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Ferri G, Isopi E, Pecce R, Mattoscio D, Lamolinara A, Iezzi M, Mall M, Romano M, Recchiuti A. 417 Resolvin D1 reduces cystic fibrosis lung disease and inflammation associated with mucus obstruction. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01107-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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2
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Griese M, Tullis E, Chilvers M, Fabrizzi B, Jain R, Legg J, Mall M, McKone E, Polineni D, Poplawska K, Robinson P, Taylor-Cousar J, Ahluwalia N, Doolittle C, Jennings M, Moskowitz S, Prieto-Centurion V, Tan Y, Tian S, Vinarsky V, Weinstock T, Xuan F, Ramsey B, Daines C. 170 Long-term safety and efficacy of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis and at least one F508del allele: 144-week interim results from an open-label extension study. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00861-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Chmiel J, Barry P, Colombo C, De Wachter E, Fajac I, Mall M, McBennett K, McKone E, Mondejar-Lopez P, Quon B, Ramsey B, Robinson P, Sutharsan S, Ahluwalia N, Lu M, Moskowitz S, Prieto-Centurion V, Tian S, Waltz D, Weinstock T, Xuan F, Zelazoski L, Zhang Y, Polineni D. 185 Long-term safety and efficacy of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis heterozygous for F508del-CFTR and a gating or residual function mutation. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00875-x] [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: 11/06/2022]
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Röhmel J, Dörfler F, Rohrbach A, Mall M, Ogese M, Naisbitt D. Lymphocyte transformation tests offer improved sensitivity over skin
tests for lymphocytic sensitization in CF patients with allergy to
antibiotics. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754510] [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: 11/07/2022]
Affiliation(s)
- J Röhmel
- Charité – Universitätsmedizin Berlin, Klinik
für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und
Intensivmedizin, Berlin, Germany
| | - F Dörfler
- Charité – Universitätsmedizin Berlin, Klinik
für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und
Intensivmedizin, Berlin, Germany
| | - A Rohrbach
- Charité – Universitätsmedizin Berlin, Klinik
für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und
Intensivmedizin, Berlin, Germany
| | - M Mall
- Charité – Universitätsmedizin Berlin, Klinik
für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und
Intensivmedizin, Berlin, Germany
- Berlin Institute of Health (BIH) at Charité –
Universitätsmedizin Berlin, Berlin, Germany
- German Center for Lung Research (DZL), Associated Partner Site, Berlin,
Germany
| | - M Ogese
- University of Liverpool, Department of Molecular Pharmacology,
Liverpool, United Kingdom
| | - D Naisbitt
- University of Liverpool, Department of Molecular Pharmacology,
Liverpool, United Kingdom
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5
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Jaboreck MC, Merkert S, von Schledorn L, Zöllner J, Cleve N, Haase A, Olmer R, Martin U, Galietta L, Mall M, Balázs A. P020 Evaluation of TMEM16A as a modifier of the cystic fibrosis lung phenotype utilising cystic fibrosis patient-specific human-induced pluripotent stem cells. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00353-8] [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: 10/18/2022]
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Röhmel J, Dörfler F, Koerner-Rettberg C, Brinkmann F, Schlegtendal A, Wetzke M, Helms S, Große-Onnebrink J, Yu Y, Nuesslein T, Wojsyk-Banaszak I, Becker S, Eickmeier O, Sommerburg O, Omran H, Stahl M, Mall M, Rudolf I. ePS5.09 Comparison of the Lung Clearance Index in preschool children with primary ciliary dyskinesia and cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00327-7] [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: 11/15/2022]
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Kiefer A, Plattner E, Ruppel R, Weiss C, Zhou-Suckow Z, Mall M, Renner M, Müller H. DMBT1 is upregulated in cystic fibrosis, affects ciliary motility, and is reduced by acetylcysteine. Mol Cell Pediatr 2022; 9:4. [PMID: 35249163 PMCID: PMC8898207 DOI: 10.1186/s40348-022-00136-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cystic fibrosis (CF) is the most common genetic disorder in the Caucasian population. Despite remarkable improvements in morbidity and mortality during the last decades, the disease still limits survival and reduces quality of life of affected patients. Moreover, CF still represents substantial economic burden for healthcare systems. Inflammation and infection already start in early life and play important roles in pulmonary impairment. The aim of this study is to analyze the potential role of DMBT1, a protein with functions in inflammation, angiogenesis, and epithelial differentiation, in CF. RESULTS Immunohistochemically DMBT1 protein expression was upregulated in lung tissues of CF patients compared to healthy controls. Additionally, pulmonary expression of Dmbt1 was approximately 6-fold increased in an established transgenic mouse model of CF-like lung disease (ENaC tg) compared to wild-type mice as detected by qRT-PCR. Since acetylcysteine (ACC) has been shown to reduce inflammatory markers in the airways, its potential influence on DMBT1 expression was analyzed. A549 cells stably transfected with an expression plasmid encoding the largest (8kb) DMBT1 variant (DMBT1+ cells) or an empty vector control (DMBT1- cells) and incubated with ACC both showed significantly reduced DMBT1 concentrations in the culture medium (p = 0.0001). To further elucidate the function of DMBT1 in pulmonary airways, respiratory epithelial cells were examined by phase contrast microscopy. Addition of human recombinant DMBT1 resulted in altered cilia motility and irregular beat waves (p < 0.0001) suggesting a potential effect of DMBT1 on airway clearance. CONCLUSIONS DMBT1 is part of inflammatory processes in CF and may be used as a potential biomarker for CF lung disease and a potential tool to monitor CF progression. Furthermore, DMBT1 has a negative effect on ciliary motility thereby possibly compromising airway clearance. Application of ACC, leading to reduced DMBT1 concentrations, could be a potential therapeutic option for CF patients.
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Affiliation(s)
- Alexander Kiefer
- Department of Pediatrics, University Hospital Erlangen, University of Erlangen-Nürnberg, Loschgestr. 15, 91054, Erlangen, Germany.,Department of Pediatric Pneumology and Allergology, St. Hedwig's Hospital of the Order of St. John, University Children's Hospital Regensburg (KUNO), Steinmetzstr. 1-3, 93049, Regensburg, Germany
| | - Erika Plattner
- Department of Pediatrics, University Hospital Erlangen, University of Erlangen-Nürnberg, Loschgestr. 15, 91054, Erlangen, Germany
| | - Renate Ruppel
- Department of Pediatrics, University Hospital Erlangen, University of Erlangen-Nürnberg, Loschgestr. 15, 91054, Erlangen, Germany
| | - Christel Weiss
- Department of Medical Statistics and Biomathematics, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Zhe Zhou-Suckow
- Department of Translational Pulmonology, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld, 69120, Heidelberg, Germany
| | - Marcus Mall
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Marcus Renner
- Institute of Pathology, University of Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Hanna Müller
- Department of Pediatrics, Neonatology and Pediatric Intensive Care, University of Marburg, Baldingerstraße, 35043, Marburg, Germany. .,Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Hospital Erlangen, University of Erlangen-Nürnberg, Loschgestr. 15, 91054, Erlangen, Germany.
