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Stolte KN, Mesas-Fernández A, Meier K, Klein EK, Dommisch H, Ghoreschi K, Solimani F. TYK2 inhibition with deucravacitinib ameliorates erosive oral lichen planus. Exp Dermatol 2024; 33:e15080. [PMID: 38628035 DOI: 10.1111/exd.15080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/21/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
Erosive oral lichen planus (OLP) is a challenging disease. This T cell driven disorder frequently shows a treatment unresponsive course and strongly limits patients' quality of life. The disease lacks FDA or EMA approved drugs for its treatment and the efficacy of the commonly administered treatments (i.e. topical and systemic steroids, steroid sparing agents) is often only partial. Although the etiopathogenesis of the disease still needs to be fully elucidated, recent advances helped to identify interferon-ɣ (IFN-ɣ) as a pivotal cytokine in OLP pathogenesis, thus making the interference with its signalling a therapeutic target. Janus kinase (JAK) inhibitors therefore gained relevance for their inhibitory effect on IFN-ɣ signalling. While some drugs such as abrocitinib, upadacitinib, tofacitinib directly interfere with IFN-ɣ signalling through blockade of JAK1 and/or JAK2, deucravacitinib, a selective TYK-2 inhibitor indirectly interferes on IFN-ɣ activation through interference with interleukin (IL)-12, a potent promotor for Th1/IFN-ɣ responses. This mechanism of action makes deucravacitinib a candidate drug for the treatment of OLP. Here we provide initial evidence that deucravacitinib 6 mg daily has a beneficial effect in three patients with oral OLP.
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Affiliation(s)
- Kim Natalie Stolte
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Alberto Mesas-Fernández
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Edis Kaan Klein
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Farzan Solimani
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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2
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Kanatoula DD, Bodner E, Ghoreschi K, Meier K, Solimani F. Non-biologic immunosuppressive drugs for inflammatory and autoimmune skin diseases. J Dtsch Dermatol Ges 2024; 22:400-421. [PMID: 38259085 DOI: 10.1111/ddg.15270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/08/2023] [Indexed: 01/24/2024]
Abstract
Non-biologic immunosuppressive drugs, such as azathioprine, dapsone or methotrexate are fundamental treatment options for a wide range of autoimmune and chronic inflammatory skin diseases. Some of these drugs were initially used for malignancies (e.g., azathioprine or methotrexate) or infectious diseases (e.g., hydroxychloroquine or dapsone) but are nowadays mostly used for their immunosuppressive/immunomodulating action. Although dermatologists have years of clinical experience with these drugs, some of the mechanisms of action are not fully understood and are the subject of research. Although these drugs are commonly used, lack of experience or knowledge regarding their safety profiles and management leads to skepticism among physicians. Here, we summarize the mechanism of action and detailed management of adverse effects of the most commonly used immunosuppressive drugs for skin diseases. Furthermore, we discuss the management of these drugs during pregnancy and breastfeeding, as well as their interaction and handling during vaccination.
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Affiliation(s)
- Danai Dionysia Kanatoula
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Euna Bodner
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
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3
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Kanatoula DD, Bodner E, Ghoreschi K, Meier K, Solimani F. Nicht-Biologika-Immunsuppressiva bei entzündlichen und autoimmunen Hautkrankheiten: Non-biologic immunosuppressive drugs for inflammatory and autoimmune skin diseases. J Dtsch Dermatol Ges 2024; 22:400-423. [PMID: 38450929 DOI: 10.1111/ddg.15270_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/08/2023] [Indexed: 03/08/2024]
Abstract
ZusammenfassungNicht‐Biologika‐Immunsuppressiva wie Azathioprin, Dapson oder Methotrexat sind grundlegende Behandlungsmöglichkeiten für ein breites Spektrum von Autoimmunerkrankungen und chronisch‐entzündlichen Hauterkrankungen. Einige dieser Medikamente wurden ursprünglich bei malignen Erkrankungen (zum Beispiel Azathioprin oder Methotrexat) oder Infektionskrankheiten (zum Beispiel Hydroxychloroquin oder Dapson) eingesetzt, werden aber heute hauptsächlich wegen ihrer immunsuppressiven/immunmodulierenden Wirkung verwendet. Obwohl Dermatologen über jahrelange klinische Erfahrung mit diesen Arzneimitteln verfügen, sind einige der Wirkmechanismen noch nicht vollständig geklärt und noch Gegenstand der Forschung. Obwohl diese Medikamente häufig eingesetzt werden, führen mangelnde Erfahrung oder fehlendes Wissen über ihre Sicherheitsprofile und ihr Management zu einer skeptischen Haltung bei den Ärzten. Hier fassen wir den Wirkmechanismus und das detaillierte Management der Nebenwirkungen der am häufigsten verwendeten immunsuppressiven Medikamente für Hautkrankheiten zusammen. Darüber hinaus diskutieren wir den Umgang mit diesen Medikamenten während der Schwangerschaft und Stillzeit sowie ihre Wechselwirkung und Handhabung im Zusammenhang mit Impfungen.
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Affiliation(s)
- Danai Dionysia Kanatoula
- Abteilung für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin
| | - Euna Bodner
- Abteilung für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin
| | - Kamran Ghoreschi
- Abteilung für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin
| | - Katharina Meier
- Abteilung für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin
| | - Farzan Solimani
- Abteilung für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin
- BIH Biomedical Innovation Academy, Berlin Institute of Health, Charité - Universitätsmedizin Berlin
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4
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Meier K, Riepl A, Voitl P, Lischka L, Voitl JJM, Langer K, Kuzio U, Redlberger-Fritz M, Diesner-Treiber SC. Characterisation of RSV infections in children without chronic diseases aged 0-36 months during the post-COVID-19 winter season 2022/2023. Front Pediatr 2024; 12:1342399. [PMID: 38379907 PMCID: PMC10876782 DOI: 10.3389/fped.2024.1342399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/25/2024] [Indexed: 02/22/2024] Open
Abstract
Background Respiratory syncytial virus (RSV) is one of the leading causes of hospitalisation, morbidity, and mortality due to respiratory infection in the first years of life. This longitudinal prospective study outlines the 2022/23 season's viral patterns in Austria after the epidemiological changes determined by public health measures. We aimed to highlight differences within the RSV subtypes and genotypes in 0-36-month-old children without chronic diseases in the outpatient setting. Methods From November 2022 to March 2023 children younger than 36 months admitted to Vienna's largest paediatric primary healthcare centre with an acute respiratory infection were enrolled in this study. Nasal swabs and multiplex PCR panels detected 20 viruses including RSV subtypes and genotypes. Clinical presentation, features, and treatment of the participants were documented and analysed using the Modified Tal Score (MTS). Patients were scheduled for a telemedical follow-up one week after the initial appointment. Analysis was done using descriptive statistics, including Cramér V and binominal logarithmic regression. Results Among the 345 samples from 329 children, RSV was the most common virus (31.9%), followed by influenza (17.5%) and rhinovirus infections (20.58%). Of the RSV positive samples, only 13 cases were RSV subtype A (11.8%), whereas 97 were of subtype B (87.3%); ON1 and BA9 were the only detectable RSV genotypes (ON1: BA9 = 1:9.25). RSV was the main predictor of hospitalisation (OR: 7.5, 95% CI: (1.46-38.40), and age had a significant but smaller effect (OR: 0.89, 95% CI: (0.81-0.99). Almost all patients' clinical status improved within the first days. Conclusion RSV cases showed a rapid onset in late November 2022, and subtype B was predominant throughout the season. RSV infection was associated with higher hospitalisation rates, even after excluding high-risk patients (preterm and severe chronic diseases population).Further testing in the upcoming winter seasons will improve our knowledge of the dominant subtype and its association with disease severity, especially with the development of novel RSV vaccine candidates.
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Affiliation(s)
| | - Angela Riepl
- First Vienna Pediatric Medical Center, Vienna, Austria
| | - Peter Voitl
- First Vienna Pediatric Medical Center, Vienna, Austria
- Sigmund Freud University Vienna, Vienna, Austria
| | - Lena Lischka
- First Vienna Pediatric Medical Center, Vienna, Austria
| | | | - Klara Langer
- First Vienna Pediatric Medical Center, Vienna, Austria
| | - Ulrike Kuzio
- First Vienna Pediatric Medical Center, Vienna, Austria
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Vega DM, Yee LM, McShane LM, Williams PM, Chen L, Vilimas T, Fabrizio D, Funari V, Newberg J, Bruce LK, Chen SJ, Baden J, Carl Barrett J, Beer P, Butler M, Cheng JH, Conroy J, Cyanam D, Eyring K, Garcia E, Green G, Gregersen VR, Hellmann MD, Keefer LA, Lasiter L, Lazar AJ, Li MC, MacConaill LE, Meier K, Mellert H, Pabla S, Pallavajjalla A, Pestano G, Salgado R, Samara R, Sokol ES, Stafford P, Budczies J, Stenzinger A, Tom W, Valkenburg KC, Wang XZ, Weigman V, Xie M, Xie Q, Zehir A, Zhao C, Zhao Y, Stewart MD, Allen J. Erratum to "Aligning tumor mutational burden (TMB) quantification across diagnostic platforms: phase II of the Friends of Cancer Research TMB Harmonization Project": [Annals of Oncology 32 (2021) 1626-1636]. Ann Oncol 2024; 35:145. [PMID: 37558578 DOI: 10.1016/j.annonc.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
- D M Vega
- Friends of Cancer Research, Washington
| | - L M Yee
- National Cancer Institute, Bethesda
| | | | - P M Williams
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | - L Chen
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | - T Vilimas
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | | | - V Funari
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - L K Bruce
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - J Baden
- Bristol Myers Squibb Co., Princeton
| | | | - P Beer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - M Butler
- LGC Clinical Diagnostics, Gaithersburg
| | | | | | - D Cyanam
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor
| | - K Eyring
- Intermountain Precision Genomics, St. George
| | - E Garcia
- Brigham and Women's Hospital, Boston, USA
| | - G Green
- Bristol Myers Squibb Co., Princeton
| | | | - M D Hellmann
- Memorial Sloan Kettering Cancer Center, New York
| | | | - L Lasiter
- Friends of Cancer Research, Washington
| | - A J Lazar
- The University of Texas MD Anderson Cancer Center, Houston
| | - M-C Li
- National Cancer Institute, Bethesda
| | | | - K Meier
- Illumina Inc, Clinical Genomics, San Diego
| | | | | | | | | | - R Salgado
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | | | - P Stafford
- Caris Life Sciences Inc, Phoenix, Arizona, USA
| | - J Budczies
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - W Tom
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor
| | | | - X Z Wang
- EMD Serono Research and Development Institute, Inc., Billerica
| | | | - M Xie
- AstraZeneca Pharmaceuticals LP, Waltham, USA
| | - Q Xie
- General Dynamics Information Technology, Inc., Columbia, USA
| | - A Zehir
- Memorial Sloan Kettering Cancer Center, New York
| | - C Zhao
- Illumina Inc, Clinical Genomics, San Diego
| | - Y Zhao
- National Cancer Institute, Bethesda
| | | | - J Allen
- Friends of Cancer Research, Washington
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6
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Hasheminasab S, Ghoreschi FC, Meier K, Nast A, Ghoreschi K, Solimani F. Progressive enlarging yellowish indurated plaques on the neck and armpits. J Dtsch Dermatol Ges 2023; 21:1235-1238. [PMID: 37282818 DOI: 10.1111/ddg.15124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/12/2023] [Indexed: 06/08/2023]
Affiliation(s)
- Sayedmohammad Hasheminasab
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Franziska C Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alexander Nast
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
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7
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Hasheminasab S, Ghoreschi FC, Meier K, Nast A, Ghoreschi K, Solimani F. Größer werdende gelbliche indurierte Plaques am Hals und in den Achselhöhlen. J Dtsch Dermatol Ges 2023; 21:1235-1238. [PMID: 37845052 DOI: 10.1111/ddg.15124_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/12/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Sayedmohammad Hasheminasab
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin
| | - Franziska C Ghoreschi
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin
| | - Katharina Meier
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin
| | - Alexander Nast
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin
| | - Kamran Ghoreschi
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin
| | - Farzan Solimani
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin
- BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin
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8
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Nguyen K, Korsing S, Mansour Y, Meier K. [Blastic plasmacytoid dendritic cell neoplasm (BPDCN) : A rare hematologic neoplasm with frequent cutaneous involvement]. Dermatologie (Heidelb) 2023; 74:787-792. [PMID: 37407876 PMCID: PMC10517032 DOI: 10.1007/s00105-023-05192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy that derives from precursors of plasmacytoid dendritic cells and is characterized by disseminated, erythematous or bluish-livid plaques or nodi. Because of the disease's rarity the diagnosis and treatment still pose a significant challenge. We present a case of a patient with BPDCN and show clinical and diagnostic characteristics as well as potential treatment regimes.
