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Lamartina L, Godbert Y, Nascimento C, Do Cao C, Hescot S, Borget I, Al Ghuzlan A, Hartl D, Hadoux J, Pottier E, Attard M, Berdelou A, Terroir M, Baudin E, Schlumberger M, Leboulleux S. Locally unresectable differentiated thyroid cancer: outcomes and perspectives. Endocrine 2020; 69:133-141. [PMID: 32147774 DOI: 10.1007/s12020-020-02245-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 02/24/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE Differentiated thyroid cancer (DTC) patients with an unresectable primary tumor cannot benefit from curative surgery, and radioiodine treatment for locoregional and distant disease is not possible with the thyroid gland still in place. Due to local invasion, these patients cannot be included in clinical trials, so that treatment options are limited. The aim of this study was to describe the characteristics and the prognosis of patients with these locally unresectable DTC. PATIENTS AND METHODS A retrospective and multicentric analysis of consecutive cases of unresectable DTC diagnosed between 2000 and 2015 was performed. RESULTS The study population consisted in 22 patients, 13 females (59%); median age: 77 years (range: 52-91). Thyroid tumors were papillary in six, follicular in seven, Hürthle cell in one and poorly differentiated in eight patients. Patients were treated with external beam radiation therapy (EBRT) (57%), locoregional therapy of distant metastases (41%), cytotoxic chemotherapy (38%) and tyrosine kinase inhibitors (TKIs) (33%). TKI treatment resulted in median disease control duration of 7 months with a grade 3-4 toxicity rate of 44%. Only one patient had a total thyroidectomy after neo-adjuvant EBRT. The 1, 3 and 5-year cumulative survival rate was 81%, 27.7% and 21.5%, respectively. The cause of death was DTC in 11 cases (local progression in 7), and to other causes in 7 cases; no patient died from treatment toxicity. CONCLUSIONS Clinical trials and approved treatments are lacking for unresectable DTC. TKI treatment may allow prolonged disease control with acceptable toxicity.
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Affiliation(s)
- L Lamartina
- Département de Médecine Nucléaire et Cancérologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France.
| | - Y Godbert
- Département de Médecine Nucléaire, Institut Bergonié, 33076, Bordeaux, France
| | - C Nascimento
- Département de Médecine Nucléaire, Hôpital René Huguenin-Institut Curie, 92210, St Cloud, France
| | - C Do Cao
- Département d'Endocrinologie, CHRU de Lille, 5900, Lille, France
| | - S Hescot
- Département de Médecine Nucléaire, Hôpital René Huguenin-Institut Curie, 92210, St Cloud, France
| | - I Borget
- Département de Biostatistique et épidémiologie, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - A Al Ghuzlan
- Département de Biologie et pathologie médicales, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - D Hartl
- Département de Chirurgie Cervico-Faciale, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - J Hadoux
- Département de Médecine Nucléaire et Cancérologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - E Pottier
- Département d'Imagerie médicale, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - M Attard
- Département d'Imagerie médicale, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - A Berdelou
- Département de Médecine Nucléaire et Cancérologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - M Terroir
- Département de Médecine Nucléaire et Cancérologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - E Baudin
- Département de Médecine Nucléaire et Cancérologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - M Schlumberger
- Département de Médecine Nucléaire et Cancérologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - S Leboulleux
- Département de Médecine Nucléaire et Cancérologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
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Fakhry N, Schultz P, Morinière S, Breuskin I, Bozec A, Vergez S, de Garbory L, Hartl D, Temam S, Lescanne E, Couloigner V, Barry B. Consensus français sur la pratique de la chirurgie oncologique ORL pendant la pandémie de COVID-19. Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 2020. [PMCID: PMC7151435 DOI: 10.1016/j.aforl.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Dans le contexte de la pandémie de COVID-19, des conseils spécifiques semblent nécessaires concernant la prise en charge des patients atteints de cancers ORL. La règle est de limiter au maximum le flux de patients afin de réduire les risques de contamination par le virus SARS-Cov-2 aussi bien des patients que du personnel soignant, particulièrement exposé en ORL. L’objectif est de limiter le risque de perte de chance pour le patient et d’anticiper le flux de patients atteints de cancers à traiter à la fin de l’épidémie, en tenant compte du degré d’urgence, de la lourdeur de la chirurgie, du risque de contamination de l’équipe soignante (trachéotomie) et de la situation locale (saturation ou non de l’hôpital et des services de réanimation).
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Hartl D, Keller M, Klenk A, Murphy M, Martinic M, Pierlot G, Groenen P, Strasser D. THU0008 DEVELOPMENT OF A NOVEL TRANSLATIONAL IN SILICO INDICATION DISCOVERY FRAMEWORK: EXEMPLIFIED BY THE CLINICAL COMPOUND CENERIMOD. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:To explore the full therapeutic spectrum of a drug it is crucial to consider its potential effectiveness in all diseases. Serendipitous clinical observations have often shown that approved drugs and those in development to be efficacious in indications different to those originally tested for. Traditional approaches to match a drug candidate with possible indications are mostly based on matching drug mechanistic knowledge with disease pathophysiology. Proof-of-concept trials or elaborate pre-clinical studies in animal models do not allow for a broad assessment due to high costs and slow progress. Gene expression changes in patients or animal models represent a good proxy to comprehensively assess both disease and drug effects. Furthermore, this data type can be integrated with a plethora of publicly available data.Objectives:Generation of a novel in silico framework to support the selection and expansion of potential indications which associate with a compound or approved drug. The framework was exemplified by the clinical compound cenerimod, a potent, selective, and orally active sphingosine-1-phosphate receptor 1 modulator (Piali et al., 2017).Methods:A total of ~13’000 public patient gene expression datasets from ~140 diseases were evaluated against cenerimod gene expression data generated in mouse disease models. To improve comparability of studies across platforms and species, computer algorithms (neural networks) were trained and employed to reduce noise within the data sets and improve signal. The predicted response to cenerimod for individual patients was contrasted against clinical patient characteristics.Results:The neural network algorithm efficiently reduced experimental noise and improved sensitivity in the gene expression data. The results predicted cenerimod to be efficacious in several auto-immune diseases foremost SLE. Additionally, focused analysis on individual patients rather than disease cohorts revealed potential determinants predictive of maximal clinical response, with the highest predicted clinical response for cenerimod in patients with severe inflammatory endotype and/or high SLE Disease Activity Index (SLEDAI).Conclusion:Combining preclinical compound data with the wealth of public disease gene expression data, provides great potential to support indication selection. The novel in silico framework identified SLE as a prime potential indication for cenerimod and supported the cenerimod phase 2b clinical trial in patients with SLE (CARE study,NCT03742037).References:[1]Piali, L., Birker-Robaczewska, M., Lescop, C., Froidevaux, S., Schmitz, N., Morrison, K., … Nayler, O. (2017). Cenerimod, a novel selective S1P1 receptor modulator with unique signaling properties. Pharmacology Research & Perspectives, 5(6), 1–12.https://doi.org/10.1002/prp2.370Disclosure of Interests:Dominik Hartl Shareholder of: Idorsia shares, Employee of: Idorsia employee, Marcel Keller Shareholder of: Idorsia options/shares, Employee of: Idorsia employee, Axel Klenk Shareholder of: Idorsia option/shares, Employee of: Idorsia employee, Mark Murphy Shareholder of: Idorsia shares and stock options, Employee of: Idorsia employee, Marianne Martinic Shareholder of: Idorsia options/shares, Employee of: Idorsia employee, Gabin Pierlot Shareholder of: Idorsia options/shares, Employee of: Idorsia employee, Peter Groenen Shareholder of: Idorsia options/shares, Employee of: Idorsia employee, Daniel Strasser Shareholder of: Idorsia options/shares, Employee of: Idorsia employee
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Fakhry N, Schultz P, Morinière S, Breuskin I, Bozec A, Vergez S, de Garbory L, Hartl D, Temam S, Lescanne E, Couloigner V, Barry B. French consensus on management of head and neck cancer surgery during COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:159-160. [PMID: 32303485 PMCID: PMC7151337 DOI: 10.1016/j.anorl.2020.04.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the context of the current pandemic, there is a need for specific advice concerning treatment of patients with Head and Neck cancers. The rule is to limit as much as possible the number of patients in order to reduce the risks of contamination by the SARS-Cov-2 virus for both patients and the caregivers, who are particularly exposed in ENT. The aim is to minimize the risk of loss of opportunity for patients and to anticipate the increased number of cancer patients to be treated at the end of the pandemic, taking into account the degree of urgency, the difficulty of the surgery, the risk of contaminating the caregivers (tracheotomy) and the local situation (whether or not the hospital and intensive care departments are overstretched).