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Bayfield KJ, Douglas TA, Rosenow T, Davies JC, Elborn SJ, Mall M, Paproki A, Ratjen F, Sly PD, Smyth AR, Stick S, Wainwright CE, Robinson PD. Time to get serious about the detection and monitoring of early lung disease in cystic fibrosis. Thorax 2021; 76:1255-1265. [PMID: 33927017 DOI: 10.1136/thoraxjnl-2020-216085] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/24/2021] [Accepted: 03/10/2021] [Indexed: 12/26/2022]
Abstract
Structural and functional defects within the lungs of children with cystic fibrosis (CF) are detectable soon after birth and progress throughout preschool years often without overt clinical signs or symptoms. By school age, most children have structural changes such as bronchiectasis or gas trapping/hypoperfusion and lung function abnormalities that persist into later life. Despite improved survival, gains in forced expiratory volume in one second (FEV1) achieved across successive birth cohorts during childhood have plateaued, and rates of FEV1 decline in adolescence and adulthood have not slowed. This suggests that interventions aimed at preventing lung disease should be targeted to mild disease and commence in early life. Spirometry-based classifications of 'normal' (FEV1≥90% predicted) and 'mild lung disease' (FEV1 70%-89% predicted) are inappropriate, given the failure of spirometry to detect significant structural or functional abnormalities shown by more sensitive imaging and lung function techniques. The state and readiness of two imaging (CT and MRI) and two functional (multiple breath washout and oscillometry) tools for the detection and monitoring of early lung disease in children and adults with CF are discussed in this article.Prospective research programmes and technological advances in these techniques mean that well-designed interventional trials in early lung disease, particularly in young children and infants, are possible. Age appropriate, randomised controlled trials are critical to determine the safety, efficacy and best use of new therapies in young children. Regulatory bodies continue to approve medications in young children based on safety data alone and extrapolation of efficacy results from older age groups. Harnessing the complementary information from structural and functional tools, with measures of inflammation and infection, will significantly advance our understanding of early CF lung disease pathophysiology and responses to therapy. Defining clinical utility for these novel techniques will require effective collaboration across multiple disciplines to address important remaining research questions. Future impact on existing management burden for patients with CF and their family must be considered, assessed and minimised.To address the possible role of these techniques in early lung disease, a meeting of international leaders and experts in the field was convened in August 2019 at the Australiasian Cystic Fibrosis Conference. The meeting entitiled 'Shaping imaging and functional testing for early disease detection of lung disease in Cystic Fibrosis', was attended by representatives across the range of disciplines involved in modern CF care. This document summarises the proceedings, key priorities and important research questions highlighted.
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Affiliation(s)
- Katie J Bayfield
- Department of Respiratory Medicine, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Tonia A Douglas
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Tim Rosenow
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.,Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia.,Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, Western Australia, Australia
| | - Jane C Davies
- National Heart and Lung Institute, Imperial College London, London, UK.,Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Stuart J Elborn
- Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Marcus Mall
- Department of Pediatric Pulmonology, Immunology, and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Department of Translational Pulmonology, German Center for Lung Research, Berlin, Germany
| | - Anthony Paproki
- The Australian e-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Felix Ratjen
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queenland, Herston, Queensland, Australia
| | - Alan R Smyth
- Division of Child Health, Obstetrics & Gynaecology. School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Stephen Stick
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.,Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia.,Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Claire E Wainwright
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul D Robinson
- Department of Respiratory Medicine, Children's Hospital at Westmead, Westmead, New South Wales, Australia .,Airway Physiology and Imaging Group, Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.,The Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
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Stahl M, Roehmel J, Eichinger M, Doellinger F, Naehrlich L, Kopp M, Dittrich AM, Lee C, Sommerburg O, Tian S, Xu T, Wu P, Joshi A, Duncan M, Wielpütz M, Mall M. WS12.1 An exploratory study to determine the impact of lumacaftor/ivacaftor (LUM/IVA) on disease progression in children 2 through 5 years of age with cystic fibrosis homozygous for F508del-CFTR (F/F). J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)00981-4] [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: 11/30/2022]
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10
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Temming S, Thalemann R, Andert M, Nährlich L, Baumeister H, Mall M, Staab D. P210 COACH project - screening for psychological comorbidity in adolescents with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01235-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jung E, Domínguez Azorín D, Hausmann D, Mall M, Koch P, Wick W, Winkler F. P11.29 Development of ex vivo models for deeper insights into the biology and therapeutic targeting of tumor microtube networks in gliomas. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.175] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
The formation of multicellular networks via thin cellular protrusions named tumor microtubes (TMs) emerged as a novel mechanism of therapy resistance in malignant glioma. TMs are also involved in tumor cell invasion and growth. Within these tumor cell networks, connected tumor cells communicate via intercellular calcium waves (ICWs). Only few molecular drivers of TMs (Gap43, Ttyh1, Connexin 43) have been identified until now. Furthermore, the molecular mechanisms underlying ICWs as well as their specific biological role in glioma remains to be elucidated. A better understanding of the biology and the identification of molecular key drivers is essential for the development of drugs targeting TM formation and function.
MATERIAL AND METHODS
For this purpose, we have developed novel ex vivo models that not only provide insights into TM biology but further allow medium throughput drug screening. As classical response parameters such as the inhibition of cell growth or cytotoxicity do not necessarily correlate with effects on TM formation or function, a morphometrical approach employing laser scanning microscopy and machine-learning based image analysis tools is used. The application of fluorescent probes and genetic fluorescent reporter systems provides novel longitudinal insights into cytoskeletal dynamics, the role and exchange of organelles such as mitochondria, mechanisms of homeostasis within tumor cell networks (e.g. redox homeostasis) and ICWs in live cells. In addition to 2D glioma cell and co-culture models we have developed a fully human and mature brain organoid model. Here, complex 3D tumor cell networks corresponding to the morphology and exhibiting calcium communication patterns observed in our mouse model can be established and studied ex vivo. Furthermore, with these models not only the role of the brain microenvironment on TM formation but also direct interactions of glioma cells with neurons and glial cells as well as drug effects such as cytotoxicity on these brain cells can be investigated ex vivo.
CONCLUSION
In summary, novel tumor models enable further insights into TM biology and hence provide the basis for development of TM- and network disrupting drugs. First results of this screening opportunity will be presented.