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Affiliation(s)
- Katrin Nguyen
- Klinik für Dermatologie, Allergologie und Venerologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Sören Korsing
- Klinik für Dermatologie, Allergologie und Venerologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Yasmine Mansour
- Klinik für Dermatologie, Allergologie und Venerologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Katharina Meier
- Klinik für Dermatologie, Allergologie und Venerologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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9
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Roehrig S, Ackerstaff J, Jiménez Núñez E, Teller H, Ellerbrock P, Meier K, Heitmeier S, Tersteegen A, Stampfuss J, Lang D, Schlemmer KH, Schaefer M, Gericke KM, Kinzel T, Meibom D, Schmidt M, Gerdes C, Follmann M, Hillisch A. Design and Preclinical Characterization Program toward Asundexian (BAY 2433334), an Oral Factor XIa Inhibitor for the Prevention and Treatment of Thromboembolic Disorders. J Med Chem 2023; 66:12203-12224. [PMID: 37669040 PMCID: PMC10510402 DOI: 10.1021/acs.jmedchem.3c00795] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Indexed: 09/06/2023]
Abstract
Activated coagulation factor XI (FXIa) is a highly attractive antithrombotic target as it contributes to the development and progression of thrombosis but is thought to play only a minor role in hemostasis so that its inhibition may allow for decoupling of antithrombotic efficacy and bleeding time prolongation. Herein, we report our major efforts to identify an orally bioavailable, reversible FXIa inhibitor. Using a protein structure-based de novo design approach, we identified a novel micromolar hit with attractive physicochemical properties. During lead modification, a critical problem was balancing potency and absorption by focusing on the most important interactions of the lead series with FXIa while simultaneously seeking to improve metabolic stability and the cytochrome P450 interaction profile. In clinical trials, the resulting compound from our extensive research program, asundexian (BAY 2433334), proved to possess the desired DMPK properties for once-daily oral dosing, and even more importantly, the initial pharmacological hypothesis was confirmed.
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Affiliation(s)
- Susanne Roehrig
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | | | | | | | | | | | - Stefan Heitmeier
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | - Adrian Tersteegen
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | - Jan Stampfuss
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | - Dieter Lang
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | | | | | - Kersten M. Gericke
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | | | - Daniel Meibom
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | - Martina Schmidt
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | - Christoph Gerdes
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
| | - Markus Follmann
- Pharmaceuticals, Research
and Development, Bayer AG, 42133 Wuppertal, Germany
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10
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Solimani F, Heinrichson M, Berneburg M, Hertl M, Welzel J, Meier K. Zertifizierung: "Führen in der Dermatologie (DDA)". J Dtsch Dermatol Ges 2023; 21:1089-1091. [PMID: 37700426 DOI: 10.1111/ddg.15224_g] [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: 09/14/2023]
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11
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Haralanova V, Meier K, Pleyer U. [Diagnostics of ocular mucous membrane pemphigoid]. Ophthalmologie 2023; 120:484-495. [PMID: 37147531 DOI: 10.1007/s00347-023-01856-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 05/07/2023]
Abstract
The diagnosis of ocular mucous membrane pemphigoid (MMP) remains a challenge as the timing and choice of diagnostic methods have a decisive influence on its quality. A systematic approach is required that includes a comprehensive medical history, critical evaluation of the clinical findings and targeted laboratory testing. The diagnosis is complicated by the fact that some patients present purely clinically the symptoms of MMP without fulfilling the required immunohistochemical and laboratory criteria. Basically, the diagnosis of ocular MMP is based on three pillars: 1) medical history and clinical findings, 2) positive immunohistological (direct immunofluorescence) tissue sample and 3) specific serological autoantibodies. As the diagnosis of ocular MMP often implies prolonged systemic immunomodulatory treatment in predominantly older patients, the accurate diagnosis and approach are of critical relevance. The aim of this article is to present the recently updated diagnostic procedure.
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Affiliation(s)
- Velina Haralanova
- Klinik für Augenheilkunde, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Katharina Meier
- Klinik für Dermatologie, Venerologie und Allergologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Deutschland
| | - Uwe Pleyer
- Klinik für Augenheilkunde, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Deutschland.
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12
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Solimani F, Mesas-Fernandez A, Dilling A, Nast A, Hilke FJ, Ghoreschi FC, Worm M, Ghoreschi K, Meier K. The Janus kinase inhibitor 1 abrocitinib for the treatment of oral lichen planus. J Eur Acad Dermatol Venereol 2023. [PMID: 36974430 DOI: 10.1111/jdv.19069] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Farzan Solimani
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Charitéplatz 1, 10117, Berlin, Germany
| | - Alberto Mesas-Fernandez
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
| | - Amrei Dilling
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
| | - Alexander Nast
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
| | - Franz J Hilke
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
| | - Franziska C Ghoreschi
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
| | - Margitta Worm
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
| | - Kamran Ghoreschi
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
| | - Katharina Meier
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117, Berlin, Germany
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13
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Mesas-Fernández A, Bodner E, Hilke FJ, Meier K, Ghoreschi K, Solimani F. Interleukin-21 in autoimmune and inflammatory skin diseases. Eur J Immunol 2023; 53:e2250075. [PMID: 36811452 DOI: 10.1002/eji.202250075] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 06/30/2022] [Revised: 02/01/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
Studies on the role of interleukins (ILs) in autoimmune and inflammatory diseases allow for the better understanding of pathologic mechanisms of disease and reshaping of treatment modalities. The development of monoclonal antibodies targeting specific ILs or IL signaling pathways (i.e., anti-IL-17/IL-23 in psoriasis or anti-IL-4/IL-13 in atopic dermatitis) is the shining example of therapeutic interventions in research. IL-21, belonging to the group of ɣc-cytokines (IL-2, IL-4, IL-7, IL-9, and IL-15), is gaining attention for its pleiotropic role in several types of immune cells as activator of various inflammatory pathways. In both health and disease, IL-21 sustains T- and B-cell activity. Together with IL-6, IL-21 helps to generate Th17 cells, promotes CXCR5 expression in T cells, and their maturation into follicular T helper cells. In B cells, IL-21 sustains their proliferation and maturation into plasma cells and promotes class switching and antigen-specific antibody production. Due to these characteristics, IL-21 is a main factor in numerous immunologic disorders, such as rheumatoid arthritis and MS. Studies in preclinical skin disease models and on human skin strongly suggest that IL-21 is crucially involved in inflammatory and autoimmune cutaneous disorders. Here, we summarize the current knowledge of IL-21 in well-known skin diseases.
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Affiliation(s)
- Alberto Mesas-Fernández
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Euna Bodner
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Franz Joachim Hilke
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Farzan Solimani
- BIH Charité Clinician Scientist Program, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Berlin, Germany
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14
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Solimani F, Mesas-Fernández A, Bodner E, Carevic-Neri M, Hasheminasab M, Jakovljevicova T, Philipp A, Nast A, Worm M, Hilke FJ, Meier K, Ghoreschi K. Clinical and immunological impact of booster immunization with recombinant mRNA vaccines for SARS-CoV-2 in patients with pemphigus and bullous pemphigoid. J Eur Acad Dermatol Venereol 2023; 37:e695-e697. [PMID: 36786360 DOI: 10.1111/jdv.18967] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/08/2023] [Indexed: 02/15/2023]
Affiliation(s)
- F Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - A Mesas-Fernández
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - E Bodner
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - M Carevic-Neri
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - M Hasheminasab
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - T Jakovljevicova
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Philipp
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Nast
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - M Worm
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - F J Hilke
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - K Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - K Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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15
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Breznik M, Ge Y, Bluck JP, Briem H, Hahn DF, Christ CD, Mortier J, Mobley DL, Meier K. Prioritizing Small Sets of Molecules for Synthesis through in-silico Tools: A Comparison of Common Ranking Methods. ChemMedChem 2023; 18:e202200425. [PMID: 36240514 PMCID: PMC9868080 DOI: 10.1002/cmdc.202200425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/10/2022] [Indexed: 01/26/2023]
Abstract
Prioritizing molecules for synthesis is a key role of computational methods within medicinal chemistry. Multiple tools exist for ranking molecules, from the cheap and popular molecular docking methods to more computationally expensive molecular-dynamics (MD)-based methods. It is often questioned whether the accuracy of the more rigorous methods justifies the higher computational cost and associated calculation time. Here, we compared the performance on ranking the binding of small molecules for seven scoring functions from five docking programs, one end-point method (MM/GBSA), and two MD-based free energy methods (PMX, FEP+). We investigated 16 pharmaceutically relevant targets with a total of 423 known binders. The performance of docking methods for ligand ranking was strongly system dependent. We observed that MD-based methods predominantly outperformed docking algorithms and MM/GBSA calculations. Based on our results, we recommend the application of MD-based free energy methods for prioritization of molecules for synthesis in lead optimization, whenever feasible.