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Affiliation(s)
- N Fakhry
- Department of otorhinolaryngology, head and neck surgery, centre hospitalier universitaire (CHU) la Conception, Aix Marseille université, Assistance publique-Hôpitaux de Marseille, Marseille, France.
| | - P Schultz
- Department of otorhinolaryngology, head and neck surgery, CHU, Strasbourg, France
| | - S Morinière
- Department of otorhinolaryngology, head and neck surgery, CHU, Tours, France
| | - I Breuskin
- Department of otorhinolaryngology, head and neck surgery, institut Gustave-Roussy, Villejuif, France
| | - A Bozec
- Department of otorhinolaryngology, head and neck surgery, centre Antoine-Lacassagne, Institut universitaire de la face et du cou, Nice, France
| | - S Vergez
- Department of otorhinolaryngology, head and neck surgery, CHU de Toulouse/Oncopôle, Toulouse, France
| | - L de Garbory
- Department of otorhinolaryngology, head and neck surgery, CHU, Bordeaux, France
| | - D Hartl
- Department of otorhinolaryngology, head and neck surgery, institut Gustave-Roussy, Villejuif, France
| | - S Temam
- Department of otorhinolaryngology, head and neck surgery, institut Gustave-Roussy, Villejuif, France
| | - E Lescanne
- Department of otorhinolaryngology, head and neck surgery, CHU, Tours, France
| | - V Couloigner
- Department of otorhinolaryngology, head and neck surgery, université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France
| | - B Barry
- Department of otorhinolaryngology, head and neck surgery, hôpital Xavier Bichat-Claude Bernard, CHU Paris Nord-Val de Seine, Assistance publique-Hôpitaux de Paris, Paris, France
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Filetti S, Durante C, Hartl D, Leboulleux S, Locati LD, Newbold K, Papotti MG, Berruti A. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol 2019; 30:1856-1883. [PMID: 31549998 DOI: 10.1093/annonc/mdz400] [Citation(s) in RCA: 480] [Impact Index Per Article: 96.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
MESH Headings
- Humans
- Adenocarcinoma, Follicular/diagnosis
- Adenocarcinoma, Follicular/epidemiology
- Adenocarcinoma, Follicular/pathology
- Adenocarcinoma, Follicular/therapy
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/epidemiology
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Follow-Up Studies
- Thyroid Cancer, Papillary/diagnosis
- Thyroid Cancer, Papillary/epidemiology
- Thyroid Cancer, Papillary/pathology
- Thyroid Cancer, Papillary/therapy
- Thyroid Carcinoma, Anaplastic/diagnosis
- Thyroid Carcinoma, Anaplastic/epidemiology
- Thyroid Carcinoma, Anaplastic/pathology
- Thyroid Carcinoma, Anaplastic/therapy
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/epidemiology
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/therapy
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Affiliation(s)
- S Filetti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - C Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - D Hartl
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif; Université Paris Saclay, Villejuif
| | - S Leboulleux
- Université Paris Saclay, Villejuif; Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Villejuif, France
| | - L D Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - K Newbold
- Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - M G Papotti
- Department of Pathology, University of Turin, Turin
| | - A Berruti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology Unit, University of Brescia, ASST Spedali Civili, Brescia, Italy
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Heigl T, Singh A, Saez B, Kaes J, Van Herck A, Sacreas A, Beeckmans H, Verleden S, Van Raemdonck D, Verleden G, Vanaudenaerde B, Hartl D, Vos R. Myeloid-Derived Suppressor Cells in Lung Transplant Recipients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.636] [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: 11/29/2022] Open
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Bouroche G, Motamed C, de Guibert J, Hartl D, Bourgain J. Rescue transtracheal jet ventilation during difficult intubation in patients with upper airway cancer. Anaesth Crit Care Pain Med 2018; 37:539-544. [DOI: 10.1016/j.accpm.2017.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/24/2017] [Accepted: 10/14/2017] [Indexed: 01/08/2023]
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Hoffmann JHO, Schaekel K, Hartl D, Enk AH, Hadaschik EN. Dimethyl fumarate modulates neutrophil extracellular trap formation in a glutathione- and superoxide-dependent manner. Br J Dermatol 2017; 178:207-214. [PMID: 28733990 DOI: 10.1111/bjd.15839] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Neutrophil (polymorphonuclear) granulocytes (PMN) have been shown to contribute to the pathogenesis of psoriasis by releasing interleukin-17 and LL37-DNA complexes via neutrophil extracellular traps (NETs), webs of chromatin strands decorated with antimicrobial peptides, in psoriatic skin. Fumaderm® , a fumaric acid ester (FAE) formulation consisting of different FAE salts, has been successfully used to treat psoriasis for decades. Most recently, FAE treatment was reported to inhibit NET formation in murine epidermolysis bullosa acquisita. OBJECTIVES To elucidate the effect of FAE treatment on human psoriasis and healthy donor NET formation. RESULTS Among the compounds present in the FAE formulation, dimethyl fumarate (DMF) pretreatment of human psoriasis and healthy donor PMN resulted in a consistent inhibitory effect on NET formation in response to phorbol 12-myristate 13-acetate but not to platelet activating factor and ionomycin. This effect was l-glutathione (GSH) dependent and involved a decrease in reactive oxygen species (ROS) production, a key event in NET formation. In contrast, G-protein-coupled signalling and protein synthesis were not involved. Monomethyl fumarate (MMF) was found to slightly reduce ROS production without affecting NET formation. CONCLUSIONS We report DMF as a potent, stimulus-specific, GSH- and ROS-dependent modulator of NET formation. Our results support the notion that modulation of NET formation contributes to the beneficial effects of FAEs in a variety of inflammatory conditions.
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Affiliation(s)
- J H O Hoffmann
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - K Schaekel
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - D Hartl
- University Children's Hospital Tübingen, University of Tübingen, Tübingen, Germany.,Roche Pharma Research and Early Development (pRED), Immunology, Inflammation and Infectious Diseases (I3) Discovery and Translational Area, Basel, Switzerland
| | - A H Enk
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - E N Hadaschik
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany.,Department of Dermatology, University of Essen, Essen, Germany
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Affiliation(s)
- Daniel Dykhuizen
- Department of Biological Sciences; Purdue University; West Lafayette Indiana 47907
| | - Daniel Hartl
- Department of Biological Sciences; Purdue University; West Lafayette Indiana 47907
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Köstlin N, Hofstädter K, Ostermeir AL, Spring B, Leiber A, Haen S, Abele H, Bauer P, Pollheimer J, Hartl D, Poets CF, Gille C. Granulozytäre MDSC akkumulieren in der Plazenta und werden durch Interaktion mit Tropoblast-Zellen aktiviert. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592737] [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
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Lamartina L, Ippolito S, Danis M, Bidault F, Borget I, Berdelou A, Al Ghuzlan A, Hartl D, Blanchard P, Terroir M, Deandreis D, Schlumberger M, Baudin E, Leboulleux S. Antiangiogenic Tyrosine Kinase Inhibitors: Occurrence and Risk Factors of Hemoptysis in Refractory Thyroid Cancer. J Clin Endocrinol Metab 2016; 101:2733-41. [PMID: 27082933 DOI: 10.1210/jc.2015-4391] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND Antiangiogenic tyrosine kinase inhibitors (TKIs) are the mainstay of advanced thyroid cancer (TC) treatment. Concern is rising about TKI-related toxicity. OBJECTIVE To determine the incidence and to investigate the risk factors of hemoptysis in TC patients during TKI treatment. METHODS We analyzed consecutive TC patients treated with TKI in our center between 2005 and 2013 and performed an independent review of computed tomography scan images for airway invasion assessment. Occurrence of grade 1-2 or grade 3-5 hemoptysis according to Common Terminology Criteria for Adverse Events version 4.03 and risk factors for hemoptysis were investigated. RESULTS A total of 140 patients (89 males; median age, 52 y) with medullary (56%), differentiated (33%), and poorly differentiated (11%) TC were enrolled. Thyroidectomy±neck dissection was performed in 123 patients and neck/mediastinum external-beam radiotherapy in 41 (32% with therapeutic purpose and 68% with adjuvant purpose). Patients received from 1 to 4 lines of TKI (median 1). Median follow-up was 24 months. Airway invasion was found in 65 (46%) cases. Hemoptysis occurred in 9 patients: grade 1-2 in 7 cases (5%) and grade 3-5 in 2 (1.4%) cases (fatal in 1). Hemoptysis was associated with presence of airway invasion (P = .04), poorly differentiated pathology (P = .03), history of therapeutic external-beam radiotherapy (P = .003), and thyroidectomy without neck dissection (P = .02). CONCLUSION Airway invasion, poorly differentiated pathology, therapeutic external-beam radiotherapy, and thyroidectomy without neck dissection are associated with and increased risk of hemoptysis in TC patients during antiangiogenic TKI treatment. Further research is needed to confirm this data and to sort out interactions between these risk factors. A careful assessment of airway invasion is mandatory before TKI introduction.