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Affiliation(s)
- E Jung
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | | | - D Hausmann
- CCU Neurooncology, German Cancer Research Center, Heidelberg, Germany
| | - M Mall
- Cell Fate Engineering and Disease Modeling Group, German Cancer Research Center, Heidelberg, Germany
| | - P Koch
- Central Institute of Mental Health (ZI), Mannheim, Germany
| | - W Wick
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - F Winkler
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
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12
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Eschenhagen P, Bacher P, Kaufmann S, Rickerts V, Seidel K, Holz F, Scheffold A, Mall M, Schwarz C. P169 Longitudinal observation of azol-resistance Aspergillus fumigatus in patients with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30463-1] [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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13
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Holz F, Kallinich T, Röhmel J, Eschenhagen P, Mehl A, Staab D, Kaufmann S, Gräber S, Mall M, Schwarz C. WS17-1 Prospective evaluation of arthropathy in patients with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30217-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Eschenhagen P, Bacher P, Kaufmann S, Rickerts V, Seidel K, Röhmel J, Mehl A, Staab D, Gräber S, Holz F, Scheffold A, Mall M, Schwarz C. P165 Prospective evaluation of Aspergillus fumigatus-specific IgG in patients with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30459-x] [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: 10/26/2022]
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Kreuter M, Herth FJF, Wacker M, Witt S, Kabitz HJ, Hagmeyer L, Hammerl P, Esselmann A, Wiederholf C, Skowasch D, Stolpe C, Joest M, Veitshans S, Leidl R, Hellmann A, Pfeifer M, Behr J, Kauschka D, Mall M, Günther A, Markart P. Diagnostik und Therapie von Patienten mit interstitiellen Lungenerkrankungen in Deutschland – das EXCITING ILD Register. Pneumologie 2018. [DOI: 10.1055/s-0037-1619191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Kreuter
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik; Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (TLRC); Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - FJF Herth
- Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg
| | - M Wacker
- Institute of Health Economics and Healthcare Management, Helmholtz Centre Munich GmbH, German Research Centre for Environmental Health, Member of the German Centre for Lung Research (DZL), Comprehensive Pneumology Centre Munich (CPC-M)
| | - S Witt
- Institute of Health Economics and Healthcare Management, Helmholtz Centre Munich GmbH, German Research Centre for Environmental Health, Member of the German Centre for Lung Research (DZL), Comprehensive Pneumology Centre Munich (CPC-M)
| | | | - L Hagmeyer
- Clinic of Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Hospital Bethanien Solingen
| | | | - A Esselmann
- Outpatient Center for Pulmonology, Warendorf
| | | | - D Skowasch
- Medical Clinic II, University Hospital Bonn
| | - C Stolpe
- Outpatient Center for Pulmonology, Ibbenbüren
| | - M Joest
- Malteser Center for Pulmonology and Allergology, Bonn
| | - S Veitshans
- Outpatient Center for Pulmonology, Böblingen
| | - R Leidl
- Institute of Health Economics and Healthcare Management, Helmholtz Centre Munich GmbH, German Research Centre for Environmental Health, Member of the German Centre for Lung Research (DZL), Comprehensive Pneumology Centre Munich (CPC-M)
| | - A Hellmann
- Outpatient Center for Pulmonology, Augsburg
| | - M Pfeifer
- Klinik Donaustauf und Universitätsklinikum Regensburg
| | | | | | - M Mall
- Translational Pulmonology, University of Heidelberg, Germany, Member of the German Center for Lung Research (TLRC)
| | - A Günther
- Universitätsklinikum Gießen und Marburg
| | - P Markart
- Medical Clinic II, University Hospital Gießen, Universities of Gießen and Marburg Lung Centre (Ugmlc), Member and Medical Clinic V (Pneumology), Cardiothoracic Centre, Campus Fulda, University Medicine Marburg
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16
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Sommerburg O, Stahl M, Hammermann J, Okun JG, Kulozik A, Hoffmann G, Mall M. [Newborn Screening on Cystic Fibrosis in Germany: Comparison of the new Screening Protocol with an Alternative Protocol]. Klin Padiatr 2017; 229:59-66. [PMID: 28444650 DOI: 10.1055/s-0042-124187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background For the new cystic fibrosis (CF) newborn screening program in Germany the Federal Joint Committee (G-BA) implemented a new screening protocol using immunoreactive trypsinogen (IRT) as first and pancreatitis associated protein (PAP) as second tier. Gene analysis with a panel of 31 CFTR-mutations is used as third tier to increase the positive predictive value (PPV) which is known to be low in pure biochemical IRT/PAP protocols. Methods For post hoc analysis the data pool (n=372 906) of a study evaluating a pure biochemical IRT/PAP protocol was used for assessment of the 3-step G-BA protocol in comparison with an alternative screening protocol recommended by the authors. The difference between the 2 protocols is the procedure when IRT>99.9th percentile. In the G BA protocol PAP and DNA analysis will be by-passed while in the alternative protocol only the PAP step will be circumvented. Results Both 3-tier IRT/PAP+SN/DNA protocols did not lose sensitivity due to addition of genetic analysis when the results were compared to those of the 2-tier biochemical IRT/PAP protocol. However, the protocols provide different results regarding PPV. The G-BA protocol showed with 351 a much higher number of false-positively detected newborns (PPV 20.2%) when compared to 31 false-positively detected newborns in the alternative protocol (PPV 69.6%). Conclusions The G-BA protocol had a worse performance when compared with the alternative protocol recommended by the authors. The higher number of false-positively detected newborns using the G-BA protocol will lead to more consultations including sweat tests, will create more anxiety in parents, and will result in higher costs after screening.
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Affiliation(s)
- Olaf Sommerburg
- Sektion für Pädiatrische Pneumologie & Allergologie und Mukoviszidose-Zentrum, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg
| | - Mirjam Stahl
- Sektion für Pädiatrische Pneumologie & Allergologie und Mukoviszidose-Zentrum, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg
| | - Jutta Hammermann
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden
| | - Jürgen G Okun
- Dietmar-Hopp-Stoffwechselzentrum, Zentrum für Kinder- und Jugendmedizin des Universitätsklinikums Heidelberg
| | - Andreas Kulozik
- Sektion für Pädiatrische Pneumologie & Allergologie und Mukoviszidose-Zentrum, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg
| | - Georg Hoffmann
- Zentrum für Translationale Lungenforschung Heidelberg (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg
| | - Marcus Mall
- Sektion für Pädiatrische Pneumologie & Allergologie und Mukoviszidose-Zentrum, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg
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Kreuter M, Wacker M, Hammerl P, Wiederhold C, Kabitz HJ, Hagmeyer L, Skowasch D, Leidl R, Hellmann A, Pfeifer M, Behr J, Witt S, Kauschka D, Mall M, Günther A, Herth FJF, Markart P. Interims Analyse des EXCITING-ILD Registers (Registry for Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases). Pneumologie 2017. [DOI: 10.1055/s-0037-1598497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (Tlrc), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - M Wacker
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | | | | | - HJ Kabitz
- II. Medizinische Klinik, Klinikum Konstanz
| | - L Hagmeyer