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Affiliation(s)
- Marko Breznik
- Computational Molecular Design, Pharmaceuticals, R&D, Bayer AG, 13342 Berlin, Germany
| | - Yunhui Ge
- Department of Pharmaceutical Sciences, University of California, Irvine, CA 92697, USA
| | - Joseph P. Bluck
- Computational Molecular Design, Pharmaceuticals, R&D, Bayer AG, 13342 Berlin, Germany
| | - Hans Briem
- Computational Molecular Design, Pharmaceuticals, R&D, Bayer AG, 13342 Berlin, Germany
| | - David F. Hahn
- Computational Chemistry, Janssen Research & Development, Turnhoutseweg 30, Beerse B-2340, Belgium
| | - Clara D. Christ
- Molecular Design, Pharmaceuticals, R&D, Bayer AG, 13342 Berlin, Germany
| | - Jérémie Mortier
- Computational Molecular Design, Pharmaceuticals, R&D, Bayer AG, 13342 Berlin, Germany
| | - David L. Mobley
- Department of Pharmaceutical Sciences, University of California, Irvine, CA 92697, USA,Department of Chemistry, University of California, Irvine, CA 92697, USA
| | - Katharina Meier
- Computational Life Science Technology Functions, Crop Science, R&D, Bayer AG, 40789 Monheim, Germany
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16
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D’Amore L, Hahn DF, Dotson DL, Horton JT, Anwar J, Craig I, Fox T, Gobbi A, Lakkaraju SK, Lucas X, Meier K, Mobley DL, Narayanan A, Schindler CE, Swope WC, in ’t Veld PJ, Wagner J, Xue B, Tresadern G. Collaborative Assessment of Molecular Geometries and Energies from the Open Force Field. J Chem Inf Model 2022; 62:6094-6104. [PMID: 36433835 PMCID: PMC9873353 DOI: 10.1021/acs.jcim.2c01185] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Force fields form the basis for classical molecular simulations, and their accuracy is crucial for the quality of, for instance, protein-ligand binding simulations in drug discovery. The huge diversity of small-molecule chemistry makes it a challenge to build and parameterize a suitable force field. The Open Force Field Initiative is a combined industry and academic consortium developing a state-of-the-art small-molecule force field. In this report, industry members of the consortium worked together to objectively evaluate the performance of the force fields (referred to here as OpenFF) produced by the initiative on a combined public and proprietary dataset of 19,653 relevant molecules selected from their internal research and compound collections. This evaluation was important because it was completely blind; at most partners, none of the molecules or data were used in force field development or testing prior to this work. We compare the Open Force Field "Sage" version 2.0.0 and "Parsley" version 1.3.0 with GAFF-2.11-AM1BCC, OPLS4, and SMIRNOFF99Frosst. We analyzed force-field-optimized geometries and conformer energies compared to reference quantum mechanical data. We show that OPLS4 performs best, and the latest Open Force Field release shows a clear improvement compared to its predecessors. The performance of established force fields such as GAFF-2.11 was generally worse. While OpenFF researchers were involved in building the benchmarking infrastructure used in this work, benchmarking was done entirely in-house within industrial organizations and the resulting assessment is reported here. This work assesses the force field performance using separate benchmarking steps, external datasets, and involving external research groups. This effort may also be unique in terms of the number of different industrial partners involved, with 10 different companies participating in the benchmark efforts.
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Affiliation(s)
- Lorenzo D’Amore
- Computational Chemistry, Janssen R&D, C/ Jarama 75A, 45007 Toledo, Spain
| | - David F. Hahn
- Computational Chemistry, Janssen R&D, Turnhoutseweg 30, Beerse B-2340, Belgium
| | - David L. Dotson
- The Open Force Field Initiative, Open Molecular Software Foundation, Davis, California 95616, USA
| | - Joshua T. Horton
- School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Jamshed Anwar
- Department of Chemistry, Lancaster University, Lancaster LA1 4YW, UK
| | - Ian Craig
- Molecular Modeling & Drug Discovery, BASF SE, 67056 Ludwigshafen, Germany
| | - Thomas Fox
- Medicinal Chemistry, Boehringer Ingelheim Pharma GmbH & Co KG, 88397 Biberach/Riss, Germany
| | - Alberto Gobbi
- Genentech, Inc., 1 DNA Way, South San Francisco, California, 94080, USA
| | | | - Xavier Lucas
- Roche Pharma Research and Early Development, Therapeutic Modalities, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Katharina Meier
- Computational Life Science Technology Functions, Crop Science, R&D, Bayer AG, 40789 Monheim, Germany
| | - David L. Mobley
- Departments of Pharmaceutical Sciences and Chemistry, University of California 92617, Irvine, USA
| | - Arjun Narayanan
- Data and Computational Sciences, Vertex Pharmaceuticals, 50 Northern Ave, Boston, MA 02210, USA
| | | | - William C. Swope
- Genentech, Inc., 1 DNA Way, South San Francisco, California, 94080, USA
| | | | - Jeffrey Wagner
- The Open Force Field Initiative, Open Molecular Software Foundation, Davis, California, 95616, USA,Chemistry Department, The University of California at Irvine, Irvine, California, 92617, USA
| | - Bai Xue
- XtalPi Inc. Floor 3, International Biomedical Innovation Park II, No. 2 Hongliu Road, Fubao Community, Fubao Street, Futian District, Shenzhen, Guangdong, 518040 China
| | - Gary Tresadern
- Computational Chemistry, Janssen R&D, Turnhoutseweg 30, Beerse B-2340, Belgium
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17
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Solimani F, Dilling A, Ghoreschi FC, Nast A, Ghoreschi K, Meier K. Upadacitinib for treatment‐resistant Lichen amyloidosis. J Eur Acad Dermatol Venereol 2022; 37:e633-e635. [PMID: 36394121 DOI: 10.1111/jdv.18756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022]
Affiliation(s)
- F. Solimani
- Department of Dermatology, Venereology and Allergology, Charité‐Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Charitéplatz 1, 10117 Berlin Germany
| | - A. Dilling
- Department of Dermatology, Venereology and Allergology, Charité‐Universitätsmedizin Berlin Berlin Germany
| | - F. C. Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité‐Universitätsmedizin Berlin Berlin Germany
| | - A. Nast
- Department of Dermatology, Venereology and Allergology, Charité‐Universitätsmedizin Berlin Berlin Germany
| | - K. Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité‐Universitätsmedizin Berlin Berlin Germany
| | - K. Meier
- Department of Dermatology, Venereology and Allergology, Charité‐Universitätsmedizin Berlin Berlin Germany
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18
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Pradeau M, Ghoreschi K, Meier K. [Mucosal lichen planus-a diagnostic and therapeutic challenge]. Dermatologie (Heidelb) 2022; 73:670-681. [PMID: 35943534 DOI: 10.1007/s00105-022-05034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Mucosal lichen planus (MLP) is a chronic inflammatory disease of the mucosa. This condition can affect the mouth, esophagus, pharynx, genitalia, anus, and conjunctiva. This disease shows a tendency to chronicity with phases of relapses for a duration of 3-10 years. It presents with varying morphologies including lacy or fern-like, slightly raised striae, erosions, erythema, and atrophy. The pathophysiology is not yet fully understood and is dominated by the classic band-like lymphocytic infiltrate along the dermoepidermal junction. MLP is very challenging to treat, since the clinical course entails frequent relapses and shows resistance to therapy. The most commonly used local treatments are topical corticosteroids or calcineurin inhibitors. In addition to systemic glucocorticosteroids and traditional systemic drugs such as oral retinoids or methotrexate, emerging anti-inflammatory therapies such as Janus kinase inhibitors and biologics may be promising and are currently being evaluated in clinical trials.
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Affiliation(s)
- Marie Pradeau
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Deutschland.
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19
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Proft F, Lüders S, Hunter T, Luna G, Rios Rodriguez V, Protopopov M, Meier K, Kokolakis G, Ghoreschi K, Poddubnyy D. Early identification of axial psoriatic arthritis among patients with psoriasis: a prospective multicentre study. Ann Rheum Dis 2022; 81:annrheumdis-2022-222562. [PMID: 35922123 PMCID: PMC9606505 DOI: 10.1136/ard-2022-222562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/13/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To evaluate a dermatologist-centred screening tool followed by a structured rheumatological examination including MRI of sacroiliac joints and spine for the recognition of psoriatic arthritis with axial involvement (axPsA). METHODS This was a prospective multicentre study. Adult patients with a confirmed diagnosis of psoriasis who had chronic back pain (≥3 months), onset <45 years and had not been treated with any biologic or targeted synthetic disease-modifying antirheumatic drug in the 12 weeks before screening were referred to a specialised rheumatology clinic. A rheumatological investigation including clinical, laboratory and genetic assessments as well as imaging with conventional radiography and MRI of sacroiliac joints and spine was performed. The primary outcome of the study was the proportion of patients diagnosed with axPsA among all referred patients with PsO. RESULTS Rheumatologists examined 100 patients of those who qualified for referral. 14 patients (including 3 with both axial and peripheral involvement) were diagnosed with axPsA and 5 were diagnosed with peripheral PsA solely. All patients diagnosed with axPsA had active inflammatory and/or structural (post)inflammatory changes in the sacroiliac joints and/or spine on imaging. In five patients, MRI changes indicative of axial involvement were found only in the spine. All but one patient with PsA (13/14 with axPsA and 5/5 with pPsA) fulfilled the Classification Criteria for Psoriatic Arthritis criteria for PsA. The Assessment of SpondyloArthritis International Society criteria for axSpA were fulfilled in 9 (64.3%) patients diagnosed with axPsA. CONCLUSIONS Applying a dermatologist-centred screening tool may be useful for the early detection of axPsA in at-risk patients with psoriasis .
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Affiliation(s)
- Fabian Proft
- Department of Gastroenterology, Infectiology and Rheumatology, Charite Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany
| | - Susanne Lüders
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Theresa Hunter
- Value Evidence and Outcomes, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Gustavo Luna
- Global Health Economics, Outcomes Research and Epidemiology, ICON plc, Stockholm, Sweden
| | - Valeria Rios Rodriguez
- Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Mikhail Protopopov
- Department of Gastroenterology, Infectiology and Rheumatology, Charite Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Freie Universitat Berlin, Berlin, Germany
| | - Georgios Kokolakis
- Department of Dermatology, Venereology and Allergology, Freie Universitat Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Freie Universitat Berlin, Berlin, Germany
| | - Denis Poddubnyy
- Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany
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20
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Kinberger M, Bonnekoh H, Dilling A, Meier K. [Granulomatous dermatoses]. Z Rheumatol 2022; 81:577-586. [PMID: 35854155 DOI: 10.1007/s00393-022-01239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
Abstract
The group of granulomatous dermatoses refers to a multitude of clinically different diseases, which are characterized by a histopathologically similar pattern of inflammation. The cause of granulomatous inflammatory reactions can be infections and also noninfectious stimuli, such as cell disintegration or foreign bodies. The aim of this immunological defence reaction is encapsulation in order to prevent further spread and delimitation from healthy tissue. This is histologically expressed as a granuloma in the sense of a circumscribed aggregation of histiocytes and multinucleated giant cells mostly in dermal connective tissue. The following can be histologically differentiated: sarcoid granuloma characterized by a sparse lymphocytic inflammatory infiltrate and tuberculous granuloma with central necrosis and denser lymphocytic inflammatory infiltrate. Neutrophilic granulocytes together with macrophages occur in suppurative granulomas and palisaded granulomas are characterized by peripherally arrayed macrophages.