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Affiliation(s)
- Livia Lamartina
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - S Ippolito
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - M Danis
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - F Bidault
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - I Borget
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - A Berdelou
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - A Al Ghuzlan
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - D Hartl
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - P Blanchard
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - M Terroir
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - D Deandreis
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - M Schlumberger
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - E Baudin
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
| | - S Leboulleux
- Departments of Nuclear Medicine and Endocrine Oncology (L.L., S.I., A.B., M.T., D.D., M.S., E.B., S.L.), Radiology (M.D., F.B.), Biostatistics and Epidemiology (I.B.), Medical Biology and Pathology (A.A.G.), Surgery (D.H.), and Department of Radiotherapy (P.B.), Gustave Roussy and University Paris Saclay, 94805 Villejuif, France
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12
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Schäfer J, Katharina S, Teufel M, Fleischer S, Graepler-Mainka U, Riethmüller J, Gatidis S, Hartl D, Tsiflikas I. Ein neuer MRT-Score bei Cystischer Fibrose (CF) sagt Abfall der forcierten Einsekundenkapazität (FEV1) voraus. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Carevic M, Öz H, Fuchs K, Laval J, Schroth C, Frey N, Hector A, Bilich T, Haug M, Schmidt A, Autenrieth SE, Bucher K, Beer-Hammer S, Gaggar A, Kneilling M, Benarafa C, Gao JL, Murphy PM, Schwarz S, Moepps B, Hartl D. CXCR1 Regulates Pulmonary Anti-Pseudomonas Host Defense. J Innate Immun 2016; 8:362-73. [PMID: 26950764 DOI: 10.1159/000444125] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/19/2016] [Indexed: 11/19/2022] Open
Abstract
Pseudomonas aeruginosa is a key opportunistic pathogen causing disease in cystic fibrosis (CF) and other lung diseases such as chronic obstructive pulmonary disease (COPD). However, the pulmonary host defense mechanisms regulating anti-P. aeruginosa immunity remain incompletely understood. Here we demonstrate, by studying an airway P. aeruginosa infection model, in vivo bioluminescence imaging, neutrophil effector responses and human airway samples, that the chemokine receptor CXCR1 regulates pulmonary host defense against P. aeruginosa. Mechanistically, CXCR1 regulates anti-Pseudomonas neutrophil responses through modulation of reactive oxygen species and interference with Toll-like receptor 5 expression. These studies define CXCR1 as a novel, noncanonical chemokine receptor that regulates pulmonary anti-Pseudomonas host defense with broad implications for CF, COPD and other infectious lung diseases.
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Affiliation(s)
- M Carevic
- Children's Hospital and Interdisciplinary Center for Infectious Diseases, University of Tx00FC;bingen, Tx00FC;bingen, Germany
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14
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Ogbunugafor CB, Hartl D. A pivot mutation impedes reverse evolution across an adaptive landscape for drug resistance in Plasmodium vivax. Malar J 2016; 15:40. [PMID: 26809718 PMCID: PMC4727274 DOI: 10.1186/s12936-016-1090-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 09/12/2015] [Accepted: 01/10/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The study of reverse evolution from resistant to susceptible phenotypes can reveal constraints on biological evolution, a topic for which evolutionary theory has relatively few general principles. The public health catastrophe of antimicrobial resistance in malaria has brought these constraints on evolution into a practical realm, with one proposed solution: withdrawing anti-malarial medication use in high resistance settings, built on the assumption that reverse evolution occurs readily enough that populations of pathogens may revert to their susceptible states. While past studies have suggested limits to reverse evolution, there have been few attempts to properly dissect its mechanistic constraints. METHODS Growth rates were determined from empirical data on the growth and resistance from a set of combinatorially complete set of mutants of a resistance protein (dihydrofolate reductase) in Plasmodium vivax, to construct reverse evolution trajectories. The fitness effects of individual mutations were calculated as a function of drug environment, revealing the magnitude of epistatic interactions between mutations and genetic backgrounds. Evolution across the landscape was simulated in two settings: starting from the population fixed for the quadruple mutant, and from a polymorphic population evenly distributed between double mutants. RESULTS A single mutation of large effect (S117N) serves as a pivot point for evolution to high resistance regions of the landscape. Through epistatic interactions with other mutations, this pivot creates an epistatic ratchet against reverse evolution towards the wild type ancestor, even in environments where the wild type is the most fit of all genotypes. This pivot mutation underlies the directional bias in evolution across the landscape, where evolution towards the ancestor is precluded across all examined drug concentrations from various starting points in the landscape. CONCLUSIONS The presence of pivot mutations can dictate dynamics of evolution across adaptive landscape through epistatic interactions within a protein, leaving a population trapped on local fitness peaks in an adaptive landscape, unable to locate ancestral genotypes. This irreversibility suggests that the structure of an adaptive landscape for a resistance protein should be understood before considering resistance management strategies. This proposed mechanism for constraints on reverse evolution corroborates evidence from the field indicating that phenotypic reversal often occurs via compensatory mutation at sites independent of those associated with the forward evolution of resistance. Because of this, molecular methods that identify resistance patterns via single SNPs in resistance-associated markers might be missing signals for resistance and compensatory mutation throughout the genome. In these settings, whole genome sequencing efforts should be used to identify resistance patterns, and will likely reveal a more complicated genomic signature for resistance and susceptibility, especially in settings where anti-malarial medications have been used intermittently. Lastly, the findings suggest that, given their role in dictating the dynamics of evolution across the landscape, pivot mutations might serve as future targets for therapy.
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Affiliation(s)
- C Brandon Ogbunugafor
- Department of Biology, University of Vermont, Burlington, VT, USA.
- Vermont Complex Systems Center, The University of Vermont, Burlington, VT, USA.
| | - Daniel Hartl
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA.
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15
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Corbett-Detig R, Jacobs-Palmer E, Hartl D, Hoekstra H. Direct Gamete Sequencing Reveals No Evidence for Segregation Distortion in House Mouse Hybrids. PLoS One 2015; 10:e0131933. [PMID: 26121240 PMCID: PMC4487504 DOI: 10.1371/journal.pone.0131933] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 06/08/2015] [Indexed: 12/30/2022] Open
Abstract
Understanding the molecular basis of species formation is an important goal in evolutionary genetics, and Dobzhansky-Muller incompatibilities are thought to be a common source of postzygotic reproductive isolation between closely related lineages. However, the evolutionary forces that lead to the accumulation of such incompatibilities between diverging taxa are poorly understood. Segregation distorters are believed to be an important source of Dobzhansky-Muller incompatibilities between hybridizing species of Drosophila as well as hybridizing crop plants, but it remains unclear if these selfish genetic elements contribute to reproductive isolation in other taxa. Here, we collected viable sperm from first-generation hybrid male progeny of Mus musculus castaneus and M. m. domesticus, two subspecies of rodent in the earliest stages of speciation. We then genotyped millions of single nucleotide polymorphisms in these gamete pools and tested for a skew in the frequency of parental alleles across the genome. We show that segregation distorters are not measurable contributors to observed infertility in these hybrid males, despite sufficient statistical power to detect even weak segregation distortion with our novel method. Thus, reduced hybrid male fertility in crosses between these nascent species is attributable to other evolutionary forces.