- Klinik für Pneumologie und Allergologie, Krankenhaus Bethanien gGmbH
| | - D Skowasch
- Medizinische Klinik II, Kardiologie, Pneumologie, Uniklinikum Bonn
| | - R Leidl
- Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Helmholtz Zentrum München, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | | | - M Pfeifer
- Krankenhaus Donaustauf; Universität Regensburg
| | - J Behr
- Zentrum für Pneumologie und Thoraxchirurgie, Asklepios Fachkliniken München-Gauting; Med. Klinik V, LMU, München, Mitglied des Dzl
| | - S Witt
- Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Helmholtz Zentrum München
| | - D Kauschka
- C/O Dagmar Kauschka, 1. Vorsitzende, Lungenfibrose e.V
| | - M Mall
- Zentrum für Kinder- und Jugendmedizin, Sektion Pädiatrische Pneumologie & Allergologie und Mukoviszidose-Zentrum, Universitätsklinikum Heidelberg
| | - A Günther
- Med. Klinik II, Schwerpunkt Pneumologie, Univ.-Klinikum Gießen
| | - FJF Herth
- Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (Tlrc), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - P Markart
- Medizinische Klinik V, Klinikum Fulda
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Pieper M, Schulz-Hildebrandt H, Mall M, Hüttmann G, König P. Intravital microscopy of mucus transport in mice provides mechanistic insight into hypertonic saline treatment of Cystic Fibrosis. Pneumologie 2016. [DOI: 10.1055/s-0036-1584654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schütte A, Zhou-Suckow Z, Schatterny J, Schmidt S, Hassel S, Weitnauer M, Dalpke A, Mall M. The effect of the antiinflammatory IL-1R antagonist anakinra in mice with CF-like lung disease and Pseudomonas aeruginosa infection. Pneumologie 2016. [DOI: 10.1055/s-0036-1584630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Boutin S, Stahl M, Graeber SY, Dittrich S, Mall M, Dalpke AH. Longitudinal analysis of cystic fibrosis of airways' microbiota. Pneumologie 2016. [DOI: 10.1055/s-0036-1584655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schulz-Hildebrandt H, Pieper M, Kasper J, Traulsen N, Mall M, König P, Hüttmann G. Towards automated evaluation of mucus transport measured by microscopic OCT (mOCT) during hypertonic saline treatment of Cystic Fibrosis. Pneumologie 2016. [DOI: 10.1055/s-0036-1584651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kreuter M, Herth FJF, Wacker M, Leidl R, Hellmann A, Pfeifer M, Behr J, Witt S, Kauschka D, Mall M, Günther A, Markart P. Interims Analyse des EXCITING-ILD Registers (Registry for Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases). Pneumologie 2016. [DOI: 10.1055/s-0036-1572075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hector A, Schäfer H, Pöschel S, Fischer A, Fritzsching B, Ralhan A, Carevic M, Öz H, Zundel S, Hogardt M, Bakele M, Rieber N, Riethmueller J, Graepler-Mainka U, Stahl M, Bender A, Frick JS, Mall M, Hartl D. Regulatory T-cell impairment in cystic fibrosis patients with chronic pseudomonas infection. Am J Respir Crit Care Med 2015; 191:914-23. [PMID: 25632992 DOI: 10.1164/rccm.201407-1381oc] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Patients with cystic fibrosis (CF) lung disease have chronic airway inflammation driven by disrupted balance of T-cell (Th17 and Th2) responses. Regulatory T cells (Tregs) dampen T-cell activation, but their role in CF is incompletely understood. OBJECTIVES To characterize numbers, function, and clinical impact of Tregs in CF lung disease. METHODS Tregs were quantified in peripheral blood and airway samples from patients with CF and from lung disease control patients without CF and healthy control subjects. The role of Pseudomonas aeruginosa and CF transmembrane conductance regulator (CFTR) in Treg regulation was analyzed by using in vitro and murine in vivo models. MEASUREMENTS AND MAIN RESULTS Tregs were decreased in peripheral blood and airways of patients with CF compared with healthy controls or lung disease patients without CF and correlated positively with lung function parameters. Patients with CF with chronic P. aeruginosa infection had lower Tregs compared with patients with CF without P. aeruginosa infection. Genetic knockout, pharmacological inhibition, and P. aeruginosa infection studies showed that both P. aeruginosa and CFTR contributed to Treg dysregulation in CF. Functionally, Tregs from patients with CF or from Cftr(-/-) mice were impaired in suppressing conventional T cells, an effect that was enhanced by P. aeruginosa infection. The loss of Tregs in CF affected memory, but not naive Tregs, and manifested gradually with disease progression. CONCLUSIONS Patients with CF who have chronic P. aeruginosa infection show an age-dependent, quantitative, and qualitative impairment of Tregs. Modulation of Tregs represents a novel strategy to rebalance T-cell responses, dampen inflammation, and ultimately improve outcomes for patients with infective CF lung disease.
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Kreuter M, Günther A, Leidl R, Hellmann A, Pfeifer M, Behr J, Wacker M, Witt S, Kauschka D, Mall M, Herth FJF, Markart P. Interimsanalyse des EXCITING-ILD Registers (Registry for Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases). Pneumologie 2015. [DOI: 10.1055/s-0035-1544823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Oltmanns U, Palmowski K, Kahn N, Baroke E, Eberhardt R, Wege S, Wiebel M, Kreuter M, Herth FJF, Mall M. Die optische Koherenztomografie in der in-vivo Darstellung struktureller Nasenschleimhautveränderungen bei Patienten mit zystischer Fibrose. Pneumologie 2015. [DOI: 10.1055/s-0035-1544816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Liu X, Riederer B, Anagnostopoulou P, Li T, Rausch B, Duerr J, Soleimani M, Mall M, Seidler U. Absence of Slc26a9 results in altered tracheobronchial anion transport and high mortality in neonate mice (1181.7). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.1181.7] [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)
- Xuemei Liu
- Department of Gastroenterology Hannover Medical SchoolHannoverGermany
| | - Brigitte Riederer
- Department of Gastroenterology Hannover Medical SchoolHannoverGermany
| | - Pinelopi Anagnostopoulou
- Center for Translational Lung Research and Division for Pediatric Pulmonology University of HeidelbergHeidelbergGermany
| | - Taolang Li
- Department of Gastroenterology Hannover Medical SchoolHannoverGermany
| | - Brigitte Rausch
- Department of Gastroenterology Hannover Medical SchoolHannoverGermany
| | - Julia Duerr
- Center for Translational Lung Research and Division for Pediatric Pulmonology University of HeidelbergHeidelbergGermany
| | - Manoocher Soleimani
- Division of Nephrology and HypertensionDepartment of MedicineUniversity of Cincinnati College of MedicineCincinnatiOHUnited States
| | - Marcus Mall
- Center for Translational Lung Research and Division for Pediatric Pulmonology University of HeidelbergHeidelbergGermany
| | - Ursula Seidler
- Department of Gastroenterology Hannover Medical SchoolHannoverGermany