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Affiliation(s)
- Maria Kinberger
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Hanna Bonnekoh
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Amrei Dilling
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
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21
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Schmitt T, Pircher J, Steinert L, Meier K, Ghoreschi K, Vielmuth F, Kugelmann D, Waschke J. Dsg1 and Dsg3 Composition of Desmosomes Across Human Epidermis and Alterations in Pemphigus Vulgaris Patient Skin. Front Immunol 2022; 13:884241. [PMID: 35711465 PMCID: PMC9196036 DOI: 10.3389/fimmu.2022.884241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/12/2022] [Indexed: 11/13/2022] Open
Abstract
Desmosomes are important epidermal adhesion units and signalling hubs, which play an important role in pemphigus pathogenesis. Different expression patterns of the pemphigus autoantigens desmoglein (Dsg)1 and Dsg3 across different epidermal layers have been demonstrated. However, little is known about changes in desmosome composition in different epidermal layers or in patient skin. The aim of this study was thus to characterize desmosome composition in healthy and pemphigus skin using super-resolution microscopy. An increasing Dsg1/Dsg3 ratio from lower basal (BL) to uppermost granular layer (GL) was observed. Within BL desmosomes, Dsg1 and Dsg3 were more homogeneously distributed whereas superficial desmosomes mostly comprised one of the two molecules or domains containing either one but not both. Extradesmosomal, desmoplakin (Dp)-independent, co-localization of Dsg3 with plakoglobin (Pg) was found mostly in BL and extradesmosomal Dsg1 co-localization with Pg in all layers. In contrast, in the spinous layer (SL) most Dsg1 and Dsg3 staining was confined to desmosomes, as revealed by the co-localization with Dp. In pemphigus patient skin, Dsg1 and Dsg3 immunostaining was altered especially along blister edges. The number of desmosomes in patient skin was reduced significantly in basal and spinous layer keratinocytes with only few split desmosomes found. In addition, Dsg1-Pg co-localization at the apical BL and Dsg3-Pg co-localization in SL were significantly reduced in patients, suggesting that that extradesmosomal Dsg molecules were affected. These results support the hypothesis that pemphigus is a desmosome assembly disease and may help to explain histopathologic differences between pemphigus phenotypes.
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Affiliation(s)
- Thomas Schmitt
- Chair of Vegetative Anatomy, Instiute of Anatomy, Faculty of Medicine, Ludwig-Maximilian-Universität München (LMU) Munich, München, Germany
| | - Julia Pircher
- Chair of Vegetative Anatomy, Instiute of Anatomy, Faculty of Medicine, Ludwig-Maximilian-Universität München (LMU) Munich, München, Germany
| | - Letyfee Steinert
- Chair of Vegetative Anatomy, Instiute of Anatomy, Faculty of Medicine, Ludwig-Maximilian-Universität München (LMU) Munich, München, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berli, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berli, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Franziska Vielmuth
- Chair of Vegetative Anatomy, Instiute of Anatomy, Faculty of Medicine, Ludwig-Maximilian-Universität München (LMU) Munich, München, Germany
| | - Daniela Kugelmann
- Chair of Vegetative Anatomy, Instiute of Anatomy, Faculty of Medicine, Ludwig-Maximilian-Universität München (LMU) Munich, München, Germany
| | - Jens Waschke
- Chair of Vegetative Anatomy, Instiute of Anatomy, Faculty of Medicine, Ludwig-Maximilian-Universität München (LMU) Munich, München, Germany
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Proft F, Lüders S, Hunter T, Luna G, Rios Rodriguez V, Protopopov M, Meier K, Kokolakis G, Ghoreschi K, Poddubnyy D. POS1445 EARLY DETECTION OF AXIAL PSORIATIC ARTHRITIS IN PATIENTS WITH PSORIASIS: A PROSPECTIVE, MULTICENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4375] [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
BackgroundIn the absence of reliable serological and/or imaging biomarkers that can support an early diagnosis of psoriatic arthritis (PsA) in patients with psoriasis (PsO), and considering the known diagnostic delay there is a need for screening tools for detection of early PsA. While different validated screening/referral tools focusing on peripheral manifestations of PsA exist, validated referral algorithms for PsA with axial involvement (also referred to as axial PsA - axPsA) are still missing.ObjectivesIn this prospective, multicenter study we applied a dermatologist-centered screening tool and a structured rheumatologic examination including magnetic resonance imaging (MRI) of sacroiliac joints (SIJs) and spine to detect axPsA in patients with psoriasis (PsO).MethodsPatients with PsO were systematically screened by their dermatologist for eligibility for referral to a rheumatology clinic. Eligible patients were ≥ 18 years with a confirmed diagnosis of PsO who reported having chronic back pain (≥ 3 months) with onset prior to 45 years of age and who had not been treated with any biologic or targeted synthetic DMARD 12 weeks prior to screening. For those patients who qualified for referral a rheumatologic investigation including clinical, laboratory and genetic assessments as well as imaging with conventional radiography and MRI of sacroiliac joints and spine was performed. The primary outcome of the study was the proportion of patients diagnosed with axPsA among all referred PsO patients.ResultsIn total 355 patients were screened at 14 dermatology sites, of whom 151 (42.5%) qualified for referral to rheumatology clinic and 100 (28.2%) were seen by a rheumatologist. The diagnosis of axPsA was confirmed in 14 patients (3/14 with both, axial and peripheral involvement) and the diagnosis of peripheral PsA (pPsA) without axial involvement was made in five patients. The ASAS classification criteria for axSpA were fulfilled in nine (64.3%) of the patients diagnosed with axPsA. All but one patient diagnosed with PsA (13/14 with axPsA and 5/5 with pPsA) fulfilled the CASPAR criteria for PsA.Patient characteristics are presented in Table 1. All patients diagnosed with axPsA had active inflammatory and/or structural (post)inflammatory changes in the sacroiliac joints and/or spine on imaging. In five patients (35.7%), MRI changes indicative of axial involvement were found only in the spine as illustrated in Figure 1.Table 1.Clinical characteristics of all referred patients with PsO and suspicion of axSpA.Patient characteristicpPsA (N=5)axPsA (N=14)No PsA (N=81)p-value1Age (years) – Mean (SD)42.8 (9.0)46.2 (13.6)45.7 (13.3)0.883Female – n (%)2 (40.0)9 (64.3)45 (55.6)0.543PASI – Mean (SD)3.3 (2.1)4.3 (4.9)4.0 (4.5)0.971Inflammatory back pain – n (%)5 (100.0)8 (57.1)36 (44.4)0.379HLA-B27 positive – n (%)04 (28.6)12 (14.8)0.204Elevated CRP (>5 mg/L) – n (%)1 (20.0)5 (35.7)11 (13.6)0.041Peripheral arthritis, current (last 7 days) – n (%)5 (100.0)3 (21.4)3 (3.7)0.012Radiographic sacroiliitis as per mNY criteria – n (%)04 (28.6)1 (1.2)<0.001Active inflammation, sacroiliac joint (MRI) – n (%)08 (57.1)0<0.001Structural (post)inflammatory changes, sacroiliac joint (MRI) – n (%)08 (57.1)0<0.001Active inflammation, spine (MRI) – n (%)013 (92.9)0<0.001Structural (post)inflammatory changes, spine (MRI) – n (%)08 (57.1)0<0.0011Statistically significant differences between the axPsA and No PsA groups of patients were determined by using Mann–Whitney U test for continuous data and Chi-square test for categorical dataFigure 1.Imaging features of axial involvement in PsO patients diagnosed with axPsAConclusionOur study revealed that applying a dermatologist-centered screening tool may be useful for the early detection of patients with a high probability of PsA (and specifically axPsA) in PsO patients. Given the high prevalence of isolated spinal involvement (without SIJs), imaging of the entire axial skeleton may be required as a part of diagnostic procedure in patients with suspected axPsA.AcknowledgementsCaroline Höppner, Rebecca Bolce, David Sandoval, Hagen Russ, Burkhard Muche, Judith Rademacher, Hildrun Haibel, Laura Spiller and all cooperating dermatologists.Disclosure of InterestsFabian Proft: None declared, Susanne Lüders: None declared, Theresa Hunter Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Gustavo Luna: None declared, Valeria Rios Rodriguez: None declared, Mikhail Protopopov: None declared, Katharina Meier: None declared, Georgios Kokolakis: None declared, Kamran Ghoreschi: None declared, Denis Poddubnyy: None declared
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Schmell AL, Meier K, Alejo O, Bhayadia R, Heckl D, Klusmann JH. Identifying gene targets for drug repurposing to preventing myeloid
malignancies. KLINISCHE PADIATRIE 2022. [DOI: 10.1055/s-0042-1748724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A-L Schmell
- Department of Pediatrics, Goethe-University Frankfurt, Frankfurt am
Main, Germany
| | - K Meier
- Pediatric Hematology and Oncology, Martin-Luther-University
Halle-Wittenberg, Germany
| | | | - R Bhayadia
- Department of Pediatrics, Goethe-University Frankfurt, Frankfurt am
Main, Germany
| | - D Heckl
- Pediatric Hematology and Oncology, Martin-Luther-University
Halle-Wittenberg, Germany
| | - J-H Klusmann
- Department of Pediatrics, Goethe-University Frankfurt, Frankfurt am
Main, Germany
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Meier K, Holstein J, Zidane M, Kokolakis G, Ghoreschi FC, Ulrich C, Ghoreschi K, Solimani F. Paradoxical lichen planus induced during anti-IL-17A treatment is immunologically different from spontaneously occurring lichen planus. J Eur Acad Dermatol Venereol 2022; 36:e532-e534. [PMID: 35143081 DOI: 10.1111/jdv.17996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/06/2022] [Accepted: 02/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- K Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - J Holstein
- Department of Dermatology, University Medical Center, Eberhard Karls Universität Tubingen, Tubingen, Germany
| | - M Zidane
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - G Kokolakis
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - F C Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - C Ulrich
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - K Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - F Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Onken J, El Sheikha A, Senger C, Kaul D, Radke J, Meier K, Karimian N, Vajkoczy P, Onken J. Neurooncological Challenges in Relapsing Intracranial Melanoma Metastases: A Case Report. Surg Case Rep 2022. [DOI: 10.31487/j.scr.2022.01.01] [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: 11/12/2022] Open
Abstract
Introduction: Treatment of melanoma brain metastases (MBM) is a complex interdisciplinary challenge. Relapsing MBMs pose an extra challenge due to limited therapeutic options and higher complication rate. Multiple surgical interventions and radiation can be indicated in the case of intracranial relapse with extracranial disease control under oncological therapy e.g., immunotherapy.
Case Presentation: Here, we report on a 37-year-old female patient with stage IV metastatic melanoma, who underwent six neurosurgical procedures, including five tumor resections, and three courses of different irradiation protocols in 26 months, all while receiving multiple regimens of immunotherapy. Throughout the different therapies, the patient showed varying neurological deficits, including facial nerve palsy, hemiparesis and reduction of cognitive function. The patient died due to symptoms related to leptomeningeal spread of the tumor.
Conclusion: With this case, we want to share our experience with multiple neurosurgical interventions and repeated brain irradiation procedures in a patient with relapsing MBM. Neurosurgical interventions contributed to symptom relief, saved steroids and potentially prolonged survival. Therefore, based on the events of this case, repeated surgery could be considered for progressive brain metastases.