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Affiliation(s)
- Russell Corbett-Detig
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail: (RCD); (HH)
| | - Emily Jacobs-Palmer
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
- Howard Hughes Medical Institute, Department of Molecular & Cellular Biology, Museum of Comparative Zoology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Daniel Hartl
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Hopi Hoekstra
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
- Howard Hughes Medical Institute, Department of Molecular & Cellular Biology, Museum of Comparative Zoology, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail: (RCD); (HH)
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16
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17
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Hector A, Berenbrinker S, Kirn T, Graepler-Mainka U, Riethmueller J, Kappler M, Griese M, Hartl D. 157 Long-term impact of fungi on pediatric cystic fibrosis lung disease. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60293-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Rieber N, Hector A, Carevic M, Hartl D. Current concepts of immune dysregulation in cystic fibrosis. Int J Biochem Cell Biol 2014; 52:108-12. [PMID: 24495876 DOI: 10.1016/j.biocel.2014.01.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 01/13/2014] [Accepted: 01/21/2014] [Indexed: 12/18/2022]
Abstract
Cystic fibrosis (CF) lung disease is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene and is characterized by a perpetuated feedback loop of bacterial infection and inflammation. Both intrinsic (CFTR-dependent) and extrinsic (CFTR-independent) mechanisms contribute to the inflammatory phenotype of CF lung disease. Innate immune cells, initially recruited to combat bacterial pathogens, are acting in a dysregulated and non-resolving fashion in CF airways and cause harm to the host by releasing proteases and oxidants. Targeting harmful immune pathways, while preserving protective ones, remains the challenge for the future. This review highlights current concepts of innate immune dysregulation in CF lung disease.
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Affiliation(s)
- N Rieber
- CF Research Group, Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - A Hector
- CF Research Group, Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - M Carevic
- CF Research Group, Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - D Hartl
- CF Research Group, Department of Pediatrics I, University of Tübingen, Tübingen, Germany.
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19
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Rieber N, Wecker I, Neri D, Fuchs K, Schäfer I, Brand A, Pfeiffer M, Lang P, Bethge W, Amon O, Handgretinger R, Hartl D. Extracorporeal photopheresis increases neutrophilic myeloid-derived suppressor cells in patients with GvHD. Bone Marrow Transplant 2014; 49:545-52. [DOI: 10.1038/bmt.2013.236] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 12/13/2013] [Accepted: 12/13/2013] [Indexed: 11/09/2022]
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20
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Rieber N, Gille C, Köstlin N, Schäfer I, Spring B, Ost M, Spieles H, Kugel HA, Pfeiffer M, Heininger V, Alkhaled M, Hector A, Mays L, Kormann M, Zundel S, Fuchs J, Handgretinger R, Poets CF, Hartl D. Neutrophilic myeloid-derived suppressor cells in cord blood modulate innate and adaptive immune responses. Clin Exp Immunol 2013; 174:45-52. [PMID: 23701226 DOI: 10.1111/cei.12143] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2013] [Indexed: 01/15/2023] Open
Abstract
Neonates show an impaired anti-microbial host defence, but the underlying immune mechanisms are not understood fully. Myeloid-derived suppressor cells (MDSCs) represent an innate immune cell subset characterized by their capacity to suppress T cell immunity. In this study we demonstrate that a distinct MDSC subset with a neutrophilic/granulocytic phenotype (Gr-MDSCs) is highly increased in cord blood compared to peripheral blood of children and adults. Functionally, cord blood isolated Gr-MDSCs suppressed T cell proliferation efficiently as well as T helper type 1 (Th1), Th2 and Th17 cytokine secretion. Beyond T cells, cord blood Gr-MDSCs controlled natural killer (NK) cell cytotoxicity in a cell contact-dependent manner. These studies establish neutrophilic Gr-MDSCs as a novel immunosuppressive cell subset that controls innate (NK) and adaptive (T cell) immune responses in neonates. Increased MDSC activity in cord blood might serve as key fetomaternal immunosuppressive mechanism impairing neonatal host defence. Gr-MDSCs in cord blood might therefore represent a therapeutic target in neonatal infections.
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Affiliation(s)
- N Rieber
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
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21
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Nascimento C, Borget I, Troalen F, Al Ghuzlan A, Deandreis D, Hartl D, Lumbroso J, Chougnet CN, Baudin E, Schlumberger M, Leboulleux S. Ultrasensitive serum thyroglobulin measurement is useful for the follow-up of patients treated with total thyroidectomy without radioactive iodine ablation. Eur J Endocrinol 2013; 169:689-93. [PMID: 23939918 DOI: 10.1530/eje-13-0386] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
CONTEXT Thyroglobulin (Tg) measurement is a major tool for the follow-up of differentiated thyroid cancer (DTC) patients; however, in patients who do not undergo radioactive iodine (RAI) ablation, normal ultrasensitive Tg levels measured under levothyroxine treatment (usTg/l-T4) are not well defined. OBJECTIVE AND DESIGN This single-center retrospective study assessed usTg/l-T4 level in 86 consecutive patients treated with total thyroidectomy without RAI ablation for low-risk DTC (n=77) or for tumors of uncertain malignant potential (TUMP) (n=9). RESULTS DTCS were classified as PT1, PT2, and PT3 in 75, 1, and 1 case respectively and PN0, PN1, and PNX in 40, 6, and 31 respectively. following surgery, ten patients had TG antibodieS (TGAB). Among those without TGAB, the first USTG/L-T4 determination obtained at a mean time of 9 months after surgery was 0.1NG/ML in 62% of cases, 0.3NG/ML in 82% of cases, 1NG/ML in 91%, and 2NG/ML in 96% of cases. after a median follow-up of 2.5 years (range: 0.6-7.2 years), one patient had persistent disease with an usTg/l-T4 at 11 ng/ml and an abnormal neck ultrasonography (US) and two patients had usTg/l-T4 level >2 ng/ml (3.9 and 4.9 ng/ml) with a normal neck US. Within the first 2 years following total thyroidectomy without RAI ablation, usTg/l-T4 level is ≤2 ng/ml in 96% of the cases. CONCLUSION After total thyroidectomy, sensitive serum Tg/l-T4 level is ≤2 ng/ml in most patients and can be used for patient follow-up.
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Affiliation(s)
- C Nascimento
- Departments of Nuclear Medicine and Endocrine Oncology
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22
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Rieber N, Brand A, Neri D, Hall T, Schäfer I, Hansmann S, Kümmerle-Deschner J, Hartl D. PW02-042 - Induction of MDSC in Muckle-Wells syndrome. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952133 DOI: 10.1186/1546-0096-11-s1-a183] [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: 11/28/2022] Open
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23
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Levy A, Blanchard P, Temam S, Hartl D, Mirghani H, Bourhis J, Daly-Schveitzer N, Tao Y. Squamous Cell Carcinoma of the Larynx With Subglottic Extension: Is Larynx Preservation Possible? Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1190] [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: 11/16/2022]
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24
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Arnold B, Corbett-Detig RB, Hartl D, Bomblies K. RADseq underestimates diversity and introduces genealogical biases due to nonrandom haplotype sampling. Mol Ecol 2013; 22:3179-90. [DOI: 10.1111/mec.12276] [Citation(s) in RCA: 297] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/24/2013] [Accepted: 01/25/2013] [Indexed: 12/16/2022]
Affiliation(s)
- B. Arnold
- Department of Organismic and Evolutionary Biology; Harvard University; Cambridge MA 02138 USA
| | - R. B. Corbett-Detig
- Department of Organismic and Evolutionary Biology; Harvard University; Cambridge MA 02138 USA
| | - D. Hartl
- Department of Organismic and Evolutionary Biology; Harvard University; Cambridge MA 02138 USA
| | - K. Bomblies
- Department of Organismic and Evolutionary Biology; Harvard University; Cambridge MA 02138 USA
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25
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Hajje G, Borget I, Leboulleux S, Chougnet C, Al Ghuzlan A, Mirghani H, Caramella C, Hartl D, Schlumberger M, Baudin E. Early changes in carcinoembryonic antigen but not in calcitonin levels are correlated with the progression-free survival in medullary thyroid carcinoma patients treated with cytotoxic chemotherapy. Eur J Endocrinol 2013; 168:113-8. [PMID: 23093698 DOI: 10.1530/eje-12-0771] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The prognostic value of serum calcitonin (CT) and carcinoembryonic antigen (CEA) doubling time has been recently demonstrated in medullary thyroid carcinoma (MTC) patients. No study has yet validated the surrogate role of these markers for survival during treatment. The aim of this study was to evaluate, in patients with advanced MTC treated with cytotoxic chemotherapy, the relationship between early changes of serum CT or CEA levels and progression-free survival (PFS). PATIENTS AND METHODS The files of 28 consecutive metastatic MTC patients with progressive disease, treated with cytotoxic chemotherapy in a single tertiary referral center between 2000 and 2010, were retrospectively reviewed. Serum CT and CEA measurements and radiological Response Evaluation Criteria in Solid Tumors (RECIST) evaluations were collected every 3 months. The relationship between changes in serum CT and CEA levels at 3 months, defined by an increase or a decrease of at least 20%, and PFS according to RECIST 1.0, was estimated using Kaplan-Meier curves and log-rank test. RESULTS The median follow-up for the 28 patients was 68 months. According to RECIST, a partial response, a stabilization or a progression was observed in 14, 43, and 43% of cases respectively. Median PFS from the initiation of cytotoxic chemotherapy was 4.5 months. Median PFS among patients with and without significant CT increase at 3 months was 4.6 and 3.3 months respectively (P=0.75). Median PFS among patients with a significant CEA increase at 3 months was 2.7 months, whereas it was 19.1 months in patients in whom CEA did not increase (P=0.02). CONCLUSION At 3 months, an increase of serum CEA but not of CT levels appears as a valuable surrogate marker of short PFS in MTC patients treated with cytotoxic chemotherapy. A prospective validation is expected.