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Kreuter M, Günther A, Leidl R, Hellmann A, Pfeifer M, Behr J, Wacker M, Witt S, Kauschka D, Mall M, Herth FJF, Markart P. EXCITING (Registry for Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases) – ein aufregend neues deutsches ILD Register. Pneumologie 2014. [DOI: 10.1055/s-0034-1367998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bader A, Brodarac A, Hetzer R, Kurtz A, Stamm C, Baraki H, Kensah G, Asch S, Rojas S, Martens A, Gruh I, Haverich A, Kutschka I, Cortes-Dericks L, Froment L, Kocher G, Schmid RA, Delyagina E, Schade A, Scharfenberg D, Skorska A, Lux C, Li W, Steinhoff G, Drey F, Lepperhof V, Neef K, Fatima A, Wittwer T, Wahlers T, Saric T, Choi YH, Fehrenbach D, Lehner A, Herrmann F, Hollweck T, Pfeifer S, Wintermantel E, Kozlik-Feldmann R, Hagl C, Akra B, Gyongyosi M, Zimmermann M, Pavo N, Mildner M, Lichtenauer M, Maurer G, Ankersmit J, Hacker S, Mittermayr R, Mildner M, Haider T, Nickl S, Zimmermann M, Beer L, Lebherz-Eichinger D, Schweiger T, Mitterbauer A, Keibl C, Werba G, Frey M, Ankersmit HJ, Herrmann S, Lux CA, Steinhoff G, Holfeld J, Tepekoylu C, Wang FS, Kozaryn R, Schaden W, Grimm M, Wang CJ, Holfeld J, Tepekoylu C, Kozaryn R, Urbschat A, Zacharowski K, Grimm M, Paulus P, Avaca MJ, Kempf H, Malan D, Sasse P, Fleischmann B, Palecek J, Drager G, Kirschning A, Zweigerdt R, Martin U, Katsirntaki K, Haller R, Ulrich S, Sgodda M, Puppe V, Duerr J, Schmiedl A, Ochs M, Cantz T, Mall M, Martin U, Mauritz C, Kensah G, Lara AR, Dahlmann J, Zweigerdt R, Schwanke K, Hegermann J, Skvorc D, Gawol A, Azizian A, Wagner S, Krause A, Drager G, Ochs M, Haverich A, Gruh I, Martin U, Klopsch C, Gaebel R, Kaminski A, Chichkov B, Jockenhoevel S, Steinhoff G, Klose K, Roy R, Brodarac A, Kang KS, Bieback K, Nasseri B, Choi YH, Kurtz A, Stamm C, Lepperhof V, Polchynska O, Kruttwig K, Bruggemann C, Xu G, Drey F, Neef K, Saric T, Lichtenauer M, Werba G, Mildner M, Baumgartner A, Hasun M, Nickl S, Beer L, Mitterbauer A, Zimmermann M, Gyongyosi M, Podesser BK, Ankersmit HJ, Ludwig M, Tolk A, Skorska A, Noack T, Steinhoff G, Margaryan R, Assanta N, Menciassi A, Burchielli S, Matteucci M, Lionetti V, Luchi C, Cariati E, Coceani F, Murzi B, Martens A, Rojas SV, Kensah G, Rotarmel A, Baraki H, Haverich A, Martin U, Gruh I, Kutschka I, Nasseri BA, Klose K, Ebell W, Dandel M, Kukucka M, Gebker R, Choi YH, Hetzer R, Stamm C, Paulus P, Holfeld J, Urbschat A, Mutlak H, Ockelmann P, Tacke S, Zacharowski K, Scheller B, Pereszlenyi A, Rojas SV, Martens A, Baraki H, Schwanke K, Zweigerdt R, Martin U, Haverich A, Kutschka I, Rojas SV, Martens A, Meier M, Baraki H, Schecker N, Rathert C, Zweigerdt R, Martin U, Haverich A, Kutschka I, Roy R, Brodarac A, Kukucka M, Kurtz A, Becher PM, Choi YH, Drori-Carmi N, Bercovich N, Zahavi-Goldstein E, Jack M, Netzer N, Pinzur L, Chajut A, Tschope C, Stamm C, Ruch U, Kaminski A, Strauer BE, Tiedemann G, Steinhoff G, Schade A, Delyagina E, Scharfenberg D, Lux C, Steinhoff G, Schlegel F, Dhein S, Akhavuz O, Mohr FW, Dohmen PM, Schlegel F, Salameh A, Oelmann K, Kiefer P, Dhein S, Mohr FW, Dohmen PM, Schwanke K, Merkert S, Templin C, Jara-Avaca M, Muller S, Haverich A, Martin U, Zweigerdt R, Skorska A, von Haehling S, Ludwig M, Slavic S, Curato C, Altarche-Xifro W, Unger T, Steinhoff G, Li J, Zhang Y, Li WZ, Ou L, Lux CA, Ma N, Steinhoff G, Haase A, Alt R, Schwanke K, Martin U. 3rd EACTS Meeting on Cardiac and Pulmonary Regeneration Berlin-Brandenburgische Akademie, Berlin, Germany, 14-15 December 2012. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivs561] [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: 11/13/2022] Open
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Hartl D, Gaggar A, Bruscia E, Hector A, Marcos V, Jung A, Greene C, McElvaney G, Mall M, Döring G. Innate immunity in cystic fibrosis lung disease. J Cyst Fibros 2012; 11:363-82. [PMID: 22917571 DOI: 10.1016/j.jcf.2012.07.003] [Citation(s) in RCA: 173] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 06/29/2012] [Accepted: 07/02/2012] [Indexed: 12/16/2022]
Abstract
Chronic lung disease determines the morbidity and mortality of cystic fibrosis (CF) patients. The pulmonary immune response in CF is characterized by an early and non-resolving activation of the innate immune system, which is dysregulated at several levels. Here we provide a comprehensive overview of innate immunity in CF lung disease, involving (i) epithelial dysfunction, (ii) pathogen sensing, (iii) leukocyte recruitment, (iv) phagocyte impairment, (v) mechanisms linking innate and adaptive immunity and (iv) the potential clinical relevance. Dissecting the complex network of innate immune regulation and associated pro-inflammatory cascades in CF lung disease may pave the way for novel immune-targeted therapies in CF and other chronic infective lung diseases.
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Affiliation(s)
- D Hartl
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany.
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Seeger W, Welte T, Eickelberg O, Mall M, Rabe K, Keller B, Winkler S, Koller U. Das Deutsche Zentrum für Lungenforschung - Translationale Forschung für Prävention, Diagnose und Therapie von Atemwegserkrankungen. Pneumologie 2012; 66:464-9. [DOI: 10.1055/s-0032-1310086] [Citation(s) in RCA: 6] [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] [Indexed: 10/28/2022]
Affiliation(s)
- W. Seeger
- Universities of Gießen and Marburg Lung Center (UGMLC), Mitglied im DZL
| | - T. Welte
- Breath (Biomedical Research in Endstage and Obstructive Lung Disease Hannover), Mitglied im DZL
| | - O. Eickelberg
- Comprehensive Pneumology Center, Klinikum der Ludwig-Maximilians-Universität München und Helmholtz Zentrum München, Mitglied im DZL
| | - M. Mall
- Heidelberg Translational Lung Research Center (TLRC), Mitglied im DZL
| | - K. Rabe
- Airway Research Center North, Mitglied im DZL
| | - B. Keller
- Helmholtz Zentrum München, Abteilung Kommunikation, Mitglied im DZL
| | - S. Winkler
- Helmholtz Zentrum München, Abteilung Kommunikation, Mitglied im DZL
| | - U. Koller
- Helmholtz Zentrum München, Abteilung Kommunikation, Mitglied im DZL
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Mauritz C, Schmeckebier S, Katsirntaki K, Sgodda M, Puppe V, Duerr J, Schubert S, Schmiedl A, Ochs M, Cantz T, Mall M, Martin U. Key factors for the differentiation of embryonic and induced pluripotent stem cells into respiratory epithelial cells. Pneumologie 2012. [DOI: 10.1055/s-0032-1315507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fritzsching E, Eichingen M, Kopp-Schneiden A, Sumkauskaite M, Optazaite DE, Puderbach M, Mall M. 191* Magnetic resonance imaging (MRI) as a non-invasive, radiation-free imaging modality to study the onset and progression of lung disease in infants and young children with cystic fibrosis. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60207-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Puderbach M, Eichinger M, Häselbarth J, Niemann A, Mall M, Kauczor HU. Magnetresonanztomographie (MRT) zur Frühdiagnostik von Lungenveränderungen bei Kindern mit Cystischer Fibrose (CF). ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Livraghi A, Mall M, Paradiso AM, Boucher RC, Ribeiro CMP. Modelling dysregulated Na+ absorption in airway epithelial cells with mucosal nystatin treatment. Am J Respir Cell Mol Biol 2007; 38:423-34. [PMID: 17989361 DOI: 10.1165/rcmb.2007-0177oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In cystic fibrosis (CF), the absence of functional CFTR leads to dysregulated Na(+) absorption across airway epithelia. We established an in vitro model of dysregulated Na(+) absorption by treating polarized normal human bronchial epithelial cells (HBEs) with nystatin (Nys), a polyene antibiotic that enables monovalent cations to permeate biological membranes. Acute mucosal Nys produced a rapid increase in short circuit current (I(sc)) that reflected increased transepithelial Na(+) absorption and required Na(+)/K(+)ATPase activity. The acute increase in I(sc) was associated with increased mucosal liquid absorption. Prolonged mucosal Nys treatment resulted in sustained Na(+) hyperabsorption, associated with increased mucosal liquid absorption in comparison with naïve (nontreated, kept under air-liquid interface conditions) or vehicle-treated cultures. Nys treatment was not toxic. Increased lactate accumulation in Nys-treated culture media suggested a higher metabolic rate associated with the higher energy demand for Na(+) transport. After chronic Nys treatment, the increased I(sc) was rapidly lost when the cultures were mounted in Ussing chambers, indicating that Nys could be rapidly removed from the apical membrane. Importantly, chronic Nys treatment promoted sustained mucosal liquid depletion and caused mucus dehydration, compaction, and adhesion to the apical surface of Nys-treated cultures. We conclude that mucosal Nys treatment of HBEs provides a simple in vitro model to recapitulate the Na(+) and volume hyperabsorptive features of CF airway epithelia.