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Vega DM, Yee LM, McShane LM, Williams PM, Chen L, Vilimas T, Fabrizio D, Funari V, Newberg J, Bruce LK, Chen SJ, Baden J, Carl Barrett J, Beer P, Butler M, Cheng JH, Conroy J, Cyanam D, Eyring K, Garcia E, Green G, Gregersen VR, Hellmann MD, Keefer LA, Lasiter L, Lazar AJ, Li MC, MacConaill LE, Meier K, Mellert H, Pabla S, Pallavajjalla A, Pestano G, Salgado R, Samara R, Sokol ES, Stafford P, Budczies J, Stenzinger A, Tom W, Valkenburg KC, Wang XZ, Weigman V, Xie M, Xie Q, Zehir A, Zhao C, Zhao Y, Stewart MD, Allen J. Aligning tumor mutational burden (TMB) quantification across diagnostic platforms: phase II of the Friends of Cancer Research TMB Harmonization Project. Ann Oncol 2021; 32:1626-1636. [PMID: 34606929 DOI: 10.1016/j.annonc.2021.09.016] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tumor mutational burden (TMB) measurements aid in identifying patients who are likely to benefit from immunotherapy; however, there is empirical variability across panel assays and factors contributing to this variability have not been comprehensively investigated. Identifying sources of variability can help facilitate comparability across different panel assays, which may aid in broader adoption of panel assays and development of clinical applications. MATERIALS AND METHODS Twenty-nine tumor samples and 10 human-derived cell lines were processed and distributed to 16 laboratories; each used their own bioinformatics pipelines to calculate TMB and compare to whole exome results. Additionally, theoretical positive percent agreement (PPA) and negative percent agreement (NPA) of TMB were estimated. The impact of filtering pathogenic and germline variants on TMB estimates was assessed. Calibration curves specific to each panel assay were developed to facilitate translation of panel TMB values to whole exome sequencing (WES) TMB values. RESULTS Panel sizes >667 Kb are necessary to maintain adequate PPA and NPA for calling TMB high versus TMB low across the range of cut-offs used in practice. Failure to filter out pathogenic variants when estimating panel TMB resulted in overestimating TMB relative to WES for all assays. Filtering out potential germline variants at >0% population minor allele frequency resulted in the strongest correlation to WES TMB. Application of a calibration approach derived from The Cancer Genome Atlas data, tailored to each panel assay, reduced the spread of panel TMB values around the WES TMB as reflected in lower root mean squared error (RMSE) for 26/29 (90%) of the clinical samples. CONCLUSIONS Estimation of TMB varies across different panels, with panel size, gene content, and bioinformatics pipelines contributing to empirical variability. Statistical calibration can achieve more consistent results across panels and allows for comparison of TMB values across various panel assays. To promote reproducibility and comparability across assays, a software tool was developed and made publicly available.
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Affiliation(s)
- D M Vega
- Friends of Cancer Research, Washington, USA
| | - L M Yee
- National Cancer Institute, Bethesda, USA
| | | | - P M Williams
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - L Chen
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - T Vilimas
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - D Fabrizio
- Foundation Medicine Inc., Cambridge, USA
| | - V Funari
- NeoGenomics Laboratories, Aliso Viejo, USA
| | - J Newberg
- Foundation Medicine Inc., Cambridge, USA
| | - L K Bruce
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - J Baden
- Bristol Myers Squibb Co., Princeton, USA
| | | | - P Beer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - M Butler
- LGC Clinical Diagnostics, Gaithersburg, USA
| | | | | | - D Cyanam
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor, USA
| | - K Eyring
- Intermountain Precision Genomics, St. George, USA
| | - E Garcia
- Brigham and Women's Hospital, Boston, USA
| | - G Green
- Bristol Myers Squibb Co., Princeton, USA
| | | | - M D Hellmann
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - L A Keefer
- Personal Genome Diagnostics, Baltimore, USA
| | - L Lasiter
- Friends of Cancer Research, Washington, USA
| | - A J Lazar
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M-C Li
- National Cancer Institute, Bethesda, USA
| | | | - K Meier
- Illumina Inc, Clinical Genomics, San Diego, USA
| | | | | | | | | | - R Salgado
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | - E S Sokol
- Foundation Medicine Inc., Cambridge, USA
| | | | - J Budczies
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - W Tom
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor, USA
| | | | - X Z Wang
- EMD Serono Research and Development Institute, Inc., Billerica, USA
| | | | - M Xie
- AstraZeneca Pharmaceuticals LP, Waltham, USA
| | - Q Xie
- General Dynamics Information Technology, Inc., Columbia, USA
| | - A Zehir
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Zhao
- Illumina Inc, Clinical Genomics, San Diego, USA
| | - Y Zhao
- National Cancer Institute, Bethesda, USA
| | - M D Stewart
- Friends of Cancer Research, Washington, USA.
| | - J Allen
- Friends of Cancer Research, Washington, USA
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Elsner K, Holstein J, Hilke FJ, Blumenstock G, Walker B, Schmidt S, Schaller M, Ghoreschi K, Meier K. Prevalence of Candida species in Psoriasis. Mycoses 2021; 65:247-254. [PMID: 34787934 DOI: 10.1111/myc.13399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Psoriasis patients are more frequently colonised with Candida species. The correlation between fungal colonisation and clinical severity is unclear, but may exacerbate psoriasis and the impact of antipsoriatic therapies on the prevalence of Candida is unknown. OBJECTIVES To examine the prevalence of C species in psoriasis patients compared to an age- and sex-matched control population, we investigated the influence of Candida colonisation on disease severity, immune cell activation and the interplay on psoriatic treatments. METHODS The prevalence of C species was examined in 265 psoriasis patients and 200 control subjects by swabs and stool samples for fungal cultures. Peripheral mononuclear blood cells (PBMCs) were collected from 20 fungal colonised and 24 uncolonised patients and stimulated. The expression of interferon (IFN)-γ, IL-17A, IL-22 and tumour necrosis factor (TNF)-α from stimulated PBMCs was measured by quantitative real-time polymerase chain reaction (qPCR). RESULTS A significantly higher prevalence for Candida was detected in psoriatic patients (p ≤ .001) compared to the control subjects; most abundant in stool samples, showing Candida albicans. Older participants (≥51 years) were more frequent colonised, and no correlation with gender, disease severity or systemic treatments like IL-17 inhibitors was found. CONCLUSIONS Although Candida colonisation is significantly more common in patients with psoriasis, it does not influence the psoriatic disease or cytokine response. Our study showed that Candida colonisation is particularly more frequent in patients with psoriasis ≥51 years of age. Therefore, especially this group should be screened for symptoms of candidiasis during treatment with IL-17 inhibitors.
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Affiliation(s)
- Kevin Elsner
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Julia Holstein
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Franz Joachim Hilke
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Gunnar Blumenstock
- Deptartment of Clinical Epidemiology and Biostatistics, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Birgit Walker
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Sybille Schmidt
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Martin Schaller
- Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Fernández ASM, Hilke F, Meier K, Solimani F, Ghoreschi K. 029 Deciphering the functionality of T regulatory subsets in pemphigus. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seep L, Bonin A, Meier K, Diedam H, Göller AH. Ensemble completeness in conformer sampling: the case of small macrocycles. J Cheminform 2021; 13:55. [PMID: 34325738 PMCID: PMC8320181 DOI: 10.1186/s13321-021-00524-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 06/05/2021] [Indexed: 11/18/2022] Open
Abstract
In this study we compare the three algorithms for the generation of conformer ensembles Biovia BEST, Schrödinger Prime macrocycle sampling (PMM) and Conformator (CONF) form the University of Hamburg, with ensembles derived for exhaustive molecular dynamics simulations applied to a dataset of 7 small macrocycles in two charge states and three solvents. Ensemble completeness is a prerequisite to allow for the selection of relevant diverse conformers for many applications in computational chemistry. We apply conformation maps using principal component analysis based on ring torsions. Our major finding critical for all applications of conformer ensembles in any computational study is that maps derived from MD with explicit solvent are significantly distinct between macrocycles, charge states and solvents, whereas the maps for post-optimized conformers using implicit solvent models from all generator algorithms are very similar independent of the solvent. We apply three metrics for the quantification of the relative covered ensemble space, namely cluster overlap, variance statistics, and a novel metric, Mahalanobis distance, showing that post-optimized MD ensembles cover a significantly larger conformational space than the generator ensembles, with the ranking PMM > BEST >> CONF. Furthermore, we find that the distributions of 3D polar surface areas are very similar for all macrocycles independent of charge state and solvent, except for the smaller and more strained compound 7, and that there is also no obvious correlation between 3D PSA and intramolecular hydrogen bond count distributions.
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Affiliation(s)
- Lea Seep
- Pharmaceuticals R&D, Digital Technologies, Bayer AG, 42096, Wuppertal, Germany
| | - Anne Bonin
- Pharmaceuticals R&D, Digital Technologies, Bayer AG, 42096, Wuppertal, Germany
| | - Katharina Meier
- Pharmaceuticals R&D, Digital Technologies, Bayer AG, 42096, Wuppertal, Germany
| | - Holger Diedam
- Engineering & Technology, Applied Mathematics, Bayer AG, 51368, Leverkusen, Germany
| | - Andreas H Göller
- Pharmaceuticals R&D, Digital Technologies, Bayer AG, 42096, Wuppertal, Germany.
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Wilke L, Moustakis C, Blanck O, Albers D, Albrecht C, Avcu Y, Boucenna R, Buchauer K, Etzelstorfer T, Henkenberens C, Jeller D, Jurianz K, Kornhuber C, Kretschmer M, Lotze S, Meier K, Pemler P, Riegler A, Röser A, Schmidhalter D, Spruijt KH, Surber G, Vallet V, Wiehle R, Willner J, Winkler P, Wittig A, Guckenberger M, Tanadini-Lang S. Improving interinstitutional and intertechnology consistency of pulmonary SBRT by dose prescription to the mean internal target volume dose. Strahlenther Onkol 2021; 197:836-846. [PMID: 34196725 PMCID: PMC8397670 DOI: 10.1007/s00066-021-01799-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
Purpose Dose, fractionation, normalization and the dose profile inside the target volume vary substantially in pulmonary stereotactic body radiotherapy (SBRT) between different institutions and SBRT technologies. Published planning studies have shown large variations of the mean dose in planning target volume (PTV) and gross tumor volume (GTV) or internal target volume (ITV) when dose prescription is performed to the PTV covering isodose. This planning study investigated whether dose prescription to the mean dose of the ITV improves consistency in pulmonary SBRT dose distributions. Materials and methods This was a multi-institutional planning study by the German Society of Radiation Oncology (DEGRO) working group Radiosurgery and Stereotactic Radiotherapy. CT images and structures of ITV, PTV and all relevant organs at risk (OAR) for two patients with early stage non-small cell lung cancer (NSCLC) were distributed to all participating institutions. Each institute created a treatment plan with the technique commonly used in the institute for lung SBRT. The specified dose fractionation was 3 × 21.5 Gy normalized to the mean ITV dose. Additional dose objectives for target volumes and OAR were provided. Results In all, 52 plans from 25 institutions were included in this analysis: 8 robotic radiosurgery (RRS), 34 intensity-modulated (MOD), and 10 3D-conformal (3D) radiation therapy plans. The distribution of the mean dose in the PTV did not differ significantly between the two patients (median 56.9 Gy vs 56.6 Gy). There was only a small difference between the techniques, with RRS having the lowest mean PTV dose with a median of 55.9 Gy followed by MOD plans with 56.7 Gy and 3D plans with 57.4 Gy having the highest. For the different organs at risk no significant difference between the techniques could be found. Conclusions This planning study pointed out that multiparameter dose prescription including normalization on the mean ITV dose in combination with detailed objectives for the PTV and ITV achieve consistent dose distributions for peripheral lung tumors in combination with an ITV concept between different delivery techniques and across institutions. Supplementary Information The online version of this article (10.1007/s00066-021-01799-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L Wilke
- Klinik für Radio-Onkologie, Universitätsspital Zürich, Zürich, Switzerland.