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Affiliation(s)
- G Hajje
- Department of Nuclear Medicine and Endocrine Tumors, Institut Gustave Roussy, University Paris Sud, 39 Rue Camille Desmoulins, 94805 Villejuif Cedex, France.
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26
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Hartl D, Gaggar A, Bruscia E, Hector A, Marcos V, Jung A, Greene C, McElvaney G, Mall M, Döring G. Innate immunity in cystic fibrosis lung disease. J Cyst Fibros 2012; 11:363-82. [PMID: 22917571 DOI: 10.1016/j.jcf.2012.07.003] [Citation(s) in RCA: 173] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 06/29/2012] [Accepted: 07/02/2012] [Indexed: 12/16/2022]
Abstract
Chronic lung disease determines the morbidity and mortality of cystic fibrosis (CF) patients. The pulmonary immune response in CF is characterized by an early and non-resolving activation of the innate immune system, which is dysregulated at several levels. Here we provide a comprehensive overview of innate immunity in CF lung disease, involving (i) epithelial dysfunction, (ii) pathogen sensing, (iii) leukocyte recruitment, (iv) phagocyte impairment, (v) mechanisms linking innate and adaptive immunity and (iv) the potential clinical relevance. Dissecting the complex network of innate immune regulation and associated pro-inflammatory cascades in CF lung disease may pave the way for novel immune-targeted therapies in CF and other chronic infective lung diseases.
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Affiliation(s)
- D Hartl
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany.
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27
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Kappler M, Espach C, Schweiger-Kabesch A, Lang T, Hartl D, Hector A, Glasmacher C, Griese M. Ursodeoxycholic acid therapy in cystic fibrosis liver disease--a retrospective long-term follow-up case-control study. Aliment Pharmacol Ther 2012; 36:266-73. [PMID: 22670841 DOI: 10.1111/j.1365-2036.2012.05177.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 01/04/2012] [Accepted: 05/17/2012] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prevention and treatment of liver disease associated with cystic fibrosis remain a significant unresolved problem. AIM To assess the long-term effects of continuous ursodeoxycholic acid (UDCA) therapy in cystic fibrosis patients with constantly elevated serum liver enzymes. METHODS The primary endpoint was the incidence of overt liver disease. Between 1989 and 2005, UDCA treatment was started in 98 subjects from a cohort of 382 cystic fibrosis patients. These subjects were compared with a historic control group of 352 subjects who attended our centre between 1975 and 1989 before UDCA became standard treatment. For the long-term comparison of liver function and lung function tests, a group of 98 matched contemporary cystic fibrosis patients were compared with the 98 subjects treated with UDCA. RESULTS Overt liver disease developed in only one of the 382 patients who was treated with UDCA for increased serum liver enzymes compared with nine patients in the historic control group (P < 0.05). Serum liver enzyme levels declined in most patients receiving UDCA treatment during the 17-year follow-up (87/98, P < 0.05). No difference was seen in lung function between subjects with cystic fibrosis-related liver disease and the matched controls. CONCLUSIONS Regular and systematic screening for liver involvement enables early introduction of UDCA therapy in affected cystic fibrosis patients, reduces the development of severe liver disease and leads to a significant and persistent improvement in serum liver tests, without impairing long-term pulmonary outcome.
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Affiliation(s)
- M Kappler
- Children's University Hospital of the Ludwig-Maximilians-University, Dr von Haunersches Kinderspital, Munich, Germany.
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28
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Kappler M, Espach C, Schweiger-Kabesch A, Lang T, Hartl D, Hector A, Glasmacher C, Griese M. Ursodeoxycholic acid therapy in cystic fibrosis liver disease--a retrospective long-term follow-up case-control study. Aliment Pharmacol Ther 2012. [PMID: 22670841 DOI: 10.1111/j.1365-2036.2012.05177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prevention and treatment of liver disease associated with cystic fibrosis remain a significant unresolved problem. AIM To assess the long-term effects of continuous ursodeoxycholic acid (UDCA) therapy in cystic fibrosis patients with constantly elevated serum liver enzymes. METHODS The primary endpoint was the incidence of overt liver disease. Between 1989 and 2005, UDCA treatment was started in 98 subjects from a cohort of 382 cystic fibrosis patients. These subjects were compared with a historic control group of 352 subjects who attended our centre between 1975 and 1989 before UDCA became standard treatment. For the long-term comparison of liver function and lung function tests, a group of 98 matched contemporary cystic fibrosis patients were compared with the 98 subjects treated with UDCA. RESULTS Overt liver disease developed in only one of the 382 patients who was treated with UDCA for increased serum liver enzymes compared with nine patients in the historic control group (P < 0.05). Serum liver enzyme levels declined in most patients receiving UDCA treatment during the 17-year follow-up (87/98, P < 0.05). No difference was seen in lung function between subjects with cystic fibrosis-related liver disease and the matched controls. CONCLUSIONS Regular and systematic screening for liver involvement enables early introduction of UDCA therapy in affected cystic fibrosis patients, reduces the development of severe liver disease and leads to a significant and persistent improvement in serum liver tests, without impairing long-term pulmonary outcome.
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Affiliation(s)
- M Kappler
- Children's University Hospital of the Ludwig-Maximilians-University, Dr von Haunersches Kinderspital, Munich, Germany.
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29
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Nascimento C, Borget I, Al Ghuzlan A, Deandreis D, Chami L, Travagli JP, Hartl D, Lumbroso J, Chougnet C, Lacroix L, Baudin E, Schlumberger M, Leboulleux S. Persistent disease and recurrence in differentiated thyroid cancer patients with undetectable postoperative stimulated thyroglobulin level. Endocr Relat Cancer 2011; 18:R29-40. [PMID: 21183629 DOI: 10.1677/erc-10-0292] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
(131)I is given in differentiated thyroid cancer (DTC) without taking into account thyroglobulin (Tg) levels at the time of ablation, whereas 6-18 months later it is a major criterion for cure. This single-center retrospective study assessed the frequency and risk factors for persistent disease on postablation whole body scan (WBS) and postoperative neck ultrasonography (n-US) and for recurrent disease during the subsequent follow-up, in patients with DTC and undetectable TSH-stimulated Tg level (TSH-Tg) in the absence of Tg antibodies (TgAb) at the time of ablation. Among 1031 patients ablated, 242 (23%) consecutive patients were included. Persistent disease occurred in eight cases (3%) (seven abnormal WBS and one abnormal n-US), all with initial neck lymph node metastases (N1). N1 was a major risk factor for persistent disease. Among 203 patients with normal WBS and a follow-up over 6 months, TSH-Tg 6-18 months after ablation was undetectable in the absence of TgAb in 173 patients, undetectable with TgAb in 1 patient and equal to 1.2 ng/ml in 1 patient. n-US was normal in 152 patients and falsely positive in 3 patients. After a mean follow-up of 4 years, recurrence occurred in two cases (1%), both with aggressive histological variants. The only risk factor for recurrence was an aggressive histological variant (P = 0.03). In conclusion, undetectable postoperative TSH-Tg in the absence of TgAb at the time of ablation is frequent. In these patients, repeating TSH-Tg 6-18 months after ablation is not useful. (131)I ablation could be avoided in the absence of N1 and aggressive histological variant.
