehmann C. Maternal microcirculation and sidestream dark field imaging: a prospective assessment of the association between labour pain and analgesia on the microcirculation of pregnant women. Clin Hemorheol Microcirc 2016; 60:389-95. [PMID: 24934438 DOI: 10.3233/ch-141851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Pregnancy places significant demands on the cardiovascular system leading to measurable changes in the macrocirculation and potentially the microcirculation. During labour, both uterine contractions and labour pain can further impact cardiovascular status. The objective of this observational study was to compare sublingual microcirculation in labouring parturients before and after epidural analgesia. METHODS Healthy pregnant, labouring women requesting epidural analgesia were approached to participate. Participants with cardiovascular disease, diabetes, obesity, smoking or caffeine intake were excluded. The sidestream dark field device was applied to the sublingual mucosa obtaining images of at least 20 seconds in 5 visual fields before and after epidural analgesia. Video clips were analyzed randomly and blindly. The primary outcome was mean microvascular flow index (MFI). RESULTS Twelve participants completed this study. The results demonstrate no statistically significant difference in the MFI during labour pain (2.9±0.1) compared to after epidural analgesia (3.0±0.04, p = 0.31). Furthermore, there were no statistically significant differences in any secondary outcomes. CONCLUSION Our findings indicate that epidural analgesia may not impact sublingual microcirculation in labouring women. This agrees with literature supporting epidural analgesia as a safe, appropriate method of pain relief during labour with limited impact on peripheral macro or microcirculation.
Collapse
Affiliation(s)
- R B George
- Department of Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, NS, Canada.,Department of Anesthesiology, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - J DesRoches
- Dalhousie University School of Medicine, Halifax, NS, Canada
| | - I Abdo
- Department of Anesthesiology, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Anesthesiology and Intensive Care Medicine, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Czech Republic
| | - C Lehmann
- Department of Anesthesiology, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
33
|
Doxiadis I, Lehmann C. Epitop-(Mis)Matching in der Organtransplantation. Transfusionsmedizin 2016. [DOI: 10.1055/s-0042-114197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- I. Doxiadis
- Institut für Transfusionsmedizin, Universitätsklinikum Leipzig
| | - C. Lehmann
- Institut für Transfusionsmedizin, Universitätsklinikum Leipzig
| |
Collapse
|
34
|
Niggemann B, Hinrichs B, Lehmann C, Koerner-Rettberg C, Köster H, Spindler T, Weiss C. Habitueller Husten im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2016. [DOI: 10.1007/s00112-016-0193-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
35
|
Toguri JT, Moxsom R, Szczesniak AM, Zhou J, Kelly MEM, Lehmann C. Cannabinoid 2 receptor activation reduces leukocyte adhesion and improves capillary perfusion in the iridial microvasculature during systemic inflammation. Clin Hemorheol Microcirc 2016; 61:237-49. [PMID: 26410875 DOI: 10.3233/ch-151996] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Leukocyte adhesion to the endothelium and decreased microvascular blood flow causing microcirculatory dysfunction are hallmarks of systemic inflammation. We studied the impact of cannabinoid receptor activation on the iridial microcirculation, which is accessible non-invasively in vivo, in systemic inflammation induced by endotoxin challenge. METHODS 40 Lewis rats were used in the experiments. Endotoxemia was induced by 2 mg/kg i.v. lipopolysaccharide (LPS). Cannabinoid receptors (CBRs) were stimulated by i.v. administration of WIN 55212-2 (WIN; 1 mg/kg). CB1R antagonist (AM281; 2.5 mg/kg i.v.) or CB2R antagonist (AM630; 2.5 mg/kg i.v.) treatment prior to WIN was applied to identify the anti-inflammatory effects underlying each CBR subtype. Leukocyte-endothelial interactions were examined in rat iridial microvas culature by intravital microscopy at baseline and 1 and 2 h post-LPS. Additionally, systemic (mean arterial pressure, heart rate) and local (laser Doppler flow) hemodynamic variables were measured prior to and during cannabinoid treatments. RESULTS Endotoxemia resulted in severe inflammation as shown by significantly increased numbers of adherent leukocytes at 1 and 2 h observation time post-LPS challenge and decreased microcirculatory blood flow at 2 h within the iridial microcirculation. WIN treatment significantly reduced leukocyte adhesion in iridial microvessels with a diameter greater and less than 25 μm during endotoxemia (p < 0.05). Pre-treatment of animals by CB1R antagonist, AM281, did not affect WIN effects on LPS-induced leukocyte adhesion. When pre-treated with the CB2R antagonist, AM630, a reversal of the WIN-induced reduction in leukocyte adhesion was noticed in vessels with a diameter of less than 25 μm (p < 0.05). Cannabinoid treatment significantly increased the local iridial microcirculatory blood flow 2 hours after systemic LPS administration (p < 0.05). CONCLUSIONS Systemic administration of the CBR agonist, WIN, decreased leukocyte-adhesion and improved iridial microvascular blood flow. This effect is most likely mediated by CB2R activation. Our findings indicate that the iris microvasculature can serve as a model to study the microcirculation during systemic inflammation and help to identify potential therapies to treat microcirculatory dysfunction in diseases such as sepsis.