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Affiliation(s)
- Alessandra Livraghi
- University of North Carolina at Chapel Hill, Cystic Fibrosis/Pulmonary Research and Treatment Center, CB#7248 Thurston Bowles Bldg., Room # 6029, Chapel Hill, NC 27599, USA.
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Kunzelmann K, Bachhuber T, Adam G, Voelcker T, Murle B, Mall M, Schreiber R. Role of CFTR and Other Ion Channels in Cystic Fibrosis. Advances in Experimental Medicine and Biology 2007. [DOI: 10.1007/0-387-23250-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Unger K, Zurnadzhy L, Walch A, Mall M, Bogdanova T, Braselmann H, Hieber L, Tronko N, Hutzler P, Jeremiah S, Thomas G, Zitzelsberger H. RET rearrangements in post-Chernobyl papillary thyroid carcinomas with a short latency analysed by interphase FISH. Br J Cancer 2006; 94:1472-7. [PMID: 16641909 PMCID: PMC2365029 DOI: 10.1038/sj.bjc.6603109] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Tissue samples from 13 post-Chernobyl childhood thyroid tumours that occurred within a short period of time (4–8 years) after the Chernobyl accident have been investigated by interphase FISH analysis for rearrangements of RET. In all, 77% of cases showed RET/PTC rearrangements and a distinct intratumoural genetic heterogeneity. The data were compared to findings on 32 post-Chernobyl PTCs that occurred after a longer period of time (9–12 years) after the accident. In none of the cases from either group were 100% of cells positive for RET rearrangement. In addition, the pattern of RET-positive cells was different in the two groups (short vs longer latency). A significant clustering of aberrant cells could be detected in the long-latency subgroup, whereas the aberrant cells were more homogeneously distributed among the short-latency tumours. The findings suggest that oligoclonal tumour development occurs in post-Chernobyl PTCs. This pattern of different clones within the tumour appears to become more discrete in cases with longer latencies, suggesting either outgrowth of individual clones or development of later subclones with time.
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Affiliation(s)
- K Unger
- Institute of Molecular Radiobiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
| | - L Zurnadzhy
- Institute of Endocrinology and Metabolism, Academy of Medical Sciences of the Ukraine, Kiev, Ukraine
| | - A Walch
- Institute of Pathology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
| | - M Mall
- Institute of Molecular Radiobiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
| | - T Bogdanova
- Institute of Endocrinology and Metabolism, Academy of Medical Sciences of the Ukraine, Kiev, Ukraine
| | - H Braselmann
- Institute of Molecular Radiobiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
| | - L Hieber
- Institute of Molecular Radiobiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
| | - N Tronko
- Institute of Endocrinology and Metabolism, Academy of Medical Sciences of the Ukraine, Kiev, Ukraine
| | - P Hutzler
- Institute of Pathology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
| | - S Jeremiah
- South West Wales Cancer Institute, Singleton Hospital, Swansea, UK
| | - G Thomas
- South West Wales Cancer Institute, Singleton Hospital, Swansea, UK
| | - H Zitzelsberger
- Institute of Molecular Radiobiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
- Ingolstädter Landstr. 1, Neuherberg, D-85764 Germany. E-mail:
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Kunzelmann K, Sun J, Markovich D, König J, Mürle B, Mall M, Schreiber R. Control of ion transport in mammalian airways by protease activated receptors type 2 (PAR-2). FASEB J 2005; 19:969-70. [PMID: 15809358 DOI: 10.1096/fj.04-2469fje] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Protease-activated receptors (PARs) are widely distributed in human airways. They couple to G- proteins and are activated after proteolytic cleavage of the N terminus of the receptor. Evidence is growing that PAR subtype 2 plays a pivotal role in inflammatory airway diseases, such as allergic asthma or bronchitis. However, nothing is known about the effects of PAR-2 on electrolyte transport in the native airways. PAR-2 is expressed in airway epithelial cells, where they are activated by mast cell tryptase, neutrophil proteinase 3, or trypsin. Recent studies produced conflicting results about the functional consequence of PAR-2 stimulation. Here we report that stimulation of PAR-2 receptors in mouse and human airways leads to a change in electrolyte transport and a shift from absorption to secretion. Although PAR-2 appears to be expressed on both sides of the epithelium, only basolateral stimulation results in inhibition of amiloride sensitive Na+ conductance and stimulation of both luminal Cl- channels and basolateral K+ channels. The present data indicate that these changes occur through activation of phospholipase C and increase in intracellular Ca2+, which activates basolateral SK4 K+ channels and luminal Ca2+-dependent Cl- channels. In addition, the present data suggest a PAR-2 mediated release of prostaglandin E2, which may contribute to the secretory response. In conclusion, these results provide further evidence for a role of PAR-2 in inflammatory airway disease: stimulation of these receptors may cause accumulation of airway surface liquid, which, however, may help to flush noxious stimuli away from the affected airways.
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Affiliation(s)
- Karl Kunzelmann
- Institut für Physiologie, Universität Regensburg, Regensburg, Germany.
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Kreda SM, Mall M, Mengos A, Rochelle L, Yankaskas J, Riordan JR, Boucher RC. Characterization of wild-type and deltaF508 cystic fibrosis transmembrane regulator in human respiratory epithelia. Mol Biol Cell 2005; 16:2154-67. [PMID: 15716351 PMCID: PMC1087225 DOI: 10.1091/mbc.e04-11-1010] [Citation(s) in RCA: 214] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Previous studies in native tissues have produced conflicting data on the localization and metabolic fate of WT and deltaF508 cystic fibrosis transmembrane regulator (CFTR) in the lung. Combining immunocytochemical and biochemical studies utilizing new high-affinity CFTR mAbs with ion transport assays, we examined both 1) the cell type and region specific expression of CFTR in normal airways and 2) the metabolic fate of deltaF508 CFTR and associated ERM proteins in the cystic fibrosis lung. Studies of lungs from a large number of normal subjects revealed that WT CFTR protein localized to the apical membrane of ciliated cells within the superficial epithelium and gland ducts. In contrast, other cell types in the superficial, gland acinar, and alveolar epithelia expressed little WT CFTR protein. No deltaF508 CFTR mature protein or function could be detected in airway specimens freshly excised from a large number of deltaF508 homozygous subjects, despite an intact ERM complex. In sum, our data demonstrate that WT CFTR is predominantly expressed in ciliated cells, and deltaF508 CFTR pathogenesis in native tissues, like heterologous cells, reflects loss of normal protein processing.
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Affiliation(s)
- Silvia M Kreda
- Cystic Fibrosis/Pulmonary Research and Treatment Center, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7248, USA.