| | - C Moustakis
- Klinik für Strahlentherapie, Universitätsklinikum Münster, Münster, Germany
| | - O Blanck
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein - Campus Kiel, Kiel, Germany
| | - D Albers
- Klinik für Strahlentherapie und Radioonkologie, Universtitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - C Albrecht
- CyberKnife Centrum Süd, Schwarzwald-Baar Klinikum Villingen-Schwenningen, Villingen-Schwenningen, Germany
| | - Y Avcu
- Klinik für Strahlentherapie und Radioonkologie, Universitätsspital Basel, Basel, Switzerland
| | - R Boucenna
- Institut de radio-oncologie, Hislanden Lausanne, Lausanne, Switzerland
| | - K Buchauer
- Klinik für Radio-Onkologie, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - T Etzelstorfer
- Radio-Onkologie, Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | - C Henkenberens
- Klinik für Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - D Jeller
- Radio-Onkologie, Kantonsspital Luzern, Luzern, Switzerland
| | - K Jurianz
- MVZ Gamma-Knife Zentrum Krefeld, Krefeld, Germany
| | - C Kornhuber
- Klinik für Strahlentherapie, Universitätsklinikum Halle, Halle, Germany
| | | | - S Lotze
- Klinik für Radioonkologie und Strahlentherapie, Uniklinik RWTH Aachen, Aachen, Germany
| | - K Meier
- Strahlentherapie, Klinikum Wolfsburg, Wolfsburg, Germany
| | - P Pemler
- Klinik für Radioonkologie, Stadtspital Triemli, Zürich, Switzerland
| | - A Riegler
- Institut für Radioonkologie und Strahlentherapie, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - A Röser
- Strahlentherapie und Radio-Onkologie, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - D Schmidhalter
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern, Switzerland.,University Hospital, and University of Bern, Bern, Switzerland
| | - K H Spruijt
- Institut de radio-oncologie, Clinique des Grangettes, Geneva, Switzerland
| | - G Surber
- Institut für Radiochirurgie und Präzisionsbestrahlung, CyberKnife Centrum Mitteldeutschland, Erfurt, Germany
| | - V Vallet
- Service de radio-oncologie, Centre hospitalier universitaire vaudois, Lausanne, Switzerland
| | - R Wiehle
- Klinik für Strahlenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany
| | - J Willner
- Klinik für Strahlentherapie, Klinikum Bayreuth, Bayreuth, Germany
| | - P Winkler
- Universitätsklinik für Strahlentherapie-Radioonkologie, LKH-Univ. Klinikum Graz, Graz, Austria
| | - A Wittig
- Departent of Radiotherapy and Radiation Oncology, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany
| | - M Guckenberger
- Klinik für Radio-Onkologie, Universitätsspital Zürich, Zürich, Switzerland
| | - S Tanadini-Lang
- Klinik für Radio-Onkologie, Universitätsspital Zürich, Zürich, Switzerland
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Solimani F, Mansour Y, Didona D, Dilling A, Ghoreschi K, Meier K. Development of severe pemphigus vulgaris following SARS-CoV-2 vaccination with BNT162b2. J Eur Acad Dermatol Venereol 2021; 35:e649-e651. [PMID: 34169588 PMCID: PMC8447452 DOI: 10.1111/jdv.17480] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/23/2021] [Indexed: 12/20/2022]
Affiliation(s)
- F Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Y Mansour
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - D Didona
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - A Dilling
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - K Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - K Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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33
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Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K. Lichen planus – ein Klinikleitfaden. J Dtsch Dermatol Ges 2021; 19:864-883. [PMID: 34139075 DOI: 10.1111/ddg.14565_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Farzan Solimani
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | | | | | - Kamran Ghoreschi
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | - Katharina Meier
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
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34
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Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K. Lichen planus - a clinical guide. J Dtsch Dermatol Ges 2021; 19:864-882. [PMID: 34096678 DOI: 10.1111/ddg.14565] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/05/2021] [Indexed: 12/15/2022]
Abstract
Lichen planus (LP) is a chronic lichenoid inflammatory disorder of the skin, mucosa and of the appendages. LP is classically characterized by the presence of a rich infiltration of inflammatory T cells, which migrate in the upper part of the dermis, arranged in a band-like pattern. Different sub types of the disease have been so far described. Albeit LP is clinically well defined, the disease still represents a therapeutic enigma. Especially with regard to mucosal or scalp affecting LP types, which often present a recalcitrant and treatment unresponsive course, efficacious therapeutic options are still lacking. Thus, LP represents a disease with a high psychosocial burden. Yet, development in the deciphering of LP pathogenesis reveals possible new druggable targets, thus paving the way for future therapeutic options. In this clinical guide, we summarize the current clinical knowledge and therapeutic standards and discuss the future perspective for the management of LP.
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Affiliation(s)
- Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stephan Forchhammer
- Department of Dermatology, University Medical Center, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Alexandra Schloegl
- Department of Dermatology, University Medical Center, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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35
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Truong K, Meier K, Nikolajsen L, van Tulder MW, Sørensen JCH, Rasmussen MM. Cryoneurolysis' outcome on pain experience (COPE) in patients with low-back pain: study protocol for a single-blinded randomized controlled trial. BMC Musculoskelet Disord 2021; 22:458. [PMID: 34011351 PMCID: PMC8135178 DOI: 10.1186/s12891-021-04320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/05/2021] [Indexed: 11/26/2022] Open
Abstract
Background Low-back pain, including facet joint pain, accounts for up to 20 % of all sick leaves in DenmarkA proposed treatment option is cryoneurolysis. This study aims to investigate the effect of cryoneurolysis in lumbar facet joint pain syndrome. Methods A single-center randomized controlled trial (RCT) is performed including 120 participants with chronic facet joint pain syndrome, referred to the Department of Neurosurgery, Aarhus University Hospital. Eligible patients receive a diagnostic anesthetic block, where a reduction of pain intensity ≥ 50 % on a numerical rating scale (NRS) is required to be enrolled. Participants are randomized into three groups to undergo either one treatment of cryoneurolysis, radiofrequency ablation or placebo. Fluoroscopy and sensory stimulation is used to identify the intended target nerve prior to administrating the above-mentioned treatments. All groups receive physiotherapy for 6 weeks, starting 4 weeks after treatment. The primary outcome is the patients’ impression of change in pain after intervention (Patient Global Impression of Change (PGIC)) at 4 weeks follow-up, prior to physiotherapy. Secondary outcomes are a reduction in low-back pain intensity (numeric rating scale) and quality of life (EQ-5D, SF-36) and level of function (Oswestry Disability Index), psychological perception of pain (Pain Catastrophizing Scale) and depression status (Major Depression Inventory). Data will be assessed at baseline (T0), randomization (T1), day one (T2), 4 weeks (T3), 3 (T4), 6 (T5) and 12 months (T6). Discussion This study will provide information on the effectiveness of cryoneurolysis vs. the effectiveness of radiofrequency ablation or placebo for patients with facet joint pain, and help to establish whether cryoneurolysis should be implemented in clinical practice for this patient population. Trial registration The trial is approved by the ethical committee of Central Jutland Denmark with registration number 1-10-72-27-19 and the Danish Data Protection Agency with registration number 666,852. The study is registered at Clinicaltrial.gov with the ID number NCT04786145.
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Affiliation(s)
- K Truong
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark. .,Center for Experimental Neuroscience (CENSE) and CENSE-spine, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - K Meier
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.,Center for Experimental Neuroscience (CENSE) and CENSE-spine, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - L Nikolajsen
- Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - M W van Tulder
- Department of Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J C H Sørensen
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.,Center for Experimental Neuroscience (CENSE) and CENSE-spine, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - M M Rasmussen
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.,Center for Experimental Neuroscience (CENSE) and CENSE-spine, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
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36
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Solimani F, Meier K, Ghoreschi K. Janus kinase signaling as risk factor and therapeutic target for severe SARS-CoV-2 infection. Eur J Immunol 2021; 51:1071-1075. [PMID: 33675065 PMCID: PMC8250126 DOI: 10.1002/eji.202149173] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/08/2021] [Accepted: 03/01/2021] [Indexed: 12/21/2022]
Abstract
Cytokine signaling, especially interferon (IFN) signaling is closely linked to several aspects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. During initial SARS-CoV-2 infection, symptomatic patients present with impaired type I/III IFN-mediated antiviral responses. Interestingly, IFNs regulate the cellular entry receptor for SARS-CoV-2 on epithelial and endothelial cells. As reported recently, critically ill COVID-19 patients show genetic polymorphisms in one IFN receptor gene (IFNRA2) and in a gene locus near the Janus kinase (JAK) TYK2, which is key for IFN, interleukin (IL)-12 and IL-23 signaling, and T helper (Th) 1/Th17 cell-mediated antiviral immune responses. In the advanced stage of the disease, critically ill COVID-19 patients develop a cytokine storm where many inflammatory mediators using the JAK/STAT signaling pathway such as IL-6, IFN-γ, the granulocyte colony-stimulating factor (G-CSF) or IL-2, and chemokines result in an influx of macrophages and neutrophils damaging the lung tissue. The knowledge on the cytokine and JAK/STAT signaling pathways in severe COVID-19 disease explains the promising first results with JAK inhibitors like baricitinib, which not only dampen the inflammation but in the case of baricitinib also affect virus replication and endocytosis in target cells. Here, we summarize the current immunological associations of SARS-CoV-2 infection with cytokine signaling, the JAK/STAT pathway, and the current clinical stage of JAK inhibitors for improving severe COVID-19 disease.
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Affiliation(s)
- Farzan Solimani
- Department of Dermatology, Venereology and AllergologyCharité–Universitätsmedizin BerlinBerlinGermany
| | - Katharina Meier
- Department of Dermatology, Venereology and AllergologyCharité–Universitätsmedizin BerlinBerlinGermany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and AllergologyCharité–Universitätsmedizin BerlinBerlinGermany
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Abstract
Bromodomains (BDs) are small protein modules that interact with acetylated marks in histones. These posttranslational modifications are pivotal to regulate gene expression, making BDs promising targets to treat several diseases. While the general structure of BDs is well known, their dynamical features and their interplay with other macromolecules are poorly understood, hampering the rational design of potent and selective inhibitors. Here, we combine extensive molecular dynamics simulations, Markov state modeling, and available structural data to reveal a transiently formed state that is conserved across all BD families. It involves the breaking of two backbone hydrogen bonds that anchor the ZA-loop with the αA helix, opening a cryptic pocket that partially occludes the one associated to histone binding. By analyzing more than 1,900 experimental structures, we unveil just two adopting the hidden state, explaining why it has been previously unnoticed and providing direct structural evidence for its existence. Our results suggest that this state is an allosteric regulatory switch for BDs, potentially related to a recently unveiled BD-DNA-binding mode.