Collapse
Affiliation(s)
- J T Toguri
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.,Department of Anesthesia, Dalhousie University, Halifax, NS, Canada
| | - R Moxsom
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - A M Szczesniak
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - J Zhou
- Department of Anesthesia, Dalhousie University, Halifax, NS, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - M E M Kelly
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.,Department of Anesthesia, Dalhousie University, Halifax, NS, Canada.,Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
| | - C Lehmann
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.,Department of Anesthesia, Dalhousie University, Halifax, NS, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
36
|
Philipp R, Mehnert A, Lehmann C, Oechsle K, Bokemeyer C, Krüll A, Vehling S. Detrimental social interactions predict loss of dignity among patients with cancer. Support Care Cancer 2016; 24:2751-8. [DOI: 10.1007/s00520-016-3090-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/14/2016] [Indexed: 11/29/2022]
|
37
|
Richter D, Ernst J, Lehmann C, Koch U, Mehnert A, Friedrich M. Communication Preferences in Young, Middle-Aged, and Elderly Cancer Patients. Oncol Res Treat 2015; 38:590-5. [DOI: 10.1159/000441312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 09/28/2015] [Indexed: 11/19/2022]
|
38
|
Jarosch S, Lehmann C. Physical restraint in the ICU: does it prevent device removal? A critical appraisal. Minerva Anestesiol 2015; 81:1053-1055. [PMID: 25501845] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- S Jarosch
- Department of Anesthesia and Intensive Care Medicine, SANA Klinikum Lichtenberg, Berlin, Germany -
| | | |
Collapse
|
39
|
Ernst J, Friedrich M, Lehmann C, Vehling S, Oechsle K, Koch U, Mehnert A. [Communication Bad News by Physicians: The German Version of the MPP (Measure of Patients' Preferences) Questionnaire to the Communicative Preferences of Cancer Patients]. Gesundheitswesen 2015; 78:520-5. [PMID: 25664906 DOI: 10.1055/s-0034-1396849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Breaking bad news is as one of the most distressing tasks that doctors face with high demands on their communication and psychosocial skills. Patient preferences for communicating bad news influence the course of such consultations. The purpose of this study was to evaluate the psychometric characteristics of the German version of the Measure of Patients' Preferences (MPP), a questionnaire that has been validated in several international studies. METHOD Statistical analyses were performed in a sample of N=270 cancer patients during early treatment phase (mixed cancer entities, mean age 56.9 years, 46.7% female). In this prospective study with 2 assessment times, the factorial structure of the MPP-D was examined using principal components analysis with varimax rotation. RESULTS Factor analysis resulted in a 9-factor solution, the 3 factor structure of the original version was not replicated. Cronbachs α was>0.80 for 7 of the MPP-D subscales indicating good to excellent reliability. CONCLUSION Further psychometric testing and optimisation of the measure is recommended.
Collapse
Affiliation(s)
- J Ernst
- Medizinische Psychologie und Medizinische Soziologie, Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - M Friedrich
- Medizinische Psychologie und Medizinische Soziologie, Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - C Lehmann
- Hamburg, Deutsche Gesellschaft für Rehabilitationswissenschaften e.V., DGVT-Ausbildungszentrum Hamburg
| | - S Vehling
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - K Oechsle
- II. Medizinische Klinik und Poliklinik für Onkologie, Hämatologie mit der Sektion Pneumologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - U Koch
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - A Mehnert
- Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig
| |
Collapse
|
40
|
Wafa K, Lehmann C, Wagner L, Drzymulski I, Wegner A, Pavlovic D. Desmopressin improves intestinal functional capillary density and decreases leukocyte activation in experimental endotoxemia. Microvasc Res 2015; 97:98-104. [DOI: 10.1016/j.mvr.2013.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 08/27/2013] [Accepted: 09/05/2013] [Indexed: 12/16/2022]
|
41
|
Burkovskiy IB, Zhou J, Robertson G, Lehmann C. Cannabinoid 2 receptor antagonism reverses central nervous system injury-induced immune deficiency syndrome. Crit Care 2015. [PMCID: PMC4472342 DOI: 10.1186/cc14535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
42
|
Lehmann C, Heldstab H, Greeff NG. Resting State of S4 Identified for Each Domain of Nav1.2 using Omega Current Technique. Biophys J 2015. [DOI: 10.1016/j.bpj.2014.11.3128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
43
|
Greeff NG, Lehmann C, Heldstab H. Inactivation Voltage Sensor S4 in Domain IV of Nav1.2 Controls Immobilization of S4 in Domain III as Shown by Omega Currents. Biophys J 2015. [DOI: 10.1016/j.bpj.2014.11.2683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