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Hirtz S, Gonska T, Seydewitz HH, Thomas J, Greiner P, Kuehr J, Brandis M, Eichler I, Rocha H, Lopes AI, Barreto C, Ramalho A, Amaral MD, Kunzelmann K, Mall M. CFTR Cl- channel function in native human colon correlates with the genotype and phenotype in cystic fibrosis. Gastroenterology 2004; 127:1085-95. [PMID: 15480987 DOI: 10.1053/j.gastro.2004.07.006] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS Cystic fibrosis (CF) is caused by over 1000 mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene and presents with a widely variable phenotype. Genotype-phenotype studies identified CFTR mutations that were associated with pancreatic sufficiency (PS). Residual Cl- channel function was shown for selected PS mutations in heterologous cells. However, the functional consequences of most CFTR mutations in native epithelia are not well established. METHODS To elucidate the relationships between epithelial CFTR function, CFTR genotype, and patient phenotype, we measured cyclic adenosine monophosphate (cAMP)-mediated Cl- secretion in rectal biopsy specimens from 45 CF patients who had at least 1 non-DeltaF508 mutation carrying a wide spectrum of CFTR mutations. We compared CFTR genotypes and clinical manifestations of CF patients who expressed residual CFTR-mediated Cl- secretion with patients in whom Cl- secretion was absent. RESULTS Residual anion secretion was detected in 40% of CF patients, and was associated with later disease onset (P < 0.0001), higher frequency of PS (P < 0.0001), and less severe lung disease (P < 0.05). Clinical outcomes correlated with the magnitude of residual CFTR activity, which was in the range of approximately 12%-54% of controls. CONCLUSIONS Specific CFTR mutations confer residual CFTR function to rectal epithelia, which is related closely to a mild disease phenotype. Quantification of rectal CFTR-mediated Cl- secretion may be a sensitive test to predict the prognosis of CF disease and identify CF patients who would benefit from therapeutic strategies that would increase residual CFTR activity.
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Affiliation(s)
- Stephanie Hirtz
- Department of Pediatrics and Adolescent Medicine, ALbert Ludwigs University, Freiburg, Germany
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Abstract
The Ussing chamber technique has contributed significantly to our understanding of the role of ion transport in the pathogenesis of human diseases like cystic fibrosis (CF). Here, we summarize protocols developed to study the Cl- channel function of the cystic fibrosis transmembrane conductance regulator (CFTR) protein in rectal biopsies from normal individuals and CF patients. These protocols can be applied to study the function and pharmacological modulation of wild-type and mutant CFTR in the context of the native epithelium. Together with sweat testing and genetic analyses, these functional measurements may aid in establishing a diagnosis of CF.
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Affiliation(s)
- Marcus Mall
- Department of Pediatrics III, Pediatric Pulmonology and Infectious Diseases, University of Heidelberg, lm Neuenheimer Feld 153, Heidelberg D-69120, Germany.
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Affiliation(s)
- Celeste Barreto
- Cystic Fibrosis Centre, Paediatrics Department, University Hospital of Santa Maria, Lisboa, Portugal.
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Mall M, Grubb BR, Harkema JR, O'Neal WK, Boucher RC. Increased airway epithelial Na+ absorption produces cystic fibrosis-like lung disease in mice. Nat Med 2004; 10:487-93. [PMID: 15077107 DOI: 10.1038/nm1028] [Citation(s) in RCA: 662] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2003] [Accepted: 03/24/2004] [Indexed: 11/09/2022]
Abstract
Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene result in defective epithelial cAMP-dependent Cl(-) secretion and increased airway Na(+) absorption. The mechanistic links between these altered ion transport processes and the pathogenesis of cystic fibrosis lung disease, however, are unclear. To test the hypothesis that accelerated Na(+) transport alone can produce cystic fibrosis-like lung disease, we generated mice with airway-specific overexpression of epithelial Na(+) channels (ENaC). Here we show that increased airway Na(+) absorption in vivo caused airway surface liquid (ASL) volume depletion, increased mucus concentration, delayed mucus transport and mucus adhesion to airway surfaces. Defective mucus transport caused a severe spontaneous lung disease sharing features with cystic fibrosis, including mucus obstruction, goblet cell metaplasia, neutrophilic inflammation and poor bacterial clearance. We conclude that increasing airway Na(+) absorption initiates cystic fibrosis-like lung disease and produces a model for the study of the pathogenesis and therapy of this disease.
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Affiliation(s)
- Marcus Mall
- Cystic Fibrosis/Pulmonary Research and Treatment Center, School of Medicine, The University of North Carolina at Chapel Hill, 7011 Thurston Bowles Building, Chapel Hill, North Carolina 27599-7248, USA.
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Kunzelmann K, Mall M. Pharmacotherapy of the ion transport defect in cystic fibrosis: role of purinergic receptor agonists and other potential therapeutics. ACTA ACUST UNITED AC 2004; 2:299-309. [PMID: 14719996 DOI: 10.1007/bf03256658] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Cystic fibrosis (CF), is an autosomal recessive disease frequently seen in the Caucasian population. It is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. CF is characterized by enhanced airway Na(+) absorption, mediated by epithelial Na(+) channels (ENaC), and deficient Cl(-) transport. In addition, other mechanisms may contribute to the pathophysiological changes in the CF lung, such as defective regulation of HCO(3)(-) secretion. In other epithelial tissues, epithelial Na(+) conductance is either increased (intestine) or decreased (sweat duct) in CF. CFTR is a cyclic AMP-regulated epithelial Cl(-) channel, and appears to control the activity of several other transport proteins. Accordingly, defective epithelial ion transport in CF is likely to be a combination of defective Cl(-) channel function and impaired regulator function of CFTR, which in turn is linked to impaired mucociliary clearance and development of chronic lung disease. As the clinical course of CF is determined primarily by progressive lung disease, novel pharmacological strategies for the treatment of CF focus on correction of the ion transport defect in the airways. In recent years, it has been demonstrated that activation of purinergic receptors in airway epithelia by extracellular nucleotides (adenosine triphosphate/uridine triphosphate) has beneficial effects on mucus clearance in CF. Activation of the dominant class of metabotropic purinergic receptors, P2Y(2) receptors, appears to have a 2-fold benefit on ion transport in CF airways; excessive Na(+) absorption is attenuated, most likely by inhibition of the ENaC and, simultaneously, an alternative Ca(2+)-dependent Cl(-) channel is activated that may compensate for the CFTR Cl(-) channel defect. Thus activation of P2Y(2) receptors is expected to lead to improved hydration of the airway surface liquid in CF. Furthermore, purinergic activation has been shown to promote other components of mucociliary clearance such as ciliary beat frequency and mucus secretion. Clinical trials are under way to test the effect of synthetic purinergic compounds, such as the P2Y(2) receptor agonist INS37217, on the progression of lung disease in patients with CF. Administration of these compounds alone, or in combination with other drugs that inhibit accelerated Na(+) transport and help recover or increase residual activity of mutant CFTR, is most promising as successful therapy to counteract the ion transport defect in the airways of CF patients.
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Affiliation(s)
- Karl Kunzelmann
- Physiologisches Institut, Universitäts Regensburg, Regensburg, Germany.
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Mall M, Kreda SM, Mengos A, Jensen TJ, Hirtz S, Seydewitz HH, Yankaskas J, Kunzelmann K, Riordan JR, Boucher RC. The DeltaF508 mutation results in loss of CFTR function and mature protein in native human colon. Gastroenterology 2004; 126:32-41. [PMID: 14699484 DOI: 10.1053/j.gastro.2003.10.049] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Deletion of the codon for phenylalanine at position 508 (DeltaF508) is the most frequent disease-causing mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. In heterologous cells, defective processing of the DeltaF508 protein results in endoplasmic reticulum retention, proteolytic degradation, and absence of adenosine 3',5'-cyclic monophosphate (cAMP)-dependent plasma membrane Cl(-) conductance. However, data with respect to the processing block of DeltaF508 protein in native epithelia are limited and conflicting. METHODS To characterize both the fate and function of DeltaF508 protein in a native epithelium, we measured CFTR-mediated Cl(-) secretion, localization of the CFTR protein, and CFTR maturation in rectal biopsy specimens from normal individuals and DeltaF508 homozygous patients with cystic fibrosis (CF). RESULTS Ussing chamber studies showed that cAMP-dependent and cholinergic Cl(-) secretion was absent from rectal tissues freshly excised from DeltaF508 homozygous patients with CF. By immunohistochemistry, we detected wild-type but not DeltaF508 CFTR at the luminal membrane of crypt colonocytes. By sequential immunoprecipitation and immunoblotting analyses, mature CFTR protein was detected in normal but not in DeltaF508 homozygous tissues. CONCLUSIONS Collectively, these data show that there is insufficient maturation and transport of DeltaF508 CFTR from the endoplasmic reticulum to the apical membrane to support CFTR-mediated Cl(-) secretion in the CF colon.