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Affiliation(s)
- C Nascimento
- Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, Univ. Paris-Sud, Villejuif, France
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30
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Abstract
Significant airway remodelling is a major component of the increased morbidity and mortality observed in cystic fibrosis (CF) patients. These airways feature ongoing leukocytic inflammation and unrelenting bacterial infection. In contrast to acute bacterial pneumonia, CF infection is not cleared efficiently and the ensuing inflammatory response causes tissue damage. This structural damage is mainly a result of free proteolytic activity released by infiltrated neutrophils and macrophages. Major proteases in this disease are serine and matrix metalloproteases (MMPs). While the role of serine proteases, such as elastase, has been characterised in detail, there is emerging evidence that MMPs could play a key role in the pathogenesis of CF lung disease. This review summarises studies linking MMPs with CF lung disease and discusses the potential value of MMPs as future therapeutic targets in CF and other chronic lung diseases.
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Affiliation(s)
- A Gaggar
- Dept of Medicine, University of Alabama at Birmingham, Birmingham, AL 35244, USA.
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31
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Abstract
Magnetic force combined with magnetic nanoparticles recently has shown potential for enhancing nucleic acid delivery. Achieving effective siRNA delivery into primary cultured cells is challenging. We compared the utility of magnetofection with lipofection procedures for siRNA delivery to primary and immortalized mammalian fibroblasts. Transfection efficiency and cell viability were analyzed by flow cytometry and effects of gene knockdown were quantified by real-time PCR. Lipofectamine 2000 and magnetofection achieved high transfection efficiencies comparable to similar gene silencing effects of about 80%; the cytotoxic effect of magnetofection, however, was significantly less. Magnetofection is a reliable and gentle alternative method with low cytotoxicity for siRNA delivery into difficult to transfect cells such as mammalian fibroblasts. These features are especially advantageous for functional end point analyses of gene silencing, e.g., on the metabolite level.
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Affiliation(s)
- R Ensenauer
- Children's Research Center, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
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32
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Hector A, Jonas F, Kappler M, Feilcke M, Hartl D, Griese M. Novel Method to Process Cystic Fibrosis Sputum for Determination of Oxidative State. Respiration 2009; 80:393-400. [DOI: 10.1159/000271607] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 10/15/2009] [Indexed: 11/19/2022] Open
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33
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Abstract
Neutrophils, the prototypic cells of the innate immune system, are recruited to infected sites to protect the human body from invading pathogens. To accomplish this function, neutrophils sense pathogens and endogenous damage-associated molecules via innate immune receptors, such as Toll-like receptors (TLRs) and other pattern recognition receptors. This defence function is essential for the pulmonary microenvironment where the host is faced with millions of particles and pathogens inhaled daily. Chronic lung diseases, such as cystic fibrosis or chronic obstructive pulmonary disease are characterized by a neutrophil accumulation and chronic bacterial colonization of the airways. Consequently, insights into the role of TLRs on neutrophils in chronic lung diseases are of high relevance for further diagnostic and therapeutic approaches. Here we summarize and discuss recent advances in the expression, regulation and functional role of TLRs on neutrophils in chronic lung diseases.
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Affiliation(s)
- B Koller
- Children's Hospital Research Center, Department of Dermatology, LMU University of Munich, Munich, Germany
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34
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Abstract
Progressive lung disease determines the morbidity and mortality of cystic fibrosis (CF) patients. CF lung disease is characterised by endobronchial inflammation sustained by bacterial infections and an ongoing accumulation of airway neutrophils. Activated or necrotic neutrophils liberate proteases that cause damage to structural, cellular and soluble components of the pulmonary microenvironment. Among various proteases released by airway cells, elastase is considered to play the major role in CF lung disease. Based on this concept, several therapeutic approaches have been developed to inhibit free elastolytic activity, including small synthetic chemical compounds, semi-synthetic inhibitors and natural inhibitors of free elastase. The present review summarises and discusses the pathophysiological rationales, methodological requirements and clinical implications of inhibition of airway proteases in cystic fibrosis lung disease.
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Affiliation(s)
- M Griese
- Ludwig Maximilians University, Children's Hospital, Lindwurmstr. 4, D-80337 Munich, Germany.
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35
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Hartl D. Keeping pace with change. Nature 2008. [DOI: 10.1038/451017a] [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: 11/09/2022]
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36
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Mehlhorn AT, Niemeyer P, Kaschte K, Muller L, Finkenzeller G, Hartl D, Sudkamp NP, Schmal H. Differential effects of BMP-2 and TGF-beta1 on chondrogenic differentiation of adipose derived stem cells. Cell Prolif 2007; 40:809-23. [PMID: 18021172 DOI: 10.1111/j.1365-2184.2007.00473.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES This article addresses the interaction of transforming growth factor beta1 (TGF-beta1) and bone morphogenic protein 2 (BMP-2) during osteo-chondrogenic differentiation of adipose-derived adult stem cells (ASC). TGF-beta1 was expected to modulate the BMP-2-induced effects through transcriptional regulation of Dlx-5, Msx-2 and Runx-2. MATERIALS AND METHODS Encapsulated ASC were cultured for 14 days in medium containing TGF-beta1 and/or BMP-2. mRNA expression of the extracellular matrix molecules col2a1, cartilage oligomeric matrix protein, col10a1, alkaline phosphatase (AP) and transcription factors Msx-2, Dlx-5 and Runx-2 was analysed. Release of glycosaminoglycans, collagen types II and X into the extracellular matrix was demonstrated. RESULTS BMP-2 and TGF-beta1 induced a chondrogenic phenotype in ASC. Combined growth factor treatment had a synergistic effect on col10a1 and an additive effect on col2a1 mRNA expression. Synthesis of glycosaminoglycans was enhanced by combined growth factor treatment. Addition of TGF-beta1 inhibited BMP-2 induced AP expression and activity and both proteins promoted chondrogenic maturation. CONCLUSIONS Prevention of BMP-2-induced osteogenic transdifferentiation by TGF-beta1 seemed not to be mediated by transcriptional regulation of Dlx-5. Due to these findings, simultaneous stimulation of ASC with BMP-2 and TGF-beta1 seemed to be beneficial for complete differentiation of ASC into chondrocytes.
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Affiliation(s)
- A T Mehlhorn
- Department of Orthopaedic and Trauma Surgery, University Medical Center Freiberg, Germany.
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37
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Latzin P, Hartl D, Regamey N, Frey U, Schoeni MH, Casaulta C. Comparison of serum markers for allergic bronchopulmonary aspergillosis in cystic fibrosis. Eur Respir J 2007; 31:36-42. [PMID: 17898016 DOI: 10.1183/09031936.00078107] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) is a challenge. Thymus- and activation-regulated chemokine (TARC) has recently been reported to play a role in ABPA. The aim of this study was to compare the diagnostic value of TARC with that of known serological markers for diagnosis of ABPA in CF patients. The present study longitudinally followed 48 CF patients, of whom 12 had a diagnosis of ABPA according to Nelson's criteria, for 1-8 yrs with repeated measurements of serum total immunoglobulin (Ig)E, specific Aspergillus fumigatus IgE and IgG, specific IgE against recombinant A. fumigatus allergens (rAsp f) 1, 3, 4 and 6, and TARC. Median (interquartile range) TARC levels were 589 (465-673) pg x mL(-1) in ABPA patients and 232 (189-289) pg x mL(-1) in non-ABPA patients. Receiver operating characteristic curves revealed that TARC was superior to the other markers for diagnosis of ABPA. Diagnostic accuracy was greater for TARC (93%) than for total IgE (74%), or rAsp f 4 (75%) or f 6 (79%). The present study indicates that thymus- and activation-regulated chemokine may be useful in the diagnosis of allergic bronchopulmonary aspergillosis in cystic fibrosis patients. However, larger studies are needed before thymus- and activation-regulated chemokine can routinely be used in diagnostic algorithms.
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Affiliation(s)
- P Latzin
- Division of Respiratory Medicine, Dept of Paediatrics, University Children's Hospital of Bern, Inselspital, 3010 Bern, Switzerland.