44
|
Greeff N, Heldstab H, Lehmann C. Selective Immobilization of S4 in Domain III and IV of Rat Brain Nav1.2 Shown by Omega Currents. Biophys J 2015. [DOI: 10.1016/j.bpj.2014.11.3129] [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] Open
|
45
|
Toguri JT, Lehmann C, Laprairie RB, Szczesniak AM, Zhou J, Denovan-Wright EM, Kelly MEM. Anti-inflammatory effects of cannabinoid CB(2) receptor activation in endotoxin-induced uveitis. Br J Pharmacol 2014; 171:1448-61. [PMID: 24308861 DOI: 10.1111/bph.12545] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 11/28/2013] [Accepted: 12/02/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Cannabinoid CB2 receptors mediate immunomodulation. Here, we investigated the effects of CB2 receptor ligands on leukocyte-endothelial adhesion and inflammatory mediator release in experimental endotoxin-induced uveitis (EIU). EXPERIMENTAL APPROACH EIU was induced by intraocular injection of lipopolysaccharide (LPS, 20 ng·μL(-1) ). Effects of the CB2 receptor agonist, HU308 (1.5% topical), the CB2 receptor antagonist, AM630 (2.5 mg·kg(-1) i.v.), or a combination of both compounds on leukocyte-endothelial interactions were measured hourly for 6 h in rat iridial vasculature using intravital microscopy. Anti-inflammatory actions of HU308 were compared with those of clinical treatments for uveitis - dexamethasone, prednisolone and nepafenac. Transcription factors (NF-κB, AP-1) and inflammatory mediators (cytokines, chemokines and adhesion molecules) were measured in iris and ciliary body tissue. KEY RESULTS Leukocyte-endothelium adherence was increased in iridial microvasculature between 4-6 h after LPS. HU308 reduced this effect after LPS injection and decreased pro-inflammatory mediators: TNF-α, IL-1β, IL-6, CCL5 and CXCL2. AM630 blocked the actions of HU-308, and increased leukocyte-endothelium adhesion. HU-308 decreased levels of the transcription factors NF-κB and AP-1, while AM630 increased levels of NF-κB. Topical treatments with dexamethasone, prednisolone or nepafenac, failed to alter leukocyte adhesion or mitigate LPS-induced increases in inflammatory mediators during the 6 h of EIU. CONCLUSION AND IMPLICATIONS Activation of CB2 receptors was anti-inflammatory in a model of acute EIU and involved a reduction in NF-κB, AP-1 and inflammatory mediators. CB2 receptors may be promising drug targets for the development of novel ocular anti-inflammatory agents. LINKED ARTICLES This article is part of a themed section on Cannabinoids 2013. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-6.
Collapse
Affiliation(s)
- J T Toguri
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | | | | | | | | | | | | |
Collapse
|
46
|
Gamal El-Din TM, Heldstab H, Lehmann C, Greeff NG. Double gaps alongShakerS4 demonstrate omega currents at three different closed states. Channels (Austin) 2014. [DOI: 10.4161/chan.4.2.10672] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
47
|
Wafa K, Herrmann A, Kuhnert T, Wegner A, Gründling M, Pavlovic D, Lehmann C. Short time impact of different hydroxyethyl starch solutions on the mesenteric microcirculation in experimental sepsis in rats. Microvasc Res 2014; 95:88-93. [DOI: 10.1016/j.mvr.2014.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 07/27/2014] [Accepted: 07/28/2014] [Indexed: 12/30/2022]
|
48
|
Lehmann C, Burkovskiy I, Kuethe J, Zhou J, Caldwell C, Kelly M. Inhibition of the cannabinoid 2 receptor in CNS-injury induced immunodeficiency syndrome. Med Hypotheses 2014; 82:736-9. [DOI: 10.1016/j.mehy.2014.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 02/25/2014] [Accepted: 03/08/2014] [Indexed: 10/25/2022]
|
49
|
Mauer D, Mockel-Tenbrinck N, Drechsel K, Lehmann C, Johnston I, Bohnenkamp H, Assenmacher M, Kaiser A. Potent polyclonal T cell activation and expansion through GMP-grade transact nano-matrices. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
50
|
ten Freyhaus H, Vogel D, Lehmann C, Kümmerle T, Wyen C, Fätkenheuer G, Rosenkranz S. Echocardiographic screening for pulmonary arterial hypertension in HIV-positive patients. Infection 2014; 42:737-41. [PMID: 24619834 DOI: 10.1007/s15010-014-0610-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 02/28/2014] [Indexed: 12/28/2022]
Abstract
Human immunodeficiency virus (HIV) infection is associated with an increased risk for pulmonary arterial hypertension (PAH). Upon the screening of 220 asymptomatic HIV-positive individuals by echocardiography, we detected and confirmed HIV-associated PAH in 0.45 % of cases. Mild elevations of systolic pulmonary arterial pressure most probably owing to left ventricular diastolic dysfunction were found in 7.7 % of cases, without progress after 2 years. We suggest that the screening of asymptomatic HIV-positive patients for PAH should not be performed.
Collapse
Affiliation(s)
- H ten Freyhaus
- Klinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Kerpener Strasse 62, 50937, Cologne, Germany,
| | | | | | | | | | | | | |
Collapse
|