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Affiliation(s)
- Lluís Raich
- Department of Mathematics and Computer Science, Freie Universität Berlin, 14195 Berlin, Germany
| | - Katharina Meier
- Computational Molecular Design, Pharmaceuticals, R&D, Bayer AG, 42096 Wuppertal, Germany
| | - Judith Günther
- Computational Molecular Design, Pharmaceuticals, R&D, Bayer AG, 13342 Berlin, Germany
| | - Clara D Christ
- Computational Molecular Design, Pharmaceuticals, R&D, Bayer AG, 13342 Berlin, Germany
| | - Frank Noé
- Department of Mathematics and Computer Science, Freie Universität Berlin, 14195 Berlin, Germany;
- Department of Chemistry, Rice University, Houston, TX 77005
| | - Simon Olsson
- Department of Mathematics and Computer Science, Freie Universität Berlin, 14195 Berlin, Germany;
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38
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Meier K, Schloegl A, Poddubnyy D, Ghoreschi K. Skin manifestations in spondyloarthritis. Ther Adv Musculoskelet Dis 2020; 12:1759720X20975915. [PMID: 33343725 PMCID: PMC7727049 DOI: 10.1177/1759720x20975915] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/03/2020] [Indexed: 12/30/2022] Open
Abstract
Spondyloarthritides (SpA) like psoriatic arthritis, axial spondyloarthritis/ankylosing spondylitis, reactive arthritis and inflammatory bowel disease (IBD)-associated SpA can present with characteristic skin manifestations. These SpA-associated skin disorders may precede joint involvement, reflect a loss of efficacy of a current systemic treatment or can even be treatment associated. Cutaneous manifestations in SpA not only add additional morbidity with physical impact but also impose a psychosocial burden on affected patients. Psoriasis (PsO) - the main skin disease in SpA - has a variety of clinical presentations, including plaque-type PsO, inverse PsO, guttate PsO, erythrodermic PsO, nail PsO and pustular types. SpA associated with IBD presents with neutrophilic and granulomatous skin disorders, including pyoderma gangrenosum, hidradenitis suppurativa and cutaneous Crohn's disease. Reactive arthritides has a favourable prognosis and may feature keratoderma blenorrhagicum or balanitis circinatum as typical skin manifestations. Immunologically, SpA-associated skin diseases share interleukin (IL)-17 and IL-23 dysregulation but show distinctive genetic and immunological profiles. Therefore, they vary in their treatment responses to targeted therapies with biologicals or small molecules. In this review, we highlight the clinical presentation of skin manifestations in SpA and discuss therapeutic approaches in this interdisciplinary field.
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Affiliation(s)
- Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany
| | | | - Denis Poddubnyy
- Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Kamran Ghoreschi
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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39
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Solimani F, Meier K, Zimmer CL, Hashimoto T. Immune serological diagnosis of pemphigus. Ital J Dermatol Venerol 2020. [PMID: 33228340 DOI: 10.23736/s0392-0488.20.06788-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pemphigus is a rare autoimmune blistering disease which manifests with painful erosions and blisters of the skin and mucosa. This disorder is caused by autoantibodies attacking desmosomal proteins, necessary for cell-cell contact stability and epidermal integrity. Desmoglein (Dsg) 1 and Dsg3 are the two major target antigens in pemphigus. Yet, many other target proteins, which have been described over the years, seem to be involved in the loss of epidermal integrity. Clinical examination, combined to serological advances and detection of targeted antigens, permitted to differentiate among several pemphigus subtypes, in which pemphigus vulgaris and pemphigus foliaceus are the most common. Nowadays, serological analysis in pemphigus is a fundamental step of the diagnostic algorithm. This is based on analysis of clinical symptoms, histopathological examination of lesional skin, detection of tissue bound and circulating antibodies by direct and indirect immunofluorescence, and determination of target antigens either by enzyme-linked immunosorbent essay (ELISA) or by western blot analysis. A correct and exhaustive diagnostic algorithm is fundamental to characterize pemphigus subtypes, which lastly permits to adopt a correct treatment approach. Moreover, quality and quantity of circulating antibodies in patient's sera deliver important information regarding clinical course, disease severity and treatment response; thus, relevantly affecting physician's decision. To facilitate this process, "easy-to-perform" diagnostic kits with high sensitivity and specificity are being commercialized. In this review, we focus on available methods and established assays to correctly detect circulating autoantibodies in pemphigus. Moreover, we discuss subtype specific serological peculiarities in the five most relevant subtypes (pemphigus vulgaris, pemphigus foliaceus, pemphigus vegetans, paraneoplastic pemphigus and intercellular IgA dermatosis (also called as IgA pemphigus).
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Affiliation(s)
- Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany -
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christine L Zimmer
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Takashi Hashimoto
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
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40
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Solimani F, Meier K, Zimmer CL, Hashimoto T. Immune serological diagnosis of pemphigus. Ital J Dermatol Venerol 2020; 156:151-160. [PMID: 33228340 DOI: 10.23736/s2784-8671.20.06788-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pemphigus is a rare autoimmune blistering disease which manifests with painful erosions and blisters of the skin and mucosa. This disorder is caused by autoantibodies attacking desmosomal proteins, necessary for cell-cell contact stability and epidermal integrity. Desmoglein (Dsg) 1 and Dsg3 are the two major target antigens in pemphigus. Yet, many other target proteins, which have been described over the years, seem to be involved in the loss of epidermal integrity. Clinical examination, combined to serological advances and detection of targeted antigens, permitted to differentiate among several pemphigus subtypes, in which pemphigus vulgaris and pemphigus foliaceus are the most common. Nowadays, serological analysis in pemphigus is a fundamental step of the diagnostic algorithm. This is based on analysis of clinical symptoms, histopathological examination of lesional skin, detection of tissue bound and circulating antibodies by direct and indirect immunofluorescence, and determination of target antigens either by enzyme-linked immunosorbent essay (ELISA) or by western blot analysis. A correct and exhaustive diagnostic algorithm is fundamental to characterize pemphigus subtypes, which lastly permits to adopt a correct treatment approach. Moreover, quality and quantity of circulating antibodies in patient's sera deliver important information regarding clinical course, disease severity and treatment response; thus, relevantly affecting physician's decision. To facilitate this process, "easy-to-perform" diagnostic kits with high sensitivity and specificity are being commercialized. In this review, we focus on available methods and established assays to correctly detect circulating autoantibodies in pemphigus. Moreover, we discuss subtype specific serological peculiarities in the five most relevant subtypes (pemphigus vulgaris, pemphigus foliaceus, pemphigus vegetans, paraneoplastic pemphigus and intercellular IgA dermatosis (also called as IgA pemphigus).
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Affiliation(s)
- Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany -
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christine L Zimmer
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Takashi Hashimoto
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
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41
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Holstein J, Solimani F, Baum C, Meier K, Pollmann R, Didona D, Tekath T, Dugas M, Casadei N, Hudemann C, Polakova A, Matthes J, Schäfer I, Yazdi AS, Eming R, Hertl M, Pfützner W, Ghoreschi K, Möbs C. Immunophenotyping in pemphigus reveals a T H17/T FH17 cell-dominated immune response promoting desmoglein1/3-specific autoantibody production. J Allergy Clin Immunol 2020; 147:2358-2369. [PMID: 33221382 DOI: 10.1016/j.jaci.2020.11.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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: 03/26/2020] [Revised: 10/19/2020] [Accepted: 11/13/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND TH2 cells were thought to be a pivotal factor for initiation of the autoimmune blistering disease pemphigus. However, the role of other T-cell subsets in pemphigus pathogenesis remained unclear. OBJECTIVE We aimed to characterize the exact phenotype of T cells responsible for the development of pemphigus. METHODS Whole transcriptome shotgun sequencing was performed to determine differential gene expression in pemphigus lesions and skin of healthy individuals. The cutaneous cytokine signature was further evaluated by real-time quantitative PCR. In peripheral blood, the distribution of TH cell and folliclular helper (TFH) cell subsets was analyzed by flow cytometry. Finally, the capacity of TH and TFH cell subsets to induce desmoglein (Dsg)-specific autoantibodies by memory B cells was evaluated in coculture experiments. RESULTS Transcriptome analysis of skin samples identified an IL-17A-dominated immune signature in patients with pemphigus, and Kyoto Encyclopedia of Genes and Genomes pathway analysis confirmed the dominance of the IL-17A signaling pathway. Increased expression of IL17A and associated cytokines was also detected by real-time quantitative PCR comparing lesional with perilesional or healthy skin. Interestingly, utilization of flow cytometry showed that patients with active pemphigus had elevated levels of circulating IL-17+, TH17, TFH17, and TFH17.1 cells. Notably, levels of TH17 and TFH17 cells correlated with levels of Dsg-specific CD19+CD27+ memory B cells, and patients with acute pemphigus showed higher levels of Dsg3-autoreactive TFH17 cells. Coculture experiments revealed TFH17 cells as primarily responsible for inducing Dsg-specific autoantibody production by B cells. CONCLUSION Our findings show that TFH17 cells are critically involved in the pathogenesis of pemphigus and offer novel targets for therapeutic intervention.
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Affiliation(s)
- Julia Holstein
- Department of Dermatology, University Medical Center, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Carolin Baum
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Robert Pollmann
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Dario Didona
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Tobias Tekath
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Martin Dugas
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Nicolas Casadei
- Institute of Medical Genetics and Applied Genomics, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Christoph Hudemann
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Alexandra Polakova
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Jakob Matthes
- Institute of Medical Genetics and Applied Genomics, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Iris Schäfer
- Department of Dermatology, University Medical Center, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Amir S Yazdi
- Department of Dermatology and Allergology, Uniklinik RWTH Aachen, Aachen, Germany
| | - Rüdiger Eming
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Wolfgang Pfützner
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Christian Möbs
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
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Pietschke K, Holstein J, Meier K, Schäfer I, Müller-Hermelink E, Gonzalez-Menendez I, Quintanilla-Martinez L, Ghoreschi FC, Solimani F, Ghoreschi K. The inflammation in cutaneous lichen planus is dominated by IFN-ϒ and IL-21-A basis for therapeutic JAK1 inhibition. Exp Dermatol 2020; 30:262-270. [PMID: 33113249 DOI: 10.1111/exd.14226] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Cutaneous lichen planus (CLP) and psoriasis (PSO) are both common chronic inflammatory skin diseases for which development of new treatments requires the identification of key targets. While PSO is a typical Th17/IL-17-disorder, there is some evidence that Th1/IFN-ɣ dominate the inflammatory process in CLP. Nonetheless, the immunopathogenesis of CLP is not fully explained and key immunological factors still have to be recognized. In this study, we compared the immune signature of CLP lesions with the well-characterized inflammation present in PSO skin. First, we analysed the histological and immunohistological characteristics of CLP and PSO. Second, we assessed the cytokine expression (IL1A, IL1B, IL4, IL6, IL8, IL10, IL17A, IL19, IL21, IL22, IL23A, IL13, IFNG, TNF, IL12A, IL12B and IL36G) of lesional skin of CLP with PSO by qPCR. Histology revealed a similar epidermal thickness in CLP and PSO. Immunohistochemically, both diseases presented with an inflammatory infiltrate mainly composed by CD3+ CD4+ T cells rather than CD3+ CD8+ . Importantly, mRNA analysis showed a distinct cytokine signature: while levels of IL12B, IL1A, IL6 and IL23 were similar between the two groups, the characteristic PSO-associated cytokines IL8, IL17A, IL22, IL19 and IL36G were expressed at very low levels in CLP. In contrast, CLP lesional skin was dominated by the expression of IFNG, IL21, IL4, IL12A and TNF. Immunohistochemistry confirmed the dominance of IL-21, IFN-ɣ and also pSTAT1 in the dermal infiltrate of CLP, while IL-17A was more present in PSO. Collectively, this study improves our understanding of the immunological factors dominating CLP. The dominating cytokines and signalling proteins identified suggest that anti-cytokine therapeutics like JAK inhibitors may be beneficial in CLP.