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38
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Schmal H, Niemeyer P, Roesslein M, Hartl D, Loop T, Südkamp NP, Stark GB, Mehlhorn AT. Comparison of cellular functionality of human mesenchymal stromal cells and PBMC. Cytotherapy 2007; 9:69-79. [PMID: 17361488 DOI: 10.1080/14653240601011557] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Human mesenchymal stromal cells (MSC) and PBMC play significant roles in repair processes following inflammation. Mechanisms of recruitment are still under investigation. METHODS AND RESULTS MIP-1alpha induced the chemotactic migration of MSC but not of PBMC. Correlating with this, 7.7% of MSC expressed the chemokine receptor CCR-1, as shown by FACS analysis. In contrast, PBMC did not express CCR-1 or CCR-2 but did express CXCR-4 (81.9%) and CCR-7 (42.2%). Setum induced the chemotaxis of both cell types, and zymosan activation increased the migration of PBMC but not of MSC. Corresponding with this, C5a induced the migration of PBMC but not of MSC. Dose-dependent and -specific adhesion to fibronectin, fibrinogen, collagen type I and collagen type II could be demonstrated for MSC; in contrast, PBMC did not adhere to any of the investigated proteins. Real-time PCR of receptor expression revealed a 12.2-fold higher expression of alphav in MSC compared with PBMC. Incubation of MSC with tumor necrosis factor-alpha (TNFalpha) induced NFkappaB activation and increased the chemotactic response to serum and adhesion to fibronedtin. DISCUSSION Chemotaxis and adhesion are crucial and differing cell fundtons of MSC and PBMC.
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Affiliation(s)
- H Schmal
- Department of Orthopedics and Traumatology, Ludwig-Maximilians University, Munich, Germany.
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39
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Abstract
Surfactant associated protein-A (SP-A) is the most abundant pulmonary surfactant protein and belongs to the family of innate host defense proteins termed collectins. Besides pulmonary host defense, SP-A is also involved in the formation of pulmonary surfactant, as it is essential for the structure of tubular myelin. The human SP-A gene locus includes two functional genes, SFTPA1 and SFTPA2 which are expressed independently, and a pseudo gene. The largest amount of SP-A1 proteins assemble to larger molecular complexes, whereas SP-A2 forms mainly dimers and trimers. SP-A polymorphisms play a role in respiratory distress syndrome, allergic bronchopulmonary aspergillosis and idiopathic pulmonary fibrosis. The levels of SP-A are decreased in the lungs of patients with cystic fibrosis, respiratory distress syndrome and further chronic lung diseases. Future areas for clinical research include disease specific SP-A expression pattern and their functional consequences, the differential roles of SP-A1 and SP-A2 in human lung diseases, and therapeutical approaches to correct altered SP-A levels.
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Affiliation(s)
- S Heinrich
- Pediatric Pneumology, Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
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40
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Latzin P, Beck-Ripp J, Hartl D, Bartenstein A, Noss J, Griese M. 8-Isoprostane in nasally exhaled breath condensate in different pediatric lung diseases. Eur J Med Res 2007; 12:21-5. [PMID: 17363354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
OBJECTIVE Increased levels of 8-isoprostane were found in various human lung diseases suggesting 8-isoprostane as a marker of pulmonary oxidative stress in vivo. The exact role in pediatric lung diseases has not been defined yet. The goal of this study was to clarify the role of 8-isoprostane in nasally exhaled breath condensate as possible marker of oxidative stress in children with different lung diseases. METHODS Levels of 8-isoprostane were measured in nasally exhaled breath condensate of 29 cystic fibrosis patients, 19 children with a history of wheezing episodes, 8 infants with acute respiratory tract infection and 53 healthy subjects using a specific enzyme immunoassay. RESULTS Levels of 8-isoprostane did neither discriminate between different disease groups nor correlate with lung function in cystic fibrosis patients. CONCLUSIONS Levels of 8-isoprostane in nasally exhaled breath condensate do not reflect oxidative stress in children with different lung diseases.
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Affiliation(s)
- P Latzin
- Dr. von Haunersches Kinderspital, Ludwig-Maximilians-University, Lindwurmstr. 4, 80337 Munich, Germany
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41
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Gunasekera AM, Wickramarachchi T, Neafsey DE, Ganguli I, Perera L, Premaratne PH, Hartl D, Handunnetti SM, Udagama-Randeniya PV, Wirth DF. Genetic Diversity and Selection at the Plasmodium vivax Apical Membrane Antigen-1 (PvAMA-1) Locus in a Sri Lankan Population. Mol Biol Evol 2007; 24:939-47. [PMID: 17244598 DOI: 10.1093/molbev/msm013] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Plasmodium vivax apical membrane antigen 1 (PvAMA-1) is an important malaria vaccine candidate. We present the first comprehensive analysis of nucleotide diversity across the entire PvAMA-1 gene using a single population sample from Sri Lanka. In contrast to what has been observed at the AMA-1 locus of Plasmodium falciparum, the signature of diversifying selection is seen most strongly in Domain II of PvAMA-1, indicating that the different domains in each species may be subject to varying selective pressures and functional constraints. We also find that recombination plays an important role in generating haplotype diversity at this locus, even in a region of low endemicity such as Sri Lanka. Mapping of diversity and recombination hotspots onto a 3-dimensional structural model of the protein indicates that one surface of the molecule may be particularly likely to bear epitopes for antibody recognition. Regions of this surface that show constrained variability may prove to be promising vaccine targets.
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MESH Headings
- Adolescent
- Amino Acid Sequence
- Animals
- Antigens, Protozoan/chemistry
- Antigens, Protozoan/genetics
- Base Sequence
- DNA, Protozoan/chemistry
- DNA, Protozoan/genetics
- Genetic Variation
- Genotype
- Humans
- Linkage Disequilibrium
- Malaria, Vivax/blood
- Malaria, Vivax/parasitology
- Membrane Proteins/chemistry
- Membrane Proteins/genetics
- Models, Molecular
- Molecular Sequence Data
- Plasmodium vivax/genetics
- Plasmodium vivax/metabolism
- Polymorphism, Genetic
- Protein Conformation
- Protozoan Proteins/chemistry
- Protozoan Proteins/genetics
- Selection, Genetic
- Sequence Alignment
- Sequence Analysis, DNA
- Sri Lanka
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Affiliation(s)
- Anusha M Gunasekera
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Harvard University, USA
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42
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Schmal H, Zwingmann J, Fehrenbach M, Finkenzeller G, Stark GB, Südkamp NP, Hartl D, Mehlhorn AT. bFGF influences human articular chondrocyte differentiation. Cytotherapy 2007; 9:184-93. [PMID: 17453970 DOI: 10.1080/14653240601182846] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The possible functional role of basic fibroblast growth factor (bFGF) in regulating the mitotic and metabolic activity of primary human articular chondrocytes was investigated. METHODS [EF1]Chondrocytes were enzymatically isolated from femoral head cartilage, and were cultured in vitro in monolayer. bFGF-dependent cell proliferation, production of collagen type II and aggrecan were monitored 10 days after isolation. Furthermore, effect of bFGF on cell cycle, cell morphology, and mRNA expression of integrins and chondrogenic markers determined by real time PCR were analyzed. RESULTS bFGF concentrations in supernatants of primary human articular chondrocytes peaked immediately after isolation and then declined. In a dose-dependent manner, bFGF enhanced cell amplification and viability. BFGF induced a decrease in the apoptotic cell population, while the number of proliferating cells remained unchanged. Supplementation of cell culture with bFGF reduced collagen type II mRNA by 49%, but increased expression of the integrin alpha(2) by 70%. bFGF did not significantly regulate the integrins alpha(1), alpha(5), alpha(10), alpha(v) and type I collagen. bFGF reduced the amount of collagen type II by 53%, which was correlated with diminished mRNA production. Monolayer cultured chondrocytes secreted significant amounts of aggrecan that decreased over time. Secretion of this cartilage-specific marker was further reduced by the addition of bFGF. DISCUSSION These findings highlight the potential role of bFGF as an endogenous chondrocyte mediator that can enhance cell amplification and regulate cell differentiation.
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Affiliation(s)
- H Schmal
- Department of Orthopedics and Traumatology, University of Freiburg Medical Center, Freiburg, Germany.