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Affiliation(s)
- Marcus Mall
- School of Medicine, University of North Carolina at Chapel Hill, NC 27599, USA
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Abstract
Cystic fibrosis (CF), the most-common lethal hereditary disease in the white population, is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The mutation that is most frequently responsible for the disease, DeltaF508, causes misfolding and retention of the CFTR protein in the endoplasmic reticulum. This leads to a series of cellular dysfunctions and results in a multi-organ disease. In a recent report, Egan et al.(1) demonstrated that curcumin, a non-toxic natural product and major constituent of turmeric spice, corrected the CF defects in DeltaF508 CF mice. This paper aroused a lot of attention and hopes were raised that curcumin might produce similar effects in human, giving an efficient treatment for most CF patients. However, skepticism is growing since subsequent studies fail to reproduce these initial exciting results. Thus, although herbal medicines and dietary supplements can be desirable alternatives to classical pharmacological compounds, their efficacy needs careful evaluation both in vivo and ex vivo.
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Affiliation(s)
- Marcus Mall
- Department of Pediatrics III, University of Heidelberg, Germany
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Ramalho AS, Beck S, Penque D, Gonska T, Seydewitz HH, Mall M, Amaral MD. Transcript analysis of the cystic fibrosis splicing mutation 1525-1G>A shows use of multiple alternative splicing sites and suggests a putative role of exonic splicing enhancers. J Med Genet 2003; 40:e88. [PMID: 12843337 PMCID: PMC1735516 DOI: 10.1136/jmg.40.7.e88] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A S Ramalho
- Department of Chemistry and Biochemistry, Faculty of Sciences, University of Lisboa, Portugal
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Mall M, Gonska T, Thomas J, Schreiber R, Seydewitz HH, Kuehr J, Brandis M, Kunzelmann K. Modulation of Ca2+-activated Cl- secretion by basolateral K+ channels in human normal and cystic fibrosis airway epithelia. Pediatr Res 2003; 53:608-18. [PMID: 12612194 DOI: 10.1203/01.pdr.0000057204.51420.dc] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Human airway epithelia express Ca2+-activated Cl- channels (CaCC) that are activated by extracellular nucleotides (ATP and UTP). CaCC is preserved and seems to be up-regulated in the airways of cystic fibrosis (CF) patients. In the present study, we examined the role of basolateral K+ channels in CaCC-mediated Cl- secretion in native nasal tissues from normal individuals and CF patients by measuring ion transport in perfused micro Ussing chambers. In the presence of amiloride, UTP-mediated peak secretory responses were increased in CF compared with normal nasal tissues. Activation of the cAMP pathway further increased CaCC-mediated secretion in CF but not in normal nasal mucosa. CaCC-dependent ion transport was inhibited by the chromanol 293B, an inhibitor of cAMP-activated hKvLQT1 K+ channels, and by clotrimazole, an inhibitor of Ca2+-activated hSK4 K+ channels. The K+ channel opener 1-ethyl-2-benzimidazolinone further increased CaCC-mediated Cl- secretion in normal and CF tissues. Expression of hSK4 as well as hCACC-2 and hCACC-3 but not hCACC-1 was demonstrated by reverse transcriptase PCR on native nasal tissues. We conclude that Ca2+-activated Cl- secretion in native human airway epithelia requires activation of Ca2+-dependent basolateral K+ channels (hSK4). Co-activation of hKvLQT1 improves CaCC-mediated Cl- secretion in native CF airway epithelia, and may have a therapeutic effect in the treatment of CF lung disease.
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Affiliation(s)
- Marcus Mall
- Department of Pediatrics and Adolescent Medicine, Albert Ludwigs University, Freiburg, Germany.
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Abstract
Protease-activated receptors type 2 (PAR2) are activated by serine proteases like trypsin and mast cell tryptase. The function and physiological significance of PAR2 receptors is poorly understood, but recent studies suggest a role during inflammatory processes in both airways and intestine. PAR2 receptors are also likely to participate in the control of ion transport in these tissues. We demonstrate that stimulation of PAR2 in airways and intestine significantly enhanced ion transport. Trypsin induced Cl- secretion in both airways and intestine when added to the basolateral but not to the luminal side of these tissues. In both airways and intestine, stimulation of ion transport was largely dependent on the increase in intracellular Ca2+. Effects of trypsin were largely reduced by basolateral bumetanide and barium and by trypsin inhibitor. Thrombin, an activator of proteinase-activated receptors types 1, 3, and 4 had no effects on equivalent short-circuit current in either airways or intestine. Expression of PAR2 in colon and airways was further confirmed by reverse transcription-polymerase chain reaction. We postulate that these receptors play a significant role in the regulation of electrolyte transport, which might be important during inflammatory diseases of airways and intestine.
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Affiliation(s)
- Karl Kunzelmann
- School of Biomedical Sciences, Department of Physiology & Pharmacology, University of Queensland, Brisbane, Australia.
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Abstract
Both purinergic stimulation and activation of cystic fibrosis transmembrane conductance regulator (CFTR) increases Cl(-) secretion and inhibit amiloride-sensitive Na(+) transport. CFTR has been suggested to conduct adenosine 5'-triphosphate (ATP) or to control ATP release to the luminal side of epithelial tissues. Therefore, a possible mechanism on how CFTR controls the activity of epithelial Na(+) channels (ENaC) could be by release of ATP or uridine 5'-triphosphate (UTP), which would then bind to P2Y receptors and inhibit ENaC. We examined this question in native tissues from airways and colon and in Xenopus oocytes. Inhibition of amiloride-sensitive transport by both CFTR and extracellular nucleotides was observed in colon and trachea. However, nucleotides did not inhibit ENaC in Xenopus oocytes, even after coexpression of P2Y(2) receptors. Using different tools such as hexokinase, the P2Y inhibitor suramin or the Cl(-) channel blocker 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS), we did not detect any role of a putative ATP secretion in activation of Cl(-) transport or inhibition of amiloride sensitive short circuit currents by CFTR. In addition, N(2),2'-O-dibutyrylguanosine 3',5'-cyclic monophosphate (cGMP) and protein kinase G (PKG)-dependent phosphorylation or the nucleoside diphosphate kinase (NDPK) do not seem to play a role for the inhibition of ENaC by CFTR, which, however, requires the presence of extracellular Cl(-).
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Affiliation(s)
- Jens König
- Department of Physiology and Pharmacology, University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia
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Abstract
Cystic fibrosis (CF) is a complex disease affecting epithelial ion transport. There are not many diseases like CF that have triggered such intense research activities. The complexity of the disease is due to mutations in the CFTR protein, now known to be a Cl(-) channel and a regulator of other transport proteins. The various interactions and the large number of disease-causing CFTR mutations is the reason for a variable genotype-phenotype correlation and sometimes unpredictable clinical manifestation. Nevertheless, the research of the past 10 years has resulted in a tremendous increase in knowledge, not only in regard to CFTR but also in regard to molecular interactions and completely new means of ion channel and gene therapy.
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Affiliation(s)
- R Greger
- Physiologisches Institut, Albert-Ludwigs Universität, Hermann-Herder-Strasse 7, 79104 Freiburg, Germany
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