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Affiliation(s)
- Katharina Pietschke
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany
| | - Julia Holstein
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Iris Schäfer
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany
| | - Eva Müller-Hermelink
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany.,Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Irene Gonzalez-Menendez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tubingen and Comprehensive Cancer Center, Tubingen University Hospital, Tubingen, Germany
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tubingen and Comprehensive Cancer Center, Tubingen University Hospital, Tubingen, Germany
| | - Franziska C Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Wehrhan L, Hillisch A, Mundt S, Tersteegen A, Meier K. Front Cover: Druggability Assessment for Selected Serine Proteases in a Pharmaceutical Industry Setting (ChemMedChem 21/2020). ChemMedChem 2020. [DOI: 10.1002/cmdc.202000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leon Wehrhan
- Bayer AG Research & Development, Pharmaceuticals 42096 Wuppertal Germany
| | - Alexander Hillisch
- Bayer AG Research & Development, Pharmaceuticals 42096 Wuppertal Germany
| | - Stefan Mundt
- Bayer AG Research & Development, Pharmaceuticals 42096 Wuppertal Germany
| | - Adrian Tersteegen
- Bayer AG Research & Development, Pharmaceuticals 42096 Wuppertal Germany
| | - Katharina Meier
- Bayer AG Research & Development, Pharmaceuticals 42096 Wuppertal Germany
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Meier K, Holstein J, Solimani F, Waschke J, Ghoreschi K. Case Report: Apremilast for Therapy-Resistant Pemphigus Vulgaris. Front Immunol 2020; 11:588315. [PMID: 33193415 PMCID: PMC7653172 DOI: 10.3389/fimmu.2020.588315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/05/2020] [Indexed: 01/19/2023] Open
Abstract
Background In pemphigus, elucidating the disease-causing immune mechanism and developing new therapeutic strategies are needed. In this context, the second messenger 3′,5′-cyclic adenosine monophosphate (cAMP) is gaining attention. cAMP is important in hematological and auto-inflammatory disorders. A class of enzymes called phosphodiesterases (PDEs) control intracellular cAMP levels. In pemphigus, cAMP levels increase following IgG binding to Dsg3. This appears to be a mechanism to preserve epithelial integrity. Objectives To determine whether apremilast, an inhibitor of the PDE4 normally used in psoriasis, may be of benefit in the blistering skin disorder pemphigus. Methods Here we report of a 62 years old patient with chronic debilitating and recalcitrant pemphigus not responding to several previous treatments, who received treatment with apremilast over a period of 32 weeks. Desmoglein autoantibody levels were assessed by Enzyme-linked Immunosorbent Assay (ELISA), whereas disease severity and quality of life were assessed by the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). In an attempt to explain the effects of apremilast in pemphigus, peripheral blood mononuclear cells (PBMCs) were analyzed for the duration of treatment by flow cytometry for the distribution of specialized T cell subsets. The frequencies of circulating T helper (Th) 1, Th2, Th17, Th17.1 and T follicular helper (Tfh) 1, Tfh2, Tfh17, and Tfh17.1 were analyzed by CCR6, CXCR3, and CXCR5 expression of CD4+ T cells. Further, based on the different expressions of CXCR5, CD127, and CD25, we analyzed the T regulatory (Treg) and T follicular regulatory (Tfreg) compartment. Results In response to apremilast treatment, Dsg-specific autoantibody titers decreased, blistering ceased and lesions healed, showing a long-lasting effect. While the frequencies of most of the Th and Tfh cell subsets remained unchanged, we observed a continuous increase in Treg and Tfreg cell levels. Conclusion Our findings are encouraging and warrant extension of the beneficial effect of PDE4 inhibition on a larger cohort of pemphigus patients.
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Affiliation(s)
- Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, University Medical Center, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Julia Holstein
- Department of Dermatology, University Medical Center, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jens Waschke
- Faculty of Medicine, Institute of Anatomy, Ludwig Maximilians University Munich, Munich, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, University Medical Center, Eberhard Karls Universität Tübingen, Tübingen, Germany
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45
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Abstract
Intravenous immunoglobulins are an effective and well-tolerated treatment option for immune dermatological diseases. However, they are primarily used to treat diseases with a severe course and are mostly used off-label. Therefore, it is important to document case series on the use of intravenous immunoglobulins in rare immune dermatological diseases. We present here 32 patients who were treated with intravenous immunoglobulins in our clinic between 2015 and 2020. The indications were dermatomyositis, including amyopathic and paraneoplastic forms, as well as overlap-syndromes (n = 18), pemphigus vulgaris (n = 2), mucous membrane pemphigoid (n = 2), linear IgA dermatosis (n = 1), necrotizing vasculitis (n = 1), urticarial vasculitis (n = 1), systemic scleroderma (n = 1), Stevens-Johnson syndrome (n = 1), pyoderma gangrenosum (n = 3), and livedoid vasculopathy (n = 2). The data from this case series confirm the efficacy and tolerability of intravenous immunoglobulins as an adjuvant treatment option for rare therapy-resistant immune dermatoses.
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Affiliation(s)
- Roberta Scarpone
- Division of Allergy and Immunology, Charité - Universitätsmedizin Berlin, DE-10117 Berlin, Germany
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46
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Wehrhan L, Hillisch A, Mundt S, Tersteegen A, Meier K. Druggability Assessment for Selected Serine Proteases in a Pharmaceutical Industry Setting. ChemMedChem 2020; 15:2010-2018. [PMID: 32776472 DOI: 10.1002/cmdc.202000425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Indexed: 01/15/2023]
Abstract
Target druggability assessment is an integral part of the early target characterization and selection process in pharmaceutical industry. Here, we investigate a set of five different serine proteases from the blood coagulation cascade. The aim of this study is twofold. Firstly, leveraging the wealth of available in-house high-throughput screening (HTS) data, we analyze HTS hit rates and discuss their predictive value for the development of small molecule (SMOL) candidates. Purely structure-activity relationship (SAR) based druggability ratings are compared with computational protein-structure based druggability assessments. Secondly, we evaluate the impact of using conformational ensembles from molecular dynamics (MD) simulations instead of single static crystal structures as basis for computational druggability assessments. Based on this study, we recommend incorporating molecular dynamics routinely into the early target characterization process, especially if only a single X-ray structure is available.
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Affiliation(s)
- Leon Wehrhan
- Bayer AG, Research & Development, Pharmaceuticals, 42096, Wuppertal, Germany
| | - Alexander Hillisch
- Bayer AG, Research & Development, Pharmaceuticals, 42096, Wuppertal, Germany
| | - Stefan Mundt
- Bayer AG, Research & Development, Pharmaceuticals, 42096, Wuppertal, Germany
| | - Adrian Tersteegen
- Bayer AG, Research & Development, Pharmaceuticals, 42096, Wuppertal, Germany
| | - Katharina Meier
- Bayer AG, Research & Development, Pharmaceuticals, 42096, Wuppertal, Germany
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47
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Meier K, Ghoreschi K. Among the brightest antipsoriatic stars. Br J Dermatol 2020; 183:201-202. [DOI: 10.1111/bjd.18867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. Meier
- Department of Dermatology, Venereology and Allergology Charité‐Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
| | - K. Ghoreschi
- Department of Dermatology, Venereology and Allergology Charité‐Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
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Holstein J, Solimani F, Meier K, Tekath T, Ghoreschi K. 029 Transcriptome analysis suggests a role of IL-17-related genes in pemphigus. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.031] [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: 11/24/2022]
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Meier K, Schaller M, Yazdi AS. Multilokuläres Borrelien-assoziiertes Pseudolymphom. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-0981-8112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungKutane Pseudolymphome sind reaktive lymphoproliferative T- oder B-Zellinfiltrate, die sowohl klinisch als histologisch dem Bild eines kutanen Lymphoms entsprechen können. Wir stellen einen Patienten mit einem seit 2 Jahren bestehenden ausgeprägten multilokulären B-Zell-Pseudolymphom am Rücken vor. In der weiteren Diagnostik zeigten sich Antikörper gegenüber Borrelien vom IgG- und IgM-Typ sowie ein CD20-positives Infiltrat, nukleär eine bcl-6-Expression sowie ein Fehlen einer bcl-2-Expression. Es wurde ein IgM-positives Borrelien-assoziiertes multilokuläres Pseudolymphom diagnostiziert und eine Therapie mit Doxycyclin 200 mg/Tag über 3 Wochen eingeleitet.
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Affiliation(s)
- K. Meier
- Klinik für Dermatologie, Venerologie und Allergologie Charité Universitätsmedizin, Berlin
- Universitäts-Hautklinik, Tübingen
| | | | - A. S. Yazdi
- Klinik für Dermatologie und Allergologie, Uniklinik RWTH Aachen
- Universitäts-Hautklinik, Tübingen
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50
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Abstract
Accumulating data on cellular and molecular pathways help to develop novel therapeutic strategies in skin inflammation and autoimmunity. Examples are psoriasis and atopic dermatitis, two clinically and immunologically well-defined disorders. Here, the elucidation of key pathogenic factors such as IL-17A/IL-23 on the one hand and IL-4/IL-13 on the other hand profoundly changed our therapeutic practice. The knowledge on intracellular pathways and governing factors is shifting our attention to new druggable molecules. Multiple cytokine receptors signal through Janus kinases (JAKs) and associated signal transducer and activators of transcription (STATs). Inhibition of JAKs can simultaneously block the function of multiple cytokines. Therefore, JAK inhibitors (JAKi) are emerging as a new class of drugs, which in dermatology can either be used systemically as oral drugs or locally in topical formulations. Inhibition of JAKs has been shown to be effective in various skin disorders. The first oral JAKi have been recently approved for the treatment of rheumatoid arthritis and psoriatic arthritis. Currently, multiple inhibitors of the JAK/STAT pathway are being investigated for skin diseases like alopecia areata, atopic dermatitis, dermatomyositis, graft-versus-host-disease, hidradenitis suppurativa, lichen planus, lupus erythematosus, psoriasis, and vitiligo. Here, we aim to discuss the immunological basis and current stage of development of JAKi in dermatology.
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Affiliation(s)
- Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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