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43
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Renner E, Rylaarsdam S, Anover S, Hartl D, Jayakumar A, Belohradsky B, Ermer U, Jin Y, Kleiner G, Nagel F, Zhu Q, Claymann G, Torgerson T, Ochs H. Comèl-Netherton Syndrome - New Insight Into The Molecular Basis of this Rare Syndrome Characterized by Atopic Diathesis and Immune Deficiency. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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44
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Dalla Pozza R, Hartl D, Bechtold S, Urschel S, Kozlik-Feldmann R, Pankuweit S, Belohradsky B, Netz H. Recurrent pericarditis in children: elevated cardiac autoantibodies. Clin Res Cardiol 2006; 96:168-75. [PMID: 17180574 DOI: 10.1007/s00392-007-0471-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2006] [Accepted: 10/20/2006] [Indexed: 12/31/2022]
Abstract
UNLABELLED Recurrent pericarditis is a rare disease in childhood. Nevertheless, it may represent a challenge to the clinician due to its resistance to anti-inflammatory treatment. The initial etiology often remains unclear; specific laboratory parameters predicting the frequency or severity of the recurrences are lacking. We report on four patients with recurrent pericarditis in whom antimyolemmal antibodies (AMLAs) were detected. A prolonged persistence of IgM-type AMLAs was found in three patients: two of them presented with acute inflammation as the initial event and one with 48 recurrences during 5.5 years. The fourth patient showed a fast conversion from IgM to IgG-type AMLAs after a less acute initial presentation and showed 4 mild recurrences during the 48-month follow-up. CONCLUSION We were able to detect AMLAs in four children with recurrent pericarditis. This finding may be attributed to an auto-immunological disease following a first, acute event. We propose the detection of AMLAs in all children with unexplained recurrent pericarditis. Pediatric patients with a persistence of IgM-type AMLAs may face frequent recurrences and should be monitored therefore more closely. In addition, medical treatment may be changed in these patients with a slower tapering of the dosage of steroidal and non-steroidal antiinflammatory drugs.
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Affiliation(s)
- R Dalla Pozza
- Department of Pediatric Cardiology, University Children's Hospital, Lindwurmstr. 4, 80337, Munich, Germany.
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45
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Müller H, End C, Renner M, Helmke BM, Gassler N, Lyer S, Beedgen B, Pöschl J, Hartl D, Griese M, Poustka A, Mollenhauer J, Linderkamp O. Erhöhte pulmonale DMBT1-Expression bei Infektionen von Frühgeborenen und DMBT1-bedingte negative Modulation der Surfactantfunktion. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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46
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Griese M, Latzin P, Kappler M, Weckerle K, Heinzlmaier T, Bernhardt T, Hartl D. 1-Antitrypsin inhalation reduces airway inflammation in cystic fibrosis patients. Eur Respir J 2006; 29:240-50. [PMID: 17050563 DOI: 10.1183/09031936.00047306] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The airways of cystic fibrosis (CF) patients are characterised by neutrophils that release high amounts of elastase overwhelming the local antiprotease shield. Inhalation of alpha(1)-antitrypsin (AAT) may restore the protease-antiprotease balance and attenuate airway inflammation in CF airways. The aims of the present study were: 1) to assess the best deposition region for inhaled AAT by two different inhalation strategies; and 2) to examine the effect of 4 weeks of AAT inhalation on lung function, protease-antiprotease balance and airway inflammation in CF patients. In a prospective, randomised study, 52 CF patients received a daily deposition by inhalation of 25 mg AAT for 4 weeks targeting their peripheral or bronchial compartment. The levels of elastase activity, AAT, pro-inflammatory cytokines, neutrophils, immunoglobulin G fragments and the numbers of Pseudomonas aeruginosa were assessed in induced sputum before and after the inhalation period. Inhalation of AAT increased AAT levels and decreased the levels of elastase activity, neutrophils, pro-inflammatory cytokines and the numbers of P. aeruginosa. However, it had no effect on lung function. No difference was found between the peripheral and bronchial inhalation mode. In conclusion, although no effect on lung function was observed, the clear reduction of airway inflammation after alpha(1)-antitrypsin treatment may precede pulmonary structural changes. The alpha(1)-antitrypsin deposition region may play a minor role for alpha(1)-antitrypsin inhalation in cystic fibrosis patients.
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Affiliation(s)
- M Griese
- Lung Research Group, Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Lindwurmstr 4, D-80337 Munich, Germany.
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47
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Durante C, Haddy N, Baudin E, Leboulleux S, Hartl D, Travagli JP, Caillou B, Ricard M, Lumbroso JD, De Vathaire F, Schlumberger M. Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. J Clin Endocrinol Metab 2006; 91:2892-9. [PMID: 16684830 DOI: 10.1210/jc.2005-2838] [Citation(s) in RCA: 1009] [Impact Index Per Article: 56.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM The goal of this study was to estimate the cumulative activity of (131)I to be administered to patients with distant metastases from thyroid carcinoma. METHODS A total of 444 patients were treated from 1953-1994 for distant metastases from papillary and follicular thyroid carcinoma: 223 had lung metastases only, 115 had bone metastases only, 82 had both lung and bone metastases, and 24 had metastases at other sites. Treatment consisted of the administration of 3.7 GBq (100 mCi) (131)I after withdrawal of thyroid hormone treatment, every 3-9 months during the first 2 yr and then once a year until the disappearance of any metastatic uptake. Thyroxine treatment was given at suppressive doses between (131)I treatment courses. RESULTS Negative imaging studies (negative total body (131)I scans and conventional radiographs) were attained in 43% of the 295 patients with (131)I uptake; more frequently in those who were younger, had well-differentiated tumors, and had a limited extent of disease. Most negative studies (96%) were obtained after the administration of 3.7-22 GBq (100-600 mCi). Almost half of negative studies were obtained more than 5 yr after the initiation of the treatment of metastases. Among patients who achieved a negative study, only 7% experienced a subsequent tumor recurrence. Overall survival at 10 yr after initiation of (131)I treatment was 92% in patients who achieved a negative study and 19% in those who did not. CONCLUSION (131)I treatment is highly effective in younger patients with (131)I uptake and with small metastases. They should be treated until the disappearance of any uptake or until a cumulative activity of 22 GBq has been administered. In the other patients, other treatment modalities should be used when tumor progression has been documented.
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Affiliation(s)
- C Durante
- Institut Gustave Roussy, 94805 Villejuif Cédex, France
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48
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Abstract
The lung is continuously exposed to inhaled pollutants, microbes and allergens. Therefore, the pulmonary immune system has to defend against harmful pathogens, while an inappropriate inflammatory response to harmless particles must be avoided. In the bronchoalveolar space this critical balance is maintained by innate immune proteins, termed surfactant proteins. Among these, surfactant protein D (SP-D) plays a central role in the pulmonary host defence and the modulation of allergic responses. Several human lung diseases are characterized by decreased levels of bronchoalveolar SP-D. Thus, recombinant SP-D has been proposed as a therapeutical option for cystic fibrosis, neonatal lung disease and smoking-induced emphysema. Furthermore, SP-D serum levels can be used as disease activity markers for interstitial lung diseases. This review illustrates the emerging role of SP-D translated from in vitro studies to human lung diseases.
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Affiliation(s)
- D Hartl
- Department of Pediatric Pneumology, Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
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49
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Müller H, End C, Renner M, Helmke BM, Gassler N, Lyer S, Beedgen B, Pöschl J, Hartl D, Griese M, Poustka A, Mollenhauer J, Linderkamp O. Erhöhte pulmonale DMBT1-Expression bei Infektionen von Frühgeborenen und DMBT1-bedingte negative Modulation der Surfactantfunktion. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Abstract
Rapid evolution of asexual populations, such as that of cancer cells or of microorganisms developing drug resistance, can include the simultaneous spread of distinct beneficial mutations. We demonstrate that evolution in such cases is driven by the fitness effects and appearance times of only a small minority of favorable mutations. The complexity of the mutation-selection process is thereby greatly reduced, and much of the evolutionary dynamics can be encapsulated in two parameters-an effective selection coefficient and effective rate of beneficial mutations. We confirm this theoretical finding and estimate the effective parameters for evolving populations of fluorescently labeled Escherichia coli. The effective parameters constitute a simple description and provide a natural standard for comparing adaptation between species and across environments.
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Affiliation(s)
- Matthew Hegreness
- Bauer Center for Genomics Research, Harvard University, Cambridge, MA 02138, USA
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